The percentage of peripheral eosinophils as a sensitive marker for differentiating FIGO grade in endometrial adenocarcinomas
Studies on eosinophils have mostly been directed to parasitic infections and allergic diseases, but the role of eosinophils in oncology has been largely ignored. Eosinophils are an important modulator of the immune response and components of the inflammatory process against the tumor. This study was performed to investigate the pre-operative peripheral blood eosinophil percentages in patients with a histopathologically diagnosed pure endometrioid type endometrial carcinoma. Patients' data were analyzed in two groups as present/absent according to whether there are tumor metastases in the adnexes, lymph nodes, cervical stroma, and whether there was lymphovascular space invasion. FIGO grade was taken as the basis of the tumor grade: Low-grade equated to grade 1 or 2, and high-grade equated to grade 3. The requirement for lymph node dissection was based on the Mayo criteria. The data of a total of 268 patients were included. The mean percentage of eosinophils in high-grade patients (n=29) was 2.75±0.35, and was significantly higher than the mean percentage of eosinophils of found in low-grade patients (n=239), which was 1.79±0.09 (p=0.013). Receiver operator curve analysis showed that a cut-off eosinophil percentage of 1.95% resulted in a sensitivity of 62% and specificity of 67% (p=0.004). Eosinophil percentages, which are a simple, easily accessible, and inexpensive can be an important pre-operative predictive tool. Eosinophil percentages can be used in determining the need for surgical staging in endometrial cancer.


Harvest of young red cells on an automated cell separator.
Red cells can be fractionated by age on a blood processor (Model 2991, IBM). However, little data exist on processing a product for transfusion. This report details a method for collecting young erythrocyte (YE) units containing a mean hemoglobin content of 56.43 +/- 1.39 (SEM) grams. Enrichment with YEs was indicated by greater activity of the enzyme pyruvate kinase (PK) in aliquots of YE units. The mean ratio of PK activity in the young red cell product compared to unfractionated blood was 1.14 +/- 0.03 (SEM). An increased PK ratio was noted in 23 of 26 units studied. Based on the PK ratio, the mean age of the erythrocytes was 46 days, compared to 60 days for standard units of blood. In the 6 units assayed, the reticulocyte count was increased. Collection of YE units was relatively easy, no untoward donor reactions were observed, and no deleterious effects developed in the recipient. Although these data suggest enrichment with a young population of red cells, YE units produced by this method are experimental. Routine use of this procedure awaits demonstration of a significant decrease in transfusion frequency in patients receiving YE units for chronic red cell therapy.


Children's social reasoning about inclusion and exclusion in gender and race peer group contexts.
This study investigated whether children's and adolescents' judgments about exclusion of peers from peer group activities on the basis of their gender and race would differ by both age level and the context in which the exclusion occurred. Individual interviews about exclusion in several different contexts were conducted with 130 middle-class, European American children and adolescents. Younger children were expected to reject exclusion, by using judgments based on moral reasoning, regardless of the potential cost to group functioning, whereas older children were expected to condone exclusion on the basis of group membership in cases in which the inclusion of these children might interrupt effective group functioning. On measures of judgments, justifications for those judgments, and ratings of the appropriateness of exclusion, the vast majority of children used moral reasoning and rejected exclusion in contexts in which only the presence of a stereotype justified it. As expected, however, older children (13 years) were more likely to allow exclusion than younger children (7 and 10 years) when group functioning was threatened, and they justified this exclusion by using appeals to effective group functioning.


V beta-specific deletion of mature thymocytes induced by the plant superantigen Urtica dioica agglutinin.
Urtica dioica agglutinin (UDA), a plant protein, is a superantigen activating in a MHC class II-restricted manner the V beta 8. 3-bearing T-cells (Galelli and Truffa-Bachi, J. Immunol. 151, 1821, 1993). Administration of UDA to adult mice provokes the clonal expansion of the responding cells which is followed by the deletion of the major fraction of the UDA-sensitive cells, whereas the remaining cells become anergic (Galelli et al., J. Immunol. 154, 2600, 1995). We have analyzed the effect of UDA on thymocytes. Injection of UDA resulted in a rapid, but transient, deletion of a large fraction of the V beta 8.3-bearing mature T-cells. In contrast to other exogenous superantigens, this deletion was not preceded by the clonal expansion of the UDA-responding thymocytes. Moreover, the V beta 8.3-bearing mature T-cells escaping the deletion were not anergic to an in vitro UDA restimulation. UDA and the other superantigens also differ as the general, V beta-unrestricted, thymic atrophy induced by classical superantigens was not observed with UDA.


Label-free optical sensor based on red blood cells laser tweezers Raman spectroscopy analysis for ABO blood typing.
The clinical significance of ABO blood typing extends beyond transfusion medicine and is demonstrated to be associated with susceptibility to various diseases, even including cancer. In this study, a home-made laser tweezers Raman spectroscopy (LTRS) system was applied to detect red blood cells (RBCs) with the aim to develop a label-free, simple and objective blood typing method for the first time. High-quality Raman spectra of RBCs in the fingerprint region of 420-1700 cm-1 can be obtained, meanwhile exciting blood typing results can be achieved, especially with an accuracy of 100% for identifying Type AB from other blood types with the use of multivariate statistical analysis based on principal component analysis (PCA) combined with linear discriminant analysis (LDA). This primary work demonstrates that the label-free RBCs LTRS analysis in conjunction with PCA-LDA diagnostic algorithms has great potential as a biosensor for ABO blood typing.


Critical role of macrophytes in achieving low iron concentrations in mine water treatment wetlands.
Aerobic wetlands are increasingly being included in mine water treatment systems which need to achieve low residual iron concentrations (<0.5 mg L(-1)) in final discharges. Traditionally the macrophyte components of such systems have been thought to be insignificant sinks for major contaminants such as iron. However, we report high rates of plant uptake of iron where the latter is present at relatively low concentrations, suggesting that macrophytes may well be critical to achieving low residual iron concentrations in final effluents from such systems. The wetland macrophyte Phragmites australis was grown in waters with a range of iron concentrations (0-50 mg L(-1)). At an Fe supply of 1 mg L(-1) almost 100% of the Fe was taken up into plant tissues. The majority of iron was stored in and around the roots of the plants, which helps allay fears of possible release of contaminants during seasonal die-back of emergent shoots and leaves. The 1 mg L(-1) threshold also proved to be important in terms of plant growth, with significant inhibition (evident in root length and in dry weights of shoots and roots) in plants grown in waters with Fe above this concentration. No direct causal relationship between iron content in aerial tissues and growth inhibition was found, which strongly suggests that iron toxicity cannot explain these results. These results have implications for the design of mine water treatment wetlands, particularly with regard to initial establishment of vegetation and achieving sufficient Fe removal in "polishing" applications (i.e. where it is intended to remove the last few mg L(-1) of Fe).


Catholics using contraceptives: religion, family planning, and interpretive agency in rural Mexico.
Research on how religion shapes contraceptive practices and fertility has paid insufficient attention to how people interpret religious teachings. This study draws on ethnographic fieldwork in Degollado, Mexico, to describe generational and social-contextual differences in how women interpret and use religious doctrine to achieve their fertility desires without jeopardizing their standing as devout Catholics. Contrasting the family planning beliefs and practices of young Mexican women with those of older women (many of whom are the younger women's parents and in-laws), in a rural town in which the religious regulation of everyday life is pervasive, reveals how a common set of religious teachings and principles can be used to guide two different generational strategies for fertility regulation. The ethnographic data presented here highlight the creativity with which people use religious frameworks to justify their behavior. Research exploring how religion--and culture more broadly--influences fertility and contraceptive use should give greater attention to the dynamic interplay between cultural beliefs and institutions, social context, and interpretive agency. (STUDIES


A novel EFNB1 mutation (c.712delG) in a family with craniofrontonasal syndrome and diaphragmatic hernia.
We report on the occurrence of congenital diaphragmatic hernia in a family with craniofrontonasal syndrome found to have a previously unreported mutation in EFNB1. The female proband presented with hypertelorism, telecanthus, bifid nasal tip, widow's peak, frontal bossing, and a widened metopic suture. Her father was noted to have hypertelorism, telecanthus, widow's peak, and a history of pectus carinatum. He was found to have a previously unreported mutation in exon 5 of EFNB1 predicted to cause premature protein truncation. The parents of the proband previously had a female fetus with congenital diaphragmatic hernia. The occurrence of congenital diaphragmatic hernia, phenotypic differences between males and females, and utility of molecular testing in craniofrontonasal syndrome are demonstrated.


Multiple prototropism of fisetin in sodium cholate and related bile salt media.
Fisetin, a bioflavonoid, has important biological relevance. It exhibits intramolecular excited state proton transfer (ESIPT), analogous to the structurally similar flavonoids. The presence of multiple prototropic forms of fisetin was observed at various concentrations of different bile salt molecules. The presence of ground state fisetin anion (FA)(GS) (λ(ex) 418 nm; λ(em) 490 nm) in alcohols and bile salt micellar media is a novel observation. The interaction of fisetin with sodium cholate (NaC) and some other bile salts has been studied in detail, using the intrinsic fluorescence of different prototropic forms of fisetin: neutral form (FN, λ(ex) 369 nm, λ(em) ~ 400 nm), ground state anion form ((FA)(GS), λ(ex) 418 nm, λ(em) 490 nm) and phototautomer (FT, λ(ex) 369 nm, λ(em) 540 nm). The hypsochromic shift of (FA*)(ES) emission and bathochromic shift of FT emission with increasing bile salt concentration suggests the progressive reduction of polarity of the bile salt media, which could be resulting from the neutralization of bile salt molecules as their concentration increases.


A practical enantioselective total synthesis of the bengamides B, E, and Z.
[reaction: see text] A practical total synthesis of Bengamides B, E, and Z from a common polyol intermediate is described. Consecutive aldol condensations afford a protected polyol thioester side chain suitable for coupling to the Bengamides. A novel chiral phase transfer catalyzed enantioselective alkylation affords the more highly functionalized amino caprolactams required for Bengamides B and Z. Use of the 2-naphthylmethyl ether protecting group, compatible with the boron Lewis acids required for enantioselective aldol condensation, allows direct access to Bengamide B.


