Five-year survival of patients with hepatocellular carcinoma treated with laparoscopic microwave coagulation therapy.
Hepatocellular carcinomas (HCCs) that are located near the liver surface are difficult to treat with percutaneous locoregional therapies, so we have performed laparoscopic microwave coagulation therapy (LMCT) for these HCCs. We assessed the long-term survival of patients with HCCs treated with LMCT, the factors related to their survival, and the rates and causes of local and distant recurrences. Participants were 68 patients with HCC treated in the past 8 years with LMCT under local or general anesthesia. LMCT was done using microwave electrodes with tips ranging from 15 to 45 mm in length; the effectiveness of LMCT was confirmed using contrast-enhanced computed tomography (CT) within 2 weeks of the LMCT procedure while patients were still in hospital, and within 1-3 months after the procedure in an outpatient setting; and the follow-up study was performed periodically by CT, ultrasonography, or magnetic resonance imaging (MRI) in addition to estimation of alpha fetoprotein. Factors contributing to survival were analyzed statistically. The mean lengths of the major and minor axes of the 71 HCC nodules in 68 patients were 20 mm and 18 mm, respectively, and the mean lengths of the major and minor axes of the coagulated areas were 43 mm and 29 mm, respectively. At dynamic CT after the LMCT procedure, treatment in 62 of the 68 patients (91%) was judged to have been completely effective; the remaining six patients underwent additional therapy while still in hospital. Eight of the 68 patients (12%) had local recurrences, 39 of them (57%) had distant recurrences, and 21 of them (31%) had no recurrence up to December 31, 2003. A total of 14 patients (21%) died during the 16-56 months after LMCT. When the survival rate was assessed for all patients treated with LMCT, 1-year survival was 97 %, 3-year survival was 81%, and 5-year survival was 43%. Whether the therapy was for primary or secondary HCC strongly influenced survival. LMCT is a useful modality in clinical practice for treatment of HCC nodules located near the liver surface, and it can be safely performed, in its entirety, under direct visual guidance.


Anterior sacrodural attachments - Trolard's ligaments revisited.
In contrast to the attention paid to the structures surrounding spinal nerve roots in the intervertebral foramina, the anterior dural attachments are largely ignored, although they have been described since the last decades of the 19th century. These anterior attachments were systematically studied in a series of 30 cadaver dissections and were found to be present in almost 94% of cases. Four types of anterior attachments were observed. The most frequent form (84%) being a system of filaments that present as a double cross vault between the dura mater and the posterior longitudinal ligament extending from L3 to S3 levels. Less frequent were sagittal filaments (30%), short strong ligaments (17%) and a median septum from L3 to the end of the dural sac (7%). No attachments were found in two cadavers. Further studies are needed to clarify the possible role of these structures in transmitting movement to the dural sac and periradicular sleeves when mobilising the last three lumbar vertebrae or the sacrum.


Distribution of the 22 cytokine gene polymorphisms in healthy Macedonian population.
Distribution of cytokine gene polymorphisms may vary significantly among different ethnic groups, and eventually contribute to observed differences in disease frequencies. To genotype 22 cytokine polymorphisms in the Macedonian population. The Macedonian population consists of 301 healthy unrelated individuals. Blood samples were collected after written consent, DNA was isolated from peripheral blood, and 22 polymorphisms were typed: IL-1alpha -889, IL-1beta -511, IL-1beta +3962, IL-1R psti1970, IL-1RN mspa11100, IL-4Ralpha +1902, IL-12 -1188, IFNgamma utr5644, TGF-beta1 cdn10, TGF-beta1 cdn25, TNF-alpha -308, TNF-alpha -238, IL-2 -330, IL-2 +166, IL-4 -1098, IL-4 -590, IL-4 -33, IL-6 -174, IL-6 565, IL-10 -1082, IL-10 -819, and IL-10 -592. Cytokine genotyping was performed by PCR-SSP (Heidelberg kit). The population genetics analysis package, PyPop, was used for analysis of the cytokine data. Test of neutrality (Fnd) showed negative value, but was significantly different from 0 for TGF-beta1 1 cdn10 and IFNgamma utr5644 (p of F = 0.001, and 0.012 respectively). Several SNPs (IL-1alpha -889, IL-1beta +3962, IL-2 + 166, IL-4 -1098, IL-4 -590, IL-4 -33, and IL-10 -592) were not in HWP (p 0.005). Test of neutrality for cytokine haplotypes (TGF-beta1, TNFalpha, IL-2, IL-4, IL-6, and IL-10) showed significantly difference from 0 only for IL-2 haplotypes (p=0.020). The results of cytokine polymorphisms in Macedonian population can be used for anthropological comparisons, as well as for association studies with different diseases (Tab. 6, Ref. 34). Full Text (Free, PDF) www. bmj. sk.


Breast cancer worry among women awaiting mammography: is it unfounded? Does prior counseling help?
The purpose of this study was to explore the prevalence of breast cancer anxiety and risk counseling in women undergoing mammography, and the association with known risk factors for cancer. Women awaiting mammography were surveyed regarding anxiety, prior breast cancer risk counseling, demographic and risk factors. Anxiety was assessed via 7-point Likert-type scale (LS). Risk was defined by Gail model or prior breast cancer. Data were analyzed by nonparametric methods; significance determined at alpha = 0.05. Of 227 women surveyed, 54 were classified "higher risk". Counseling prevalence was similar (52%) for all ethnic groups, but higher (72%, P<0.001) for "higher risk" women. On average, women awaiting screening/diagnostic mammography were somewhat worried (median LS = 4). Worry was significantly higher (P<0.05) in "higher risk" women (LS = 5), and in women living outside Honolulu (LS = 6). Counseling by primary care physicians (PCP) did not correlate with lower worry scores. It was concluded that most women awaiting mammography are not unduly anxious. Additionally, the findings showed a correlation between a woman's concern about developing cancer with known risk factors and rural residence.


Identification of the nitrate contamination sources of the Brusselian sands groundwater body (Belgium) using a dual-isotope approach.
Isotopic fingerprinting is an advanced technique allowing the classification of the nitrate source pollution of groundwater, but needs further development and validation. In this study, we performed measurements of natural stable isotopic composition of nitrate ((15)N and (18)O) in the groundwater body of the Brussels sands (Belgium) and studied the spatial and temporal dynamics of the isotope signature of this aquifer. Potential nitrogen sources sampled in the region had isotopic signatures that fell within the corresponding typical ranges found in the literature. For a few monitoring stations, the isotopic data strongly suggest that the sources of nitrate are from mineral fertiliser origin, as used in agriculture and golf courses. Other stations suggest that manure leaching from unprotected stockpiles in farms, domestic gardening practices, septic tanks and probably cemeteries contribute to the nitrate pollution of this groundwater body. For most monitoring stations, nitrate originates from a mixing of several nitrogen sources. The isotopic signature of the groundwater body was poorly structured in space, but exhibited a clear temporal structure. This temporal structure could be explained by groundwater recharge dynamics and cycling process of nitrogen in the soil-nitrogen pool.


Tinnitus and Its Association With Mental Health and Health-Related Quality of Life in an Older Population: A Nationwide Cross-Sectional Study.
This study investigated the relationship of tinnitus with mental health and health-related quality of life (QoL) in older people. Data source included 5,129 community-dwelling men and women ≥60 years old from the Korean National Health and Nutrition Examination Survey. Tinnitus was categorized into three groups: normal, tolerable tinnitus, and annoying tinnitus. Mental health and health-related QoL were assessed according to three dimensions (depressive mood, psychological distress, and suicidal ideation) and five domains (impaired mobility, impaired self-care, impaired usual activities, pain/discomfort, and anxiety/depression). The odds ratios (ORs) and 95% confidence intervals (CIs) of mental health and health-related QoL were calculated using multiple logistic regression analyses. Annoying tinnitus was positively and independently associated with deteriorated mental health and health-related QoL, suggesting comprehensive care is needed in older people with annoying tinnitus.


Aerodynamic properties, solubility and in vitro antibacterial efficacy of dry powders prepared by spray drying: Clarithromycin versus its hydrochloride salt.
Antibiotic therapy for a direct administration to the lung in cystic fibrosis patients has to provide suitable availability, possibly in the lower respiratory tract, characterized by the presence of thick secretions. One of the crucial steps in the therapeutic management of the respiratory disease could be the drug solubilization directly in this site of action. The aim of the study was to prepare respirable powders of clarithromycin, while improving drug aqueous solubility. With this aim, several batches of micronized particles were prepared by spray drying different feed solutions, varying the solvent composition (water/isopropyl alcohol ratio), the drug concentration and pH of the liquid feeds. Particle size distribution of raw materials and engineered particles was determined using a light-scattering laser granulometer while particle morphology was assessed by scanning electron microscopy. The in vitro deposition of the micronized clarithromycin powders was evaluated by means of a Single-Stage Glass Impinger using the RS01 model7 by Plastiape® as device for the aerosolization. Solubility measurements of raw and spray-dried (SD) drug were carried out at 37°C in phosphate buffer (0.05M, pH 6.8). Results indicate that morphology and aerodynamic properties of SD particles were strongly influenced by organic solvent concentration and pH of the liquid feeds processed, both modifying drug solubility. Spherical particles and crystals were obtained at higher pH and lower organic solvent content, while wrinkled particles with very interesting aerodynamic properties and higher drug solubility were obtained at lower pH values. Thanks to a fine tuning of the process parameters and liquid feed composition, we produced SD powders with good aerodynamic properties, without using any excipients. Furthermore, SD powders of clarithromycin hydrochloric salt showed higher activity against Pseudomonas aeruginosa growth, compared to clarithromycin raw material.


Osteopontin is elevated during neointima formation in rat arteries and is a novel component of human atherosclerotic plaques.
In an earlier report, we used differential cloning to identify genes that might be critical in controlling arterial neointima formation (Giachelli, C., N. Bae, D. Lombardi, M. Majesky, and S. Schwartz. 1991. Biochem. Biophys. Res. Commun. 177:867-873). In this study, we sequenced the complete cDNA and conclusively identified one of these genes, 2B7, as rat osteopontin. Using immunochemistry and in situ hybridization, we found that medial smooth muscle cells (SMC) in uninjured arteries contained very low levels of osteopontin protein and mRNA. Injury to either the adult rat aorta or carotid artery using a balloon catheter initiated a qualitatively similar time-dependent increase in both osteopontin protein and mRNA in arterial SMC. Expression was transient and highly localized to neointimal SMC during the proliferative and migratory phases of arterial injury, suggesting a possible role for osteopontin in these processes. In vitro, basic fibroblast growth factor (bFGF), transforming growth factor-beta (TGF-beta), and angiotensin II (AII), all proteins implicated in the rat arterial injury response, elevated osteopontin expression in confluent vascular SMC. Finally, we found that osteopontin was a novel component of the human atherosclerotic plaque found most strikingly associated with calcified deposits. These data implicate osteopontin as a potentially important mediator of arterial neointima formation as well as dystrophic calcification that often accompanies this process.


