Genetics and cardiac anomalies: the heart of the matter.
The recent exponential increase in knowledge in genetics has revolutionized all aspects of medicine. The completion of the first draft of the human genome project has provided for clinicians a range and depth of information never before imagined. Over the last 25 years understanding the anatomical and physiological basis of a number of congenital cardiac anomalies has led to better care and outcome for the patients born with congenital cardiac defects. In the last decade the role of genes, their critical timing of expression, and understanding of important downstream pathways for optimizing normal development and control of the left right asymmetry have emerged. The progress in cardiac genetics has been supplemented by advances in cardiac imaging modalities leading to improvements in diagnosis of the cardiac anomalies. About 30% of all congenital heart diseases are associated with extra- cardiac malformations. Chromosomal anomalies are more common in patients with cardiac anomalies than the general population. Presence of facial dysmorphic features and associated extra-cardiac anomalies should alert the pediatricians to an underlying syndrome diagnosis. Newer molecular cytogenetics techniques such as fluorescence in situ hybridization (FISH) and molecular tests are now routinely utilized for confirming clinical diagnoses. In this review we have summarized clinical features and discussed the genetic basis of several syndromes (for example, 22q11 deletion syndrome, Williams syndrome, Down Syndrome, Kabuki syndrome etc.) where specific cardiac anomalies are frequently encountered. The importance of establishing an accurate clinical diagnosis cannot be over emphasized. The families need genetic counselling with accurate information on the recurrence risks. With the advent of the Internet and rapid access to information, the clinicians and the patient families can access valuable information regarding the prognosis, natural history, and clinical interventions for the affected child, and useful support groups for the family. Detection of cardiac anomalies during antenatal period warrants a genetics assessment.


Contemporary review of drug-induced pancreatitis: A different perspective.
Although gallstone and alcohol use have been considered the most common causes of acute pancreatitis, hundreds of frequently prescribed medications are associated with this disease state. The true incidence is unknown since there are few population based studies available. The knowledge of drug induced acute pancreatitis is limited by the availability and the quality of the evidence as the majority of data is extrapolated from case reports. Establishing a definitive causal relationship between a drug and acute pancreatitis poses a challenge to clinicians. Several causative agent classification systems are often used to identify the suspected agents. They require regular updates since new drug induced acute pancreatitis cases are reported continuously. In addition, infrequently prescribed medications and herbal medications are often omitted. Furthermore, identification of drug induced acute pancreatitis with new medications often requires accumulation of post market case reports. The unrealistic expectation for a comprehensive list of medications and the multifactorial nature of acute pancreatitis call for a different approach. In this article, we review the potential mechanisms of drug induced acute pancreatitis and provide the perspective of deductive reasoning in order to allow clinicians to identify potential drug induced acute pancreatitis with limited data.


Personality predictors of longevity: activity, emotional stability, and conscientiousness.
To examine the association between personality traits and longevity. Using the Guilford-Zimmerman Temperament Survey, personality traits were assessed in 2359 participants (38% women; age = 17 to 98 years, mean = 50 years) from the Baltimore Longitudinal Study of Aging, starting in 1958. Over the duration of the study, 943 (40%) participants died, on average 18 years after their personality assessment. The association of each trait with longevity was examined by Cox regression controlling for demographic variables. In preliminary analyses among the deceased, those who scored 1 standard deviation (SD) above the mean on General Activity (a facet of Extraversion), Emotional Stability (low Neuroticism), or Conscientiousness lived on average 2 to 3 years longer than those scoring 1 SD below the mean. Survival analyses on the full sample confirmed the association of General Activity, Emotional Stability, and Conscientiousness with lower risk of death, such that every 1-SD increase was related to about 13%, 15%, and 27% risk reduction, respectively. The association of personality traits with longevity was largely independent from the influence of smoking and obesity. Personality predictors of longevity did not differ by sex, except for Ascendance (a facet of Extraversion). Emotional Stability was a significant predictor when the analyses were limited to deaths due to cardiovascular disease, with comparable effect sizes for General Activity and Conscientiousness. In a large sample of generally healthy individuals followed for almost five decades, longevity was associated with being conscientious, emotionally stable, and active.


Influence of fluid removal rate during hemodialysis on left ventricular performance and exercise tolerance in patients with coronary artery disease.
The effect of hemodialysis (HD) on left ventricular (LV) function and exercise tolerance were measured at rest and during exercise using gated equilibrium radionuclide ventriculography in seven patients with confirmed coronary artery disease (CAD). To separate the effects of fluid removal rate on LV function in CAD, we investigated the same patients with identical overall volume loss of 4 liters during two different treatment times (4 hr and 2 hr). HD significantly increased resting LV ejection fraction (EF) from 55.7 +/- 8% to 64.7 +/- 8% (P less than 0.01) during the 4 hr HD and from 58.1 +/- 9 to 68.1 +/- 10 (P less than 0.05) during the 2 hr HD. Indicating ischemia, EF decreased at pre- and postdialysis peak exercise without differences between both treatments. HD also resulted in an improved segmental wall motion score. Exercise duration as well as S-T segment depression and angina score improved during HD, whereas heart rate, blood pressure and double product remained unchanged. We conclude that HD improves global and regional resting LV function and exercise tolerance in patients with CAD. The degree of interdialytic hydration and not the degree of fluid removal per time affects LV performance in CAD. Since LV function is the major prognostic factor in CAD, those patients require volume restriction and/or shorter interdialytic phases.


Impact of computer-based pregnancy-induced hypertension and diabetes decision AIDS on empowering pregnant women.
We designed a computer-based decision aid (CDA) for use by pregnant women at home to investigate and participate in solving their pregnancy problems related to pregnancy-induced hypertension (PIH) and gestational diabetes (GD). The system cannot and is not intended to replace visits to physicians; rather it can help women focus on the most important symptoms and provides guidance on when to see a doctor. The study is a randomized controlled trial, which is performed among Iranian pregnant women. For subjects, 420 healthy pregnant women have been recruited from two private and two public prenatal centers. The intervention group will receive the CDA for use at home, and the control group will receive care as usual. The CDA relies on knowledge extracted from the national guidelines on PIH and GD. The two primary outcomes for the study are self-efficacy and knowledge. Self-efficacy will be measured by the Stanford self-efficacy scale and knowledge will be evaluated by 15 binary (true/false) questions provided by the researchers. Secondary outcomes include type and frequency of doctor and/or medical center visits; blood pressure and blood sugar changes based on the national guidelines and according to pregnancy records, and anxiety will be assessed by the state component of the short Spielberger anxiety scale. This paper describes the design of a CDA and a protocol for a randomized controlled trial to study the effects of the CDA on self-efficacy and knowledge of pregnant women pertaining to PIH and GD. Differences in the primary outcomes will be analyzed using 'intention-to-treat' principles.


A clinical trial of co-trimazine (sulfadiazine + trimethoprim) in flare-ups of chronic bronchitis.
The authors treated acute flare-ups of chronic bronchitis with a combination of sulfadiazine (SDZ) and trimethoprim (TMP) (cotrimazine). They treated thirty patients for a week, with daily dosages of 900 mg SDZ and 300 mg TMP, in an open trial in comparison with ampicillin 2 g daily. The result of treatment (course and duration of the acute episode, fever, cough, dyspnoea, sputum amount and description, chest sounds, ESR, and WBC count), tested by suitable statistical methods, showed that cotrimazine had excellent therapeutic activity and was readily tolerated; over-all results compared closely with those obtained with ampicillin. In their concluding remarks the authors state that in addition to being effective in the morbid condition selected for trial, cotrimazine offers some advantages over similar combinations of TMP and other sulfonamides, both because of the intrinsic physicochemical and pharmacological properties of SDZ and because of its lower dosage in this combination.


PIXEL SENSIBLE LOCAL BAND ANALYSIS IN MICROSCOPIC CHROMOSOME IMAGES USING CSPA.
In chromosome analysis, local band analysis plays the main role to identify the perfect matched chromosome in metaspread images to attain the karyotyping. Literature investigations are narrow in chromosome image band analysis due to the higher complexities. In this paper, Pixel level based Conditional Seed Point Algorithm (CSPA) is proposed. This simulation algorithm separates the weak band region to the strong band region, and the strong band region area evaluated was based on the Region of Seed condition Points. This algorithm works well for different intensity levels and adopts the structural changes to identify the bands in image. This algorithm was simulated in more than 450 individual chromosomes to identify the local bands in the chromosome images and provided the accuracy more than 96%.


Insights about the Absence of Rb Cation from the 3D Perovskite Lattice: Effect on the Structural, Morphological, and Photophysical Properties and Photovoltaic Performance.
Efficiencies >20% are obtained from the perovskite solar cells (PSCs) employing Cs+ and Rb+ based perovskite compositions; therefore, it is important to understand the effect of these inorganic cations specifically Rb+ on the properties of perovskite structures. Here the influence of Cs+ and Rb+ is elucidated on the structural, morphological, and photophysical properties of perovskite structures and the photovoltaic performances of resulting PSCs. Structural, photoluminescence (PL), and external quantum efficiency studies establish the incorporation of Cs+ (x < 10%) but amply rule out the possibility of Rb-incorporation into the MAPbI3 (MA = CH3 NH3+ ) lattice. Moreover, morphological studies and time-resolved PL show that both Cs+ and Rb+ detrimentally affect the surface coverage of MAPbI3 layers and charge-carrier dynamics, respectively, by influencing nucleation density and by inducing nonradiative recombination. In addition, differential scanning calorimetry shows that the transition from orthorhombic to tetragonal phase occurring around 160 K requires more thermal energy for the Cs-containing MAPbI3 systems compared to the pristine MAPbI3 . Investigation including mixed halide (I/Br) and mixed cation A-cation based compositions further confirms the absence of Rb+ from the 3D-perovskite lattice. The fundamental insights gained through this work will be of great significance to further understand highly promising perovskite compositions.


