Supramalleolar osteotomy using circular external fixation with six-axis deformity correction of the distal tibia.
Supramalleolar osteotomy using circular external fixation with six-axis deformity correction is a rarely reported treatment method particularly well-suited for complex multidimensional deformities of the adult ankle. The purpose of this study was to assess the accuracy of deformity correction and change in functional status using this technique. We present a retrospective review of 52 patients who underwent supramalleolar osteotomy with application of the Taylor Spatial Frame (Smith & Nephew, Memphis, TN). Mean age was 44 (range, 18 to 79) years. The primary outcome was change in preoperative to postoperative distal tibial joint orientation angles. Coronal and sagittal plane joint orientation angles were measured for all 52 enrolled patients. The secondary outcome was change in AOFAS scores which were available for 31 patients. Twenty-two patients had oblique plane deformities. The mean time in frame was 4 (range, 2 to 11) months, and patients were followed for a mean of 14 months after frame removal. All aggregate postoperative distal tibial angles underwent a significant improvement (p < 0.05) and were within 0 degrees to 4 degrees of normal in the various deformity groups. Average preoperative AOFAS score was 40 (range, 12 to 67) and average postoperative AOFAS score was 71 (range, 34 to 97; p < 0.001). Complications included two patients with nonunions at the osteotomy site that healed with further treatment. Three patients went on to have ankle fusion. We feel that supramalleolar osteotomy using circular external fixation with six-axis deformity correction was an effective method for correction of distal tibial deformities in the adult population, particularly for those patients with complex oblique-plane deformities, associated rotational deformity, a compromised soft tissue envelope, or a prior history of infection.


Detailed oligosaccharide structures of human integrin alpha 5 beta 1 analyzed by a three-dimensional mapping technique.
Structures of N-linked oligosaccharides obtained from human integrin alpha 5 beta 1 are described. Integrin alpha 5 beta 1 (4.5 mg) was purified from human placenta and digested using trypsin and chymotrypsin. N-linked oligosaccharides were released from the glycopeptides by digestion with glycoamidase A (from almond). The reducing ends of the oligosaccharides were derivatized with 2-aminopyridine. The pyridylamino-oligosaccharides were separated and these structures were identified by a three-dimensional HPLC mapping technique on three kinds of HPLC columns [Takahashi, N., Nakagawa, H., Fujikawa, K., Kawamura, Y. & Tomiya, N. (1995) Anal. Biochem. 226, 139-146]. Finally, 35 different oligosaccharide structures were identified, 10 of which were neutral, 6 mono-sialyl, 10 di-sialyl, 7 tri-sialyl and 2 tetra-sialyl. The molar ratio of neutral, mono-sialyl, di-sialyl, tri-sialyl and tetra-sialyl oligosaccharides was 20.8%, 24.8%, 27.7%, 18.1% and 8.6%, respectively. High-mannose-type oligosaccharides accounted for only 1.5% of the total. The remaining oligosaccharides were all complex type. The most predominant structure was the diantennary di-alpha-(2,3)-sialyl fucosyl. Major linking of sialic acid was alpha-(2,3)-linkage, and over 50% of all oligosaccharides were fucosylated at the N-acetylglucosamine residue of the reducing end.


Syntheses, structures and anti-tumor activity of four new organotin(iv) carboxylates based on 2-thienylselenoacetic acid.
With the 2-thienylselenoacetic acid ligand, four new organotin complexes, [Me3Sn(O2CCH2SeC4H3S-o)]n (), [(Ph3Sn)6(O2CCH2SeC4H3S-o)6] (), [(Me2Sn)4(μ3-O)2(O2CCH2SeC4H3S-o)4] (), and [(PhSn)6(μ3-O)6(O2CCH2SeC4H3S-o)6] (), have been synthesized and characterized by X-ray crystallography, elemental analysis, FT-IR and NMR ((1)H, (13)C, and (119)Sn) spectroscopy. The structure analysis indicates that complex adopts a 1D infinite zig-zag chain structure, while complex shows a centrosymmetric hexanuclear 24-membered macrocycle. In contrast, complex and complex display ladder and drum structures, respectively. Examination of the non-covalent intermolecular contacts in complex reveals the existence of the C-HO and C-Hπ interactions, which play an important function in the supramolecular construction. These compounds are rare examples of selenium carboxylic acid-based organotin derivatives. Furthermore, the anti-tumor activity of complexes has also been studied. Importantly, the anti-proliferative properties and possible mechanism of complex are preliminarily investigated. The results demonstrate that complex could induce apoptotic cell death via accumulation of ROS and collapse of the mitochondrial membrane permeabilization (MMP).


Impact of gender, albumin, and CYP2C19 polymorphisms on valproic acid in Chinese patients: a population pharmacokinetic model.
This prospective study aimed to establish the valproic acid (VPA) population pharmacokinetic model in Chinese patients and realise personalised medication on the basis of population pharmacokinetics. The patients' clinical information and VPA plasma concentrations were collected from The General Hospital of Taiyuan Iron & Steel (Group) Corporation (TISCO). Nonlinear mixed-effect modelling was used to build the population pharmacokinetic model. To characterise the pharmacokinetic data, a one-compartment pharmacokinetic model with first-order absorption and elimination was used. The first-order conditional estimation with η-ε interaction was applied throughout the model-developing procedure. The absorption rate constant (Ka) was fixed at 2.38 hour-1, and the impact of covariates on clearance and apparent volume of distribution were also explored. Medical records of 60 inpatients were reviewed prospectively and the objective function value (OFV) of the base model and final model were 851.813 and 817.622, respectively. Gender was identified as the covariate that had a significant impact on the volume of distribution, and albumin and CYP2C19 genotypes influenced clearance. Bootstrap and VPC indicated that a reliable model had been developed that was based on the simulation results, and a simple-to-use dosage regimen table was created to guide clinicians for VPA drug dosing.


Development of a quantitative polyacrylamide gel electrophoresis analysis using a multichannel radioactivity counter for the evaluation of oligonucleotide-bound drug carrier.
A quantitative polyacrylamide gel electrophoresis (PAGE) analysis using a multichannel radioactivity counter was designed for the evaluation of 33P-labeled antisense oligonucleotide associated with polymeric drug carrier (nanoparticles). The proposed analytical method was first validated. The criteria of specificity, linearity, reliability, detection and quantification limits, and resolution power were determined. Results were compared to those obtained using liquid scintillation counting of crude samples or after solubilization of gel slices. The proposed method gave a better linearity and reliability than liquid scintillation counting of solubilized gel slices. In comparison with the liquid scintillation counting of crude samples, the method presented the advantage of being able to directly separate oligonucleotides differing by only one nucleotide in length. This method was applied for the separation of free oligonucleotides and oligonucleotides bound onto nanoparticles, allowing quantification of the amount of free and bound oligonucleotides without any further separation steps. Thus, because it is easy and rapid, the quantitative PAGE analysis using a multichannel radioactivity counter offers interesting possibilities for the characterization of oligonucleotide nanoparticles.


WYSIWYG Design of Hypnotic Line Art.
Hypnotic line art is a modern form in which white narrow curved ribbons, with the width and direction varying along each path over a black background, provide a keen sense of 3D objects regarding surface shapes and topological contours. However, the procedure of manually creating such line art work can be quite tedious and time-consuming. In this article, we present an interactive system that offers a What-You-See-Is-What-You-Get (WYSIWYG) scheme for producing hypnotic line art images by integrating and placing evenly-spaced streamlines in tensor fields. With an input picture segmented, the user just needs to sketch a few illustrative strokes to guide the construction of a tensor field for each part of the objects therein. Specifically, we propose a new method which controls, with great precision, the aesthetic layout and artistic drawing of an array of streamlines in each tensor field to emulate the style of hypnotic line art. Given several parameters for streamlines such as density, thickness, and sharpness, our system is capable of generating professional-level hypnotic line art work. With great ease of use, it allows art designers to explore a wide variety of possibilities to obtain hypnotic line art results of their own preferences.


Cytological evaluation of head and neck tumors in children--a pattern analysis.
A total of 135 pediatric head and neck tumors diagnosed in our institute were reviewed with a view to elucidate the overall cytological patterns and analyze the important cytological features. Ninety-four tumors (69.6%) were aspirated for a primary diagnosis, and in 41 (30.4%) cases, fine-needle aspiration cytology was performed to document relapse, recurrence or a metastasis. Among the 94 tumors aspirated for a primary diagnosis, 66 cases (70.2%) were accurately diagnosed, in 22 cases (23.4%) a broad working diagnosis was offered, and 6 cases (6.4%) were misdiagnosed. The accuracy rate was higher (79.3%) when relapse-recurrent and metastatic tumors were included. The smears were broadly divided into six patterns, viz. round cell, epithelial, anaplastic, giant cell, mixed inflammatory, and spindle cell patterns. The round cell pattern was the most frequent one encountered in this group. The cytological features that stood the test of variability were lymphoglandular bodies and a noncohesive cell population in hematolymphoid malignancies, pale chromatin and cytoplasmic vacuoles in primitive neuroectodermal tumor/Ewing's sarcoma (PNET/ES), neuropil and rosettes in neuroblastoma, and plasmacytoid rhabdomyoblasts in rhabdomyosarcoma. A fairly good accuracy was seen in the diagnosis of metastatic undifferentiated carcinoma and anaplastic lymphoma, but the giant-cell and spindle-cell tumors continued to pose a problem in diagnosis. Ancillary techniques such as immunocytochemistry and electron microscopy applied in limited cases helped evaluate Langerhans cell histiocytosis, alveolar rhabdomyosarcoma, and the PNET/ES family of tumors.


Inverted Proximal Ileal Loop Prolapse with Ileal Rupture through a Patent Omphalomesenteric Duct: A Rare Case.
Prolapse of the small intestine through the umbilicus is indeed a rare presentation and is the most significant complication of the patent omphalomesenteric duct which requires pediatric surgical emergency due to its significant increase of mortality. To date, it is less than twenty cases of this presentation have been reported in medical literature. We are reporting a case of the same in an infant presenting with it on 1st week after he was delivered, but was followed by ileal rupture as well. We present a case of a patent omphalomesenteric duct with ileal prolapse and ileal rupture as its complication. It is a case of a 1-year-old infant with a history of unusual bleed-on-touch mass emerging from the anterior abdominal wall with absent umbilicus. Once his condition is stabilised, he underwent a reduction of the prolapsed bowel along with complete excision of the omphalomesenteric duct and restoration of the ileal continuity. Post-operatively he regained normal bowel function and resumed breastfeeding 5 days after surgery. This case is an important addition to the literature about patent omphalomesenteric duct with complications of inverted proximal ileal loop prolapse and ileal rupture.


