The destruction of the lower urinary tract by ketamine abuse: a new syndrome?
To report the clinical spectrum seen in young abusers of street-ketamine (regular recreational abusers of street-ketamine, for its hallucinogenic effects) in Hong Kong, presenting with significant lower urinary tract symptoms (LUTS) but with no evidence of bacterial infection. We retrospectively analysed the clinical presentations, pelvic pain and urgency/frequency scores, video-urodynamic studies, cystoscopy findings, histological features of bladder biopsies and radiological findings of 59 ketamine abusers who were referred to the urology units of Princess Margaret and Tuen Mun Hospital, Hong Kong, from March 2000 to December 2007. Of the 59 patients, all had moderate to severe LUTS, i.e. frequency, urgency, dysuria, urge incontinence and occasionally painful haematuria. Forty-two (71%) patients had a cystoscopy that showed various degrees of epithelial inflammation similar to that seen in chronic interstitial cystitis. All of 12 available bladder biopsies had histological features resembling those of interstitial cystitis. Urodynamically, either detrusor overactivity or decreased bladder compliance with or without vesico-ureteric reflux was detected to some degree in all of 47 patients. Thirty patients (51%) had unilateral or bilateral hydronephrosis on renal ultrasonography, and four (7%) showed features suggestive of papillary necrosis on radiological imaging. Eight patients had a raised serum creatinine level. A syndrome of cystitis and contracted bladder can be associated with street-ketamine abuse. Secondary renal damage can occur in severe cases which might be irreversible, rendering patients dependent on dialysis. The present data do not establish the precise cause nor the incidence. Street-ketamine abuse is not only a drug problem, but might be associated with a serious urological condition causing a significant burden to healthcare resources.


Predictive factors for acute renal failure in thoracic and thoracoabdominal aortic aneurysm surgery.
The purpose of this study was to analyze the factors associated with acute renal failure in total descending thoracic and thoracoabdominal aortic aneurysm surgery. A total of 234 patients underwent thoracoabdominal aortic aneurysm or total descending thoracic aneurysm repair between January 1991 and January 1994. Eighty-five women and 149 men were evaluated. The median age was 67 years (range 8 to 88 years). Seventy-seven patients had type I thoracoabdominal aortic aneurysm, 99 had type II, 51 had type III or IV, and 7 had total descending thoracic aneurysm. Factors such as age, sex, aneurysm type, and visceral and distal aortic perfusion were examined with univariate fourfold table and multivariate logistic regression analysis. Acute renal failure, defined as an increase in serum creatinine by 1 mg/dl per day for two consecutive days after surgery, occurred in 41 (17.5%) of 234 patients. Thirty-six (15%) of 234 patients required dialysis. Twenty (49%) of 41 patients with acute renal failure died. Of the 21 survivors with renal failure, renal failure resolved in 18 (86%) within 30 days of surgery. The univariate odds ratio of death, given acute renal failure, was 6.7 (95% confidence interval [CI] 3.2 to 14.2, p < 0.0001). No significant association was found between the probability of acute renal failure and age, sex, hypertension, right renal artery reattachment, or renal bypass. Factors associated with increased risk of acute renal failure in multivariate analysis were visceral perfusion (odds ratio [OR] = 3.6 95%, CI 1.2 to 11.0, p < 0.02), left renal artery reattachment (OR = 4.4 95%, CI 1.6 to 11.9, p < 0.004), preoperative creatinine > or = 2.8 mg/dl (OR = 10.3, 95% CI 12.0 to 411.8, p < 0.0001), and simple clamp technique (OR = 3.4 95%, CI 1.07 to 10.76, p < 0.04). Direct univariate correlation was seen between preoperative creatinine and acute renal failure (OR = 3.2 per mg/dl increase, 95% CI 2.7 to 10.1, p < 0.0001). Postoperative acute renal failure after thoracoabdominal and total descending thoracic aortic aneurysm surgery is associated with preoperative creatinine level, visceral perfusion, left renal artery reattachment, and simple cross-clamp technique.


Long-term and therapeutic-level hepatic gene expression of human factor IX after naked plasmid transfer in vivo.
Naked DNA transfer of a high-expressing human factor IX (hFIX) plasmid yielded long-term (over 1 1/2 years) and therapeutic-level (0.5-2 microg/ml) gene expression of hFIX from mouse livers. The expression cassette contained a hepatic locus control region from the ApoE gene locus, an alpha1-anti-trypsin promoter, hFIX cDNA, a portion of the hFIX first intron, and a bovine growth hormone polyadenylation signal. In contrast, a hFIX plasmid containing the expression cassette without effective regulatory elements produced initially low-level gene expression that rapidly declined to undetectable levels. Southern analyses of the cellular DNA indicated that the majority of the input genome from either vector persisted as episomal forms of the original plasmids. Together with RT-PCR analyses of the transcripts, these data indicated that at least two processes are critical for sustained gene expression: persistence of vector DNA and transcriptional/posttranscriptional activation. Liver regeneration after partial hepatectomy resulted in a significant decline in transgene expression, further suggestive of decreased episomal plasmid maintenance rather than transgene integration. Transaminase levels and liver histology showed that rapid intravenous plasmid injection into mice induced transient focal acute liver damage (< 5% of hepatocytes), which was rapidly repaired within 3 to 10 days and resulted thereafter in histologically normal tissue. No significant differences were observed between rapid injection of plasmid and saline control solutions. Transient, very low level antibodies directed against hFIX did not prevent the circulation of therapeutic levels of the protein. Gene transfer of hFIX plasmid DNA into liver elicited neither transgene-specific cytotoxic effect nor long-term toxicity. These results demonstrate that long-term expression of hFIX can be achieved by nonviral plasmid transfer and suggest that this occurs independent of integration.


[Muir-Torre syndrome].
The Muir-Torre syndrome (MTS) is an autosomal dominant disease defined by the coincidence of at least one sebaceous skin tumor and one internal malignancy. We describe an additional case and give a review of the literature. Over a period of 7 years, 19 skin tumors were excised in a 50 year old male patient. A total of 3 colonic carcinomas, one gastric carcinoma and one laryngeal carcinoma were operated successfully. The underlying defective mutation in the hMSH2 gene and the microsatellite instability were demonstrable. MTS is graded as a subgroup of hereditary non-polyposis colorectal cancer (HNPCC). In patients with MTS and with family members with known defective mutation, regular follow-up and search for new malignancies are mandatory.


An assessment of donor-to-recipient transmission patterns of human cytomegalovirus by analysis of viral genomic variants.
We studied human cytomegalovirus (CMV) donor-to-recipient transmission patterns in organ transplantation by analyzing genomic variants on the basis of CMV glycoprotein B (gB) genotyping. Organ transplant recipients were included in the study if they had CMV viremia, if they had received an organ from a CMV-seropositive donor, and if there was at least 1 other recipient of an organ from the same donor who developed CMV viremia. Genotypes (gB1-4) were determined by real-time polymerase chain reaction. Forty-seven recipients of organs from 21 donors developed CMV viremia. Twenty-three recipients had a pretransplant donor/recipient (D/R) CMV serostatus of D(+)/R(+), and 24 had a serostatus of D(+)/R(-). The prevalences of genotypes in recipients were as follows: for gB1, 51% (n = 24); for gB2, 19% (n = 9); for gB3, 9% (n = 4); for gB4, 0% (n = 0); and for mixed infection, 21% (n = 10). Recipients of an organ from a common donor had infection with CMV of the same gB genotype in 12 (57%) of 21 instances. Concordance between genotypes was higher among seronegative (i.e., D(+)/R(-)) recipients than among seropositive (D(+)/R(+)) recipients, although discordances resulting from the transmission of multiple strains were seen. In seropositive recipients, transmission of multiple strains from the donor could not be differentiated from reactivation of a recipient's own strains. Our analysis of strain concordance among recipients of organs from common donors showed that transmission of CMV has complex dynamic patterns. In seropositive recipients, transmission or reactivation of multiple CMV strains is possible.


How do teachers with self-reported voice problems differ from their peers with self-reported voice health?
This randomized case-control study compares teachers with self-reported voice problems to age-, gender-, and school-matched colleagues with self-reported voice health. The self-assessed voice function is related to factors known to influence the voice: laryngeal findings, voice quality, personality, psychosocial and coping aspects, searching for causative factors of voice problems in teachers. Subjects and controls, recruited from a teacher group in an earlier questionnaire study, underwent examinations of the larynx by high-speed imaging and kymograms; voice recordings; voice range profile; audiometry; self-assessment of voice handicap and voice function; teaching and environmental aspects; personality; coping; burnout, and work-related issues. The laryngeal and voice recordings were assessed by experienced phoniatricians and speech pathologists. The subjects with self-assessed voice problems differed from their peers with self-assessed voice health by significantly longer recovery time from voice problems and scored higher on all subscales of the Voice Handicap Index-Throat. The results show that the cause of voice dysfunction in this group of teachers with self-reported voice problems is not found in the vocal apparatus or within the individual. The individual's perception of a voice problem seems to be based on a combination of the number of symptoms and of how often the symptoms occur, along with the recovery time. The results also underline the importance of using self-assessed reports of voice dysfunction.


Compressed sensing MRI reconstruction from 3D multichannel data using GPUs.
To accelerate iterative reconstructions of compressed sensing (CS) MRI from 3D multichannel data using graphics processing units (GPUs). The sparsity of MRI signals and parallel array receivers can reduce the data acquisition requirements. However, iterative CS reconstructions from data acquired using an array system may take a significantly long time, especially for a large number of parallel channels. This paper presents an efficient method for CS-MRI reconstruction from 3D multichannel data using GPUs. In this method, CS reconstructions were simultaneously processed in a channel-by-channel fashion on the GPU, in which the computations of multiple-channel 3D-CS reconstructions are highly parallelized. The final image was then produced by a sum-of-squares method on the central processing unit. Implementation details including algorithm, data/memory management, and parallelization schemes are reported in the paper. Both simulated data and in vivo MRI array data were tested. The results showed that the proposed method can significantly improve the image reconstruction efficiency, typically shortening the runtime by a factor of 30. Using low-cost GPUs and an efficient algorithm allowed the 3D multislice compressive-sensing reconstruction to be performed in less than 1 s. The rapid reconstructions are expected to help bring high-dimensional, multichannel parallel CS MRI closer to clinical applications. Magn Reson Med 78:2265-2274, 2017. © 2017 International Society for Magnetic Resonance in Medicine.


