MLC compatibility, HLA-D and DR typing in cadaver kidney transplantations.
During a period of one year, spleen lymphocytes from cadaver kidney donors were cryopreserved for later investigations. The HLA-D types of 33 donors and the corresponding 39 recipients were determined in six experiments and the reactivities of the lymphocytes of the individual recipients towards those of the donors were assayed in MLC. The MLC experiments included a sufficient number of unrelated responders and stimulators to allow an estimate of the specific MLC reactivity by the stabilized relative response. A strong and significant correlation was found between specifically low reactivity of recipient lymphocytes against donor lymphocytes and graft survival. A correlation was also found between HLA-D compatibility and graft survival. DR typing was performed on the same donor-recipient pairs. In sixteen cases the DR typing of the recipients was initially a technical failure but successful when repeated on cryopreserved lymphocytes. There was a significant correlation between HLA-DR compatibility and graft survival. HLA-A, B matching and pretransplant blood transfusion did not significantly affect graft survival in this material.


The DIAMORFOSIS (DIAgnosis and Management Of lung canceR and FibrOSIS) survey: international survey and call for consensus.
Currently there is major lack of agreement on the diagnostic and therapeutic management of patients with idiopathic pulmonary fibrosis (IPF) and lung cancer. Our aim was to identify variations in diagnostic and management strategies across different institutions and provide rationale for a consensus statement on this issue. This was a joint-survey by European Respiratory Society (ERS) Assemblies 8, 11 and 12. The survey consisted of 25 questions. Four hundred and ninety-four (n=494) physicians from 68 different countries and five continents responded to the survey. Ninety-four per cent of participants were pulmonologists, 1.8% thoracic surgeons and 1.9% oncologists; 97.7% were involved in multidisciplinary team approaches on diagnosis and management. Regular low-dose high-resolution computed tomography (HRCT) scan was used by 49.5% of the respondents to screen for lung cancer in IPF. Positron emission tomography (PET) scan and endobronchial ultrasound (EBUS) is performed by 60% and 88% to diagnose nodular lesions with mediastinal lymphadenopathy in patients with advanced and mild IPF, respectively. Eighty-three per cent of respondents continue anti-fibrotics following lung cancer diagnosis; safety precautions during surgical interventions including low tidal volume are applied by 67%. Stereotactic radiotherapy is used to treat patients with advanced IPF (diffusing capacity of the lung for carbon monoxide (D LCO) <35%) and otherwise operable nonsmall cell lung cancer (NSCLC) by 54% of respondents and doublet platinum regimens and immunotherapy for metastatic disease by 25% and 31.9%, respectively. Almost all participants (93%) replied that a consensus statement for the management of these patients is highly warranted. The diagnosis and management of IPF-lung cancer (LC) is heterogeneous with most respondents calling for a consensus statement.


[Flow cytometric analysis of the DNA content of the urinary bladder cancers--study on the DNA heterogeneity in bladder cancers].
To evaluate the clinical relevance between the DNA ploidy and histopathology, and the incidence of the DNA heterogeneity in patients with bladder cancers. Flow cytometry (FCM) was used to study the DNA ploidy in 63 patients who underwent total cystectomy. The DNA ploidy and DNA index were analyzed by FCM in total 328 paraffin embedded samples (5.2 samples per case on the average). The DNA ploidy of 52 bladder cancers, that had coexisted after total cystectomy, showed that 24 cases, 46% were DNA aneuploid and 18 cases, 35% had DNA heterogeneity. The DNA ploidy of 11 cases that were eradicated after cystectomy was all DNA diploid. There were significantly good correlation among DNA ploidy pattern and intravesical involvement (lymph duct involvement and venous involvement), but were not among the DNA ploidy pattern and tumor grade and stage. With regard to the evaluation of two vertical divided samples of tumors, DNA aneuploid had been not always recognized in the deeper sample, therefore, we did not determine that there was good correlation between the DNA ploidy and the tumor invasion. These data suggest that although the incidence of DNA heterogeneity in bladder cancers (35%) is thought to be relatively small, the DNA ploidy will be able to the important prognosticating factor in bladder cancers.


Influence of surfactant-treated starch on the disintegration and dissolution of sulphadiazine tablets.
The effects of treating cassava starch with sodium lauryl sulphate and Polysorbate 80 and the method of incorporating the treated and plain starch as disintegrant on the physical properties of sulphadiazine tablets were investigated. Disintegration and dissolution rates were faster with starch in which surfactant was incorporated in dry state than with starch treated with solution of surfactant. A direct correlation was observed between the Hardness-Friability Index and T90 values. Polysorbate 80-treated starch exhibited a better dissolution profile than SLS-treated starch.


Faecal genetic analysis to determine the presence and distribution of elusive carnivores: design and feasibility for the Iberian lynx.
Noninvasive methods using genetic markers have been suggested as ways to overcome difficulties associated with documenting the presence of elusive species. We present and assess a novel, reliable and effective molecular genetic technique for the unequivocal genetic identification of faeces from the endangered Iberian lynx (Lynx pardinus). From mitochondrial DNA (mtDNA) cytochrome b and D-loop region sequences, we designed four species-specific primers (for products 130-161 bp long) that were considered to be likely to amplify degraded DNA. We compared two DNA extraction methods, various DNA amplification conditions and the robustness and specificity of the primer pairs with 87 lynx samples from 5 potentially different lynx populations and with 328 samples of other carnivore species. The utility of the identification technique was tested with faeces of different ages, with faeces from controlled field experiments, and with faeces collected from locales with possible lynx populations from throughout the state of Andalusia, Spain (8052 km2). Faecal mtDNA extraction was more efficient using PBS wash of the faeces instead of a faeces homogenate. Our assay increased from 92.6 to 99% efficiency with a second amplification and a reduction in template concentration to overcome polymerase chain reaction (PCR) inhibition. Our assay never produced false positives, and correctly identified all lynx faeces. Of 252 faeces samples of unknown species collected throughout Andalusia, 26.6% (from three different areas) were classified as Iberian lynx, 1.4% showed evidence of PCR inhibition and 1.2% were of uncertain origin. This method has proven to be a reliable technique that can be incorporated into large-scale surveys of Iberian lynx populations and exemplifies an approach that can easily be extended to other species.


Thrombotic microangiopathy in patients with acquired immunodeficiency syndrome before and during the era of introduction of highly active antiretroviral therapy.
The incidence of thrombotic microangiopathy (TMA) was retrospectively evaluated in a cohort of 1223 patients with acquired immunodeficiency syndrome (AIDS) who were observed from January 1985 through December 1996 (before the era of highly active antiretroviral therapy [HAART]), and the incidence was prospectively assessed for 347 patients with AIDS during the period of January 1997 through December 2000 (during the HAART era). Seventeen cases were reported in the former cohort (1.4%). The increased risk of developing TMA was statistically significant in patients with cryptosporidiosis or AIDS-related cancer but not in those with other diseases. In the 1997-2000 cohort, no cases were observed during follow-up. TMA is associated with conditions observed in the advanced phases of human immunodeficiency virus infection. The disappearance of TMA during the HAART era may be explained by the lower percentage of patients with long-lasting CD4+ T cell depletion, advanced AIDS, or cryptosporidiosis or who have undergone multiple courses of chemotherapy for treatment of cancer.


Phorbol ester pretreatment desensitizes the inhibition of Ca2+ channels induced by kappa-opiate, alpha 2-adrenergic, and muscarinic receptor agonists.
Acute treatment of rat spinal cord-dorsal root ganglion cocultured neurons with 12-O-tetradecanoylphorbol 13-acetate (TPA), a known activator of protein kinase C, inhibited the dihydropyridine-sensitive voltage-dependent 45Ca2+ influx measured in these cells (IC50 of approximately 100 nM, 66% inhibition at 1 microM TPA). However, prolonged preincubation (24 h) of the cells with 100 nM TPA followed by extensive washing completely abolished, i.e., desensitized, the capacity of a second application of TPA to inhibit the activity of the voltage-dependent Ca2+ channels. Moreover, this treatment also abolished the inhibition of Ca2+ influx produced by kappa-opiate as well as by alpha 2-adrenergic and muscarinic receptor agonists. Substantial desensitization was already observed following a 1-h pretreatment with 100 nM TPA. In contrast to TPA, an inactive phorbol ester (4 beta-phorbol 13-acetate) did not affect the inhibition of the voltage-dependent Ca2+ influx by these receptor agonists. These results suggest that protein kinase C may have a role in the modulation of Ca2+ channels by kappa-opiate, alpha 2-adrenergic, and muscarinic receptor agonists.


Occurrence of Idiopathic Pulmonary Fibrosis in Italy: Latest Evidence from Real-World Data.
The aim of the study was to evaluate the trend in the incidence of idiopathic pulmonary fibrosis (IPF) in a real-world setting of the Marche region, a region of Central Italy, between 2014 and 2019. This observational prospective study was based on administrative databases of hospital discharges and drug prescriptions. All adult residents in the Marche Region with a first prescription of antifibrotic drugs, or a first hospitalization with a diagnosis of IPF during the study period, were identified as incident cases of IPF. A multiple Poisson regression analysis was used to estimate the IPF incidence trend, adjusted for age, sex, and health conditions. The mean incidence rate was 9.8 cases per 100,000 person-years. A significant increasing trend of 6% per year was observed. The incidence rates were significantly higher in males than females, older subjects, and those with poorer health conditions. To our knowledge, this is the first study evaluating incidences of IPF over a 6-year period in Italy, combining hospital discharge and drug prescription databases. The study highlights that the combined use of two secondary sources is a reliable strategy to accurately identify new cases of IPF when the appropriate disease registry is lacking.


Links Between Emotion Regulation Strategies and Internalizing and Externalizing Problems in Chinese American Adolescents.
Adolescents from immigrant families are at risk for psychological health issues due to acculturative stress and the marked increases in internalizing and externalizing problems accompanying adolescence. Emotion Regulation (ER) may be an important protective resource for these adolescents. The present study tested the links between ER and internalizing and externalizing problems in 131 first- and second-generation Chinese American adolescents. Adolescents' reappraisal was associated with less internalizing and externalizing problems; adolescents' suppression was associated with more internalizing and externalizing problems. These links were somewhat more pronounced in adolescents high in American cultural orientation as well as in adolescents low in Chinese cultural orientation. Our results advance our understanding of the links between ER and psychological health in Chinese American youth.


