Treatment of Mucous Cyst of the Distal Interphalangeal Joint With Osteophyte Excision and Joint Debridement.
Mucous cyst of the distal interphalangeal joint (DMC) or interphalangeal connection of the thumb is common in middle-aged and elderly people, and it often occurs in the fingers of people with osteoarthritis (OA). Although there are many conservative treatments, DMC is usually treated by surgery. The common complications of surgical treatment are recurrence of DMC and skin necrosis. This article introduces the method and clinical effect of osteophyte excision and joint debridement in the treatment of DMC of the distal interphalangeal (DIP) joint. In total, 19 cases of affected fingers made an 'S' incision in the DIP joint under local anesthesia to remove the osteophyte of the DIP joint, clean the dorsal joint capsule, wash the joint, and retain only the bilateral collateral ligament and extensor tendon device. It is suspected that the injured finger of the extensor tendon should be protected by external fixation. Out of 15 patients, 1 patient presented with partial skin necrosis that healed after dressing changes while the other patients recovered well. The visual analog scale (VAS) scores of all affected fingers after surgery were lower than those before the surgery (VAS score: 4.93 ± 0.88 vs. 4.07 ± 1.03, p < 0.05). The range of motion (ROM) of the affected finger decreased in one patient, and the post-operative activity of the other fingers increased in varying degrees (ROM: 67.60 ± 5.40 vs. 71.27 ± 7.06, p > 0.05). Using osteophyte excision and joint debridement to treat DMC can avoid skin necrosis caused by cyst removal and can avoid the recurrence of DMC to the greatest extent, so it is a safe and effective way of treatment.


XPS at solid-aqueous solution interface.
Application of X-ray Photoelectron Spectroscopy (XPS) to study the solid-aqueous solution interface is reviewed. XPS provides complementary physicochemical information about electrical double layer from the perspective of the solid surface. Experimental techniques, such as differential pumping, controlled adsorption/co-adsorption, freeze-drying, and fast-freezing, are discussed for both electrochemical and dielectric solid-solution interfaces. The use of fast-freezing, as applied to wet pastes centrifuged from aqueous suspensions, makes it possible to approach a real solid-solution interface in UHV conditions. XPS data allow estimation of the surface density of counter-ions, surface point of zero charge, and in some cases the measurement of surface potential. Interfacial chemical reactions such as ion pair formation, specific adsorption and ligand exchange can be directly observed. The technique is easy to apply to any suspension including colloids and gels of inorganic or organic nature, and can be adapted for electrochemistry as complementary to traditional "emersed electrode" studies.


Sensitivity analysis of progression-free survival with dependent withdrawal.
We develop a sensitivity analysis method for comparing treatment-specific distributions where the endpoint is progression-free survival (PFS). The censoring process may be informative due to selective patient withdrawal, which occurs whenever disease evaluation has been discontinued without progression being documented. The sensitivity analysis explores the effects of the dependence between patient withdrawal and progression time using a conditional probability model which incorporates a set of sensitivity parameters. We propose an EM algorithm for estimation of PFS under the model for dependence and construct log-rank-type score statistics from the estimated distributions. Bootstrap procedures are used to estimate the variance of the score statistic. We also extend the methodology to incorporate additional survival information, which may be available on the cases who were withdrawn. An Eastern Cooperative Oncology Group (ECOG) advanced lung cancer clinical trial (E1594) is used to illustrate the methodology.


Octane-Assisted Reverse Micellar Dyeing of Cotton with Reactive Dyes.
In this study, we investigated the computer colour matching (CCM) of cotton fabrics dyed with reactive dye using the octane-assisted reverse micellar approach. The aim of this study is to evaluate the colour quality and compare the accuracy between CCM forecasting and simulated dyeing produced by conventional water-based dyeing and octane-assisted reverse micellar dyeing. First, the calibration of dyeing databases for both dyeing methods was established. Standard samples were dyed with known dye concentrations. Computer colour matching was conducted by using the colour difference formula of International Commission on Illumination (CIE) L*a*b*. Experimental results revealed that the predicted concentrations were nearly the same as the expected known concentrations for both dyeing methods. This indicates that octane-assisted reverse micellar dyeing system can achieve colour matching as good as the conventional water-based dyeing system. In addition, when comparing the colour produced by the conventional water-based dyeing system and the octane-assisted reverse micellar dyeing system, the colour difference (ΔE) is ≤1, which indicates that the reverse micellar dyeing system could be applied for industrial dyeing with CCM.


Solitary Crossed Renal Ectopia: Concurrence of Posterior Urethral Valve and Hypospadias.
Solitary crossed renal ectopia (SCRE) represents an exceedingly rare congenital disorder. Although skeletal and genitourinary abnormalities most commonly accompany this condition, vesicoureteral reflux (VUR) has been described in only a few cases. Here, we present two unique cases of SCRE complicated by high-grade VUR concomitant with posterior urethral valve in one case and hypospadias in the other one. We also provide a brief review of the literature on this subject.


Multimodal evaluation of osteosarcoma choroidal metastasis.
Osteosarcoma (OS) is the most common primary bone carcinoma. Adulthood most frequent intraocular malignant tumor is choroidal metastasis; however, these are rarely related to sarcomas. There are only two OS-related choroidal metastasis cases reported in the literature, both prior to 1970. A 20-year-old man with a history of tibial OS, right leg amputation, and lung and brain metastases, presented with decreased vision in his right eye (OD). Ophthalmic examination revealed a best-corrected visual acuity of hand movements and a large, posterior pole, nodular, subretinal mass, with associated fluid. B-scan revealed a heterogeneous lump, with medium/high reflectivity, and a height-to-base ratio (HBR) of 1-1.2, approximately. Computerized tomography (CT) scan showed a hyperdense and contrast-enhanced mass, while on magnetic resonance imaging (MRI) the lesion appeared T1-isointense and T2-hypointense. Choroidal OS metastasis can appear as a pink nodule with high HBR and intralesional hyperreflective deposits. Sudden visual changes in individuals with OS-related systemic metastatic disease should be monitored closely by ophthalmology and oncology jointly.


Ultrasound-guided peripheral intravenous access in the emergency department: patient-centered survey.
To assess characteristics, satisfaction, and disposition of emergency department (ED) patients who successfully received ultrasound (US)-guided peripheral intravenous (IV) access. This is a prospective observational study among ED patients who successfully received US-guided peripheral IV access by ED technicians. Nineteen ED technicians were taught to use US guidance to obtain IV access. Training sessions consisted of didactic instruction and hands-on practice. The US guidance for IV access was limited to patients with difficult access. After successfully receiving an US-guided peripheral IV, patients were approached by research assistants who administered a 10-question survey. Disposition information was collected after the conclusion of the ED visit by accessing patients' electronic medical record. In total, 146 surveys were completed in patients successfully receiving US-guided IVs. Patients reported an average satisfaction with the procedure of 9.2 of 10. Forty-two percent of patients had a body mass index (BMI) of greater than 30, and 17.8% had a BMI of more than 35. Sixty-two percent reported a history of central venous catheter placement. This patient population averaged 3 ED visits per year in the past year. Fifty-three percent of the patients were admitted. Patients requiring US-guided IVs in our ED are discharged home at the conclusion of their ED visit about half of the time. These patients reported high rates of both difficult IV access and central venous catheter placement in the past. Patient satisfaction with US-guided IVs was very high. These data support the continued use of US-guided peripheral IVs in this patient population.


Abnormalities of hemorheological, endothelial, and platelet function in patients with chronic heart failure in sinus rhythm: effects of angiotensin-converting enzyme inhibitor and beta-blocker therapy.
To investigate the hypothesis that abnormalities of hemorheological (fibrinogen, plasma viscosity), endothelial (von Willebrand factor [vWF]), and platelet (soluble P-selectin) function would exist in patients with chronic heart failure (CHF) who are in sinus rhythm, we conducted a cross-sectional study of 120 patients with stable CHF (median ejection fraction 30%). We also hypothesized that ACE inhibitors and beta-blockers would beneficially affect the measured indices. In the cross-sectional analysis, plasma viscosity (P=0.001), fibrinogen (P=0.02), vWF (P<0.0001), and soluble P-selectin (P<0.001) levels were elevated in patients with CHF compared with healthy controls. Women demonstrated greater abnormalities of hemorheological indices and vWF than males (all P<0.05). Plasma viscosity (P=0.009) and fibrinogen (P=0.0014) levels were higher in patients with more severe symptoms (New York Heart Association [NYHA] class III-IV), but there was no relationship with left ventricular ejection fraction. When ACE inhibitors were introduced, there was a reduction in fibrinogen (repeated-measures ANOVA, P=0.016) and vWF (P=0.006) levels compared with baseline. There were no significant changes in hemorheological, endothelial, or platelet markers after the introduction of beta-blocker therapy, apart from a rise in mean platelet count (P<0.001). Abnormal levels of soluble P-selectin, vWF, and hemorheological indices may contribute to a hypercoagulable state in CHF, especially in female patients and in those with more severe NYHA class. Treatment with ACE inhibitors improved the prothrombotic state in CHF, whereas the addition of beta-blockers did not. These positive effects of ACE inhibitors may offer an explanation for the observed reduction in ischemic events in clinical trials.


Characterization of Intestinal Microbiomes of Hirschsprung's Disease Patients with or without Enterocolitis Using Illumina-MiSeq High-Throughput Sequencing.
Hirschsprung-associated enterocolitis (HAEC) is a life-threatening complication of Hirschsprung's disease (HD). Although the pathological mechanisms are still unclear, studies have shown that HAEC has a close relationship with the disturbance of intestinal microbiota. This study aimed to investigate the characteristics of the intestinal microbiome of HD patients with or without enterocolitis. During routine or emergency surgery, we collected 35 intestinal content samples from five patients with HAEC and eight HD patients, including three HD patients with a history of enterocolitis who were in a HAEC remission (HAEC-R) phase. Using Illumina-MiSeq high-throughput sequencing, we sequenced the V4 region of bacterial 16S rRNA, and operational taxonomic units (OTUs) were defined by 97% sequence similarity. Principal coordinate analysis (PCoA) of weighted UniFrac distances was performed to evaluate the diversity of each intestinal microbiome sample. The microbiota differed significantly between the HD patients (characterized by the prevalence of Bacteroidetes) and HAEC patients (characterized by the prevalence of Proteobacteria), while the microbiota of the HAEC-R patients was more similar to that of the HAEC patients. We also observed that the specimens from different intestinal sites of each HD patient differed significantly, while the specimens from different intestinal sites of each HAEC and HAEC-R patient were more similar. In conclusion, the microbiome pattern of the HAEC-R patients was more similar to that of the HAEC patients than to that of the HD patients. The HD patients had a relatively distinct, more stable community than the HAEC and HAEC-R patients, suggesting that enterocolitis may either be caused by or result in a disruption of the patient's uniquely adapted intestinal flora. The intestinal microbiota associated with enterocolitis may persist following symptom resolution and can be implicated in the symptom recurrence.