Cooling in intracerebral hemorrhage (CINCH) trial: protocol of a randomized German-Austrian clinical trial.
Intracerebral hemorrhage accounts for up to 15% of all strokes and is frequently associated with poor functional outcome and high mortality. So far, there is no clear evidence for a specific therapy, apart from general stroke unit or neurointensive care and management of secondary complications. Promising experimental and pilot clinical data support the use of therapeutic hypothermia after intracerebral hemorrhage. The study aims to determine if therapeutic hypothermia improves survival rates and reduces cerebral lesion volume after large intracerebral hemorrhage compared with conventional treatment. The Cooling in IntraCerebral Hemorrhage trial is a prospective, multicenter, interventional, randomized, parallel, two-arm (1 : 1) phase II trial with blinded end-point adjudication. Enrolment: 50 patients (age: 18 to 65 years) with large (25 to 64 ml on cranial computertomography), primary intracerebral hemorrhage of the basal ganglia or thalamus within 6 to 18 h after symptom onset are randomly allocated to therapeutic hypothermia for eight-days or conventional temperature management. In the therapeutic hypothermia group, a target temperature of 35.0°C is achieved by endovascular catheters and followed by slow controlled rewarming. Data analysis is based on the intent-to-treat population. The primary outcome measure of the study is the development in total lesion volume on cranial computertomography (intracerebral hemorrhage plus perihemorrhagic edema on day 8 ± 0.5 and day 1 ± 0.5 after intracerebral hemorrhage) and the mortality after 30 days. Secondary end-points are the in-hospital mortality, mortality, and functional outcome (modified Rankin Scale and Barthel-Index) after 90 and 180 days. Safety measures include any adverse events associated with therapeutic hypothermia. In the face of a lack of evidence-based therapies for patients with large intracerebral hemorrhage, new promising approaches are desperately needed, but need evaluation in randomized controlled trials. The results of Cooling in IntraCerebral Hemorrhage trial are believed to directly influence future therapy of large intracerebral hemorrhage.


Jasmonic acid induces resistance to economically important insect pests in winter wheat.
Insect damage induces chemical changes in plants, and frequently these changes are part of a defensive response to the insect injury. Induced resistance was activated in winter wheat using a foliar application of synthetic jasmonic acid. Field trials were conducted to observe effects of jasmonic acid application on some wheat insects. Two wheat cultivars (Cubus and Tommi) were sprayed twice at growth stages (GS) 41 and 59 with two concentrations of jasmonic acid, along with control plots that were sprayed with water. There was a significant difference in the number of thrips and wheat blossom midges (WBM) among treatments in both cultivars. Plants in control plots had higher numbers of thrips and midges than in treated plots. There were higher numbers of thrips in the Tommi cultivar than in the Cubus cultivar, while the latter had higher numbers of WBM larvae than the Tommi cultivar. There was a positive correlation between WBM numbers and infested kernels in both cultivars. This study also indicated that jasmonic acid enhances the wheat yield in sprayed plots compared with control plots. The results indicate that jasmonic acid induced pest resistance in wheat plants and may act as a resistance mechanism of wheat against insect herbivores.


[A survey on prevalence of hypertension in Macao area].
To study the prevalence of hypertension and population blood pressure levels in Macao area. According to requirements set in "Manual for National Sampling Survey on Hypertension in 1991", 5,171 permanent residents aged more than 15 years in Macao area were investigated and their blood pressure measured with standardized methods and under strict quality control. The survey showed that crude prevalence rate of hypertension was 29.46 percent in Macao, 20.45 percent after standardization, and it should be categorized into a hypertension prevalent area based on the domestic criteria for hypertension categorization. Systolic and diastolic blood pressure averaged 17.18 kPa (128.82 mmHg) and 10.86 kPa (81.47 mmHg), respectively, for males and 16.32 kPa (122.38 mmHg) and 10.15 kPa (76.15 mmHg), respectively, for females, higher than those in Guangdong Province and Beijing. Prevalence in males was higher than that in females and it increased more quickly in those more than 35 years old, similar to that in the other areas at home. Prevalence in new immigrants was lower than that in the original residents. Hypertension was severely prevalent in Macao area and an important issue in public health not to be ignorant. Health education and health promotion should be strengthened to reach the primary and secondary prevention for it.


Normothermic ex situ pancreas perfusion for the preservation of porcine pancreas grafts.
Pancreas transplantation improves and extends the life of patients with insulin-dependent diabetes. Pancreata from extended criteria donors have been increasingly used due to the scarcity of available grafts. Normothermic ex situ pancreas perfusion (NESPP) can keep grafts metabolically active, potentially allowing for assessment and organ repair, and could improve outcomes of marginal grafts. A novel NESPP technique was developed and tested. Porcine pancreata were removed after a short period of warm ischemia and subjected to 6 h of NESPP. Perfusion parameters, potential graft assessment markers and graft injury were measured. Next, pancreata subjected to 3 h of NESPP were transplanted and animals were followed for up to 3 days. Graft function and injury post-transplantation were evaluated. Using this novel system of perfusion, pancreata were perfused for an extended period of time with minimal edema. Histology at the end of perfusion showed intact islet cells with only mild signs of tissue injury. NESPP transplanted grafts showed immediate function after transplantation, with glucose levels in normal range. NESPP maintains a physiologic environment and excellent graft function without causing significant graft injury. Porcine pancreas transplantation is feasible and allows for in vivo graft assessment of pancreas function and injury after NESPP.


LPS-induced effects on angiotensin I-converting enzyme expression and shedding in human pulmonary microvascular endothelial cells.
Angiotensin I-converting enzyme (kininase II, ACE, and CD143) availability is a determinant of local angiotensin and kinin concentrations and their physiological actions. Until now, it is unclear whether the decrease of pulmonary ACE activity in sepsis-described in clinical studies-is due to an enzyme compensatory downregulation (reduced ACE-mRNA expression) to shedding of ACE or endothelial damage. To address these questions, ACE distribution under septic conditions was studied in vitro by treating pulmonary microvascular endothelial cells (HPMEC) and human umbilical vein endothelial cells (HUVEC) with lipopolysaccharide from Escherichia coli (LPS). Primary isolated HUVEC and HPMEC were compared by detecting ACE activity, membrane-bound ACE, as well as shedding and mRNA production of ACE with and without LPS (1 ng/ml-1 μg/ml). ACE mRNA expression was detected by real-time PCR, and shedded ACE was measured in cell culture supernatant by ELISA. Additionally, membrane-bound protein expression was investigated by immunohistochemistry in situ. In septic ARDS, the distribution of ACE protein was significantly reduced in all lung endothelial cells (p<0.001). After stimulation with LPS, cultivated HPMEC showed more markedly than HUVEC, a concentration-dependent reduction of ACE protein expression compared to the respective untreated controls. Real-time PCR demonstrated a reduced ACE mRNA expression after LPS stimulation, predominantly in HPMEC. Specifically, in HPMEC, a concentration-dependent increase of shedded ACE was shown 24 h after LPS treatment. HPMEC cultures are an apt model for the investigation of pulmonary ACE expression in sepsis. This study suggests that reduced pulmonary microvascular endothelial ACE expression in septic ARDS is caused by two processes: (initial) increased shedding of ACE accompanied by a compensatory downregulation of ACE-mRNA and membrane-bound protein expression.


Down-regulation of GP130 signaling sensitizes bladder cancer to cisplatin by impairing Ku70 DNA repair signaling and promoting apoptosis.
Chemoresistance is one of the barriers for the development of bladder cancer treatments. Previously, we showed that glycoprotein-130 (GP130) is overexpressed in chemoresistant bladder cancer cells and that knocking down GP130 expression reduced cell viability. In our current work, we showed that down-regulation of GP130 sensitized bladder cancer cells to cisplatin-based chemotherapy by activating DNA repair signaling. We performed immunohistochemistry and demonstrated a positive correlation between the levels of Ku70, an initiator of canonical non-homologous end joining repair (c-NHEJ) and suppressor of apoptosis, and GP130 in human bladder cancer specimens. GP130 knockdown by SC144, a small molecule inhibitor, in combination with cisplatin, increased the number of DNA lesions, specifically DNA double-stranded breaks, with a subsequent increase in apoptosis and reduced cell viability. Furthermore, GP130 inhibition attenuated Ku70 expression in bladder and breast cancer cells as well as in transformed kidney cells. In addition, we fabricated a novel polymer-lipid hybrid delivery system to facilitate GP130 siRNA delivery that had a similar efficiency when compared with Lipofectamine, but induced less toxicity.


[Child nasopharyngeal angiofibroma].
Angiofibromas are benign tumors, highly vascularized, that affect male adolescents and young men. We present a clinical case of an 11-year-old patient with an angiofibroma of the nasopharynx, reviewing the etiopathogenic theories and current surgical approaches.


Efficacy of multiple low-dose photodynamic TMPYP4 therapy on cervical cancer tumour growth in nude mice.
Photodynamic therapy (PDT) is an emerging therapeutic procedure suitable for the treatment of cervical cancer. However, the side effects of PDT are severe, including skin ulceration, so we designed an experiment to examine the effects of multiple low- dose photodynamic therapy of 5, 10, 15, 20-tetrakis(1- methylpyridinium-4-yl) porphyrin (Tmpyp4) on tumour growth by utilizing a model in nude mice implanted with Hela cervical cancer cells. Female BALB/c nude mice (aged 5-6 weeks, weighing 18-20 g) were used. Hela cervical cancer cells were injected subcutaneously (1 x 10(7) cells/200 μL). Ten days after injection, the mice were divided into three groups (n=6), the A group of controls without any treatment, the B group receiving a single-treatment with Tmpyp4 (10 mg/kg, intratumor injection) and irradiation (blue laser, 108 J/cm(2)), and the C group given three-treatments with Tmpyp4 (10 mg/ kg, intratumor injection) and irradiation at intervals of two days. After starting treatment, tumours were measured every two days, to assess growth. At 2 weeks after the last treatment of C group, tumour tissue and organs were collected from each mouse to evaluate tumor histology and organ damage. Tumour growth in C group was significantly inhibited compared with A and B groups (P <0.05), without any injury to the skin and internal organs. Our novel findings demonstrated that multiple low-dose photodynamic therapy of Tmpyp4 could inhibit cervical cancer growth significantly with no apparent side effects.