Ese-3 contributes to colon cancer progression by downregulating EHD2 and transactivating INPP4B.
Epithelium-specific Ets protein 3 (Ese-3), a member of the Ets family of transcription factors, plays an important role in the development of cancers. However, little is known concerning its role in colon cancer (CC). In this study, we demonstrate that the expression of Ese-3 is upregulated in CC tissues and elevated Ese-3 expression is relationship with advanced T stage (P=0.037) and poor disease-free survival (DFS, P=0.044). Univariate and multivariate cox regression analyses show that Ese-3 expression may be an independent prognostic value for CC patients. Moreover, Ese-3 knockdown suppresses CC cell proliferation in vitro and in vivo, while Ese-3 overexpression has the opposite result. Further, we first demonstrate that EHD2 and INPP4B are the downstream genes of Ese-3. Subsequent investigation find that EHD2 is downregulated in CC tissues and knockdown of EHD2 significantly increase CC cell proliferation in vitro and vivo. Our findings reveal that Ese-3 promotes CC cell proliferation by downregulating EHD2 and transactivating INPP4B, and targeting the pathway may be a promising therapeutic target for CC patients.


Platelet Phagocytosis via P-selectin Glycoprotein Ligand 1 and Accumulation of Microparticles in Systemic Sclerosis.
It is unclear why activated platelets and platelet-derived microparticles (MPs) accumulate in the blood of patients with systemic sclerosis (SSc). This study was undertaken to investigate whether defective phagocytosis might contribute to MP accumulation in the blood of patients with SSc. Blood samples were obtained from a total of 81 subjects, including 25 patients with SSc and 26 patients with stable coronary artery disease (CAD). Thirty sex- and age-matched healthy volunteers served as controls. Studies were also conducted in NSG mice, in which the tail vein of the mice was injected with MPs, and samples of the lung parenchyma were obtained for analysis of the pulmonary microvasculature. Tissue samples from human subjects and from mice were assessed by flow cytometry and immunochemical analyses for determination of platelet-neutrophil interactions, phagocytosis, levels and distribution of P-selectin, P-selectin glycoprotein ligand 1 (PSGL-1), and HMGB1 on platelets and MPs, and concentration of byproducts of neutrophil extracellular trap (NET) generation/catabolism. Activated P-selectin+ platelets and platelet-derived HMGB1+ MPs accumulated in the blood of SSc patients but not in the blood of healthy controls. Patients with CAD, a vasculopathy independent of systemic inflammation, had fewer P-selectin+ platelets and a negligible number of MPs. The expression of the receptor for P-selectin, PSGL-1, in neutrophils from SSc patients was significantly decreased, raising the possibility that phagocytes in SSc do not recognize activated platelets, leading to a failure of phagocytosis and continued neutrophil release of MPs. As evidence of this process, activated platelets were not detected in the neutrophils from SSc patients, whereas they were consistently present in the neutrophils from patients with CAD. HMGB1+ MPs elicited generation of NETs, which were only detected in the plasma of SSc patients. In mice, P-selectin-PSGL-1 interaction resulted in platelet phagocytosis in vitro and influenced the ability of MPs to elicit NETs, endothelial activation, and migration of leukocytes through the pulmonary microvasculature. The clearance of activated platelets via PSGL-1 limits the undesirable effects of MP-elicited neutrophil activation. This balance is disrupted in patients with SSc. Its reconstitution might curb vascular inflammation and prevent fibrosis.


Exposure to pets and atopic dermatitis during the first two years of life. A cohort study.
The aim of this study was to assess the association between keeping pets in early childhood and the occurrence of atopic dermatitis in an ongoing birth cohort followed up to the age of 2 years. We analyzed data of 4578 children in the intervention and observation part of an ongoing cohort study. The children were recruited at birth in the two study regions Wesel and Munich between January 1996 and June 1998. Information on atopic diseases and pet ownership was obtained by questionnaire at the child's first and second birthday. The logistic regression model showed a negative association between 'keeping any pet' and in particular 'keeping dogs' in the 1st year of life and the development of atopic dermatitis in the 1st and the 2nd years of life. The protective effects remained statistically significant after adjusting for several possible confounding variables (1st year(any) pet OR 0.71, 95% CI [0.55;0.92], 1st year(dog) OR 0.62, 95% CI [0.39;0.98], 2nd year(any) pet OR 0.74, 95% CI [0.57;0.97], 2nd year(dog) OR 0.63, 95% CI [0.40;0.98]). Ownership of small furred pets (hamster, rabbit and guinea pig) also showed a borderline protective effect for the 1st year. We assume an association between keeping pets and undefined environmental factor(s) that contribute protectively to the development of atopic dermatitis in early life, presumably by effects on the maturation of the immune system.


[Child marriage in Brazil: an analysis from the National Health Survey].
This paper aims to characterize children and adolescents in a child marriage situation using data from the National Health Survey of 2013. The prevalence of child marriage (under 18 years old) was estimated according to socioeconomic, demographic, and health variables by three age categories (10-13; 14-15; 16-17 years). Prevalence ratios (PR) were estimated using Poisson regression. The prevalence of child marriage was 3.9% (n=1,168); 254 (1.8%) were under 14 years old, 285 (3.8%) were between 14 or 15 years old and 629 (8.1%) were between 16 and 17 years old. Higher probability of the outcome was observed among girls in the 14-15- and 16-17-years age groups compared to male, and those who did not attend school (observed in all age groups). Children living with four people were less likely to be in child marriage in the 14-15- and 16-17-years' age group compared to those who lived with one to two people. This study discusses the implications of the findings for preventing child marriage by focusing on gender inequalities and access to education and health services.


Apolipoprotein E-epsilon 4 allele and familial risk in Alzheimer's disease.
Recent studies have found an association between presence of apolipoprotein E (APOE) epsilon 4 allele and Alzheimer's disease (AD). The present study compared the cumulative risk of primary progressive dementia (PPD) in relatives of AD probands carrying at least one copy of the epsilon 4 allele with the relatives of AD probands not carrying epsilon 4 and with relatives of non-demented controls. Our aim was to determine whether the familial aggregation of PPD in relatives of AD probands is primarily due to those carrying epsilon 4. Seventy-seven neuropathologically diagnosed AD patients were obtained as probands through our Alzheimer's Disease Research Center Brain Bank. AD probands were genotyped for APOE. As a comparison group, 198 non-demented probands were also included. Through family informants, demographic and diagnostic data were collected on 382 first-degree relatives (age > or = 45 years) of AD probands and 848 relatives of the controls. We found that the cumulative risk of PPD in both relatives of AD probands with and without the epsilon 4 allele was significantly higher than that in the relatives of non-demented controls. However, the increased risk in the relatives of AD probands with the epsilon 4 allele was marginally, but not significantly, lower than the risk in the relatives of probands without epsilon 4. A greater likelihood of death by heart diseases over developing PPD in relatives of AD probands with epsilon 4 (3.1-fold increase) was found compared to relatives of probands without epsilon 4 (1.7-fold increase), especially prior to age 70, although the difference was not statistically significant. The increased familial risk for PPD in the relatives of AD probands with the APOE-epsilon 4 allele relative to controls suggests that familial factors in addition to APOE-epsilon 4 are risk factors for AD. Differential censorship from increased mortality of heart diseases may have prevented a higher incidence of PPD among the relatives of probands with epsilon 4.


Antiphospholipid antibodies and idiopathic infertility.
The aim of our study was to evaluate obstetric outcome of women affected by idiopathic infertility showing persistently positive antiphospholipid antibodies (aPL). : From 2000 consecutive patients undergoing ART, we selected 151 (7.55%) clinical records of patients affected by idiopathic infertility undergoing ICSI and showing positive aPL. Persistently positive aPL were found in 64/151 (42.38%) of the patients: in 34/64 (53.12%) at medium/high titers (group A) and in 30/64 (46.87%) at low titers (group B). Primary or secondary antiphospholipid syndrome (APS) was diagnosed in 25% of the patients, whereas 37.5% women showed clinical and/or laboratory features suggestive of APS, but not fulfilling clinical or laboratory classification criteria. Idiopathic infertility was the sole symptom in 31.25%. In 55% of these infertile patients, a history of recurrent failures of assisted reproductive techniques (ART) was also observed. Eighty-eight percent (88.88%) of women became pregnant and 77.77% gave birth. During pregnancy, an increase of aPL values was observed in 29.41% women of group B. A careful selection of patients allowed us to confirm that women affected by idiopathic infertility show a high prevalence of aPL, suggesting that these autoantibodies can also affect conception. Considering pregnancy complications and thrombotic risk related to ovarian stimulation, measuring aPL can represent a valid tool to identify among infertile women undergoing ART those at higher risk of pregnancy complications potentially life-threatening for mother and the fetus. In such patients, an accurate diagnosis and an adequate therapy are related to a better ART outcome.


Amylases in Pea Tissues with Reduced Chloroplast Density and/or Function.
Pea (Pisum sativum L.) tissues with reduced chloroplast density (e.g. petals and stems) or function (i.e. senescent leaves and leaves darkened for prolonged periods) were surveyed to determine whether tissues with genetically or environmentally reduced chloroplast density and/or function also have significantly different amylolytic enzyme activities and/or isoform patterns than leaf tissues with totally competent chloroplasts. Native PAGE followed by electrophoretically blotting through a starch or beta-limit dextrin containing gel and KI/I(2) staining revealed that the primary amylases in leaves, stems, petals, and roots were the primarily vacuolar beta-amylase (EC 184.108.40.206) and the primarily apoplastic alpha-amylase (EC 22.214.171.124). Among tissues of light grown pea plants, petals contained the highest levels of total amylolytic (primarily beta-amylase) activity and considerably higher ratios of beta- to alpha-amylase. In aerial tissues there was an inverse relationship between chlorophyll and starch concentration, and beta-amylase activity. In sections of petals and stems there was a pronounced inverse relationship between chlorophyll concentration and the activity of alpha-amylase. Senescing leaves of pea, as determined by age, and protein and chlorophyll content, contained 3.8-fold (fresh weight basis) and 32-fold (protein basis) higher alpha-amylase activity than fully mature leaves. Leaves maintained in darkness for 12 days displayed a 14-fold (fresh weight basis) increase in alpha-amylase activity over those grown under continuous light. In senescence and prolonged darkness studies, the alpha-amylase that was greatly increased in activity was the primarily apoplastic alpha-amylase. These studies indicate that there is a pronounced inverse relationship between chloroplast function and levels of apoplastic alpha-amylase activity and in some cases an inverse relationship between chloroplast density and/or function and vacuolar beta-amylase activity.


