The Nordic maintenance care program: what are the indications for maintenance care in patients with low back pain? A survey of the members of the Danish Chiropractors' Association.
Maintenance care (MC) is relatively commonly used among chiropractors. However, factual information is needed on its indications for use. This study had two objectives: 1) to describe which role patients' past history and treatment outcome play in chiropractors' decision to use MC in patients with low back pain, 2) to investigate if the chiropractors' clinical/educational background has an effect on the frequency of using MC and their indications for use of MC. An anonymous questionnaire was sent to all 413 chiropractors practising in Denmark. Its main part consisted of 3 sets of 4 questions relating to one basic case of low back pain. For each case, the chiropractors were asked if they would use MC as they self-defined the term (no/perhaps/yes). There were questions also on gender, age, educational and clinical background, and on the number of MC patients seen by these chiropractors. Their decision to recommend MC was reported. Associations between the demographic variables and 1) the frequency of MC-use and 2) their indications for use of MC were tested through multivariate analysis. The response rate was 72%. Non-indications for MC were: 1) a good outcome combined with no previous events, or 2) a past history of LBP and gradual worsening with treatment. Indications for MC were a good outcome combined with a previous history of low back pain between once a month and once a year. The mean proportion of MC patients per week were 22% (SD 19), ranging from 0% to 100%. The use of MC was highest among experienced chiropractors, those who were educated in North America, and clinic owners. However, in Denmark most chiropractors graduated before 1999, are educated abroad, whereas most chiropractors thereafter are educated in Denmark. Therefore, we cannot conclude whether this difference relates to education or years of experience. There were no associations detected between demographic variables and the indications for MC. There is relatively high consensus on when MC should and should not be used. A history of prior low back pain combined with a positive response to treatment encourages the use of MC, whereas no previous history of back pain or a worsening of symptoms discourages the use of MC. There seems to be a difference in the proportional use of MC between chiropractors with more experience educated in North America and those with less experience educated in Denmark.


Structural determinants regulating cell surface targeting of melanocortin receptors.
Melanocortin receptors (MCRs) belong to the G-protein-coupled receptor family of transmembrane proteins. They recognize specific ligands named melanocortins that are mainly produced in the pituitary and hypothalamus. Newly synthesized MCRs at the endoplasmic reticulum are subjected to quality control mechanisms that screen for the correct structure, folding or processing, essential for their proper cell surface expression. Some motifs, located at the N- or C-terminus or even on transmembrane and in loop regions, have been implicated in these biological processes. This article reviews these specific domains and the role of accessory proteins and post-translation modifications in MCRs' targeting to cell surface. Additionally, promising approaches involving pharmacological stabilization of misfolded and misrouted mutant MCRs, which improve their forward transport, are reported. Understanding the MCRs' structural determinants fundamental for their proper cell surface integration is essential for correcting abnormalities found in some diseases.


Thermo-optic waveguide gate switch arrays based on direct UV-written highly fluorinated low-loss photopolymer.
Novel thermo-optic waveguide gate switch arrays were designed and fabricated based on the direct UV-written technique. Highly fluorinated low-loss photopolymers and organic-inorganic grafting materials were used as the waveguide core and cladding, respectively. The low absorption loss characteristics and excellent thermal stabilities of the core and cladding materials were obtained. The rectangular waveguides and arrayed electrode heaters have been theoretically designed and numerically simulated to realize single-mode transmission. The propagation loss of a 4-μm-wide straight waveguide was measured as 0.15 dB/cm. The insertion loss of the device was directly measured to be about 5.5 dB. The rise and fall times of the device applied 100 Hz square-wave voltage were obtained as 1.068 and 1.245 ms, respectively. The switching power was about 9.2 mW, and the extinction ratio was 17.8 dB. The low-loss integrated switch arrays are suitable for realizing large-scale photonic integrated circuits.