Application of quantitative nuclear magnetic resonance spectroscopy for the determination ofamantadine and acyclovir in plasma and pharmaceutical samples.
Rapid, simple, and selective methods for determining amantadine HCI and acyclovir antiviral drugs in pharmaceutical and plasma samples were developed using 1H-NMR spectroscopy with dimethyl sulfoxide (DMSO-d6) as the solvent. Integrations of the 1H-NMR signals at 2.07 and 7.82 ppm were used, respectively, for quantifying the two drugs, with the malonic acid signal at 3.24 ppm as the internal reference signal. Average recoveries of 98.24-101.00 +/- 4.82% and 97.7-100.38 +/- 3.36% were obtained for amantadine HCI and acyclovir in pharmaceutical samples, respectively. Average recoveries of 97.36-103.68 +/- 2.99 and 93.81-99.80 +/- 2.93 were obtained, respectively, for both drugs in plasma samples. The statistical Student's t-test gave t-values < or = 1.41 for analyzed pharmaceutical samples and t-values < or = 0.29 for analyzed plasma samples. These values indicated insignificant difference between the real and measured contents at the 95% confidence level. Application of the statistical F-test for the analytical results of amantadine HCI gave F-values < or = 6.44 and 2.80 in pharmaceutical and plasma samples, respectively. F-values < or = 6.82 and 3.86 were obtained for acyclovir in pharmaceutical and plasma, respectively. These values indicated insignificant differences in precisions between the developed NMR methods and arbitrarily chosen HPLC methods reported for determining both drugs in pharmaceutical and plasma samples.


Experimental membranous nephropathy redux.
Membranous nephropathy (MN) is a common cause of nephrotic syndrome in adults. Active and passive Heymann nephritis (HN) in rats are valuable experimental models because their features so closely resemble human MN. In HN, subepithelial immune deposits form in situ as a result of circulating antibodies. Complement activation leads to assembly of C5b-9 on glomerular epithelial cell (GEC) plasma membranes and is essential for sublethal GEC injury and the onset of proteinuria. This review revisits HN and focuses on areas of substantial progress in recent years. The response of the GEC to sublethal C5b-9 attack is not simply due to disruption of the plasma membrane but is due to the activation of specific signaling pathways. These include activation of protein kinases, phospholipases, cyclooxygenases, transcription factors, growth factors, NADPH oxidase, stress proteins, proteinases, and others. Ultimately, these signals impact on cell metabolic pathways and the structure/function of lipids and key proteins in the cytoskeleton and slit-diaphragm. Some signals affect GEC adversely. Thus C5b-9 induces partial dissolution of the actin cytoskeleton. There is a decline in nephrin expression, reduction in F-actin-bound nephrin, and loss of slit-diaphragm integrity. Other signals, such as endoplasmic reticulum stress, may limit complement-induced injury, or promote recovery. The extent of complement activation and GEC injury is dependent, in part, on complement-regulatory proteins, which act at early or late steps within the complement cascade. Identification of key steps in complement activation, the cellular signaling pathways, and the targets will facilitate therapeutic intervention in reversing GEC injury in human MN.


Recurrent ovarian cancer.
Ovarian cancer is the most common cause of death from gynecologic malignancies in the United States. Although ovarian cancer is very responsive to multiple chemotherapeutic agents, with objective response rates of up to 80% with the standard platinum and taxane doublets, 75% of patients relapse within 2 years of primary therapy and become candidates for treatment of recurrent disease. Recurrent ovarian cancer is increasingly approached as a chronic disease that requires sequential therapy with available agents. Several issues remain controversial regarding the treatment of patients with recurrent ovarian cancer, including the timing of salvage therapy, choice of agents, and use of monotherapy versus combination regimens. Also, the role of the CA125 tumor marker in detection of recurrence and assessing response to therapy remains unresolved. In this article we address these issues with an emphasis on evidence from the available literature and also discuss the clinical trials that are currently underway to resolve these issues.


An Optimized Two-Herb Chinese Food as Medicine Formula Reduces Cisplatin-Induced Nephrotoxicity in the Treatment of Lung Cancer in Mice.
Chemotherapy is considered a most effective way to treat cancer. However, it is very common that chemotherapy causes unbearable mental and physical side effects to cancer patients, which ultimately reduces the patients' confidence of overcoming diseases and compromises the treatment of chemotherapy. Cisplatin (DDP), a widely used anticancer agent for various types of cancers, also damages nontumor cells and tissues, which are mostly related to the activation of the inflammation pathway. Previously, we have discovered a few rational formulas of food as medicine materials that reduced systemic inflammation in in vitro and in vivo models. Hence, this study reports the ability of an optimized traditional Chinese anti-inflammatory formulation capable of synergizing the antitumor effect of DDP in vitro and in vivo. More significantly, by formulation of two anti-inflammatory herbal medicine, the Chrysanthemum × morifolium (Ramat.) Hemsl [Asteraceae] and Lonicera japonica Thunb [Caprifoliaceae] with a mediator Glycyrrhiza uralensis Fisch. ex DC [Fabaceae], a best formula relieved the kidney damage imposed by DDP. Treatments of various combinations of major chemical components of the three herbs also exhibited a similar trend for lowering the DDP-induced nephrotoxicity; however, contrary to that of the formula of herbal extracts, all chemical formulas could not recover the body weight and food intake of the tumor-bearing mice treated by DDP. Our findings suggested that the therapeutic index of DDP-based chemotherapy was able to be improved by minimizing toxicities from the two-herb formula to inhibit the inflammation in mouse tumor models and DDP-induced acute kidney injury mouse models.


The rate of development and time of transfer play different roles in influencing the viability of human blastocysts.
Improved embryo culture protocols now render more feasible the possibility of obtaining human blastocysts after in-vitro fertilization. In this study we present: (i) results of blastocyst development from supernumerary embryos after co-culture on green monkey kidney epithelial cells and (ii) pregnancy rates after transfer of frozen blastocysts. In addition, we have examined the influence of the day of blastocyst freezing and the day of transfer after the luteinizing hormone (LH) peak on pregnancy and implantation rates. Of 423 supernumerary embryos, 200 developed to the blastocyst stage (47.3%). By days 5 and 6, 67% of the blastocysts had reached the blastocyst stage, and were frozen, compared to 28.5% by day 7. When we compared the cases where only blastocysts frozen on days 5 and 6 were transferred compared to those frozen and transferred on or after day 7 the pregnancy rates were 7/18 (38.9%) and 1/16 (6.2%) respectively. In contrast, when we examined the influence of the day of transfer we found that pregnancies were established from day 5 up to day 9 post LH peak. Based on these results, we suggest that every attempt should be made to increase the development rate of supernumerary embryos to the blastocyst stage, as it appears that the quality of blastocysts transferred, as shown in this study by rate of development, plays a more crucial role than the timing of transfer.


Near-field terahertz probes with room-temperature nanodetectors for subwavelength resolution imaging.
Near-field imaging with terahertz (THz) waves is emerging as a powerful technique for fundamental research in photonics and across physical and life sciences. Spatial resolution beyond the diffraction limit can be achieved by collecting THz waves from an object through a small aperture placed in the near-field. However, light transmission through a sub-wavelength size aperture is fundamentally limited by the wave nature of light. Here, we conceive a novel architecture that exploits inherently strong evanescent THz field arising within the aperture to mitigate the problem of vanishing transmission. The sub-wavelength aperture is originally coupled to asymmetric electrodes, which activate the thermo-electric THz detection mechanism in a transistor channel made of flakes of black-phosphorus or InAs nanowires. The proposed novel THz near-field probes enable room-temperature sub-wavelength resolution coherent imaging with a 3.4 THz quantum cascade laser, paving the way to compact and versatile THz imaging systems and promising to bridge the gap in spatial resolution from the nanoscale to the diffraction limit.


Comparing predictive abilities of longitudinal child growth models.
The Bill and Melinda Gates Foundation's Healthy Birth, Growth and Development knowledge integration project aims to improve the overall health and well-being of children across the world. The project aims to integrate information from multiple child growth studies to allow health professionals and policy makers to make informed decisions about interventions in lower and middle income countries. To achieve this goal, we must first understand the conditions that impact on the growth and development of children, and this requires sensible models for characterising different growth patterns. The contribution of this paper is to provide a quantitative comparison of the predictive abilities of various statistical growth modelling techniques based on a novel leave-one-out validation approach. The majority of existing studies have used raw growth data for modelling, but we show that fitting models to standardised data provide more accurate estimation and prediction. Our work is illustrated with an example from a study into child development in a middle income country in South America.


The Relationship Between Atomic Structure and Strain Distribution of Misfit Dislocation Cores at Cubic Heteroepitaxial Interfaces.
The atomic reconstruction of a misfit dislocation (MD) core causes change in the strain distribution around the core. Several MD cores at the AlSb/GaAs (001) cubic zincblende interface, including a symmetrical glide set Lomer dislocation (LD), a left-displaced glide set LD, a glide set LD with an atomic step, a symmetrical shuffle set LD, and a 60° dislocation pair, were studied using simulated projected potential and aberration-corrected transmission electron microscope images. Image deconvolution was also used to restore structure images from nonoptimum-defocus images. The corresponding biaxial strain maps, ε xx (in-plane) and ε yy (out-of-plane), were obtained by geometric phase analysis using the GaAs substrate as the reference lattice. The results show that atomic structure characteristics of MD cores can be revealed by the strain maps. The strain maps should be measured from optimum-defocus images or restored structure images. Furthermore, the ε xx strain map has been found more accurate than the ε yy strain map for MD cores, and the specimen thickness should be below the critical thickness due to the influence of dynamical scattering.


T-cell homeostasis in humans with thymic hypoplasia due to chromosome 22q11.2 deletion syndrome.
Patients with chromosome 22q11.2 deletion syndrome (DiGeorge syndrome/velocardiofacial syndrome) typically exhibit thymic hypoplasia, conotruncal cardiac defects, and hypoparathyroidism. The immunodeficiency that results from the thymic hypoplasia has been extensively described and consists primarily of T-cell lymphopenia. A curious feature of the T-cell lymphopenia is that the age-related rate of decline of T-cell numbers is slower in patients than controls. This leads to T-cell numbers in adulthood that are minimally decreased compared with controls. This suggests that homeostatic mechanisms might be acting to preserve the peripheral blood T-cell numbers in patients. We characterized changes in CD4/CD45RA and CD4/CD45RO T-cell populations in patients and controls of various ages and determined T-cell recombination excision circles and telomere length within the CD4/CD45RA population. Patients had evidence of accelerated conversion of naive to memory cells and had evidence of more extensive replicative history within the CD4/CD45RA compartment compared with controls. Oligoclonal T-cell receptor (TCR) Vbeta families and missing Vbeta families were seen more often in patients than controls. These data are consistent with homeostatic proliferation of T cells in patients with limited T-cell production due to thymic hypoplasia.