Gut microbiota composition modifies fecal metabolic profiles in mice.
The gut microbiome is known to be extensively involved in human health and disease. In order to reveal the metabolic relationship between host and microbiome, we monitored recovery of the gut microbiota composition and fecal profiles of mice after gentamicin and/or ceftriaxone treatments. This was performed by employing (1)H nuclear magnetic resonance (NMR)-based metabonomics and denaturing gradient gel electrophoresis (DGGE) fingerprint of gut microbiota. The common features of fecal metabolites postantibiotic treatment include decreased levels of short chain fatty acids (SCFAs), amino acids and primary bile acids and increased oligosaccharides, d-pinitol, choline and secondary bile acids (deoxycholic acid). This suggests suppressed bacterial fermentation, protein degradation and enhanced gut microbial modification of bile acids. Barnesiella, Prevotella, and Alistipes levels were shown to decrease as a result of the antibiotic treatment, whereas levels of Bacteroides, Enterococcus and Erysipelotrichaceae incertae sedis, and Mycoplasma increased after gentamicin and ceftriaxone treatment. In addition, there was a strong correlation between fecal profiles and levels of Bacteroides, Barnesiella, Alistipes and Prevotella. The integration of metabonomics and gut microbiota profiling provides important information on the changes of gut microbiota and their impact on fecal profiles during the recovery after antibiotic treatment. The correlation between gut microbiota and fecal metabolites provides important information on the function of bacteria, which in turn could be important in optimizing therapeutic strategies, and developing potential microbiota-based disease preventions and therapeutic interventions.


The pattern of slow wave activity in spontaneously occurring long sleep.
The aim of the present study was to estimate the time course of slow wave activity (SWA) in naturally occurring long sleep episodes (ad lib). Sixteen male shift workers were subjected to 24 h ambulatory polysomnography in connection with an afternoon shift. The EEG was subjected to spectral analysis (FFT) as well as to traditional sleep stage scoring. SWA (0.5-4.5 Hz band, both nonREM and REM sleep) declined exponentially and reached an asymptote by the fifth or sixth sleep cycle. However, half the subjects showed a reduced SWA in the first cycle, with a subsequent recovery in the second cycle. The SWA reduction of the first cycle was associated with a reduced REM-latency and it was suggested that uncontrolled external influences of the real life settings may have affected SWA in the first cycle. It was concluded that the decline of SWA across time may deviate from an exponential shape under real life conditions.


Are greenhouse gas emissions and cognitive skills related? Cross-country evidence.
Are greenhouse gas emissions (GHG) and cognitive skills (CS) related? We attempt to answer this question by exploring this relationship, using cross-country data for 150 countries, for the period 1997-2012. After controlling for the level of economic development, quality of political regimes, population size and a number of other controls, we document that CS robustly predict GHG. In particular, when CS at a national level increase by one standard deviation, the average annual rate of air pollution changes by nearly 1.7% (slightly less than one half of a standard deviation). This significance holds for a number of robustness checks.


Chlorophyll a fluorescence and carbon assimilation in developing leaves of light-grown cucumber.
The development of photochemical activity and carbon assimilation in light-grown cucumber (Cucumis sativus L. cv Natsusairaku) leaves was studied to determine the pattern of acquisition and its relationship to leaf growth and expansion. Measurements of chlorophyll a fluorescence showed that leaves acquire photochemical function over a period of 6 or more days, and gas exchange studies showed increases in carbon assimilation over a parallel time period. As leaves expand and mature, they undergo a sequential, three-step series of changes in fluorescence response. The initial kinetics show the absence of wholly functional quenching mechanisms. Dynamic imaging of fluorescence kinetics showed that a temporal series of changes occurred within defined areas of individual developing leaves. The spatial acquisition of photochemical activity in leaves was basipetal as is their directional expansion, development of air spaces and stomata, and the cessation of imported carbon.


Operative versus closed treatment of primary dislocation of the patella. Similar 2-year results in 125 randomized patients.
To assess whether initial surgery is beneficial for patients with primary dislocation of the patella, we carried out a prospective randomized study. Knee stability was examined under anesthesia, and associated injuries were excluded by diagnostic arthroscopy. 55 patients then had closed treatment and 70 patients were operated on with individually adjusted proximal realignment procedures. Surgery gave no benefit based on 2 years of follow-up. The subjective result was better in the non-operative group in respect of mean Houghston VAS knee score (closed 90, operative 87), but similar in terms of the patient's own overall opinion and mean Lysholm II knee score. Recurrent instability episodes (redislocation or recurrent subluxation) occurred in 20 nonoperated and in 18 operated patients. Of these, 15 and 12, respectively, then suffered redislocations. Function was better after closed treatment. Serious complications occurred after surgery in 4 patients. In conclusion, the recurrence of patellar dislocation may be more frequent than reported, whatever the form of treatment. Routine operative management cannot be recommended for primary dislocation of the patella.


Changes of plasma endothelin concentrations before and after percutaneous balloon mitral valvuloplasty in patients with mitral stenosis.
Plasma concentrations of endothelin in blood from the femoral vein and the antecubital vein were measured in 35 patients with mitral stenosis and heart failure before and after percutaneous balloon mitral valvuloplasty (PBMV). The basal plasma concentrations of endothelin in blood from the antecubital vein in the patients were significantly higher than those in 32 control subjects (15.40 +/- 3.32 vs. 9.59 +/- 2.66 pg/ml, P < 0.001). Plasma endothelin concentrations in patients in New York Heart Association functional classes II and III were significantly higher than those in control subjects, respectively. The concentrations of endothelin in patients with atrial fibrillation were also significantly higher than those in patients with normal sinus rhythm. Ten to fifteen minutes after PBMV, plasma endothelin concentrations in blood from the femoral vein significantly decreased from 16.14 +/- 3.34 to 13.74 +/- 3.78 pg/ml (P < 0.01). Seventy-two hours after the procedure, the concentrations of endothelin in blood from the antecubital vein had fallen to 12.31 +/- 2.55 pg/ml (P < 0.001 vs. before PBMV and control subjects). Plasma endothelin concentrations still tended to be higher in patients with atrial fibrillation than those in normal sinus rhythm, but the difference did not reach statistical significance. There were weak but significantly correlations of plasma endothelin concentrations with the mean left atrial pressure (r = 0.424, P < 0.001), mean right atrial pressure (r = 0.323, P < 0.01), mean transmitral pressure gradient (r = 0.397, P < 0.001), heart rate (r = 0.350, P < 0.005) and mitral valve area (r = -0.454, P < 0.001) in the patients before and after PBMV.


AULA virtual reality test as an attention measure: convergent validity with Conners' Continuous Performance Test.
The majority of neuropsychological tests used to evaluate attention processes in children lack ecological validity. The AULA Nesplora (AULA) is a continuous performance test, developed in a virtual setting, very similar to a school classroom. The aim of the present study is to analyze the convergent validity between the AULA and the Continuous Performance Test (CPT) of Conners. The AULA and CPT were administered correlatively to 57 children, aged 6-16 years (26.3% female) with average cognitive ability (IQ mean = 100.56, SD = 10.38) who had a diagnosis of attention deficit/hyperactivity disorder (ADHD) according to DSM-IV-TR criteria. Spearman correlations analyses were conducted among the different variables. Significant correlations were observed between both tests in all the analyzed variables (omissions, commissions, reaction time, and variability of reaction time), including for those measures of the AULA based on different sensorial modalities, presentation of distractors, and task paradigms. Hence, convergent validity between both tests was confirmed. Moreover, the AULA showed differences by gender and correlation to Perceptual Reasoning and Working Memory indexes of the WISC-IV, supporting the relevance of IQ measures in the understanding of cognitive performance in ADHD. In addition, the AULA (but not Conners' CPT) was able to differentiate between ADHD children with and without pharmacological treatment for a wide range of measures related to inattention, impulsivity, processing speed, motor activity, and quality of attention focus. Additional measures and advantages of the AULA versus Conners' CPT are discussed.


May the first-line treatment for foreign body aspiration in childhood be flexible bronchoscopy?
Rigid bronchoscopy (RB) is the traditional treatment in foreign body (FB) aspiration in childhood but is a traumatic and invasive procedure. However, flexible optic bronchoscopy (FoB) is a noninvasive and nontraumatic respiratory intervention. The aim of this study was to evaluate FoB as a first-line treatment modality in pediatric cases presenting with a preliminary diagnosis of FB aspiration. Subjects who underwent FoB under general anesthesia with the preliminary diagnosis of FB aspiration were enrolled in this cross-sectional study. Two cases were inherited from pediatric surgery because they were not removed with FoB. The demographic, clinical, and radiological findings at the presentation were recorded. Results of success rate and complications were recorded. Among the FB aspiration cases age range of 7 months to 16 years. FoB demonstrated a FB in the airways of 31 (62.2%) subjects. The duration of the symptoms in the subjects was 9.1 ± 8.8 days. Three of the cases were taken over from pediatric surgery because they were not removed with RB. Most commonly encountered FB's were organic materials (n = 20, 64%). FoB was successful in removing the FB from the proximal and also distal airways in 93% of the subjects. No significant complications and side effects were observed except post-FoB cough. This result has shown that FoB for the treatment of FB aspiration is successful in removing FB aspiration from both the proximal and distal airway that the RB cannot remove. Furthermore, FoB did not have any significant airway complication. FoB may be used as the first-line treatment modality for FB aspiration instead of RB in childhood the fact that noninvasive and nontraumatic respiratory intervention.


The symbiont side of symbiosis: do microbes really benefit?
Microbial associations are integral to all eukaryotes. Mutualism, the interaction of two species for the benefit of both, is an important aspect of microbial associations, with evidence that multicellular organisms in particular benefit from microbes. However, the microbe's perspective has largely been ignored, and it is unknown whether most microbial symbionts benefit from their associations with hosts. It has been presumed that microbial symbionts receive host-derived nutrients or a competition-free environment with reduced predation, but there have been few empirical tests, or even critical assessments, of these assumptions. We evaluate these hypotheses based on available evidence, which indicate reduced competition and predation are not universal benefits for symbionts. Some symbionts do receive nutrients from their host, but this has not always been linked to a corresponding increase in symbiont fitness. We recommend experiments to test symbiont fitness using current experimental systems of symbiosis and detail considerations for other systems. Incorporating symbiont fitness into symbiosis research will provide insight into the evolution of mutualistic interactions and cooperation in general.


Correlation between skin surface temperature over masticatory muscles and pain intensity in women with myogenous temporomandibular disorder.
Pain is a common clinical manifestation in individuals with temporomandibular disorder (TMD). The literature report changes in microcirculation in this condition. The aim of the present study was to correlate skin surface temperature at the central point of the masticatory muscles with pain intensity in women with myogenous TMD. The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) and the visual analogue scale (VAS) were used to divide 40 female university students into four groups: control group (n=10), mild pain group (n=10), moderate pain group (n=10) and severe pain group (n=10). Infrared thermography was used to assess the masticatory muscles. No significant correlations were found between pain intensity and skin surface temperature over the left masseter (p=0.368), right masseter (p=0.618), left anterior temporalis (p=0.293) and right anterior temporalis (p=0.922) muscles. No correlations were found between pain intensity and asymmetry of the masseter (p=0.375) and anterior temporalis (p=0.090) muscles. Moreover, no significant difference in skin surface temperature (p> 0.05) was found among the different groups. Pain intensity in women with myogenous TMD was not associated with skin surface temperature at the central point of the masseter and anterior temporalis muscles.