Meandering pulmonary vein: A case report.
Anomalies of the pulmonary venous circulation are extremely uncommon. We report a case of an anomalous unilateral single pulmonary vein also referred to as a meandering pulmonary vein. A single large tortuous pulmonary vein was seen on the right side draining into the left atrium with associated ipsilateral absence of the middle lobe bronchus and interlobar fissures. This is considered a variant of the classical scimitar syndrome. The venous anatomy was depicted with considerable accuracy using multidetector computed tomography (MDCT) non-invasively.


[Gabaergic NADPH-diaphorase-positive Martinotti cells in the visual cortex in rats].
NADPH-diaphorase positive cells were described in the visual cortex of the rat in layers II-VI and in the white matter. Their somata were large or medium-sized, oval or elongated, and their cytoplasm was accumulated at the poles. Some proximal thickened coarse dendrites formed a bitufted dendritic field. These features showed a cell type impregnated with the Golgi-Kopsch-method and a Golgi-deimpregnation-method described as Martinotti cell (sparsely spined polarized neurons with ascending axons). The immunocytochemical evidence of GABA in NADPH-diaphorase positive neurons (double labeling) showed the GABA ergic nature of these cells, but an attempt for a double labelling of NADPH-diaphorase and Parvalbumin was negative.


Flexible Ceramic Film Sensors for Free-Form Devices.
Recent technological innovations, such as material printing techniques and surface functionalization, have significantly accelerated the development of new free-form sensors for next-generation flexible, wearable, and three-dimensional electronic devices. Ceramic film sensors, in particular, are in high demand for the production of reliable flexible devices. Various ceramic films can now be formed on plastic substrates through the development of low temperature fabrication processes for ceramic films, such as photocrystallization and transferring methods. Among flexible sensors, strain sensors for precise motion detection and photodetectors for biomonitoring have seen the most research development, but other fundamental sensors for temperature and humidity have also begun to grow. Recently, flexible gas and electrochemical sensors have attracted a lot of attention from a new real-time monitoring application that uses human breath and perspiration to accurately diagnose presymptomatic states. The development of a low-temperature fabrication process of ceramic film sensors and related components will complete the chemically stable and reliable free-form sensing devices by satisfying the demands that can only be addressed by flexible metal and organic components.


Single nucleotide polymorphisms of the human M1 muscarinic acetylcholine receptor gene.
The gene encoding the human muscarinic receptor, type 1 (CHRM1), was genotyped from 245 samples of the Coriell Collection (Coriell Institute for Medical Research, Camden, NJ). Fifteen single nucleotide polymorphisms (SNPs) were discovered, 9 of which are located in the coding region of the receptor. Of these, 8 represent synonymous SNPs, indicating that CHRM1 is highly conserved in humans. Only a single allele was found to contain a nonsynonymous SNP, which encodes an amino acid change of Cys to Arg at position 417. This may have functional consequences because a C417S point mutation in rat M1 was previously shown to affect receptor binding and coupling. Furthermore, 0 of 4 SNPs within CHRM1 previously deduced from sequencing of the human genome were found in this study despite a prediction that a majority of such inferred SNPs are accurate. The consensus sequence of CHRM1 obtained in our study differs from the deposited reference sequence (AC NM_000738) in 2 adjacent nucleotides, leading to a V173M change, suggesting a sequencing error in the reference sequence. The extraordinary sequence conservation of the CHRM1 gene-coding region was unexpected as M1-knockout mice show only minimal functional impairments.


Correlation of growth hormone secretion during pregnancy with circulating prolactin in rats.
Growth hormone (GH) concentrations were measured throughout pregnancy in rats. The effects of surgical stress, ovariectomy, and treatments with the antiprogesterone mifepristone (RU 486) or the antioestrogen tamoxifen on serum GH, progesterone and prolactin were studied. GH concentrations were low during the first 18 days of pregnancy, except on the morning of day 5, and increased progressively from day 19 reaching peak values on the mornings of days 21 and 22. Thereafter GH concentrations decreased progressively, reaching very low values at 24.00 h on day 22, in parallel with a rise in serum prolactin concentrations. Surgical stress, performed at 12.00 h on day 20 of pregnancy, diminished serum GH concentrations 10 min later, but these returned to values similar to those of the non-operated rats 1-24 h later. Surgical stress did not modify serum prolactin concentrations at any time. Ovariectomy performed on the morning of day 19 produced the expected fall in serum progesterone and a rise in prolactin which lasted until the night of day 20. Serum GH concentrations were significantly diminished with respect to controls on day 20 and the morning of day 21 and then increased. Treatment with mifepristone on day 19 produced a simultaneous rise in serum prolactin and a fall in serum progesterone and GH by 08.00 h on day 21. Treatment with tamoxifen on days 3 and 4, or given daily from day 17 onwards did not modify prolactin concentrations but diminished serum GH concentrations at 08.00 on day 5 and on days 19-22, with the exception of a peak on day 22 (08.00 h). Tamoxifen also decreased serum progesterone concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)


Parkinson's disease mortality and the industrial use of heavy metals in Michigan.
Parkinson's disease (PD) mortality rates in Michigan counties for 1986-1988 were calculated with respect to potential heavy metal exposure (iron, zinc, copper, mercury, magnesium, and manganese) from industry based on recent census data. Individuals were counted as a PD death if the diagnosis was listed as an "underlying" or "related" cause of death on the death certificate. Counties with an industry in the paper, chemical, iron, or copper related-industrial categories (ICs) had statistically significantly (p < 0.05) higher PD death rates than counties without these industries. Significant correlations of chemical (rs = 0.22; p = 0.05), paper (rs = 0.22; p = 0.05) and iron (rs = 0.29; p = 0.008) industry densities with PD death rates were also present. Counties were divided into high (> 15/100,000 individuals 45 years old and over) and low (< = 15/100,000) PD death rate counties by cluster analysis. Geographically, counties with high PD mortality were located mainly in the southern half of the lower peninsula and eastern half of the upper peninsula; low PD death rate counties formed two distinct clusters in the western edge of the upper peninsula and the north-central portion of the lower peninsula. Other possible risk factors that may explain the varied distribution of PD death rates in Michigan were examined. Those significantly correlated with PD mortality included population density (rs = 0.31; p = 0.005), farming density (rs = 0.25; p = 0.02), and well water use (rs = -0.24; p = 0.03). These ecologic findings suggest a geographic association between PD mortality and the industrial use of heavy metals.


Prevalence of co-infections with other sexually transmitted infections in patients newly diagnosed with anogenital warts in Guangzhou, China.
Prevalence of co-infecting sexually transmitted infections (STIs) among patients newly diagnosed with anogenital warts is under-reported. Our objective is to determine the prevalence of six common STIs, Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Mycoplasma genitalium (MG), genital herpes (herpes simplex virus type 2 [HSV-2]), HIV, and syphilis for patients visiting a sexual health clinic in Guangzhou, China. Demographics, sexual health, and medical histories were collected at patient intake. Patients diagnosed with anogenital warts (N = 200) were invited to participate. We collected urine samples, and urethral, cervical, and rectal swabs to test for CT, NG, and MG, and blood samples for serological detection of HSV-2, syphilis, and HIV. Overall 49 (24.5%) had a co-infection (22.2% of men and 27.7% of women). All six STIs were observed among men: CT (6.8%), NG (3.4%), MG (5.1%), HIV (4.3%), HSV-2 (4.3%), and syphilis (1.7%). Women had fewer STIs, but at higher rates: CT (13.3%), MG (6.0%), and HSV-2 (8.4%). Individual men had up to two co-infections, while women had no more than one co-infection. Chlamydia was the most common STI. Patients aged 18-25 years (35.4%) had the highest prevalence. Although opportunistic screening is often applied for high-risk groups, expansion to patients with anogenital warts in all health-care settings would improve detection of problematic asymptomatic co-infections, thereby increasing China's capacity to contribute toward global surveillance systems.


Development of a controlled-atmosphere, rapid-cooling cryogenic chamber for tribological and mechanical testing.
Mechanical testing of seals, bearing materials, and mechanisms in cryogenic environments is a rapidly growing field of research, as it promises improvements in equipment performance and reliability for applications such as space exploration, liquid hydrocarbon storage, and superconducting devices. Cooling of test equipment is usually performed within a well-insulated test chamber, via direct or indirect evaporation of liquid cryogen. State-of-the-art equipment is frequently insufficient for rigorous testing, being expensive and cumbersome, cooling slowly, struggling to replicate relevant environmental conditions, and/or failing to reach the temperature of the cryogen. Herein, we employ a rapid prototyping approach using polymer 3D printing to iteratively refine cryogen-based cooling of a tribometer. The final design greatly exceeds the minimum temperature of state-of-the-art equipment, cooling a chamber to liquid nitrogen temperatures (-196 °C) while maintaining dry test conditions. When modified for use on a cryogenic tensile tester, the design cools to -150 °C in 149 s, significantly improving upon state-of-the-art performance. By utilizing this 3D-printed equipment, we find that components produced via Fused Deposition Modeling with unmodified, commodity polylactic acid have favorable mechanical properties in a cryogenic environment: tensile strength of 110 MPa, elongation at break of 10%, and specific wear of 5.6 × 10-5 mm3/Nm against stainless steel. By leveraging 3D printing for rapid manufacture of production-quality parts, highly refined cooling chamber designs have been experimentally developed for both a tribometer and a load frame in rapid succession, enabling significant improvements in cryogenic test capabilities.