Endometriosis of the pelvis presenting as hip pain. A case report.
Endometriosis is a disorder resulting from the presence of actively growing and functioning endometrial tissue in aberrant sites outside the uterus. Ectopic implantation of the endometrium can be located throughout the pelvic cavity. Depending on the location of the endometriosis, it can mimic common musculoskeletal problems, especially in young women who are menstruating. A young woman presented to an orthopaedic specialist with bilateral hip pain for the last several years. Magnetic resonance imaging subsequently was performed on both hips and showed evidence of bilateral intrapelvic endometriosis adjacent to both acetabula. The patient was seen by her gynecologist, who prescribed cyclic hormonal suppressive therapy. On followup visit to the orthopaedist, the patient's symptoms had resolved completely.


Correlation of mass spectrometry identified bacterial biomarkers from a fielded pyrolysis-gas chromatography-ion mobility spectrometry biodetector with the microbiological gram stain classification scheme.
A pyrolysis-gas chromatography-ion mobility spectrometry (Py-GC-IMS) briefcase system has been shown to detect and classify deliberately released bioaerosols in outdoor field scenarios. The bioaerosols included Gram-positive and Gram-negative bacteria, MS-2 coliphage virus, and ovalbumin protein species. However, the origin and structural identities of the pyrolysate peaks in the GC-IMS data space, their microbiological information content, and taxonomic importance with respect to biodetection have not been determined. The present work interrogates the identities of the peaks by inserting a time-of-flight mass spectrometry system in parallel with the IMS detector through a Tee connection in the GC module. Biological substances producing ion mobility peaks from the pyrolysis of microorganisms were identified by their GC retention time, matching of their electron ionization mass spectra with authentic standards, and the National Institutes for Standards and Technology mass spectral database. Strong signals from 2-pyridinecarboxamide were identified in Bacillus samples including Bacillus anthracis, and its origin was traced to the cell wall peptidoglycan macromolecule. 3-Hydroxymyristic acid is a component of lipopolysaccharides in the cell walls of Gram-negative organisms. The Gram-negative Escherichia coli organism showed significant amounts of 3-hydroxymyristic acid derivatives and degradation products in Py-GC-MS analyses. Some of the fatty acid derivatives were observed in very low abundance in the ion mobility spectra, and the higher boiling lipid species were absent. Evidence is presented that the Py-GC-ambient temperature and pressure-IMS system generates and detects bacterial biochemical information that can serve as components of a biological classification scheme directly correlated to the Gram stain reaction in microorganism taxonomy.


Vasculitis affecting the kidney: presentation, histopathology and long-term outcome.
Fifty-three patients who by clinical and/or histological criteria were judged to have vasculitis affecting the kidney were reviewed. Patients with systemic lupus or Schönlein-Henoch purpura were excluded. Segmental necrotising glomerulitis was taken as a manifestation of vasculitis ('microscopic polyarteritis'). Those patients in whom vasculitis was confined to glomerular capillaries were compared with those who in addition had vascular lesions outside the glomeruli. The two groups were found to have identical clinical features. Clinical presentation was predominantly extrarenal, and exclusively renal in only two. Three patients were classified histologically as Wegener's granulomatosis, four had malignant tumours and two relapsing polychondritis. Hepatitis B surface antigen was absent in all of 37 patients tested. Renal disease presented with microscopic haematuria and minor proteinuria in the majority (32) but 16 patients presented with rapid deterioration of renal function, including seven with anuria. Histologically 42 patients showed segmental necrotising glomerulitis ('microscopic polyarteritis'), six diffuse proliferative glomerulonephritis,and in five only minor or ischaemic glomerular changes were present. Crescents were found in 41/42 of those with segmental necrotising glomerulitis, nd involved more than 50 per cent of glomeruli in 15 patients. Immunohistochemical studies were generally negative except the fibrin. Electron microscopy showed no evidence of immune deposits in necrotising glomerulitis, but these were present in 2/6 patients with diffuse proliferative glomerulonephritis. Overall prognosis was poor, 35 patients having died, 20 early in the course of the disease and 15 later. Oligoanuria and extensive crescent formation were adverse signs. Survivals were 54, 38 and 34 per cent at one, five and 10 years respectively. Of those who survived the initial illness, 12 were stable with apparently inactive disease, whilst 16 continued to show clinical signs of activity and required treatment. A variety of treatments was employed including oral and intravenous corticosteroids, immunosuppressive agents, anticoagulants; only one patient was treated by plasmapheresis. It is difficult to draw any firm conclusions as to the efficacy of treatment and survival rates remain unsatisfactory.


Investigation of allele-specific expression of genes involved in adipogenesis and lipid metabolism suggests complex regulatory mechanisms of PPARGC1A expression in porcine fat tissues.
The expression of genes involved in regulating adipogenesis and lipid metabolism may affect economically important fatness traits in pigs. Allele-specific expression (ASE) reflects imbalance between allelic transcript levels and can be used to identify underlying cis-regulatory elements. ASE has not yet been intensively studied in pigs. The aim of this investigation was to analyze the differential allelic expression of four genes, PPARA, PPARG, SREBF1, and PPARGC1A, which are involved in the regulation of fat deposition in porcine subcutaneous and visceral fat and longissimus dorsi muscle. Quantification of allelic proportions by pyrosequencing revealed that both alleles of PPARG and SREBF1 are expressed at similar levels. PPARGC1A showed the greatest ASE imbalance in fat deposits in Polish Large White (PLW), Polish Landrace and Pietrain pigs; and PPARA in PLW pigs. Significant deviations of mean PPARGC1A allelic transcript ratio between cDNA and genomic DNA were detected in all tissues, with the most pronounced difference (p < 0.001) in visceral fat of PLW pigs. To search for potential cis-regulatory elements affecting ASE in the PPARGC1A gene we analyzed the effects of four SNPs (rs337351686, rs340650517, rs336405906 and rs345224049) in the promoter region, but none were associated with ASE in the breeds studied. DNA methylation analysis revealed significant CpG methylation differences between samples showing balanced (allelic transcript ratio ≈1) and imbalanced allelic expression for CpG site at the genomic position in chromosome 8 (SSC8): 18527678 in visceral fat (p = 0.017) and two CpG sites (SSC8:18525215, p = 0.030; SSC8:18525237, p = 0.031) in subcutaneous fat. Our analysis of differential allelic expression suggests that PPARGC1A is subjected to cis-regulation in porcine fat tissues. Further studies are necessary to identify other regulatory elements localized outside the PPARGC1A proximal promoter region.


An oxidized derivative of linoleic acid affects aldosterone secretion by adrenal cells in vitro.
Based on the clinical observation that humans with visceral adiposity have higher plasma aldosterone levels than controls, we postulated that endogenous fatty acids can be oxidized by the liver to form stimuli of the adrenal cortex. Although we could show that hepatocytes produced adrenal stimuli from linoleic acid in vitro, the yield was very small. To facilitate the elucidation of chemical structures, we incubated a large amount of linoleic acid with lipoxygenase, then treated the hydroperoxide with cysteine and iron. The major product of this process was 12,13-epoxy-9-keto-10-trans-octadecenoic acid. This epoxy-keto compound stimulated aldosterone production at concentrations from 0.5 to 15 microm. At higher concentrations, it was inhibitory. The epoxy-keto-octadecenoic acid exhibited the chromatographic characteristics of one product of the incubation of linoleic acid with hepatocytes. The results are consistent with the postulated conversion of linoleic acid to stimuli of aldosterone production. This may be a mechanistic link between visceral obesity and hypertension in humans.


[The influence of recombinant human growth hormone on the apoptosis and intestinal mucosal structure in severely scalded rats].
To explore the influence of recombinant human growth hormone (rhGH) on the apoptosis and intestinal mucosal structure in severely scalded rats. Thirty male Wistar rats were randomly divided into three groups, i.e. control, scalding and rhGH groups. The rats in scalding and rhGH groups were inflicted with 25% TBSA III degree scalding on the back and immediately followed by intraperitoneal injection of dexamethasone (80 mg/kg). The scalded rats were administered with normal saline and rhGH (1.33 IU.kg(-1).d(-1)) since 2 postburn hours (PBHs), respectively in the last two groups. The changes of the apoptosis rate, the intestinal mucosal proliferative index (PI) and epithelial ultrastructure and the intestinal mucosal pathomorphology of the distal end of ileal mucosal tissue were observed on 30 and 96 PBHs. The intestinal mucosa morphology and epithelia in scalding group were severely injured but were significantly ameliorated by rhGH to near those in control group. The PI in rhGH and scalding groups at 30 PBHs was evidently higher that that in control group (P < 0.05 - 0.01). But the PI exhibited no obvious difference between scalding and rhGH groups. While the PI in rhGH group at 96 PBHs was obviously higher than that in both scalding and control groups (P < 0.01). The intestinal mucosal epithelial apoptotic rate in scalding group was significantly higher than that in control group (P < 0.01), while that in rhGH group was evidently lower than that in scalding and control groups (P < 0.05 - 0.01). rhGH could promote postburn intestinal mucosa epithelial proliferation in slow - action manner and inhibit intestinal mucosal epithelial apoptosis with rapid and obvious effects. As a result, the intestinal mucosal epithelial injury could be ameliorated by rhGH by means of its inhibiting roles and the normal morphological structure of intestinal mucosa was maintained ad hoc.


Stem cell harvesting protocol research in autologous transplantation setting: large volume vs. conventional cytapheresis.
The use of peripheral blood as a source of hematopoietic stem cells (SCs) is progressively increasing and has nearly supplanted bone marrow transplantation. Interpatient variability in the degree and kinetics of SC mobilization into peripheral blood is an expected event after conventional chemotherapy-based treatment, followed by sequential administration of recombinant granulocyte-colony-stimulating factor (rHu-CSF). In this study, specific factors associated with the application of two different SC-harvesting approaches, including the use of large volume leukapheresis (LVL) vs. repetitive conventional apheresis (RCA), were analyzed. The basic goal of the study was to evaluate the influence of apheresis protocol (collection timing, processed blood volume and cell yield) upon the clinical outcome of transplantation. Results obtained by LVL (76 pts) and RCA (20 pts--control group) were compared. The SC mobilizing regimen used was cyclophosphamide (4-7 g/m2) or polychemotherapy and rHuG-CSF 10-16 microg/kg of body mess (bm) per day. Cell harvesting was performed using Caridian-BCT Spectra (Gambro, USA). The volume of processed blood in LVL setting was > or = 3.5-fold of the patient's circulating blood quantity (ranged from 12.7 to 37.8 l). All patients tolerated well the use of intensive treatment, without any side or adverse effects. Our original controlled-rate cryopreservation was carried out with 10% dimethyl sulfoxide (DMSO) using Planer R203/200R or Planer 560-16 equipments (Planer Products Ltd, UK). Total nucleated cell (NC) and mononuclear cell (MNC) counts were examined by flow cytometry (Advia-2120 Bayer, Germany; Technicon H-3 System, USA). The CD34+ cell surface antigen was investigated by the EPICS XL-MCL device (Coulter, Germany). Performing LVL-apheresis, high-level MNC and CD34+ cell yields (7.6 +/- 4.6 x 10(8)/kg bm and 11.8 +/- 6.5 x 10(6)/kg bm, respectively) were obtained. As a result, rapid hematopoietic reconstitution ("graft-healing")--on the 9.4th and 12.4th day for granulocytes and platelets, respectively was achieved. Using repetitive conventional apheresis (2-3 procedures), the total MNC count was high (8.2 +/- 7.0 x 10(8)/kg bm), but the total CD34+ yield was lower 10.8 +/- 9.9 due to inferior CD34+ vs. MNC ratio. The results obtained suggest that well-timed LVL-apheresis increased SC-yield in cell harvest, resulting in faster bone marrow repopulation and hematological reconstitution, as well as better overall clinical outcome of transplantation. These results necessitate additional examinations of CD34+ subsets ratio in cell harvest.