Assessing gene function in the ruminant placenta.
The placenta provides the means for nutrient transfer from the mother to the fetus, waste transfer from the fetus to the mother, protection of the fetus from the maternal immune system, and is an active endocrine organ. While many placental functions have been defined and investigated, assessing the function of specific genes expressed by the placenta has been problematic, since classical ablation-replacement methods are not feasible with the placenta. The pregnant sheep has been a long-standing animal model for assessing in vivo physiology during pregnancy, since surgical placement of indwelling catheters into both maternal and fetal vasculature has allowed the assessment of placental nutrient transfer and utilization, as well as placental hormone secretion, under unanesthetized-unstressed steady state sampling conditions. However, in ruminants the lack of well-characterized trophoblast cell lines and the inefficiency of creating transgenic pregnancies in ruminants have inhibited our ability to assess specific gene function. Recently, sheep and cattle primary trophoblast cell lines have been reported, and may further our ability to investigate trophoblast function and transcriptional regulation of genes expressed by the placenta. Furthermore, viral infection of the trophoectoderm layer of hatched blastocysts, as a means for placenta-specific transgenesis, holds considerable potential to assess gene function in the ruminant placenta. This approach has been used successfully to "knockdown" gene expression in the developing sheep conceptus, and has the potential for gain-of-function experiments as well. While this technology is still being developed, it may provide an efficient approach to assess specific gene function in the ruminant placenta.


Risk factors for rising incidence of esophageal and gastric cardia adenocarcinoma.
In the last 30 years, the incidence of esophageal and gastric cardia adenocarcinoma has steadily increased. The increase in incidence is approximately seven-fold, which is a more substantial increase than that of several malignancies, including melanoma, breast cancer, and prostate cancer. The rising incidence has led to a steady increase in mortality from 2 to 15 deaths per 100,000 in the last three decades. The etiologic factors involved in the development of these malignancies include gastroesophageal reflux disease, Barrett's esophagus, acid-suppressive medication use, obesity, and tobacco use. This article discusses the contribution of these etiologic risk factors to this increase in incidence.


Measurement of self-efficacy and proxy efficacy for middle school youth physical activity.
This study developed youth self-efficacy (SEPA) and proxy efficacy (PEPA) measures for physical activity (PA). Proxy efficacy was defined as a youth's confidence in his or her skills and abilities to get others to act in one's interests to create supportive environments for PA. Each spring of their sixth-, seventh-, and eighth-grade years, middle school students completed SEPA and PEPA questions and then, for 3 days, recalled their previous day's after-school PA. Exploratory and confirmatory factor analyses revealed a four-factor structure (SEPA for 1-3 days, SEPA for 5-7 days, PEPA-Parents, PEPA-School). Across study years, SEPA 1-3 days and 5-7 days increased and PEPA-Parents and PEPA-School decreased. Initial levels of PEPA-Parents and SEPA scales were associated with initial levels of PA. From sixth through seventh grade, changes in SEPA scales were associated with changes in PA. Studies should test whether interventions targeting self-efficacy and proxy efficacy influence PA.


Paraoxonase gene polymorphism and serum activity in progressive IgA nephropathy.
HDL-associated paraoxonase (PON1) reduces oxidation of lipids in LDL, and activity is inversely related to coronary heart disease risk with a beneficial effect on the development of atherosclerosis. Risk factors associated with atherosclerosis, such as hypertension, dyslipidemia and smoking, also promote the progression of chronic glomerulonephritides which may therefore be associated with perturbations in PON1 activity. We performed a genetic association study in patients with IgA nephropathy (IgAN) (n=115) compared with control subjects (n=118). The aim was to test whether polymorphisms in the PON1 coding region (Q192R and L55M) and its promoter (-108C/T and -162A/G) are associated with either IgAN or with the progression. We measured serum paraoxonase activity in 60 out of 115 patients. All patients had been followed up for more than 4 years. There were no differences in the genotype frequency at 3 of the polymorphic sites (Q192R, L55M and -108C/T) between the patients and controls. However, the frequency distribution at -162 position (A/G) was significantly diffe-rent in IgAN (p=0.028, chi-square test) with a higher frequency of the heterozygote (0.017, Fisher exact test [FE]; odds ratio [OR] = 1.99; 95% confidence interval [95% CI], 1.14-3.47). Although there were no differences in the genotype frequency at 3 of the polymorphic sites (Q192R, L55M and -162C/T) between the patients with progressive IgA and the nonprogressive patients, we found that the frequency of the C allele for the -108C/T polymorphism was elevated in those patients with nonprogressive disease (n=85) compared with those with progressive disease (n=30) (61% vs. 47%; p=0.070, FE; OR=1.75, 95% CI, 0.97-3.18). Furthermore, PON1 activity was significantly higher in nonprogressive patients compared with progressors (206 +/- 71 vs. 136 +/- 48; p<0.001), and activity significantly correlated with 1/serum creatinine (SCr) (p<0.001; r=0.38). The results of this study suggest that in IgAN, lower PON1 activity may be associated with the deterioration of kidney function. This could be due to variable expression of the PON1 gene, or a functional effect of the gene product.


Computed tomography guidance for spinal intervention: basics of technique, pearls, and avoiding pitfalls.
The utilization of spinal interventional pain techniques has grown rapidly over the last decade. However, practitioners use widely different techniques in these procedures, particularly in the use of image guidance. The importance of image guidance was highlighted by the fact that in recent systematic reviews on therapeutic effectiveness of epidural steroid injections and facet joint interventions, only studies that used image guidance were included. The choice of image guidance remains a matter of physician preference with conventional fluoroscopic or Computed Tomography (CT) guidance most common. There are many advantages to CT guidance for certain spinal interventional pain procedures, mainly due to increased needle tip positioning accuracy. CT guidance provides greater anatomical detail that facilitates accurate needle trajectory planning, monitoring and final placement. Unlike conventional fluoroscopy that may be hindered by tissue overlap and lack of surrounding anatomical detail CT guidance offers direct visualization of the entire needle trajectory and the surrounding soft tissue and bone structures. Large osteophytes and adjacent vascular structures can be identified and safely avoided. The goals of this narrative review are to provide a basic overview of CT techniques available for spinal interventional pain procedures, to discuss the potential advantages and disadvantages of CT guidance, to provide a simple step-by-step approach to use of CT guidance, to share technical pearls, and to discuss methods to avoid potential pitfalls. This review will provide interventional pain physicians with knowledge of relevant CT image acquisition techniques and appropriate radiation dose reduction strategies. This will contribute to increased technical success rates while reducing radiation dose to the patient and staff.


Hydraulic differences along the water transport system of South American Nothofagus species: do leaves protect the stem functionality?
Hydraulic traits were studied for six Nothofagus species from South America (Argentina and Chile), and for three of these species two populations were studied. The main goal was to determine if properties of the water conductive pathway in stems and leaves are functionally coordinated and to assess if leaves are more vulnerable to cavitation than stems, consistent with the theory of hydraulic segmentation along the vascular system of trees in ecosystems subject to seasonal drought. Vulnerability to cavitation, hydraulic conductivity of stems and leaves, leaf water potential, wood density and leaf water relations were examined. Large variations in vulnerability to cavitation of stems and leaves were observed across populations and species, but leaves were consistently more vulnerable than stems. Water potential at 50% loss of maximum hydraulic efficiency (P(50)) ranged from -0.94 to -2.44 MPa in leaves and from -2.6 to -5.3 MPa in stems across species and populations. Populations in the driest sites had sapwood and leaves more vulnerable to cavitation than those grown in the wettest sites. Stronger diurnal down-regulation in leaf hydraulic conductance compared with stem hydraulic conductivity apparently has the function to slow down potential water loss in stems and protect stem hydraulics from cavitation. Species-specific differences in wood density and leaf hydraulic conductance (K(Leaf)) were observed. Both traits were functionally related: species with higher wood density had lower K(Leaf). Other stem and leaf hydraulic traits were functionally coordinated, resulting in Nothofagus species with an efficient delivery of water to the leaves. The integrity of the more expensive woody portion of the water transport pathway can thus be maintained at the expense of the replaceable portion (leaves) of the stem-leaf continuum under prolonged drought. Compensatory adjustments between hydraulic traits may help to decrease the rate of embolism formation in the trees more vulnerable to cavitation.


Invited review: Stem cells and muscle diseases: advances in cell therapy strategies.
Despite considerable progress to increase our understanding of muscle genetics, pathophysiology, molecular and cellular partners involved in muscular dystrophies and muscle ageing, there is still a crucial need for effective treatments to counteract muscle degeneration and muscle wasting in such conditions. This review focuses on cell-based therapy for muscle diseases. We give an overview of the different parameters that have to be taken into account in such a therapeutic strategy, including the influence of muscle ageing, cell proliferation and migration capacities, as well as the translation of preclinical results in rodent into human clinical approaches. We describe recent advances in different types of human myogenic stem cells, with a particular emphasis on myoblasts but also on other candidate cells described so far [CD133+ cells, aldehyde dehydrogenase-positive cells (ALDH+), muscle-derived stem cells (MuStem), embryonic stem cells (ES) and induced pluripotent stem cells (iPS)]. Finally, we provide an update of ongoing clinical trials using cell therapy strategies.


Does thoracic or lumbar spine bone architecture predict vertebral failure strength more accurately than density?
Trabecular bone microstructure was studied in 6 mm bone biopsies taken from the 10th thoracic and 2nd lumbar vertebra of 165 human donors and shown to not differ significantly between these sites. Microstructural parameters at the locations examined provided only marginal additional information to quantitative computed tomography in predicting experimental failure strength. It is unknown whether trabecular microstructure differs between thoracic and lumbar vertebrae and whether it adds significant information in predicting the mechanical strength of vertebrae in combination with QCT-based bone density. Six mm cylindrical biopsies taken at mid-vertebral level, anterior to the center of the thoracic vertebra (T) 10 and the lumbar vertebra (L) 2 were studied with micro-computed tomography (microCT) in 165 donors (age 52 to 99 years). The segment T11-L1 was examined with QCT and tested to failure using a testing machine. The correlation of microstructural properties was moderate between T10 and L2 (r <or= 0.5). No significant differences were observed in the microstructural properties between the thoracic and lumbar spine, nor were sex differences at T10 or L2 observed. Cortical/subcortical density of T12 (r(2)=48%) was more strongly correlated with vertebral failure stress than trabecular density (r(2)=32%). BV/TV (of T10) improved the prediction by 52% (adjusted r(2)) in a multiple regression model. Microstructural properties of trabecular bone biopsies displayed a high degree of heterogeneity between vertebrae but did not differ significantly between the thoracic and lumbar spine. At the locations examined, bone microstructure only marginally improved the prediction of structural vertebral strength beyond QCT-based bone density.