Effect of repetitive transcranial magnetic stimulation on rate of memory acquisition.
Repetitive transcranial magnetic stimulation (rTMS) may temporarily accelerate knowledge acquisition by neural networks, possibly by promoting rapid Hebbian learning. The authors tested this hypothesis in 20 normal subjects by comparing the impact of 25 minutes of high-frequency left dorsolateral prefrontal rTMS with that of sham rTMS on subsequent knowledge acquisition in several procedural and declarative memory domains. No significant group effects, positive or negative, were noted for any memory acquisition test, but prefrontal rTMS did reduce motor evoked potential threshold.


Separation of living and dead cells by dielectrophoresis.
High-frequency non-uniform electric fields were used to cause selective dielectrophoresis of yeast cells in an aqueous medium. Living cells separated from admixed dead ones remained viable after the separation process.


Clinical Significance of Wnt/β-Catenin Signalling and Androgen Receptor Expression in Prostate Cancer.
To investigate the relationships among the Wnt/β-catenin pathway, androgen receptor (AR), and clinicopathological factors in hormone-naïve prostate cancer. This study was conducted with132 cases of hormone-naïve prostate cancer treated by prostatectomy and prostate needle biopsy. An immunohistochemical study using antibodies against β-catenin, matrix metalloproteinase-7 (MMP-7), and the AR was performed. For the in vitro study, PC-3, LNCaP, 22Rv1, and DU145 cell lines were used. The clinical or pathological stage ware a localized cancer in 36 patients (27.3%), locally advanced cancer in 31 (23.5%), and metastatic cancer in 65 (49.2%). We detected increased β-catenin, AR, and MMP-7 expression with a high Gleason grade, disease progression, and increasing serum prostate-specific antigen (PSA) levels (p<0.01). In Spearman's rank correlations, the expression of cytoplasmic β-catenin, MMP-7, and the AR were found to be significantly positively correlated. In addition, the expression of β-catenin, MMP-7, and the AR were significantly correlated with clinicopathological variables indicative of a poor prognosis. Forty-nine patients with primary androgen deprivation had short response durations from hormone therapy to PSA progression with elevated MMP-7 expression on the Kaplan-Meier curve (p=0.0036). These data show that an activated Wnt/β-catenin pathway and AR expression in prostate cancer are correlated with metastasis and aggressiveness. In addition, the expression of MMP-7 protein, a target of the Wnt/β-catenin pathway, is associated with PSA progression in prostate cancer patients undergoing primary hormone therapy.


Characterization of double-strand break-induced recombination: homology requirements and single-stranded DNA formation.
In the yeast Saccharomyces cerevisiae, a double-strand chromosome break created by the HO endonuclease is frequently repaired in mitotically growing cells by recombination between flanking homologous regions, producing a deletion. We showed that single-stranded regions were formed on both sides of the double-strand break prior to the formation of the product. The kinetics of the single-stranded DNA were monitored in strains with the recombination-deficient mutations rad52 and rad50 as well as in the wild-type strain. In rad50 mutants, single-stranded DNA was generated at a slower rate than in the wild type, whereas rad52 mutants generated single-stranded DNA at a faster rate. Product formation was largely blocked in the rad52 mutant. In the rad50 rad52 double mutant, the effects were superimposed in that the exonucleolytic activity was slowed but product formation was blocked. rad50 appears to act before or at the same stage as rad52. We constructed strains containing two ura3 segments on one side of the HO cut site and one ura3 region on the other side to characterize how flanking repeats find each other. Deletions formed preterentially between the homologous regions closest to the double-strand break. By varying the size of the middle ura3 segment, we determined that recombination initiated by a double-strand break requires a minimum homologous length between 63 and 89 bp. In these competition experiments, the frequency of recombination was dependent on the length of homology in an approximately linear manner.