Periodic subgingival antimicrobial irrigation of periodontal pockets (I). Clinical observations.
The present investigation was undertaken to study the clinical effect of professionally performed periodic subgingival irrigation per se and as an adjunct to scaling and root planing. 10 patients suffering from moderate-severe periodontal disease participated in the study. Following an initial 3-month period of supervised supragingival plaque control, a total of 102 periodontal sites with probing pocket depth greater than or equal to 6 mm and "bleeding on probing" were selected and subjected to a Baseline examination comprising assessments of oral hygiene and gingival conditions, probing depths and probing attachment levels. The pockets in the various jaw quadrants were randomly assigned to one of the following treatment groups: (1) periodic subgingival irrigation with hydrogen peroxide, (2) periodic subgingival irrigation with chlorhexidine, (3) periodic subgingival irrigation with saline and (4) no subgingival treatment. During the first part of the study (baseline-32 weeks), no mechanical debridement of the subgingival area was performed. The irrigation treatment was carried out by the operator 3 times per week during weeks 1 + 2 and 5 + 6 of the trial. In the 2nd part of the trial (32-52 weeks), the sites were subjected to scaling and root planing combined with professional irrigation during weeks 32-38. The previously non-irrigated control sites were not subjected to adjunctive irrigation when mechanically debrided. During the entire study, the patients were recalled for professional tooth cleaning once every 4 weeks. Re-examinations were carried out at 4, 6, 32, 40 and 52 weeks. The results revealed that repeated professional irrigation of unscaled periodontal pockets with chlorhexidine or hydrogen peroxide resulted in a temporarily reduced frequency of bleeding sites, but not in any clinically significant changes in probing assessments. A similar improvement of bleeding scores was observed in the saline-irrigated control group. Scaling and root planing, in combination with an optimal supragingival plaque control, resulted in a marked resolution of the clinical symptoms of periodontal disease. Adjunctive irrigation with chlorhexidine or hydrogen peroxide did not improve the healing result above and beyond that obtained after mechanical debridement alone or in combination with saline irrigation. Hence, the study failed to demonstrate that professionally performed periodic subgingival irrigation with chlorhexidine or hydrogen peroxide, used alone or in combination with thorough mechanical debridement, has a significant therapeutic effect.


Long term follow-up and transition of care in anorectal malformations: An international survey.
The aim of the study was to assess current international practice in the long term follow-up, in managing active problems and transition of care for teenagers born with anorectal malformations (ARM). An original survey was administered to delegates attending two large colorectal surgical meetings in 2015. The 21 questions covered long term follow-up, specific issues for teenagers and transition of care. 96/236 delegates completed the survey. Follow-up was routinely suspended before 10 year of age by 33% of respondents. 90% of them did not use a scoring system to assess or risks stratify patients, despite 81% stating that an objective score would be beneficial. 40% of respondents felt that >30% of their teenagers had ongoing active medical or psychosocial issues. 42% thought their patients were not ready to be transitioned. The process of transition should start around 13-16 years according to 54% of respondents. 72% had no protocol for transition and 82% did not hold multidisciplinary meetings with adult practitioners before transition. International consensus on the following aspects of the care in ARM is needed: structured long term follow-up, objective assessment and risk stratification scores, pathways of transition and methods to prepare patients, parents and adult practitioners.


Potentiation of enediyne-induced apoptosis and differentiation by Bcl-2.
Bcl-2 overexpression has been shown to be protective against apoptosis induced by a variety of mechanistically diverse chemotherapeutic drugs. Recently, oxygen radical species have been implicated in the process of apoptosis, and Bcl-2 has been proposed to exert its protective effect by altering the redox state of the cell. Unlike most other chemotherapeutic agents, naturally occurring enediynes are rendered more cytotoxic in the presence of a higher reducing potential, because as prodrugs, they require reduction for activation. We demonstrate herein that induction of Bcl-2 expression in PC12 cells potentiates the induction of apoptosis and differentiation by the enediyne neocarzinostatin. In contradistinction, Bcl-2 abrogates the induction of apoptosis and differentiation by the autoactivating enediyne, enediyne-5, and the non-enediyne chemotherapeutic agent, cisplatin. We further demonstrate that enediyne potentiation by Bcl-2 is related to an increase in cellular glutathione. The present studies suggest that enediynes that require reductive activation might be critically useful agents in the therapy of tumors such as neuroblastomas and estrogen-responsive breast cancers, the resistance of which is related to up-regulation of Bcl-2.


Immune Cell Profiling of IFN-λ Response Shows pDCs Express Highest Level of IFN-λR1 and Are Directly Responsive via the JAK-STAT Pathway.
The interferon lambda (IFN-λ) cytokines have well-known antiviral properties, yet their contribution to immune regulation is not well understood. Epithelial cells represent the major target cell of IFN-λ; peripheral blood mononuclear cells are generally considered nonresponsive, with the exception of plasmacytoid dendritic cells (pDCs). In this study we aimed to define the potential for discrete subpopulations of cells to directly respond to IFN-λ. Analysis of peripheral blood leukocytes reveals that, while pDCs uniformly express the highest levels of IFN-λ receptor, a small proportion of B cells and monocytes also express the receptor. Nevertheless, B cells and monocytes respond poorly to IFN-λ stimulation in vitro, with minimal STAT phosphorylation and interferon-stimulated gene (ISG) induction observed. We confirm that pDCs respond to IFN-λ in vitro, upregulating their expression of pSTAT1, pSTAT3, and pSTAT5. However, we found that pDCs do not upregulate pSTAT6 in response to IFN-λ treatment. Our results highlight unique aspects of the response to IFN-λ and confirm that while the IFN-λ receptor is expressed by a small proportion of several different circulating immune cell lineages, under normal conditions only pDCs respond to IFN-λ stimulation with robust STAT phosphorylation and ISG induction. The difference in STAT6 responsiveness of pDCs to type I and type III interferons may help explain the divergence in their biological activities.


6-Phosphofructo-2-kinase/fructose-2,6-biphosphatase 4 acts as a protein kinase to regulate glioblastoma progression by activating the AKT/forkhead box O1 pathway.
Abnormal expression of 6-phosphofructo-2-kinase/fructose-2,6-biphosphatase 4 (PFKFB4) is closely related to the occurrence and development of tumors, and PFKFB4 has been shown to function as a protein kinase. However, the molecular mechanisms through which PFKFB4 functions in glioblastoma (GBM) remain poorly understood. Accordingly, in this study, we assessed the roles of PFKFB4 in GBM. Compared to in adjacent tissues, PFKFB4 was highly expressed in GBM, and its expression level was negatively correlated with the overall survival time. In addition, knockdown of PFKFB4 inhibited the proliferation and invasion of GBM cells and promoted apoptosis. In a xenograft tumor model, tumor growth was inhibited by knockdown of PFKFB4 using short hairpin RNA. Further studies demonstrated that PFKFB4 is involved in regulating the AKT signaling pathway. Thus, PFKFB4 acts as a protein kinase to regulate GBM progression by activating the AKT/forkhead box O1 pathway, which may be a potential therapeutic target in GBM.


Strain-specific effects of amphetamine on prepulse inhibition and patterns of locomotor behavior in mice.
Several reports describe substantive behavioral differences between strains of mice both at baseline and in response to pharmacological manipulations. For example, mouse strain differences have been reported in prepulse inhibition (PPI) and patterns of locomotor activity, two behavioral processes that are altered by dopamine (DA) agonists such as amphetamine. Here, we characterized acoustic and tactile startle reactivity, acoustic PPI, and both the amounts and spatial patterns of locomotor activity in C57BL/6J, 129SvEv (129S6), and 129SvJ (129X1) mice at baseline and in amphetamine dose-response studies. Because hearing loss is common in numerous strains of mice, we also assessed cross-modal PPI using a light prepulse with an airpuff startle stimulus. The results establish that these three inbred strains of mice display both intra- and cross-modal PPI, and that amphetamine decreases PPI and startle reactivity in a dose-, sensory modality-, and strain-specific manner. Furthermore, the amount of locomotor activity and the spatial pattern of motor sequences are altered differentially after treatment with amphetamine in C57BL/6J and 129X1 mice, but not in 129S6 mice. Given that amphetamine releases presynaptic DA, these findings are consistent with the role of DA in the modulation of PPI and motor patterns in mice. These findings highlight the importance of selecting appropriate strains of mice for behavioral, pharmacological, and genetic studies.


[Continuous subarachnoid analgesia and anesthesia for labor and cesarean section in a patient who had previously undergone surgery for ependymoma].
We report the case of a 38-year-old primipara who had undergone surgery 2 years earlier for an intradural ependymoma at L2-L3 and who was currently asymptomatic. A combined epidural-subarachnoid block was performed for analgesia during labor but this technique was only effective for the first 2 hours. When analgesia via epidural cannula was no longer adequate, it was decided to perform a continuous subarachnoid block. Later, the fetus's head was seen to be too large to fit through the pelvis; for cesarean section, the mother was administered fractionated doses of local anesthetic via the subarachnoid cannula until analgesia reached T4. The patient did not develop postdural puncture headache. Continuous subarachnoid anesthesia may be considered the technique of choice where the patient has a history of spinal surgery.