Effects of laboratory culture on compatibility between snails and schistosomes.
The genetic control of compatibility between laboratory strains of schistosomes and their snail hosts has been studied intensively since the 1970s. These studies show (1) a bewildering array of genotype-by-genotype interactions - compatibility between one pair of strains rarely predicts compatibility with other strains, and (2) evidence for a variety of (sometimes conflicting) genetic mechanisms. Why do we observe such variable and conflicting results? One possibility is that it is partly an artifact of the use of laboratory strains that have been in culture for many years and are often inbred. Here we show that results of compatibility trials between snails and schistosomes - all derived from the same natural population - depend very much on whether one uses laboratory-cultured or field-collected individuals. Explanations include environmental effects of the lab on either host or parasite, and genetic changes in either host or parasite during laboratory culture. One intriguing possibility is that genetic bottlenecks during laboratory culture cause the random fixation of alleles at highly polymorphic loci that control the matched/mismatched status of hosts and parasites. We show that a simple model of phenotype matching could produce dose response curves that look very similar to empirical observations. Such a model would explain much of the genotype-by-genotype interaction in compatibility observed among strains.


Alpha oscillations in left perisylvian cortices support semantic processing and predict performance.
Semantic processing is the ability to discern and maintain conceptual relationships among words and objects. While the neural circuits serving semantic representation and controlled retrieval are well established, the neuronal dynamics underlying these processes are poorly understood. Herein, we examined 25 healthy young adults who completed a semantic relation word-matching task during magnetoencephalography (MEG). MEG data were examined in the time-frequency domain and significant oscillatory responses were imaged using a beamformer. Whole-brain statistical analyses were conducted to compare semantic-related to length-related neural oscillatory responses. Time series were extracted to visualize the dynamics and were linked to task performance using structural equation modeling. The results indicated that participants had significantly longer reaction times in semantic compared to length trials. Robust MEG responses in the theta (3-6 Hz), alpha (10-16 Hz), and gamma (64-76 Hz and 64-94 Hz) bands were observed in parieto-occipital and frontal cortices. Whole-brain analyses revealed stronger alpha oscillations in a left-lateralized network during semantically related relative to length trials. Importantly, stronger alpha oscillations in the left superior temporal gyrus during semantic trials predicted faster responses. These data reinforce existing literature and add novel temporal evidence supporting the executive role of the semantic control network in behavior.


Uptake and Release of Abscisic Acid by Isolated Photoautotrophic Mesophyll Cells, Depending on pH Gradients.
Uptake and release of abscisic acid (AbA) by isolated mesophyll cells of Papaver somniferum is characterized by the following observations: (a) Uptake rate is a linear function of the external AbA concentration in the range from 10(-6) to 5 x 10(-5) molar, and decreases with increasing pH. At any pH, uptake rate is linearly related to the concentration of undissociated abscisic acid, calculated from the pK = 4.7 according to the Henderson-Hasselbalch equation. At low external pH (5.0), AbA accumulation in the cells is about 10-fold. (b) Uptake of AbA is completely inhibited by salts such as KNO(2) or sodium acetate, which decrease the pH gradient between medium and cells. KCN or m-chlorocarbonylcyanide phenylhydrazone inhibits AbA uptake only after longer incubation periods (20-40 minutes). (c) Uptake rate as well as equilibrium concentration is significantly higher in light than in darkness. (d) At low external pH, release of AbA from preloaded cells is strongly stimulated by KNO(2). It is concluded that AbA is distributed between leaf cells and free space according to pH gradients, with the undissociated abscisic acid being the main penetrating species. Uptake and release occur via diffusion, without participation of a carrier.


Hexaamminecobalt(III) aquabis(nitrilotriacetato-kappa4N,O,O',O")gadolinate(III) octahydrate.
Crystals of the title compound, [Co(NH(3))(6)][Gd(C(6)H(6)NO(6))(2)(H(2)O)].8H(2)O, were synthesized in and collected from aqueous solution. The hexaamminecobalt(III) cation has the expected octahedral geometry, while the Gd coordination sphere has the geometry of a tricapped trigonal prism, with the two nitrilotriacetate N atoms and one water molecule occupying the capping positions.


Partial purification and properties of rat urine arylamidases.
1. Arylamidases were isolated from rat urine using L-aminoacyl-2-naphthylamides and L-Leu-p-nitroanilide as substrates to monitor the purification. 2. Ion-exchange chromatography separated three peaks of activity (A, B and C). After gel filtration chromatography, the second and third peaks (B and C) were further purified to provide B1 and C1. Each behaved like a single active protein band on 7.5% polyacrylamide gel electrophoresis without SDS. The molecular weights of fractions B1 and C1 determined by SDS-PAGE were 440 and 270 kDa, respectively. 3. The pH optimum for arylamidase activity was 7.5 for both forms on all substrates tested. The maximum value for the Vmax/Km ratio was obtained using L-Leu-2-naphthylamide as substrate for both forms. 4. The arylamidase activity of B1 and C1 was not affected by the presence of chloride ions and was increased in the presence of CaCl2 and MnCl2 only when L-Glu-2-naphthylamide was used as substrate. EDTA (3.3-33.0 microM) and o-phenanthroline (0.1-1.0 mM) but not -SH (0.08-0.67 mM) or -S-S-(0.42-3.3 mM) group reagents inhibited the arylamidase activity. Hydrolysis of L-Leu-2-naphthylamide by fractions B1 and C1 was competitively inhibited by leucine (0.14-0.56 mM), indomethacin and puromycin (67-267 microM) and bestatin (8.3-33.3 microM). For each inhibitor, the Ki values were similar in the two fractions: 100 microM for L-leucine, 10 microM for indomethacin and puromycin and 1.0 microM for bestatin.(ABSTRACT TRUNCATED AT 250 WORDS)


Lysis of intraventricular hematoma with tissue plasminogen activator. Case report.
A 42-year-old woman suffered a severe intracerebral and intraventricular hemorrhage from a ruptured anterior cerebral artery aneurysm. Evacuation of the frontal hematoma and clipping of the aneurysm was performed but the intraventricular blood clot persisted, causing ventricular dilatation and high intracranial pressure (ICP) 24 hours after surgery despite external ventricular drainage. Over this period of time the patient's clinical condition improved from Grade V to Grade IVb (World Federation of Neurological Surgeons classification). The intraventricular hematoma was lysed with a total of 8 mg recombinant tissue plasminogen activator injected directly into the ventricles on the 1st and 2nd postoperative days, resulting in rapid normalization of ventricular size and ICP. The patient has since made a substantial recovery and has been able to return home.


Hygiene During Childbirth: An Observational Study to Understand Infection Risk in Healthcare Facilities in Kogi and Ebonyi States, Nigeria.
Background: Infections acquired during labour and delivery are a significant cause of maternal and child morbidity and mortality. Adherence to hand hygiene protocols is a critical component of infection prevention strategies, but few studies have closely examined the hand hygiene of health care providers with sufficient detail to understand infection risks and prioritize prevention strategies. Methods: This observational study was conducted in six healthcare facilities in Nigeria. In each, five women were observed from the onset of labour through to delivery of the placenta. Hand hygiene infection risk was estimated for all procedures requiring aseptic technique compared against adherence to proper hand hygiene protocol and potential recontamination events. Results: Hands were washed with soap and sterile gloves applied with no observed recontamination before only 3% of all observed procedures requiring aseptic technique. There was no significant difference in hygiene compliance between midwives and doctors nor facilities or states. Adherence to proper hygiene protocol was observed more in morning compared to afternoon and night shifts. Conclusions: This study highlights that hand hygiene remains a barrier to delivering high-quality and safe care in health facilities. Improving hygiene practices during labour and delivery will require strategies that extend beyond infrastructure provision.


Liberation of thyreotropin, thyroxine and triiodothyronine in the controllable and uncontrollable stress and after administration of naloxone in rats.
The aim of this study was to investigate whether controllable stress, in which the animal can avoid a stressor, and uncontrollable stress, in which the animal can not avoid its influence change the activity of the endocrine pituitary-thyroid axis and whether these changes are modified by naloxone--the antagonist of opioid receptors. The experiments were carried out on rats using electric foot shock as a stressor and the concentration of thyreotropin, thyroxine and triiodothyronine in the blood was determined with radioimmunoassay. The uncontrollable stress caused the inhibition of secretion of the hormones mentioned above, but the controllable stress did not influence their secretion. Naloxone administered centrally to lateral ventricle of the brain decreased the inhibitional influence on the pituitary-thyroid axis. The obtained results suggest that change of pituitary-thyroid axis activity during the stress depends not only on the stressor but also on the animal's abilities to control that stressor.


A Case of Post-COVID-19 Fibrosis Mimicking Thoracic Manifestation of Ankylosing Spondylitis.
The most common thoracic manifestation form of ankylosing spondylitis is apical fibrocystic changes. It is also known as apical fibrobullous disease (AFBD). The patient was diagnosed with ankylosing spondylitis before 9 years. He suffered COVID-19 infection and passed an intensive care period. However, post-covid fibrosis (PCF) atypically affected dominantly apical zones. If we had no sequential CT evaluations, our case could be easily confused with AFBD. On CT taken before COVID-19, the lung apex was normal. Thus, it was confirmed that there was no rheumatologic thoracic manifestation in the patient before suffering from COVID-19 pneumonia. PCF created similar changes as AFBD. Our case is the first reported paper on this topic.


Immunoregulatory Effects of Mitochondria Transferred by Extracellular Vesicles.
Mitochondria participate in immune regulation through various mechanisms, such as changes in the mitochondrial dynamics, as metabolic mediators of the tricarboxylic acid cycle, by the production of reactive oxygen species, and mitochondrial DNA damage, among others. In recent years, studies have shown that extracellular vesicles are widely involved in intercellular communication and exert important effects on immune regulation. Recently, the immunoregulatory effects of mitochondria from extracellular vesicles have gained increasing attention. In this article, we review the mechanisms by which mitochondria participate in immune regulation and exert immunoregulatory effects upon delivery by extracellular vesicles. We also focus on the influence of the immunoregulatory effects of mitochondria from extracellular vesicles to further shed light on the underlying mechanisms.


[Fever without a localizing source in infants].
In this chapter we will give an overview over the most frequent etiologies of fever in infants in Switzerland, propose an algorithm to evaluate this children, and we will end up with a discussion on the value of additional laboratory parameters. Fever in infants and small children is a leading cause for parents to seek medical attention. The vast majority has a self limiting viral infection, but all the same, all infants need to be thoroughly evaluated. After this process, the treating physician has to decide, which child needs to be specifically treated or cared for, either to avoid overtreatment nor overlooking a serious infection. Because of a broader immunization coverage against bacterial infections, the epidemiology of invasive bacterial disease is changing. Additional laboratory work up is sometimes necessary, but has it's limitations. The interpretation of lab values must taken into account the changing prevalence of serious bacterial infections. Newer parameters (e. g. Procalcitonin) are upcoming, of which the importance is still debatable. Fever causes in this age other than infectious diseases will be alluded.