Validation of an educational manual for breast cancer patients undergoing radiotherapy.
to validate the content and appearance of an educational manual for breast cancer patients undergoing radiation therapy. methodological research, which had the Theory of Psychometry as a theoretical-methodological reference. The minimum 80% Concordance Index was considered to ensure the adequacy of the material. The sample consisted of 17 experts in the subject area of the educational manual and 12 patients previously submitted to radiotherapy due to the diagnosis of breast cancer. two items of the expert evaluation tool were found to have a concordance index <80%. The other items were considered adequate and/or totally adequate in the three blocks of analysis proposed for the experts: objectives - 89.07%, structure and presentation - 92.94%, and relevance - 93.13%; and good and/or very good in the five blocks of analysis proposed for the patients: objectives, organization, writing style, appearance, and motivation, all with 100% agreement rate. the educational manual, after having been perfected based on the suggestions of the sample and the scientific literature, was considered valid according to its content and appearance, suggesting its contribution to the clinical practice of nursing and to the understanding of the treatment to which patients with breast cancer are submitted.


Co-Application of Biochar and Arbuscular mycorrhizal Fungi Improves Salinity Tolerance, Growth and Lipid Metabolism of Maize (Zea mays L.) in an Alkaline Soil.
This study reports the mitigating strategy against salinity by exploring the potential effects of biochar (5%), Arbuscular mycorrhizal fungi (20 g/pot, AMF), and biochar + AMF on maize (Zea mays L.) plants grown under saline stress in a greenhouse. The maize was grown on alkaline soil and subjected to four different saline levels; 0, 50, 100, and 150 mM NaCl. After 90 d for 100 mM NaCl treatment, the plant's height and fresh weight were reduced by 17.84% and 39.28%, respectively, compared to the control. When the saline-treated soil (100 mM NaCl) was amended with AMF, biochar, and biochar + AMF, the growth parameters were increased by 22.04%, 26.97%, 30.92% (height) and 24.79%, 62.36%, and 107.7% (fresh weight), respectively. Compared to the control and single AMF/biochar treatments, the combined application of biochar and AMF showed the most significant effect in improving maize growth under saline stress. The superior mitigating effect of biochar + AMF was attributed to its effective ability in (i) improving soil nutrient content, (ii) enhancing plant nutrient uptake, (iii) increasing the activities of antioxidant enzymes, and (iv improving the contents of palmitoleic acid (C16:1), oleic acid (C18:1), linoleic acid (C18:2), and linolenic acid (C18:3). Thus, our study shows that amending alkaline and saline soils with a combination of biochar-AMF can effectively mitigate abiotic stress and improve plant growth. Therefore, it can serve as a reference for managing salinity stress in agricultural soils.


Germacrane-type sesquiterpenoids from the roots of Valeriana officinalis var. latifolia.
Eight new germacrane-type sesquiterpenoids, volvalerenals A-E (2-6) and volvalerenic acids A-C (7-9), along with four known compounds, were isolated from a chloroform extract of the roots of Valeriana officinalis var. latifolia. The structures and relative configurations of 2-9 were elucidated on the basis of spectroscopic data interpretation. The effects of all compounds isolated on acetylcholinesterase were evaluated.


"They're Really PD Today".
The therapeutic relationship is of particular importance when working with patients with antisocial personality disorder, but despite this, there is a paucity of literature exploring student nurses' perceptions of developing a therapeutic relationship with such patients. Hence, this qualitative study explored the perceptions of second-year mental health nursing students of developing a therapeutic relationship with this patient group. Student nurses from a University in the Northwest of England participated in two focus groups, to compare the perceptions of a group of student nurses who had experience in secure settings (forensic hospital) with those who had not. Four key themes emerged: diagnosis, safety, engagement, and finally environmental influences. Both groups commented on looking beyond the diagnosis and seeing the person. The student nurses cited other staff in their clinical placement areas as hugely influential in terms of the development of their perceptions of patients with antisocial personality disorder and how to relate to them.


Evidence for two independent lineages of shiitake of the americas (Lentinula boryana) based on rDNA and beta-tubulin gene sequences.
Portions of ribosomal RNA genes (rDNA) were sequenced from members of the genus Lentinula and were used, along with partial beta-tubulin gene sequences, for phylogenetic reconstructions. The rDNA sequences of L. boryana were separated into two well-defined lineages. Lineage 1 was composed of isolates from Mexico and Costa Rica while lineage 2 encompassed isolates from the United States, Venezuela, and Brazil. The two South American isolates of L. boryana had nearly identical ITS sequences and very closely related beta-tubulin sequences. This high level of similarity may indicate that sexual reproduction occurs among the sampled populations, although this is difficult to reconcile with the large geographic distances (over 4000 km) that separate some of the collecting locations. An alternative explanation may be that the isolates sampled are the product of a rapid population expansion over a large geographic area. Analyses of partial beta-tubulin gene sequences that were rooted using Pleurotus spp. support the hypothesis that L. boryana is monophyletic.


How does replication-associated mutational pressure influence amino acid composition of proteins?
We have performed detrended DNA walks on whole prokaryotic genomes, on noncoding sequences and, separately, on each position in codons of coding sequences. Our method enables us to distinguish between the mutational pressure associated with replication and the mutational pressure associated with transcription and other mechanisms that introduce asymmetry into prokaryotic chromosomes. In many prokaryotic genomes, each component of mutational pressure affects coding sequences not only in silent positions but also in positions in which changes cause amino acid substitutions in coded proteins. Asymmetry in the silent positions of codons differentiates the rate of translation of mRNA produced from leading and lagging strands. Asymmetry in the amino acid composition of proteins resulting from replication-associated mutational pressure also corresponds to leading and lagging roles of DNA strands, whereas asymmetry connected with transcription and coding function corresponds to the distance of genes from the origin or terminus of chromosome replication.


[Esculentoside reduces expression of Th17 cell-related cytokines in the imiquimod-induced psoriasis-like dermatitis mouse model].
Objective To observe the effect of esculentoside A (EsA) on Th17 cell-related factors in psoriasis-like mouse model. Methods A total of 48 female BALB/c mice were randomly divided into blank control group, model group, Tuiyin decoction group [66.60 g/(kg.d)], low-, middle- and high-dose groups of EsA [5, 10, 20 mg/(kg.d), respectively], 8 mice in each group. Psoriasis mouse model was induced by imiquimod. Pathological changes of skin lesions in mice were assessed by psoriasis area and severity index (PASI) and HE staining. ELISA was used to detect the changes of interleukin-17 (IL-17), IL-22, IL-6 and tumor necrosis factor-α (TNF-α). Results Compared with the model group, the skin lesions, pathological changes and PASI scores were improved after the treatments with either Tuiyin decoction or EsA, among which the PASI score of Tuiyin decoction group and high-dose group of EsA decreased significantly. The expression of Th17 cell-related factors of the model group was obviously higher than that of the blank control group. Each treated group had obviously lower expression than the model group, and the expression of IL-6 of high-dose group of EsA was close to the blank control group. Conclusion EsA may improve the skin lesions of the psoriasis-like mice by down-regulating the expression of Th17 cell-related cytokines.


Auditory superiority for perceiving the beat level but not measure level in music.
Auditory perception of time is superior to visual perception, both for simple intervals and beat-based musical rhythms. To what extent does this auditory advantage characterize perception of different hierarchical levels of musical meter, and how is it related to lifelong experience with music? We paired musical excerpts with auditory and visual metronomes that matched or mismatched the musical meter at the beat level (faster) and measure level (slower) and obtained fit ratings from adults and children (5-10 years). Adults exhibited an auditory advantage in this task for the beat level, but not for the measure level. Children also displayed an auditory advantage that increased with age for the beat level. In both modalities, their overall sensitivity to beat increased with age, but they were not sensitive to measure-level matching at any age. More musical training was related to enhanced sensitivity in both auditory and visual modalities for measure-level matching in adults and beat-level matching in children. These findings provide evidence for auditory superiority of beat perception across development, and they suggest that beat and meter perception develop quite gradually and rely on lifelong acquisition of musical knowledge. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Transmission of pandemic influenza H1N1 (2009) in Vietnamese swine in 2009-2010.
The pandemic of 2009 was caused by an H1N1 (H1N1pdm) virus of swine origin. This pandemic virus has repeatedly infected swine through reverse zoonosis, although the extent of such infection in swine remains unclear. This study targets small and commercial pig producers in North Vietnam, in order to estimate the extent of H1N1pdm infection in swine and to identify the risk factors of infection. Virologic and serologic surveillance of swine was carried out in 2009-2010 in pig farms (38 swabs and 1732 sera) and at a pig slaughterhouse (710 swabs and 459 sera) in North Vietnam. The sera were screened using a influenza type A-reactive ELISA assay, and positive sera were tested using hemagglutination inhibition tests for antibody to a panel of H1-subtype viruses representing pandemic (H1N1) 2009 (H1N1pdm), triple reassortant (TRIG), classical swine (CS), and Eurasian avian-like (EA) swine lineages. Farm-level risk factors were identified using a zero-inflated negative binomial model. We found a maximal seroprevalence of H1N1pdm of 55·6% [95% CI: 38·1-72·1] in the slaughterhouse at the end of December 2009, 2 weeks after the peak of reported human fatalities with H1N1pdm. Farm-level seroprevalence was 29% [95% CI: 23·2-35·7]. In seropositive farms, within-herd seroprevalence ranged from 10 to 100%. We identified an increased risk of infection for farms that specialized in fattening and a decreased risk of infection in farms hiring external swine workers. Our findings suggest extensive reverse-zoonotic transmission from humans to pigs with subsequent onward transmission within pig herds.


[Quality assurance in rheumatology].
The German legislation on medicine demands that each person examining or treating patients must prove the quality of their work. That is done by way of "external evidence", by application of qualified studies or, if in default of those, by documentation on results and evaluation of each individual patient ("internal evidence"). Such evidences pertain to diagnostics (methods and their evaluation), treatment (medication and physical therapy) and the organization of work (staff, timeframes, available space etc.). The demand of assuring quality means that those methods which have no proven efficiency are automatically dropped, which in turn brings cost reduction.