The effects of some anti-arthritic drugs and cytokines on the shape and function of rodent macrophages.
Non-steroidal antiinflammatory drugs (NSAID) enhanced the spreading of mouse and rat peritoneal macrophages attached to either plastic or glass. This was probably due to drug inhibition of prostaglandin E2 (PGE2) production since spreading was also inhibited by adding exogenous PGE2. Corticosteroids (dexamethasone, cortisol and prednisolone) and some immunosuppressants (6-mercaptopurine, methotrexate, but not cyclosporin-A) also enhanced in-vitro spreading of murine peritoneal macrophages. Some recombinant cytokines (human tumour necrosis factor alpha and beta, murine tumour necrosis factor alpha, and murine interferon gamma, but not human interferon gamma) also enhanced the spreading of mouse peritoneal macrophages in vitro. Scanning electron microscopy revealed significant differences in morphology of cells induced to spread by these drugs and cytokines. NSAID treatment also enhanced macrophage clumping in vitro, indicating that cell spreading may play an important role in the resolution of inflammatory processes and/or the formation of multinucleated giant cells.


Enhanced stability of two model proteins in an agitated solution environment using poloxamer 407.
To enhance the physical stability of two model proteins during solution agitation, we investigated the interaction of the nonionic surfactant poloxamer 407 (Pluronic F-127) with each protein. Vigorous agitation of aqueous solutions of interleukin-2 and urease which contained no poloxamer 407 and were maintained at 4 degrees C resulted in a greater than 50% loss in the biological activity at 12 and 24 hours, respectively. Similar aqueous solutions which were maintained at 4 degrees C and contained either urease or interleukin-2 and poloxamer 407 at a concentration of 10% w/w and 0.5% w/w, respectively lost negligible biological activity when left undisturbed for 96 hours. Moreover, when aqueous solutions of urease and interleukin-2 which contained poloxamer 407 at a concentration of 10% w/w and 0.5% w/w, respectively were maintained at 4 degrees C and subjected to agitation for 96 hours, no significant loss in the biological activity was observed for either protein. In addition, urease was observed to have increased enzymatic activity at early time points regardless of the hydrodynamic solution conditions and poloxamer 407 concentrations evaluated. In contrast, a negligible enhancement in the biological activity of interleukin-2 was observed when aqueous solutions of the protein were exposed to similar hydrodynamic conditions employed for urease solutions, but different poloxamer concentrations (0% w/w vs. 0.5% w/w). Results of molar ellipticity, [theta], versus wavelength, lambda, profiles using CD spectropolarimetry on individual aqueous solutions of both proteins containing 2% w/w poloxamer 407 were in close agreement to spectrum obtained with each protein in pH = 7 phosphate buffer (PB).(ABSTRACT TRUNCATED AT 250 WORDS)


A prospective case-controlled study of patients presenting with idiopathic sensorineural hearing loss to examine the relationship between hyperlipidaemia and sensorineural hearing loss.
The prevalence of hyperlipidaemia in the normal population means that hyperlipidaemia is often found in patients who have a hearing loss of unknown aetiology. We prospectively undertook a case-controlled study of 85 patients presenting consecutively with a sensorineural hearing loss of unknown aetiology to see if the prevalence of hyperlipidaemia differed between the group with an idiopathic sensorineural hearing loss and a control population. Control subjects were recruited from patients undergoing nasal surgery for structural abnormalities. Both the study and control groups were also compared with the National Study of Hearing data. Hyperlipidaemia was no more prevalent in a population with idiopathic sensorineural hearing loss than a control population. No consistent association between hyperlipidaemia and hearing loss was found.


Species diversity, systematic revision and molecular phylogeny of Ganodermataceae (Polyporales, Basidiomycota) with an emphasis on Chinese collections.
Ganodermataceae is one of the main families of macrofungi since species in the family are both ecologically and economically important. The double-walled basidiospores with ornamented endospore walls are the characteristic features of Ganodermataceae. It is a large and complex family; although many studies have focused on Ganodermataceae, the global diversity, geographic distribution, taxonomy and molecular phylogeny of Ganodermataceae still remained incompletely understood. In this work, taxonomic and phylogenetic studies on worldwide species of Ganodermataceae were carried out by morphological examination and molecular phylogenetic analyses inferred from six gene loci including the internal transcribed spacer regions (ITS), the large subunit of nuclear ribosomal RNA gene (nLSU), the second largest subunit of RNA polymerase II gene (rpb2), the translation elongation factor 1-α gene (tef1), the small subunit mitochondrial rRNA gene (mtSSU) and the small subunit nuclear ribosomal RNA gene (nSSU). A total of 1 382 sequences were used in the phylogenetic analyses, of which 817 were newly generated, including 132 sequences of ITS, 139 sequences of nLSU, 83 sequences of rpb2, 124 sequences of tef1, 150 sequences of mtSSU and 189 sequences of nSSU. The combined six-gene dataset included sequences from 391 specimens representing 146 taxa from Ganodermataceae. Based on morphological and phylogenetic analyses, 14 genera were confirmed in Ganodermataceae: Amauroderma, Amaurodermellus, Cristataspora, Foraminispora, Furtadoella, Ganoderma, Haddowia, Humphreya, Magoderna, Neoganoderma, Sanguinoderma, Sinoganoderma, Tomophagus and Trachydermella. Among these genera, Neoganoderma gen. nov. is proposed for Ganoderma neurosporum; Sinoganoderma gen. nov. is proposed for Ganoderma shandongense; Furtadoella gen. nov. is proposed to include taxa previously belonging to Furtadoa since Furtadoa is a homonym of a plant genus in the Araceae; Trachydermella gen. nov. is proposed to include Trachyderma tsunodae since Trachyderma is a homonym of a lichen genus in the Pannariaceae. Twenty-three new species, viz., Ganoderma acaciicola, G. acontextum, G. alpinum, G. bubalinomarginatum, G. castaneum, G. chuxiongense, G. cocoicola, G. fallax, G. guangxiense, G. puerense, G. subangustisporum, G. subellipsoideum, G. subflexipes, G. sublobatum, G. tongshanense, G. yunlingense, Haddowia macropora, Sanguinoderma guangdongense, Sa. infundibulare, Sa. longistipitum, Sa. melanocarpum, Sa. microsporum and Sa. tricolor are described. In addition, another 33 known species are also described in detail for comparison. Scanning electron micrographs of basidiospores of 10 genera in Ganodermataceae are provided. A key to the accepted genera of Ganodermataceae and keys to the accepted species of Ganoderma, Haddowia, Humphreya, Magoderna, Sanguinoderma and Tomophagus are also provided. In total, 278 species are accepted as members of Ganodermataceae including 59 species distributed in China. Taxonomic novelties: New genera: Furtadoella B.K. Cui & Y.F. Sun, Neoganoderma B.K. Cui & Y.F. Sun, Sinoganoderma B.K. Cui, J.H. Xing & Y.F. Sun and Trachydermella B.K. Cui & Y.F. Sun; New species: Ganoderma acaciicola B.K. Cui, J.H. Xing & Y.F. Sun, G. acontextum B.K. Cui, J.H. Xing & Vlasák, G. alpinum B.K. Cui, J.H. Xing & Y.F. Sun, G. bubalinomarginatum B.K. Cui, J.H. Xing & Y.F. Sun, G. castaneum B.K. Cui, J.H. Xing & Y.F. Sun, G. chuxiongense B.K. Cui, J.H. Xing & Y.F. Sun, G. cocoicola B.K. Cui, J.H. Xing & Y.F. Sun, G. fallax B.K. Cui, J.H. Xing & Vlasák, G. guangxiense B.K. Cui, J.H. Xing & Y.F. Sun, G. puerense B.K. Cui, J.H. Xing & Y.F. Sun, G. subangustisporum B.K. Cui, J.H. Xing & Y.F. Sun, G. subellipsoideum B.K. Cui, J.H. Xing & Y.F. Sun, G. subflexipes B.K. Cui, J.H. Xing & Y.F. Sun, G. sublobatum B.K. Cui, J.H. Xing & Y.F. Sun, G. tongshanense B.K. Cui, J.H. Xing & Y.F. Sun, G. yunlingense B.K. Cui, J.H. Xing & Y.F. Sun, Haddowia macropora B.K. Cui, Vlasák & Y.F. Sun, Sanguinoderma guangdongense B.K. Cui & Y.F. Sun, Sa. infundibulare B.K. Cui & Y.F. Sun, Sa. longistipitum B.K. Cui & Y.F. Sun, Sa. melanocarpum B.K. Cui & Y.F. Sun, Sa. microsporum B.K. Cui & Y.F. Sun and Sa. tricolor B.K. Cui & Y.F. Sun; New combinations: Furtadoella biseptata (Costa-Rezende et al.) B.K. Cui & Y.F. Sun, Fu. brasiliensis (Singer) B.K. Cui & Y.F. Sun, Fu. corneri (Gulaid & Ryvarden) B.K. Cui & Y.F. Sun, Neoganoderma neurosporum (J.S. Furtado) B.K. Cui & Y.F. Sun, Sinoganoderma shandongense (J.D. Zhao & L.W. Xu) B.K. Cui, J.H. Xing & Y.F. Sun and Trachydermella tsunodae (Yasuda ex Lloyd) B.K. Cui & Y.F. Sun. Citation: Sun Y-F, Xing J-H, He X-L, Wu D-M, Song C-G, Liu S, Vlasák J, Gates G, Gibertoni TB, Cui B-K (2022). Species diversity, systematic revision and molecular phylogeny of Ganodermataceae (Polyporales, Basidiomycota) with an emphasis on Chinese collections. Studies in Mycology 101: 287-415. doi: 10.3114/sim.2022.101.05.


Emphasis of short-duration acoustic speech cues for cochlear implant users.
A new speech-coding strategy for cochlear implant users, called the transient emphasis spectral maxima (TESM), was developed to aid perception of short-duration transient cues in speech. Speech-perception scores using the TESM strategy were compared to scores using the spectral maxima sound processor (SMSP) strategy in a group of eight adult users of the Nucleus 22 cochlear implant system. Significant improvements in mean speech-perception scores for the group were obtained on CNC open-set monosyllabic word tests in quiet (SMSP: 53.6% TESM: 61.3%, p<0.001), and on MUSL open-set sentence tests in multitalker noise (SMSP: 64.9% TESM: 70.6%, p<0.001). Significant increases were also shown for consonant scores in the word test (SMSP: 75.1% TESM: 80.6%, p<0.001) and for vowel scores in the word test (SMSP: 83.1% TESM: 85.7%, p<0.05). Analysis of consonant perception results from the CNC word tests showed that perception of nasal, stop, and fricative consonant discrimination was most improved. Information transmission analysis indicated that place of articulation was most improved, although improvements were also evident for manner of articulation. The increases in discrimination were shown to be related to improved coding of short-duration acoustic cues, particularly those of low intensity.