Evaluation of spatial anisotropy by curvature analysis of elliptical targets.
Spatial relationship perception (SRP), defined as the function able to detect the difference between the perceived extent of a shape along the x/y cardinal coordinates, has been investigated in 42 eyes of 21 emmetropic subjects by means of a psychophysical test conceived on purpose. Aiming to the highest sensibility and since curvature detection is reckoned as an hyperacuity, elliptical stimuli have been chosen to measure the spatial relationship anisotropy (SRA) in the visual system. Observers turned out to be able to detect curvature differences along the elliptical contour as low as 33.6 sec arc, which in terms of SRP means an aspect ratio (i.e. the ratio between the height and the width of the ellipse) as low as 1.0022-1.0035. By comparing these results with those obtained in previous investigations from other curvature discrimination tasks, it is argued that recognition threshold is conditioned by the amount of space anisotropy of the visual system. Indeed, in about half of the recruited subjects, vertical/horizontal anisotropy is found to a certain extent and such SRA correlates with the recognition threshold (r= 0.69, p<0.01). There is direct evidence of visual spatial distortion and in particular increased anisotropy in neuro-ophtalmological diseases such as hemianopia and around scotomatous regions in the visual field. Thence, apart from theoretical considerations in physiological field, results collected in this study may be regarded as normative data for future clinical investigations.


Factors Associated With Emergency Department Length of Stay and In-hospital Mortality in Intracerebral Hemorrhage Patients.
BACKGROUND: Spontaneous intracerebral hemorrhage (ICH) is a medical emergency that requires rapid identification and focused assessment early to ensure the best possible outcomes. The purpose of this study is to evaluate the associations between system and patient factors and emergency department (ED) length of stay and in-hospital mortality in patients given a diagnosis of ICH. METHODS: A sample of 3108 ICH patients was selected from a statewide administrative database for cross-sectional retrospective analysis. System characteristic (hospital stroke certification), patient characteristics (age, sex, and race), and covariate conditions (stroke severity and comorbidities) were analyzed using descriptive statistics and hierarchical logistic regression models to address the study questions. RESULTS: The mean ED length of stay is 2.9 ± 3 hours (range, 0-42 hours) before admission to an inpatient unit. Inpatient mortality is 14.9%. Stroke center certification (P < .000) and stroke severity (P ≤ .000) are significant predictors of ED length of stay, whereas age (P < .000), stroke severity (P < .000), comorbidities (P = .047), and ED length of stay (P = .04) are significant predictors of in-hospital mortality. Most notably, an ED length of stay of 3 hours or longer has a 37% increase in the odds of in-hospital mortality. CONCLUSION: Our findings support age, stroke severity, and ED length of stay as predictors of in-hospital mortality for ICH patients. The importance of timely admission to an inpatient unit is emphasized. Optimal systems of care and expedited inpatient admission are vital to reduce morbidity and mortality for ICH stroke patients.


Quantification of spatial subclonal interactions enhancing the invasive phenotype of pediatric glioma.
Diffuse midline gliomas (DMGs) are highly aggressive, incurable childhood brain tumors. They present a clinical challenge due to many factors, including heterogeneity and diffuse infiltration, complicating disease management. Recent studies have described the existence of subclonal populations that may co-operate to drive pro-tumorigenic processes such as cellular invasion. However, a precise quantification of subclonal interactions is lacking, a problem that extends to other cancers. In this study, we combine spatial computational modeling of cellular interactions during invasion with co-evolution experiments of clonally disassembled patient-derived DMG cells. We design a Bayesian inference framework to quantify spatial subclonal interactions between molecular and phenotypically distinct lineages with different patterns of invasion. We show how this approach could discriminate genuine interactions, where one clone enhanced the invasive phenotype of another, from those apparently only due to the complex dynamics of spatially restricted growth. This study provides a framework for the quantification of subclonal interactions in DMG.


Sexual dysfunction in women with diabetes mellitus.
Sexual problems in men with diabetes mellitus are common and often result from diabetic complications. However, although diabetic complications are similar in both sexes, little attention has been given to the effects of diabetes on female sexuality and sexual function. It is reasonable to suggest that women with diabetes will experience sexual problems due to neuropathy, endocrine changes and vascular complications. However there is little research into the physical effects of diabetes on female sexual function. Reduced vaginal lubrication in women with diabetes has been reported yet this is rarely documented as a sexual problem. Previous studies in women with diabetes may also neglect the importance of the subjective qualities associated with female sexuality and sexual expression.


Regulation of ribulose-1,5-bisphosphate carboxylase activity in response to diurnal changes in irradiance.
The regulation of ribulose-1,5-bisphosphate (RuBP) carboxylase (Rubisco) activity and metabolite pool sizes in response to natural diurnal changes in photon flux density (PFD) was examined in three species (Phaseolus vulgaris, Beta vulgaris, and Spinacia oleracea) known to differ in the mechanisms used for this regulation. Diurnal regulation of Rubisco activity in P. vulgaris was primarily the result of metabolism of the naturally occurring tight-binding inhibitor of Rubisco, 2-carboxyarabinitol 1-phosphate (CA1P). In B. vulgaris, the regulation of Rubisco activity was the result of both changes in activation state and CA1P metabolism. In S. oleracea, Rubisco activity was regulated by a combination of changes in activation state and the binding/release of another tight binding inhibitor, probably RuBP. Despite these different mechanisms for the light regulation of Rubisco activity, the relationship between the in vivo activity of Rubisco and the PFD was the same for all three species. Rates of CA1P metabolism were thus sufficient to allow this mechanism to participate in the diurnal regulation of Rubisco activity as PFD changed at its normal rate. Furthermore, under natural conditions this regulatory mechanism was found to be important in controlling Rubisco activity over approximately the same range of PFD as did changes in activation state of the enzyme. Finally, this regulation of Rubisco activity resulted in relatively similar and saturating RuBP pool sizes for photosynthesis at all but the lowest PFD values in all three species.


Responsiveness of a single-item indicator versus a multi-item scale: assessment of emotional well-being in an international adjuvant breast cancer trial.
A single-item linear analogue self-assessment scale for mood was compared with a 28-item adjective checklist for emotional well-being. To confirm its concurrent validity and responsiveness to treatment and recurrence in patients with breast cancer, emotional well-being was assessed every 3 months for 2 years and at 1 and 6 months after recurrence in 1,169 patients who were premenopausal and 960 patients who were postmenopausal. These patients were enrolled in two International Breast Cancer Study Group randomized clinical trials in operable breast cancer conducted from 1986 to 1993. To assess concurrent validity, Pearson's correlation between the linear analogue self-assessment scale and the adjective checklist were calculated for each time-point within each treatment group and for the two assessments after recurrence. Responsiveness to treatment and recurrence were analyzed using paired t tests and the squared ratio of these t tests, an estimate of relative efficiency. Concurrent validity of the mood linear analogue self-assessment was consistently confirmed across four language groups. Both measures were responsive; out of 24 changes over time, 19 were in the expected direction for the linear analogue self-assessment scale (p < or = 0.05 for 9 of 19) and 17 for the adjective checklist (p < or = 0.05 for 10 of 17). The linear analogue self-assessment scale was less but significantly efficient for detection of treatment effects, with relative efficiency estimates ranging from 0.16 to 2.45 and a median of 0.66 among the comparisons with relatively stable estimates (/t/ > or = 1.0) and more efficient for recurrence than the adjective checklist. The mood linear analogue self-assessment scale is a valid indicator of emotional well-being in patients with breast cancer in large multicenter, multicultural trials in which comprehensive scales are less feasible. This investigation supports the clinical relevance of linear analogue self-assessment scales as indicators of components of quality of life in cancer clinical trials.


Reconstituting the frequency spectrum of ascertained single-nucleotide polymorphism data.
Most of the available SNP data have eluded valid population genetic analysis because most population genetical methods do not correctly accommodate the special discovery process used to identify SNPs. Most of the available SNP data have allele frequency distributions that are biased by the ascertainment protocol. We here show how this problem can be corrected by obtaining maximum-likelihood estimates of the true allele frequency distribution. In simple cases, the ML estimate of the true allele frequency distribution can be obtained analytically, but in other cases computational methods based on numerical optimization or the EM algorithm must be used. We illustrate the new correction method by analyzing some previously published SNP data from the SNP Consortium. Appropriate treatment of SNP ascertainment is vital to our ability to make correct inferences from the data of the International HapMap Project.


Towards smoke-free cars in the Republic of Korea: Evidence from environmental and biochemical monitoring of third-hand smoke exposure in taxis.
To evaluate the level of tobacco smoke exposure in taxis in Korea using tobacco specific environmental markers. From June to September 2012, cross-sectional measurements of air nicotine levels and dust nicotine-derived nitrosamine ketone (NNK) concentrations were conducted in 17 taxis in Goyang, Korea. Field investigators completed an observational questionnaire on building characteristics, smoking policies and evidence of smoking. Descriptive statistics including geometric means (GMs) ± standard deviations were produced for air nicotine levels and dust NNK concentrations. There was no evidence of active smoking in the 17 taxis monitored, despite the fact that 10 drivers were current smokers. The overall GMs of air nicotine and dust NNK concentration were 0.42 μg/m3 and 6.78 pg/mg, respectively. These levels were 3.4-fold and 2.6-fold higher in taxis whose drivers were current smokers compared to the taxis of nonsmokers (GM of air nicotine: 0.65 μg/m3 vs 0.19 μg/m3; GM of dust NNK: 10.07 pg/mg vs 3.85 pg/mg). The present study shows that air nicotine and dust NNK were detected in all taxis regardless of whether the taxi driver was smoking or not, which indicates the potential for exposure to SHS or THS. It suggests that an appreciable level of SHS and TSH exposure might occur if the environment is not completely smoke-free and enforcement is lacking. THS: third-hand smoke, SHS: second-hand smoke, FCTC: Framework Convention Alliance for Tobacco Control, NNK: 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone, LOD: limit of detection, GM: geometric mean, GSD: geometric standard deviation.