Aspiration cytodiagnostics of breast tumours.
Aspiration cytology has been performed in 2,180 cases of breast alterations. Cytological examination was followed by histological control in 967 cases. Diagnostic value (sensitivity) of the method proved to be as high as 83%. As a matter of principle, the technique cannot substitute histology. Using in combination with other clinical diagnostic measures like palpation, mammography, xeromammography, thermography the diagnostic possibilities are multipled. This preoperative morphological test of orientatory value which is rapid, cheap and painless and devoid of any complications is worth of widespread use. According to the authors opinion its routine application in the clinical practice is highly desirable.


Thioarsenite Detection and Implications for Arsenic Transport in Groundwater.
Arsenic toxicity and mobility in groundwater depend on its aqueous speciation. Uncertainty about the methods used for measuring arsenic speciation in sulfate-reducing environments hampers transport and fate analyses and the development of in situ remediation approaches for treating impacted aquifers. New anion-exchange chromatography methods linked to inductively coupled plasma mass spectrometry (ICP-MS) are presented that allow for sample/eluent pH matching. Sample/eluent pH matching is advantageous to prevent thioarsenic species transformation during chromatographic separation because species protonation states remain unaffected, hydroxyl-for-bisulfide ligand substitution is avoided, and oxidation of reduced arsenic species is minimized. We characterized model and natural solutions containing mixtures of arsenic oxyanions with dissolved sulfide and solutions derived from the dissolution of thioarsenite and thioarsenate solids. In sulfidic solutions containing arsenite, two thioarsenic species with S/As ratios of 2:1 and 3:1 were important over the pH range from 5.5 to 8.5. The 3:1 thioarsenic species dominated when disordered As2S3 dissolved into sulfide-containing solution at pH 5.4. Together with the preferential formation of arsenite following sample dilution, these data provide evidence for the formation and detection of thioarsenite species. This study helps resolve inconsistencies between spectroscopic and chromatographic evidence regarding the nature of arsenic in sulfidic waters.


Attitudes towards the relevance of biological, behavioural and social sciences in nursing education.
This paper explores the perceptions of staff and students regarding the supporting sciences within nursing education and how they feel such content relates to the 'real world' of nursing. A qualitative study examining the perceptions of students and teaching staff, particularly the concept of relevance, was conducted to explore factors which impact upon the integration of theory and practice. The teaching approaches used, assessment items selected, and the perceptions held about what nurses actually do all impinge upon what, and how, students learn in subjects which are essentially non-nursing in their orientation. Through an awareness of factors affecting how students and teaching staff actually approach supporting sciences content, better informed curriculum decisions can be made.


Learning, school performance, and children with asthma: how much at risk?
Children with asthma may be at risk for decreased school functioning due to acute exacerbations, increased absenteeism, iatrogenic effects of their asthma medication, and the stress associated with a chronic illness. The purpose of this article is to critically review extant research pertaining to the school functioning of children with asthma, including studies of school attendance, school performance, the effects of asthma medications on learning and behavior, and the role of psychological variables in the development of functional impairments. There is not sufficient evidence to suggest that children with asthma are at significantly higher risk for poor school performance than children without asthma. Factors that may contribute to poor school performance among children with asthma include iatrogenic effects of oral steroids, poor medical management of the disease, and psychological problems. Recommendations for improving the school functioning of children with asthma are discussed.


[Postoperative survival in patients with inoperable lung cancer].
Despite the advances in treatment in the last two decades, the prognosis in lung cancer remains infavourable. Only 20-25% of the patients are suitable for operative treatment. Almost 75% of the patients are inoperable at the time of diagnosis. We present 148 patients, who underwent non-radical operation for the period 01.01.1997 - 31.12.2005 - 129 men (87.16%) and 19 women (12.84%), age range - 29-65 years (53.67 +/- 0.60). The mean time of survival for the group submitted to radiotherapy is 13.74 months, while for the group without postoperative radiotherapy is 9.31 months. The mean time of survival for the group submitted to chemotherapy is 9.99 months, while for the group without adjuvant chemotherapy is 10.27 months. The radiotherapy significantly improves the survival in the patients with inoperable lung cancer, while the chemotherapy don't increase the survival.


Injuries to volunteer fire fighters in West Virginia.
The distribution and characteristics of workplace injuries for West Virginia volunteer fire fighters (VFFs) are described using 1992 workers' compensation data. Most of the injuries occurred in VFFs who were less than 30 years of age (62%). The most common type of injuries were those in the category of lacerations and contusions (28.9%), with a notable percentage of injuries due to smoke inhalation and respiratory problems (13.7%). The proportional rates related to falls in VFFs were almost twice the national figures for the same year (39.3% versus 22.3%). County population density was found to be directly associated with injury rates, even when adjusted for number of responses. Claims statistics mirror a similar geographical trend in overall workers' compensation claims for all injuries in West Virginia. The results of this study provide a foundation for additional follow-up studies in order to develop improved occupational safety policies and target educational programs aimed at the prevention of injuries in volunteer fire fighters. Several findings have already resulted in programmatic recommendations.


Multifractal spectrum of chorionic villi: a novel approach.
To measure the multifractal dimension in histopathology sections of chorionic villi to study its role to distinguish between normal chorionic villi and hydatidiform mole. Multifractal spectrum was measured in 10 each cases of normal chorionic villi and hydatidiform mole. The values of alpha max and alpha min and their difference Delta alpha (alpha max--alpha min) were recorded in each case. The data for these groups were compared. The mean +/- SD of alpha max, alpha min, and Delta alpha (alpha max--alpha min) of normal chorionic villi were 2.6335 +/- 0.16109, 1.6975 +/- 0.04435, and 0.9360 +/- 0.12725, respectively. Whereas the mean +/- SD of alpha max, alpha min, and Delta of hydatidiform moles were 2.3196 +/- 0.11937, 1.6209 +/- 0.06208, and 0.7000 +/- 0.08350, respectively. The mean alpha max, alpha min, and Delta alpha of normal chorionic villi were much higher than for hydatidiform mole. Independent sample t-test shows significant difference (p < 0.001) in alpha max, alpha min, and Delta alpha of normal chorionic villi and hydatidiform mole. Multifractal dimension was significantly different in normal chorionic villi and hydatidiform mole.


Heavy metal and nutrient uptake in plants colonizing post-flotation copper tailings.
Copper ore mining and processing release hazardous post-flotation wastes that are difficult for remediation. The studied tailings were extremely rich in Cu (1800 mg kg-1) and contaminated with Co and Mn, and contained very little available forms of P, Fe, and Zn. The plants growing in tailings were distinctly enriched in Cu, Cd, Co, Ni, and Pb, and the concentration of copper achived the critical toxicity level in shoots of Cerastium arvense and Polygonum aviculare. The redundancy analysis demonstrated significant relationship between the concentration of available forms of studied elements in substrate and the chemical composition of plant shoots. Results of the principal component analysis enabled to distinguish groups of plants which significantly differed in the pattern of element accumulation. The grass species Agrostis stolonifera and Calamagrostis epigejos growing in the tailings accumulated significantly lower amounts of Cu, but they also had the lowest levels of P, Fe, and Zn in comparison to dicotyledonous. A. stolonifera occurred to be the most suitable species for phytostabilization of the tailings with regard to its low shoot Cu content and more efficient acquisition of limiting nutrients in relation to C. epigejos. The amendments improving texture, phosphorus fertilization, and the introduction of native leguminous species were recommended for application in the phytoremediation process of the tailings.


Prevalence and determinants of the dual burden of malnutrition at the household level in Puna and Quebrada of Humahuaca, Jujuy, Argentina.
The objective of the present study was to identify households in which overweight and underweight coexisted (dual burden of malnutrition) and explore the factors that could be contributing to the dual burden of malnutrition at the household level in this population. Cross-sectional nutritional survey. After applying the exclusion criteria, 136 households were included. Mothers were classified as normal weight or overweight/obese based on body mass index (BMI) cut-off points and children and adolescents were classified as stunted or not based on height-for-age z-score. Households with an obese mother and a stunted children or adolescent were categorized as dual burden households. The prevalence of dual burden household was 12%. Compared with other households, dual burden households tended to have more people living in the house, and the educational level of the head of household was lower. Individuals living in dual burden households showed overall lower energy intakes and were more likely to have inadequate intakes of calcium and iron. The nutrition transition in this community might be one of the leading causes of the observed dual burden of malnutrition. The results presented here indicate the need to consider whether programs that focus on only one type of nutritional problem come might actually exacerbate the other.


Assessment of knowledge, practice, and status of food handlers toward Salmonella, Shigella, and intestinal parasites: A cross-sectional study in Tigrai prison centers, Ethiopia.
Unsafe food becomes a global public health and economic threat to humans. The health status, personal hygiene, knowledge, and practice of food handlers have crucial impact on food contamination. Hence, this study is aimed at assessing the knowledge, practice, and prevalence of Salmonella, Shigella, and intestinal parasites among food handlers in Eastern Tigrai prison centers, Northern Ethiopia. An institutional-based cross-sectional study was carried out from April to September 2019 among food handlers in Eastern Tigrai prison centers, Northern Ethiopia. A structured questionnaire was used to collect the demographic characteristics, the knowledge, and the practice of the study participants. Direct wet mount and formol-ether concentration techniques were applied to identify intestinal parasites. Culture and biochemical tests were used to isolate the Salmonella and the Shigella species. Additionally, antimicrobial susceptibility tests to selected antibiotics were performed using Kirby-Baur disk diffusion method. We used SPSS version 23 software for statistical analysis. Thirty-seven (62.7%, 37/59) of the participants had harbored one or more intestinal parasites. The protozoan Entamoeba histolytica/dispar was detected among 23.7% (14/59) of the study participants who provided stool specimen. Besides, 6.8% (4/59) of the samples were positive for either Salmonella or Shigella species. The Salmonella isolates (n = 2) were sensitive to Gentamicin, Ciprofloxacin, Ceftriaxone, and Clarithromycin but resistant to Amoxicillin, Ampicillin, and Amoxicillin/clavulanic acid. Similarly, the two Shigella isolates were susceptible to Gentamicin, Ciprofloxacin, and Ceftriaxone but showed resistance to Amoxicillin, Tetracycline, and Chloramphenicol. Further, 60.6% (40/66) of the participants had good level of knowledge, and 51.5% (34/66) had good level of practice on foodborne diseases and on food safety. We conclude that foodborne pathogens are significant health problems in the study areas. Regular health education and training programs among the food handlers are demanded to tackle foodborne diseases at the prison centers.