Early formative stage of human focal cortical gyration anomalies: fetal MRI.
Limited information is available about the development of focal cortical gyration anomalies in the human brain. Using prenatal MRI, we characterized focal cortical gyration anomalies at an early formative stage and sought clues about the mechanisms of their development. From a large prenatal MRI database, 30 cases (gestational age, ≤ 24 weeks) with reported focal distortion of the cortical rim profile were selected. Eight cases were matched with histologic examinations; another seven had prenatal MRI, MRI autopsy, or postnatal MRI follow-up; and 15 had no follow-up but did present analogous abnormal cortical features. Focal cortical gyration anomalies were detectable when the brain was still smooth (i.e., physiological lissencephaly). Four patterns of cortical plate anomaly were identified: wartlike (11 cases), abnormal invaginating sulcus (11 cases), sawtooth (six cases), and single or multiple bumps (two cases). A thinned or blurred subplate and intermediate zone in the focal cortical gyration anomaly site was detected in 80% of cases. All but two cases had other intracranial anomalies. Seven cases were classified as hypoxic-ischemic, five as genetic, and three as infective. In 15 cases, the cause could not be established. In five fetuses with further intrauterine or postnatal MRI, focal cortical gyration anomalies increased in complexity, fulfilling postnatal imaging criteria of polymicrogyria. Focal cortical gyration anomalies can be detected at the early sulcation process stage. The process leading to abnormal gyration may evolve faster than physiologic ones and seems to be related to alterations of parenchymal layering occurring before 24 weeks' gestation. Most focal cortical gyration anomalies evolve toward what is currently considered polymicrogyria.


Value of serum GGT level in the timing of diagnosis of choledochal cyst perforation.
Choledochal cyst perforation is extremely rare, and early diagnosis or prediction is important for the immediate therapeutic intervention of perforations. This study aimed to define the predictor(s) of an impending or complete spontaneous perforation of choledochal cyst and establish the optimal operative timing. All 429 consecutive choledochal cyst patients from January 2015 to December 2021, were included. A retrospective study was performed based on Kaplan-Meier analysis, and Cox univariate and multivariate analyses. A total of 429 patients were included, among which, 21 had choledochal cyst perforations (group A), and 408 did not (group B). Compared to group B, the serum alanine aminotransferase, aspartate aminotransferase, direct bilirubin, gamma-glutamyl transpeptidase, indirect bilirubin, total bilirubin, and alkaline phosphatase were significantly higher in group A (p = 0.025, 0.006, < 0.0001, 0.0001, 0.001, < 0.0001, and 0.033). High serum gamma-glutamyl transpeptidase was negatively associated with perforation-free preoperative survival, and multivariate Cox regression revealed that serum gamma-glutamyl transpeptidase was an independent predictive factor for an impending or complete perforation (p = 0.042). A gamma-glutamyl transpeptidase level ≥ 346.5 U/L accompanied with significantly elevated liver enzymes and bilirubin levels was indicative of the possibility of an impending or complete choledochal cyst perforation, and a proactive surgical approach should be considered.


Neural networks differentiate between Middle and Later Stone Age lithic assemblages in eastern Africa.
The Middle to Later Stone Age transition marks a major change in how Late Pleistocene African populations produced and used stone tool kits, but is manifest in various ways, places and times across the continent. Alongside changing patterns of raw material use and decreasing artefact sizes, changes in artefact types are commonly employed to differentiate Middle Stone Age (MSA) and Later Stone Age (LSA) assemblages. The current paper employs a quantitative analytical framework based upon the use of neural networks to examine changing constellations of technologies between MSA and LSA assemblages from eastern Africa. Network ensembles were trained to differentiate LSA assemblages from Marine Isotope Stage 3&4 MSA and Marine Isotope Stage 5 MSA assemblages based upon the presence or absence of 16 technologies. Simulations were used to extract significant indicator and contra-indicator technologies for each assemblage class. The trained network ensembles classified over 94% of assemblages correctly, and identified 7 key technologies that significantly distinguish between assemblage classes. These results clarify both temporal changes within the MSA and differences between MSA and LSA assemblages in eastern Africa.


Clinical implementation of a multidimensional basic protocol for assessing functional results of voice therapy. A preliminary study.
45 patients with various kinds of organic benignant voice pathology (vocal fold nodules, polyp, Reinke's oedema, unilateral paralysis, sulcus/scar) and/or with muscle tension disorders, for which a (pre-operative) functional voice therapy was indicated, were evaluated before and after this short period of voice therapy (4-26 sessions), in order to check a basic multidimensional protocol for assessing functional results of voice treatments, developed by the Committee on Phoniatrics of the ELS. Perception: Grade, Breathiness and Roughness from the GRBAS-scale, as rated by two experienced judges (0 = normal or absent; 3 = severely deviant or present). Acoustics: Jitter % and Shimmer % as computed by the MDVP program of Kay Elemetrics on a /a:/, at comfortable loudness and pitch. Also Fo-range and softest possible intensity were registered. Videostroboscopy: Glottal closure, regularity, mucosal wave and symmetry, as rated separately on visual analog scales of 10 cm by 2 experienced laryngologists. Phonation quotient: computed by dividing the vital capacity (ml) by the maximum phonation time (s) (best value of 2 x 3 trials). Self rating by the patient: voice quality in itself and general social/occupational handicap due to the voice problem were rated on 2 visual analog scales. Results show that there is a large variation in the interindividual and interdimensional results of the voice therapy: in a same patient, one dimension may be significantly improved while another one is significantly worsened. The 5 considered dimensions may be considered as low redundant.


Causal learning with local computations.
The authors proposed and tested a psychological theory of causal structure learning based on local computations. Local computations simplify complex learning problems via cues available on individual trials to update a single causal structure hypothesis. Structural inferences from local computations make minimal demands on memory, require relatively small amounts of data, and need not respect normative prescriptions as inferences that are principled locally may violate those principles when combined. Over a series of 3 experiments, the authors found (a) systematic inferences from small amounts of data; (b) systematic inference of extraneous causal links; (c) influence of data presentation order on inferences; and (d) error reduction through pretraining. Without pretraining, a model based on local computations fitted data better than a Bayesian structural inference model. The data suggest that local computations serve as a heuristic for learning causal structure.


Association between Dietary Consumption of Meals Combining the Five Food Groups and Stage of Change in the Fifth and Sixth Elementary and Junior High School-Aged Children in Sports Clubs: A Cross-Sectional Research at Soccer Clubs.
This study examined the relationship between dietary intake and stage of change for "combining the five food groups" (grains, fish and meat, vegetables, milk, and fruits) and examined characteristics of dietary intake by stage of change among fifth and sixth graders in elementary and junior high school in sports clubs. The 395 children who completed the self-reported dietary consumption form and questionnaire on stage of change for combining the five food groups were analyzed. Logistic regression analysis was conducted to analyze the relationship between intake of the combined five food groups and stage of change, with frequency of the five meals as dependent variable and stage of change as independent variable. Compared to the precontemplation stage, action (A) and maintenance stages (M) were associated with a higher frequency of the number of meals combining the five food groups (A, stage adjusted odds ratio [AOR]: 5.11, 95% confidence interval (CI): 1.50-17.36, p=0.009; M, AOR: 3.84, 95%CI: 1.58-9.33, p=0.003). In breakfast, the number of and each of combining the five food groups meal, and in dinner, the number of combining the five food groups meal, vegetable dishes and fruits were significantly higher in the A and M than in the pre-action stages. These findings suggest that the number of times meals combining the five food groups are consumed was associated with stage of change while breakfast and dinner showed differences in meal consumption between stages in the fifth and sixth grades elementary and junior high school students belonging to sports clubs.


Impact of pedicle screw fixation on loss of deformity correction in patients with adolescent idiopathic scoliosis.
Loss of coronal correction has been reported in the presence of a solid posterior fusion mass in patients who are skeletally immature. Significant increases in postoperative coronal curvature are typically attributed to the presence of pseudarthrosis, loss of instrumentation fixation, or adding-on. We evaluated the clinical and radiographic factors associated with a loss of correction that was not attributed to these etiologies as well as the impact of pedicle screw fixation on loss of correction. A prospective, longitudinal study database was retrospectively queried for patients with at least 2 years of follow-up who underwent surgery for adolescent idiopathic scoliosis. Loss of correction was defined (1) clinically, as a >5 degree increase in the inclinometer reading at any time interval after surgery, excluding preoperative values; or (2) radiographically, as an increase of ≥ 10 degrees in the coronal Cobb angle of an instrumented curve. Patients with pseudarthrosis, adding-on, or loss of fixation were excluded. Ninety-three of 800 patients (11.6%) had loss of deformity correction. Twenty-one patients (2.5%) had >5 degrees of inclinometer change and 76 patients (9.5%) had ≥10 degrees of Cobb change, with a mean loss of 10.85±4.2 degrees. When comparing pedicle screw constructs only, 10% of patients developed loss of correction as opposed to 20% of the patients with hybrid constructs (P=0.036). Factors associated with loss of correction were: age, hybrid construct, magnitude of thoracic curve, thoracic apical translation, and T1 tilt angle. This study reports a high percentage of loss of coronal correction (12%) after 2 years of follow-up that was not associated with infection, adding-on, or apparent pseudarthrosis. Larger magnitude thoracic curves with apical deviation and hybrid constructs were associated with an increased likelihood of loss of curve correction where use of pedicle screw fixation seems to decrease its incidence. III.


Effect of Senokot on rat intestinal electrolyte transport. Evidence of Ca++ dependence.
The mechanism of action of Senokot, a widely used laxative, has not been established. Senokot was given orally to rats 8-14 h before intestinal water and electrolyte transport were studied. Senokot significantly decreased colonic and jejunal water absorption measured in vivo by the single-pass perfusion technique. The Senokot changes were not associated with changes in jejunal or colonic histology or adenylate cyclase activity or colonic cyclic adenosine monophosphate content. Senokot also altered active electrolyte transport in rat descending colon as measured by the Ussing chamber-voltage clamp technique. These changes consisted of an increase in short-circuit current and a decrease in active Na and Cl transport that was due to a decrease in the mucosal-to-serosal fluxes. The changes in active electrolyte transport were dependent on Ca++ in the serosal but not the mucosal bathing solution. In contrast, addition of 10(-4) M verapamil to the serosal surface did not alter the Senokot effect. In spite of a dependence on serosal Ca++, Senokot did not alter 45Ca++ entry across the colonic serosal surface. The phospholipase A2 inhibitor quinacrine (10(-4) M) also did not alter the effect of Senokot on colonic Na and Cl transport. Senokot alters active colonic Na and Cl transport via a presently unknown mechanism that is dependent on serosal Ca++.