Ultracold collisions of O(1D) and H2: the effects of H2 vibrational excitation on the production of vibrationally and rotationally excited OH.
A quantum dynamics study of the O((1)D) + H2(v = 0 - 2, j = 0) system has been carried out using the potential energy surfaces of Dobbyn and Knowles [Mol. Phys. 91, 1107 (1997)]. A time-independent quantum mechanical method based on hyperspherical coordinates is adopted for the dynamics calculations. Energy dependent cross section, probability, and rate coefficients are computed for the elastic, inelastic, and reactive channels over collision energies ranging from the ultracold to thermal regimes and for total angular momentum quantum number J = 0. The effect of initial vibrational excitation of the H2 molecule on vibrational and rotational populations of the OH product is investigated as a function of the collision energy. Comparison of results for vibrational levels v = 0 - 2 of H2 demonstrates that the vibrational excitation of H2 and its non-reactive relaxation pathway play a minor role in the overall collisional outcome of O((1)D) and H2. It is also found that while the state-resolved product vibrational distributions are sensitive to the initial collision energy and H2 vibrational level, the product rotational distribution depicts an inverted population that is largely insensitive to initial conditions. Rate coefficients evaluated using a J-shifting approximation show reasonable agreement with available theoretical and experimental results suggesting that the J-shifting approximation may be used to evaluate the rate coefficients for O((1)D) + H2 reaction.


Accuracy of pulse oximetry in hypothermic neonates and infants undergoing cardiac surgery.
To assess the accuracy of pulse oximetry under hypothermic conditions in neonates and infants undergoing cardiac surgery, and to assess the effect of probe site as well as probe site skin temperature on the reliability of pulse oximetry. Prospective Study. Cardiac operating room and intensive care unit of children's hospital. Twenty-five infants <3 months of age undergoing cardiac surgery with cardiopulmonary bypass. Pulse oximeter readings (Sp O2) from probes placed on the hand and foot were recorded at various skin temperatures and compared with hemoximeter oxygen saturations (Sa O2) obtained on simultaneously drawn arterial blood samples. Core temperature, arterial pressure and vasodilator use were recorded simultaneously. Pulse oximetry bias (Sp O2 - Sa O2) increased to an unacceptable range (>+3% or <-3%) in 45.5% of the readings at foot probe site temperatures of <27 degrees. Pulse oximetry bias was within an acceptable range in 94.7% of the readings at temperatures >29 degrees. There was no significant difference between oximeter readings obtained from two probe sites (hand and foot). Administration of phenoxybenzamine improved the accuracy of pulse oximetry in ten infants at skin temperature of <27 degrees. Pulse oximetry readings in small infants are likely to be unreliable at skin temperatures of <27 degrees, irrespective of probe site. Intravenous phenoxybenzamine appeared to improve the accuracy of pulse oximetry at low temperatures.


Development and identification of monoclonal antibodies against parathion.
An amino-derivative of parathion was prepared and conjugated to human serum albumin (HSA) and bovine thyroglobulin (BTG) via diazonium condensation. Spleen cells producing high titer antibody were removed and fused with myeloma cells of SP2/0 origin. Using a conventional immunization protocol, we generated nine stable murine monoclonal antibodies (MAbs) producing cell lines to parathion. After four successive limiting dilutions, antibodies produced by nine clones had high affinities, ranging from 10(9) to 10(12) M(-1). These clones were found to be of IgG class and IgM class with k light chain. Subclass determination showed that the clones produced IgG(1), IgG(2a), IgG(2b), and IgM types of antibody. One clone (2H(9)) was used to establish the calibration curve with a sensitivity of 26 ng/mL, a practical working range of 46.8-6000 ng/mL parathion.


Quantitative study of phenol as a neurolytic agent in the urinary bladder.
The endoscopic subtrigonal injection of a 6% aqueous phenol solution is an effective technique for denervating the bladder but its clinical usefulness is limited by unpredictable side effects. This study explored the possibility of making this procedure safer by comparing the neurolytic effects of different concentrations and carriers of phenol. Phenol in 2.5 and 5% solutions in three different carriers (water, glycerine and oil) was injected into the rectovesical pouch in 35 rats. After 3 weeks the bladders were excised and the effects on the density of acetylcholinesterase-positive nerves were assessed in each animal using morphometric techniques. The density of enzyme-containing nerves was reduced by 20% in the phenolised animals when compared with controls. This reduction was maximum when water was used as the carrier for either 2.5 or 5% phenol solutions.


Active fixation of endocardial pacing leads: the preferred method of pediatric pacing.
Pacing system failure due to lead related problems may necessitate repositioning or explantation of the problem lead. Pediatric patients with permanent pacemakers have additional considerations that necessitate revision or explantation of pacing leads. Active fixation type leads appear to offer the physician advantages over passive fixation leads that may make them the lead of choice for use in children. We reviewed our experience with active fixation type leads to determine whether the ease with which these leads could be revised or explanted justified recommending their use in our patients. Eleven patients underwent 13 lead revisions. The time from implant to revision was a mean of 12.3 months. Six patients had previously undergone repair of a congenital heart defect. Modes of pacing were: DDD (seven); AAI (three); and VVI (one). Exposed, isodiametric leads accounted for 11/13 leads. Leads were successfully explanted in nine cases and repositioned in four cases. The only lead that could not be revised and resulted in retention was a nonisodiametric, retractable helix lead at the junction of the subclavian vein and clavicle. We conclude isodiametric active fixation leads can be safely repositioned or explanted in children and should be considered the preferred method for endocardial pacing in children.


Management of and Revitalization Strategy for Megacities Under Major Public Health Emergencies: A Case Study of Wuhan.
The outbreak of the COVID-19 pandemic in late 2019 has meant an uphill battle for city management. However, due to deficiencies in facilities and management experience, many megacities are less resilient when faced with such major public health events. Therefore, we chose Wuhan for a case study to examine five essential modules of urban management relevant to addressing the pandemic: (1) the medical and health system, (2) lifeline engineering and infrastructure, (3) community and urban management, (4) urban ecology and (5) economic development. The experience and deficiencies of each module in fighting the pandemic are analyzed, and strategies for revitalization and sustainable development in the future are proposed. The results show that in response to large-scale public health events, a comprehensive and coordinated medical system and good urban ecology can prevent the rapid spread of the epidemic. Additionally, good infrastructure and community management can maintain the operation of the city under the pandemic, and appropriate support policies are conducive to the recovery and development of the urban economy. These precedents provide insights and can serve as a reference for how to change the course of the pandemic in megacities that are still at risk, and they provide experience for responding to other pandemics.


The regulatory implications of hydroquinone for the multifunctional enzyme dehaloperoxidase-hemoglobin from Amphitrite ornata.
Hydroquinone (H2Q) has been observed to compete with the oxidation of substrates 2,4,6-tribromophenol (2,4,6-TBP) and 2,4,6-trichlorophenol (2,4,6-TCP) catalyzed by the dehaloperoxidase-hemoglobin (DHP) from Amphitrite ornata in the presence of H2O2. This competition is observed as a lag phase during which H2Q is preferentially oxidized to 1,4-benzoquinone (1,4-BQ) while totally inhibiting either 2,4,6-TBP or 2,4,6-TCP oxidation. The inhibition by H2Q is distinct from that of the native competitive inhibitor 4-bromophenol (4-BP) since H2Q is itself oxidized and its product 1,4-BQ is not an inhibitor. Thus, once H2Q is completely consumed, the inhibition is removed, and normal substrate turnover is initiated, which explains the lag phase. To probe the mechanism of lag phase, the reactions between H2Q and DHP were both studied both in the presence and in the absence of H2O2. The reversible reactions between ferric/oxyferrous DHP A and H2Q/1,4-BQ are shown to involve a proton-coupled electron transfer (PCET) mechanism, where the distal histidine His(55) serves as the proton acceptor. The pKa of the distal histidine His(55) has been determined by resonance Raman spectroscopy in order to corroborate its involvement in this mechanism. Consistent with the proposed mechanism, kinetic assays have shown that H2Q serves as a substrate for DHP that follows the Michaelis-Menten kinetics. Unlike H2Q, the product 1,4-BQ has a relatively large Ki value and therefore has negligible inhibition. This study sheds light on understanding the difference between substrate and inhibitor binding sites and regulatory implication for the peroxidase and oxygen-transporter functions in DHP. It also provides information on PCET in DHP, which is important for resolving the switching between the ferric peroxidase catalytic function and the ferrous oxygen transport function.


Antioxidant responses and reactive oxygen species generation in different body regions of the estuarine polychaeta Laeonereis acuta (Nereididae).
The aim of this study was to analyze the total antioxidant capacity (TOSC), generation of reactive oxygen species (ROS) and lipid peroxidation (LPO) in the different body regions of the estuarine polychaeta Laeonereis acuta (Nereididae) sampled at non-polluted (NOPOL) and polluted (POL) sites from Lagoa dos Patos (Southern Brazil). Organisms collected at POL during summer showed similar (p>0.05) TOSC values along the body, but worms collected at NOPOL presented higher (p<0.05) TOSC values in the posterior (P) region in respect of anterior (A) region and middle (M) region. TOSC in the P region at NOPOL was higher (p<0.05) compared with the same body region of worms at POL. In summer, ROS concentration was higher in A and M regions of worms at POL in respect of the organisms at NOPOL. During winter all the regions showed higher ROS in worms sampled at POL. It was registered absence of season influence on LPO content, but in the P region at NOPOL in summer there were lower LPO levels compared with the others regions (p<0.05). In vitro assays showed that P region, despite a higher basal ROS, presented a higher competence to cope with pro-oxidants compared with A and M regions (p<0.05), corroborating the field results. A lower proteic sulfhydril content was observed in P in respect of the other regions (p<0.05) supporting the idea of a highest oxidant condition in this region. The results indicate that worms collected at the POL site are confronted to higher ROS concentrations, affecting its antioxidant capacity, a result that depends of body regions.


Serum uric acid level increases in proportion to the severity of pulmonary thromboembolism.
Serum uric acid (UA) has been proposed as a marker for impaired oxidative metabolism and the present study investigated whether serum UA level increases in proportion to the severity of pulmonary thromboembolism (PTE) in 193 patients. Serum UA was repeatedly measured after treatment of PTE in 76 patients. Right heart catheterization was performed in a subgroup of patients (n=104). Serum UA on admission was significantly elevated in patients with acute PTE (6.2+/-2.3 mg/dl) and those with chronic PTE (7.0+/-2.1 mg/dl) compared with age-matched controls (4.5+/-0.9 mg/ml). In particular, serum UA was markedly higher in the 27 patients who died during hospitalization than in the remaining survivors (8.3+/-2.2 vs 6.5+/-2.2 mg/dl, p<0.001). In acute PTE, serum UA negatively correlated with cardiac output, but not significantly with mean pulmonary arterial pressure. In chronic PTE, serum UA negatively correlated with cardiac output and positively correlated with mean pulmonary arterial pressure. Serum UA significantly decreased from 6.7+/-2.0 to 5.8+/-1.9 mg/dl with treatment, associated with an increase in cardiac output and in PaO2. Serum UA increases in proportion to the severity of PTE, and thereby may serve as a potential indicator of the efficacy of treatment of PTE.