Adsorption of highly charged polyelectrolytes onto an oppositely charged porous substrate.
The adsorption behavior of highly charged cationic polyelectrolytes onto porous substrates is electrostatic in nature and has been shown to be highly dependent on the polyelectrolyte properties. Copolymers of acrylamide (AM) and diallyldimethylammonium chloride (DADMAC) were synthesized to have a range of macromolecular properties (i.e., charge density and molecular mass). Traditional titration methods have been complemented by fluorescence labeling techniques that were developed to directly observe the extent that fluorescently labeled poly(AM- co-DADMAC) adsorbs into the pore structure of a cellulosic substrate. Although contributing to the electrostatic driving force, the charge density acts to limit adsorption to the outermost surface under electrolyte-free conditions. However, adsorption into the pores can occur if both the molecular mass and charge density of poly(AM- co-DADMAC) are sufficiently low. Adsorption initially increases as the electrolyte concentration is increased. However, the electrostatic persistence length of poly(AM- co-DADMAC) restricts the polyelectrolyte from entering the pores. Therefore, changes in the adsorption behavior at moderate electrolyte concentrations have been attributed to swelling of the polyelectrolyte layer at the fiber exterior. The adsorption behavior changes again at high electrolyte concentrations such that poly(AM- co-DADMAC) could adsorb into the pore structure. This occurred when the electrolyte concentration was sufficient to screen the electrostatic persistence length of poly(AM- co-DADMAC), provided that the entropic driving force for adsorption still existed. It is suggested that adsorption into the pore structure is a kinetic process that is governed by localized electrostatic interactions between poly(AM- co-DADMAC) and the charges located within the pores.


Modulation of *CHxO Adsorption to Facilitate Electrocatalytic Reduction of CO2 to CH4 over Cu-Based Catalysts.
Copper (Cu) can efficiently catalyze the electrochemical CO2 reduction reaction (CO2RR) to produce value-added fuels and chemicals, among which methane (CH4) has drawn attention due to its high mass energy density. However, the linear scaling relationship between the adsorption energies of *CO and *CHxO on Cu restricts the selectivity toward CH4. Alloying a secondary metal in Cu provides a new freedom to break the linear scaling relationship, thus regulating the product distribution. This paper describes a controllable electrodeposition approach to alloying Cu with oxophilic metal (M) to steer the reaction pathway toward CH4. The optimized La5Cu95 electrocatalyst exhibits a CH4 Faradaic efficiency of 64.5%, with the partial current density of 193.5 mA cm-2. The introduction of oxophilic La could lower the energy barrier for *CO hydrogenation to *CHxO by strengthening the M-O bond, which would also promote the breakage of the C-O bond in *CH3O for the formation of CH4. This work provides a new avenue for the design of Cu-based electrocatalysts to achieve high selectivity in CO2RR through the modulation of the adsorption behaviors of key intermediates.


Brugada syndrome: an update.
More than 20 years have passed since the description of Brugada syndrome as a clinical entity. The original case series depicted patients who all had coved ST-segment elevation in the right precordial leads, associated with a high risk of sudden death and no apparent structural heart disease. As subsequent registry data were published, it became apparent that the spectrum of risk is wide, with the majority of patients classified as low risk. Two consensus documents have been published that will continue to be updated. Despite intense research efforts, many controversies still exist over its pathophysiology and the risk stratification for sudden death. Management continues to be challenging with a lack of drug therapy and high complication rates from implantable cardioverter defibrillators. In this review, we highlight the current state-of-the-art therapies and their controversies.


[Rare Case of Strongyloides stercoralis with Vitamin B12 Deficiency].
Strongyloidiyasis is endemic in tropical and subtropical regions, and mostly soil transmitted nematode disease that is seen as sporadic cases in Turkey. As may be asymptomatic in healthy individuals, it may even cause death in immunosuppressive people. We report a case of Strongyloides stercoralis infection in a patient, 29 years old young male was admitted to our institution with diarrhea who has got vitamin B12 deficiency and eosinophilia. The case represents an extremely rare and in our knowledge, it is the first case in Sakarya.


Overcoming fear of eating: A case study of a novel use of exposure and response prevention.
Even after successful weight restoration, many patients with anorexia nervosa (AN) continue to exhibit maladaptive eating including repetitive behaviors (i.e., food rituals) used to decrease anxiety about food, and to describe fears related to food content, including its effect on shape and weight. Although there are important differences between eating disorders and anxiety disorders, the shared clinical phenomena suggest potentially useful overlap in treatment strategies. This case study will describe treatment of a woman with AN using Exposure and Response Prevention for Anorexia Nervosa (AN-EXRP) as an adjunct to concurrent inpatient treatment. This is a novel use of a treatment approach with established efficacy in the treatment of anxiety disorders. AN-EXRP specifically targets eating-related anxiety with the intent to improve the restrictive eating patterns that persist after acute weight restoration. The case study described includes descriptions of (a) the treatment rationale and its phases of implementation, (b) illustrative sample dialogue between the patient and therapist, (c) pre- and posttreatment data on outcome measures of interest (e.g., food intake at a laboratory meal, self-report anxiety ratings, self-report eating-related rituals, and preoccupations), and (d) therapist considerations (e.g., maintaining alliance, adhering to treatment frame). (PsycINFO Database Record


Intraoperative OCT-Assisted Subretinal Perfluorocarbon Liquid Removal in the DISCOVER Study.
To assess the role for intraoperative optical coherence tomography (iOCT) during subretinal perfluoro-n-octane (PFO) removal and evaluate it as an assistive technique during surgical maneuvers. DISCOVER is a prospective study examining microscope-integrated iOCT systems in ophthalmic surgery. The authors report a technique utilizing iOCT guidance and feedback for surgical removal of chronic subretinal PFO. In this technique, real-time iOCT feedback successfully guided surgical maneuvers to facilitate removal of PFO. Due to the chronicity of the PFO, it was loculated and resistant to multiple maneuvers. Utilizing real-time feedback, additional maneuvers were attempted with feedback to the surgeon regarding the success of removal. Postoperatively, visual acuity improved with anatomic normalization. Microscope-integrated iOCT with real-time feedback provided important information to the surgeon that helped facilitate subretinal PFO removal and guided surgical maneuvers.


Analysis of evolution through competitive selection.
Recent studies of in vitro evolution of DNA via protein binding indicate that the evolution behavior is qualitatively different in different parameter regimes. I here present a general theory that is valid for a wide range of parameters, and which reproduces and extends previous results. Specifically, the mean-field theory of a general translation-invariant model can be reduced to the basic diffusion equation with a dynamic boundary condition. The simple analytical form yields both quantitatively accurate predictions and valuable insight into the principles involved.


[Increased hepatic aryl 4-monoxygenase in chickens caused by lipophilic xenobiotics].
Hens were treated with three types of lipophil xenobiotics - polychlorinated biphenyl (PCB), lindane and hexachlorobenzene (HCB) - to study changes in the levels of microsomal proteins and in the activity of microsomal aryl 4-monooxygenase in liver. The above foreign substances were given in feed at a dose of 50 mg per kg during a fortnight. The level of microsomal proteins in liver increased after seven-day administration of xenobiotics and was always higher in the course of the experiment than in the controls. The activity of the microsomal enzyme (aryl 4-monooxygenase) was significantly higher in treated hens after seven- and 14-day interval, and also seven days after the end of feeding the contaminated feed mixture. Inductive properties were strongest in polychlorinated biphenyl (Delor 103), but lindane and hexachlorobenzene also induced a statistically significant rise, in comparison with the controls. It is shown that the inductive ability of lipophil xenobiotics is stronger in hens than in chicks, which may influence the metabolism of some biologically important substances in poultry organism.


Acknowledging a persistent truth: domestic violence in pregnancy.
Violence against women has a devastating effect on women's sexual and reproductive health, and also affects the health of their children. Such behaviour is rooted in gender inequality, which is sadly persistent, arguably throughout all societies. This phenomenon is a serious health and development concern, in addition to a violation of a woman's human rights. Violence can begin or escalate in pregnancy and has significant consequences for the woman, fetus and child. Questioning pregnant women about the presence of violence and offering referral to a secondary agency can help to break the pattern of abuse.


Neonatal encephalopathy is associated with altered perinatal systemic neutrophil apoptosis.
Systemic hypoxia-ischemia at birth may alter the neonatal neutrophil phenotype. In this study, we evaluated alterations in perinatal neutrophil phenotype following systemic hypoxia-ischemia compared with normal controls. Neutrophils from adults (n = 15), normal newborns (n = 20), newborns requiring resuscitation at birth (n = 17), and their respective maternal samples were incubated alone or with lipopolysaccharide (LPS). Surface receptor CD11b (neutrophil activation) and the percentage apoptosis (persistence of inflammatory response) were assessed using flow cytometry. Neutrophil apoptosis was decreased in neonates requiring resuscitation at birth and was further exaggerated in infants who developed mild neurological signs. All infants who required resuscitation were LPS hyporesponsive irrespective of neurological findings. Newborns with severe neurological signs had increased apoptosis and decreased CD11b. Maternal neutrophils were LPS hyporesponsive only if their infants had moderate/severe neurological signs. Infants with mild encephalopathy may display a predominantly proinflammatory neutrophil response with a persistent inflammatory response, whereas those with moderate/severe encephalopathy have a tendency toward immunosuppression.