Clinical application of BVS5000 left ventricular assist device in heart failure patients.
Mechanical ventricular assistance is an important therapeutic method for severe heart failure patients. A variety of ventricular assist devices have been designed for use. The purpose of this report was to describe the experience of using Abiomed BVS5000 as a means of left ventricular support as a clinical treatment for heart failure patients. From February 2004 to April 2006, 12 male patients were supported with Abiomed BVS5000 left ventricular assist device (LVAD) at Fu Wai Hospital. The average age was (55.2 +/- 9.6) years (range 39 to 68 years). The mean body surface area was (1.76 +/- 0.1) m(2) (range 1.6 to 1.9 m(2)). Devices were inserted for post-cardiotomy shock after coronary artery bypass graft in 11 patients (92%) and in 1 dilated cardiomyopathy patient for acute cardiogenic shock. Modified cannulation methods by inserting the arterial cannulae in femoral artery and inserting the venous cannula in left atrium through a segment of bovine jugular vein were used in 7 patients. In this way, the device could be taken off without re-sternotomy when support was finished. A comparison was made between the modified method and routine left atrium-to-ascending aorta cannulating method. The median duration of support was 5 (3 - 43) days, with support flow rate of 3.8 - 4.5 L/min. There were 9 (75%) patients weaned from support and 8 (67%) patients discharged from the hospital. Four (33%) patients were dead. The most common morbidity was adverse neurological events. There is no statistical difference between modified and routine method on average in BVS5000 support duration, in assisted flow rate, in mechanical ventilation duration, in the intensive care unit stay and thoracic drainage. The Abiomed BVS5000 is valuable to support patients with acute cardiogenic shock for short-term use. By the modified cannulating method, the weaning procedure can be effectively simplified. Optimization of inserting indication remains challenging and attributes to a successful assist program.


Morbidity of sickle cell trait at high altitude.
A Caucasian with sickle cell trait (54% A, 43% S hemoglobin) had symptoms and signs of chronic hemolytic anemia as well as splenic infarction while living at very high altitude (in excess of 2,800 m). Trips from sea level back to high altitude repeatedly precipitated pulmonary infarctions. All symptoms and evidence of hemolysis resolved at low altitude.


Interparticle Spacing Effect among Quantum Dots with High-Pressure Regulation.
In this paper, we explore whether interparticle spacing affects steady-state and transient-state optical properties by comparing close-packed CdSe/ZnS-quantum dots (QDs) and CdSe/ZnS-QDs dispersed in polymethyl methacrylate (PMMA). High-pressure is an effective physical means to adjust the interparticle spacing of QDs, which may artificially expand the application of QDs further. The results under high-pressure indicate that it is the reduced interparticle spacing rather than the enhanced quantum confinement effect with volume compression that has a stronger effect on exciton relaxation of CdSe/ZnS-QDs. This work is hoped to help us further understand the effect of interparticle spacing among QDs in various integrated environments.


A review of the six-minute walk test: its implication as a self-administered assessment tool.
Promoting self-management and monitoring physical activity are important strategies in chronic heart disease (CHD) management. The six-minute walk test (6MWT) is a commonly used sub-maximal exercise test for measuring physical functional capacity. The aim of this paper is to review the current literature on 6MWT relating to methodological issues as well as exploring the potential of the protocol to be adopted as a self-administered exercise test. The Medline, CINAHL, Science Direct and the World Wide Web using the search engine Google, were searched for articles describing the administration, reliability and validity of the 6MWT. Findings of the integrative literature review The 6MWT is a simple, safe and inexpensive sub-maximal exercise test. The 6MWT distance is strongly associated with functional capacity, and it is a useful prognostic tool. To date, the capacity for self-administration of the 6MWT has not been investigated. Adapting the 6MWT as a patient-reported outcome measure may enhance the capacity, not only for clinicians to monitor functional status, but also promote self-management by enabling individuals to monitor changes in their functional capacity.


Vitamin B-12, vitamin B-6, and folate nutritional status in men with hyperhomocysteinemia.
We measured the vitamin B-6, vitamin B-12, and folic acid nutritional status in a group of apparently healthy men (n = 44) with moderate hyperhomocysteinemia (plasma homocysteine concentration > 16.3 mumol/L). Compared with control subjects (n = 274) with normal plasma homocysteine (< or = 16.3 mumol/L) concentrations, significantly lower plasma concentrations of pyridoxal-5'-phosphate (P < 0.001), cobalamin (P < 0.001), and folic acid (P = 0.004) were demonstrated in hyperhomocysteinemic men. The prevalence of suboptimal vitamin B-6, B-12, and folate status in men with hyperhomocysteinemia was 25.0%, 56.8%, and 59.1%, respectively. In a placebo-controlled follow-up study, a daily vitamin supplement (10 mg pyridoxal, 1.0 mg folic acid, 0.4 mg cyanocobalamin) normalized elevated plasma homocysteine concentrations within 6 wk. Because hyperhomocysteinemia is implicated as a risk factor for premature occlusive vascular disease, appropriate vitamin therapy may be both efficient and cost-effective to control elevated plasma homocysteine concentrations.


Government directives and changes: the potential impact on clinical practice.
Since publication of The new NHS: modern, dependable we have had more guidance and circulars from central government than have ever before been received in such a short space of time: 242 in 1998 and already well over 100 in 1999. Furthermore, 'joined-up government' may not have been achieved yet, but it certainly means that all agencies are being changed or modernised simultaneously, and so are all in the same position. This paper examines the impact that some of these directives and changes may have on clinicians and clinical practice. The paper does not deal with the issue of setting up primary care groups (PCGs), which could form the basis of an article on its own.


Long-term oxygen therapy: physiologic and economic considerations.
Long-term oxygen therapy appears to be a safe means of treating hypoxemia. It can provide many physiologic improvements and prolongs life in persons with severe chronic arterial hypoxemia at rest. Recent studies suggest that arterial hypoxia is common during exercise and sleep, and it is likely that some patients with intermittent desaturation would benefit physiologically from supplemental oxygen. Oxygen is an expensive drug, and we do not know whether its benefits are greater than its costs in patients who are not hypoxic at rest. I believe that low-flow oxygen administered as continuously as possible should be strongly considered for all patients whose PaO2 is 55 mm Hg or less at rest, regardless of whether they have cor pulmonale, and for all patients with cor pulmonale, regardless of their PaO2.


Dysthanasia versus euthanasia.
The concept of dysthanasia is contrasted with euthanasia, and the suggestion is advanced that it may not be merely the dictionary opposite of euthanasia.


Exploratory Validation Study of the Individual AUDIT-C Items among Older People.
The AUDIT-C is a brief and commonly used alcohol screening tool, with few data available on the relative validity of the three individual items in older adult populations. The aim of this study was to explore the validity of the AUDIT-C items in identifying unhealthy drinking among older people, with a view to developing a single-item screener. A sample of 143 older adults (mean age = 71) were recruited from non-clinical settings in the UK. AUDIT-C scores were compared to an unhealthy drinking reference category of consuming more than the UK recommended weekly units of alcohol. Standard analyses were conducted for men and women, and for those prescribed medications for long term conditions. The AUDIT-C items performed well in identifying unhealthy drinking in this sample of older people, with generally high sensitivity, specificity and area under the ROC curve. No significant differences were found in the validity of the three items, though the combined sensitivity and specificity scores and ROC values for item 3 were consistently slightly lower than for items 1 and 2. The findings were similar for men and women, and for participants prescribed medications for long-term conditions. AUDIT-C items 1 and 2 performed as well as item 3 in identifying unhealthy drinking among older people in this study. Both are reasonable single-item screener candidates, especially given relative ease of administration, with further validation study needed to examine psychometrics and how alcohol screening for older people can best be implemented in clinical settings.


HIV and CKD epidemiology.
Nephrologists can serve many important functions for HIV-infected patients, including identifying risks for developing kidney disease, detecting and diagnosing kidney disease, distinguishing antiretroviral-induced kidney injury from kidney disease in the setting of antiretroviral therapy, comanaging the clinical course and complications of CKD, and preparing patients for dialysis and/or transplantation. The epidemiology of kidney disease in HIV informs us for these functions by describing the natural history of disease, its frequent occurrence in high-risk communities, and its potential causes. Risk factors that drive CKD in HIV are black race, hypertension, diabetes, HIV viral replication with low CD4 cell counts, high viral load or acquired immune deficiency syndrome-defining conditions, and antiretroviral agents with nephrotoxic potential. The prevalence of these risk factors in any population determines the magnitude of the problem, which can range from as low as 2% to as high as 30%. Recent research focuses on kidney health in HIV. Important links between HIV viral replication and glomerular filtration rate, even in patients with normal kidney function, are now being reported. A review of these data provides the foundation for a better understanding of kidney disease and, hopefully, better treatment for patients with HIV.


Contrasting the Role of Ni/Al2O3 Interfaces in Water-Gas Shift and Dry Reforming of Methane.
Transition metal nanoparticles (NPs) are typically supported on oxides to ensure their stability, which may result in modification of the original NP catalyst reactivity. In a number of cases, this is related to the formation of NP/support interface sites that play a role in catalysis. The metal/support interface effect verified experimentally is commonly ascribed to stronger reactants adsorption or their facile activation on such sites compared to bare NPs, as indicated by DFT-derived potential energy surfaces (PESs). However, the relevance of specific reaction elementary steps to the overall reaction rate depends on the preferred reaction pathways at reaction conditions, which usually cannot be inferred based solely on PES. Hereby, we use a multiscale (DFT/microkinetic) modeling approach and experiments to investigate the reactivity of the Ni/Al2O3 interface toward water-gas shift (WGS) and dry reforming of methane (DRM), two key industrial reactions with common elementary steps and intermediates, but held at significantly different temperatures: 300 vs 650 °C, respectively. Our model shows that despite the more energetically favorable reaction pathways provided by the Ni/Al2O3 interface, such sites may or may not impact the overall reaction rate depending on reaction conditions: the metal/support interface provides the active site for WGS reaction, acting as a reservoir for oxygenated species, while all Ni surface atoms are active for DRM. This is in contrast to what PESs alone indicate. The different active site requirement for WGS and DRM is confirmed by the experimental evaluation of the activity of a series of Al2O3-supported Ni NP catalysts with different NP sizes (2-16 nm) toward both reactions.


The role of US in finding intussusception and alternative diagnosis: a report of 100 pediatric cases.
The clinical diagnosis of intussusception remains challenging, because many children with intussusception may present with non-specific signs and symptoms, which overlap with other conditions. Therefore imaging, in particular ultrasonography (US), plays a significant role in the management of these patients. To evaluate how US can contribute to the diagnosis in clinically suspected intussusception and finding alternative diagnosis. We retrospectively reviewed reports of US examinations and medical records of 100 patients (51 boys, 49 girls; mean age, 23.0 ± 12.1 months) who underwent abdominal US for clinically suspected intussusception. Each US study was assessed for the presence or absence of intussusception and for a possible alternative diagnosis in cases interpreted as negative for intussusception. Thirty-seven patients had US findings consistent with intussusception, which was confirmed by air enema. In seven patients, US studies were normal. Alternative diagnoses were identified by US for each of the remaining 56 patients, including ileocolitis (n = 20), terminal ileitis (n = 18), mesenteric lymphadenitis (n = 13), choledochal cyst (n = 1), accessory spleen torsion (n = 1), small bowel ileus (n = 1), midgut volvulus with bowel ischemia (n = 1), and hydronephrosis (n = 1). With the high sensitivity and specificity of this study we conclude that US is valuable in detecting intussusception and finding the alternative diagnosis.