Spatial modeling using mixed models: an ecologic study of visceral leishmaniasis in Teresina, Piauí State, Brazil.
Most ecologic studies use geographical areas as units of observation. Because data from areas close to one another tend to be more alike than those from distant areas, estimation of effect size and confidence intervals should consider spatial autocorrelation of measurements. In this report we demonstrate a method for modeling spatial autocorrelation within a mixed model framework, using data on environmental and socioeconomic determinants of the incidence of visceral leishmaniasis (VL) in the city of Teresina, Piauí, Brazil. A model with a spherical covariance structure indicated significant spatial autocorrelation in the data and yielded a better fit than one assuming independent observations. While both models showed a positive association between VL incidence and residence in a favela (slum) or in areas with green vegetation, values for the fixed effects and standard errors differed substantially between the models. Exploration of the data's spatial correlation structure through the semivariogram should precede the use of these models. Our findings support the hypothesis of spatial dependence of VL rates and indicate that it might be useful to model spatial correlation in order to obtain more accurate point and standard error estimates.


[Exploration of professor ZHANG Shan-chen's academic thoughts].
Professor ZHANG Shan-chen's clinical experience and academic thoughts in the field of acupuncture are summarized. Professor ZHANG stresses on theoretical exploration and has written Zhenjiu Jiayijing Shuxue Chongji, published a series of articles on textual research and expounded the nomenclature of acupoints. He believes that clinical practice should be guided by theory and the comprehensive syndrome differentiation be emphasized. Hence, a holistic idea should be cultivated, in which, the human body is considered as an organic whole and should be adaptive to the nature. Based on the theory above, the diagnosis can be determined and the effective treatment be received. He suggests selecting few acupoints, identifying the deficiency from the excess so as to determine the reinforcing or replenishing method and exerting appropriate needling manipulation. Additionally, the response should be enhanced on the identification of deqi after needle insertion. Moreover, a great consideration is laid on the clinical trial and application of moxibustion, which is complemented with acupuncture technique each other and mutually conductive to the clinical effect.


Transcatheter mitral valve repair for the treatment of severe mitral regurgitation and exertional pre-syncope in a patient with non-obstructive hypertrophic cardiomyopathy: a case report.
Hypertrophic cardiomyopathy (HCM) has a complex pathophysiology and heterogeneous phenotypic expression. In obstructive HCM with significant mitral regurgitation (MR), MitraClip device implantation reduces MR severity and symptoms. There are no data regarding MitraClip implantation in patients with non-obstructive HCM and significant MR. A 78-year-old woman with non-obstructive HCM and significant functional MR (3+) was admitted to our centre for dyspnoea and episodes of pre-syncope under light stress. Transthoracic and transoesophageal echocardiography showed a normal left ventricular ejection fraction and normal right heart pressures, an inverted mitral filling pattern, and a central prevalent jet (A2-P2 origin) of MR. Exercise echocardiography performed to verify exercise tolerance was interrupted at the 50-W stage due to severe hypotension and pre-syncope. After transcatheter edge-to-edge repair using the MitraClip system, the patient exhibited a reduction in MR Grade from 3+ to 1+. Follow-up up to 1-year post-procedure revealed noticeable improvements in exercise tolerance and symptoms. There were no further episodes of pre-syncope. In non-obstructive HCM, the pathophysiological role of MR in symptom generation is unknown. In this patient, we speculated that significant MR contributed to the mechanisms responsible for severe hypotension and pre-syncope during exercise. A reduction in MR after MitraClip implantation was associated with symptomatic improvements. Our findings further highlight the potential utility of the exercise stress test in therapeutic decision-making for patients with non-obstructive HCM and MR.


Salivary Streptococcus Mutans and Lactobacillus spp. levels in patients during rapid palatal expansion.
To assess the microbial level of Streptococcus Mutans and Lactobacillus spp. during rapid palatal expansion, and compare the data with untreated control patients. Thirty patients aged between 6-9 years were enrolled in this study (15 males and 15 females). The patients were divided into three groups: 10 patients were treated with rapid palatal expander (RPE) (Test Group 1), 10 patients were treated with Mc Namara expander, and 10 patients were enrolled in the control untreated group. Whole stimulated saliva was collected from each patient at three time points: before initiation of expansion therapy (baseline at T0), after 3 months (T1), after initiation of treatment, and after 6 months from T0 (T2). The protocol of rapid palatal expansion for the two groups was as follows: at placement of the expander 4 activations were performed by the orthodontist (1 mm expansion), followed by 4 activations per day by the parents (two in the morning and two in the evening, 1 mm per day total) to be repeated for 7 days. Statistics: In this study a different trend in the microbial colonisation for the two treated groups was observed. In the Test Group 1, in which patients were treated with the RPE, there was a significant difference between Strp T0 T1 and between Strp T0 and T2 (p< 0.05). There was also a significant difference between LAC T1 T0 and LAC T2 and T0 (p<0.05). In the Test Group 2, treated with McNamara expanders, it was found was a significant difference between LAC T2 T0 and LAC T1 T0. In the same group it was also found a significant difference between Strp T2 T0; T1 T0; T1 T2 (p<0.05). The level of the various species of bacteria changes during rapid palatal expansion, and this seems to depend on the type of orthodontic expander. During rapid palatal expansion treatment it is also advisable a periodical microbial monitoring using in-office bacteria tests.


Reduction of multifetal pregnancies to twins does not increase obstetric or perinatal risks.
Selective reduction in cases of multiple fetuses is used more often nowadays due to the increased number of multiple pregnancies resulting from assisted reproduction. In this retrospective study, we investigated whether twin pregnancies derived from fetal reduction carry a higher obstetric and perinatal risk compared to standard twin pregnancies. We found that the rate of miscarriage was 10.6% in the reduction group (n = 158) compared to 9.5% in the controls (n = 135). Mean gestational age at delivery was 35.7 weeks in the reduction group versus 35.1 weeks in the control group. Mean neonatal weight at birth was 2.260 g (800-3.750 g) in the reduction group compared to 2.240 g (540-3.360 g) in controls. Perinatal mortality rate was 49.3 per thousand after reduction and 42.0 per thousand in the control group. There was no statistically significant difference in any of the above parameters. Therefore, multifetal pregnancy reduction to twins does not appear to increase obstetric or perinatal risks.


Puma and Trail/Dr5 pathways control radiation-induced apoptosis in distinct populations of testicular progenitors.
Spermatogonia- stem cells and progenitors of adult spermatogenesis- are killed through a p53-regulated apoptotic process after gamma-irradiation but the death effectors are still poorly characterized. Our data demonstrate that both intrinsic and extrinsic apoptotic pathways are involved, and especially that spermatogonia can be split into two main populations, according to apoptotic effectors. Following irradiation both Dr5 and Puma genes are upregulated in the alpha6-integrin-positive Side Population (SP) fraction, which is highly enriched in spermatogonia. Flow cytometric analysis confirms an increased number of Dr5-expressing SP cells, and Puma-beta isoform accumulates in alpha6-integrin positive cellular extracts, enriched in spermatogonia. Trail-/- or Puma-/- spermatogonia display a reduced sensitivity to radiation-induced apoptosis. The TUNEL kinetics strongly suggest that the extrinsic and intrinsic pathways, via Trail/Dr5 and Puma respectively, could be engaged in distinct subpopulations of spermatogonia. Indeed flow cytometric studies show that Dr5 receptor is constitutively present on more than half of the undifferentiated progenitors (Kit- alpha6+ SP) and half of the differentiated ones (Kit+ alpha6+ SP). In addition after irradiation, Puma is not detected in the Dr5-positive cellular fraction isolated by immunomagnetic purification, while Puma is present in the Dr5-negative cell extracts. In conclusion, adult testicular progenitors are divided into distinct sub-populations by apoptotic effectors, independently of progenitor types (immature Kit-negative versus mature Kit-positive), underscoring differential radiosensitivities characterizing the stem cell/progenitors compartment.


Suppression of lymphocyte blastogenesis in cows with puerperal metritis and mastitis.
Mitogenic responses of peripheral blood lymphocytes in naturally occurring clinical puerperal metritis and mastitis were investigated. Glucose consumption index (GCI) values for phytohaemagglutinin (PHA), concanavalin A (Con A) and pokeweed mitogen (PWM) in the puerperal metritic cows and mastitic cows were significantly lower than those in the healthy cows. Suppression of lymphocyte blastogenesis was correlated to an increased concentration of serum ammonia in the puerperal metritic cows, and of alpha 1-acid glycoprotein (alpha 1AG) in the mastitic cows. Lymphocyte blastogenesis in the mastitic cows was also correlated to the serum concentration of vitamin E. These findings indicate that the puerperal metritic and mastitic cows are associated with impaired lymphocyte blastogenesis.


Comprehensive proteomics of Methylobacterium extorquens AM1 metabolism under single carbon and nonmethylotrophic conditions.
In order to validate a gel free quantitative proteomics assay for the model methylotrophic bacterium Methylobacterium extorquens AM1, we examined the M. extorquens AM1 proteome under single carbon (methanol) and multicarbon (succinate) growth, conditions that have been studied for decades and for which extensive corroborative data have been compiled. In total, 4447 proteins from a database containing 7556 putative ORFs from M. extorquens AM1 could be identified with two or more peptide sequences, corresponding to a qualitative proteome coverage of 58%. Statistically significant nonzero (log(2) scale) differential abundance ratios of methanol/succinate could be detected for 317 proteins using summed ion intensity measurements and 585 proteins using spectral counting, at a q-value cut-off of 0.01, a measure of false discovery rate. The results were compared to recent microarray studies performed under equivalent chemostat conditions. The M. extorquens AM1 studies demonstrated the feasibility of scaling up the multidimensional capillary HPLC MS/MS approach to a prokaryotic organism with a proteome more than three times the size of microbes we have investigated previously, while maintaining a high degree of proteome coverage and reliable quantitative abundance ratios.