In vitro recombinants of ground squirrel and woodchuck hepatitis viral DNAs produce infectious virus in squirrels.
Hepatitis B viruses of humans, woodchucks, ground squirrels, and ducks are similar biochemically but differ with respect to host range and pathogenicity. To pursue the genetic basis of these properties in the absence of a cell culture system for virus growth, we exploited the demonstrated infectivity of cloned hepatitis B virus DNA in whole animals. We constructed several recombinant molecules in vitro between cloned infectious genomes of woodchuck hepatitis virus (WHV) and ground squirrel hepatitis virus (GSHV) and assayed the recombinants for infectivity after intrahepatic injection in ground squirrels, which support growth of GSHV but not WHV. Two of the recombinants molecules initiated productive infection; in one recombinant genome, 76% of the coding region for the major surface glycoprotein of GSHV and for the overlapping portion of the presumptive gene for DNA polymerase was replaced by WHV DNA; in the other, 29% of the same coding domain was replaced by WHV DNA. These findings demonstrate the feasibility of generating viable recombinants of hepatitis B viruses from different animal species and suggest that the major host range determinants are not encoded within the surface antigen gene of these viruses.


[Forced expiration index, signal and noise].
Although forced expiration measurements are extensively used, there is no general agreement concerning the best way to quantify the data. In this context, it may be of interest to examine indices from the point of view of their signal/noise ratio. The signal depends upon the actual sensitivity of the index to the kind of abnormality which is to be detected. In general, the relationship between signal and degree of abnormality is strongly non-linear, so that sensitivity is not a constant. The noise depends upon the kind of investigation which is made. When a subject is compared to himself (bronchomotor challenge, follow-up studies, etc.), it is mainly due to intraindividual variability. FEV1 is an example of index with a low sensitivity to peripheral airway abnormality, but a high reproducibility, so that its signal/noise ratio for paired measurements is comparatively good. When two groups are to be compared, the relevant noise is interindividual variability. Coefficient of variation of transit times and slope ratios are quite effective in detecting abnormalities in young smokers, probably because their sensitivity to mild peripheral airway disease is large compared to their interindividual variability. It follows that, according to the type of study, as well as to the nature and extent of abnormality, many indices may qualify as being the best.


The Effect of Snail1 Gene Silencing by siRNA in Metastatic Breast Cancer Cell Lines.
Breast cancer is the most common diagnosed cancer among women in the world. Snail1 plays a role in the development of the invasive phenotypes of cancer, neural cell differentiation, cell division and apoptosis in tumor cells. Traces of snail1 in metastasis of breast cancer to bone are observed. The aim of this study was to investigate the effect of specific snail1 siRNAs on the proliferation, migration, induction of apoptosis and cell cycle arrest of MDA-MB-468 cells. In 2015, this experimental study was performed on the MDA-MB-468 cell lines in Immunology Research Center, Tabriz University of Medical Sciences. After the design and construction of siRNA, transfection was performed with transfection reagent. The expression levels of mRNA and protein were measured by qRT-PCR and western blot analysis, respectively. The survival of cells was determined by using MTT assay cells, apoptosis using Tunel assay, Cell migration using scratch assay, Cell cycle analysis by Propidium Iodide (PI) DNA staining method using flow cytometry on the MDA-MB-468. Transfection with siRNA significantly suppressed the expression of snail1 gene in dose-dependent manner after 48 h (P<0.0001). Surprisingly, treatment with snail1 siRNA arrested cell cycle in S phases (P<0.0001). Moreover, siRNA transfection had effects on breast adenocarcinoma cells and inhibited the migration (P<0.0001), proliferation (P<0.0001) and induced apoptosis (P<0.0016). The snail1 can be considered as a potent adjuvant in breast cancer therapy.


Dysregulation of miR-200 family microRNAs and epithelial-mesenchymal transition markers in oral squamous cell carcinoma.
MicroRNAs (miRNAs) are reported to function as a major component in the cellular signaling circuit, which regulates epithelial-mesenchymal transition (EMT). Dysregulation of the microRNA-200 (miR-200) family and EMT-associated genes enables tumor metastasis and resistance to therapy. The present study profiled miR-200 family members miR-200a, miR-200b, miR-200c, miR-141 and miR-429, and also several EMT-regulatory genes including zinc finger E-box-binding homeobox (ZEB)1, ZEB2, epithelial cadherin and vimentin in 40 oral primary tumors in order to understand their role(s) in oral squamous cell carcinoma (OSCC). The reverse transcription-quantitative polymerase chain reaction was used to analyze each sample. Results demonstrated a significant downregulation of miR-200 family members in tumors with a history of tobacco chewing/smoking (P<0.0006, P=0.0467, P=0.0014, P=0.0087 and P=0.0230, respectively) and undifferentiated pathology (miR-200a, P=0.0067; miR-200c, P=0.0248). EMT markers ZEB2 (P=0.0451) and vimentin (P=0.0071) were significantly upregulated in the oral tumors. Furthermore, ZEB2 antisense RNA1 was overexpressed in 50% of OSCC samples (P=0.0075). EMT-regulatory genes did not exhibit any association with clinical outcome. The present study also analyzed the expression of EMT-regulatory genes in 523 head and neck squamous cell carcinoma (HNSCC) samples from The Cancer Genome Atlas (TCGA) database, and the association with treatment outcome. Analysis of TCGA datasets also demonstrated no significant association in the expression of EMT markers with disease recurrence and treatment outcome. The results of the present study revealed dysregulation of miR-200 family miRNAs and EMT-regulatory genes in OSCC without any significant effect on treatment outcome.


Equivalence tests for safety assessment of genetically modified crops using plant composition data.
The evaluation of compositional characteristics of plants harvested from field trials is an important step in the safety assessment of a genetically modified crop and its derived products for food and feed. The European Food Safety Authority (EFSA) evaluates safety by testing for equivalence between the GM genotype and other genotypes, typically with a history of safe use. Here, a new equivalence test is proposed, which addresses issues with the EFSA test. The method is motivated by a recently proposed equivalence test for analysis of data from animal feeding trials. In order to be suitable for practical safety assessment, the new method has a statistical power set to a desired value, e.g. 95%, by construction. In addition, we assess distributions rather than average values. This way, equivalence limits can also be established when there is limited genotypic variation. The original EFSA equivalence test breaks down in this case. The method is illustrated by its application to data from a field study on maize grain. Simulation studies indicate that the proposed test has appropriate performance characteristics and is competitive with respect to recently proposed alternatives, including the EFSA/EU equivalence test.


[Tissue distribution of TPGS modified artesunate liposome and its metabolites in rats].
Artesunate, which is a widely used anti-malaria medicine, can be made into liposome to overcome its poor bioactivity. Its tissue distribution in rats may change with different dosage forms, which therefore shall be studied after ARS-TPGS-Lipo was injected. Based on this experiment, ARS-TPGS-Lipo and ARS-Lipo were prepared by thin-film hydration method. LC-MS/MS method was used to simultaneously determine ARS and DHA in rat tissues at different time points. The results showed that this method was suitable for the content analysis of ARS and DHA in biological samples. The distribution of ARS and DHA in ARS-TPGS-Lipo, ARS-Lipo and ARS groups were quite different. The content of ARS-TPGS-Lipo in liver was the highest, with significant differences.ARS and DHA contents in ARS group eliminated rapidly. ARS and DHA contents in ARS-Lipo group were higher in liver and spleen, while those in ARS-TPGS-Lipo group significantly increased only in liver (P<0.05).


Deregulation of MicroRNAs in Gastric Lymphomagenesis Induced in the d3Tx Mouse Model of Helicobacter pylori Infection.
Helicobacter pylori infection is considered as an excellent model of chronic inflammation-induced tumor development. Our project focuses on gastric MALT lymphoma (GML) related to H. pylori infection and mediated by the chronic inflammatory process initiated by the infection. Recently, microRNAs (miRNAs) have emerged as a new class of gene regulators, which play key roles in inflammation and carcinogenesis acting as oncogenes or tumor suppressors. Their precise characterization in the development of inflammation and their contribution in regulating host cells responses to infection by H. pylori have been little explored. Our goal was to analyze the changes in miRNAs in a GML mouse model using BALB/c mice thymectomized at day 3 post-birth (d3Tx model) and to clarify their implication in GML pathogenesis. PCR array followed by RT-qPCR identified five miRNAs (miR-21a, miR-135b, miR-142a, miR-150, miR-155) overexpressed in the stomachs of GML-developing d3Tx mice infected by H. pylori. The analysis of their putative targets allowed us to identify TP53INP1, an anti-proliferative and pro-apoptotic protein, as a common target of 4 of the 5 up-regulated miRNAs. We postulate that these miRNAs may act in synergy to promote the development of GML. miR-142a was also overexpressed in mouse sera samples and therefore could serve as a diagnostic marker. In situ hybridization on gastric samples with miR-142a revealed a global up-regulation of this miRNA by the tumor microenvironment at the lymphoma stage. Dysregulation of miR-21a, miR-135b, miR-142a, miR-150, miR-155 could play a critical role in the pathogenesis of GML and might offer potential applications as therapeutic targets and novel biomarkers for this disease.


[Emile Auguste Bégin (1802-1888): health official, physician, historian, librarian].
Born in Metz, in 1802, E.A. Bégin son of an "Officier de Santé", was accepted for the "Military Instruction Hospital" of this town he left in 1822, promoted "Aide-Major" (a surgeon). He was appointed to the same establishment before having been incorporated, in 1824, into the French occupying power in Spain, and, after his return to Nancy and Strasbourg hospitals, in 1828. Then, he carried on studying medicine and became Doctor of Strasbourg Faculty.


Single-centre experience with mitral valve repair in asymptomatic patients with severe mitral valve regurgitation.
Guidelines recommend surgical mitral valve repair in selected patients with asymptomatic severe mitral valve regurgitation (MR), but the role of repair remains a matter of debate. Survival analyses of operated asymptomatic patients have been reported, but long-term haemodynamics and quality of life are not well defined. The aim of this study was to report the long-term follow-up focusing on these aspects. Our database identified patients who underwent primary isolated mitral valve repair for severe MR and were asymptomatic by New York Heart Association Class I and in sinus rhythm. To obtain sufficient length of follow-up, only patients operated on before 2006 returned for an echocardiogram and quality-of-life assessment (SF-36). Between May 1991 and December 2005, 46 asymptomatic patients with severe MR and a normal left ventricular function (ejection fraction >60%) were operated on. Mean age was 50.2 ± 13.2 years and 89% of patients were male. There were no operative deaths. Mean follow-up was 8.4 ± 3.9 years with 386 patient-years, survival was 93.3% at 12 years and comparable with the general age-matched Dutch population. Follow-up echocardiography showed that 92% had no to mild MR, and 3 patients had moderate MR. Left ventricular function was good/impaired/moderate in 66/29/5% of patients. Quality-of-life SF-36 assessment showed that mean physical and mental health components were 83 ± 17 and 79 ± 17, which was comparable with that of the general age- and gender-matched Dutch population. Our experience shows that mitral valve repair for severe MR in asymptomatic patients is safe, and has satisfactory long-term survival with a low recurrence rate of MR, good left ventricular function, and excellent quality of life that is comparable with the general Dutch population.