Distinguishable in vitro binding mode of monomeric TRBP and dimeric PACT with siRNA.
RNA interference (RNAi) is an evolutionally conserved posttranscriptional gene-silencing mechanism whereby small interfering RNA (siRNA) triggers sequence-specific cleavage of its cognate mRNA. Dicer, Argonaute (Ago), and either TAR-RNA binding protein (TRBP) or a protein activator of PKR (PACT) are the primary components of the RNAi pathway, and they comprise the core of a complex termed the RNA-induced silencing complex (RISC)-loading complex (RLC). TRBP and PACT share similar structural features including three dsRNA binding domains (dsRBDs), and a complex containing Dicer and either TRBP or PACT is considered to sense thermodynamic asymmetry of siRNA ends for guide strand selection. Thus, both TRBP and PACT are thought to participate in the RNAi pathway in an indistinguishable manner, but the differences in siRNA binding mode and the functional involvement of TRBP and PACT are poorly understood. Here, we show in vitro binding patterns of human TRBP and PACT to siRNA using electrophoresis mobility shift analysis and gel filtration chromatography. Our results clearly showed that TRBP and PACT have distinct in vitro siRNA binding patterns from each other. The results suggest that monomeric TRBP binds to siRNA at the higher affinity compared to the affinity for own homodimerization. In contrast, the affinity between PACT and siRNA is lower than that of homodimerization or that between TRBP and siRNA. Thus, siRNA may be more readily incorporated into RLC, interacting with TRBP (instead of PACT) in vivo.


Association between antibiotic consumption and the rate of carbapenem-resistant Gram-negative bacteria from China based on 153 tertiary hospitals data in 2014.
This study aimed to investigate the relationship between the rate of carbapenem-resistant Gram-negative bacteria and antibiotic consumption intensity in 153 tertiary hospitals from China in 2014. A retrospective study using national surveillance data from 2014 was conducted. Data on the annual consumption of each antibiotic, as well as the rate of carbapenem-resistant Gram-negative bacteria, were collected from each participating hospital, and the correlation between antibiotic consumption and carbapenem- resistant rate was analyzed. The overall antibiotic consumption intensity among the hospitals varied between 23.93 and 86.80 defined daily dosages (DDDs) per 100 patient-days (median, 46.30 DDDs per 100 patient-days). Cephalosporins were the most commonly used antibiotic, followed by quinolones, penicillins, and carbapenems, and the rate of carbapenem-resistant Gram-negative bacteria from each hospital varied. The correlations between carbapenem consumption intensity and rate of carbapenem resistance revealed correlation factors of 0.271 for Escherichia coli (p < 0.01), 0.427 for Klebsiella pneumoniae (p < 0.01), 0.463 for Pseudomonas aeruginosa (p < 0.01), and 0.331 for Acinetobacter baumannii (p < 0.01). A significant relationship existed between the carbapenem consumption and the rates of carbapenem-resistant gram negative bacilli. Rational use of carbapenems should be implemented to address the issue of carbapenem resistance in hospitals.


Organ-Protective Intensive Care in Organ Donors.
The ascertainment of brain death (the irreversible, total loss of brain function) gives the physician the opportunity to limit or stop further treatment. Alternatively, if the brain-dead individual is an organ donor, the mode of treatment can be changed from patient-centered to donationcentered. Consensus-derived recommendations for the organ-protective treatment of brain-dead organ donors are not yet available in Germany. This review is based on pertinent publications retrieved by a selective search in PubMed, and on the authors' clinical experience. Brain death causes major pathophysiological changes, including an increase in catecholamine levels and a sudden drop in the concentration of multiple hormones, among them antidiuretic hormone, cortisol, insulin, and triand tetraiodothyronine. These changes affect the function of all organ systems, as well as the hemodynamic state and the regulation of body temperature. The use of standardized donor management protocols might well increase the rate of transplanted organs per donor and improve the quality of the transplanted organs. In addition, the administration of methylprednisolone, desmopressin, and vasopressin could be a useful supplement to treatment in some cases. Randomized controlled trials have not yet demonstrated either improved organ function or prolonged survival of the transplant recipients. The evidence base for organ-protective intensive care is weak; most of the available evidence is on the level of expert opinion. There is good reason to believe, however, that the continuation of intensive care, in the sense of early donor management, can make organ transplantation more successful both by increasing the number of transplantable organs and by improving organ quality.


Survival of adhering staphylococci during exposure to a quaternary ammonium compound evaluated by using atomic force microscopy imaging.
Effects of a quaternary ammonium compound (QAC) on the survival of adhering staphylococci on a surface were investigated using atomic force microscopy (AFM). Four strains with different minimal inhibitory concentrations (MIC) and minimal bactericidal concentrations (MBC) for the QAC were exposed to three different concentrations of the QAC in potassium phosphate buffer (0.5×, 1×, and 2× MBC) while adhering to glass. Adhering staphylococci were repeatedly imaged with AFM in the contact mode, and the cell surface was found to wrinkle upon progressive exposure to the QAC until bacteria disappeared from the substratum. Higher concentrations of QAC yielded faster wrinkling and the disappearance of bacteria during imaging. Two slime-producing staphylococcal strains survived longer on the surface than two non-slime-producing strains despite similar MICs and MBCs. All staphylococci adhering in unscanned areas remained adhering during exposure to QAC. Since MICs and MBCs did not relate to bacterial cell surface hydrophobicities and zeta potentials, survival on the surface is probably not determined by the direct interaction of QAC molecules with the cell surface. Instead, it is suggested that the pressure of the AFM tip assists the incorporation of QAC molecules in the membrane and enhances their bactericidal efficacy. In addition, the prolonged survival under pressure from slime-producing strains on a surface may point to a new protective role of slime as a stress absorber, impeding the incorporation of QAC molecules. The addition of Ca(2+) ions to a QAC solution yielded longer survival of intact, adhering staphylococci, suggesting that Ca(2+) ions can impede the exchange of membrane Ca(2+) ions required for QAC incorporation.


The TDNNS method for Reissner-Mindlin plates.
A new family of locking-free finite elements for shear deformable Reissner-Mindlin plates is presented. The elements are based on the "tangential-displacement normal-normal-stress" formulation of elasticity. In this formulation, the bending moments are treated as separate unknowns. The degrees of freedom for the plate element are the nodal values of the deflection, tangential components of the rotations and normal-normal components of the bending strain. Contrary to other plate bending elements, no special treatment for the shear term such as reduced integration is necessary. The elements attain an optimal order of convergence.


Do guilt- and shame-proneness differentially predict prosocial, aggressive, and withdrawn behaviors during early adolescence?
In this short-term longitudinal study, we systematically examined the distinctiveness of guilt- and shame-proneness in early adolescents (N = 395, mean age = 11.8 years) in terms of differential relations with peer reported prosocial behavior, withdrawal, and aggression. Results from structural equation modeling indicated that guilt-proneness concurrently predicted more aggressive and less prosocial behavior as well as subsequent increases in prosocial behavior. Shame-proneness predicted subsequent decreases in prosocial behavior. Although girls reported a greater proneness to experience guilt and shame than boys, the associations between the two dispositional emotions and social behaviors were found to be similar across time and gender.


Fine-needle aspiration cytology of adrenal cryptococcosis: a case report.
A case of adrenal cryptococcosis diagnosed by fine-needle aspiration biopsy cytology in a 58-yr-old man is presented. The organisms were easily seen with routine modified Wright stain (Diff-Quik) as variably sized yeasts, some with a brightly eosinophilic capsule. The diagnosis was confirmed with mucicarmine and silver stains. The identification of fungi with routine cytologic stains allows a rapid presumptive diagnosis of the infectious agent, collection of material for confirmatory special stains, and prompt initiation of therapy.


Composited Film of Poly(3,4-ethylenedioxythiophene) and Graphene Oxide as Hole Transport Layer in Perovskite Solar Cells.
It is important to lower the cost and stability of the organic-inorganic hybrid perovskite solar cells (PSCs) for industrial application. The commonly used hole transport materials (HTMs) such as Spiro-OMeTAD, poly[bis(4-phenyl)(2,4,6-trimethylphenyl)amine] (PTAA) and poly(3-hexylthiophene-2,5-diyl) (P3HT) are very expensive. Here, 3,4-ethylenedioxythiophene (EDOT) monomers are in-situ polymerized on the surface of graphene oxide (GO) as PEDOT-GO film. Compared to frequently used polystyrene sulfonic acid (PSS), GO avoids the corrosion of the perovskite and the use of H2O solvent. The composite PEDOT-GO film is between carbon pair electrode and perovskite layer as hole transport layer (HTL). The highest power conversion efficiency (PCE) is 14.09%.


Pandemic influenza A (H1N1) in non-vaccinated, pregnant women in Spain (2009-2010).
The aim of this study was to investigate the main characteristics of non-vaccinated pregnant women who were hospitalised for influenza A (H1N1) pdm09 pandemic versus pregnant women hospitalised for non-influenza-related reasons in Spain, and to characterise the clinical presentation of the disease in this population to facilitate early diagnosis and future action programmes. Understanding influenza infection during pregnancy is important as pregnant women are a high-risk population for increased morbidity from influenza infection. We investigated the socio-demographic and clinical features of 51 non-vaccinated, pregnant women infected with the pandemic influenza A (H1N1) virus in Spain (cases) and compared them to 114 controls (non-vaccinated and non-infected pregnant women) aged 15-44 years. Substantial and significant odd ratios (ORs) for pandemic influenza A (H1N1) were found for the pregnant women who were obese compared with controls (body mass index > 30) (OR 3.03; 95% confidence intervals 1.13-8.11). The more prevalent symptoms observed in pandemic influenza-infected pregnant women were high temperature, cough (82.4%), malaise (80.5%), myalgia (56.1%), and headaches (54.9%). Our results suggest that the initial symptoms and risk factors for infection of pregnant women with the influenza A (H1N1) pdm09 virus are similar to the symptoms and risk factors for seasonal influenza, which make early diagnosis difficult, and reinforces the need to identify and protect high-risk groups.