[Franz Josef Kallmann (1897-1965) and the transfer of psychiatric-genetic scientific concepts from national socialist Germany to the U.S.A].
The founding of the German Research Institute for Psychiatry and its Genealogic-Demographic Department (Genealogisch-Demographische Abteilung; GDA) in 1918 gave the world the first institutional platform for the field of psychiatric genetics. The years between the two World Wars saw the GDA grow in importance with much international respect. The close collaboration between the GDA's protagonist Ernst Rüdin and the National Socialist regime was certainly not an inhibiting factor for the worldwide recognition of the eugenic research conducted in Munich. Around the mid-1930s, the German psychiatrist émigré Franz Josef Kallmann brought the field of study which had been put into practice in Munich to the United States. He fought an uphill battle to be accepted by the North American scientific community, but finally he was able to establish himself as the main researcher in the field of psychiatric genetics. Interestingly enough, the fact that his kind of research had been heavily supported by the National Socialist regime was not a barrier to his acceptance. The fact that it took him a long time to establish the field of eugenics in the U.S.A. is better explained by the psychoanalytic research methods at the time, which gave hereditary transmission short shrift. At the New York State Psychiatric Institute he was able to continue his research, including the examination of race-hygienic motifs, where he designed a research program that was directly based on concepts and methods from Ernst Rüdin's team of researchers in Munich. The only deviation from the original research was in terms of the use of eugenic prophylaxis where he aligned his research in the context of North American democracy in the post-war era. However, the eugenic goal of elimination of certain categories of peoples remained unchanged.


Weight Gain After Thyroidectomy: A Systematic Review and Meta-Analysis.
Weight gain is a major driver of dissatisfaction and decreased quality of life in patients with hypothyroidism. Data on the changes in body weight following thyroidectomy are conflicting. To perform a systematic review of the literature and a meta-analysis of weight changes following total thyroidectomy. Literature search on PubMed. Studies in English published between September 1998 and May 2018 reporting post-thyroidectomy weight changes. Data were reviewed and compared by 3 investigators; discrepancies were resolved by consensus. Meta-analyses were performed using fixed and random effect models. Univariable and multivariable meta-regression models for weight change were implemented against study follow-up, gender, and age. Exploratory subgroup analyses were performed for indication for surgery. Seventeen studies (3164 patients) with 23.8 ± 23.6 months follow-up were included. Severe heterogeneity across studies was observed. Using a random effect model, the estimated overall weight change was a gain of 2.13 kg, 95% confidence interval (CI; 0.95, 3.30). Age was negatively associated with weight change (β = -0.238, P < 0.001). In subgroup analyses, weight gain was more evident in patients undergoing thyroidectomy for hyperthyroidism: 5.19 kg, 95% CI (3.21, 7.17) vs goiter or malignancy 1.55 kg, 95% CI (0.82, 2.27) and 1.30 kg, 95% CI (0.45, 2.15), respectively. Patients undergoing thyroidectomy experience possible mild weight gain, particularly younger individuals and those with hyperthyroidism as the indication for surgery. Prospective studies directed to assess the pathophysiology of weight gain post-thyroidectomy, and to test novel treatment modalities, are needed to better characterize post-thyroidectomy weight changes.


Talin-null cells of Dictyostelium are strongly defective in adhesion to particle and substrate surfaces and slightly impaired in cytokinesis.
Dictyostelium discoideum contains a full-length homologue of talin, a protein implicated in linkage of the actin system to sites of cell-to-substrate adhesion in fibroblasts and neuronal growth cones. Gene replacement eliminated the talin homologue in Dictyostelium and led to defects in phagocytosis and cell-to-substrate interaction of moving cells, two processes dependent on a continuous cross talk between the cell surface and underlying cytoskeleton. The uptake rate of yeast particles was reduced, and only bacteria devoid of the carbohydrate moiety of cell surface lipopolysaccharides were adhesive enough to be recruited by talin-null cells in suspension and phagocytosed. Cell-to-cell adhesion of undeveloped cells was strongly impaired in the absence of talin, in contrast with the cohesion of aggregating cells mediated by the phospholipid-anchored contact site A glycoprotein, which proved to be less talin dependent. The mutant cells were still capable of moving and responding to a chemoattractant, although they attached only loosely to a substrate via small areas of their surface. With their high proportion of binucleated cells, the talin-null mutants revealed interactions of the mitotic apparatus with the cell cortex that were not obvious in mononucleated cells.


Evaluation and treatment of vestibular dysfunction in children.
The effect of vestibular dysfunction since birth is more debilitating than that attained later in life, and unlike adults, children with vestibular dysfunction since or shortly after birth do not recover function without intervention. The purpose of this report is to provide an overview of the etiology of vestibular dysfunction in children as well as the related impairments, and to describe testing methods and evidence based interventions to ameliorate the vestibular related impairments in children. In recent years, investigations have revealed that vestibular dysfunction is more common in children than previously thought, with consequent impairments in motor development, balance and reading abilities. The dysfunction may be due to central or peripheral lesions, each with distinct presentation of symptoms and test results. Common etiologies and clinical presentation of vestibular dysfunction in children are reviewed; appropriate screening and diagnostic techniques and efficacious medical and rehabilitation interventions are presented. Despite advances in clinical and diagnostic testing of vestibular function in children and infants, testing of vestibular function is not typically done. Comprehensive testing of signs and symptoms is critical for diagnosis and implementation of appropriate interventions.


Effects of trimethoprim-sulfadiazine on tear production and the fluctuations of Schirmer tear test values in horses.
The objectives of this study were to observe the effects of trimethoprim-sulfadiazine on equine tear production and to determine normal fluctuations in Schirmer tear test (STT) values in horses. A randomized, placebo-controlled, blinded clinical trial measuring STT values in 15 horses over an 8-week period was performed. The treatment group (eight horses) received 30 mg/kg trimethoprim-sulfadiazine orally once a day and the control group (seven horses) received placebo (flour) at the same time. All horses were housed outdoors throughout the study. Schirmer tear test values were measured at 0, 2, 4, 6 and 8 weeks, and 4 weeks after discontinuation of treatment. There were no significant differences in tear production between the treated and control groups. Fluctuations in STT were observed and may result from individual and environmental variations. Trimethoprim-sulfadiazine did not decrease tear production in the horses in this study. Horses normally experience periodic fluctuations in STT values.


Reconstructive dosimetry and radiation dose evaluation of workers and public due to a Brazilian radiological accident in industrial radiography.
Radiological accidents occur mainly in the practices recognized as high risk and which are classified by the International Atomic Energy Agency (IAEA) as Categories 1 and 2: radiotherapy, industrial irradiators and industrial radiography. In Brazil, five important cases in industrial gamma radiography occurred from 1985 to 2018, involving seven radiation workers and 19 members of the public. The accidents caused localized radiation lesions on the hands and fingers. One of these accidents is the focus of this paper. In this accident, a 3.28 TBq192Ir radioactive source was left unshielded for 9 h in a non-destructive testing (NDT) company parking lot, and many radiation workers, employees and public, including teachers of a primary school were exposed. The radioactive source was also directly handled by a security worker for about 1.5 min causing severe radiation injuries in the hand and fingers. This paper presents radiation dose estimates for all accidentally exposed individuals. Four scenarios were considered, and three internationally recognised and updated reconstructive dosimetry techniques were used, named, Brazilian visual Monte Carlo Dose Calculation (VMC), virtual environment for radiological and nuclear accidents simulation (AVSAR) and RADPRO Calculator®. The main radiation doses estimated by VMC were the absorbed dose of 34 Gy for the security worker's finger and his effective dose of 91 mSv; effective doses from 43 to 160 mSv for radiation workers and NDT employees; and effective doses of 9 mSv for teachers in the schoolyard.


Reproducibility of the new indicator test for sudomotor function (Neuropad) in patients with type 2 diabetes mellitus: short communication.
The aim of this study was to examine the reproducibility of the new indicator test for sudomotor function (Neuropad) in type 2 diabetic patients. The study included 142 type 2 diabetic patients (70 men) with a mean age of 67.3 +/- 7.6 years and a mean diabetes duration of 14.2 +/- 6.3 years. Sudomotor function was assessed by means of colour change in the indicator test. Each patient was examined twice. Moreover, inter-observer variability was assessed in 60 patients (35 patients with sudomotor dysfunction, 25 patients without sudomotor dysfunction). In the right foot, a highly significant (r = 0.91, p = 0.001) correlation was observed between time until complete colour change of the test on the first (910.7 +/- 431.6 seconds) and second examination (935.8 +/- 440.1 seconds). In the left foot, a highly significant (r = 0.89, p = 0.001) correlation was observed between time until complete colour change of the test on the first (911.6 +/- 430.3 seconds) and second examination (940.5 +/- 441.2 seconds). Reproducibility was excellent both in patients with sudomotor dysfunction (p = 0.001) and in those without sudomotor dysfunction (p = 0.001). Agreement in diagnosis of sudomotor dysfunction between the two examinations was 98 %. Inter-observer reproducibility was excellent (p = 0.001), both in patients with sudomotor dysfunction and in those without sudomotor dysfunction. Intra- and interobserver Coefficient of Variance ranged between 4.1 % and 5.1 %. These results indicate that reproducibility of the new indicator test for sudomotor function is excellent in type 2 diabetic patients with or without sudomotor impairment.


Improving function through primary care treatment of posttraumatic stress disorder study outcomes: A randomized controlled trial of prolonged exposure for primary care in veterans.
Despite high cost and wide prevalence of posttraumatic stress disorder (PTSD) in veteran populations, and Veterans Health Administration (VA)-wide mental health provider training in evidence-based treatments for PTSD, most veterans with PTSD do not receive best practices interventions. This may be because virtually all evidence-based PTSD treatment is offered through specialty clinics, which require multiple steps and referrals to access. One solution is to offer PTSD treatment in VA primary care settings, which are often the first and only contact point for veterans. The present study, Improving Function Through Primary Care Treatment of PTSD (IMPACT), used a randomized controlled design to compare an adaptation of prolonged exposure for PTSD to primary care (PE-PC) versus best practices Primary Care Mental Health Integration (PCMHI) clinic treatment as usual (TAU) in terms of both functioning and psychological symptoms in 120 veterans recruited between April 2019 and September 2021. Participants were mostly males (81.7%) with a mean age of 43.6 years (SD = 12.8), and more than half were non-White veterans (50.8%). Both conditions evinced significant improvement over baseline across functioning, PTSD, and depression measures, with no differences observed between groups. As observed in prior studies, PTSD symptoms continued to improve over time in both conditions, as measured by structured clinical interview. Both PE-PC and best-practices TAU are effective in improving function and reducing PTSD severity and depression severity. Although we did not observe differences between the two treatments, note that this study site and two PCMHI clinics employ primarily cognitive behavioral therapies (e.g., exposure and behavioral activation). (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Fast Online Optimization for Terrain-Blind Bipedal Robot Walking With a Decoupled Actuated SLIP Model.
We present an online optimization algorithm which enables bipedal robots to blindly walk over various kinds of uneven terrains while resisting pushes. The proposed optimization algorithm performs high-level motion planning of footstep locations and center-of-mass height variations using the decoupled actuated spring-loaded inverted pendulum (aSLIP) model. The decoupled aSLIP model simplifies the original aSLIP with linear inverted pendulum (LIP) dynamics in horizontal states and spring dynamics in the vertical state. The motion planning can be formulated as a discrete-time model predictive control (MPC) problem and solved at a frequency of 1 kHz. The output of the motion planner is fed into an inverse-dynamics-based whole body controller for execution on the robot. A key result of this controller is that the feet of the robot are compliant, which further extends the robot's ability to be robust to unobserved terrain variations. We evaluate our method in simulation with the bipedal robot SLIDER. The results show that the robot can blindly walk over various uneven terrains including slopes, wave fields, and stairs. It can also resist pushes of up to 40 N for a duration of 0.1 s while walking on uneven terrains.