Cell lineage, axis formation, and the origin of germ layers in the amphipod crustacean Orchestia cavimana.
Embryos of the amphipod crustacean Orchestia cavimana are examined during cleavage, gastrulation, and segmentation by using in vivo labelling. Single blastomeres of the 8- and 16-cell stages were labelled with DiI to trace cell lineages. Early cleavage follows a distinct pattern and the a/p and d/v body axes are already determined at the 4- and 8-cell stages, respectively. In these stages, the germinal rudiment and the naupliar mesoderm can be traced back to a single blastomere each. In addition, the ectoderm and the postnaupliar mesoderm are separated into right and left components. At the16-cell stage, naupliar ectoderm is divided from the postnaupliar ectoderm, and extraembryonic lineages are separated from postnaupliar mesoderm and endoderm. From our investigation, it is evident that the cleavage pattern and cell lineage of Orchestia cavimana are not of the spiral type. Furthermore, the results of the labelling show many differences to cleavage patterns and cell lineages in other crustaceans, in particular, other Malacostraca. The cleavage and cell lineage patterns of the amphipod Orchestia are certainly derived within Malacostraca, whose ancestral cleavage mode was most likely of the superficial type. On the other hand, Orchestia exhibits a stereotyped cell division pattern during formation and differentiation of the germ band that is typical for malacostracans. Hence, a derived (apomorphic) early cleavage pattern is the ontogenetic basis for an evolutionarily older cell division pattern of advanced developmental stages. O. cavimana offers the possibility to trace the lineages and the fates of cells from early developmental stages up to the formation of segmental structures, including neurogenesis at a level of resolution that is not matched by any other arthropod system.


Auditory and visual rhythmic pattern recognition by emotionally disturbed and normal adolescents.
Sixty-six emotionally disturbed and normal adolescents were given tests of rhythmic pattern recognition in the visual and auditory modes. Performance for both groups was significantly superior in the auditory versus the visual mode (p less than .001). No significant differences were found between subject groups' performance on auditory, visual, or combined scores.


Supercritical fluid extraction of grape glycosides.
Supercritical fluid extraction with methanol-modified CO(2) was used to extract glycosides from grapes. An optimization design involving 12 extraction variables was applied to achieve quantitative recoveries. The most important factor was the amount of organic modifier, a consequence of the high degree of glycoside polarity. By the proposed method, the total time of analysis can be decreased relative to that required for more conventional extractions. The full method can also be automated.


Solvent-Exchange Strategy toward Aqueous Dispersible MoS2 Nanosheets and Their Nitrogen-Rich Carbon Sphere Nanocomposites for Efficient Lithium/Sodium Ion Storage.
Major challenges in developing 2D transition-metal disulfides (TMDs) as anode materials for lithium/sodium ion batteries (LIBs/SIBs) lie in rational design and targeted synthesis of TMD-based nanocomposite structures with precisely controlled ion and electron transport. Herein, a general and scalable solvent-exchange strategy is presented for uniform dispersion of few-layer MoS2 (f-MoS2 ) from high-boiling-point solvents (N-methyl-2-pyrrolidone (NMP), N,N-dimethyl formaldehyde (DMF), etc.) into low-boiling-point solvents (water, ethanol, etc.). The solvent-exchange strategy dramatically simplifies high-yield production of dispersible MoS2 nanosheets as well as facilitates subsequent decoration of MoS2 for various applications. As a demonstration, MoS2 -decorated nitrogen-rich carbon spheres (MoS2 -NCS) are prepared via in situ growth of polypyrrole and subsequent pyrolysis. Benefiting from its ultrathin feature, largely exposed active surface, highly conductive framework and excellent structural integrity, the 2D core-shell architecture of MoS2 -NCS exhibits an outstanding reversible capacity and excellent cycling performance, achieving high initial discharge capacity of 1087.5 and 508.6 mA h g-1 at 0.1 A g-1 , capacity retentions of 95.6% and 94.2% after 500 and 250 charge/discharge cycles at 1 A g-1 , for lithium/sodium ion storages, respectively.


Effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections: open randomised controlled trial.
To assess the effectiveness of adenoidectomy in children with recurrent upper respiratory tract infections. Open randomised controlled trial. 11 general hospitals and two academic centres. 111 children aged 1-6 with recurrent upper respiratory tract infections selected for adenoidectomy. A strategy of immediate adenoidectomy with or without myringotomy or a strategy of initial watchful waiting. Main outcome measure Primary outcome measure: number of upper respiratory tract infections per person year calculated from data obtained during the total follow-up (maximum 24 months). days with upper respiratory tract infection per person year, middle ear complaints with fever in episodes and days, days with fever, prevalence of upper respiratory tract infections, and health related quality of life. During the median follow-up of 24 months, there were 7.91 episodes of upper respiratory tract infections per person year in the adenoidectomy group and 7.84 in the watchful waiting group (difference in incidence rate 0.07, 95% confidence interval -0.70 to 0.85). No relevant differences were found for days of upper respiratory tract infections and middle ear complaints with fever in episodes and days, nor for health related quality of life. The prevalence of upper respiratory tract infections decreased over time in both groups. Children in the adenoidectomy group had significantly more days with fever than the children in the watchful waiting group. Two children had complications related to surgery. In children selected for adenoidectomy for recurrent upper respiratory tract infections, a strategy of immediate surgery confers no clinical benefits over a strategy of initial watchful waiting. Trial registration Dutch Trial Register NTR968: ISRCTN03720485.


The outcome of hematopoietic stem cell transplantation in Korean children with hemophagocytic lymphohistiocytosis.
Chemoimmunotherapy-based treatments have improved the survival of patients with HLH, but outcomes of the patients are still unsatisfactory. We report here the outcome of Korean children with HLH who underwent HSCT, which was analyzed from the data of a nation-wide HLH registry. Retrospective nation-wide data recruitment for the pediatric HLH patients diagnosed between 1996 and 2008 was carried out by the Histiocytosis Working Party of the Korean Society of Hematology. Nineteen patients who received HSCT among the total of 148 enrolled children with HLH were analyzed for the transplant-related variables and events. The probability of five-yr survival after HSCT was 73.3% with a median follow-up of 57. Two months compared to 54.3% for the patients who were treated with chemoimmunotherapy only (p = 0.05). The reasons for HSCT were active disease after eight wk of initial treatment (n = 9), relapsed disease (n = 5), and FHL (n = 5). Fourteen patients are currently alive without disease after HSCT, four patients died of treatment-related events (infection in two and graft failure in two) at early post-transplant period, and one patient died of relapse at one yr post transplantation. The survival of patients who were transplanted because of active disease after eight wk of initial treatment was worse compared to those patients who had inactive state at that time (60.6% vs. 100%, respectively, p = 0.06). Of the four patients who received transplants using cord blood, three died of graft failure (n = 2) and relapse (n = 1). The five-yr probability of survival after HSCT according to the donor type was 85.7% for the MRDs (n = 6), 87.5% for the MUDs (n = 8), and 40% for the MMUDs (n = 5) (p = 0.03). Other variables such as age, CNS involvement at the time of diagnosis, the etiology of HLH (familial or secondary), and the conditioning regimens had no influence on the five-yr OS of the HLH patients who underwent HSCT. HSCT improved the survival of the patients who had familial, relapsed, or severe and persistent SHLH in the Korean nation-wide HLH registry. Although numbers were small, these results are similar to other reports in the literature. The disease state after initial treatment, the stem cell source of the transplant, and the donor type were the important prognostic factors that affected the OS of the HLH patients who underwent HSCT.


Pooling Upper Respiratory Specimens for Rapid Mass Screening of COVID-19 by Real-Time RT-PCR.
To validate the specimen-pooling strategy for real-time reverse transcription PCR detection of severe acute respiratory syndrome coronavirus 2, we generated different pools including positive specimens, reflecting the distribution of cycle threshold values at initial diagnosis. Cumulative sensitivities of tested pool sizes suggest pooling of <6 specimens for surveillance by this method.


Molecular Profiling of Merkel Cell Polyomavirus-Associated Merkel Cell Carcinoma and Cutaneous Melanoma.
Merkel cell carcinoma (MCC) is a rare, high-grade, aggressive cutaneous neuroendocrine malignancy most commonly associated with sun-exposed areas of older individuals. A relatively newly identified human virus, the Merkel cell polyomavirus (MCPyV) has been implicated in the pathogenesis of MCC. Our study aimed to examine nine MCC cases and randomly selected 60 melanoma cases to identify MCPyV status and to elucidate genetic differences between virus-positive and -negative cases. Altogether, seven MCPyV-positive MCC samples and four melanoma samples were analyzed. In MCPyV-positive MCC RB1, TP53, FBXW7, CTNNB1, and HNF1A pathogenic variants were identified, while in virus-negative cases only benign variants were found. In MCPyV-positive melanoma cases, besides BRAF mutations the following genes were also affected: PIK3CA, STK11, CDKN2A, SMAD4, and APC. In contrast to studies found in the literature, a higher tumor burden was detected in virus-associated MCC compared to MCPyV-negative cases. No association was identified between virus infection and tumor burden in melanoma samples. We concluded that analyzing the key morphologic and immunohistological features of MCC is critical to avoid confusion with other cutaneous malignancies. Molecular genetic investigations such as next-generation sequencing (NGS) enable molecular stratification, which may have future clinical impact.


Antinuclear antibody studies in juvenile chronic arthritis.
This study of children with chronic arthritis confirms that patients at greatest risk for chronic iridocyclitis have a young age of onset and positive antinuclear antibodies (ANA). Children who are ANA negative have a low risk of iridocyclitis. When it occurs it is at a significantly older age. No child developing juvenile chronic arthritis over 9, even with positive ANA, had chronic iritis. There was remarkable variation in ANA titres; these correlated with erythrocyte sedimentation rate, active arthritis, and iridocyclitis. Maximum ANA titres were often seen very early in the disease but at this time were usually not associated with a poor prognosis. Histocompatibility antigens A2 and DRw8 were significantly increased, suggesting primary associations in pauciarticular arthritis with ANA. HLA-DR5 was associated with mild forms of arthritis and with absence of, or only mild, iritis. HLA-B15/w62 was associated with severe forms of eye involvement.


[Extracellular matrix degradation enzymes: important factors in liver metastasis of colorectal cancer and good targets for anticancer metastatic therapy].
Extracellular matrix (ECM) degradation enzymes, such as matrix metalloproteinases (MMPs) and plasminogen activators, are important factors in cancer invasion and metastasis, because invasion and metastasis of cancer cells require destruction of mesenchymal collagen or the endothelial basement membrane. Moreover, recent studies have shown that ECM degradation enzymes play important roles in cancer cell proliferation, cancer escape from the immune system, and tumor angiogenesis. ECM degradation enzymes, especially some MMPs, are good targets for anticancer metastatic therapy. Numerous anti-MMP agents have been developed and phase III clinical trials in advanced cancers ongoing. Successful control of MMPs induced by cancer cells will prevent liver metastasis of colorectal cancer.