Surgical treatment of posterior fossa tumors via the occipital transtentorial approach: evaluation of operative safety and results in 14 patients with anterosuperior cerebellar tumors.
To determine the safety and usefulness of performing surgery via the occipital transtentorial approach to treat anterosuperior cerebellar tumors, evaluation of 14 patients was performed over a 5-year period. The study was performed in 14 patients, aged 6 months to 71 years, who harbored anterosuperior cerebellar tumors of the posterior fossa including four hemangioblastomas, three cerebellar astrocytomas, three medulloblastomas, two metastatic tumors, one recurrent astrocytoma, and one rhabdoid cell tumor. All patients underwent surgical treatment by the same surgical team and via the same surgical approach. Endoscopy combined with neuronavigation was used for large, deep-seated tumors extending to the fourth ventricle. Of the 14 patients, total or gross-total removal was achieved in 12 patients and subtotal removal in two patients. There was no incidence of mortality or morbidity in the 14 patients, and all functional outcomes were good to excellent postoperatively. Postoperative magnetic resonance imaging revealed that none of the patients had suffered brain damage or infarction around the cerebellum, brainstem, or occipital lobe. Although this study was the first in which a specific examination of the efficacy of the occipital transtentorial approach in patients with anterosuperior cerebellar tumors was undertaken, our findings suggest that this surgical approach is very useful, safe, and accurate for removing the primary tumor and evaluating the surrounding anatomy, as well as for determining operative strategy.


[A study on hepatic arterial infusion for metastatic liver tumor].
This study was designed to evaluate whether hepatic arterial infusion is effective in terms of response rate and survival time of patients with unresectable liver metastasis from colorectal and gastric cancer. In 19 patients with liver metastasis from colorectal cancer, one patient had a CR, 3 had a PR or MR and the remainder showed NC or PD, with an overall response rate of 16.7%. The response rate was higher in men than in women as well as in patients with metachronous liver metastasis. The dose schedules showed no effectiveness in patients with histologically well-differentiated adenocarcinoma. However, there was a statistical difference in survival time according to the response. The overall response rate in 7 patients with liver metastasis from gastric cancer was 42.9% with one patient achieving CR, 2 patients PR and the others PD. As a result, hepatic arterial infusion of antitumor regimen was an effective method for inoperable metastatic liver cancer.


Extracorporeal support for patients with hepatic failure.
Extracorporeal support has been advocated for patients with acute and chronic liver failure. Patients with acute liver failure and those with decompensated cirrhosis can be broadly divided into two groups. The first group comprises those with acute liver failure and ongoing hepatic necrosis, and the second, those with long-standing chronic decompensation admitted with one or more complications of liver failure, such as encephalopathy without any evidence of a precipitating factor or accompanying acute deterioration of liver function. This second group includes patients with acute liver failure, where the insult causing hepatic necrosis has been resolved, and those patients with chronic decompensation who suffer another insult to the liver, such as acute infection or variceal hemorrhage that causes further liver injury in the setting of multiorgan failure. These two groups are likely to have different outcomes and may need to be managed differently. In the first group, liver transplantation is the only possible long-term therapeutic option, whereas in the second group, other possibilities such as extracorporeal liver support systems and/or medical therapy may allow these patients to return to their previous state before the acute insult. Over time extracorporeal support has expanded from simple peritoneal dialysis and hemodialysis, to the development of circuits designed primarily to remove both water and lipid-soluble toxins and, in addition, bioartificial devices to provide replacement synthetic hepatic function. Because many of the patients with an acute liver insult have ongoing chronic liver disease and develop hepatorenal syndrome, this group of patients has been targeted by several groups to study the role of liver support systems.


Revisiting the Stanford prison experiment, again: Examining demand characteristics in the guard orientation.
The day before the Stanford prison experiment began, the investigators held an orientation session for the guards in which they communicated expectations for hostile guard behavior, a flippant prisoner mindset, and the possibility of ending the study prematurely. While the study's principal investigator has minimized the influence of this orientation, critics have speculated that it provided a "script" for guard abuse. In the present studies, participants were presented with a hypothetical prison simulation study and randomly assigned as guards to an orientation session that included these expectations (Stanford orientation) or one providing basic study information. Across three studies, participants exposed to the Stanford orientation relative to a control orientation, reported greater expectations for hostile and oppressive behavior on the part of the study's investigator and from others and themselves as guards. The present results provide empirical support for speculation that the language of the guard orientation in the Stanford prison experiment sanctioned abuse among guards.


Dermatomyositis-polymyositis and malignancy. Is there a direct relation?
An association between dermatomyositis-polymyositis and malignancy has been reported. However, controversy exists regarding a direct causal relationship between the two diseases. We describe a patient who had the concurrent onset and parallel clinical course of dermatomyositis and malignancy, and discuss the possible mechanisms for the association of the two disorders.


[Effects of aerosolized perfluorocarbon on gas exchange, respiratory mechanics and hemodynamics in a swine model of acute respiratory distress syndrome].
To investigate the effects of aerosolized perfluorocarbon (PFC) on gas exchanges, respiratory mechanics and hemodynamics in a swine model of acute respiratory distress syndrome (ARDS). ARDS was induced by intratracheal instillation of detergent in 16 piglets, and the animals were then randomly assigned to a PFC treated group (n = 8) and a control group (n = 8). Animals of the control group were gas-ventilated with 100% O2 (3 L/min), while those of the PFC treated group received an additional continuous aerosolized PFC at 7 - 8 ml.kg(-1).h(-1). Blood gases, average artery pressure, heart rate, platform pressure, compliance, expiratory tidal volume and intrinsic positive end-expiratory pressure (PEEPi) were measured per 15 minutes. Detergent instillation resulted in a marked decrease in arterial oxygen pressure (PaO2) within 60 min, from (383 +/- 53) mm Hg (1 mm Hg = 0.133 kPa) to (49 +/- 12) mm Hg in the control group [fraction of inspired oxygen (FiO2) 100%], and from (377 +/- 55) mm Hg to (56 +/- 13) mm Hg in the PFC group (FiO2 100%). After 2 h treatment, PaO2 was increased from (49 +/- 12) mm Hg to (83 +/- 51) mm Hg in the control group, compliance from (1.4 +/- 0.4) ml/cm H2O to (2.8 +/- 1.8) ml/cm H2O, and expiratory tidal volume from (30.8 +/- 5.5) ml to (50.1 +/- 4.1) ml in the control group; PaO2 from (56 +/- 13) mm Hg to (189 +/- 133) mm Hg, compliance from (1.5 +/- 0.4) ml/cm H2O to (4.1 +/- 1.4) ml/cm H2O, and expiratory tidal volume from (30.8 +/- 3.3) ml to (74.5 +/- 16.9) ml in the PFC group (all P < 0.05). There were no significant differences between groups in arterial carbon dioxide pressure (PaCO2), pH values, blood pressure, heart rates, plat pressure and PEEPi during treatment (all P > 0.05). It is suggested that aerosolized PFC increases arterial oxygenation, compliance, and expiratory tidal volume in extended detergent-induced ARDS.


Thermoelectric properties of Cu-dispersed bi0.5sb1.5te3.
A novel and simple approach was used to disperse Cu nanoparticles uniformly in the Bi0.5Sb1.5Te3 matrix, and the thermoelectric properties were evaluated for the Cu-dispersed Bi0.5Sb1.5Te3. Polycrystalline Bi0.5Sb1.5Te3 powder prepared by encapsulated melting and grinding was dry-mixed with Cu(OAc)2 powder. After Cu(OAc)2 decomposition, the Cu-dispersed Bi0.5Sb1.5Te3 was hot-pressed. Cu nanoparticles were well-dispersed in the Bi0.5Sb1.5Te3 matrix and acted as effective phonon scattering centers. The electrical conductivity increased systematically with increasing level of Cu nanoparticle dispersion. All specimens had a positive Seebeck coefficient, which confirmed that the electrical charge was transported mainly by holes. The thermoelectric figure of merit was enhanced remarkably over a wide temperature range of 323-523 K.PACS: 72.15.Jf: 72.20.Pa.


Anomalies of Pulmonary Circulation as a Cause of Hemoptysis: A Series of Unusual Cases and Review of the Literature.
The expectoration of blood originating from the lower respiratory tract, called hemoptysis, is a common clinical condition with many potential etiologies. Massive hemoptysis is life threatening and needs urgent intervention. Multidetector computed tomography (MDCT) is a useful non-invasive imaging modality for the initial assessment of hemoptysis. Using MDCT with multiplanar reformatted images has improved the diagnosis and management of hemoptysis by providing a more precise depiction of bronchial and non-bronchial systemic arteries than conventional computed tomography (CT). In 95% of hemoptysis cases, the systemic arterial system is the origin of bleeding and pulmonary vascular anomalies are a rare cause. Among these, pulmonary arteriovenous malformation, hereditary hemorrhagic telangiectasia, and Osler-Weber-Rendu disease are well known entities. However, primary anomalies affecting pulmonary vessels in the mediastinum or diseases secondarily affecting the pulmonary vessels are unusual causes. Here we present three cases where patients had pulmonary vascular anomalies causing hemoptysis. These patients had decreased pulmonary arterial pressures leading to bronchial and systemic arterial hypertrophy and development of bronchopulmonary collaterals. Secondary CT signs in the parenchyma and mediastinum (mosaic attenuation, ground glass haze, subpleural interstitial thickening, and hypertrophied bronchial arteries) were similar in all patients. Hence, evaluation of the MDCT images for primary abnormality led to the diagnosis.


Business of radiology: financial fundamentals for radiologists.
The purposes of this article are to provide a primer on financial statements and to review several financial concepts that are at the foundation of the business of medicine. For radiologists to effectively contribute to the leadership and management of their practices, it is imperative that they understand the business aspects of radiology. Radiologists' understanding and participation in practice management may also facilitate job satisfaction and assist the provision of optimal patient care.