The immune response to Mycobacterium tuberculosis.
Mycobacteria are worldwide spread and satisfactory vaccines against pathogenic species have not been developed, yet. Mycobacteria, inside phagocytic cells, are able to escape humoral attack and maintain viability for long periods of time. T cells are engaged in the activation and regulation of macrophages and subsequently, in the control of mycobacterial growth. It appears that different T cell sets including CD4 alpha/beta T cells, CD8 alpha/beta T cells and gamma/delta T cells are involved in antimycobacterial immunity. Both, phagocyte and microorganism synthesize heat shock proteins in order to facilitate their survival. HSP possesses potent immunogenicity, a high degree of homology among different species and hence may play an important role in resistance against and pathogenesis of mycobacterial infections.


Brand and size matter when choosing a syringe to relieve pressure in a tracheal tube cuff.
We studied the use of an inline syringe as a pressure relief valve for tracheal tube cuffs during exposure to nitrous oxide to see if the technique works. Bench testing was done to determine the stick and slip characteristics of syringes of different brands and sizes. Cuffs were inflated with 20 mL of air, producing a cuff pressure of 100-120 mm Hg. Then the plunger of the syringe was allowed to passively rebound to a steady pressure at which the plunger stopped ("stick pressure"). After several minutes, pressure in the syringe was forcibly increased with a second syringe until the plunger started moving again ("slip pressure"). Stick pressure varied from 18 to 82 mm Hg depending on the brand and size of syringe used. Slip pressures exceeded stick pressures by 20-120 mm Hg. Cuff pressure increased in a linear fashion during nitrous oxide exposure, and no syringe demonstrated automatic pressure reduction. We conclude that a syringe attached to the pilot balloon connector can be used to control tracheal tube cuff pressure during nitrous oxide anesthesia. However, not all syringes are suitable for this purpose: large syringes are better than small syringes, and the Terumo brand is more suitable than BD or Monoject. The system does not work automatically, and intermittent compression of the syringe plunger to overcome static friction is required to avoid overdistension.


Comparison of Submicron Particle Counting Methods with a Heat Stressed Monoclonal Antibody: Effect of Electrolytes and Implications on Sample Preparation.
Within this study, the performance and limitations of tunable resistive pulse sensing (TRPS) was evaluated to characterize submicron particles in unstressed and heat stressed monoclonal antibody (mAb) solutions. These were compared with microfluidic resistive pulse sensing (MRPS), resonant mass measurement (RMM), and nanoparticle tracking analysis (NTA). For TRPS and MRPS measurements, an adjustment of ionic strength was required to achieve suitable measurement conditions. The addition of electrolytes is potentially critical for protein formulations and therefore the effect of salt concentration and pH on submicron particle levels was further investigated. Heat stress caused a sharp increase in particle levels between 250-900 nm, observable by all four techniques. Due to reduced colloidal stability, indicated by increased attractive forces and reduced aggregation onset temperatures in the presence of sodium chloride, protein aggregation was observed in heat stressed mAb only after the addition of sodium chloride. Achieving adequate ionic strength by replacing sodium chloride with other electrolytes similarly resulted in reduced colloidal stability and protein aggregation. It is recommended that protein samples prone for aggregation in the presence of high ionic strength should not be analyzed by RPS measurements after the addition of electrolytes. However, protein samples containing already required ionic strength can be analyzed by any of the four techniques.


Valsartan therapy has additive anti-oxidative effect to that of fluvastatin therapy against low-density lipoprotein oxidation: studies in hypercholesterolemic and hypertensive patients.
In hypercholesterolemic and hypertensive patients, an increased propensity of their low-density lipoprotein (LDL) to oxidative modification has been observed. Because oxidized LDL (ox-LDL) plays a major role in atherosclerosis, the current study analyzed the anti-oxidative effect of valsartan (an angiotensin II receptor antagonist) therapy in combination with fluvastatin therapy in these patients. Administration of 40 mg/d of fluvastatin for 2 months to seven patients resulted in significant reduction in plasma total and LDL cholesterol (by 24-28%). Valsartan administration (80 mg/d for an additional 2-month period) in combination with fluvastatin did not further affect plasma cholesterol levels. Fluvastatin therapy inhibited the susceptibility of LDL to copper ion-induced oxidation, as shown by prolongation of the lag time by 22% and by a reduction of thiobarbituric acid-reactive substances (TBARS) levels by 14%, as compared with the patient's LDL baseline oxidation. The addition of valsartan to fluvastatin resulted in a further 17% prolongation of the lag time and in an additional reduction of 21% in TBARS levels. In a parallel study, the LDL from eight patients who were first treated with 80 mg/d of valsartan for 2 months demonstrated reduced susceptibility to copper ion-induced oxidation, as observed by prolongation of lag time by 23% and reduction in TBARS levels by 19%, compared with the baseline values. The administration of 40 mg/d of fluvastatin for an additional 2 months in combination with valsartan, however, demonstrated no further inhibitory effect on LDL oxidation. The anti-oxidative properties of fluvastatin and valsartan against LDL oxidation were also demonstrated in vitro and the combination of both drugs was shown to have an additive effect. Valsartan therapy in hypercholesterolemic and hypertensive patients has an additive anti-oxidative effect to that of fluvastatin therapy. This may be related both to the anti-oxidative properties of valsartan and to the blocking of angiotensin II-induced oxidative stress.


Layer-by-Layer Films of Gold Nanoparticles and Carbon Nanotubes for Improved Amperometric Detection of Cholesterol.
Distinct architectures of layer-by-layer (LbL) films made of carbon nanotubes and gold nanoparticles were investigated to serve as the matrix to immobilize cholesterol oxidase, with which cholesterol could be detected using amperometry. The gold nanoparticles were synthesized by metal reduction stabilized in poly(allylamine hydrochloride) (PAH) providing a stable AuNPs-PAH suspension, while multi-walled carbon nanotubes (CNTs) were functionalized with carboxylic groups to obtain an aqueous suspension. The LbL films were deposited on ITO, with a cushion film of PAH and poly(vinyl sulfonic acid) (PVS). Owing to the synergy between CNTs and AuNPs, the electrode ITO/(PAH/PVS)₂ (AuNPs-PAH/CNTs)10 was selected for immobilization of cholesterol oxidase (ChOx). This sensor could detect cholesterol with a limit of detection of 14.8 μmol L-1 and sensitivity of 36.47 (μA cm-2)·(mmol L-1)-1. It was also able to determine cholesterol in egg yolk with a recovery of 97.7%.


[Colo(ileo)rectoplasty in the treatment of Hirschsprung's disease and congenital neural malformations of the distal intestines].
The objective of the presented paper is to define the characteristics of colo(ileo)rectoanastomosis for the treatment of Hirschsprung's disease (H. d.) and other congenital malformations in the innervation of the distal gut (CMDI). During 1979-1994 at the Clinic of Paediatric Surgery of the Second Medical Faculty in Prague-Motol 137 patients (100 boys and 37 girls), aged 5 months to 18 years with H. d. and CMDI were operated. In 124 patients Kasai's colorectoplasty was used, in 40 of them supplemented by partial sphincteromyectomy of the internal sphincter of the anus (SPME) and Swenson's transanal colorectal anastomosis. In 10 patients with total aganglionosis of the colon (TCA) in three instances ileorectoplasty and Martin's anastomosis was used, in seven instances only ileorectoplasty. In three patients the authors used Soave's endorectal pull-through. 85 patients (62.1%) had no postoperative complications. Early infection was recorded in 12 patients (8.6%), dehiscence of the surgical wound in seven patients (5.1%). Dehiscence of the colo(ileo)rectorectal anastomosis occurred in 13 patients (9.5%), stricture in 10 patients (7.2%). Postoperative obstruction of the gut was recorded in 7 (5.1%) patients, postoperative enterocolitis in three patients (2.2%). There were no deaths. Regular opening of the bowels after 1-2-day intervals was achieved in 110 patients (84.1%). Patients after surgery of TCA have on average 2-5 stools per day. Sixteen patients developed chronic constipation and subileous conditions. Incontinence of faeces was found in two patients with Down's disease. Colo(ileo)rectoplasty in H. d. and other CMDI should meet the following conditions: maximal resection of the affected portion--creation of a satisfactory anastomosis with a minimal occurrence of strictures and dehiscences--preservation of satisfactory continence--elimination of anorectal sphincteroachalasia. Modified Kasai's rectoplasty or Swenson's procedure meet these conditions. In case of TCA a 10-15 cm ileorectocolic anastomosis is quite sufficient. For reoperations of strictures and inflammatory complications after previous colo(ileo)rectoplasty Soave's technique is probably the best choice.


Net P-removal deterioration in enriched PAO sludge subjected to permanent aerobic conditions.
Recently, some research in the field of enhanced biological phosphorus removal (EBPR) has been focused on studying systems where the electron donor (substrate) and the electron acceptor (nitrate or oxygen) are present simultaneously. This can occur, for example, in a full scale wastewater treatment plant during heavy rainfall periods when the anaerobic hydraulic retention time is temporarily shortened. To study this situation that could induce EBPR failure, the operation of a sequencing batch reactor (SBR) working under alternating anaerobic-aerobic conditions with an enriched EBPR population (50% Candidatus Accumulibacter phosphatis and less than 1% Candidatus Competibacter phosphatis) was shifted to strict aerobic operation. Seven cycle studies were performed during the 11 days of aerobic operation. Net P-removal was observed in this aerobic SBR during the first 4 days of operation but the system could not achieve net-P removal after this period, although the microbial composition, in terms of percentage of Accumulibacter and Competibacter, did not change significantly. The observed changes in the different compounds analysed (phosphorus, acetate, glycogen and PHB) as well as in the OUR profile indicate that metabolic changes are produced for the adaptation of PAO to aerobic conditions.


LC-MS-(MS) determination of oxidative degradation products of nonylphenol ethoxylates, carboxylates and nonylphenols in water.
A commercial blend of nonylphenol ethoxylates (NPEOs) was chosen as representative for non-ionic polyethoxylated surfactants to study the oxidative degradation of this class of surfactants in water using ozonation as well as electron beam irradiation with and without the addition of ozone as treatment processes. The electron beam irradiation processes applied represent so-called Advanced Oxidation Processes (AOPs); the combined ozone/electron beam irradiation is, moreover, the most powerful AOP which can be applied in aqueous systems. It was found that both ozonation and the two AOPs applied were able to decompose not only the NPEOs but also the polyethyleneglycoles (PEGs) formed as by-products from NPEO degradation to residual concentrations below the limit of detection. Moreover, the treatment processes were also used to study the oxidative degradation of nonylphenoxy acetic acid (NPEC) and of nonylphenol (NP) which are formed as by-products from biodegradation of NPEOs.