Neuroprotection and dopamine agonists.
Several factors are known to be capable of inducing relatively selective dopaminergic cell death in the substantia nigra and inducing the clinical features that characterize Parkinson's disease (PD). Neuronal toxins such as 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) can induce parkinsonism in human and animal models, and rotenone, another specific mitochondrial complex I inhibitor, can induce similar effects in rodents to produce a model for PD. Studies in twins suggest a significant genetic component to young-onset PD, and several gene mutations have now been identified as causing familial autosomal dominant or autosomal recessive PD. Etiologic factors including free radical-mediated damage (including excitotoxicity), mitochondrial dysfunction, and inflammation-mediated cell damage can contribute to pathogenesis. In addition, the recent interest in protein misfolding, aggregation, and proteosomal activity has provided further insight into potential pathogenetic pathways in PD. Against this background there has been increasing interest in the development of drugs to modify these biochemical abnormalities and thus alter the course of PD, either by retarding the rate of cell death or by restoring function to neurons that are likely to be damaged but not dead. In this context, dopamine agonists have shown significant promise. Not only do these drugs provide symptomatic relief of PD but they also appear to be associated with a significant decrease in the rate of motor complications and to be capable of protecting against some of the adverse consequences of levodopa use. However, evidence is now emerging that dopamine agonists may have additional neuroprotective properties. As a group, they have antioxidant actions in vitro and in vivo. More specifically, the D(2)/D(3) dopamine agonist pramipexole may have neuroprotective activity that is, at least in part, unrelated to its dopamine agonist action. Protection in cell and animal models against a variety of toxins, including MPTP and 6-hydroxydopamine, confirms that this agonist has in vitro and in vivo neuroprotective action. Evidence is now emerging that some of this may be mediated by direct action on mitochondrial membrane potential and the inhibition of apoptosis. If the neuroprotective action of this drug is confirmed in patients with PD, this will have important implications for its early use in patients.


Guidelines for antihypertensive therapy: problems with a strategy based on absolute cardiovascular risk.
It has been suggested that selection for antihypertensive therapy should be based on absolute risk of a cardiovascular disease (CVD) event and that treatment should be offered only if the 10-year risk exceeds 20%. Although interesting and challenging, this strategy would have the effect of greatly emphasizing treatment of the elderly and downplaying treatment of the middle-aged. It is argued in this paper that the use of one and the same time-frame for all age groups is illogical; some inverse age-related adjustment is needed. In addition, it is suggested that selection for active treatment would be better based not on the total absolute risk of CVD but rather on the marginal hypertensive risk (i.e. that part of the total risk which can be attributed to raised blood pressure). Problems in the use of antihypertensive drugs in people with 'high normal' blood pressure in order to compensate for risk factors such as obesity, hyperlipidaemia and smoking are discussed. The effect of antihypertensive treatment administered in large-scale trials to the most hypertensive control subjects has been (and continues to be) largely ignored; it should be taken into account in all calculations in this field. A policy based on absolute risk is certainly worth examining but it should not be considered self-evidently correct and needs testing in all its aspects before it is adopted on a large scale.


Prognostic importance of flow cytometric immunophenotyping of 540 consecutive patients with B-cell chronic lymphocytic leukemia.
Blood mononuclear cells from 540 newly diagnosed, unselected patients with B-cell chronic lymphocytic leukemia (CLL) were examined by immunofluorescence flow cytometry for a panel of surface membrane markers, including IgM and IgD, the monoclonal antibodies anti-CD3, -5, -20, -21, -22, -FMC7, and, for the final 125 patients, anti-CD23. There were 503 CD5+ and 37 CD5- cases. In the CD5+ cases, the cells typically expressed IgM, IgD, CD20, CD21, CD22, and CD23. In univariate analysis, age, clinical stage, IgM-fluorescence intensity, CD23, and FMC7 had significant prognostic importance, with high IgM-fluorescence intensity, high FMC7, and low CD23 expression being associated with a short survival. There was no significant difference in survival between 351 cases expressing IgMD and 55 cases expressing IgM without IgD, or between kappa and lambda light chain monoclonal cases. CD20, CD21, and CD22 had no prognostic importance. In Cox multiple regression analyses, age, CD23, IgM-fluorescence intensity, and clinical stage (International Workshop System) had independent prognostic importance. Thus, besides clinical variables, CD23 and IgM intensity might be useful prognostic markers in the management of CD5+, B-cell CLL. The survival of CD5- patients was on the borderline of being significantly shorter than that of CD5+ patients. The majority of the CD5- cases were FMC7+, CD23-, had strong IgM fluorescence, and had splenomegaly.


Estimation of the number of authentic orphan genes in bacterial genomes.
Genome annotation produces a considerable number of putative proteins lacking sequence similarity to known proteins. These are referred to as "orphans." The proportion of orphan genes varies among genomes, and is independent of genome size. In the present study, we show that the proportion of orphan genes roughly correlates with the isolation index of organisms (IIO), an indicator introduced in the present study, which represents the degree of isolation of a given genome as measured by sequence similarity. However, there are outlier genomes with respect to the linear correlation, consisting of those genomes that may contain excess amounts of orphan genes. Comparisons of genome sequences among closely related strains revealed that some of the annotated genes are not conserved, suggesting that they are ORFs occurring by chance. Exclusion of these non-conserved ORFs within closely related genomes improved the correlation between the proportion of orphan genes and the IIO values. Assuming that the correlation holds in general, this relationship was used to estimate the number of "authentic" orphan genes in a genome. Using this definition of authentic orphan genes, the anomalies arising from over-assignments, e.g., the percentages of structural annotations, were corrected for 16 genomes, including those of five archaea.


Role of nitric oxide in photoreceptor survival in embryonic chick retinal cell culture.
The presence of nitric oxide synthase (NOS) in chick retina during development has allowed us to study the role of nitric oxide (NO) during retinal differentiation in dissociated chick retinal cell culture from embryonic day 6. We have demonstrated the presence of nicotinamide adenine dinucleotide phosphate diaphorase staining in these cultures after 3 days in vitro (Div), with a maximal intensity after 8 Div, corresponding to embryonic day 14. Immunohistochemistry studies confirmed the presence of the two isoforms of NOS, NOS-I and -III, in dissociated retinal cell cultures at 8 Div. Addition of NG-monomethyl-L-arginine, a NOS inhibitor, to retinal cell cultures prevented NO production but did not modify the appearance and the survival of ganglion and amacrine cells. However, immunohistochemical analysis with distinct markers for photoreceptor cells (rods and cones) showed that inhibition of endogenous NOS in retinal cell cultures prevented the developmental decrease of rod number between 5 and 8 Div, thus supporting the hypothesis that NO may be involved in the cell death of rods during the development of the retina.


Degradation of phenol under meso- and thermophilic, anaerobic conditions.
Based on the results of preliminary studies on phenol degradation under mesophilic conditions with a mixed methanogenic culture, we proposed a degradation pathway in which phenol is fermented to acetate: Part of the phenol is reductively transformed to benzoate while the rest is oxidised, forming acetate as end product. According to our calculations, this should result in three moles of phenol being converted to two moles of benzoate and three moles of acetate (3 phenol + 2 CO2 + 3 H2O --> 3 acetate + 2 benzoate): To assess the validity of our hypothesis concerning the metabolic pathway, we studied the transformation of phenol under mesophilic and thermophilic conditions in relation to the availability of hydrogen. Hence, methanogenic meso- and thermophilic cultures amended with phenol were run with or without an added over-pressure of hydrogen under methanogenic and non-methanogenic conditions. Bromoethanesulfonic acid (BES) was used to inhibit methanogenic activity. In the mesophilic treatments amended with only BES, about 70% of the carbon in the products found was benzoate. During the course of phenol transformation in these BES-amended cultures, the formation pattern of the degradation products changed: Initially nearly 90% of the carbon from phenol degradation was recovered as benzoate, whereas later in the incubation, in addition to benzoate formation, the aromatic nucleus degraded completely to acetate. Thus, the initial reduction of phenol to benzoate resulted in a lowering of H2 levels, giving rise to conditions allowing the degradation of phenol to acetate as the end product. Product formation in bottles amended with BES and phenol occurred in accordance with the hypothesised pathway; however, the overall results indicate that the degradation of phenol in this system is more complex. During phenol transformation under thermophilic conditions, no benzoate was observed and no phenol was transformed in the BES-amended cultures. This suggests that the sensitivity of phenol transformation to an elevated partial pressure of H2 is higher under thermophilic conditions than under mesophilic ones. The lack of benzoate formation could have been due to a high turnover of benzoate or to a difference in the phenol degradation pathway between the thermophilic and mesophilic cultures.


[Tolerance of high dosage carbamazepine monotherapy in treatment of epilepsy].
We examined whether high dose carbamazepine (CBZ) monotherapy (CBZ serum levels > 9 mg/l) is well tolerated. Forty-one patients with localisation-related epilepsy were enrolled. They received high dose monotherapy either from the time of recruitment (30/41), or their CBZ treatment was pushed into the high dose range (11/41) during the observation period (mean 145 days). CBZ and CBZ metabolite serum levels, full blood counts, liver function tests, electrolytes were measured in addition to clinical assessments. The mean daily CBZ dose was 1515 mg (median 1500, range 600-3600 mg). Mean CBZ serum level was 11.1 mg/l (median 11.1, range 5.3-16.4 mg/l). Eleven of 41 patients (26.8%) reported side effects (mean serum level 11.4, median 11.6, range 8.7-13.7 mg/l), but side effects were intolerable in only five patients so that the CBZ dose had to be reduced (mean CBZ serum level 11.4, median 11.6, range 8.7-13.7 mg/l). The total daily CBZ dose but not CBZ or CBZ metabolite levels were correlated with side effects. No treatment changes had to be undertaken because of abnormal laboratory parameters. High dose CBZ anticonvulsant monotherapy is well tolerated.