Symmorphic Intersecting Nodal Rings in Semiconducting Layers.
The unique properties of topological semimetals have strongly driven efforts to seek for new topological phases and related materials. Here, we identify a critical condition for the existence of intersecting nodal rings (INRs) in symmorphic crystals, and further classify all possible kinds of INRs which can be obtained in the layered semiconductors with Amm2 and Cmmm space group symmetries. Several honeycomb structures are suggested to be topological INR semimetals, including layered and "hidden" layered structures. Transitions between the three types of INRs, named as α, β, and γ type, can be driven by external strains in these structures. The resulting surface states and Landau-level structures, more complicated than those resulting from a simple nodal loop, are also discussed.


[Rare complications of the double-curved J ureteral stent].
The authors reported two cases of failure of the double-curved ureteral stent. The first is a spontaneous breakage and the second is migration downward and stone formation. The two polyurethane stend had been supported respectively 24 months and 15 months. The first case had been treated with endourology and the second with surgery.


The total and HDL-cholesterol levels in populations of St. Petersburg (Russia) and Leipzig (Germany).
In the early 90s an increase in coronary heart disease (CHD) mortality in post-communist countries was observed. Based on the lipid theory of the pathogenesis of atherosclerosis, we looked to see whether these changes were accompanied by changes in blood lipid profiles and how lipid levels are related in a post-communist country with a relatively high standard of living (East Germany) and a country still facing economic troubles (Russia). This investigation was conducted in 1995-1997 by a cooperative program between the Department of Clinical Chemistry and Pathobiochemistry, University of Leipzig, Leipzig, Germany and the Department of Biochemistry, Institute for Experimental Medicine, St. Petersburg, Russia. The Russian part of the study included 1646 subjects and the German part 3189 subjects. The blood lipids were measured using a dry-chemistry analyzer (Reflotron). Russian and German males had almost the same level of total cholesterol with a significantly lower level of HDL-C in Russians. A significantly lower level of HDL-C was also observed in Russian females. Differences were in range 2-3 mg/dl for males and 8-13 mg/dl for females. In St. Petersburg, almost 40% of all screened young males (age < 30 yr) had hypoalphacholesterolemia. In the St. Petersburg study carried out in 1986-1988, in age group 40-49 years around 6% of those screened had HDL-C lower than 35 mg/dl. In 1995-1997 this number increased to 36%. The number of subjects with HDL-C less than 30 mg/dl in 1986-1988 was only 2.4% and in 1995-1997, 12.3%. There is a dramatic decrease in HDL-C in the Russian population, probably due to the socioeconomic factors which began to develop after the fall of communist.


Effects of local osteoprotegerin gene transfection on orthodontic root resorption during retention: an in vivo micro-CT analysis.
External root resorption (ERR) is a serious complication of orthodontic treatment. Aim of this study was to evaluate the effects of local osteoprotegerin (OPG) gene transfection on ERR during retention. Eighteen 6-week-old male Wistar rats were divided into three groups. All the rats were subjected to 2 weeks of orthodontic tooth movement followed by a 2-week retention period. During retention, the three groups of rats received local OPG gene transfection (OPG transfection group, n=6), mock vector transfection (mock group, n=6), or no injections (control group, n=6). ERR of all three groups was evaluated with in vivo micro-CT analysis at three different time points: baseline, the last day of orthodontic tooth movement, and the last day of retention. In the OPG transfection group, there was no significant difference between ERR at the baseline and ERR on the last day of retention. By the last day of retention, the repair ratio of ERR in the OPG transfection group was statistically higher in relation to the repair ratio of the other groups (p<0.001). The results indicated that local OPG gene transfection significantly enhanced the repair of ERR during retention. Local OPG gene transfection might therefore be a useful tool for ERR repair during retention.


A new paradigm of DNA synthesis: three-metal-ion catalysis.
Enzyme catalysis has been studied for over a century. How it actually occurs has not been visualized until recently. By combining in crystallo reaction and X-ray diffraction analysis of reaction intermediates, we have obtained unprecedented atomic details of the DNA synthesis process. Contrary to the established theory that enzyme-substrate complexes and transition states have identical atomic composition and catalysis occurs by the two-metal-ion mechanism, we have discovered that an additional divalent cation has to be captured en route to product formation. Unlike the canonical two metal ions, which are coordinated by DNA polymerases, this third metal ion is free of enzyme coordination. Its location between the α- and β-phosphates of dNTP suggests that the third metal ion may drive the phosphoryltransfer from the leaving group opposite to the 3'-OH nucleophile. Experimental data indicate that binding of the third metal ion may be the rate-limiting step in DNA synthesis and the free energy associated with the metal-ion binding can overcome the activation barrier to the DNA synthesis reaction.


Left ventricular diastolic function in essential hypertensive patients: influence of age and left ventricular geometry.
To evaluate diastolic dysfunction (DD) in essential hypertension and the influence of age and cardiac geometry on this parameter. Four hundred sixty essential hypertensive patients (HT) underwent Doppler echocardiography to obtain E/A wave ratio (E/A), atrial deceleration time (ADT), and isovolumetric relaxation time (IRT). All patients were grouped according to cardiac geometric patterns (NG - normal geometry; CR - concentric remodeling; CH- concentric hypertrophy; EH - eccentric hypertrophy) and to age (<40; 40 - 60; >60 years). One hundred six normotensives (NT) persons were also evaluated. A worsening of diastolic function in the HT compared with the NT, including HT with NG (E/A: NT - 1.38+/-0.03 vs HT - 1.27+/-0.02, p<0.01), was observed. A higher prevalence of DD occurred parallel to age and cardiac geometry also in the prehypertrophic groups (CR). Multiple regression analysis identified age as the most important predictor of DD (r2=0.30, p<0.01). DD was prevalent in this hypertensive population, being highly affected by age and less by heart structural parameters. DD is observed in incipient stages of hypertensive heart disease, and thus its early detection may help in the risk stratification of hypertensive patients.


Task shifting and sharing in maternal and reproductive health in low-income countries: a narrative synthesis of current evidence.
Reducing maternal mortality and providing universal access to reproductive health in resource poor settings has been severely constrained by a shortage of health workers required to deliver interventions. The aim of this article is to determine evidence to optimize health worker roles through task shifting/sharing to address Millennium Development Goal 5 and reduce maternal mortality and provide universal access to reproductive health. A narrative synthesis of peer-reviewed literature from 2000 to 2011 was undertaken with retrieved documents assessed using an inclusion/exclusion criterion and quality appraisal guided by critical assessment tools. Concepts were analysed thematically. The analysis identified a focus on clinical tasks (the delivery of obstetric surgery, anaesthesia and abortion) that were shifted to and/or shared with doctors, non-physician clinicians, nurses and midwives. Findings indicate that shifting and sharing these tasks may increase access to and availability of maternal and reproductive health (MRH) services without compromising performance or patient outcomes and may be cost effective. However, a number of issues and barriers were identified with health workers calling for improved in-service training, supervision, career progression and incentive packages to better support their practice. Collaborative approaches involving community members and health workers at all levels have the potential to deliver MRH interventions effectively if accompanied by ongoing investment in the health care system.


Regulatory mechanisms of a chemoattractant receptor on leukocytes.
Chemoattractant receptors on leukocytes initiate a number of coordinated biochemical and biological processes in a strict dose-related manner. Chemotaxis-related functions occur at low doses of chemoattractants whereas the microbicidal or secretory functions (i.e., secretion of lysosomal enzymes and superoxide anion production) require 10- to 50-fold higher concentrations. The study of the oligopeptide chemoattractant receptor on human polymorphonuclear leukocytes (PMNs) has permitted better understanding of the regulation of leukocyte function. The receptor in leukocyte membranes exists in two affinity states, which are in part interconvertible. Convertibility between a portion of the high- and low-affinity states is regulated by guanine nucleotides, which suggests that a nucleotide regulatory unit allosterically modifies receptor affinity and participates in its transduction mechanisms. Approximately one-third of the high-affinity receptors in PMN membranes are not subject to guanine nucleotide regulation. This fraction can be increased by agonist preincubation and could represent an intermediate form of the receptor before signal transduction and/or internalization. Pharmacological manipulation of viable PMNs demonstrates that the affinity and functional activity of the chemoattractant receptor can be altered in different directions by aliphatic alcohols and polyene antibiotics. The alcohols raise the receptors' affinity and enhance chemotaxis, but markedly depress chemoattractant-induced secretory mechanisms. In contrast, polyene antibiotics lower the receptors' affinity and depress chemotaxis, but enhance specific granule secretion. Thus, the chemoattractant receptors' transduction signals for chemotaxis and secretion are discrete and can be modified independently by pharmacological techniques. A relationship exists between the chemoattractant receptors' affinity and its ability to transduce signals for either chemotaxis or secretion.


A robust 3-D IVUS transducer tracking using single-plane cineangiography.
During an intravascular ultrasound (IVUS) intervention, a catheter with an ultrasound transducer is introduced in the body through a blood vessel, and then, pulled back to image a sequence of vessel cross sections. Unfortunately, there is no 3-D information about the position and orientation of these cross-section planes, which makes them less informative. To position the IVUS images in space, some researchers have proposed complex stereoscopic procedures relying on biplane angiography to get two X-ray image sequences of the IVUS transducer trajectory along the catheter. To simplify this procedure, we and others have elaborated algorithms to recover the transducer 3-D trajectory with only a single view X-ray image sequence. In this paper, we present an improved method that provides both automated 2-D and 3-D transducer tracking based on pullback speed as a priori information. The proposed algorithm is robust to erratic pullback speed and is more accurate than the previous single-plane 3-D tracking methods.


Chronic, active Epstein-Barr virus infection.
Chronic active Epstein-Barr virus (EBV) infection is an uncommon outcome of EBV infection and may present as a waxing and waning or fulminant syndrome. Unlike acute infectious mononucleosis, wherein EBV establishes lifelong infection and survives by maintaining a delicate balance with the host as a latent infection, in chronic active EBV infection the host-virus balance is disturbed. The mechanisms by which this balance becomes perturbed are likely to be heterogenous and may involve host immune factors, viral factors, or both. A number of subtle immunologic defects have been reported in patients with chronic active EBV infection. Enhanced expression of viral genes has also been noted in some cases. Treatment of chronic active EBV infection has proven difficult, but new modalities including etoposide-based regimens and adoptive transfer of EBV-specific cytotoxic T lymphocytes have shown promise.