Sequencing of the total course of hyperthermia and irradiation.
The effect of sequencing of the total course of hyperthermia and irradiation on local tumor control was studied on a murine tumor system (RIF). The results showed a 20% control rate for the treatment arms: (a) total course of irradiation followed by total course of hyperthermia; or (b) total course of hyperthermia followed by total course of irradiation. A superior (70%) control rate was achieved when irradiation and heat were given close to each other on each session. The detailed results are presented.


Abdominoplasty flap elevation in a more superficial plane: decreasing the need for drains.
Abdominoplasty has continued to become more frequently performed in the post-bariatric surgery and aesthetic patient populations. With the increase in these procedures, there is a need to decrease the length of drains for patient comfort and postoperative recovery. The authors' hypothesis was that a more superficial plane of abdominal flap elevation during abdominoplasty would decrease the postoperative need for drains. The authors reviewed 202 consecutive abdominoplasties with 99 procedures performed using a standard suprafascial dissection (group I) and 103 procedures using a modified plane of flap elevation that preserves the thin areolar tissue along the abdominal wall (group II). Patient demographics, perioperative complications, and drain data were recorded. Patient characteristics did not differ significantly, with the mean age of group I and group II (44 +/- 8.9 years and 44 +/- 9.6 years, respectively) and body mass index of group I and group II (24 +/- 3.8 and 24 +/- 3.8, respectively) being similar. Perioperative complications included seven seromas in group I and two seromas in group II. There were two minor hematomas in group I and two minor hematomas in group II. The drains for patients in group II met criteria for removal 3 days earlier than those for group I (p < 0.0001). On average, patients in group II had drains removed at postoperative days 4 to 5. Flap elevation in a plane superficial to the standard suprafascial approach during abdominoplasty may decrease the length of time required for drains in the postoperative period in the abdominoplasty patient. Decreasing the length of time for postoperative drains may improve patient comfort and expedite recovery.


Is mechanically induced cystic endometrial hyperplasia (CEH) a suitable model for study of spontaneously occurring CEH in the uterus of the bitch?
Cystic endometrial hyperplasia (CEH) was experimentally reproduced by the intraluminal insertion of a silk wire in the uterus of metestral bitches to obtain a model for the study of spontaneously occurring CEH in the bitch. This mechanically reproduced CEH corresponded histologically very well to spontaneously occurring CEH. With respect to sex hormone receptor expressions, however, there was no similarity. In the mechanically induced CEH, progesterone receptor expression was reduced in the epithelial cells (surface epithelium and endometrial glands) and slightly increased in the stromal fibroblasts and myometrium as compared with the normal metestrus uterus. The oestrogen receptor expression in mechanically induced CEH was reduced in the epithelial cells (surface epithelium and endometrial glands) and more or less unchanged in the stromal fibroblast and myometrium as compared with the normal metestrus uterus. This is in contrast to the increased sex hormone receptor expressions in all uterine cell types, observed in spontaneously occurring CEH. The mechanically induced CEH model corresponds immunohistochemically more to early placentation and to pyometra in the bitch. Thus this experimental CEH model is not suitable for pathogenic studies of spontaneously occurring CEH in the bitch.


U.S. and Canadian internal medicine clerkship directors' opinions about teaching procedural and interpretive skills to medical students.
Although medical students gain experience in performing procedures during their clinical clerkships, which skills they should acquire remains unclear. The authors sought opinions from internal medicine clerkship directors regarding procedural and interpretive skills students should and do learn during clerkships. In 2002, the 123 members of the Clerkship Directors in Internal Medicine (CDIM) were confidentially surveyed using a 79-item questionnaire about the appropriateness of 20 procedural skills, demographics, clerkship characteristics, and curricula in procedural skills. Participants had the choice of completing a mailed paper questionnaire or an electronic version on the CDIM's Web site. After univariate analysis, adjusted comparisons among participants were made using linear regression. Surveys were completed by 89 clerkship directors (72%). Most thought that students should be taught 17 of 20 procedural skills. However, the majority thought students do not learn five of these skills. Over 80% of respondents thought students should learn: chest x-ray interpretation, electrocardiogram interpretation, phlebotomy, throat culture, blood culture, urinalysis, Pap smear, central line placement, peripheral blood smear. However, the majority thought students do not learn five of these skills. The mean of skills that should be taught and are learned were 15 (standard deviation [SD] = 3) and 12 (SD = 4), respectively. About half used formal teaching in procedures (44%), used logs (51%) and tested competency (45%). CDIM members thought medical students should be taught a variety of procedural skills but thought students fail to learn many. These findings may help prioritize which procedures to teach. It may be helpful to develop standardized curricular materials on teaching procedures.


Phosphate-activated glutaminase activity is enhanced in brain, intestine and kidneys of rats following portacaval anastomosis.
To assess whether portacaval anastomosis (PCA) in rats affects the protein expression and/or activity of glutaminase in kidneys, intestines and in three brain areas of cortex, basal ganglia and cerebellum and to explain the neurological alterations found in hepatic encephalopathy (HE). Sixteen male Wistar rats weighing 250-350 g were grouped into sham-operation control (n=8) or portacaval shunt (n=8). Twenty-eight days after the procedure, the animals were sacrificed. The duodenum, kidney and brain were removed, homogenised and mitochondria were isolated. Ammonia was measured in brain and blood. Phosphate-activated glutaminase (PAG) activity was determined by measuring ammonia production following incubation for one hour at 37 celsius degree with O-phthalaldehyde (OPA) and specific activity expressed in units per gram of protein (mukat/g of protein). Protein expression was measured by immunoblotting. Duodenal and kidney PAG activities together with protein content were significantly higher in PCA group than in control or sham-operated rats (duodenum PAG activity was 976.95+/-268.87 mukat/g of protein in PCA rats vs 429.19+/-126.92mukat/g of protein in sham-operated rats; kidneys PAG activity was 1259.18+/-228.79 mukat/g protein in PCA rats vs 669.67+/-400.8 mukat/g of protein in controls, P<0.05; duodenal protein content: 173% in PCA vs sham-operated rats; in kidneys the content of protein was 152% in PCA vs sham-operated rats). PAG activity and protein expression in PCA rats were higher in cortex and basal ganglia than those in sham-operated rats (cortex: 6646.6+/-1870.4 mukat/g of protein vs 3573.8+/-2037.4 mukat/g of protein in control rats, P<0.01; basal ganglia, PAG activity was 3657.3+/-1469.6 mukat/g of protein in PCA rats vs 2271.2+/-384 mukat/g of protein in sham operated rats, P<0.05; In the cerebellum, the PAG activity was 2471.6+/-701.4 mukat/g of protein vs 1452.9+/-567.8 mukat/g of protein in the PCA and sham rats, respectively, P<0.05; content of protein: cerebral cortex: 162%+/-40% vs 100%+/-26%, P<0.009; and basal ganglia: 140%+/-39% vs 100%+/-14%, P<0.05; but not in cerebellum: 100%+/-25% vs 100%+/-16%, P=ns). Increased PAG activity in kidney and duodenum could contribute significantly to the hyperammonaemia in PCA rats, animal model of encephalopathy. PAG is increased in non-synaptic mitochondria from the cortex and basal ganglia and could be implicated in the pathogenesis of hepatic encephalopathy. Therefore, PAG could be a possible target for the treatment of HE or liver dysfunction.


The core network in absence epilepsy. Differences in cortical and thalamic BOLD response.
We used EEG-fMRI to study epileptiform activity in a cohort of untreated children with typical absence seizures (AS). Our aim was to identify cortical and subcortical regions involved in spike and wave events and to explore the timing of activity in these regions. Eleven children with AS confirmed on video-EEG underwent EEG-fMRI. An event-related analysis of epileptiform activity was performed. Regions of interest (ROIs), identified in the event-related analysis, were used to study the time course of the blood oxygen level-dependent (BOLD) signal prior to and immediately following events of interest in these ROIs. Group analysis confirmed positive BOLD in the thalamus and negative BOLD in the lateral and mesial parietal lobe, caudate nuclei, and additionally the brainstem reticular formation. The event-related time course differed between the thalamus, the parietal cortex, and the pons and caudate nuclei. In the subcortical structures, BOLD signal change occurred at, or immediately after, electrographic onset. Importantly, in the parietal cortex, but not in other cortical regions, there was a subtle BOLD signal increase for 10 seconds prior to the onset of epileptiform activity. In children with typical AS, we have confirmed a core network of structures involved in generalized epileptiform activity that includes the reticular structures of the brainstem. Furthermore, we have identified changes in parietal BOLD signal which precede the onset of epileptiform activity, suggesting the parietal cortex has a role in the initiation of epileptiform activity.


The use of magnetic resonance in myocardial ischaemia.
Despite the efforts that have been made at an international level to identify and control cardiovascular risk factors, cardiopathies and, in particular, coronary artery disease (CAD), remain the principal cause of death in Europe and the United States. These data confirm the importance and necessity of noninvasive, reliable diagnostic imaging of early CAD. Coronary angiography is still the hinge, around which all instrumental and laboratory investigations turn, for cardiac ischaemia today. Indeed, it still holds the role of "gold standard" for the study of the coronary arterial lumina, particularly the smaller vessels due to their complex spatial geometry and because of cardiac motion. At present, with the exception of the study of the coronary arterial lumen, MR is a non-invasive examination, already capable of supplying precise global and regional function, the evaluation of the intra-cardiac flow, myocardial perfusion and the overall viability of the heart.