The Novel Design of a Single-Sided MRI Probe for Assessing Burn Depth.
Burn depth assessment in clinics is still inaccurate because of the lack of feasible and practical testing devices and methods. Therefore, this process often depends on subjective judgment of burn surgeons. In this study, a new unilateral magnetic resonance imaging (UMRI) sensor equipped with a 2D gradient coil system was established, and we attempted to assess burns using unilateral nuclear magnetic resonance devices. A reduced Halbach magnet was utilized to generate a magnetic field that was relatively homogeneous on a target plane with a suitable field of view for 2D spatial localization. A uniplanar gradient coil system was designed by utilizing the mainstream target field method, and a uniplanar RF (radio frequency) coil was designed by using a timeharmonic inverse method for the UMRI sensor. A 2D image of the cross sections of a simple burn model was obtained by a fast 2D pure-phase encoding imaging method. The design details of the novel single-sided MRI probe and imaging tests are also presented.


A Case of an Extremely Low Birth Weight Infant with Morganella morganii Bacteremia and Peritonitis.
We describe a case of late onset Morganella morganii sepsis in an extremely low birth weight male neonate born at 23 and 4/7 weeks gestational age to a 30-year-old primigravid mother due to preterm labor. The mother was otherwise healthy with an unremarkable prenatal course. She received steroids and ampicillin prior to delivery. While initial blood cultures were negative, at day of life 4, the neonate developed signs of sepsis with leukocytosis and bandemia, and subsequent blood culture demonstrated growth of M. morganii . The patient then had spontaneous intestinal perforation on day of life 8 with peritoneal cultures growing M. morganii . The infant responded to standard therapy and survived to discharge, with few mild developmental delays upon outpatient follow-up. While M. morganii has been demonstrated in the neonatal population, it generally causes early onset sepsis and is associated with high mortality in preterm neonates. Here, we present this case of late onset neonatal sepsis with M. morganii complicated by spontaneous intestinal perforation, with survival in a 23 weeks gestation infant.


Pedodynographic measurements after forefoot reconstruction in rheumatoid arthritis patients.
From January 1987 to December 1992, 38 patients (59 feet) with rheumatoid arthritis underwent reconstruction of the forefoot using Keller-Lelièvre arthroplasty of the first metatarsophalangeal joint and Hoffman resection of the lesser metatarsal heads. The average age of the patients was 61.3 years, with both feet involved in 21 patients and 17 with single foot involvement. The aim of our study was to evaluate the results both on a functional and an objective basis using dynamic and static pedodynographic measurements. Attention was given to dynamic pressure measurements under the metatarsal heads, the center of pressure distribution, gait analysis, and peak loads taken on different areas of the forefoot during normal walking. Correlations were made between these measurements and symptoms. After a mean follow-up time of 35 months, the clinical results were satisfactory in 54%, satisfactory with some reservations in 39%, satisfactory with major reservations in 3%, and unsatisfactory in 3% of patients.


[Estimation of integral value of input function for the quantification of cerebral blood flow with 123I-IMP using one-point arterial blood sampling].
Cerebral blood flow (CBF) has been measured using a microsphere model with octanol-extracted radioactivity counts (integral value of input function). We developed a new method estimating the integral value of input function. First, we fitted the whole brain time-activity curves early after intravenous injection of N-isopropyl-p-[123I]iodoamphetamine (123I-IMP) by the least-squares method. Second, we differentiated this equation. Third, we calibrated it using octanol-extracted radioactivity counts of the arterial blood sampled at 5 min. Finally, we integrated it. A significant correlation was found between the integral values obtained using a new method and those obtained using the continuous arterial blood sampling data (y = 1.048x-1206, r = 0.984). The errors between the CBF values obtained using a new method and those obtained using the 5-min continuous arterial blood sampling was 6.88 +/- 4.78%. Measurement of integral values of the input function using a new method with one-point arterial blood sampling is less invasive and convenient, and is not influenced by cardiopulmonary disease or smoking. Therefore, it would be useful for the routine measurement of CBF.


Electrostatic Potential Determined Magnetic Dynamics Observed in Two Mononuclear β-Diketone Dysprosium(III) Single-Molecule Magnets.
Two β-diketone mononuclear Dy(III) compounds, formulated as Dy(BTFA)3(H2O)2 (1) and Dy(BTFA)3(bpy) (2) (BTFA = 3-benzoyl-1,1,1-trifluoroacetone, bpy = 2,2'-bipyridine), were prepared. Compound 1 can be identified to transform to 2 in the attendance of bpy coligand, when the local geometry symmetry of eight-coordinated Dy(III) ion changes from a dodecahedron (D2d) in 1 to a square antiprism (D4d) in 2. Fine-tuning structure aroused by auxiliary ligand has dramatical impact on magnetic properties of compounds 1 and 2. Magnetic investigations demonstrate that both 1 and 2 display dynamic magnetic relaxation of single-molecule magnets (SMMs) behavior with different effective barriers (ΔE/kB) of 93.09 K for 1 under zero direct-current (DC) field as well as 296.50 K for 1 and 151.01 K for 2 under 1200 Oe DC field, respectively. As noticed, compound 1 possesses higher effective barrier than 2, despite 1 exhibiting a lower geometrical symmetry of the Dy(III) ion. Ab initio studies reveal that the Kramers doublet ground state is predominantly axial with the gz tensors of two compounds matching the Ising-limit factor of 20 anticipated for the pure MJ = ±15/2 state. Electrostatic analysis confirms the uniaxial anisotropy directions, highlighting that the proper electrostatic distribution of the coordination sphere around Ln(III) center is the critical factor to improve the magnetic anisotropy and determine the dynamic behaviors of SMMs.


Morphometric study of the extraocular muscles in Thai population.
Morphology of the extraocular muscles plays an important role in many ophthalmological surgeries and diagnostic imaging studies. Detailed understanding of length, width, point of insertion and the relationships between these muscles could be of significance for successful surgical outcomes. Forty-six orbital contents were extracted from formaldehyde-embalmed cadavers. Dissection was performed to reveal the extraocular muscles from their origins to insertions on the sclera. Muscle length, muscle width, distance from point of insertion to the sclerocorneal limbus, relationship between the superior oblique and superior rectus and between the inferior oblique and lateral rectus were measured. The lateral rectus and superior rectus were the longest muscles. The insertion of the medial rectus muscle was closest to the sclerocorneal limbus while the inferior rectus, lateral rectus and superior rectus insertions were progressively further apart. Only the length of the inferior rectus and medial rectus were significantly different between males and females. The distances between the superior oblique and superior rectus and between the inferior oblique and lateral rectus were slightly greater than in previous study. A direct comparison of these parameters between ethnic groups is still needed for an improvement of the procedural outcomes.


The ongoing evolution of antibody-based treatments for Ebola virus infection.
The 2014-2016 Ebola virus outbreak in West Africa was the deadliest in history, prompting the evaluation of various drug candidates, including antibody-based therapeutics for the treatment of Ebola hemorrhagic fever (EHF). Prior to 2014, only convalescent blood products from EHF survivors had been administered to newly infected individuals as a form of treatment. However, during the recent outbreak, monoclonal antibody cocktails such as ZMapp, ZMAb and MB-003 were either tested in a human clinical safety and efficacy trial or provided to some based on compassionate grounds. This review aims to discuss the evolution of antibody-based treatments for EHF, their clinical trial efficacy and the development of new antibody-based therapies currently advancing in preclinical testing.


An evaluation of standardized software for processing GC/MS data from different vendors' instruments in a forensic laboratory.
Forensic science laboratories perform analyses on a variety of materials using gas chromatography/mass spectrometry (GC/MS). Instruments from different vendors may be used, requiring analysts to be proficient in the use of multiple proprietary software packages for collecting and processing data. There is no standardized GC/MS software available that can acquire data from different vendors' instruments. However, there are third-party processing software products that can import data files in different formats. The Centre of Forensic Sciences compared the data processing performance of one such product, ACD/MS Manager Suite, with three instrument vendors' software used for casework analysis. This product was tested for its compatibility with the existing software, its capability to load and present data, and to initiate searches of commercial libraries. The study shows that the MS Manager module provides a means for the forensic analyst to view, process, and report on data from different sources in one software package.


Rapid, selective and homogeneous brain cooling with transnasal flow of ambient air for pediatric resuscitation.
Neurologic outcome from out-of-hospital pediatric cardiac arrest remains poor. Although therapeutic hypothermia has been attempted in this patient population, a beneficial effect has yet to be demonstrated, possibly because of the delay in achieving target temperature. To minimize this delay, we developed a simple technique of transnasal cooling. Air at ambient temperature is passed through standard nasal cannula with an open mouth to produce evaporative cooling of the nasal passages. We evaluated efficacy of brain cooling with different airflows in different size piglets. Brain temperature decreased by 3°C within 25 minutes with nasal airflow rates of 16, 32, and 16 L/min in 1.8-, 4-, and 15-kg piglets, respectively, whereas rectal temperature lagged brain temperature. No substantial spatial temperature gradients were seen along the neuroaxis, suggesting that heat transfer is via blood convection. The evaporative cooling did not reduce nasal turbinate blood flow or sagittal sinus oxygenation. The rapid and selective brain cooling indicates a high humidifying capacity of the nasal turbinates is present early in life. Because of its simplicity, portability, and low cost, transnasal cooling potentially could be deployed in the field for early initiation of brain cooling prior to maintenance with standard surface cooling after pediatric cardiac arrest.