THE EMERGENT CONCERN OF SEROPOSITIVE STATUS OF HEPATITIS-B VIRUS AND HEPATITIS-C VIRUS IN THE PREGNANT FEMALES ATTENDING A TERTIARY CARE HOSPITAL.
Viral hepatitis is a global problem affecting millions of people including pregnant females. Viral hepatitis during pregnancy is associated with both maternal and neonatal mortality and morbidity. This study was an attempt to assess the seropositive status of hepatitis-B and C infection among pregnant women in Karachi, Pakistan. This cross sectional observational study was conducted at Sir Syed College of Medical Sciences and Trust Hospital, Karachi from January to September 2012. Patients were recruited by consecutive sampling. At the booking visit, blood was drawn and tested for HbsAg and Anti HCV by Eliza method. Among the screened population, 2% were reactive for HBV and 13.3% were found reactive for HCV. All HbsAg and HCV positive pregnant patients had one or more than one delivery. In our study sample, high frequency of HBV and HCV is suggestive of the importance of antenatal screening of these viral diseases, which has impact on the mother as well as the new born baby. HCV was more common as compared to HBV which is quite alarming.


Electron diffraction as a structure tool for charged and neutral nanoclusters formed in superfluid helium droplets.
This perspective presents the current status and future directions in using electron diffraction to determine the structures of clusters formed in superfluid helium droplets. The details of the experimental setup and data treatment procedures are explained, and several examples are illustrated. The ease of forming atomic and molecular clusters has been recognized since the invention of superfluid helium droplet beams. To resolve atomic structures from clusters formed in droplets, substantial efforts have been devoted to minimizing the contribution of helium to diffraction signals. With active background subtraction, we have obtained structures from clusters containing a few to more than 10 monomers, with and without heavy atoms to assist with the diffraction intensity, for both neutral and ionic species. From fittings of the diffraction profiles using model structures, we have observed that some small clusters adopt the structures of the corresponding solid sample, even for dimers such as iodine and pyrene, while others require trimers or tetramers to reach the structural motif of bulk solids, and smaller clusters such as CS2 dimers adopt gas phase structures. Cationic clusters of argon clusters contain an Ar3+ core, while pyrene dimers demonstrate a change in the intermolecular distance, from 3.5 Å for neutral dimers to 3.0 Å for cations. Future improvements in reducing the background of helium, and in expanding the information content of electron diffraction such as detection of charge distributions, are also discussed.


Executive dysfunction is associated with poorer health-related quality of life in adolescents with type 1 diabetes: differences by sex.
Type 1 diabetes (T1D) is one of the most complex and demanding chronic diseases in adolescents. Given the detrimental impact of problems with executive function (EF; the ability to initiate, plan, and monitor behavior) on health outcomes in adolescents with T1D, most studies have examined common diabetes-specific outcomes related to self-management and glycemic control. This study aims to investigate the impact of executive dysfunction on health-related quality of life (HRQoL; an individual's perceived impact of illness and treatment on daily functioning) in adolescents with T1D from a multi-informant perspective. In this cross-sectional study, 169 adolescents (mean ± SD age 15.9 ± 1.3 years) and their parents reported on adolescent EF and HRQoL (assessed by the BRIEF and PedsQL, respectively). Parent-youth interview and chart review provided demographic and clinical characteristics. Statistical analyses encompassed bivariate correlations, t-tests, chi-squared tests, and multivariable analyses. Adolescent self-reports and parent proxy-reports identified 13% and 32% of adolescents, respectively, as having executive dysfunction. Poorer adolescent EF was associated with poorer adolescent HRQoL by both adolescent self-report and parent proxy-report, respectively. In significant multivariable models, adjusted for adolescent age, sex, diabetes duration, and glycemic control, 21% and 24% of the variance in adolescent self-reported and parent proxy-reported HRQoL were explained by adolescent self-reported and parent proxy-reported executive dysfunction. A significant interaction of sex with adolescent self-report of executive dysfunction indicated that executive dysfunction had a greater negative impact on HRQoL in females than males (p < .01). Findings suggest that the impact of EF problems in adolescents with T1D goes beyond diabetes-specific outcomes and focuses attention on the need to evaluate and preserve HRQoL.


Conditions for correction of linear and quadratic field-dependent aberrations in plane-symmetric optical systems.
The Abbe sine condition and the recently developed pupil astigmatism conditions provide a powerful set of relationships for describing imaging systems that are free from aberrations that have linear and quadratic dependence on field, to all orders in the pupil. We have proved both of these conditions and applied them to axisymmetric imaging systems. We now extend our approach to plane-symmetric systems. Still using Hamilton's characteristic functions, we derive the general sine conditions and the pupil astigmatism conditions that describe plane-symmetric systems that are free of all aberrations with linear and quadratic field dependence.


The Efficacy of Leviteracetam versus Carbamazepine for Epilepsy: A Meta-Analysis.
Leviteracetam (LEV) is a novel antiepileptic drug with improved tolerance and safety, while carbamazepine (CBZ) represents classical antiepileptic drugs. So far, a systemic comparison of the efficacy and side effects of these two drugs is lacking. A literature review on the comparison of leviteracetam versus carbamazepine for patients with epilepsy was performed up to September 2013 using PubMed, EMBASE, the Cochrane Library and ISI web of science. Finally, 3 randomized controlled trials (RCT) studies met the criteria on comparing the efficacy of leviteracetam versus carbamazepine for patients with epilepsy were included for meta-analysis. Stata 11.0 was used to analyze and summarize the respective data. Three RCTs met the entry criteria. The relative risk (RR) and 95% and the confidence interval (CI) of leviteracetam versus carbamazepine for 6- and 12-month seizure free intervals were 1.0 (0.91-1.10) and 0.97 (0.84-1.13), respectively, for therapy discontinuation due to adverse events (AEs) were 0.62 (0.48-0.80) and 1.00 (0.94-2.05), respectively, and for withdrawal after 6- and 12-month treatment were 0.8 (0.64-0.99) and 0.87 (0.74-1.03), respectively. The RR and 95% CI for occurrence of headache, fatigue, diarrhea, vertigo, nasopharyngitis, depression, weight gain and rash were 0.88 (0.73-1.06), 1.08(0.63-1.83), 1.23 (0.66-2.28), 0.92 (0.49-1.71), 0.85 (0.59-1.22), 2.15 (1.26-3.68), 0.69 (0.45-1.04), 0.39 (0.23-0.68), respectively. The major outcomes such as rate of seizure freedom were similar between leviteracetam and carbamazepine. However, leviteracetam led to depression more frequently than carbamazepine, while carbamazepine caused rash more frequently. However, the limited numbers of available RCTs studies and included patients in this study made our results less convincing and accurate.


Frailty Syndrome-Fall Risk and Rehabilitation Management Aided by Virtual Reality (VR) Technology Solutions: A Narrative Review of the Current Literature.
Frailty, a physiological syndrome (FS) affecting primarily the older adults, manifests itself through significantly depleted bodily reserves, and appreciably higher (up to over threefold) individual exposure to fall risk. Concomitant medical conditions such as balance impairment, reduced visual acuity, limited mobility, and significantly diminished daily functional performance further exacerbate the patients' condition. Their resultant susceptibility to frequent hospitalisations makes their prognosis even worse. This narrative review aimed to provide an overview of published studies focused on rehabilitation management approaches aided by virtual reality (VR) technology in frail older adults. The authors had it also augmented with their own, evidence-based body of experience in rehabilitation. Making use of technologically advanced exercise machinery, specially adapted for rehabilitating frail older adults, combined with a structured exercise regimen, further aided by the application of select virtual reality (VR) technology solutions, clearly proved effective. Consequently, the patients were helped to move back from the frail to the pre-frail stage, as well as had their motor and cognitive functions appreciably enhanced. The application of modern technology in rehabilitating older adults over 65, affected by FS, when specifically aided by the select VR technology solutions, was also proven to complement successfully the conventional rehabilitation management. The overall versatility of the VR technology solutions, e.g., adaptation for home use allowing remote supervision, also makes this novel approach to rehabilitation far more appealing to the patients. They find it both very attractive and far more mentally engaging. Its considerable potential lies mostly in being appreciably more effective in bringing in desirable therapeutic outcomes.


[LOW-ENERGY LASER TECHNOLOGY IN THE COMPLEX TREATMENT OF PRESSURE SORES IN PATIENTS WITH SEVERE BRAIN DAMAGE].
Aim - to improve the results of treatment of pressure sores using low-energy laser technology. The authors performed a comparative analysis of the effectiveness of the use of low-energy laser irradiation in the complex treatment of pressure ulcers of 2-3 degrees in 35 patients with severe brain damage for the period from 2017-2019. The contact laser was used with the following parameters: wave length - 904 nm, frequency - 5000 Hz, irradiation mode - pulsed, power - 13.5mWt/cm2, exposure - on average 2 minutes per zone. The results were compared with those in 41 people treated according to the traditional methodology. The demographic criteria, localization and length of the process did not have significant intergroup differences. The use of low-energy laser technology in combination with other conservative methods made it possible to accelerate the healing of pressure sores by 1.3-1.4 times, and to reduce the degree of microbial contamination of the focus in earlier periods (p<0.05). At the same time, both the duration of the inpatient rehabilitation phase and the overall treatment costs are reduced. An integrated approach using low-energy laser technology as an additional physical factor can significantly improve the results of the treatment of pressure sores in people with severe brain damage.


AC conductivity parameters of graphene derived from THz etalon transmittance.
THz frequency-domain transmittance measurements were carried out on chemical-vapor-deposited (CVD) graphene films transferred to high-resistivity silicon substrates, and packaged as back-gated graphene field effect transistors (G-FETs). The graphene AC conductivity σ(ω), both real and imaginary parts, is determined between 0.2 and 1.2 THz from the transmittance using the transmission matrix method and curve-fitting techniques. Critical parameters such as the charge-impurity scattering width and chemical potential are calculated. It is found that not only the sheet charge density but also the scattering parameter can be modified by the back-gate voltage.