CK19 mRNA in blood can predict non-sentinel lymph node metastasis in breast cancer.
Reverse-transcription polymerase chain reaction (RT-PCR) is used to detect CK19 mRNA in sentinel lymph node biopsy (SLNB) tissues from breast cancer patients. We examined whether CK19 mRNA in peripheral blood is predictive of non-sentinel lymph node (nSLN) metastasis. Breast cancer cases diagnosed with clinical stage cT1-3cN0 and registered in our medical biobank were identified retrospectively. This study then included 120 breast cancer cases treated at Zhejiang Cancer Hospital from Aug 2014 to Aug 2015, including 60 SLN-positive and 60 SLN-negative cases. CK19 mRNA levels in peripheral blood samples were assessed using RT-PCR prior to tumor removal. During surgery, if SLNB tissue showed evidence of metastasis, axillary lymph node dissection (ALND) was performed. No ALND was performed if SLNB and nSLN tissues were both negative for metastasis. CK19 expression was higher in nSLN-positive patients than in nSLN-negative patients (p < 0.05). Logistic regression indicated that lymphatic vessel invasion and CK19 levels were predictive of nSLN status (p < 0.05). The area under the ROC curve for CK19 was 0.878 (p < 0.05). We conclude that high CK19 levels in peripheral blood may independently predict nSLN metastasis in breast cancer patients.


Measurement of age-dependent radiation ingestion doses due to gross alpha and gross beta exposure from medicinal plants.
This article presents the results of a study conducted to measure the gross alpha, gross beta activities in medicinal plant samples collected from different districts of Azad Kashmir, Pakistan. The ASC-950-DP gasless high-speed counter was used for the measurement of gross α/β activities. Measured activities have been used to assess age-dependent annual effective doses for infants, one-, five-, ten-, and fifteen-year-old and adult people. For a medicinal plant consumption rate (MPCR) of 1.8 kg a-1, the average gross alpha and beta annual committed effective dose (ACED) delivered to one-, five-, ten-, fifteen-year-olds and adults fall below the WHO recommended level (290 µSv a-1) and that reported in the UNSCEAR 2000 (0.3 mSv a-1) report. Results obtained for the current study show that the radiological hazard related to the consumption of natural radionuclides in medicinal plants is inconsequential with exception of the ACED delivered to infants at an MPCR of 1.8 g a-1 and higher values.


Protease IV, a quorum sensing-dependent protease of Pseudomonas aeruginosa modulates insect innate immunity.
In Pseudomonas aeruginosa, quorum sensing (QS) plays an essential role in pathogenesis and the QS response controls many virulence factors. Using a mealworm, Tenebrio molitor as a host model, we found that Protease IV, a QS-regulated exoprotease of P. aeruginosa functions as a key virulence effector causing the melanization and death of T. molitor larvae. Protease IV was able to degrade zymogens of spätzle processing enzyme (SPE) and SPE-activating enzyme (SAE) without the activation of the antimicrobial peptide (AMP) production. Since SPE and SAE function to activate spätzle, a ligand of Toll receptor in the innate immune system of T. molitor, we suggest that Protease IV may interfere with the activation of the Toll signaling. Independently of the Toll pathway, the melanization response, another innate immunity was still generated, since Protease IV directly converted Tenebrio prophenoloxidase into active phenoloxidase. Protease IV also worked as an important factor in the virulence to brine shrimp and nematode. These results suggest that Protease IV provides P. aeruginosa with a sophisticated way to escape the immune attack of host by interfering with the production of AMPs.


The effect of local perturbation fields on human DTI: characterisation, measurement and correction.
Indices derived from diffusion tensor imaging (DTI) data, including the mean diffusivity (MD) and fractional anisotropy (FA), are often used to better understand the microstructure of the brain. DTI, however, is susceptible to imaging artefacts, which can bias these indices. The most important sources of artefacts in DTI include eddy currents, nonuniformity and mis-calibration of gradients. We modelled these and other artefacts using a local perturbation field (LPF) approach. LPFs during the diffusion-weighting period describe the local mismatches between the effective and the expected diffusion gradients resulting in a spatially varying error in the diffusion weighting B matrix and diffusion tensor estimation. We introduced a model that makes use of phantom measurements to provide a robust estimation of the LPF in DTI without requiring any scanner-hardware-specific information or special MRI sequences. We derived an approximation of the perturbed diffusion tensor in the isotropic-diffusion limit that can be used to identify regions in any DTI index map that are affected by LPFs. Using these models, we simulated and measured LPFs and characterised their effect on human DTI for three different clinical scanners. The small FA values found in grey matter were biased towards greater anisotropy leading to lower grey-to-white matter contrast (up to 10%). Differences in head position due to e.g. repositioning produced errors of up to 10% in the MD, reducing comparability in multi-centre or longitudinal studies. We demonstrate the importance of the proposed correction by showing improved consistency across scanners, different head positions and an increased FA contrast between grey and white matter.


Bladder Carcinoma Associated with BK Virus in a Renal Allograft Recipient.
Bladder carcinoma is a relatively rare carcinoma reported in renal allograft recipients. While many oncogenic viruses have been implicated as causative factors for certain malignancies, questions have been raised about possible role of BK virus in pathogenesis of urothelial cancers. In this report, we have described a patient who developed BK virus nephropathy followed 3 years later by bladder carcinoma. Interestingly, while the tumor tissue demonstrated BK virus, the adjacent normal urothelium was stained negative for BK virus. Considering the viral potential to inhibit tumor suppressors and its differential localization within tumor tissue, it is possible that the virus contributes to tumorigenesis.


Comparison of NICE and ESC strategy for risk assessment in women with stable chest pain: a coronary computed tomography angiography study.
For women presenting with stable chest pain (SCP), the appropriate risk assessment strategy to identify individuals unlikely to benefit from further cardiovascular imaging testing (CIT) is debatable. Thus, the present study intended to compare two risk assessment strategies in these individuals. 2592 women with SCP who underwent coronary computed tomography angiography (CCTA) were divided into low and high risk group according to 2016 National Institute of Health and Care Excellence guideline-determined strategy (NICE strategy) and 2019 European Society of Cardiology guideline-determined strategy (ESC strategy), respectively. The associations of coronary artery disease (CAD), major adverse cardiovascular event (MACE) and other subsequent clinical outcomes with risk groups and net reclassification improvement (NRI) were evaluated to compare different strategies. Both NICE strategy which focused on symptom evaluation and ESC strategy which was based on pretest probability (PTP) determined by ESC-PTP model and coronary artery calcium score-weighted clinical likelihood (CACS-CL) model classified a proportion (34.49% and 63.97%, respectively) of individuals into the low risk group. Compared to NICE strategy, ESC strategy indicated stronger associations between risk groups and obstructive CAD (odds ratio: 27.63 versus 3.57), MACE (hazard ratios: 4.24 versus 1.91), more intensive clinical management as well as a positive NRI (27.71%, p < 0.0001). Compared to NICE strategy, ESC strategy which sequentially incorporated ESC-PTP model with CACS-CL model seemed to be associated with greater effectiveness in identifying individuals who may derive maximum benefit from further CIT in women presenting with SCP.


Post-traumatic stress disorder symptoms in first-time myocardial infarction patients: roles of attachment and alexithymia.
To explore the roles of attachment and alexithymia in the severity of post-traumatic stress disorder symptoms and to specify the relationship between sub-dimensions of attachment, alexithymia and posttraumatic stress disorder symptoms in patients with first-time myocardial infarction in mainland China. Patients experiencing myocardial infarction have a risk of developing post-traumatic stress disorder symptoms. However, there have been few studies on the roles of attachment and alexithymia. A cross-sectional survey design. Ninety-seven patients participated in the assessment of post-traumatic stress disorder symptoms, attachment and alexithymia from June-December in 2012. To assess post-traumatic stress disorder symptoms and their correlates, we administered the Post-traumatic Stress Disorder Checklist-Civilian Version, the 20-item Toronto Alexithymia Scale and the Experiences in Close Relationships Scale 5-17 days after the remission of first myocardial infarction attack. Twenty-five (25·77%) patients met the criteria of posttraumatic stress disorder symptoms. Greater attachment anxiety and avoidance were associated with more severe posttraumatic stress disorder symptoms. Except for externally oriented thinking, all dimensions of alexithymia were significantly correlated with post-traumatic stress symptoms. In the regression model, attachment anxiety and difficulties identifying feelings were found to be predictive and the total regression equation explained 24·2% variance of posttraumatic stress disorder symptoms among myocardial infarction patients. First-time myocardial infarction patients were at risk of developing posttraumatic stress disorder symptoms. Attachment anxiety and difficulties identifying feelings were positively associated with posttraumatic stress disorder symptoms in the early stage of myocardial infarction rehabilitation. It is essential to evaluate the causal relationship between attachment, alexithymia and posttraumatic stress disorder symptoms in longitudinal studies.


Iron absorption by hypotransferrinaemic mice.
Iron absorption rates by homozygous and wild-type mice from a hypotransferrinaemic mouse colony were examined with in vivo tied-off duodenal segments and in vitro incubated duodenal fragments. Enhanced initial rates of mucosal uptake and carcass transfer by homozygotes, compared to wild-types, were observed. The changes in vivo and in in vitro uptake kinetics resemble changes seen in iron deficient or hypoxic mice, suggesting that the liver iron loading shown by homozygotes is due to a failure of the normal mechanism for regulation of iron absorption. In vivo mucosal uptake and carcass transfer of radioiron showed an inverse correlation with liver non-haem iron content in homozygous hypotransferrinaemic mice, suggesting that some degree of control of absorption, albeit at markedly reduced sensitivity, can operate in these mice. No correlation between haemoglobin level and iron absorption was observed in homozygous hypotransferrinaemic mice, suggesting that this regulator of iron absorption does not function in these mice. The precise pathogenic mechanism of the enhanced iron absorption in hypotransferrinaemia remains to be determined. Mucosal transferrin levels were found to parallel serum transferrin levels in homozygotes, heterozygotes and wild-type mice. This supports previous suggestions that mucosal transferrin is derived from plasma transferrin and that the enhancement of iron absorption, by physiological mechanisms, does not require the presence of mucosal transferrin.