[New methods for studying drug associated risk: experience of the Toulouse Regional Pharmacovigilance Center].
This review examines the methods used to study adverse drug reactions (ADRs) and to quantify drug risk in pharmacovigilance. Beside analysis of spontaneous reports (the basic and universal alert method in pharmacovigilance), epidemiological methods can also be used. Classical methods are based on intensive recording, case-control or cohort studies, and clinical trials. Other more recent methods have been applied to pharmacovigilance. Using recent personal data, the authors present and discuss these new methods. Case/non-case studies quantify drug risk based on a pharmacovigilance database, and are used as signals in pharmacovigilance. Analysis of laboratory data can also be used to evaluate biological ADRs such as elevated liver enzyme and creatine phosphokinase levels. Cross-linkage studies can be used to minimize the consequences of under-notification in pharmacovigilance. Finally, ADR perception analysis is a useful method to evaluate the perceived social and medical importance of drug risks in different populations (public, pharmacists, general practitioners, medical specialists).


Retention of pharmaceutical residues and microorganisms at the Altendorf retention soil filter.
A study has been conducted on a retention soil filter (RSF) to test its effectiveness in removing pharmaceutical residues and microorganisms from combined sewer overflows (CSOs). Efficient removal of solids, nutrients and heavy metals has already been proven. The possibility that organic micropollutants and microorganisms are also retained by the use of RSFs has been identified, but data are lacking. Results obtained in this study, in which testing for removal by a RSF of numerous micro-pollutant substances was performed, are most promising. The pharmaceuticals diclofenac and ibuprofen are presented in detail as examples of such micropollutants. Both showed a reduction in positive samples of more than 55% as well as a significant reduction in median and maximum concentrations. For microorganisms such as Escherichia coli, coliphages and Giardia lamblia (cysts), an average reduction in concentrations by three logarithmic steps (99.9%) was achieved. These results add to the evidence that using a RSF in the advanced treatment of wastewater from CSOs reduces the exposure of water-courses to pharmaceutical residues and microbial contamination.


Working with identity and self-soothing in Emotion-Focused Therapy for Couples.
This paper will outline new developments in Emotion-Focused Therapy for Couples (EFT-C) (Greenberg & Goldman, Emotion-focused couples therapy: The dynamics of emotion, love, and power, Washington, DC, American Psychological Association, 2008). People are seen as primarily motivated by their affective goals and the regulation of emotional states. The three motivational systems of attachment, identity, and attraction/liking, viewed as reflective of the core concerns people bring to therapy, are briefly outlined and elaborated. The five-stage model of EFT-C is briefly described. The paper will then provide two illustrations, one that demonstrates how EFT-C therapists work with core issues related to identity, and the other that shows how therapy can promote self-soothing. In the first example, annotated transcripts taken from therapy sessions illustrate how an EFT therapist addresses issues of identity in a highly distressed couple. The second example demonstrates how to facilitate work with individuals within the couples' context to engender and develop capacities for self-soothing, seen as fundamental for the promotion of healthy emotion regulation and couples' overall health.


Determinants of urinary deoxynivalenol and de-epoxy deoxynivalenol in male farmers from Normandy, France.
Dietary exposure to deoxynivalenol (DON) from contaminated cereal crops is frequent in Europe, and farm workers who handle grain or silage may be at additional risk. In this study we refined a urinary assay for DON and present a novel assay for the DON metabolite de-epoxy-deoxynivalenol (DOM-1). These were applied to a pilot survey of male French farmers (n = 76, aged 23-74). DON was detected in 75/76 samples (range 0.5-28.8 ng/mL) and DOM-1 in 26/76 samples (range 0.2-2.8 ng/mL). In multivariate analysis including creatinine as a covariate, bread consumption, other cereal consumption, and maize acreage contributed to the model, explaining the variation in urinary "DON and DOM-1" concentration combined (R(2) = 0.33). This is the first exposure biomarker survey for DON in a French population, and the first demonstration of urinary DOM-1 in humans. Further investigations into occupational activity, handling, or airborne exposures would be informative.


Genetic analysis of the processing of a spliced tRNA.
We analyzed the effect of 18 single nucleotide changes on the processing of the transcripts produced by cloned yeast tRNATyr genes after microinjection into the nucleus of living Xenopus oocytes. The processing step most easily blocked by mutation is the early maturation of the 5' and 3' termini of the tRNATyr primary transcript, involving removal of 5'-leader and 3'-trailer sequences and CCA addition. The enzymes seem to recognize the whole tRNA cloverleaf structure since mutations in all regions of the molecule can stop processing. Mutations that affect splicing of the 92-nucleotide precursor (which has mature ends but still contains the intervening sequence, and is the normal substrate for the splicing enzymes), are located in the vicinity of the intervening sequence. Base modification enzymes that add pseudouridine, 1-methyladenosine and 5-methylcytosine appear rather insensitive to changes in secondary and tertiary structure of early transcripts in the 16 mutants examined. These enzymes may recognize only limited regions of the precursor RNA. RNA polymerase III behaves as if able to count the number of Us added before termination; and aberrant termination products in two mutants suggest that the secondary structure of the nascent transcript can be very imortant in eukaryotic transcription termination.


Molecular pharmacology of GPCRs.
This article is part of a themed section on Molecular Pharmacology of GPCRs. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.21/issuetoc.


Efficacy of twice-weekly multiple micronutrient supplementation for improving the hemoglobin and micronutrient status of anemic adolescent schoolgirls in Bangladesh.
Although iron deficiency is a major cause of anemia, other micronutrient deficiencies may also play a role. We examined whether multiple micronutrient supplementation is more efficacious than is supplementation with iron and folic acid alone for improving the hemoglobin and iron status of anemic adolescent girls in Bangladesh. Anemic (hemoglobin < 12.0 g/dL) girls (n = 197) aged 14-18 y from rural schools in Dhaka District were entered into a randomized double-blind trial and received twice-weekly supplements of iron and folic acid (IFA group) or multiple micronutrients (15 micronutrients, including iron and folic acid; MMN group) for 12 wk. At recruitment, the characteristics of the girls in the 2 groups were not significantly different, except for family size and body mass index. At the end of the study, although both groups benefited significantly from supplementation, mean changes in hemoglobin and serum ferritin concentrations were not significantly different between groups. Compared with the IFA group, girls in the MMN group had significantly greater increases in mean serum vitamin A, plasma vitamin C, red blood cell folic acid, and riboflavin concentrations (assessed as erythrocyte glutathione reductase activation coefficient). After 12 wk of supplementation, only the prevalence of vitamins A and C and riboflavin deficiencies decreased more significantly in the MMN group than in the IFA group. Twice-weekly MMN supplementation for 12 wk significantly improved the status of the micronutrients assessed but was not more efficacious than was supplementation with iron and folic acid alone in improving the hematologic status of anemic adolescent girls. More frequent doses may be needed to achieve full benefit.


Severe acute respiratory syndrome: global initiatives for disease diagnosis.
We present a retrospective analysis of the available articles on severe acute respiratory syndrome (SARS) published since the outbreak of the disease. SARS is a new infectious disease caused by a novel coronavirus. Originating in Guangdong, Southern China, at the end of 2002, it has spread to regions all over the world, affecting more than 8000 people. With high morbidity and mortality, SARS is an important respiratory disease which may be encountered world-wide. The causative virus was identified by a WHO-led network of laboratories, which identified the genome sequence and developed the first molecular assays for diagnosis. For the respiratory physician, detecting SARS in its earliest stages, identifying pathways of transmission, and implementing preventive and therapeutic strategies are all important. The WHO and the CDC have published helpful definitions of 'suspected' and 'probable' cases. However, the symptoms of the disease may change, and laboratory tests and definitions are still limited. Even in a situation of no new cases of infection, SARS remains a major respiratory health hazard. As with influenza virus outbreaks, new epidemics may arise at the end of each year.


Brincidofovir clearance of acyclovir-resistant herpes simplex virus-1 and adenovirus infection after stem cell transplantation.
Infections with adenovirus (AdV) and herpesviruses can result in considerable morbidity and mortality in pediatric hematopoietic stem cell transplant (SCT) recipients. Herpes simplex virus (HSV) reactivations are usually prevented by acyclovir (ACV) prophylaxis, whereas cidofovir (CDV) has been used off indication to manage AdV infections. We report a child with myelodysplastic syndrome undergoing multiple SCT, who experienced HSV-1 disease including severe mucositis and herpetic whitlow, as well as high viral load AdV DNAemia. Both ACV and CDV were ineffective; however, viral loads were decreased with brincidofovir, resulting in viral clearance. A subsequent Epstein-Barr virus disease with relevant meningoencephalitis responded to rituximab.


Septic arthritis in patients with rheumatoid disease: a still underdiagnosed complication.
Eight cases of septic arthritis occurring in patients with rheumatoid arthritis are reviewed. The difficulty in diagnosis of this condition is due in part to a failure of these patients to respond normally to infection. Consequently patients often present late in the course of their septic episode and treatment is often delayed. The importance of early diagnosis and treatment of the infection is stressed by the high mortality rate in this group of patients. Many factors operate to encourage infection in rheumatoid arthritis and the current concepts of the problem are reviewed.


Anti-inflammatory and neuroprotective activity of boswellic acids in rotenone parkinsonian rats.
There is evidence that inflammation and oxidative stress contribute to the neurodegenerative changes observed in Parkinson's disease. Unfortunately, there is a lack of curative treatment for this debilitating movement disorder. Boswellic acids (BAs) are pentacyclic triterpene molecules of plant origin that have been utilized for treating many inflammatory conditions. The current study was conducted to explore the protective role of BAs against rotenone-induced experimental parkinsonism. Twenty-four rats were assigned to one of four treatment groups. The first two groups were a vehicle group (no rotenone) and a rotenone control group in which rats received rotenone (1 mg/kg) every 48 h. The next 2 groups received rotenone (1 mg/kg every 48 h) plus protective oral doses of BAs (125 or 250 mg/kg daily). Rats in the rotenone group showed motor dysfunction when tested in the open-field arena and cylinder and rotarod tests. Moreover, inflammatory markers increased, whereas the dopamine level was lower in the striata of rats in the rotenone group versus those in the vehicle group. BAs taken by rats with rotenone-induced parkinsonism showed enhanced general motor performance, reduced inflammatory markers, and increased striatal dopamine level and nigral tyrosine hydroxylase immunostaining. In conclusion, BAs are promising agents in slowing the progression of Parkinson's disease if appropriate data become available about their safety and efficacy in humans.