Left and right hemisphere memory traces: their formation and fate. Evidence from events during memory formation in the chick.
In the domestic chick, different versions of a particular learning experience are elaborated by right and left hemispheres (left: selection of cues allowing selection of appropriate response; right: elaboration of relatively complete and unselected record). During memory formation, further processing of the traces is associated with a series of brief points of trace reactivation, which recur with differing periodicity in association with the two hemispheres (16 min: left; 25 min: right). As a result there is a series of near coincidences, which allow interaction between the two traces. The first, at 48-50 min, is associated with such marked changes in what is available to recall that it has been identified as the onset of long-term memory. The period is shown here to begin with a left hemisphere event, which overlaps with a right hemisphere event, beginning at 50 min, in a way that helps to explain why the interaction that occurs at this time is predominantly one in which the left hemisphere accesses right hemisphere material. It is argued that the main change during hemispheric interaction is the establishment of linkages between different trace ''fragments''.


Comparative performance studies of water lettuce, duckweed, and algal-based stabilization ponds using low-strength sewage.
A bench-scale continuous-flow wastewater treatment system comprising three parallel lines using duckweed (Spirodela polyrhiza), water lettuce (Pistia stratiotes), and algae (natural colonization) as treatment agents was set up to determine environmental conditions, fecal coliform profiles and general treatment performance. Each line consisted of four ponds connected in series fed by diluted sewage. Influent and effluent parameters measured included environmental conditions, turbidity, biochemical oxygen demand (BOD), chemical oxygen demand (COD), nitrate, nitrite, ammonia, total phosphorus, fecal coliforms, mosquito larvae, and sludge accumulations. Environmental conditions and fecal coliforms profiles were determined in the sediments (0.63 m), suspensions (0.35 m), and surfaces (0.1 m) of each pond. Acidic conditions were observed in the pistia ponds, neutral conditions in duckweed ponds, and alkaline conditions in algal ponds. Fecal coliforms log removals of 6, 4, and 3 were observed in algal, duckweed, and pistia ponds, respectively, in the final effluents, with die-off rates per pond of 2.7, 2.0, and 1.6. Sedimentation accounted for over 99% fecal coliform removal in most of the algal and pistia ponds. BOD removal was highest in the duckweed system, followed by pistia and algae at 95%, 93%, and 25%, respectively. COD removals were 65% and 59%, respectively, for duckweed and pistia, while COD increased in algal ponds by 56%. Nitrate removals were 72%, 70%, and 36%, respectively for duckweed, pistia, and algal ponds. Total phosphorus removals were 33% and 9% for pistia and duckweed systems, while an increase of 19% was observed in the algal treatment system. Ammonia removals were 95% in both pistia and duckweed and 93% in algal systems. Removals of total dissolved solids (TDS) were 70% for pistia, 15% for duckweed, and 9% for algae. Mosquito populations of 11,175/m(2), 3516/m(2), and 96/m(2) were counted in pistia, algal, and duckweed ponds, respectively. Low turbidity and low sludge accumulation characterized the macrophyte ponds. Performance in the removal of fecal coliforms in the algal-based treatment system and organic load removal in both macrophytes and algal-based treatment systems met the Ghana Environmental Protection Agency guideline values.


N omega-hydroxy-L-arginine is an intermediate in the biosynthesis of nitric oxide from L-arginine.
Authentic N omega-hydroxy-L-arginine was synthesized and used to determine whether it is an intermediate in nitric oxide (.NO) synthesis from L-arginine by macrophage .NO synthase. The apparent Km (6.6 microM) and Vmax (99 nmol x min-1 x mg-1) observed with N omega-hydroxy-L-arginine were similar to those observed with L-arginine (Km = 2.3 microM; Vmax = 54 mumol x min-1 x mg-1). N omega-Hydroxy-D-arginine was not a substrate. Stable isotope studies showed that .NO synthase exclusively oxidized the hydroxylated nitrogen of N omega-hydroxy-L-arginine, forming .NO and L-citrulline. As with L-arginine, O2 was the source of the ureido oxygen in L-citrulline from N omega-hydroxy-L-arginine. In the presence of excess N omega-hydroxy-L-arginine, .NO synthase generated a metabolite of L-[14C]arginine that cochromatographed with authentic N omega-hydroxy-L-arginine. The labeled metabolite exhibited identical chromatographic behavior in three solvent systems and generated the same product (L-citrulline) upon alkaline hydrolysis as authentic N omega-hydroxy-L-arginine. Experiments were then run to identify which redox cofactor (NADPH or tetrahydrobiopterin) participated in the enzymatic synthesis of N omega-hydroxy-L-arginine. Both cofactors were required for synthesis of .NO from either N omega-hydroxy-L-arginine or L-arginine. However, with L-arginine, the synthesis of 1 mol of .NO was coupled to the oxidation of 1.52 +/- 0.02 mol of NADPH; whereas with N omega-hydroxy-L-arginine, only 0.53 +/- 0.04 mol of NADPH was oxidized per mol of .NO formed. These results support a mechanism in which N omega-hydroxy-L-arginine is generated as an intermediate in .NO synthesis through an NADPH-dependent hydroxylation of L-arginine.


Increased sagittal vertical axis is associated with less effective control of acute pain following vertebroplasty.
Although vertebroplasty is very effective for relieving acute pain from an osteoporotic vertebral compression fracture, not all patients who undergo vertebroplasty receive the same degree of benefit from the procedure. In order to identify the ideal candidate for vertebroplasty, pre-operative prognostic demographic or clinico-radiological factors need to be identified. The objective of this study was to identify the pre-operative prognostic factors related to the effect of vertebroplasty on acute pain control using a cohort of surgically and non-surgically managed patients. Patients with single-level acute osteoporotic vertebral compression fracture at thoracolumbar junction (T10 to L2) were followed. If the patients were not satisfied with acute pain reduction after a three-week conservative treatment, vertebroplasty was recommended. Pain assessment was carried out at the time of diagnosis, as well as three, four, six, and 12 weeks after the diagnosis. The effect of vertebroplasty, compared with conservative treatment, on back pain (visual analogue score, VAS) was analysed with the use of analysis-of-covariance models that adjusted for pre-operative VAS scores. A total of 342 patients finished the 12-week follow-up, and 120 patients underwent vertebroplasty (35.1%). The effect of vertebroplasty over conservative treatment was significant regardless of age, body mass index, medical comorbidity, previous fracture, pain duration, bone mineral density, degree of vertebral body compression, and canal encroachment. However, the effect of vertebroplasty was not significant at all time points in patients with increased sagittal vertical axis. For single-level acute osteoporotic vertebral compression fractures, the effect of vertebroplasty was less favourable in patients with increased sagittal vertical axis (> 5 cm) possible due to aggravation of kyphotic stress from walking imbalance.Cite this article: Y-C. Kim, D. H. Bok, H-G. Chang, S. W. Kim, M. S. Park, J. K. Oh, J. Kim, T-H. Kim. Increased sagittal vertical axis is associated with less effective control of acute pain following vertebroplasty. Bone Joint Res 2016;5:544-551. DOI: 10.1302/2046-3758.511.BJR-2016-0135.R1.


Hemorheological disturbances correlate with the lipid profile but not with the NCEP-ATPIII score of the metabolic syndrome.
The metabolic syndrome, which is associated with an high risk for diabetes and atherothrombosis, is associated with hemorheologic abnormalities. These abnormalities seem more and more to be explained by its various symptoms than by insulin resistance which represents theoretically the core of the syndrome. In this study we aimed at defining the specific hemorheologic profile of insulin resistance and hyperinsulinemia by separating a sample of 90 subjects into 4 subgroups according to the clinical score "NCEP-ATPIII" which is the best recognized standardized definition of the syndrome. Results show no significant changes of blood rheology across classes of NCEP score despite a borderline rank correlation between RBC aggregability "M1" and the score. Whole blood viscosity was mostly correlated to HDL-cholesterol (r = -0.353, p = 0.007) and triglycerides (r = 0.574, p = 0.0001). Plasma viscosity was correlated with total cholesterol (r = 0.3359, p = 0.02) and with LDL-cholesterol (r = 0.357, p = 0.03). Red blood cell rigidity "Tk" was negatively correlated to HDL-cholesterol (r = -0.430, p = 0.007). Aggregability "M" was correlated to total cholesterol (r = 0.356, p = 0.01) and "M1" to HDL-cholesterol (r = -0.406, p = 0.006). Thus, despite previously described correlations with glucose disposal parameters, the hyperviscosity syndrome of the metabolic syndrome is not proportional to its clinical scoring and is strongly dependent upon the lipid profile.


Focus on PNA Flexibility and RNA Binding using Molecular Dynamics and Metadynamics.
Peptide Nucleic Acids (PNAs) can efficiently target DNA or RNA acting as chemical tools for gene regulation. Their backbone modification and functionalization is often used to increase the affinity for a particular sequence improving selectivity. The understanding of the trading forces that lead the single strand PNA to bind the DNA or RNA sequence is preparatory for any further rational design, but a clear and unique description of this process is still not complete. In this paper we report further insights into this subject, by a computational investigation aiming at the characterization of the conformations of a single strand PNA and how these can be correlated to its capability in binding DNA/RNA. Employing Metadynamics we were able to better define conformational pre-organizations of the single strand PNA and γ-modified PNA otherwise unrevealed through classical molecular dynamics. Our simulations driven on backbone modified PNAs lead to the conclusion that this γ-functionalization affects the single strand preorganization and targeting properties to the DNA/RNA, in agreement with circular dichroism (CD) spectra obtained for this class of compounds. MD simulations on PNA:RNA dissociation and association mechanisms allowed to reveal the critical role of central bases and preorganization in the binding process.


Veno-active drugs in the management of chronic venous disease. An international consensus statement: current medical position, prospective views and final resolution.
Veno-active drugs (VAD) have effects on edema and symptoms related to chronic venous disease (CVD), especially so-called venous pain. VAD's effectiveness, although well established, is regularly debated. Our purpose was to select all randomized controlled trials (RCTs) and meta-analyses devoted to VAD and symptoms in CVD, to submit them to a group of international experts in CVD and to vote with secrete ballot to determine the level of efficacy of each drug, according to EBM (Evidence-Based Medicine) rules and critical analysis. Publications in any language devoted to VAD and venous symptoms were searched for in different databanks and submitted to the experts prior to the meeting. 83 papers were analyzed, including 72 RCTs or meta-analyses. Experts determined the level of EBM of each drug, according to the literature and personal experience, using 3 levels of recommendation, A, B and C (from large RCTs to non-randomized trials). VAD are effective and may be applied in CVD when symptomatic, from C0s to C6s. However, etiological treatment of venous reflux and venous hypertension has always priority. In some cases VAD may replace compression and/or complement its effects. If respecting these prerequisites, VAD are safe and effective.