Transcriptome Analysis Reveals the Genetic Basis of the Resveratrol Biosynthesis Pathway in an Endophytic Fungus (Alternaria sp. MG1) Isolated from Vitis vinifera.
Alternaria sp. MG1, an endophytic fungus previously isolated from Merlot grape, produces resveratrol from glucose, showing similar metabolic flux to the phenylpropanoid biosynthesis pathway, currently found solely in plants. In order to identify the resveratrol biosynthesis pathway in this strain at the gene level, de novo transcriptome sequencing was conducted using Illumina paired-end sequencing. A total of 22,954,434 high-quality reads were assembled into contigs and 18,570 unigenes were identified. Among these unigenes, 14,153 were annotated in the NCBI non-redundant protein database and 5341 were annotated in the Swiss-Prot database. After KEGG mapping, 2701 unigenes were mapped onto 115 pathways. Eighty-four unigenes were annotated in major pathways from glucose to resveratrol, coding 20 enzymes for glycolysis, 10 for phenylalanine biosynthesis, 4 for phenylpropanoid biosynthesis, and 4 for stilbenoid biosynthesis. Chalcone synthase was identified for resveratrol biosynthesis in this strain, due to the absence of stilbene synthase. All the identified enzymes indicated a reasonable biosynthesis pathway from glucose to resveratrol via glycolysis, phenylalanine biosynthesis, phenylpropanoid biosynthesis, and stilbenoid pathways. These results provide essential evidence for the occurrence of resveratrol biosynthesis in Alternaria sp. MG1 at the gene level, facilitating further elucidation of the molecular mechanisms involved in this strain's secondary metabolism.


Bowel necrosis associated with COVID-19 pneumonia: A report of two cases.
A novel coronavirus, called as SARS-CoV-2, caused multiple typical and atypical respiratory symptoms with several reported abdominal findings. We have described 2 cases of an unusual presentation of Covid-19. For patient 1, a woman aged 59-year-old had pneumonia and new onset abdominal pain. In patient 2, a 60-year-old man admitted with positive polymerase chain reaction test and abdominal pain from 2 weeks ago. Both lung and abdominal computed tomography (CT) were achieved in a few days. Acute ischemic mesenteritis and other abdominal complications were observed in the CT scan. Bowel necrosis in combination with peritonitis founded by laparotomy. Early diagnosis of abdominal complications in Covid-19 pneumonia can improve patient outcomes.


Hepatic denervation alters the transition from the fed to the food-deprived state in conscious dogs.
The hepatic nerves can modulate hepatic glycogenolysis and glycogenesis and thus might be expected to be involved in the response of the animal to the transition from the fed to the food-deprived state. Therefore the arterial concentrations and net hepatic balance of glucose and its metabolites, as well as the hepatic glycogen concentrations, were compared in hepatic-innervated and -denervated dogs 18, 24 and 42 h after their usual daily meal. Arterial concentrations of glucose, alanine, lactate and glycerol; net hepatic balances of glucose, alanine and glycerol; and glycogen concentrations were similar in hepatic-innervated and -denervated dogs at each time investigated. Net hepatic balances of lactate (with negative values indicating uptake) in hepatic-innervated and -denervated dogs, respectively, were: 18 h, 4.1 +/- 4.3 vs. -4.3 +/- 3.6 mumol.kg-1 x min-1; 24 h, 4.8 +/- 3.6 vs. -6.7 +/- 1.7 mumol.kg-1 x min-1 (P < 0.05); 42 h, -7.0 +/- 2.0 vs. -6.8 +/- 1.0 mumol.kg-1 x min-1. Based on changes in net hepatic lactate balance, the denervated liver responds more rapidly to food deprivation than the innervated liver, but the metabolic state of the liver appears similar by 42 h after a meal.


Effect on the immune system of mice exposed chronically to 50 Hz amplitude-modulated 2.45 GHz microwaves.
The effect of continuous (CW; 2.45 GHz carrier frequency) or amplitude-modulated (AM; 50 Hz square wave) microwave radiation on the immune response was tested. CW exposures (6 days, 3 h/day) induced elevations of the number of antibody-producing cells in the spleen of male Balb/c mice (+37%). AM microwave exposure induced elevation of the spleen index (+15%) and antibody-producing cell number (+55%) in the spleen of male mice. No changes were observed in female mice. It is concluded that both types of exposure conditions induced moderate elevation of antibody production only in male mice.


Photonic defect modes in a cholesteric liquid crystal with a resonant nanocomposite layer and a twist defect.
We have studied spectral properties of a cholesteric liquid crystal with a combined defect consisting of a nanocomposite layer and a twist. The nanocomposite layer is made of metallic nanoballs dispersed in a transparent matrix and featuring effective resonant permittivity. A solution has been found for the transmission spectrum of circularly polarized waves in the structure. We have analyzed spectral splitting of the defect mode in the band gap of the cholesteric when its frequency coincides with the nanocomposite resonant frequency. Defect modes have characteristics strongly dependent on the magnitude and the sign of the phase difference of the cholesteric helix on both sides of the defect layer. It has been found that the band gap width and the position and localization degree of defect modes can be effectively controlled by external fields applied to the cholesteric.


Jet-ski injury: a case history.
A case history is presented which involves a patient who sustained severe vaginal lacerations as a result of falling backwards off of a jet-ski. The surgical repair of the lacerations and postoperative course is discussed. An extensive search of the literature has failed to reveal any published reports of a similar injury.


Diagnosis of long-term sequelae after low-voltage electrical injury.
The purpose of this study was to determine the efficacy of diagnostic tests and specialty consultations in aiding the diagnosis of long-term symptoms after low-voltage electrical injury (EI). A retrospective hospital chart review of low-voltage electrical-injured patients admitted to the outpatient burn clinic of a rehabilitation hospital was conducted (January 2002 to March 2006). Results of tests and specialty consultations were compared between patients with low-voltage contact injuries and patients with low-voltage flash injuries using Student's t-test and χ(2) with a P < .05 considered significant. Forty patients were treated for low-voltage EI, and all injuries occurred at work. Three patients were excluded due to lack of exact voltage documentation. Of the remaining 37 patients, there were 31 males (83.8%) and 6 females (16.2%) with a mean age of 36.7 ± 11.0 years and a mean TBSA of 7.7 ± 7.3%. Of 83 specialty consultations, the most frequents were psychology (38.6%), physiatry (21.7%), neurology (15.7%), and orthopedic (8.4%). Eighty percent of consultations were negative (no pathology). Patients with electrical contact injury had more specialty consultations (68.7 vs 31.3%, P = .003), especially neurology (21.1 vs 3.8%, P = .027), and more tests than patients with electrical flash injury (86.5 vs 13.5%, P < .001). Four (6.3%) CT scans and 14 (21.9%) magnetic resonance imaging scans were performed in electrical contact injury patients, but the majority of their results were negative (75 and 71.4%, respectively). Ultrasound, bone scan, and x-rays were negative: 80, 100, and 100%, respectively. Low-voltage electrical-injured patients are frequently referred for specialty consultations and tests, which are usually not effective to correlate their long-term symptoms with the initial EI.


Differentiation capacity of BrdU label-retaining dental pulp cells during pulpal healing following allogenic transplantation in mice.
Our recent study has demonstrated the localization of putative dental pulp stem cells in the developing molar by chasing 5-bromo-2'-deoxyuridine (BrdU)-labeling. However, their differentiation capacity subsequent to the tooth transplantation remains to be elucidated. This study aims to clarify the differentiation capacity of BrdU label-retaining dental pulp cells and their relationship to cell proliferation and apoptosis during pulpal healing following allogenic transplantation in mice. Following extraction of the mouse molar in BrdU-labeled animals, the roots and pulp floor were resected and immediately allo-grafted into the sublingual region in non-labeled animals, and vice versa. In the labeled transplants, label-retaining cells (LRCs) were increased in number and committed in nestin-positive newly differentiated odontoblast-like cells, whereas they were not committed in osteoblast-like cells. In the labeled host, on the contrary, LRCs were committed in neither odontoblast- nor osteoblast-like cells, although they were transiently increased in number and finally disappeared in the pulp tissue of the transplants. Interestingly, numerous apoptotic cells appeared in the pulp tissue including LRCs during the experimental period. These results suggest that transplanted LRCs maintain their proliferative and differentiation capacity in spite of extensive apoptosis occurring in the transplant, whereas transiently increased host-derived LRCs finally disappear in the pulp chamber following apoptosis.


TNF-alpha enhances contraction and inhibits endothelial NO-cGMP relaxation in systemic vessels of pregnant rats.
Tumor necrosis factor-alpha (TNF-alpha) is elevated in the plasma of preeclamptic women and may have a role in pregnancy-induced hypertension. However, whether the hemodynamic effects of TNF-alpha reflect the direct effects on vascular reactivity is unclear. We tested the hypothesis that TNF-alpha impairs endothelium-dependent relaxation and enhances vascular contraction in systemic vessels of pregnant rats. We measured isometric contraction in aortic strips isolated from virgin and pregnant Sprague-Dawley rats (nontreated vs. treated for 2 h with 10-1,000 pg/ml TNF-alpha). In endothelium-intact vascular strips, TNF-alpha caused greater enhancement of phenylephrine (Phe) contraction in pregnant than virgin rats. TNF-alpha caused significant inhibition of ACh- and bradykinin-induced vascular relaxation and nitrite/nitrate production that were more prominent in pregnant than virgin rats. N(G)-nitro-L-arginine methyl ester [L-NAME, 100 microM, an inhibitor of nitric oxide (NO) synthase] or 1H-[1,2,4]oxadiazolo[4,3]-quinoxalin-1-one (ODQ, 1 microM, an inhibitor of cGMP production in smooth muscle) inhibited ACh relaxation and enhanced Phe contraction in nontreated but to a lesser extent in TNF-alpha-treated vessels, particularly those of pregnant rats. Endothelium removal enhanced Phe contraction in nontreated but not TNF-alpha-treated vessels, especially those of pregnant rats. Relaxation of Phe contraction with the NO donor sodium nitroprusside was not different between nontreated and TNF-alpha-treated vessels. Thus TNF-alpha enhances vascular contraction and inhibits endothelium-dependent NO-cGMP-mediated vascular relaxation in systemic vessels, particularly those of pregnant rats. The results support a direct role for TNF-alpha as a possible mediator of increased vascular resistance associated with pregnancy-induced hypertension.