MicroRNA-26a Protects the Heart Against Hypertension-Induced Myocardial Fibrosis.
Background Hypertensive myocardial fibrosis (MF) is characterized by excessive deposition of extracellular matrix and cardiac fibroblast proliferation, which can lead to heart failure, malignant arrhythmia, and sudden death. In recent years, with the deepening of research, microRNAs have been found to have an important role in blood pressure control and maintaining normal ventricular structure and function. Methods and Results In this study, we first documented the downregulation of microRNA-26a (miR-26a) in the plasma and myocardium of spontaneously hypertensive rats; more importantly, miR-26a-deficient mice showed MF, whereas overexpression of miR-26a significantly prevented elevated blood pressure and inhibited MF in vivo and angiotensin II-induced fibrogenesis in cardiac fibroblasts by directly targeting connective tissue growth factor and Smad4. miR-26a inhibited cardiac fibroblast proliferation by the enhancer of zeste homolog 2/p21 pathway. Conclusions Our study identified a novel role for miR-26a in blood pressure control and hypertensive MF and provides a possible treatment strategy for miR-26a to alleviate and reverse hypertensive MF.


How have media campaigns been used to promote and discourage healthy and unhealthy beverages in the United States? A systematic scoping review to inform future research to reduce sugary beverage health risks.
Sugary beverage consumption is associated with many health risks. This study used a proof-of-concept media campaign typology to examine U.S. beverage campaigns that promoted healthy beverages and encouraged or discouraged sugary beverages. We used a three-step systematic scoping review to identify, organize, analyze, and synthesize evidence. Step 1 used Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines to search four electronic databases and gray literature through 2021. Step 2 categorized relevant media campaigns using a media campaign typology. Step 3 examined campaign evaluation outcomes. We identified 280 campaigns organized into six campaign typology categories. The media landscape was dominated by corporate marketing campaigns for branded sugary beverages (65.8%; n = 184) followed by public awareness (9.6%; n = 27), public policy (8.2%; n = 23), social marketing (7.1%; n = 20), corporate social responsibility (5.7%; n = 16), and countermarketing (3.6%; n = 10) campaigns. Evaluations for 20 unique campaigns implemented over 30 years (1992-2021) across 14 states showed reduced sugary beverage or juice and increased water or low-fat milk sales and intake. Positive short-term cognitive and mid-term retail and behavioral changes were reported. There was limited evidence for long-term policy, social norm, and population health outcomes. Future research is needed to use media campaigns in strategic communications to reduce sugary beverage health risks for Americans.


The nutrient requirements of Lactobacillus acidophilus LA-5 and their application to fermented milk.
Lactobacillus acidophilus LA-5 is a suitable probiotic for food application, but because of its slow growth in milk, an increase in its efficiency is desired. To shorten the time required for fermentation, the nutrient requirements of L. acidophilus LA-5 were analyzed, including the patterns of consumption of amino acids, purines, pyrimidines, vitamins, and metal ions. The nutrients required by L. acidophilus LA-5 were Asn, Asp, Cys, Leu, Met, riboflavin, guanine, uracil, and Mn2+, and when they were added to milk, the fermentation time of fermented milk prepared by L. acidophilus LA-5 alone was shortened by 9 h, with high viable cell counts that were maintained during storage of nutrient-supplemented fermented milk compared with the control. For fermented milk prepared by fermentation with Streptococcus thermophilus, Lactobacillus delbrueckii ssp. bulgaricus, and L. acidophilus LA-5, viable cell counts of L. acidophilus LA-5 increased 1.3-fold and were maintained during storage of nutrient-supplemented fermented milk compared with the control. Adding nutrients had no negative effect on the quality of the fermented milk. The results indicated that suitable nutrients enhanced the growth of L. acidophilus LA-5 and increased its viable cell counts in fermented milk prepared by L. acidophilus LA-5 alone and mixed starter culture, respectively.


Urinary cytologic abnormalities in bone marrow transplant recipients of cyclosporin.
The role of urinary cytology in the early diagnosis of cyclosporin nephrotoxicity was studied in 20 bone marrow transplant recipients. There was an evident cyclosporin cytopathy in 35% of bone marrow transplant recipients examined, consisting mainly of degenerative and necrotic abnormalities in cells of the proximal convoluted tubules seen in urinary samples. These findings regressed to normal after reduction of the cyclosporin dose. Urinary cytology proved to be a useful method for the early diagnosis of cyclosporin nephrotoxicity.


The association between the bovine tuberculosis status of herds in the East Offaly Project Area, and the distance to badger setts, 1988-1993.
The proximity of farms to badger setts was compared between farms that had experienced a tuberculosis breakdown and those that had not, over the 6 year period from 1988 to 1993. The data were derived from a badger removal study conducted in East Offaly County in the Republic of Ireland. Badger removal began in 1989 and continued through 1993; by the end of 1990, approximately 80% of all badgers caught in the 6 year period had been removed. All badgers were examined, grossly, for evidence of tuberculosis. Tuberculosis status of the approximately 900 study herds was based on the results of the single intradermal comparative skin test and/or lesions of bovine tuberculosis. All herds were tested at least once annually. The number of herds experiencing bovine tuberculosis declined over the period, particularly in the years 1992 and 1993. The data on farm and badger sett location were stored and analysed, initially, in a geographical information system. Owing to the badger removal programme, the distance between the barn yard of a typical farm and the nearest occupied badger sett increased, by about 300 m year-1, and by about 600 m year-1 to the closest infected sett. In bivariate analyses, in the years 1988 and 1989, the risk of tuberculosis declined with increasing distance to a badger sett containing one or more tuberculous badgers. In multivariable logistic regression analyses, year and the average number of cattle tested per farm per year were controlled. A second identical analysis was conducted to control for the repeated observations on the same herds using generalised estimating equations. In both analyses, the risk of a multiple reactor tuberculosis breakdown decreased for herds at least 1000 m away from an infected badger sett, and increased as the number of infected badgers per infected sett increased. Despite the significantly reduced risk of a breakdown with increasing distance to infected badger setts, the relationship was not strong (sensitivity and specificity of the model in the low 70% range) and explained only 9-19% of tuberculosis breakdowns.


Dihydropyridine-sensitive and insensitive Ca2+ channels in human platelets.
The Ca2+ channel blocker, nifedipine, a dihydropyridine derivative, inhibited the Ca2+ influx and release from internal stores caused by collagen or a low concentration of the thromboxane A2 (TXA2) analogue, 9,11-epithio-11,12-methano-TXA2 (STA2) (10 nM), but did not inhibit those caused by thrombin or a high concentration of STA2 (100 nM). These results indicate the presence of two distinct, dihydropyridine-sensitive and insensitive, Ca2+ channels dependent on the concentrations and classes of agonists in human platelets.


The incidence of skin squamous cell carcinoma in Osijek-Baranja County--an epidemiological study.
The aim of this study is to show the incidence of squamous cell carcinoma of the skin in Osijek Baranja County, Eastern Croatia, in period from 2004 to 2009. This is the first report of epidemiological features of squamous cell skin carcinoma in this region. In this period we registered 469 patients with SCC of the skin, from which 237 females (50.5%) and 232 males (49.5%). World age-standardised rates (ASRW per 100,000) incidence in this period was 11.8/100,000 (16.8/ 100,000 for men and 9.0/100,000 for women). SCC of the skin occur in elderly commonly after 70 years. Most common localization is on the photoexposed areas, for example head, neck and backs of the hands. These localization varied in males and females (in females 2.5 times more in the nose area than males while 6 times more on the ear). The relation between photoexposed and photo non-exposed areas is 5:1. These results will serve as reference for studying the patterns of descriptive epidemiology of squamous cell carcinoma of the skin in the Osijek-Baranja County and the surrounding region.


Complicated megaureter with aganglionosis in an adult lady.
Dilated ureters are often due to mechanical obstruction. This case report describes a young adult lady with primary megaureter due to aganglionosis finally managed with extravesical Leech-Gregor Uretroneocystostomy.


[The efficacy of intra-arterial infusion chemotherapy in patients with metastatic liver tumors].
The efficacy of intra-arterial infusion chemotherapy for the treatment of liver metastasis was investigated in 28 colorectal cancer patients, 3 gastric cancer patients and 5 breast cancer patients between April 1986 and May 1991. 1. The long-term intra-arterial infusion chemotherapy was a simple and safe method in cancer patients. 2. We examined the serial serum CEA level in cancer patients and found that the serial change in CEA level correlated well with response to chemotherapy. The efficacy of this treatment was approximately 60% in colorectal cancer, 30% in gastric cancer, 80% in breast cancer. Intra-arterial infusion chemotherapy may be an effective treatment for the patients with liver metastasis from colorectal cancers and breast cancers. 3. In 8 colorectal cancer patients, the serum CEA level decrease to half of the pretreatment level. However, in all cases it increased significantly within 6 months postoperatively. Almost the same trend was observed in two cases of breast cancer. Our results suggest that we should give careful consideration to the resistance to anti-cancer drugs and develop a new protocol in order to obtain further satisfactory results.


Genetics of sudden cardiac death.
Numerous cardiac diseases may cause sudden cardiac death (SCD), and a genetic basis for SCD has been established in the inherited cardiac conditions (ICCs). Previously, ICCs were thought to have a Mendelian inheritance pattern, wherein a rare pathogenic/likely pathogenic variant in a known diseasecausing gene conferred risk. This inheritance model, however, could not explain a large proportion of cases. Advancements in genomic technology have facilitated application of genome-wide association studies (GWAS), allowing appreciation of the full spectrum of genetic variation in large populations. It has become clear that common variants may contribute to disease phenotype in ICCs as well, albeit with a smaller effect size and the need for additional factors. This has caused a shift in the understanding of inheritance patterns in ICCs, now thought to have a more complex, polygenic nature. Implementing this knowledge into genetic testing of SCD decedents will improve its diagnostic yield by identifying a subset of patients who do not carry a variant in one of the acknowledged disease-causing genes. It will also assist our understanding of modification of phenotype and potentially outcomes.


Integrated analysis of necroptosis-related lncRNAs for prognosis and immunotherapy of patients with pancreatic adenocarcinoma.
Accumulating studies have revealed that necroptosis plays a vital role in the occurrence and development of pancreatic adenocarcinoma (PAAD). We aimed to construct a prognostic model for PAAD on the basis of necroptosis-related lncRNAs (NRLs). A coexpression network between necroptosis-related mRNAs and NRLs based on The Cancer Genome Atlas (TCGA) was constructed. Then, differentially expressed necroptosis-related lncRNAs (DENRLs) were screened from TCGA and Genotype-Tissue Expression project (GTEx) datasets. Univariate Cox regression (uni-Cox) analysis was performed on these DENRLs to identify lncRNAs significantly correlated with prognosis. Least absolute shrinkage and selection operator (LASSO) regression was performed for preventing overfitting on these lncRNAs. Multivariate Cox analysis (multi-Cox) was performed to establish a risk model based on lncRNAs that served as an independent prognostic factor. Next, the Kaplan-Meier analysis, time-dependent receiver operating characteristics (ROC), uni-Cox, multi-Cox regression, nomogram, and calibration curves were constructed to support the accuracy of the model. Gene set enrichment analysis (GSEA) and single-sample GSEA (ssGSEA) were also performed on risk groups, and it was found that the low-risk group was closely correlated with immune infiltration and immunotherapy. To further evaluate the immune differences between different clusters, we divided the patients into two clusters. Cluster 2 was more significantly infiltrated with immune cells and had higher immune scores. These results shed new light on the pathogenesis of PAAD based on NRLs and develop a prognostic model for diagnosing and guiding personalized immunotherapy of PAAD patients.