The Immunogenicity of Peptoid-Protein Conjugates.
We demonstrate that a peptoid composed of five monomers and attached via a maleimide linker to a carrier protein elicits anti-peptoid, anti-linker and anti-carrier antibodies in rabbits. Specific anti-peptoid antibodies were affinity purified and used to reproducibly retrieve three specific peptoid-coupled beads from 20,000 irrelevant peptoid-beads using magnetic screening.


Minimally invasive cardiac surgery defined.
There is no operation as complex, yet as fundamentally unchanged over time, as conventional coronary artery bypass grafting (CABG). This remarkable achievement is attributed to the operation's adaptability to a wide variety of clinical settings; its reproducibility, although performed by surgeons all across the world; and its proved track record for safety and effectiveness. A monumental effort, however, is currently under way to redefine CABG. This paradigm shift has received a groundswell of support as advances in minimally invasive surgery in other areas, such as arthroscopy, laparoscopic cholecystectomy, and thoracoscopy, combined with an increasing focus on cost containment, have forever changed the milieu of the cardiac surgeon. This review examines the clinical and research issues surrounding minimally invasive CABG from the vantage point of a surgeon-scientist working in the field.


Effects of atmospheric particulate matter pollution on sleep disorders and sleep duration: a cross-sectional study in the UK biobank.
Sleep disorder prevalence exhibited a six-fold relative increase from 2000 to 2010 in the United States. Sleep problems could increase the risk of stroke, cardiovascular disease, diabetes and cancer. Objective short sleep duration is associated with increased mortality. Obesity, smoking and sex differences could influence sleep disorders and sleep duration. The health effects of atmospheric particulate matter (PM) pollution are of great concern. However, a large general population-based study with abundant demographic and lifestyle information is needed to confirm the effect of PM pollution on sleep disorders and sleep duration. Information on PM air pollution, demographics and other related factors was obtained from the UK Biobank. Subjects' characteristics were described as the means and 95% confidence intervals (95% CIs) for continuous variables and counts (percentages) for categorical variables. In the case-control study of sleep disorders, univariate analysis, single-pollutant models and a four-pollutant model with logistic regression were performed to estimate the odds ratio (OR) of the risk factors. For sleep duration, univariate analysis, single-pollutant models and a four-pollutant model with linear regressions were carried out to assess the effect of the factors. Sensitivity analysis was performed by data imputation and study population change. There were 5976 cases and 97,160 controls included in the case-control study of sleep disorders. For sleep duration analysis, most of the participants had environmental PM data, and 457,358 participants were selected. The single-pollutant models showed that the OR of PM2.5 for sleep disorders was 2.39 (95% CI: 1.64-3.48) for every 10 μg/m3 increase. PM2.5 and PM10 reduced sleep duration by 0.14 (95% CI: 0.10-0.18) and 0.12 (95% CI: 0.10-0.14) hours for every 10 μg/m3 increase, respectively. Four-pollutant models showed that the OR of PM2.5 for sleep disorders was 4.42 (95% CI: 2.36-8.26) for every 10 μg/m3 increase. PM10 appeared to reduce sleep duration by 0.09 (95% CI: 0.06-0.12) hours for every 10 μg/m3 increase. The main results showed good robustness after sensitivity analysis. PM2.5 was a risk factor for sleep disorders. PM2.5 and PM10 reduced sleep duration. A reduction in particulate matter exposure may decrease the risk of sleep disorders and improve sleep duration.


Control of therapeutic goods produced by recombinant DNA technology.
The Therapeutics Division of the Commonwealth Department of Health is responsible for ensuring the quality, safety, and efficacy of rDNA products intended for human therapeutic use in Australia. The National Biological Standards Laboratory evaluates information on production and quality control submitted by manufacturers, and the Drug Evaluation Section examines the clinical safety and efficacy aspects of product applications. rDNA production methods are considered to be biological processes requiring control of source materials, production methods, and final product for adequate quality assurance of products. The Department has recently prepared guidelines on appropriate methods of manufacture and testing of rDNA products and the requirements for product applications. The guidelines emphasize several areas of particular regulatory concern with rDNA derived products, including non-identity with the equivalent natural protein and contamination with host cell components.


Introduction. Time and medicine.
Although historians work with the record of events in public time, they have not developed an explicit understanding of lived time. To set the stage for the other essays in this issue of Annals, this introductory essay explores how an understanding of lived or "private" time began to emerge in the early 20th century in the works of that era's major thinkers: Henri Bergson's philosophy of duration, Emile Durkheim's social time, Sigmund Freud's five psychoanalytic temporal narratives, and Eugene Minkowski's exploration of lived time. This essay then considers the reaction against the burden of history that began with the great 19th-century historicizers: Comte, Hegel, Marx, Darwin, and Spencer. It reflects on the effort, beginning in those years, of modern artists and intellectuals to focus on the personal past in place of the overbearing burden of the historical past. New ways of experiencing the present, made possible by new communication technologies, including the telephone and telegraph, have centered on the experience of simultaneity. Norbert Wiener's cybernetics, Marshall McLuhan's globalism, and the Internet have further transformed how both the medical and lay communities experience past, present, and future, as well as near and far. The discussion concludes with consideration of Eurotransplant, an Internet-based information and action network used by physicians to coordinate organ transplantation; it is a system that integrates cybernetics, globalism, and the Internet in an everyday, real drama of the electronic age of simultaneity.


[Analysis of anti-platelet antibodies using flow cytometry].
We analyzed the production of anti-platelet antibodies by alloimmunization in patients with hematological disorders who receive blood transfusions frequently. HLA antibodies were detected by anti-human globulin lymphocyte cytotoxicity test (AHG-LCT), and anti-platelet antibodies by flow cytometry (FCM). Results from FCM correlated well with those of AHG-LCT. The rate of coincidence was 92.1%. Production of alloantibodies in patients was detected in 32.7% in the without filter group, but decreased to 17.1% (p < 0.05) in the filter group. The avidin-biotin assay and concentration of globulin fraction in patient's serum by affi-gel blue column were useful for increasing sensitivity in detecting anti-platelet antibodies. Anti-platelet specific antibodies were detected in 5 patients (5/226; 2.2%) and these antibodies coexisted with HLA antibodies in all patients. The antibody in 3 of these patients were identified as HPA-2b (Siba), and those in the other 2 patients were combined antibodies on platelet identification panel and immunoblotting. It may be possible that high titer serum of anti-platelet specific antibodies could be identified by its fluorescent intensity. Measures against HPA-2b are considered necessary because platelet specific antibodies were produced in 2.2% of patients who received blood transfusions frequently.


Terrestrial gamma radiation dose in Hong Kong.
The first reactor of the Daya Bay nuclear power plant, 30 km from Hong Kong, is expected to begin operation in 1992. As a result, residents in Hong Kong are concerned with potential exposure to man-made and natural radiation. Therefore, the Radioisotope Unit of the University of Hong Kong performed studies to estimate Hong Kong's natural background radiation and the potential exposure to local residents, the results of which are presented here.


Primary Tumor and Tumor-Like Lesions of Bones of the Foot: Single-Center Experience of 166 Cases.
Primary bone tumors of the foot are rare lesions. The purpose of the present study was to evaluate the clinical manifestations, treatment modalities, and recurrences of various primary bone tumors of the foot from a specialized center for orthopedic oncology. Among 3681 musculoskeletal tumor cases, which were diagnosed and surgically treated in our hospital from 1983 to 2013, 166 primary tumor and tumor-like bone lesions of the foot (4.5%) were retrospectively reviewed regarding age, gender, localization, biopsy-revealed diagnosis, applied treatment modalities, follow-up period, and recurrence, if any. Of the 166 primary bone tumors of the foot, 155 (93.4%) were benign and 11 (6.6%) were malignant. The most common primary benign bone tumor was a unicameral bone cyst (57 of 155; 36.8%), and the most common malignant tumor was chondrosarcoma (7 of 11; 63.6%). The hindfoot was the most common location for both primary benign (104 of 155; 67.1%) and malignant (6 of 11; 54.5%) bone tumors of the foot. The results of our study have confirmed that the radiologic findings can be confusing owing to the structural and histopathologic features of the bones of the foot; thus, histopathologic diagnosis should be considered for foot involvement. Because the characteristics of the compartments in the foot allow for the rapid spread of malignant lesions, aggressive surgical management and wider resection are recommended to prevent recurrence and further spread.


Are children with clefts underweight for age at the time of primary surgery?
Children with clefts, especially those with a cleft palate, have an impaired sucking mechanism and are therefore prone to nutritional problems. This study was undertaken to determine whether children with clefts of the lip and/or palate are underweight for age at the time of primary surgery. Underweight for age was defined as being less than 80 percent of expected weight for age or below the 3rd percentile as plotted on standard percentile charts. The records of all children with clefts seen at the Red Cross Children's Hospital between 1976 and 1996 were reviewed. Of these 740 records, 100 were excluded for inadequate data (47), severe systemic syndrome (27), no operation done (22), or craniofacial cleft (4). The records of 640 children were thus included; 195 (30.5 percent) were underweight for age. By comparison, only 13.7 percent of a similar group of noncleft controls (n = 872) were underweight for age. The difference between these two groups was highly significant (p < 0.01). Factors that influenced weight at the time of primary surgery were type of cleft and age at the time of surgery. Children with cleft palate, whether associated with a cleft lip or not, were found to be more underweight for age than those with an isolated unilateral cleft lip (p = 0.008). Children who had surgery after the age of 1 year were 1.5 times more likely to be underweight for age than children who had surgery under 1 year of age (p < 0.01). Children with isolated cleft palates who were underweight for age had a tendency toward a higher fistula rate (36 percent) than those of normal weight (24 percent) (p = 0.18).


Childhood osteomyelitis. A five-year analysis of 118 cases in Nigerian children.
During the years 1976 through 1980, 118 children with osteomyelitis were seen at our hospital, an incidence of almost 24 cases per year. Twenty-eight of these had sickle cell disease. Males were more commonly affected than females, with a ratio of 2.1 to 1, and bones of the lower extremities were more commonly involved, than those of the upper extremities with a 2 to 1 ratio. Seventy patients were anemic, with hemoglobin levels of 10 g/dl or less. Staphylococcus aureus was the most common organism isolated from patients with sickle cell disease, as well as those with normal genotype.