Effect of growth hormone on hepatic cytochrome P450 activity in healthy elderly men.
Our objective was to study the effect of recombinant human growth hormone (rhGH) on hepatic cytochrome P450 (CYP) activity in 30 healthy elderly men. The study was carried out as a randomized, double-blind, placebo-controlled parallel-group study. rhGH or placebo was administered for a period of 12 weeks. CYP activity was measured before, after 12 weeks of rhGH and placebo administration, and at 4 weeks after termination of rhGH and placebo administration with use of the biomarker reactions of CYP1A2 (caffeine), CYP2C19 (mephenytoin), CYP2D6 (sparteine), CYP3A4 (endogenous cortisol metabolism), and antipyrine clearance as common markers of CYP activity. The metabolic ratio of caffeine increased significantly in the group that received growth hormone compared with placebo (median difference, 4.55; 95% confidence interval (CI), 1.64 to 8.60; versus -0.90; 95% CI, -5.70 to 1.36), indicating an induction of CYP1A2. Moreover, the S/R ratio of mephenytoin showed a small but significant increase (median difference, 0.02; 95% CI, 0 to 0.31; versus 0; 95% CI, -0.01 to 0.06), indicating an inhibition of CYP2C19. There were no significant changes of the metabolic ratios of cortisol and sparteine or the antipyrine clearance compared with placebo. These results indicate that growth hormone induces CYP1A2 and, to a lesser extent, inhibits CYP2C19 in elderly men, but it exerts no effects on CYP2D6 and CYP3A4. Although the induction of CYP1A2 may be of some clinical relevance, the small inhibition of CYP2C19 is probably unimportant.


The effect of exercise types for rotator cuff repair patients on activities of shoulder muscles and upper limb disability.
[Purpose] This study investigated the effect on activities, shoulder muscle fatigue, upper limb disability of two exercise types performed by patients in the post- immobilization period of rotator cuff repair. [Subjects and Methods] The intervention program was performed by 20 patients from 6 weeks after rotator cuff repair. Ten subjects each were randomly allocated to a group performing open kinetic chain exercise and a group preforming closed kinetic chain exercise. Muscle activity and median frequency were measured by using sEMG and the Upper Extremity Function Assessment before and after conducting the intervention and changes in the results were compared. [Results] There was a significant within group increases in the activities of the shoulder muscles, except for the posterior deltoid. The median power frequencies (MFD) of the supraspinatus, infraspinatus and anterior deltoid significantly increased in the open kinetic chain exercise group, but that of the posterior deltoid decreased. There were significant differences in the changes in the upper limb disability scores of the two groups, in the shoulder muscle activities, except for that of the posterior deltoid, in the comparison of the change in the muscle activities of the two groups, and in the MDFs of all shoulder muscles. [Conclusion] The Median power frequencies of all these muscles after closed kinetic chain exercise increased indicating that muscle fatigue decreased. Therefore, research into exercise programs using closed kinetic chain exercises will be needed to establish exercise methods for reducing muscle fatigue.


Effect of human dermal allograft thickness on glenohumeral stability for superior capsular reconstruction in irreparable supraspinatus tears: A biomechanical analysis of the superior capsular reconstruction - A cadaveric study.
The objective of this study was to compare the biomechanics of using a double layered human dermal allograft to a single layered human dermal allograft in superior capsular reconstruction. Five cadaveric shoulders were tested. The superior translation of the humerus and the subacromial contact pressure were measured at 0°, 30° and 60° of glenohumeral abduction in the following six conditions: (1) intact rotator cuff, (2) irreparable supraspinatus tear, (3) superior capsular reconstruction using a double layered human dermal allograft with and (4) without posterior suturing, (5) superior capsular reconstruction using a single human dermal allograft with and (6) without posterior suturing. There was a significant increase in superior translation of the humerus and subacromial contact pressure when comparing torn supraspinatus to intact shoulder. All superior capsular reconstruction repairs lead to a reduction in superior translation and subacromial contact pressures compared to after the supraspinatus tear except for single layered superior capsular reconstruction repair without posterior suturing. There was no difference in superior translation and subacromial contact pressures comparing the intact shoulder to any of the superior capsular reconstruction constructs. Superior capsular reconstruction using a single or double layered human dermal allograft improves superior translation after supraspinatus repair. There is some biomechanical benefit of a double layered human dermal allograft technique over a single layered graft technique in superior capsular reconstruction. IV.


Some properties of the chloroplast envelope as revealed by electrophoretic mobility studies of intact chloroplasts.
The electrophoretic mobility of mature spinach (Spinacia oleracea L. var. Americana) chloroplasts sampled over a 7-month period was between -2.03 and -2.45 micrometers per second per volt per centimeter when suspended in a solution containing 1 millimolar CaCl(2). The surface charge density of EDTA-treated chloroplasts was calculated to be -7,400 electrostatic units per square centimeter representing, on the average, one electronic charge per 645 square Angstroms. Electrophoretic mobility increases during plastid maturation. Calcium, but not magnesium, generally stabilized the envelope of isolated plastids against small increases in surface charge that occur with time in the absence of calcium. Pronase caused a sharp, but temporary, decrease in the electrophoretic mobility of chloroplasts. This was interpreted as representing a transient binding of pronase to the envelope surface during proteolysis. No -SH groups were detected on the surface of the plastid envelope. Inasmuch as the isoelectric point of intact chloroplasts was found to be at pH 4.5, it is likely that the major part of the total surface charge results from the presence of exposed carboxyl groups of intrinsic envelope proteins that are not readily hydrolyzed by mild pronase treatment.


Effect of detergents on ligand binding and translocation activities of solubilized/reconstituted nucleoside transporters.
Purification of equilibrative nucleoside transporters has been hampered by the functional instability of the detergent-solubilized proteins. A variety of nonionic detergents were compared with octylglucoside (the most commonly used detergent in this regard) for their abilities to solubilize functionally stable nucleoside transporter proteins from Ehrlich cell plasma membranes. Transporter stability was assessed through the binding of the specific probe [3H]nitrobenzylthioinosine to freshly solubilized and stored (48 h/6 degrees C) preparations. The most promising detergents were decylmaltoside and cyclohexylbutylmaltoside, both of which, like octylglucoside, solubilized over 70% of the transporters from the membrane. Decylmaltoside- and cyclohexylbutylmaltoside-solubilized transport proteins retained 61 and 83%, respectively, of their [3H]-nitrobenzylthioinosine binding activity upon storage, compared to about 30% using octylglucoside. Decylmaltoside was also superior to octylglucoside in its capacity to solubilize the transporter in a state that retained its high affinity for the transport inhibitors dilazep (Ki = 11 nM, vs 75 nM in octylglucoside) and dipyridamole (Ki = 260 nM, vs 12 microM in octylglucoside). Reconstitution studies indicated that both the decylmaltoside- and cyclohexylbutylmaltoside-solubilized transporters were capable of mediating the uptake of [3H]uridine. Decylmaltoside was superior to cyclohexylbutylmaltoside, however, in both the enhanced transport activity of the resulting proteoliposomes (Vi = 21 pmol/mg/s vs 13 pmol/mg/s, respectively) and the lower nonmediated uptake observed in the decylmaltoside-derived vesicles (27% of total uptake at 4 min incubation). Nevertheless, cyclohexylbutylmaltoside may be useful in initial solubilization procedures due to its ability to selectively solubilize the nucleoside transporter from the plasma membrane. The rational use of these detergents will enable a more extensive purification of functional nucleoside transporters.


Up-regulation of glutathione S-transferases alpha by interleukin 4 in human hepatocytes in primary culture.
During inflammation and infection, overexpression of cytokines is associated with changes in cytochrome P450 (CYP) activities. The present study investigated the effect of cytokines on expression of the glutathione S-transferases (GST), phase II enzymes, involved in drug detoxication and in protection against lipid peroxidation. Human hepatocytes in primary culture were exposed to interleukin 6 (IL6), a proinflammatory cytokine and interleukin 4 (IL4) thought to be an anti-inflammatory cytokine and known to induce CYP2E1 specifically. After a three-day treatment, no reproducible effects of IL-6 could be demonstrated on either GSTA1 and/or A2 or M1 mRNA levels (GSTA1 and A2 were not discriminated by the cDNA probe). In contrast, GSTA1 and/or A2 mRNAs and GSTA1 and A2 proteins were reproducibly increased after IL4 treatment. This increase was blocked by alpha-amanitin, suggesting that active transcription is necessary and was associated with increased AP1 binding activities. These results provide evidences that IL4 exerts important effects on detoxifying hepatic drug metabolizing enzymes.


Necrotic enteritis in chickens: a review of pathogenesis, immune responses and prevention, focusing on probiotics and vaccination.
Necrotic enteritis (NE), caused by Clostridium perfringens (CP), is one of the most common of poultry diseases, causing huge economic losses to the poultry industry. This review provides an overview of the pathogenesis of NE in chickens and of the interaction of CP with the host immune system. The roles of management, nutrition, probiotics, and vaccination in reducing the incidence and severity of NE in poultry flocks are also discussed.


Switchable metal-insulator transition in core-shell cluster-assembled nanostructure films.
Fe/Fe3O4 core-shell-cluster-assembled nanostructured films were prepared using the low-energy cluster beam deposition technique. The temperature-dependent resistivity behaviors were investigated for the films with changing core-occupation ratio of clusters. Much interestingly and surprisingly, a switchable metal-insulator transition can be observed, featuring the rapid switching from the metal state to the insulation state and then back to the metal state, for films within a specific range of core-occupation ratio. Further, the resistivity change rate used to characterize the metal-insulator transition can reach as high as two orders of magnitude over a very narrow temperature region. The design of Fe/Fe3O4 core-shell clusters plays a decisive role in the mechanism of the switchable metal-insulator transition in these films. The assembled core-shell clusters in the films form current conduction channels that are switchable between the cores and shells of clusters as the temperature changes. The switching of the current conduction channels can be regulated by controlling the core-occupation ratios of clusters, which induce a switchable metal-insulator transition and can be verified by the effective medium theory over a specific core-occupation ratio range.


Predominant site of airway resistance in chronic obstructive pulmonary disease.
The purpose of the present clinical research was to establish the major site of resistance and obstruction in patients with severe, symptomatic chronic obstructive pulmonary disease. We used a noninvasive technique by measuring airflow in a plethysmograph after patients breathed air and after breathing a mixture of 80 percent helium and 20 percent oxygen. In group 1 were 14 patients (mean age, 63 +/- 7 years [+/- 1 SD]) with bronchitis. The ratio of their forced expiratory volume in one second over the vital capacity (FEV1/VC) was 43 +/- 10 percent (mean +/- 1 SD), and their single-breath carbon monoxide diffusing capacity (Dsb) was normal (125 +/- 41 percent of the predicted value). In group 2 were 13 patients with emphysema (mean age, 60 +/- 10 years), whose FEV1/VC was 33 +/- 11 percent and Dsb was 55 +/- 14 percent of predicted. All patients had abnormally low increases in the maximum expiratory flow at midvital capacity after breathing the helium-oxygen mixture. The range in group 1 was -11 percent to +14 percent and in group 2 was -10 percent to +15 percent. Normal subjects in our laboratory show increases of at least +24 percent. This indicates that the limitation of airflow occurs primarily in the small (less than 2 mm in internal diameter) and not the large airways.