Synergistic contributions of asparagine 46 and aspartate 52 to the catalytic mechanism of chicken egg white lysozyme.
The X-ray structure of a chicken egg white lysozyme (ChEWL) complex with a peptidoglycan-derived inhibitor suggests that interactions of Asn46 and Asp52 with the D-subsite N-acetylmuramic acid residue help to distort that pyranose ring into the reactive half-chair conformation and that a hydrogen bond is formed between Asn46 and Asp52 [Strynadka, N. C. J., & James, M. N. G. (1991) J. Mol. Biol. 220, 401-424]. These hypotheses were investigated through the D52A, N46A, and D52A/N46A mutants of ChEWL. The Michaelis constants of the D52A and D52A/N46A ChEWL complexes with Micrococcus luteus cells are 3- and 4-fold higher, respectively, than the wild-type KM; the corresponding kcat values are 25- and 50-fold lower, respectively, than the wild-type kcat. These results support the proposal of Strynadka and James. The velocities of reactions catalyzed by the N46A and D52A mutants are approximately equal to each other for all classes of substrate, suggesting that the respective roles of Asn46 and Asp52 in transition state stabilization do not vary. The mutation of either Asn46 or Asp52 to Ala apparently disrupts the interactions of the other (nonmutated) residue with the substrate, supporting the crystallographic evidence of a hydrogen-bond interaction between the two residues. The mutations do not change the values of the dissociation constants of complexes with (carboxymethyl)chitin complexes, suggesting that ground state complexes of ChEWL with chitin-derived substrates differ in conformation from complexes with bacterial peptidoglycans.


Characterization of leukotriene B4 binding sites on guinea pig lung macrophages.
Specific binding sites for [3H]leukotriene B4 (LTB4) were identified on guinea pig lung macrophages, using high specific activity [3H] LTB4 in the presence or absence of unlabeled LTB4. At 0 degrees C, [3H] LTB4 binding reached equilibrium within 30 min, and addition of a large excess of unlabeled LTB4 resulted in a rapid decrease of specific binding. Binding was saturable, reversible and dependent upon the number of lung macrophages. The KD and Bmax were found to be 3.85 +/- 0.6 nM and 35 +/- 3 fmol/10(6) cells, respectively, as determined from Scatchard analysis. In competition studies for the displacement of [3H]LTB4 from binding sites, LTB4 and its analogs had the following order of potency: LTB4 (Ki = 2.9 +/- 0.8 nM) greater than 5-epi LTB4 (Ki = 58.7 +/- 0.3 nM) greater than 5-deoxy-LTB4 (Ki = 91.7 +/- 0.3 nM) greater than 12-epi LTB4 (Ki = 4.7 +/- 1.2 microM) greater than 5,12-deoxy LTB4 (Ki = 7.6 +/- 0.01 microM) greater than or equal to 12-deoxy LTB4 (Ki = 8.9 +/- 0.01 microM). LTC4 and LTD4 did not displace the [3H] LTB4 binding at concentrations up to 10 microM. [3H]LTB4 was not metabolized during the binding process as determined by reverse-phase high performance liquid chromatography. It was suggested that this binding site might be an LTB4 receptor.


Mechanisms of Drug Resistance in Veterinary Oncology- A Review with an Emphasis on Canine Lymphoma.
Drug resistance (DR) is the major limiting factor in the successful treatment of systemic neoplasia with cytotoxic chemotherapy. DR can be either intrinsic or acquired, and although the development and clinical implications are different, the underlying mechanisms are likely to be similar. Most causes for DR are pharmacodynamic in nature, result from adaptations within the tumor cell and include reduced drug uptake, increased drug efflux, changes in drug metabolism or drug target, increased capacity to repair drug-induced DNA damage or increased resistance to apoptosis. The role of active drug efflux transporters, and those of the ABC-transporter family in particular, have been studied extensively in human oncology and to a lesser extent in veterinary medicine. Methods reported to assess ABC-transporter status include detection of the actual protein (Western blot, immunohistochemistry), mRNA or ABC-transporter function. The three major ABC-transporters associated with DR in human oncology are ABCB1 or P-gp, ABCC1 or MRP1, and ABCG2 or BCRP, and have been demonstrated in canine cell lines, healthy dogs and dogs with cancer. Although this supports a causative role for these ABC-transporters in DR cytotoxic agents in the dog, the relative contribution to the clinical phenotype of DR in canine cancer remains an area of debate and requires further prospective studies.


Mitochondrial structural variations in the process of mitophagy.
Mitochondrion is one of significant organelles inside cells because it serves as a hub for energy management and intracellular signaling. Internal/external damages on mitochondria would lead to mitochondrial stresses with the malfunctions, accompanying with the changes of morphological structure and abnormal local environments (pH values). Mitophagy is capable of degradation of damaged mitochondrial segments to restore its normal metabolism, dynamics, and biogenesis. The dynamic structural visualization and pH quantification can be helpful for the understanding of mitochondrial functions as well as the diagnosis of disorders linking with this process. In this work, we use confocal laser scanning microscopy, STED super-resolution nanoscopy and fluorescence lifetime imaging microscopy, in conjunction with a mitochondrial probe to image the dynamic changes in the mitochondrial morphology and microenvironmental pH values during mitophagy in live cells, in particular, the structural changes of mitochondrial cristae beyond optical diffraction can be distinguished by STED nanoscopy with/without treatment by CCCP, which will provide a new view for the diagnosis and personalized treatment of mitochondrial dysfunction-related diseases.


Enhancement of glutathione S-transferase activity in rat liver by repeated administration of propylthiouracil.
Treatment of rats with propylthiouracil for one to two weeks caused an increase in glutathione S-transferase (GST) activity of the liver cytosol, but not of the particulate fraction. Increased GST activity was reversed two weeks after discontinuing PTU administration. Activation of the enzyme was inversely proportional to the decrease in leukocytes. Repeated administration of PTU increased the Vmax of the enzyme without affecting the Km value for the substrate 1-chloro-2,4-dinitrobenzene, whereas both the Km and Vmax for glutathione (GSH) were increased by PTU treatment. GSH content and GSH peroxidase activity were not affected by PTU, but this resulted in an increase in glucose 6-phosphate dehydrogenase activity. PTU treatment caused increase in GST activity using 1-chloro-2,4-dinitrobenzene, 1,2-dichloro-4-nitrobenzene, p-nitrobenzyl chloride, and benzalacetone as substrates; enzyme activity towards chlorodinitrobenzene was the highest.


On-Demand Generation of a Formaldehyde-in-Air Standard.
The feasibility of using catalytic conversion of methanol to formaldehyde to produce standard amount of substance fractions of formaldehyde was examined. The conversion efficiencies of several catalysts were measured as a function of temperature, balance gas, catalyst bed length, and methanol amount of substance fraction in an effort to identify conditions which yield high and consistent conversion of methanol to formaldehyde. The highest observed conversion rate was (97 ± 4) % using a molybdenum catalyst, where the error is the 2σ uncertainty. The conversion efficiency was found to be consistent over repeated cycles and over a long lifetime test, suggesting that a molybdenum catalyst is a viable candidate for a standard formaldehyde generator, particularly for low formaldehyde amount of substance fractions (< 15 μmol/mol).


Intercepting early pelvic serous carcinoma by routine pathological examination of the fimbria.
Recent evidence indicates that the distal fallopian tube is the principal site of early serous cancer in women with a hereditary risk for ovarian cancer. Moreover, the fimbria is involved by early cancer in a significant minority of pelvic serous carcinomas, irrespective of whether the patient has a hereditary BRCA1 or BRCA2 mutation. In addition, the distal tube has been identified occasionally as a site of concurrent endometrioid tumors in women with endometrial carcinoma. Although the risk of sporadic fimbrial tumors in otherwise healthy women without genetic risk is unknown, routine histological examination of the fimbria provides the opportunity to determine the risk of such an event. To illustrate this point, a case of a woman who underwent surgery for an ovarian fibroma is presented. The distal tube was submitted, and found to harbor a focus of serous tubal intraepithelial carcinoma (STIC) with a 2-mm invasive tumor. Incidentally discovered carcinomas underscore the potential risk, albeit low, of concurrent unsuspected malignancy in the distal fallopian tube and emphasize the importance of routine pathological examination of the fimbria in all salpingectomies. The rationale for this strategy, and its potential effect on early detection and in uncovering persons or families potentially at risk for ovarian cancer, is discussed.


Central serous chorioretinopathy complicated by subsequent occipital lobe infarction and sinusitis in a drug abuser.
The presence of multiple occurring, simultaneously complicated clinical findings can be challenging. A 39-year-old white male presented initially with central serous chorioretinopathy. Later, the patient reported a great deal of pain over his left eye with nasal vision loss. Comprehensive ophthalmic evaluation and neurologic consultation were invaluable in the diagnosis and management of the patient. Neurologic consultation along with computed tomography (CT) of the head with and without contrast enhancement along with magnetic resonance imaging (MRI) with and without gadolinium revealed lesions in the left occipital lobe, right cerebellum, and left thalamus area. In addition, bilateral maxillary and ethmoidal sinusitis were observed. Multiple events affecting vision are often related, sometimes not. However, co-existing factors can confound and obscure accurate diagnoses. Careful patient clinical and laboratory investigations are frequently necessary to elucidate correct diagnosis.


Beyond Individual Cognitions: Time for Intervention Science to Focus on Health Context and Audience.
Intervention science faces a hazardous paradox: on the one hand, vulnerable populations (eg, patients, people from low socioeconomic background, older adults) are those for whom adoption of healthy behaviors is most urgent; on the other hand, behavior change models are less predictive, and interventions less successful, in these populations. This commentary presents 4 reasons that may explain this issue: (1) research mostly focuses on what causes behavior and how to change it, at the expense of investigating among whom and under what conditions models are valid; (2) models put an undue emphasis on individual cognitions; (3) most studies are not conducted on vulnerable populations; and (4) most researchers are from high-income countries. Several avenues are proposed to address this issue: (1) providing a central place to the context and audience in health behavior change modelization, through collaborations with researchers from other disciplines and countries, and with members of the targeted audience; (2) better reporting samples' sociodemographic characteristics and increasing samples' diversity; and (3) using more rigorous and innovative designs (eg, powered randomized controlled trials, N-of-1 trials, intensive longitudinal studies). In conclusion, it becomes urgent to change the way we do research: the social utility and credibility of intervention science depend on it.