Alternative and improved method for the simultaneous determination of fexofenadine and pseudoephedrine in their combined tablet formulation.
An alternative method for the determination of fexofenadine (FEX) and pseudoephedrine (PSE) in their combined tablet formulation has been developed, employing the partial least squares (PLS) analysis of spectral data of the analytes in their pharmaceutical association. A full-factorially designed set of 16 synthetic samples was employed for calibration purposes. The calibration models were constructed with wavelengths selection, in the ultraviolet region, according to their predictive ability. These were validated internally by the leave-one-out procedure and externally, employing appropriate sets of validation samples. The described method was linear for both analytes, over the range 160.6-301.2 mg L(-1) for FEX (R(2)=0.9993) and between 325.6 and 610.5 mg L(-1) for PSE (R(2)=0.9992). It was accurate, exhibiting 99.8% and 99.9% drug recoveries for FEX and PSE, respectively (N=9), while in the intermediate precision experiment relative standard deviations were 1.4% for FEX and 1.2% for PSE. The contents of both analytes were assayed in commercial tablets employing this method and the results were compared with those furnished by HPLC, being in good statistical agreement. The method represents an improvement over the first derivative of spectral ratio (DSR) technique and allows high sample throughput with minimum reagent consumption and waste generation. The obtained results confirm that the method is highly suitable for its intended purpose.


Thermochemical properties of exo-tricyclo[188.8.131.52(2,6)]decane (JP-10 jet fuel) and derived tricyclodecyl radicals.
exo-Tricyclo[184.108.40.206(2,6)]decane (TCD) or exo-tetrahydrodicyclopentadiene is the principal component of the high-energy density hydrocarbon fuel commonly identified as JP-10. Thermodynamic parameters for the parent TCD molecule and of all the tricyclodecyl radicals corresponding to the loss of hydrogen atoms from different carbons sites (TCD-Ri with i indicating the given carbon center) are determined using several density functional theory and G3MP2B3 and CBS-QB3 higher level composite computational chemistry methods. Five isodesmic work reactions, three involving bridged hydrocarbon reference molecules with similar ring strains, are employed to produce a cancelation of systematic calculation errors in evaluation of standard, gas-phase formation enthalpies at 298 K. Delta(f)H degrees (298) for TCD is found to be -19.5 +/- 1.3 kcal mol(-1), which is several kcal mol(-1) lower than the commonly used values. C(i)-H bond energies for corresponding TCD carbon sites are evaluated as follows: TCD-R1, 107.2; TCD-R2, 100.1; TCD-R3, 98.0; TCD-R4, 98.5; TCD-R9, 98.7; TCD-R10, 104.1 kcal mol(-1). Results from use of five different DFT methods are in very good agreement with composite level values for all work reactions used for the radicals. The exo and endo isomers of TCD are both determined to have chair and boat conformers.


A Case of Bilateral Thalamic Infarcts Involving the Artery of Percheron in the Setting of COVID-19.
The artery of Percheron (AOP) is a rare anatomic variant, characterized by a single thalamoperforating artery arising from the P1 segment of the posterior cerebral artery that bifurcates to supply bilateral thalami with variable vascular supply to the midbrain. The occlusion of this artery is responsible for bilateral thalamic stroke with or without midbrain involvement. Since December 2019, coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to a worldwide pandemic. Acute ischemic stroke is a rare but known manifestation of COVID-19. There have only been a few reports of bilateral deep cerebral involvement in COVID-19 infection. In the absence of risk factors for such events, we suspect COVID-19 may have a contributory role. In this case report, we present a case of AOP infarction presenting as transient loss of consciousness, intermittent anisocoria, dysarthria, and right-sided weakness in the setting of COVID-19 infection. Given the degree of variation in clinical presentation for AOP infarcts and lack of evidence of ischemia on initial imaging studies, many patients may miss the time window for tissue plasminogen activator (tPA) administration. This case highlights the importance of timely neurological evaluation in patients presenting with COVID-19 and neurological complaints. Increased community awareness of neurological manifestations of AOP infarctions is of utmost importance as early detection and intervention improve clinical outcomes.


[Silent myocardial infarction caused by acute carbon monoxide poisoning].
This report describes a 63 year-old man who suffered an acute myocardial infarction after carbon monoxide exposure. When evaluated in the Emergency Room the patient was completely conscious and did not experience any chest pain. The electrocardiogram showed non-specific T wave abnormalities in inferolateral leads. The only sign consistent with a possible myocardial involvement was a slight increase in serum CPK. The electrocardiogram taken 12 hours later revealed a Q-wave inferior myocardial infarction, and CPK levels showed a typical elevation in the following 24 hours. The coronary angiography, performed about two weeks after admission, documented multiple obstructions in the main coronary branches. In the presence of a reduced coronary reserve, the onset of a prolonged myocardial ischemia might have been secondary to a decreased oxygen transport capacity of the blood, which lead to a decreased amount of oxygen available to the tissues. According to their experience, the authors emphasize the importance of a careful electrocardiographic and enzymatic monitoring of all patients in the first hours after CO exposure, because the typical chest pain may be absent.


Housing aspirations and migration in later life: developments during the 1980s.
"This paper tests hypotheses concerning the differentiation of early and late old age in the United Kingdom with reference to housing preferences and requirements and their translation into migration. Evidence is drawn from the 1991...census and from a representative sample of elderly people in SE England. The sources demonstrate the continued elaboration of long-distance, metropolitan-decentralizing migrations around the age of retirement. Also shown are relatively high rates of residential mobility among people in their seventies and eighties. Most of their migrations are short distance, but nonetheless with a net redistributional effect that sustains urban decentralization at the oldest ages. There is no evidence of significant return migration to London at advanced ages. From the survey responses, distinctive housing dissatisfactions are identified in early and late retirement, but neither set exactly matches expressed motivations for moves."


VIP: an agent with license to kill infective parasites.
Antimicrobial peptides are small, cationic, and amphipathic peptides of variable length, sequence, and structure. They are effector molecules of innate immunity with microbicidal and both pro- or anti-inflammatory activities. Vasoactive intestinal polypeptide (VIP) and the structurally related pituitary adenylate cyclase-activating polypeptide (PACAP) are well-known immunomodulators. On the basis of their cationic and amphipathic structures, resembling antimicrobial peptides, we propose that their immune role could also include a direct lethal effect against pathogens. We thus investigated the potential antiparasitic activities of VIP and PACAP against the African trypanosome Trypanosoma brucei (T. brucei). Both peptides killed the bloodstream (infective) form but not the insect (noninfective) form of the parasite. VIP and PACAP caused complete destruction of the parasite integrity through a mechanism involving their entry and accumulation into the cytosol. These results provide the basis for further studies of these and other structurally related peptides as alternative treatments for parasitic diseases mainly with associated drug resistances.


Thyroid Dysplasia in Wistar Hannover GALAS Rats.
Thyroid dysplasia was recognized in WistarHan GALAS rats and confirmed as a heritable congenital disorder. The gene or genes involved were not identified, but homozygous animals with thyroid dysplasia also exhibited stunted growth, had reduced pituitary gland growth hormone (GH) and were hypothyroid. Heterozygous animals exhibited thyroid dysplasia with normal thyroid hormonal homeostasis and no difference in the incidence of preneoplastic or neoplastic lesions in oncogenicity studies.


[One-staged orthognathic surgery and arthroscope-assisted condylar reconstruction with costochondral graft].
To investigate one-staged orthognathic surgery and arthroscope-assisted condylar reconstruction with costochondral graft for temporomandibular diseases combined with dental-maxillofacial deformities. The preoperative measurement and model surgery was performed. The patients underwent arthroscope assisted condylar reconstruction with costochondral graft combined with bimaxillary surgery or mandibular surgery. From Sept. 2003 to Dec. 2005, 15 cases were treated successfully with no bleeding, nerve injury and infection. The patients were followed up for 29 to 52 months (mean, 31.8 months). The appearance was markedly improved. TMJ function was good with no pain. The average maximum interincisal opening was 33.6 mm. Compared with traditional operation, one-staged orthognathic surgery and arthroscope-assisted condylar reconstruction with costochondral graft has its advantages. Indication selection and preoperative design are very important.


Do periodic leg movements influence patients' perception of sleep quality?
Periodic leg movements in sleep (PLMS) are a common finding in various sleep disorders. Whether PLMS are an epiphenomenon or are causally related to the presence of sleep-wake disturbances is still being debated. We investigated the relationship of the occurrence of PLMS to patients' perception of sleep quality during a night of polysomnography in various sleep disorders. The retrospective evaluation included PLMS recordings over two nights of 78 consecutive patients diagnosed with a restless legs syndrome, primary insomnia or insomnia associated with a psychiatric disorder. The subjects' perception of sleep during the polysomnography night was assessed by the subscale 'sleep quality' of the validated self-rating sleep questionnaire SFA (SFA-SQ). SFA-SQ scores correlated with the PLMS index (number of PLMS per hour of sleep) only in patients with restless legs syndrome during the first of the two nights investigated (r=-0.464, P<0.01). PLMS appear to have a low impact on the subjects' perception of sleep quality. The correlation of subjective sleep quality to PLMS index in the first of the two investigated nights in RLS patients may reflect an adaptation effect. The results of our study favor the hypothesis that PLMS most likely are not the primary cause of sleep disturbances in these patient groups.


Diagnostic laparoscopy as an adjunct to selective conservative management of solid organ injuries after blunt abdominal trauma.
To investigate the efficacy of diagnostic laparoscopy (DL) as an adjunct in patient selection for conservative management of solid organ injuries (SOI) following blunt abdominal trauma, 15 patients with injuries documented by computed tomographic (CT) scanning were prospectively evaluated. Diagnostic laparoscopy was performed in an attempt to characterize SOI, to evaluate the abdomen for associated occult injuries, and to select patients for conservative management or laparotomy. The 15 patients had CT evidence of 17 SOIs (nine spleen, eight liver), and DL allowed adequate visualization of 15 of the 17 injuries. Occult hollow viscus injury was discovered in 2 of 15 patients (one colon, one small bowel) and required laparotomy. In the remaining 13 patients, DL revealed ongoing hemorrhage in four patients and poor visualization in one patient that prompted laparotomy (four splenorrhaphy, one hepatorrhaphy). Conservative management was employed in the treatment of eight patients with findings of minor injury or adequate hemostasis on DL. The average transfusion requirement in this group was 1.8 U. No patient failed conservative management. There were no complications attributable to DL. These data demonstrate that DL may become an effective adjunct in patient selection for conservative management of SOI following blunt abdominal trauma.