Simple, inexpensive mass spectrometric analyzer for thermogravimetry.
A low-cost mass spectrometer attachment for thermogravimetric analysis has been constructed from readily available commercial instruments and components. The benefits of this set-up include excellent mass-flow repeatability, simple design, and significantly lower adoption cost as opposed to ready-built commercial solutions. The inclusion of an open source software package allows semi-automated, highly simplified data analysis. The results from the instrument show excellent sensitivity for small volumes of evolved gas, as well as highly reproducible signal strengths. The GUI-based software package provides data analysis in a way that is very intuitive and that can be easily modified to work with a broad range of TG instruments.


Cancer of the male genital tract in Circumpolar Inuit.
In an international collaboration project we combined cancers of the male genital tract among Inuit identified from routine cancer registry systems in the Circumpolar region (Alaska, Canada and Greenland) and compared incidence rates with rates in Denmark, Connecticut (USA) and Canadian non-Inuit. We observed a low risk of prostate cancer (standardized incidence ratio (SIR) 0.2-0.3) and the incidence rate of 7.8 per 100 000 (world standard) is among the lowest in the world. Dietary and not diagnostic factors are likely explanations of this finding. Testicular cancer also occurred with low rates (SIR 0.3-0.7) although only significantly so when compared with Denmark and Connecticut (USA) which have some of the world's highest incidence rates of this cancer. Penile cancer occurred with relatively high risk (SIR 1.8-3.0) based on rates among non-Inuit. The incidence is, however, lower than anticipated considering the possibility for shared risk factors with cancer of the uterine cervix.


Postnatal changes in beta-adrenoceptors in the lung and the effect of hypoxia induced pulmonary hypertension of the newborn.
1. beta-adrenoceptor activation leads to pulmonary vasodilatation. The increase in circulating catecholamines at birth may assist the postnatal fall in vascular resistance by their activation. To study beta(1)- and beta(2)-adrenoceptors during postnatal adaptation, we used [(125)I]-iodocyanopindolol (ICYP) binding to lung membranes and sections to quantify and locate the binding sites in piglets from birth to 14 days of age and compared them with those in adult pigs. In addition, pulmonary hypertension was induced in newborn piglets by hypobaric hypoxia. 2. In lung membranes the equilibrium dissociation constant (K(d)) did not change with age for total beta-adrenoceptors or for beta(2)-adrenoceptors, but there was a significant increase in maximum binding sites (B(max)) between birth and 3 days of age. On tissue sections, B(max) increased between 3 days and adulthood with no change in K(d). 3. Binding sites of beta(1)- and beta(2)-adrenoceptors were localized to the bronchial epithelium, to endothelium of extra- and intra-pulmonary arteries and to lung parenchyma. Total beta-adrenoceptor density increased with age at all locations (P<0.05 - 0.01). At birth intrapulmonary arteries showed no binding, beta(2)-adrenoceptors appeared on day 1 and increased up to 14 days of age. beta(1)-adrenoceptors appeared by 3 days of age and increased with age. 4. Hypobaric hypoxia from birth led to attenuation in the normal postnatal increase in receptor number, but hypoxia from 3 - 6 days did not decrease receptor density. 5. The normal postnatal increase in beta-adrenoceptors suggests a potential for catecholamine induced dilatation in the lung during adaptation which is attenuated in pulmonary hypertension.


Effects of glibenclamide on the regional haemodynamic actions of alpha-trinositol and its influence on responses to vasodilators in conscious rats.
1. In conscious rats, alpha-trinositol (D-myo-inositol-1, 2, 6 triphosphate; 5-80 mg kg-1 h-1 infusion) caused dose-dependent hypotension, tachycardia and hyperaemic dilatation in renal, mesenteric and hindquarters vascular beds. These effects were accompanied by inhibition of the renal vasodilator effects of acetylcholine (ACh), and of the mesenteric vasodilator effects of sodium nitroprusside (SNP) and, particularly, of levcromakalim (LCK). 2. In the light of the latter finding, in a second experiment, we assessed the influence of the KATP channel inhibitor, glibenclamide (20 mg kg-1), on resting haemodynamics, on responses to ACh, bradykinin (BK), SNP and LCK, on the haemodynamic action of alpha-trinositol, and on the effects of the latter on responses to the vasodilators, over a period of 3 days. 3. In the presence of saline, glibenclamide caused a reproducible pressor effect, accompanied by renal, mesenteric, and hindquarters vasoconstrictions on all 3 experimental days; these effects were unrelated to changes in blood glucose. In the presence of glibenclamide, only the hindquarters vasodilator response to BK, and all the cardiovascular actions of LCK were inhibited. 4. On the first experimental day, the hindquarters vasodilator effect of alpha-trinositol was substantially inhibited by glibenclamide, the renal vasodilatation less so, and the mesenteric vasodilatation not at all. However, over the subsequent two days, the mesenteric vasodilator effect of alpha-trinositol became increasingly sensitive to glibenclamide. 5. In the presence of alpha-trinositol and glibenclamide, on the first experimental day, the inhibition of the renal vasodilator effect of ACh was no greater than with alpha-trinositol alone in the first experiment. Moreover, on the third experimental day, both before and after glibenclamide, the inhibition by alpha-trinositol of the renal vasodilator response to ACh was less than on the first experimental day. Similarly, the alpha-trinositol-induced inhibition of the mesenteric vasodilator effect of SNP, and of the hindquarters vasodilator action of BK, waned over the 3 experimental days. The inhibition of the cardiovascular effects of LCK were similar on all 3 experimental days, but no greater in the presence of alpha-trinositol and glibenclamide than with glibenclamide alone. 6. These results indicate that KATP channels are involved in the maintenance of resting vasodilator tone in renal, mesenteric and hindquarters vascular beds. However, although additional activation of KATP channels is responsible for all the haemodynamic effects of LCK, it contributes only to the hindquarters vasodilator action of BK and is not involved in any of the responses to ACh or SNP. The hindquarters, renal and mesenteric vasodilator effects of alpha-trinositol may involve (in the same rank order) activation of KATP channels, probably through an indirect mechanism. However, it is unlikely that direct or indirect interaction of alpha-trinositol with KATP channels explains the ability of the drug to inhibit the renal vasodilator action of ACh, or the mesenteric vasodilator effects of SNP or LCK.


Hydrolytic biotransformation of the bumetanide ester prodrug DIMAEB to bumetanide by esterases in neonatal human and rat serum and neonatal rat brain-A new treatment strategy for neonatal seizures?
The loop diuretic bumetanide has been proposed previously as an adjunct treatment for neonatal seizures because bumetanide is thought to potentiate the action of γ-aminobutyric acid (GABA)ergic drugs such as phenobarbital by preventing abnormal intracellular accumulation of chloride and the subsequent "GABA shift." However, a clinical trial in neonates failed to demonstrate such a synergistic effect of bumetanide, most likely because this drug only poorly penetrates into the brain. This prompted us to develop lipophilic prodrugs of bumetanide, such as the N,N-dimethylaminoethyl ester of bumetanide (DIMAEB), which rapidly enter the brain where they are hydrolyzed by esterases to the parent compound, as demonstrated previously by us in adult rodents. However, it is not known whether esterase activity in neonates is sufficient to hydrolyze ester prodrugs such as DIMAEB. In the present study, we examined whether esterases in neonatal serum of healthy term infants are capable of hydrolyzing DIMAEB to bumetanide and whether this activity is different from the serum of adults. Furthermore, to extrapolate the findings to brain tissue, we performed experiments with brain tissue and serum of neonatal and adult rats. Serum from 1- to 2-day-old infants was capable of hydrolyzing DIMAEB to bumetanide at a rate similar to that of serum from adult individuals. Similarly, serum and brain tissue of neonatal rats rapidly hydrolyzed DIMAEB to bumetanide. These data provide a prerequisite for further evaluating the potential of bumetanide prodrugs as add-on therapy to phenobarbital and other antiseizure drugs as a new strategy for improving pharmacotherapy of neonatal seizures.


Genomic Tools and Animal Health.
Animals have been selected to improve their productivity in order to increase the profitability to the producer. In this scenario, not much attention was given to health traits. As a consequence of that, selection was made for animals with higher production and a shortened productive life. In addition to that, the intense production system used in livestock has forced animals to be exposed to higher pathogen loads, therefore predisposing them to infections. Infectious diseases are known to be caused by micro-organisms that are able to infect and colonize the host, affecting their physiological functions and causing problems in their production and on animal welfare. Even with the best management practices, diseases are still the most important cause of economic losses in the animal industry. In this review article we have addressed the new tools that could be used to select animals to better cope with diseases and pathogens.


Case Report: Rare site for intraoral meningioma.
Extracranial meningioma is very rare with few cases reported, especially in the oral cavity. Its diagnosis is considered a challenge owing to the unusual site of occurrence. We report, to the best of our knowledge, the first case of extra-cranial meningioma as a primary tumor in the hard palate with no detected intracranial extension. A 59-year-old Egyptian female patient presented with a 22-year history of a large painless swelling at the right side of the hard palate, which could not be seen on radiographs. An incisional biopsy was taken and, after assessment with a panel of immunohistochemical markers, the lesion was diagnosed as extracranical grade I mengiothelial meningioma. The patient did not show up for surgical excision and follow-up was not performed because of the lose of contact with the patient. Intraoral meningioma is a rare tumor. Immuohistochemical markers are important for confirming this diagnosis.


Ultrastructural immunogold localization of tumor necrosis factor-alpha to the matrix compartment of eosinophil secondary granules in patients with idiopathic hypereosinophilic syndrome.
Peripheral blood eosinophils from two normal donors and two patients with the hypereosinophilic syndrome (HES) were analyzed with a post-embedding immunogold method to detect the substructural location of tumor necrosis factor-alpha (TNF-alpha). In eosinophils of HES patients, TNF-alpha was localized to the matrix compartment of 64% of the specific secondary granules. Other structures in the HES eosinophils were unlabeled. No TNF-alpha was detected in eosinophils of normal donors. These studies document the first ultrastructural subcellular localization of any cytokine within the major population of secretory granules in human eosinophils and support other lines of evidence indicating that the expression of TNF-alpha may be greater in the eosinophils of HES patients than in those of normal donors.