World wide web stroke resources: a guide for health care professionals.
This article provides an overview of available stroke information on the World Wide Web for health care professionals and consumers. An increasing amount of high quality medical information is available online, primarily via the World Wide Web. Recommendations in regard to type of Internet access and software are provided to assist the new and intermediate users. Electronic mail proprietary online services, and Internet applications are briefly reviewed. The World Wide Web sites catalogued in this article have been linked to a single site, allowing ready access to these sites while reviewing the article; Internet address: http://griffin.vcu.edu/html/pmr/other/stroke.html. The intended audience of the article is health care professionals, including those with limited experience with computers and the Internet.


Assessment of efficacy of ultrasonography in cervical lymphadenopathy in oral malignancies.
To substantiate the use of ultrasonography in diagnosis of cervical lymphadenopathy in oral malignancies and to assess if ultrasonographic examination done prior to lymph node (LN) biopsy can yield important information regarding the diagnosis. Twenty subjects with histopathologically confirmed oral malignant lesions with clinically palpable and untreated cervical LNs included into study. These patients were subjected to clinical examination (number of LNs, shape, size, location, overlying temperature, overlying skin, tenderness, consistency, and fixity to the underlying structures), and ultrasonographic evaluation (number of LNs, shape, size (mm), location, borders, matting, peripheral halo, hilum, calcification, necrosis, reticulation, and echogenicity) of the LNs, and finally, histological assessment was done after surgical excision during the course of treatment. Predominantly male (65%) patients were having with malignant LN involvement with age group of 60-69 years, i.e., 35%. Ultrasonogram is superior to clinical examination as it detected additional 49 nodes. Malignant nodes tend to have longest axial diameter (17 mm with standard deviation of 8.7 mm). Over all 52 malignant nodes were round, whereas 35 nodes were oval in shape. Most of the nodes were detected in submandibular region. Around 61 (70.9%) nodes had sharp borders and 26 (29.9%) had smooth borders. Loss of echogenic hilus is a common feature of malignancy showing 70% sensitivity and 67% specificity. Most of malignant nodes were hypoechoic. Around 51 (58.6%) of nodes showed intranodal necrosis, whereas it was absent in 36 (41.4%) nodes. Matting and edema were present 25 (28.7%) nodes. Intranodal calcification was present in 37 nodes. Sensitivity of USG was 90%, whereas specificity was 100%. Ultrasonographic examination of cervical LNs can yield important information regarding the diagnosis. Ultrasound examination should be done prior to FNAC and ideally an ultrasound-guided FNAC.


Retinal ganglion cells: Energetics, compartmentation, axonal transport, cytoskeletons and vulnerability.
Retinal ganglion cells (RGCs) are specialized projection neurons that relay an immense amount of visual information from the retina to the brain. RGC signal inputs are collected by dendrites and output is distributed from the cell body via very thin (0.5-1 μm) and long (∼50 mm) axons. The RGC cell body is larger than other retinal neurons, but is still only a very small fraction (one ten thousandths) of the length and total surface area of the axon. The total distance traversed by RGCs extends from the retina, starting from synapses with bipolar and amacrine cells, to the brain, to synapses with neurons in the lateral geniculate nucleus. This review will focus on the energy demands of RGCs and the relevant tissues that surround them. RGC survival and function unexceptionally depends upon free energy, predominantly adenosine triphosphate (ATP). RGC energy metabolism is vastly different when compared to that of the photoreceptors. Each subcellular component of the RGC is remarkably different in terms of structure, function and extracellular environment. The energy demands and distribution of each component are also distinct as evidenced by the uneven distribution of mitochondria and ATP within the RGC - signifying the presence of intracellular energy gradients. In this review we will describe RGCs as having four subcellular components, (1) Dendrites, (2) Cell body, (3) Non-myelinated axon, including intraocular and optic nerve head portions, and (4) Myelinated axon, including the intra-orbital and intracranial portions. We will also describe how RGCs integrate information from each subcellular component in order achieve intracellular homeostatic stability as well as respond to perturbations in the extracellular environment. The possible cellular mechanisms such as axonal transport and axonal cytoskeleton proteins that are involved in maintaining RGC energy homeostasis during normal and disease conditions will also be discussed in depth. The emphasis of this review will be on energetic mechanisms within RGC components that have the most relevance to clinical ophthalmology.


Cervical intradural disc herniation with Brown-Séquard syndrome: case report and literature review.
To report a rare case of cervical intradural disc herniation (IDH) with Brown-Séquard syndrome and to review the related literature. Pathogenesis, preoperative diagnosis, and the surgical technique are discussed, and previous literature reports are reviewed. A 44-year-old woman complained of weakness of the left upper and lower extremities and paresthesias in the right limbs after a bicycle ride 3 days earlier. She had a history of neck pain for 2 years prior. CT showed obvious ossification of the posterior longitudinal ligament (OPLL), and MRI revealed C3-7 disc herniations, with a positive "halo sign" around the herniated C4/5. We performed emergency decompression through anterior cervical corpectomy, and vertebrotomy decompression and fusion. At review 3 months after surgery, the patient's neck pain was markedly relieved, and motor strength in the limbs had improved. At 1 year after surgery, she had recovered completely. Cervical IDH is a rare condition that may be related to the traumatic inflammatory response and OPLL. Relatively rare imaging features such as the hawk-beak sign, halo sign, Y sign, and epidural gas sign could help in preoperative diagnosis. Prompt anterior cervical decompression is the preferred treatment for this condition.


[Etiology and treatment of malignancy-associated anaemia]
Patients with cancer frequently develop anaemia. Various factors, including the type of malignancy and the intensity of chemotherapy influence the prevalence of anaemia and need of transfusions. Among the numerous causes of its development, the most frequent type is cancer anaemia, the so-called "anaemia of chronic disorders". Anaemia of chronic disorders is diagnosed when neoplastic disease is accompanied by an otherwise unexplained microcytic anaemia with compromised iron utilisation and decreased erythropoietin secretion. In 50-70% of patients with solid tumors or hematological malignancies, mainly with multiple myeloma and malignant lymphomas, transfusion can be avoided, or significantly decreased by the use of recombinant erythropoietin. This review provides tools to decide the best candidates for this treatment and a guideline to monitor its efficacy.


Reactive uptake of N2O5 by aerosols containing dicarboxylic acids. Effect of particle phase, composition, and nitrate content.
Reactive uptake coefficients for loss of N(2)O(5) to micron-size aerosols containing oxalic malonic, succinic, and glutaric acids, and mixtures with ammonium hydrogen sulfate and ammonium sulfate, are presented. The uptake measurements were made using two different systems: atmospheric pressure laminar flow tube reactor (Cambridge) and the Large Indoor Aerosol Chamber at Forschungszentrum Juelich. Generally good agreement is observed for the data recorded using the two techniques. Measured uptake coefficients lie in the range 5 x 10(-4)-3 x 10(-2), dependent on relative humidity, on particle phase, and on particle composition. Uptake to solid particles is generally slow, with observed uptake coefficients less than 1 x 10(-3), while uptake to liquid particles is around an order of magnitude more efficient. These results are rationalized using a numerical model employing explicit treatment of both transport and chemistry. Our results indicate a modest effect of the dicarboxylic acids on uptake and confirm the strong effect of particle phase, liquid water content, and particulate nitrate concentrations.


Imaging in neuro-ophthalmology: An overview.
Advances in neuroimaging and interventional techniques have revolutionized the early diagnosis, prognosis, and treatment of neuro-ophthalmic disorders. These techniques include computed tomography (CT), magnetic resonance imaging (MRI), CT and MR angiographic techniques, catheter digital subtraction angiography, functional MRI, positron emission tomography, and single photon emission computed tomography. In this review, the value of current techniques in the diagnosis, localization, and treatment of various neuro-ophthalmic disorders is described.


Orthovanadate, an inhibitor of protein tyrosine phosphatases, acts more potently as a promoter than as an initiator in the BALB/3T3 cell transformation.
The phosphorylation and dephosphorylation of proteins are critical in cellular signal transduction. Phorbol esters and okadaic acid, which affect protein phosphorylation, are potent promoters in mouse skin carcinogenesis and cell transformation in vitro. Orthovanadate inhibits protein tyrosine phosphatases and causes hyperphosphorylation of cellular proteins. We have performed two-stage transformation assays using BALB/3T3 cells to determine the major activity of orthovanadate (1-10 microM) for transformation. This chemical acted as a weak initiator because its initiating treatment produced a significant, though small, number of transformed foci in the presence of promoting treatment by 12-O-tetradecanoylphorbol-13-acetate (TPA) but not in the absence of TPA. Promoting treatment by orthovanadate markedly enhanced the transformation of the cells pretreated by a subthreshold dose of 3-methylcholanthrene (MCA) but not of non-pretreated cells. Superiority of promoting over initiating activity of orthovanadate was confirmed by an assay carried out in the reversed treatment sequence (orthovanadate and then MCA), where the transformation frequency was conspicuously decreased compared with the regular treatment sequence. The transformed foci in the cultures treated by orthovanadate, following MCA treatment, continued to grow in normal medium, showing cell proliferation independent of orthovanadate. Orthovanadate, in addition to TPA and okadaic acid, will be a useful reagent for studying the signaling cascades responsible for tumor promotion.


If You Are Old, Videos Look Slow. The Paradoxical Effect of Age-Related Motor Decline on the Kinematic Interpretation of Visual Scenes.
Perception and action are tightly coupled. However, there is still little recognition of how individual motor constraints impact perception in everyday life. Here we asked whether and how the motor slowing that accompanies aging influences the sense of visual speed. Ninety-four participants aged between 18 and 90 judged the natural speed of video clips reproducing real human or physical motion (SoS, Sense-of-Speed adjustment task). They also performed a finger tapping task and a visual search task, which estimated their motor speed and visuospatial attention speed, respectively. Remarkably, aged people judged videos to be too slow (speed underestimation), as compared to younger people: the Point of Subjective Equality (PSE), which estimated the speed bias in the SoS task, was +4% in young adults (<40), +12% in old adults (40-70) and +16% in elders. On average, PSE increased with age at a rate of 0.2% per year, with perceptual precision, adjustment rate, and completion time progressively worsening. Crucially, low motor speed, but not low attentional speed, turned out to be the key predictor of video speed underestimation. These findings suggest the existence of a counterintuitive compensatory coupling between action and perception in judging dynamic scenes, an effect that becomes particularly germane during aging.