Therapeutic Modulation of the Immune Response in Arrhythmogenic Cardiomyopathy.
Inflammation is a prominent feature of arrhythmogenic cardiomyopathy (ACM), but whether it contributes to the disease phenotype is not known. To define the role of inflammation in the pathogenesis of ACM, we characterized nuclear factor-κB signaling in ACM models in vitro and in vivo and in cardiac myocytes from patient induced pluripotent stem cells. Activation of nuclear factor-κB signaling, indicated by increased expression and nuclear accumulation of phospho-RelA/p65, occurred in both an in vitro model of ACM (expression of JUP2157del2 in neonatal rat ventricular myocytes) and a robust murine model of ACM (homozygous knock-in of mutant desmoglein-2 [Dsg2mut/mut]) that recapitulates the cardiac manifestations seen in patients with ACM. Bay 11-7082, a small-molecule inhibitor of nuclear factor-κB signaling, prevented the development of ACM disease features in vitro (abnormal redistribution of intercalated disk proteins, myocyte apoptosis, release of inflammatory cytokines) and in vivo (myocardial necrosis and fibrosis, left ventricular contractile dysfunction, electrocardiographic abnormalities). Hearts of Dsg2mut/mut mice expressed markedly increased levels of inflammatory cytokines and chemotactic molecules that were attenuated by Bay 11-7082. Salutary effects of Bay 11-7082 correlated with the extent to which production of selected cytokines had been blocked. Nuclear factor-κB signaling was also activated in cardiac myocytes derived from a patient with ACM. These cells produced and secreted abundant inflammatory cytokines under basal conditions, and this was also greatly reduced by Bay 11-7082. Inflammatory signaling is activated in ACM and drives key features of the disease. Targeting inflammatory pathways may be an effective new mechanism-based therapy for ACM.


Catalpol-Induced AMPK Activation Alleviates Cisplatin-Induced Nephrotoxicity through the Mitochondrial-Dependent Pathway without Compromising Its Anticancer Properties.
Nephrotoxicity is a common complication of cisplatin chemotherapy and, thus, limits the clinical application of cisplatin. In this work, the effects of catalpol (CAT), a bioactive ingredient extracted from Rehmannia glutinosa, on cisplatin-induced nephrotoxicity and antitumor efficacy were comprehensively investigated. Specifically, the protective effect of CAT on cisplatin-induced injury was explored in mice and HK-2 cells. In vivo, CAT administration strikingly suppressed cisplatin-induced renal dysfunction, morphology damage, apoptosis, and inflammation. In vitro, CAT induced activation of adenosine 5'-monophosphate- (AMP-) activated protein kinase (AMPK), improved mitochondrial function, and decreased generation of cellular reactive oxygen species (ROS), leading to a reduction in inflammation and apoptosis, which ultimately protected from cisplatin-induced injury. However, the beneficial effects of CAT were mostly blocked by coincubation with compound C. Furthermore, molecular docking results indicated that CAT had a higher affinity for AMPK than other AMPK activators such as danthron, phenformin, and metformin. Importantly, CAT possessed the ability to reverse drug resistance without compromising the antitumor properties of cisplatin. These findings suggest that CAT exerts positive effects against cisplatin-induced renal injury through reversing drug resistance via the mitochondrial-dependent pathway without affecting the anticancer activity of cisplatin.


Afterdepolarizations and triggered activity develop in a select population of cells (M cells) in canine ventricular myocardium: the effects of acetylstrophanthidin and Bay K 8644.
Early afterdepolarizations (EADs) are membrane oscillations that interrupt or retard the repolarization phase of the cardiac action potential, whereas delayed afterdepolarizations (DADs) are oscillations that arise after full repolarization. When EADs and DADs are sufficiently large to depolarize the cell membrane to its voltage threshold, they give rise to triggered action potentials, which are believed to underlie some forms of extrasystolic activity and tachyarrhythmias. EAD- and DAD-induced triggered activity have been described and well characterized in isolated Purkinje fibers exposed to a wide variety of drugs, but are rarely seen in syncytial preparations of ventricular myocardium. These results are inconsistent with those of in vivo studies or experiments involving enzymatically dissociated myocytes. In the present study, we used the cardiotonic agent acetylstrophanthidin (AcS) and the calcium channel agonist Bay K 8644 to provide evidence in support of the hypothesis that induction of prominent EADs, DADs, and triggered activity occurs in a select population of cells in ventricular myocardium. The data indicate that EADs, DADs, and triggered activity produced by digitalis and Bay K 8644 are limited to or more readily induced in the deep subepicardial cell layers of the canine ventricle (M cells). Afterdepolarization-induced triggered activity was never observed in the epicardial or endocardial layers.


Tuberculin skin testing in patients with HIV infection: limited benefit of reduced cutoff values.
When determining eligibility for isoniazid preventive therapy of human immunodeficiency virus (HIV)-infected patients, the cutoff value of the tuberculin skin test (TST) is often reduced from an induration of 10 mm in diameter to one of 5 mm in diameter to compensate for loss of sensitivity. The effectiveness of this reduction depends on the underlying mechanism: a gradual decrease in skin test responsiveness with decreasing immunocompetence or an all-or-nothing switch to complete anergy. No published studies have assessed this directly in patients with tuberculosis. We performed a cross-sectional study of TST responses and HIV infection among patients with sputum smear-positive pulmonary tuberculosis in 6 hospitals in Tanzania. Skin test anergy was defined as a TST reaction < or =2 mm in diameter. Of 991 patients with complete results, 451 (45.5%) had HIV infection. Anergy was observed in 111 (24.6%) of 451 HIV-infected patients and 18 (3.3%) of 540 HIV-uninfected patients (P<.001). The reaction size distributions among nonanergic HIV-infected and uninfected patients showed a limited difference (mean diameter +/- standard deviation, 15.9 +/- 5.0 mm and 16.8 +/- 3.8 mm, respectively; P=.048). The sensitivity of the TST among HIV-uninfected patients was 91.1% at a cutoff value of 10 mm and 95.2% at a cutoff value of 5 mm. The sensitivity of the TST among HIV-infected patients was 64.3% at a cutoff value of 10 mm and 71.2% at a cutoff value of 5 mm; the sensitivity of the TST was 67.6% and 74.5%, respectively, after adjustment for tuberculosis-specific anergy. In subjects with tuberculosis disease and HIV infection, loss of TST sensitivity is predominantly attributable to anergy (i.e., an all-or-nothing phenomenon). The decrease in the proportion of false-negative TST results obtained by reducing the cutoff value from 10 mm to 5 mm is limited.


Effect of vitamin D deficiency on the development of postoperative atrial fibrillation in coronary artery bypass patients.
Introduction: Various factors may be responsible for the development of postoperative atrial fibrillation (POAF) in coronary artery bypass graft (CABG) patients. In our study, we demonstrated the effect of vitamin D deficiency on the development of POAF. Methods: In this prospective case control study, patients undergoing elective, isolated CABG were considered. A total of 15 patients (16.6%) who developed POAF during the first five days after surgery made up the POAF group. Seventy-five patients that had a sinus rhythm in the same period were the non-POAF group. The two groups were compared statistically in terms of laboratory, clinical, echocardiographic, operative, and postoperative parameters. Results: All patients were in sinus rhythm at discharge. The baseline characteristics of the study groups were comparable. The POAF group had a lower vitamin D level than the non-POAF group (9.0 ± 5.0 and 15.0 ± 8.4 ng/mL, respectively; P=0.007). In the POAF group, the patients' left atrium diameter and incidence of hypertension (HT) were higher than those of the non-POAF group. Conclusion: Incidence of POAF was significantly higher in patients with vitamin D deficiency or insufficiency than the patients with vitamin D level in normal range. Therefore vitamin D deficiency or insufficiency may be a predictor of POAF in patients with CABG.


Angiographic and clinical results of anterior communicating artery aneurysm endovascular treatment.
The anterior communicating artery (ACoA) is the most common location of intracranial aneurysms, observed in 35% of cases. Endovascular treatment has become an alternative to surgical clipping and the primary method of choice. To assess the treatment results of ruptured and unruptured ACoA aneurysms and to assess the incidence of intraprocedural complications and various factors influencing these aspects. One hundred and eleven embolizations of ACoA aneurysms (80.7% ruptured and 19.3% unruptured) were retrospectively analysed. The methods of embolization were: coiling, balloon-assisted coiling, stent-assisted coiling. Morphology and dimensions of aneurysms were assessed on 3D digital subtraction angiography (DSA) images. Medical records were analysed for patient's clinical status at admission, intraprocedural complications, follow-up examination and modified Rankin Scale (mRS) score 1 month after discharge. Immediately after the procedure 56.9% of patients had Raymond-Roy Occlusion Classification (RROC) class I, 37.6% class II and 5.5% class III. The overall intraprocedural complication rate was 6.6%. There were significantly more cases of bleeding (p = 0.012) and coil prolapse (p = 0.012) during the procedures ending with higher packing density. Twenty-eight (25.7%) patients died during hospital stay, 27 (96.4%) with ruptured aneurysm. In the follow-up of 41 patients, RROC was the same or improved in 73.2% of cases and recanalization occurred in 26.8%. Six patients with aneurysm recanalization underwent repeat embolization. Endovascular embolization of ACoA aneurysms is an effective and safe treatment method. The most powerful factor influencing the incidence of complications is packing density. Superior orientation of the dome, initial incomplete embolization and poor outcome in mRS scale are factors predisposing to ACoA aneurysm recurrence.


Identification of drug-target interactions via multiple kernel-based triple collaborative matrix factorization.
Targeted drugs have been applied to the treatment of cancer on a large scale, and some patients have certain therapeutic effects. It is a time-consuming task to detect drug-target interactions (DTIs) through biochemical experiments. At present, machine learning (ML) has been widely applied in large-scale drug screening. However, there are few methods for multiple information fusion. We propose a multiple kernel-based triple collaborative matrix factorization (MK-TCMF) method to predict DTIs. The multiple kernel matrices (contain chemical, biological and clinical information) are integrated via multi-kernel learning (MKL) algorithm. And the original adjacency matrix of DTIs could be decomposed into three matrices, including the latent feature matrix of the drug space, latent feature matrix of the target space and the bi-projection matrix (used to join the two feature spaces). To obtain better prediction performance, MKL algorithm can regulate the weight of each kernel matrix according to the prediction error. The weights of drug side-effects and target sequence are the highest. Compared with other computational methods, our model has better performance on four test data sets.


Continuous glucose monitoring in the hospital: an update in the era of COVID-19.
Continuous glucose monitoring (CGM) systems are Food and Drug Administration approved devices for the ambulatory setting; however, they remain investigational systems for inpatient use. This review summarizes the most recent and relevant literature on the use of continuous glucose monitoring in the hospital setting. CGM provides real-time glucose data that enable healthcare professionals to make proactive and timelier clinical decisions with regards to diabetes management. CGM devices appear to be safe and accurate systems for glucose monitoring in the hospital setting. Real-time CGM systems and glucose telemetry can decrease hypoglycemia and reduce hyperglycemia in hospitalized patients with diabetes. Remote glucose monitoring decreases the need of frequent Point-of-care checks and personal protective equipment use while also mitigating staff exposure risk which is timely in the advent of the COVID-19 pandemic. Although most nursing staff have limited exposure and training on CGM technology, early studies show that CGM use in the hospital is well received by nurses. Given the evidence in the current literature regarding CGM use in the hospital, CGM devices may be incorporated in the inpatient setting.