Iterative method for zero-order suppression in off-axis digital holography.
We propose a method to suppress the so-called zero-order term in a hologram, based on an iterative principle. During the hologram acquisition process, the encoded information includes the intensities of the two beams creating the interference pattern, which do not contain information about the recorded complex wavefront, and that can disrupt the reconstructed signal. The proposed method selectively suppresses the zero-order term by employing the information obtained during wavefront reconstruction in an iterative procedure, thus enabling its suppression without any a priori knowledge about the object. The method is analyzed analytically and its convergence is studied. Then, its performance is shown experimentally. Its robustness is assessed by applying the procedure on various types of holograms, such as topographic images of microscopic specimens or speckle holograms.


[The Bartter-like syndrome in 2 twins].
We present a case of two twins, admitted to our department at the age of 9 years and 9 months for poor stature-ponderal growth. Hematochemical tests showed hypokalemia, hypomagnesemia, metabolic alkalosis, renin increase, normal aldosterone values, hypocalciuria. Arterial pressure values were normal in both patients. Renal hypokalemia with metabolic alkalosis was hypothesized and therefore tubular functions during diuresis induced by intravenous 5% dextrose in water were evaluated and fractionated tubular resorption values of chlorides were identified. The two patients presented many characteristics typical of Bartter syndrome (suggestive facies, short stature, hypokalemia, metabolic alkalosis, renin increase, decreased chloride resorption) and of Gitelman syndrome (late onset, few symptoms, hypomagnesemia, hypocalciuria, normal renal concentration). The definition "Bartter-like syndrome" seems to be more suitable for these patients, since it can include all the clinical characteristics and biochemical anomalies observed.


Mass spectrometric analysis of activity-dependent changes of neuropeptide profile in the snail, Helix pomatia.
Terrestrial snails are able to transform themselves into inactivity ceasing their behavioral activity under unfavorable environmental conditions. In the present study, we report on the activity-dependent changes of the peptide and/or polypeptide profile in the brain and hemolymph of the snail, Helix pomatia, using MALDI TOF and quadrupole mass spectrometry. The present data indicate that the snails respond to low temperature by increasing or decreasing the output of selected peptides. Average mass spectra of the brain and hemolymph revealed numerous peaks predominantly present during the active state (19 and 10 peptides/polypeptides, respectively), while others were observed only during hibernation (11 and 13). However, there were peptides and/or polypeptides or their fragments present irrespective of the activity states (49 and 18). The intensity of fourteen peaks that correspond to previously identified neuropeptides varied in the brain of active snails compared to those of hibernating animals. Among those the intensity of eight peptides increased significantly in active animals while in hibernated animals the intensity of another six peptides increased significantly. A new peptide or peptide fragment at m/z 1110.7 was identified in a brain of the snail with the following suggested amino acid sequence: GSGASGSMPATTS. This peptide was found to be more abundant in active animals because the intensity of the peptide was significantly higher compared to hibernating animals. In summary, our results revealed substantial differences in the peptide/polypeptide profile of the brain and hemolymph of active and hibernating snails suggesting a possible contribution of peptides in the process of hibernation.


Identification of 8-hydroxyguanine glycosylase activity in mammalian tissues using 8-hydroxyguanine specific monoclonal antibody.
Here we report the finding of glycosylase activity in mammalian tissues to remove 8-hydroxyguanine residues from DNA. To detect this activity, a synthetic duplex DNA containing an 8-hydroxyguanine residue was used as the substrate, and before the product was analyzed by HPLC-electrochemical detection (ECD), 8-hydroxyguanine released by the enzymatic action was specifically collected from reactions using immunoaffinity columns of 8-hydroxyguanine specific monoclonal antibody. With the application of immunoaffinity column chromatography, a single peak of 8-hydroxyguanine free from many interfering peaks of unknown origin was clearly demonstrated in HPLC-ECD even with crude tissue extracts used as assay materials. All the tissues of the rats examined showed the activity, suggesting its presence is ubiquitous. The present coupled technique of immunoaffinity column chromatography and HPLC-ECD will be very useful to many future studies of 8-hydroxyguanine glycosylase such as its activity detection, characterization and purification, etc.


Atomic Layer Deposition of Ruthenium with TiN Interface for Sub-10 nm Advanced Interconnects beyond Copper.
Atomic layer deposition of ruthenium is studied as a barrierless metallization solution for future sub-10 nm interconnect technology nodes. We demonstrate the void-free filling in sub-10 nm wide single damascene lines using an ALD process in combination with 2.5 Å of ALD TiN interface and postdeposition annealing. At such small dimensions, the ruthenium effective resistance depends less on the scaling than that of Cu/barrier systems. Ruthenium effective resistance potentially crosses the Cu curve at 14 and 10 nm according to the semiempirical interconnect resistance model for advanced technology nodes. These extremely scaled ruthenium lines show excellent electromigration behavior. Time-dependent dielectric breakdown measurements reveal negligible ruthenium ion drift into low-κ dielectrics up to 200 °C, demonstrating that ruthenium can be used as a barrierless metallization in interconnects. These results indicate that ruthenium is highly promising as a replacement to Cu as the metallization solution for future technology nodes.


The Antimicrobial Activity of (-)-Epigallocatehin-3-Gallate and Green Tea Extracts against Pseudomonas aeruginosa and Escherichia coli Isolated from Skin Wounds.
Skin infections with Gram-negative bacteria are sometimes challenging to treat, because these bacteria show multidrug resistance against commonly used antibiotics and patients with Gram-negative bacterial infection overall have deteriorated in conditions in many cases. Studies have shown that epigallocatechin gallate (EGCG) and green tea extracts (GTE) inhibit the growth of several Gram-positive bacteria species. The purpose of this study was to investigate the minimum inhibitory concentrations (MICs) of EGCG and GTE in Pseudomonas aeruginosa and Escherichia coli, and assess the use of these chemicals as an alternative or adjunct topical antimicrobial agent against P. aeruginosa and E. coli with multidrug resistance. The MICs of EGCG, GTE, and other tested antibiotics were measured and compared to determine the antibacterial efficacy and the differences in pattern of resistance. The P. aeruginosa and E. coli strains used in this study showed multidrug resistance. EGCG inhibited the growth of P. aeruginosa at a MIC level of 200~400 µg/ml. The MIC of GTE was a 1 : 16 dilution for P. aeruginosa. EGCG showed antimicrobial activity against E. coli at a MIC of 400 µg/ml. In the case of GTE, the MIC was a dilution between 1:8 and 1:4 for E. coli. EGCG and GTE showed potential as alternative or adjunct topical antimicrobial agents for infections that are resistant to traditional antibiotic therapy.


Metabolism of key atmospheric volatile organic compounds by the marine heterotrophic bacterium Pelagibacter HTCC1062 (SAR11).
Plants and phytoplankton are natural sources of the volatile organic compounds (VOCs) acetone and isoprene, which are reactive and can alter atmospheric chemistry. In earlier research we reported that, when co-cultured with a diatom, the marine bacterium Pelagibacter (strain HTCC1062; 'SAR11 clade') reduced the concentration of compounds tentatively identified as acetone and isoprene. In this study, experiments with Pelagibacter monocultures confirmed that these cells are capable of metabolizing acetone and isoprene at rates similar to bacterial communities in seawater and high enough to consume substantial fractions of the total marine acetone and isoprene budgets if extrapolated to global SAR11 populations. Homologues of an acetone/cyclohexanone monooxygenase were identified in the HTCC1062 genome and in the genomes of a wide variety of other abundant marine taxa, and were expressed at substantial levels (c. 10-4 of transcripts) across TARA oceans metatranscriptomes from ocean surface samples. The HTCC1062 genome lacks the canonical isoprene degradation pathway, suggesting an unknown alternative biochemical pathway is used by these cells for isoprene uptake. Fosmidomycin, an inhibitor of bacterial isoprenoid biosynthesis, blocked HTCC1062 growth, but the cells were rescued when isoprene was added to the culture, indicating SAR11 cells may be capable of synthesizing isoprenoid compounds from exogenous isoprene.


Insight into Noninvasive Radiological Modalities to Detect Heart Transplant Rejection.
Purpose Patients with end-stage heart failure who remain symptomatic even with exemplary medical and device therapy are treated with heart transplantation. Multitudes of endeavor have been contrived during the last decennium in the field of noninvasive tests to rule out heart transplant rejection (HTR). In spite of having supportive literature, noninvasive imaging techniques lack acceptable documentation of clinical robustness, and endomyocardial biopsy (EMB) still remains the gold standard. The aim of this review is to shed light on the existing noninvasive radiological modalities to detect rejection among heart transplant recipients. Methods A comprehensive search was conducted for this review article on the basis of literature available including scientific databases of PubMed, Embase, and Google Scholar, using keywords of "Heart transplantation," "Acute allograft rejection," "Arrhythmias," "Echocardiography," "Speckle tracking echocardiography," and "Cardiac magnetic resonance imaging" from inception until September 2020. Results After preliminary screening of the databases, details regarding existent noninvasive radiological modalities to detect HTR were gathered and compiled in this review article. Currently, deformation imaging using speckle tracking and T2 time using cardiac magnetic resonance imaging can serve as screening tools based on which further invasive investigations can be planned. Standardization of blood-based and imaging modalities as screening and possible diagnostic tools for rejection would have obvious clinical and financial benefits in the care of growing number of post heart transplant recipients in our country. Conclusion Diagnosis of allograft rejection in heart transplant recipients through noninvasive techniques is demanding. To unravel the potential of noninvasive radiological modalities that can serve as a standard-of-care test, a prospective multicentric study randomizing noninvasive modality as first strategy versus current EMB-based gold standard of care is the need of the hour.


Density matrix for the kink ground state of the ferromagnetic XXZ chain.
The exact expression for the density matrix of the kink ground state of the ferromagnetic XXZ chain is obtained. Utilizing this, we exactly calculate various correlation functions such as the longitudinal and transverse spin-spin correlation functions, and the ferromagnetic and antiferromagnetic string formation probabilities. The asymptotic behaviors of these correlation functions are also analyzed. As a consequence, we find that the spin-spin correlation functions decay exponentially for large distances, while the string formation probabilities exhibit Gaussian decay for large strings. We also evaluate the entanglement entropy, which shows interesting behaviors due to the lack of the translational invariance of the state.