Sustained release glaucoma therapies: Novel modalities for overcoming key treatment barriers associated with topical medications.
Glaucoma is a progressive optic neuropathy and a leading cause of irreversible blindness. The disease has conventionally been characterized by an elevated intraocular pressure (IOP); however, recent research has built the consensus that glaucoma is not only dependent on IOP but rather represents a multifactorial optic neuropathy. Although many risk factors have been identified ranging from demographics to co-morbidities to ocular structural predispositions, IOP is currently the only modifiable risk factor, most often treated by topical IOP-lowering medications. However, topical hypotensive regimens are prone to non-adherence and are largely inefficient, leading to disease progression in spite of treatment. As a result, several companies are developing sustained release (SR) drug delivery systems as alternatives to topical delivery to potentially overcome these barriers. Currently, Bimatoprost SR (DurystaTM) from Allergan plc is the only FDA-approved SR therapy for POAG. Other SR therapies under investigation include: bimatoprost ocular ring (Allergan) (ClinicalTrials.gov identifier: NCT01915940), iDose® (Glaukos Corporation) (NCT03519386), ENV515 (Envisia Therapeutics) (NCT02371746), OTX-TP (Ocular Therapeutix) (NCT02914509), OTX-TIC (Ocular Therapeutix) (NCT04060144), and latanoprost free acid SR (PolyActiva) (NCT04060758). Additionally, a wide variety of technologies for SR therapeutics are under investigation including ocular surface drug delivery systems such as contact lenses and nanotechnology. While challenges remain for SR drug delivery technology in POAG management, this technology may shift treatment paradigms and dramatically improve outcomes.


Critical-thinking abilities of radiologic science students.
This article reports the results of a survey conducted to determine whether critical thinking abilities differ among radiologic technology students educated at the baccalaureate, associate degree and certificate levels. The sample population was 357 students enrolled in radiologic technology programs in Louisiana, Missouri and Oklahoma who completed the Watson-Glaser Critical Thinking Appraisal. Results showed a significant difference in critical thinking abilities at the three educational levels. Baccalaureate students scored significantly higher in critical thinking abilities than associate and certificate students, and certificate students scored significantly higher than associate degree students.


Tumor necrosis factor alpha sensitizes spinal cord TRPV1 receptors to the endogenous agonist N-oleoyldopamine.
Modulation of synaptic transmission in the spinal cord dorsal horn is thought to be involved in the development and maintenance of different pathological pain states. The proinflamatory cytokine, tumor necrosis factor alpha (TNFalpha), is an established pain modulator in both the peripheral and the central nervous system. Up-regulation of TNFalpha and its receptors (TNFR) in dorsal root ganglion (DRG) cells and in the spinal cord has been shown to play an important role in neuropathic and inflammatory pain conditions. Transient receptor potential vanilloid 1 (TRPV1) receptors are known as molecular integrators of nociceptive stimuli in the periphery, but their role on the spinal endings of nociceptive DRG neurons is unclear. The endogenous TRPV1 receptor agonist N-oleoyldopamine (OLDA) was shown previously to activate spinal TRPV1 receptors. In our experiments the possible influence of TNFalpha on presynaptic spinal cord TRPV1 receptor function was investigated. Using the patch-clamp technique, miniature excitatory postsynaptic currents (mEPSCs) were recorded in superficial dorsal horn neurons in acute slices after incubation with 60 nM TNFalpha. A population of dorsal horn neurons with capsaicin sensitive primary afferent input recorded after the TNFalpha pretreatment had a basal mEPSC frequency of 1.35 +/- 0.20 Hz (n = 13), which was significantly higher when compared to a similar population of neurons in control slices (0.76 +/- 0.08 Hz; n = 53; P < 0.01). In control slices application of a low concentration of OLDA (0.2 uM) did not evoke any change in mEPSC frequency. After incubation with TNFalpha, OLDA (0.2 uM) application to slices induced a significant increase in mEPSC frequency (155.5 +/- 17.5%; P < 0.001; n = 10). Our results indicate that TNFalpha may have a significant impact on nociceptive signaling at the spinal cord level that could be mediated by increased responsiveness of presynaptic TRPV1 receptors to endogenous agonists. This could be of major importance, especially during pathological conditions, when increased levels of TNFalpha and TNFR are present in the spinal cord.


Are hearing and middle ear statuses at risk in Chinese patients undergoing orthognathic surgery?
Orthognathic surgery, which is performed to correct dentofacial abnormalities, has been associated with postoperative reduction in hearing sensitivity and middle ear dysfunction. In this study, the pre- and postoperative hearing status and middle ear function of 37 Chinese subjects who underwent orthognathic surgery, as well as subjective reports of aural symptoms, particularly hearing loss, tinnitus, fullness and otalgia, were investigated. There was a significant increase in the number of subjects with measured loss, perceived loss and aural fullness from pre-surgery to 1 week post surgery. However, the percentage of increase was small compared with previous findings. This difference in findings was attributed to the type of surgical techniques used, and to the fact that the Chinese population appears to be less susceptible to middle ear effusion. Subjective complaints of aural symptoms may not be accompanied by measured loss.


Efficient immortalization of rheumatoid synovial tissue B-lymphocytes. A comparison between the techniques of electric field-induced and PEG fusion.
In this study, B-cells isolated from rheumatoid synovial tissue were immortalized, without prior in vitro stimulation, by means of electric-field induced fusion and conventional PEG fusion in order to compare the efficiency of these methods. Two myeloma cell lines were used as fusion partners, the murine myeloma Ag8 and the murine-human heteromyeloma HAB-1. The results of seven fusion experiments performed simultaneously with identical cell populations showed that fusion frequencies obtained by electrofusion were 4 to 35 times higher than by the PEG fusion technique. The morphological and immunohistochemical evaluation of synovial tissues used for fusion showed that only tissues exhibiting a follicular distribution of B-cells with a high percentage of CD 22-positive lymphocytes gave rise to high fusion yields and produced B-cell clones, whereas synovial tissues with the same percentage of plasma cells but lower percentages of CD 22 lymphocytes yielded very low fusion rates. In conclusion, electrofusion is more efficient for immortalizing small amounts of synovial tissue B-lymphocytes than PEG fusion, since high fusion frequencies could be obtained by this technique without the need for prior in vitro stimulation. Synovial tissue exhibiting a follicular distribution of B-lymphocytes with high percentages of CD 22-positive lymphocytes gave rise to high hybridoma yields and therefore an ideal source of human rheumatoid B-cell clones.


AANA Journal course: update for nurse anesthetists--improving the efficacy of subarachnoid and epidural blocks--Part B.
In Part A of this two-part Journal course, issues of safety during subarachnoid and epidural blocks were examined (see the August 1997 issue of the AANA Journal). Part B deals with the effectiveness of spinal and epidural blocks. Although the overall failure rate for subarachnoid and epidural blocks is low, regional anesthesia is not always effective. Knowing the failure rates for various types of regional blocks and the factors that influence the rate of failure is useful for planning anesthetic care and choosing the most effective techniques. Combined spinal and epidural techniques offer the quick onset of a spinal with the continuous dosing and controllability of an epidural. The combined spinal and epidural technique is somewhat more complicated to perform especially in regard to test dosing. Opioids and vasoconstrictors enhance the density and duration of spinal and epidural blocks. In addition, opioids can be used to provide postoperative analgesia after the block has worn off. While opioid induced respiratory depression was a significant hazard during the initial development of spinal and epidural opioid techniques, refinements in dosing and monitoring of these patients have reduced the incidence of this complication to a low level. While alpha agonists, such as epinephrine, do prolong the duration of some types of blocks, they also introduce or exacerbate problems, such as urinary retention, itching, and even hypotension. Whatever technique is used, careful patient selection, allowing adequate time for the block to set up, and administering small doses of a systemic analgesic or sedative if needed may make the difference between the success or failure of a well-performed block.


Extraluminal venous interruption for free-floating thrombus in the deep veins of lower limbs.
The free-floating thrombus (FFT) represents a particular form of deep vein thrombosis with extremely high potential of fatal pulmonary embolism. The purpose of the study was to evaluate the early results of aggressive surgical approach to FFT. During the period 2005-2008 years FFT was diagnosed in 13 patients. Demographic characteristics of patients: medium age--54.7 years, male--76.9%, significant comorbidity--5 (38.5%) cases. Localization of FFT: superficial femoral vein (SFV)--5 (38.5%), common femoral vein (CFV)--4 (30.7%), external iliac vein (EIV)--2 (15.4%), inferior cava vein (ICV)--2 (15.4%). Manifestations of previous pulmonary embolism were documented preoperatively in 3 (23.1%) cases. The following emergency surgical procedures were performed: ligation--3 (23.1%) or plication--2 (15.4%) of SFV; plication of CFV--5 (38.5%) patients, combined in 4 cases with partial thrombectomy (free-floating part of thrombus); plication of common iliac vein--1 (7.6%); plication of ICV--2 (15.4%) cases. Primary or recurrent cases of clinically significant pulmonary embolism were not detected in the postoperative period. The accumulated experience of surgical management of patients with FFT reveals the important role of deep vein ligation/plication in prevention of fatal pulmonary embolism.


The use of autologous dermis grafts for the reconstruction of the anophthalmic socket.
The main objectives of enucleation, evisceration or secondary orbital implants are to replace orbital volume and obtain good motility and adaptation of the implant and the external prosthesis. We describe our experience using autologous dermis graft sutured to Tenon and conjunctiva following evisceration, enucleation and any reconstruction requiring either a primary or secondary orbital implant, even those with large tissue loss. A retrospective case series of patients who received an autologous dermis graft to assist in closure of a Tenon's capsule and conjunctiva at the time of placement of secondary orbital implants or evisceration or enucleation with fornices retraction or tension in tissues. We also describe how and from where to take the dermis graft. 72 patients were included and all received orbital porous polyethylene implants: 28 patients had secondary orbital implants, 36 patients had evisceration and 8 patients had enucleation. Implant size was 20 mm in most cases, but went to 22 mm. Follow-up ranged from 3 to 36 months. No intraoperative complications were observed in donor or receptor area. 8 cases had incipient ischemia of the dermis graft, but were treated and resolved with autologous serum. Implant exposure is due to bad surgical technique, an inadequate implant size or excessive tension on the suture. Dermis autologous graft allows moving the orbital implant anteriorly because it replaces surface to suture Tenon and conjunctiva without tension, so a good adaptation of a thinner external prosthesis is possible, resulting in better motility.