[A case of bacterial empyema caused by Gemella morbillorum].
A 44-year-old female with diabetic ketoacidosis was admitted due to right back pain and dyspnea. A chest roentgenogram showed accumulation of fluid in the right pleural space. A drain was inserted into the right thoracic cavity and pleural fluid yielded a putrid odor. Gemella morbillorum was diagnosed based on culture of the fluid. She was treated with clinidamycin and panipenem/betamipron intravenously and insertion of a drainage tube. The in vitro activity of CLDM and PAPM/BP against G. morbillorum were less than 0.025 micrograms/ml and 0.05 micrograms/ml, respectively. She was cured and discharged after 28 days of hospitalization, the portal of entry was thought to be connected with dental caries.


Directional Polarized Light Emission from Thin-Film Light-Emitting Diodes.
Light-emitting diodes (LEDs) with directional and polarized light emission have many photonic applications, and beam shaping of these devices is fundamentally challenging because they are Lambertian light sources. In this work, using organic and perovskite LEDs (PeLEDs) for demonstrations, by selectively diffracting the transverse electric (TE) waveguide mode while suppressing other optical modes in a nanostructured LED, the authors first demonstrate highly directional light emission from a full-area organic LED with a small divergence angle less than 3° and a TE to transverse magnetic (TM) polarization extinction ratio of 13. The highly selective diffraction of only the TE waveguide mode is possible due to the planarization of the device stack by thermal evaporation and solution processing. Using this strategy, directional and polarized emission from a perovskite LED having a current efficiency 2.6 times compared to the reference planar device is further demonstrated. This large enhancement in efficiency in the PeLED is attributed to a larger contribution from the TE waveguide mode resulting from the high refractive index in perovskite materials.


[Comparison of various reticulocyte counting methods and the standardization of reticulocyte counting].
The reticulocyte count has been conventionally determined using a visual method. Recently, due to technological advances an automated method has come into general use in laboratories. The precision in terms of reproducibility of automated reticulocyte counters has also made rapid progress compared with the visual method. The measurements of reticulocyte counts showed good correlation among the five automated reticulocyte counters and the visual method although the accuracy of an automated method is problematical since it is not sufficient to find the true value. It remains difficult to standardize reticulocyte counting because automated reticulocyte counting is performed in accordance with the procedure specified by the respective manufactures; thus, an external quality control survey was performed for an accuracy assurance of reticulocyte counts with the participation of many laboratories. In the future, it is necessary to develop biological reference materials equal to the true value or to establish other standardization using new technology.


Three cases of retroperitoneal schwannoma diagnosed by EUS-FNA.
Schwannomas are peripheral nerve tumors that are typically solitary and benign. Their diagnosis is largely based on surgically resected specimens. Recently, a number of case reports have indicated that retroperitoneal schwannomas could be diagnosed with endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). We report the diagnosis of three cases of schwannoma using EUS-FNA. Subjects were two males and one female, ages 22, 40, and 46 years, respectively, all of whom were symptom-free. Imaging findings showed well-circumscribed round tumors. However, as the tumors could not be diagnosed using these findings alone, EUS-FNA was performed. Hematoxylin-eosin staining of the resulting tissue fragments revealed bland spindle cells with nuclear palisading. There was no disparity in nuclear sizes. Immunostaining revealed S-100 protein positivity and all cases were diagnosed as schwannomas. Ki-67 indexes were 3%-15%, 2%-3%, and 3%, respectively. No case showed any signs of malignancy. As most schwannomas are benign tumors and seldom become malignant, we observed these patients without therapy. All tumors demonstrated no enlargement and no change in characteristics. Schwannomas are almost always benign and can be observed following diagnosis by EUS-FNA.


[Incomplete central diabetes insipidus in living kidney transplant patient].
A 31-year-old man was sent to hospital for urgent treatment. He was in the terminal state of chronic renal failure, and was placed under hemodialysis immediately. Proteinuria and hypertension had been notified since adolescence, had been left untreated, and there was no record of his conditions, was. Living kidney transplantation was conducted 8 months later. The donor was his father. After the operation, rejection was not recognized, but urine volume per day was not reduced and maintained the level around 10.000 ml. At the same time, the decrease of body weight and the rise in the serum creatinine concentration were noted. The results of magnetic resonance imaging and the hypertonic saline test (Hickey Hare Test) have formed diagnosis of incomplete diabetes insipidus. Immediately after the administration of desmopressin (rhinenchysis), the decrease of urine volume was recognized, and the body weight and serum creatinine concentration became stable.


[Extravasation of contrast media in the excretory urogram].
Aetiology and diagnostic procedure of calyceal fornix rupture during intravenous urography are discussed. In the literature the fornix rupture is described as a spontaneous event--not so in the four cases presented. In two cases a sudden increase in intrapelvic pressure was due to an ureteric calculus, in the other cases an obstruction of the ureter was secondary to neoplasm. It is recommended to perform a CT as soon as a contrast medium extravasation in intravenous urography is diagnosed.


Investigating the effect of a nap following experimental trauma on analogue PTSD symptoms.
Cognitive models assume that the incomplete integration of a traumatic experience into the autobiographical memory results in typical symptoms associated with post-traumatic stress disorder (PTSD) such as intrusive re-experiencing. Sleep supports the integration of new experiences into existing memory networks through memory consolidation. In fifty-six females, we investigated whether a 90-min daytime nap (n = 33) compared to a wake period (n = 23) after being exposed to an experimental trauma (i.e. a trauma film) prevents PTSD analogue symptoms. Intrusive memories were recorded for seven days using a diary, overall PTSD symptoms were assessed using the Impact of Event Scale (IES-R) and affective response to trauma cues were measured one week after experimental trauma. The two groups did not differ in any of the analogue PTSD symptoms. However, participants obtaining rapid eye movement (REM) sleep in the nap experienced less distressing intrusive memories. Moreover, the duration of REM sleep and slow wave activity was negatively correlated with analogue PTSD symptoms. Our findings suggest that even a short sleep period after experimental trauma can play a protective role in trauma memory formation but only if the nap contains REM sleep. Our data provide additional evidence for a critical role of REM sleep in PTSD development.


Hepatitis E virus in Common voles (Microtus arvalis) from an urban environment, Hungary: Discovery of a Cricetidae-specific genotype of Orthohepevirus C.
Hepatitis E virus is a major causative agent of acute hepatitis worldwide. Despite its zoonotic potential, there is limited information about the natural chain of hepevirus infection in wildlife, and the potential reservoir species. In this study, we performed a HEV survey by heminested RT-PCR on rodent samples from an urban environment (in the city of Pécs, Hungary) and investigated the prevalence of the virus among these native rodent species (Apodemus agrarius, Apodemus flavicollis, Apodemus sylvaticus, Microtus arvalis and Myodes glareolus). HEV was detected exclusively in Common voles (M. arvalis), in 10.2% of screened voles, and 3.2% of all investigated samples from all species. Based on the phylogenetic analysis, our strain showed the closest homology with European Orthohepevirus C strains detected previously in faecal samples of birds of prey and Red fox, supporting the possibility of the dietary origin of these strains. In addition, our samples showed close phylogenetic relation with a South American strain detected in Necromys lasiurus (Cricetidae), but separated clearly from other Muridae-associated strains, suggesting the presence of a Cricetidae-specific genotype in Europe and South-America. Based on these results, we hypothesize the reservoir role of M. arvalis rodents for the European Cricetidae-specific Orthohepevirus C genotype.


The antiproliferative effect of coumarins on several cancer cell lines.
Twenty-one coumarins were examined for their antiproliferative activity towards several cancer cell lines, namely lung carcinoma (A549), melanin pigment producing mouse melanoma (B16 melanoma 4A5), human T-cell leukemia (CCRF-HSB-2), and human gastric cancer, lymph node metastasized (TGBC11TKB). The structure-activity relationship established from the results revealed that the 6,7-dihydroxy moiety had an important role for their antiproliferative activity. Analysis of cell cycle distribution indicated that esculetin-treated cells accumulated in the G1 (at 400 microM) or in S phase (at 100 microM).


Symptom variability during repeated measurement among hospice patients with advanced cancer.
In this prospective study, we explored symptom variability in patients with cancer during repeated measurements. Patients with cancer admitted to an inpatient hospice completed a daily questionnaire throughout their admission. The questionnaire consisted of 5 visual analogue scales (VAS) for anxiety, depression, nausea, pain, and sedation and 3 verbal rating scales (VRS) for depression, pain, and vomiting. Data from those who completed 5 consecutive days were used for the primary analysis. We used all available data points to compare VAS and VRS. An index was developed to assess for daily symptom variability. A total of 125 hospice inpatients were enrolled; 46 (38%) completed 3 consecutive daily questionnaires and 30 (24%), 5 days. We found (1) a statistically significant decrease in severity of symptoms present on admission, (2) new symptoms developed, (3) consequently overall symptom prevalence on days 1 and 5 appeared unchanged, (4) high daily symptom variability as demonstrated by the variability index and also changing daily symptom interrelationships, (5) demographic characteristics influenced symptom patterns on admission and subsequently, (6) severe pain predicted more frequent and severe symptom burden only on admission, (7) severe depression predicted more frequent and severe symptom burden on admission and thereafter, (8) VAS scores for depression and pain did not correspond with discrete VRS categories (mild, moderate, severe). (1) Symptom studies in advanced disease while difficult to conduct yield valuable information, (2) symptom relationships changed daily; strict timing of data collection is crucial for data analysis, (3) symptom monitoring following admission is an overlooked measure of risk assessment, (4) symptom prevalence studies alone for treatment follow-up may be misleading, (5) depression is an important predictor of symptoms and need to be more aggressively assessed and treated, (6) demographic characteristics may help identify symptom patterns and better direct treatment, (7) VRS rather than VAS was more reliable for assessing symptoms in hospice cancer patients.


A novel technology for quick acclimation of an anaerobic microbial consortia used for biodegrading teraphthalic acid (TA).
The seed sludge originated from a methane fermentation reactor was enriched and acclimated with TA as sole carbon source under nitrate respiration mode first for 6 week, and then can be turned to methane fermentation conditions. After 6 weeks processing, the specific rate of TA degradation under nitrate respiration mode reached 23.8 mgTA/(L.gVSS), more than two times of that under methane fermentation mode 11.4 mg TA/(L.gVSS). The TA reductive cleavers' population density increased about 6 times and 20 times after 30 days and 90 days acclimation. After a total of 90 days for the enrichment and acclimation, the fermentative bacteria which originally existed in the seed sludge nearly disappeared, and instead of them, the TA reductive and cleaving bacteria group was formed in the new consortia, which was confirmed by the MPN counts and roll tube counts. Compared with the control experiment, the acclimation period can be shortened by about 50%.