Involvement of Vts1, a structure-specific RNA-binding protein, in Okazaki fragment processing in yeast.
The non-essential VTS1 gene of Saccharomyces cerevisiae is highly conserved in eukaryotes and encodes a sequence- and structure-specific RNA-binding protein. The Vts1 protein has been implicated in post-transcriptional regulation of a specific set of mRNAs that contains its-binding site at their 3'-untranslated region. In this study, we identified VTS1 as a multi-copy suppressor of dna2-K1080E, a lethal mutant allele of DNA2 that lacks DNA helicase activity. The suppression was allele-specific, since overexpression of Vts1 did not suppress the temperature-dependent growth defects of dna2Delta405N devoid of the N-terminal 405-amino-acid residues. Purified recombinant Vts1 stimulated the endonuclease activity of wild-type Dna2, but not the endonuclease activity of Dna2Delta405N, indicating that the activation requires the N-terminal domain of Dna2. Stimulation of Dna2 endonuclease activity by Vts1 appeared to be the direct cause of suppression, since the multi-copy expression of Dna2-K1080E suppressed the lethality observed with its single-copy expression. We found that vts1Delta dna2Delta405N and vts1Deltadna2-7 double mutant cells displayed synergistic growth defects, in support of a functional interaction between two genes. Our results provide both in vivo and in vitro evidence that Vts1 is involved in lagging strand synthesis by modulating the Dna2 endonuclease activity that plays an essential role in Okazaki fragment processing.


Dental bacterial plaques. Nature and role in periodontal disease.
Antony van Leeuwenhoek first described oral bacteria. However, not until almost 200 years later was the famous Koch postulate introduced. Since then, research has extensively been performed regarding the development and microbiology of dental plaques. In spite of the complexity of the developing flora of supragingival plaque, culture studies have shown a remarkably orderly succession of organisms. Lately, the concept of microbial specificity in the etiology of periodontal diseases has been widely suggested, i.e., that different forms of periodontal disease are associated with qualitatively distinct dental plaques. Cross-sectional and longitudinal studies of the predominant cultivable microflora reveal that only a small number of the over 300 species found in human subgingival plaques are associated with periodontal disease. Among the commonly mentioned are: Actinobacillus actinomycetemcomitans, Bacteroides gingivalis, Bacteroides intermedius, Capnocytophaga sp., Eikenella corrodens, Fusobacterium nucleatum, and Wolinella recta, as well as certain gram-positive bacteria such as Eubacterium species. Anti-infective therapy for many systemic infections equals the use of antimicrobial drugs. However, for localized infections like periodontal diseases, treatment may consist of a combination of mechanical wound debridement and the application of an antimicrobial agent. The general effectiveness of mechanical anti-infective therapy and successful oral hygiene in the management of periodontal disease is well established in the literature and has met the test of success in clinical practice for most cases of periodontitis in adults. The definition of periodontal pathogens as either opportunistic pathogens, or as exogenous pathogens carries with it significant implications.(ABSTRACT TRUNCATED AT 250 WORDS)


Dopamine D1 receptor binding in the striatum of patients with obsessive-compulsive disorder.
Obsessive-compulsive disorder (OCD) is a chronic anxiety disorder of unknown aetiology. Psychopharmacological studies have suggested a role for the neurotransmitter serotonin however further evidence for serotonin in the aetiology of OCD is conflicted. The authors used positron emission tomography (PET) to examine the binding of the dopamine D(1) receptor antagonist [(11)C]-SCH23390 to D(1) receptors in the striatum of drug-free OCD patients compared with healthy controls. Seven drug-free patients (two drug naïve) with OCD and seven age, gender and education matched healthy controls underwent positron emission tomography with [(11)C]-SCH23390. Binding Potentials (BP) at D(1) receptors were calculated for the caudate nucleus and putamen. Correlations between BP values for basal ganglia regions and clinical measures were performed in OCD patients. The BP for [(11)C]-SCH23390 at D(1) receptors in OCD patients was significantly reduced in both caudate nucleus (0.59+/-0.06 vs 0.88+/-0.06, p<0.05) and putamen (0.89+/-0.06 vs 1.14+/-0.06, p<0.05) compared with healthy controls. No correlations were found between D(1) BP and symptom measures. The main limitations of this study are the small sample size and the PET methodology which does not allow for disaggregation of Bmax and Kd values for D(1) receptor binding of [(11)C]-SCH23390. The finding of downregulation of D(1) receptors in the striatum of OCD patients suggests increased nigrostriatal dopaminergic drive in OCD. If confirmed, this finding provides support for trials of novel treatments in OCD based on dopaminergic system blockade.


Role of Sleep Duration in the Association Between Socioecological Protective Factors and Health Risk Behaviors in Adolescents.
The purpose of this study was to examine the associations of sleep duration and socioecological protective factors with patterns of adolescent risk behaviors in Fairfax County, VA-one of the largest public school districts in the United States. A total of 21,360 and 20,330 students in 10th and 12th grades who completed the Youth Risk Behavior Survey were included in this cross-sectional analysis. Sleep duration was measured by self-report of the average number of hours of sleep on a school night. Ten socioecological protective factors included peer-individual, family, school, and community domains. Latent class analysis was used to classify 7 risk behaviors (alcohol use, cigarette use, illicit drug use, inappropriate prescription drug use, risky sexual behavior, deviant behavior, and academic failure) into 4 class memberships (low, some, moderate, and high). Multinomial regression models were adjusted for age, sex, and race. Adolescents who reported sleeping the recommended 8 to 9 hours were significantly less likely to belong to the class memberships of greater risk behaviors compared with those who reported short and long sleep duration after controlling for age, sex, race, and survey year. There was a significant inverse relationship between the number of socioecological protective factors and risk behaviors for both 10th and 12th graders. Potential risks of age, sex, and race on risk behaviors were observed. No significant interaction between sleep duration and protective factors was found in either grade. This study highlights the significant associations between sleep duration and risk behaviors in adolescents with diverse socioecological protective factors. Prioritization of prevention-focused resources should consider sleep duration in addition to the socioecological protective factors commonly cited in the literature when addressing adolescent risk behaviors.


[Sequence polymorphisms of mitochondrial DNA hypervariable 1 of peripheral blood cells from 47 HIV/AIDS patients of Han nationality].
To investigate alterations of hyper variable region 1 (HR 1) of mitochondrial DNA Blood cells were (mtDNA) in white blood cells of Chinese Han nationality HIV/AIDS patients. obtained from 47 cases of therapy-naïve HIV/AIDS patients without opportunity infection and DNA were extracted using blood DNA extracted kit. About 600 bp fragments which contain HR 1 were amplified by PCR. Alterations were determined by directed DNA sequencing. There were 124 polymorphism sites in mtDNA HR 1 (nb16024-16383) in 47 HIV/AIDS patients. The alteration rate was 0 to 20.47% (median 5.33%). 36 cases experienced C to T nucleotide change at nt 16 223, and the alteration rate was 70.97%. At nt 16 362, 26 individuals showed T to C nucleotide change and 3 individuals showed T to G alteration, alteration rate was 55.32% (26/47) and 6.38% (3/47) individually. HIV infection may cause more alterations in HR 1 regions.


Bacterial Communities of Ixodes scapularis from Central Pennsylvania, USA.
Native microbiota represent a potential resource for biocontrol of arthropod vectors. Ixodes scapularis is mostly inhabited by the endosymbiotic Rickettsia buchneri, but the composition of bacterial communities varies with life stage, fed status, and/or geographic location. We compared bacterial community diversity among I. scapularis populations sampled within a small geographic range in Central Pennsylvania. We collected and extracted DNA from ticks and sequenced amplicons of the eubacterial 16S rRNA gene from individuals and pooled samples. We then used taxon-specific PCR and/or qPCR to confirm the abundance or infection frequency of select pathogenic and symbiotic bacteria. Bacterial communities were more diverse in pools of males than females and the most abundant taxon was Rickettsia buchneri followed by Coxiellaceae (confirmed by sequencing as an unknown Rickettsiella species). High Rickettsiella titers in pools were likely due to a few heavily infected males. We determined that the infection frequency of Borrelia burgdorferi ranged from 20 to 75%. Titers of Anaplasma phagocytophilum were significantly different between sexes. Amplicon-based bacterial 16S sequencing is a powerful tool for establishing the baseline community diversity and focusing hypotheses for targeted experiments, but care should be taken not to overinterpret data based on too few individuals. We identified intracellular bacterial candidates that may be useful as targets for manipulation.


Distinct epithelial responses in experimental colitis: implications for ion uptake and mucosal protection.
In the present study, we aimed to investigate enterocyte- and goblet cell-specific functions during the different phases of acute colitis induced with dextran sulfate sodium (DSS). Rats were treated with DSS for 7 days, followed by a 7-day recovery period. Colonic tissue was excised on days 2 (onset of disease), 7 (active disease), and 14 (regenerative phase). Enterocyte functions were studied by the expression of carbonic anhydrases (CAs), sodium/hydrogen exchangers (NHEs) and intestinal fatty acid-binding protein (iFABP) and by alkaline phosphatase (AP) activity. The expression and secretion of the mucin Muc2 and trefoil factor family peptide-3 (TFF3) were used as parameters for goblet cell function. DSS induced a downregulation of the CAs, NHEs, and iFABP in some normal-appearing surface enterocytes and in most of the flattened-surface enterocytes during disease onset and active disease. During the regenerative phase most enterocytes expressed these genes again. Quantitative analysis revealed a significant decrease in CAs, NHEs, and iFABP expression levels during onset and active disease. During the regenerative phase, the expression levels of the CAs were restored, whereas the expression levels of the NHEs and iFABP remained decreased. In contrast, enterocyte-specific AP activity was maintained in normal and flattened enterocytes during DSS-induced colitis. Goblet cells continued to express MUC2 and TFF3 during and after DSS treatment. Moreover, Muc2 and TFF3 expression and secretion levels were maintained or even increased during each of the DSS-induced disease phases. In conclusion, DSS-induced colitis was associated with decreased expression of CAs, NHEs, and iFABP. The loss of these genes possibly accounts for some of the pathology seen in colitis. The maintenance or upregulation of Muc2 and TFF3 synthesis and secretion levels implies that goblet cells at least maintain their epithelial defense and repair capacity during acute inflammation induced by DSS.