Hematopoietic growth factor (G-CSF or GM-CSF) after salvage chemotherapy in refractory or relapsed adult de novo acute leukemia.
Nineteen adults with primary refractory or relapsed acute leukemia (12 ALL and 7 ANLL) were treated with an intensive salvage chemotherapy (intermediate-dose ara-C, intermediate-dose methotrexate, vindesine, cyclophosphamide, mitoxantrone and prednisolone) followed by a hematopoietic growth factor (HGF), either granulocyte colony-stimulating factor (5 micrograms/kg) or granulocyte-macrophage colony-stimulating factor (10 micrograms/kg). Both were given from the day after chemotherapy ended and until the neutrophil count rose above 1 X 10(9)/l for three consecutive days. Eleven patients (58%, 95% CI 33% to 82%) achieved complete remission, and 15 courses of salvage therapy were given to these complete responders. In a historical control group that did not receive HGF, 23 out of 38 patients (60%, 95% CI 44% to 77%) achieved complete remission, and 27 courses of therapy were delivered to complete responders. Treatment with a HGF accelerated the recovery of neutrophils to 0.5 X 10(9)/l significantly, shortening it from a mean of 28 to 22 days (p = .0002), with no effect on platelet recovery. There were no differences in the rates of documented and fatal infections, which were relatively high in both groups. In the patients with ANLL, there was no evidence that HGF accelerated leukemic regrowth. We conclude that HGF accelerates neutrophilic recovery following intensive salvage chemotherapy for acute leukemia, although no reduction in documented infections was found. Many factors, including the small patient sample, may have contributed to this latter finding.


Noise in random Boolean networks.
We investigate the effect of noise on random Boolean networks. Noise is implemented as a probability p that a node does not obey its deterministic update rule. We define two order parameters, the long-time average of the Hamming distance between a network with and without noise, and the average frozenness, which is a measure of the extent to which a node prefers one of the two Boolean states. We evaluate both order parameters as function of the noise strength, and of the number of inputs per node K finding a smooth transition from deterministic (p=0) to fully stochastic (p=12) dynamics for networks with K < or = 2 , and a first-order transition at p=0 for K>2 . Most of the results obtained by computer simulation are also derived analytically. The average Hamming distance can be evaluated using the annealed approximation. In order to obtain the distribution of frozenness as function of the noise strength, more sophisticated self-consistent calculations had to be performed. This distribution is a collection of delta peaks for K=1 , and it has a fractal sructure for K>1 , approaching a continuous distribution in the limit K1 .


Managing the care of patients with dementia. How to maximize level of functioning and minimize behavior problems.
Effective treatment of patients with dementia involves supporting and educating the primary caregiver, uncovering and correcting the underlying cause of any decompensation that may occur, and deciding when drug therapy is appropriate. Caregivers must be taught how to cope with the patient's denial and how to modify the patient's environment so that it is safe and easy to understand. Pharmacologic therapy for depression accompanying dementia can improve a patient's quality of life and independence considerably; drugs may also be of help in dealing with patients who resist care. Psychotic symptoms usually do not require pharmacologic treatment, and hypnotics should, if possible, be avoided as a solution to sleep problems.


[Effect of dexamethasone on G-CSF mobilization of peripheral blood stem cells in healthy donors and hematopoietic reconstruction in the recipients].
This study was aimed to investigate the effects of different mobilization methods on mobilization and collection of peripheral blood stem cells in healthy donors and the adverse effect of collection, as well as hematopoietic construction in recipients. A total of 43 donors between January 2008 and May 2013 were divided into the simple mobilization group and the combined mobilization group. The simple group was subcutaneously injected with 5.0-10.0 µg/(kg·d) recombinant human granulocyte colony-stimulating factor (rhG-CSF), and the combined mobilization group was treated with rhG-CSF and intravenously dripped with 10 mg dexamethasone for 2-4 hours before collection. The acquisition and count of MNC and CD34(+) cells in different groups, the relationship between the stem cells and MNC count in blood before collection, and the adverse reactions were analyzed; the hematopoietic reconstruction of recipients was investigated. The results showed that the hematopoietic stem cell number of the two groups meet the demands. The count of MNC and CD34(+) cells in the simple mobilization group was more than that in the combined mobilization group. The MNC count in two groups positively correlated with peripheral blood MNC count before collection. The decline of hemoglobin and platelet levels was more obvious in the simple mobilization group than that in combined mobilization group. The adverse reactions of collection in the simple mobilization group could be well tolerated and reversed. There was no adverse reaction in the combined mobilization group. The differences of conditioning regimens between two groups were not statistically significant and the hematopoietic reconstruction time of combined group was shorter than that in the simple mobilization group.It is concluded that the adverse reactions in process of collection can be reduced, and enough hematopoietic stem cells can be collected by G-CSF plus dexamethasone in mobilization of peripheral blood stem cells. The count of MNC in peripheral blood before collection can be still used as a reference index to evaluate the acquisition of MNC. Especially the combination with dexamethasone for stem cell mobilization can promote the hematopoietic reconstruction of the recipients.


Domestic violence among Druze women in Israel as reflected by health status and somatization level.
Women with a history of physical or emotional abuse demonstrate a higher incidence of medical disorders but may be reluctant to disclose the abuse to health care providers. The present study explored whether measures of health status may serve as an indication of violence against women. Sixty-two Druze women (18-50 years old) completed health status (SF-36 survey), somatization (Brief Symptom Inventory-BSI), and abuse (the Abuse Assessment Screen-AAS) questionnaires during a visit to the family physician in the community primary care clinic. Higher somatization symptoms and diminished health status were associated with severity of violence. Results attest to the value of these measures as an additional indirect device for screening victims of domestic violence in general and among traditional societies in particular.


Acceptance of Insect-Based Food Products in Western Societies: A Systematic Review.
Consuming insects is a possible alternative to meat consumption that has few detrimental impacts on the environment and human health. Whether novel foods made from insects will become established in Western societies in the coming years depends largely on their acceptance by the respective populations. Numerous studies on the acceptance of insects as a novel food have already been conducted. In this systematic review, the main findings of quantitative, experimental, and tasting studies on the acceptance of insects as a novel food are summarized. The present paper is designed to serve as an orientation for practitioners in the food industry and provides information useful for the design of marketing strategies and target group-oriented product development. In addition, we highlight in which fields future studies could be conducted to further improve the understanding of the acceptance of insects as food in Western societies.


SAGE2Splice: unmapped SAGE tags reveal novel splice junctions.
Serial analysis of gene expression (SAGE) not only is a method for profiling the global expression of genes, but also offers the opportunity for the discovery of novel transcripts. SAGE tags are mapped to known transcripts to determine the gene of origin. Tags that map neither to a known transcript nor to the genome were hypothesized to span a splice junction, for which the exon combination or exon(s) are unknown. To test this hypothesis, we have developed an algorithm, SAGE2Splice, to efficiently map SAGE tags to potential splice junctions in a genome. The algorithm consists of three search levels. A scoring scheme was designed based on position weight matrices to assess the quality of candidates. Using optimized parameters for SAGE2Splice analysis and two sets of SAGE data, candidate junctions were discovered for 5%-6% of unmapped tags. Candidates were classified into three categories, reflecting the previous annotations of the putative splice junctions. Analysis of predicted tags extracted from EST sequences demonstrated that candidate junctions having the splice junction located closer to the center of the tags are more reliable. Nine of these 12 candidates were validated by RT-PCR and sequencing, and among these, four revealed previously uncharacterized exons. Thus, SAGE2Splice provides a new functionality for the identification of novel transcripts and exons. SAGE2Splice is available online at http://www.cisreg.ca.


Decellularized caprine liver extracellular matrix as a 2D substrate coating and 3D hydrogel platform for vascularized liver tissue engineering.
Development of a vascularized liver tissue construct is a need of an hour to circumvent the current demand of liver transplantation in health care sector. An appropriate matrix must support liver cell viability, functionality, and development of microvasculature. With this perspective, here, we report the use of decellularized caprine liver extracellular matrix (CLECM) derived hydrogel for tissue engineering applications. First, CLECM was used as a substrate coating material for 2D hepatocyte culture. HepG2 cells cultured on CLECM-coated surface showed higher albumin, urea, glycogen, and GAGs synthesis in comparison with collagen-coated surface (taken as control for the study). Thereafter, the cells were encapsulated in CLECM hydrogels for 3D culture. In CLECM hydrogels, HepG2 cells showed highly differentiated and polarized phenotype with the appearance of bile canaliculi-like structures and enhanced expression of mature hepatocyte markers. We further showed that CLECM hydrogels also supported the development of microvasculature in vitro, thus making it a suitable candidate for development of a prevascularized liver tissue construct. In conclusion, we proved the superiority of CLECM over collagen for 2D/3D human hepatocyte and endothelial cell culture. CLECM could serve as an efficient biomaterial platform in the development of a liver tissue construct for application in tissue engineering.


[RT-PCR use for the diagnostic of chronic myeloid leukaemia].
The molecular analysis of chromosomal abnormalities associated with hematological malignancies allowed the identification of genes involved in theses rearrangements as well as of some recurrent mechanisms. Polymerase chain reaction (PCR) tools are now available to detect these rearrangements, allowing a better follow-up of these diseases. Chronic myeloid leukemia is a myeloproliferative disorder characterized by a reciprocal translocation t(9;22)(q34;q11) which results in a bcr-abl fusion gene. Retro-transcription polymerase chain reaction (RT-PCR) is used to detect bcr-abl to establish diagnosis and to monitor patients. We report here the results of 30 patients samples tested in the hematology laboratory at Pasteur Institute, diagnosed as chronic myeloid leukemia and monitored with RT-PCR. Our results highlight the interest of molecular tools to diagnose and monitor patients mainly when cytogenetic techniques are irrelevant such as cases with complex chromosomal rearrangements or when patients achieve Philadelphia negativity after treatment.