Increased cardiac endothelin-1 and nitric oxide in adriamycin-induced acute cardiotoxicity: protective effect of Ginkgo biloba extract.
Cardiotoxicity and congestive heart failure are the major factors that limit the use of anti-neoplastic drug adriamycin (ADR). There is increasing experimental evidence that endothelin-1 (ET-1) and nitric oxide (NO) are vasoactive mediators that regulate cardiac performance. The present study was undertaken to investigate the role of ET-1 and NO in ADR-induced acute cardiotoxicity and to evaluate the protective effect of Ginkgo biloba extract (EGb761) in rats. A single dose of ADR (20 mg/kg i.p.) caused a significant increase in the cardiac enzyme activities of aspartate transaminases (AST), lactate dehydrogenase (LDH) and creatine phosphokinase isoenzyme (CK-MB) in the serum of animals. This was accompanied by significant increase in cardiac malondialdehyde (MDA), total antioxidant capacity (TAC), tumor necrosis factor-alpha (TNF-alpha), ET-1 and nitrite/nitrate (NOx) levels. On the other hand, reduced glutathione (GSH) was significantly depressed. Histopathological examination of heart tissues showed hyalinization of the myocardium, with interstitial edema and inflammatory exudates. Pre-treatment of the animals with EGb761 (100 mg/kg, orally) 10 days before and 5 days after ADR treatment reversed the cardiac enzyme levels to normal value, decreased cardiac MDA, TAC, TNF-alpha. ET-1 and NO(x), increased GSH and reversed the histopathological damage induced by ADR. In conclusion, the cardioprotective effects of EGb761 on markers of ADR-induced acute cardiotoxicity appeared to have been mediated by the regulation of inflammatory and vasoactive mediators, as well as the inhibition of membrane lipid peroxidation. Thus, EGb761 may find use as promising adjuvant therapy to ameliorate cardiotoxicity of ADR.


Inactivation of human rotavirus, SA11 and other enteric viruses in effluent by disinfectants.
A preparation of infectious human rotavirus, isolated from faeces and resuspended in wastewater effluent, was shown to be inactivated by chlorine, chlorine dioxide, ozone and peracetic acid. Infectivity was assayed in MA 104 cells by the detection of cell-associated viral antigen by immunofluorescence. The inactivation curves were similar to those reported for other enteric viruses. Human rotavirus was at least as resistant as poliovirus, coxsackievirus, echovirus and f2 coliphage and was strikingly less sensitive to inactivation than the simian rotavirus, SA11. The latter was generally the most sensitive of the six tested viruses yet is often taken as being representative of the human rotaviruses.


Uniportal video-assisted thoracic surgery for left upper lobe: single-direction lobectomy with systematic lymphadenectomy.
A 62-year-old female was admitted to our hospital after computed tomography (CT) revealed a 2.5 cm × 2.1 cm mass in the left upper lobe. PET/CT scan diagnosed as malignant lesion with no signs of metastasis. Under general anesthesia, the patient was placed in right lateral decubitus position. A 4cm incision was made in the 4th intercostal space with plastic protector. The camera was placed in the upper part of the incision and the instruments were inserted below the camera. Left upper lobectomy along with systematic lymphadenectomy was performed. Total surgical time was 135 min and estimated blood loss was 70 mL. The chest tube was removed on the 2nd postoperative day and the patient was discharged on the 3rd postoperative day with no complication. This uniportal VATS single-direction lobectomy for the left upper lobe is feasible and amplifies the concept of thoracotomy-like minimally invasive surgery.


Preparation and characteristics of bentonite-zeolite adsorbent and its application in swine wastewater.
The preparation of bentonite-zeolite (BZ) adsorbent using bentonite, aluminate, and rice husk was conducted. The adsorption experiment was performed for the removal of Cu2+ and Zn2+ from aqueous solution in single and binary systems. Results showed that gasification of rice husk could effectively improve the specific surface area and pore volume. The optimum pH for Cu2+ and Zn2+ adsorption on BZ was pH 5.0. The pseudo-first order kinetic and Langmuir isotherm model of BZ were the optimal model for Cu2+ and Zn2+. According to Langmuir isotherm model, the maximum adsorption capacity value (qm) was 16.39 and 12.72 mg·g-1 for Cu2+ and Zn2+, respectively. The adsorption affinity order of BZ in the binary solution was Cu2+ > Zn2+. NH4+-N concentration over 500 mg·L-1 significantly affected the adsorption capacity of BZ (P < 0.05). The adsorption capacity of BZ for Cu2+ and Zn2+ was higher than that artificial zeolite (AZ) and bentonite in SW.


Early changes of body composition in human immunodeficiency virus-infected patients: tetrapolar body impedance analysis indicates significant malnutrition.
Total body water, body fat, body cell mass (BCM), extracellular mass (ECM), and the ECM-BCM ratio by impedance analysis were determined in 193 human immunodeficiency virus (HIV)-infected patients and 340 control subjects. Walter Reed (WR) classification was WR 2 in 26, WR 3-5 in 85, and WR 6 in 82 patients. Whereas resistance was increased, reactance and the phase angle were significantly reduced in all patient groups. Neither body weight nor body mass index (BMI) was affected in WR 2 patients, but BCM was reduced (31.9 +/- 4.3 vs 35.8 +/- 7.3 kg, P < 0.007) and ECM (31.2 +/- 4.4 vs 28.8 +/- 3.8 kg) as well as ECM-BCM ratio increased (0.99 +/- 0.14 vs 0.83 +/- 0.16, P < 0.001). In contrast to WR classification, diarrhea did not correspond with malnutrition. A loss of BCM (malnutrition) occurred already in otherwise symptomless HIV-infected patients (WR 2). This effect can be measured by tetrapolar impedence analysis but not by body weight or BMI.


The Safety Case Management Committee: expanding the avenues for addressing patient safety.
The greatest gains in patient safety are likely to result from using a multifaceted framework of safety enhancement initiatives. The Safety Case Management Committee, which has been meeting at the VA Ann Arbor Healthcare System since early 1999, is one such initiative; it is directed at broadening organizational involvement in creating a safer clinical environment. The committee's objective is to address fundamental issues related to patient safety and quality of care. The committee aims to develop thematic approaches to improving major systems triggered by unsafe or risky incidents that demonstrate either iatrogenic harm or risk of harm to patients. COMMITTEE STRUCTURE AND FUNCTIONING: Committee members represent top management, middle management, and front-line employees, but membership is weighted toward those in direct patient care roles. The group also includes a consumer representative. Critical issues are addressed through rigorous case discussion, literature review, and expert consultation. In a 3-year period (Feb 1999 through Dec 2001), 85% of the group's 45 recommendations have been implemented. Topics have included reducing medication errors during emergency procedures, enhancing palliative care services, minimizing the risk of missed x-ray findings, optimizing anticoagulation management, reducing the risk of vascular catheter-related infection, and improving pain management. The Safety Case Management Committee has successfully addressed actual and potential errors and has implemented strategic safety improvements. The dedicated efforts of highly motivated clinicians who serve on such a committee can augment and enhance risk management advances made through other channels.


The associations of obesity, lymph node status and prognosis in breast cancer patients: dependence on estrogen and progesterone receptor status.
Breast cancer patients who are obese have a higher risk of lymph node metastases and a poorer prognosis than those who are slim. It has been claimed that estrogens derived from fat are important for these associations. If estrogens are important, these relationships must be stronger in the hormone receptor-positive than in the hormone receptor-negative groups. Body mass index (BMI) was used as a measure of obesity. The second, third, and fourth quintiles of BMI were treated as one group and termed 'medium'. Patients in the fifth quintile were termed 'obese' and those in the first quintile 'slim'. The number of women with unilateral disease treated with modified radical mastectomy and included in the study was 1211. Of all patients included, obese patients had a 1.53 higher risk of lymph node metastases compared to slim patients (p=0.02). In the PgR-negative group, obesity gave a 3.08 times higher risk of lymph node metastases (p=0.03). The risk of dying of breast cancer tended to be higher in obese than in slim patients when all patients in the study were compared (relative risk=1.38, p=0.06). BMI did not show a statistically significant relationship with prognosis if only hormone receptor status was considered. However, if lymph node status and hormone receptor status were taken together, the association was strong and reversed in the lymph node-positive group with ER-negative tumours. The adjusted relative risk was 0.33, showing that slim patients had a 3.03 (1.0/0.33) times higher risk of dying of breast cancer compared to obese patients (p=0.002). These results indicate that non-hormonal mechanisms could be important.


Extract of the mycelium of T. matsutake inhibits elastase activity and TPA-induced MMP-1 expression in human fibroblasts.
Skin aging is induced through complex biological processes in human skin caused by proteolysis of collagen and elastin, two structural proteins of the dermal extracellular matrix (ECM). Collagen and elastin degradation can induce the expression of matrix metalloproteinases (MMPs), as well as that of a family of zinc-dependent endopeptidases that play critical roles in skin aging. Moreover, elastase is a metalloproteinase which acts on the degradation of elastin in skin aging, and is also involved in the inhibition or the repair of wrinkle formation. Extract of the mycelium of Tricholoma matsutake (T. matsutake), or pine mushroom, is widely distributed in Asian countries. The extract is from the natural biomaterial of the mushroom which is rich in polysaccharides, including β-glucan. This extract has shown potent bioactive antioxidant, immunomodulatory and antitumoral properties. In the present study, we investigated whether the extract of the mycelium of T. matsutake has effects on elastase activity, as well as on the expression of tissue inhibitor of matrix metalloproteinases-1 (TIMP-1) and MMP-1 under basal conditions. Our results revealed that the extract of the mycelium of T. matsutake significantly decreased elastase activity in a dose-dependent manner and reduced the levels of MMP-1 and MMP-3. On the other hand, the expression of TIMP-1 and tropoelastin was increased in fibroblasts treated with the extract of the mycelium of T. matsutake. However, collagent expression was not affected. In addition, our results demonstrated that the extract of the mycelium of T. matsutake inhibited the 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced MMP-1 expression and suppressed TPA-induced p38 activity. Therefore, the inhibitory effects of the extract of the mycelium of T. matsutake on MMP-1 induction are mediated by the inhibition of p38 in human fibroblasts. Our data suggest that the extract of the mycelium of T. matsutake may prove to be an effective biomaterial for anti-wrinkle treatment, as it can obstruct the degradation of the dermal ECM.