Effects of the angiotensin converting enzyme inhibitor enalapril compared with diuretic therapy in elderly hypertensive patients.
The aim of this study was to evaluate the usefulness of the angiotensin converting enzyme (ACE) inhibitor enalapril in a group of 30 patients (mean age 73.3 years) with moderate hypertension and normal haematological and chemical parameters (170 +/- 8.1 mmHg systolic and 104 +/- 5.8 mmHg diastolic blood pressure), who were receiving diuretic therapy with chlorthalidone (12.5 mg/day). This therapy caused a significant decrease in systolic and diastolic blood pressure (to 165 +/- 6.7 and 98 +/- 4.7 mmHg, respectively; P less than 0.001) but it also induced hypokalaemia (3.04 +/- 0.7 mmol/l; P less than 0.001) and multiple (greater than 10/h) and complex premature ventricular depolarizations (2nd, 3rd and 4th Lown grade). Enalapril treatment (5 mg/day for 5 days and 10 mg thereafter) was added to the diuretic therapy and after 2 months a further decrease in blood pressure was observed (to 158 +/- 5.6 mmHg systolic, P less than 0.001; 87.2 +/- 5.0 mmHg diastolic, P less than 0.001). Moreover, there was a significant reduction in the mean heart rate (from 79 to 72 beats/min, P less than 0.005) and an increase in serum potassium (to 4.19 +/- 0.2 mmol/l; P less than 0.001). In 80% of patients a 24-h dynamic electrocardiogram showed a significant reduction in both the number and complexity of premature ventricular depolarizations. Our findings suggest that ACE inhibitors can be useful in patients developing hypokalaemia during therapy. However, we are not yet able to explain the beneficial effects of enalapril in decreasing the frequency of premature ventricular depolarizations.


Amino-Li-Resin-A Fiber Polyacrylamide Resin for Solid-Phase Peptide Synthesis.
Amino-Li-resin is a new and unique polyacrylamide resin presented in the form of fibers and is found to be well suited for solid-phase peptide chemistry. Although amino-Li-resin swells much better in polar solvents, it is also compatible with some non-polar solvents. It comes with a high loading of functional amino groups, thus maximizing its productivity in terms of the amount of peptide per gram of resin. In addition to its mechanical stability, this resin shows excellent stability in basic and acidic reagents; thus, allowing its broad applicability for the synthesis of a wide range of biomolecules. Finally, the appropriateness of amino-Li-resin for solid-phase peptide synthesis (SPPS) has been demonstrated for the synthesis of several model peptides, including difficult sequences and those containing hindered amino acids, all of which afforded excellent crude purity, as shown by high-performance liquid chromatography (HPLC) analysis.


Reoperation for small bowel obstruction--how critical is the timing?
The timing of reoperation for small bowel obstruction is a topic of significant debate. Any patient with evidence of strangulation should undergo urgent surgical intervention. However, predicting strangulation can be difficult. Because of this, previous authors have recommended everything from emergency operation for all patients presenting with small bowel obstruction to periods of observation that extend up to 14 days. Over the past century, the primary etiology of small bowel obstruction has shifted from hernias to postoperative adhesive disease, leading to a shift in the management paradigm. To manage small bowel obstruction successfully today, the clinician must distinguish the patient requiring urgent operation from those who benefit from nonoperative management. Furthermore, the clinician must be able to determine the appropriate length of time for conservative management. In this article we review the significant body of literature on this topic including the diagnostic workup and timing of potential operative intervention in the patient with small bowel obstruction.


Practical strategies for leading an effective group. Balancing power, participation, and problem-solving.
How can you more effectively lead your group? In today's world of rapid technological and social change, where Thriving on Chaos is the best-selling management book, group work is not a luxury, but a necessity. Although some employees naturally prefer working alone, we all must function effectively in group settings. To lead a group well, the leader needs to be sensitive to three critical variables: participation, power, and problem-solving. Balancing these processes becomes the key to effective performance. The leader must pay close attention to what is happening within the group and make specific interventions to more effectively distribute the skills and energies of the members. Making every group member a significant contributor takes skill but results in more accurate decisions and greater commitment. The group leader is the facilitator, charged with managing the problem-solving process and leading the group to the most productive, objective outcome. This article supplies many practical, corrective strategies for moving your group in a more positive direction.


A tether controlled exo-selective trans-annular Diels-Alder (TADA) reaction.
[reaction: see text] A fully substrate controlled stereoselective route to construct cis-hexahydronaphthalene 4 is described starting from nonracemic butenolide 6. The key step is an exo-selective transannular Diels-Alder reaction (TADA) of tetraene 5, whose intrinsic constraint allows selective formation of one stereodefined product. Compound 4 is a key intermediate in the synthesis of the novel antibiotic branimycin (1).


Information systems for oral health.
The global basis for an information system in oral health was introduced by WHO in 1971. Still very few countries have so far prepared a comprehensive national plan for oral health care of the entire population including an information system for monitoring and evaluation. Therefore it is important to realize that the global goals for oral health in the year 2000 introduced by WHO and FDI include a requirement to establish a national monitoring system for oral health. The WHO has developed a simple "Pathfinder' survey methodology for production of baseline data for a national plan for oral health care. This methodology has now been successfully applied in a number of countries. As a result the WHO Global Oral Data Bank contains a unique set of data on oral health worldwide. It should be understood, however, that within nations more comprehensive and sophisticated information systems are needed to support the activities related to the global goal of Health for All by the Year 2000. This paper gives a short introduction to the development of national information system for oral health utilizing statistics, records and ad hoc studies. The ultimate goal is to build a continuing surveillance system for oral health status and service organization.


Reversed halo sign in tuberous sclerosis complex.
We describe a reversed halo sign in a teenage girl with tuberous sclerosis complex (TSC). Lung manifestations of TSC include lung cysts corresponding to lymphangioleiomyomatosis and small nodules indicating multifocal micronodular pneumocyte hyperplasia (MMPH). However, a reversed halo sign in TSC has never been reported. The lesion was microscopically consistent with MMPH. Immunohistological findings also supported the notion that the lesion is associated with TSC.


Comparing and distinguishing the structure of biological branching.
Bifurcating developmental branching morphogenesis gives rise to complex organs such as the lung and the ureteric tree of the kidney. However, a few quantitative methods or tools exist to compare and distinguish, at a structural level, the critical features of these important biological systems. Here we develop novel graph alignment techniques to quantify the structural differences of rooted bifurcating trees and demonstrate their application in the analysis of developing kidneys from in normal and mutant mice. We have developed two graph based metrics: graph discordance, which measures how well the graphs representing the branching structures of distinct trees graphs can be aligned or overlayed; and graph inclusion, which measures the degree of containment of a tree graph within another. To demonstrate the application of these approaches we first benchmark the discordance metric on a data set of 32 normal and 28Tgfβ(+/-) mutant mouse ureteric trees. We find that the discordance metric better distinguishes control and mutant mouse kidneys than alternative metrics based on graph size and fingerprints - the distribution of tip depths. Using this metric we then show that the structure of the mutant trees follows the same pattern as the normal kidneys, but undergo a major delay in elaboration at later stages. Analysis of both controls and mutants using the inclusion metric gives strong support to the hypothesis that ureteric tree growth is stereotypic. Additionally, we present a new generalised multi-tree alignment algorithm that minimises the sum of pairwise graph discordance and which can be used to generate maximum consensus trees that represent the archetype for fixed developmental stages. These tools represent an advance in the analysis and quantification of branching patterns and will be invaluable in gaining a deeper understanding of the mechanisms that drive development. All code is being made available with documentation and example data with this publication.


Prevalent structural disorder in E. coli and S. cerevisiae proteomes.
Intrinsically unstructured proteins, which exist without a well-defined 3D structure, carry out essential functions and occur with high frequency, as predicted for genomes. The generality of this phenomenon, however, is questioned by the uncertainty of what fraction of genomes actually encodes for expressed proteins. Here, we used two independent bioinformatic predictors, PONDR VSL1, and IUPred, to demonstrate that disorder prevails in the recently characterized proteomes and essential proteins of E. coli and S. cerevisiae, at levels exceeding that estimated from the genomes. The S. cerevisiae proteome contains three times as much disorder as that of E. coli, with 50-60% of proteins containing at least one long (>30 residues) disordered segment. This evolutionary advance can be explained by the observation that disorder is much higher in Gene Ontology categories related to regulatory, as opposed to metabolic, functions, and also in categories unique to yeast. Thus, protein disorder is a widespread and functionally important phenomenon, which needs to be characterized in full detail for understanding complex organisms at the molecular level.


Quantum refrigeration cycles using spin-1/2 systems as the working substance.
The cycle model of a quantum refrigerator composed of two isothermal and two isomagnetic field processes is established. The working substance in the cycle consists of many noninteracting spin-1/2 systems. The performance of the cycle is investigated, based on the quantum master equation and semigroup approach. The general expressions of several important performance parameters, such as the coefficient of performance, cooling rate, and power input, are given. Especially, the case at high temperatures is analyzed in detail. The results obtained are further generalized and discussed, so that they may be directly used to describe the performance of the quantum refrigerator using spin-J systems as the working substance. Finally, the optimum characteristics of the quantum Carnot refrigerator are derived simply.


[Immunotherapy-induced endocrinopathies: Insights from the 2018 French Endocrine Society Guidelines].
The management of cancer patients has changed due to the considerably more frequent use of immune checkpoint inhibitors (ICPI). However, the use of ICPI has a risk of side-effects, particularly endocrine toxicity. Since the indications for ICPI are constantly expanding due to their efficacy, it is important that endocrinologists and oncologists know how to look for this type of toxicity and how to treat it when it arises. In view of this, the French Endocrine Society initiated the formulation of a guidance document on ICPI-related endocrine toxicity. In this paper, we summarize the main insights of experts' opinions, from an oncologist viewpoint: initial screening, monitoring, emergency situations for which immediate management by the oncologist is crucial, as well as the roles of the interactions between oncologists and endocrinologists. These points will be detailed for each endocrinopathy, i.e., dysthyroidism, hypophysitis, fulminant diabetes and primary adrenal insufficiency. In each chapter, expert opinion will be given on the diagnosis, management and monitoring for each complication. Finally, the CTCAE (Common terminology criteria for adverse events) recommendations will be discussed in view of the relatively easy management of such endocrine side-effects.