Pitfalls and sources of error in staging rectal cancer with endorectal us.
Endorectal ultrasound (US) is an accurate technique for local staging of rectal cancer. Because the choice of surgery depends on the level of tumor invasion and lymph node involvement, the surgeon relies largely on endorectal US findings when planning treatment. However, staging inaccuracies can occur due to over or underestimation of tumor depth, misinterpretation of lymph node involvement, and operator inexperience. Technical pitfalls in US of the rectal wall include proximity of the lesion to the anal verge, improper balloon inflation, a nonperpendicular imaging plane, shadowing artifacts due to air or stool, reverberation artifacts, refraction artifacts, and a transducer gain setting that is too high. Sources of error in tumor staging with endorectal US include interpretation differences, endosonologist bias, tumor location, tumor stenosis, peritumoral inflammation, postbiopsy and postsurgical changes, post irradiation changes, hemorrhage, and pedunculated or villous tumors. Node size and appearance are not reliable indicators of lymph node involvement. Awareness of these sources of error will improve the technical quality of endorectal US studies and allow more accurate tumor staging.


Modelling wastewater transformation in sewers based on ASM3.
A deterministic model for wastewater transformations in the sewer that includes activity in the wastewater and in the sewer wall biofilm was developed. It is based on the Activated Sludge Model No. 3 (ASM3). The mass transfer processes in the biofilm were modelled with the effectiveness approach. This approach allowed for fast calculation, required only a limited number of parameters and gave good results. The ASM3 related parameters were calibrated and validated with laboratory experiments. An equation for the aeration of the wastewater through the water surface was determined with a method based on the inert gas sulphur hexafluoride. The other model parameters such as wall roughness, attachment of particles to the biofilm and biofilm erosion were calibrated and validated with field experiments in a main sewer. The resulting model described the oxygen concentration and wastewater respiration well. It can be easily linked for integrated urban hydrology modelling with the WWTP Activated Sludge Model and the newly proposed River Water Quality Model No. 1.


Analysis of CXCR3 and atypical variant expression and signalling in human T lymphocytes.
Members of the chemokine (Chemotactic cytokines) superfamily and their receptors play a major role in trafficking of immune cells under homeostatic and inflammatory conditions. The chemokine receptor CXCR3 is expressed mainly on activated T lymphocytes and binds three pro-inflammatory, interferon-gamma-inducible chemokines: monokine induced by IFN-gamma (Mig/CXCL9), IFN-gamma-induced protein-10 (IP-10/CXCL10) and IFN-gamma-inducible T-cell alpha-chemoattractant (I-TAC/CXCL11). CXCR3 and its agonists are involved in a variety of inflammatory pathologies, making this receptor an attractive target for the design of new anti-inflammatory drugs. Interestingly, a growing body of evidence suggests the existence of at least two novel variants of CXCR3, namely CXCR3-B and CXCR3-alt, which present challenges in the design of new anti-inflammatory drugs targeting CXCR3. In this chapter, we describe the collection, isolation and activation of human peripheral blood-derived T lymphocytes and methods to examine the expression of CXCR3 and its atypical variants at both mRNA and protein levels, as well as protocols for exploring the biochemical and functional responses of T lymphocytes to all known CXCR3 agonists.


Doubts about medical humanities.
Editor's Introduction: The teaching of analytical skills to health workers takes many different forms, and is done in widely divergent institutions and cultures. In recent years medical humanities has been one of the most strongly advocated additions to the undergraduate medical curriculum (the medical humanities were championed in the previous issue of Health Care Analysis). However, in this issue, the discipline is taken to task.


[Not Available].
A review is made of deontology in the history of Russian medicine. On the basis of extensive case material, the author traces up a number of general moral and ethical virtues, formed in the course of historical development of Russian medicine. Numerous examples are cited of self-denying service, fulfulled doctor's duty and self-sacrificing in the course of investigating various, threatening the health of people, diseases. The author makes an attempt to substantiate the social necessity of deontology and to help arming the modern generations of medical workers with the virtues of the progressive physicians of the past. He deals with some actual problems in the practice of socialist health services in the Soviet Union.


Proacrosin activation mechanisms in capacitated and frozen-thawed boar spermatozoa.
The main objective of the current study was to explore the different activation mechanisms of capacitation and freeze-thawed spermatozoa. Using SDS-PAGE and Western blotting, the conversion process of boar proacrosin during freeze-thawing and capacitation of spermatozoa was analyzed. The results revealed that capacitated spermatozoa exhibited a greater fluorescence area than that of the freeze-thawed spermatozoa, which were smaller than those of the fresh group. Fresh spermatozoa displayed 45- and 35- kDa protein bands, while those of freeze-thawed andcapacitated spermatozoa displayed 45-, 35- and 28-kDa bands. In summary, these data indicate that proacrosin is activated, thus becoming α- and β-acrosins and a 28-kDa protein during capacitation and freeze-thawing.


The development and persistence of bronchialgland hypertrophy and goblet-cell hyperplasia in the pig after injection of isoprenaline.
Pigs were injected i.m. with isoprenaline sulphate on 6 consecutive days. In the bronchial mucosa of animals killed 24 hr after the sixth injection there was a significant increase in the ratio of submucosal gland thickness to bronchial-wall thickness, indicating glandular hypertrophy. The hypertrophy was due to an increase in size of mucous cells, which were filled with secretion. There was also a much higher proportion of acid glycoprotein in the mucous acini of IPN-treated pigs compared with those of controls. This acid glycoprotein was predominantly sialomucin, but a small quantity of sulphomucin, not present in the normal animal, was observed. IPN also caused a significant increase in the number of goblet cells in the bronchial epithelium, but there was no change in their glycoprotein type, most containing exclusively sialomucin. IPN produced a significant increase in the weight of the salivary and adrenal glands, and of the heart, in which the right and left ventricles were hypertrophied equally. Examination of pigs killed up to 3 mth after IPN showed that the submucosal gland hypertrophy persisted for about 1 mth and the goblet cell hyperplasia persisted for 2 mth.


Spinal Epidural Hematoma After Attempted Catheter Thrombectomy of a Large Iliofemoral Deep Venous Thrombosis: A Case Report.
The authors report the case of an 82-year-old woman with a spinal epidural hematoma following attempted catheter-directed thrombolysis of a large femoral- popliteal deep venous thrombosis. The patient rapidly developed acute motor and sensory paralysis below the level of T7 within hours of the thrombectomy procedure. Computed tomography imaging revealed that the catheter had perforated the wall of the right inferior vena cava and magnetic resonance imaging subsequently demonstrated an extensive T1-S1 dorsal epidural hematoma with compression of the thoracic spinal cord, conus medullaris, and cauda equina. Given the extent of cord infarction and the risks of extensive thoracolumbar laminectomy, decompression was not performed. The incidence, diagnosis, and management of anticoagulation- associated spinal epidural hematoma as well as the indications for catheter-directed thrombolysis of acute deep venous thrombosis are reviewed.


Colorless polyimide/organoclay nanocomposite substrates for flexible organic light-emitting devices.
We report the preparation and application of indium tin oxide (ITO) coated fluorine-containing polyimide/organoclay nanocomposite substrate. Fluorine-containing polyimide/organoclay nanocomposite films were prepared through thermal imidization of poly(amic acid)/organoclay mixture films, whilst on which ITO thin films were coated on the films using a radio-frequency planar magnetron sputtering by varying the substrate temperature and the ITO thickness. Finally the ITO coated fluorine-containing polyimide/organoclay nanocomposite substrate was employed to make flexible organic light-emitting devices (OLED). Results showed that the lower sheet resistance was achieved when the substrate temperature was high and the ITO film was thick even though the optical transmittance was slightly lowered as the thickness increased. approximately 10 nm width ITO nanorods were found for all samples but the size of clusters with the nanorods was generally increased with the substrate temperature and the thickness. The flexible OLED made using the present substrate was quite stable even when the device was extremely bended.


Strategies For Immobilization Of Bioactive Organic Molecules On Titanium Implant Surfaces - A Review.
Numerous approaches have been used to improve the tissue-implant interface of titanium (Ti) and titanium alloy (Ti6Al4V). They all aim at increasing cell migration and attachment to the metal, preventing unspecific protein adsorption and improving post-implantation healing process. Promising methods for titanium and titanium alloy surface modification are based on the immobilization of biologically active organic molecules. New and interesting biochemical approaches to such surface modification include layer-by-layer deposition of polyelectrolyte films, phage display-selected surface binding peptides and self-assembled DNA monolayer systems. The present review summarizes the scientific information about these methods, which are at in vitro or in vivo development stages, and hopes to promote their future application in dental implantology and in oral and maxillofacial surgery.


Self-accumulation of aromatics at the oil-water interface through weak hydrogen bonding.
It is well-known that the amphiphilic solutes are surface-active and can accumulate at the oil-water interface. Here, we have investigated the water and a light-oil model interface by using molecular dynamic simulations. It was found that aromatics concentrated in the interfacial region, whereas the other hydrocarbons were uniformly distributed throughout the oil phase. Similar to previous studies, such concentrations were not observed at pure aromatics-water interfaces. We show that the self-accumulation of aromatics at the oil-water interface is driven by differences in the interfacial tension, which is lower for aromatics-water than between the others. The weak hydrogen bonding between the aromatic rings and the water protons provides the mechanism for lowering the interfacial tension.


The complete mitochondrial genome of the Dipodomys ordii (Ord's kangaroo rat).
Ord's kangaroo rat is a kangaroo rat native to western North America. In this study, we first reported the complete mitochondrial genome of Dipodomys ordii that the first has the complete mitochondrial genome in the genus of Heteromyidae. The mitogenome is a circular molecule of 16 257 bp in length, containing 13 protein-coding genes, 2 ribosomal RNAs, 22 transfer RNAs and a putative displacement loop region. All protein-coding genes started with a traditional ATN codon and terminated with the mitochondria stop codon (TAA/TAG/AGA) or a single T base. The gene order and composition of mitogenome was similar to that of most other Sciurognathi species and its GC content was 36.73%. Thirteen protein-coding genes of D. ordii together with eight other closely species were used to construct the species phylogenetic tree for verification of the accuracy of new determined mitogenome sequences.