Pregnant women of 35 years of age or more: maternal serum markers or amniocentesis?
The aim of this prospective study was to compare triple test screening (alpha-fetoprotein, beta-chorionic gonadotrophin and unconjugated oestriol) with amniocentesis in the detection of fetuses with Down's syndrome in women of 35 years of age or more. Between 1992 and 1996, maternal serum markers were evaluated in 1406 women who had amniocentesis for prenatal diagnosis of chromosomal abnormalities related to a maternal age of 35 or more years. Sixteen fetuses with Down's syndrome were identified in the whole group by amniocentesis and karyotyping. The group with negative triple test screening consisted of 919 pregnancies and included two fetuses with trisomy-21 (false negatives). With triple test screening in the age group over 35, there was a detection rate of 87.5% for cut-off points ranging from 1:200 up to 1:350, with corresponding false positive rates ranging between 23% and 34%. In our population, if we had practiced the policy of offering amniocentesis only to women screening positive for the ages of 35 and 36 and to all pregnant women of 37 or more, we would have carried out 30% less amniocenteses. In this group of 1406 women, 33 abnormal karyotypes were detected with amniocentesis (16 Down's syndrome included) and equal number of elective abortions were carried out. Nevertheless, 19 healthy fetuses and neonates were lost after amniocentesis. Considering the high detection rates that can be achieved with triple test screening, the existing procedure related risk of amniocentesis (0.5-1.0%), and the facts that conception in women over 35 years of age is usually more difficult and the background loss usually higher than in younger women, we believe that in the future women over 35 should be offered a choice between non-invasive and invasive procedures after being thoroughly informed.


Hybridization and enzymatic extension of au nanoparticle-bound oligonucleotides.
We have investigated the impact of steric effects on the hybridization and enzymatic extension of oligonucleotides bound to 12-nm colloidal Au particles. In these experiments, a nanoparticle-bound 12-mer sequence is hybridized either to its solution phase 12-mer complement or to an 88-mer template sequence. The particle-bound oligonucleotide serves as a primer for enzymatic extension reactions, in which covalent incorporation of nucleotides to form the complement of the template is achieved by the action of DNA polymerase. Primers were attached via-C(6)H(12)SH, -C(12)H(24)SH, and -TTACAATC(6)H(12)SH linkers attached at the 5' end. Primer coverage on the nanoparticles was varied by dilution with (5')HSC(6)H(12)AAA AAA(3'). Hybridization efficiencies were determined as a function of linker length, primer coverage, complement length (12-mer vs 88-mer), and primer:complement concentration ratio. In all cases, hybridization for the 88-mer was less efficient than for the 12-mer. Low primer surface coverage, greater particle-primer separation, and higher primer:complement ratios led to optimal hybridization. Hybridization efficiencies as high as 98% and 75% were observed for the 12-mer and 88-mer, respectively. Enzymatic extension of particle-bound primers was observed under all conditions tested; however, the efficiency of the reaction was strongly affected by linker length and primer coverage. Extension of primers attached by the longest linker was as efficient as the solution-phase reaction.


Noninvasive monitoring of airway inflammation and steroid reduction in children with asthma.
Management of pediatric asthma is currently based on symptoms (often a second-hand report from parents) and lung function. Inhaled steroids are the mainstay of asthma management targeted at controlling airway inflammation. They should be used in the lowest possible doses. A number of noninvasive methods to assess inflammation have been developed in an effort to optimize anti-inflammatory treatment. The first longitudinal studies have been published demonstrating an improvement in asthma control in children by adding noninvasive monitoring of inflammation into the clinical management. New methods include exhaled nitric oxide measurements, induced sputum and markers in exhaled breath condensate. Further studies will show the practicability of including these measurement methods into everyday clinical practice. Their addition to the conventional assessment of asthma control appears promising. Using these methods to evaluate the current inflammatory state seems obligatory in research into new asthma therapeutics and management strategies. Managing asthma in children in specialist practice relying only on symptoms and lung function is no longer state of the art.


Osmotic repression of anaerobic metabolic systems in Escherichia coli.
The influence of the osmolarity of the growth medium on anaerobic fermentation and nitrate respiratory pathways was analyzed. The levels of several enzymes, including formate dehydrogenase, hydrogenase, and nitrate reductase, plus a nickel uptake system were examined, as was the expression of the corresponding structural and regulatory genes. While some functions appear to be only moderately affected by an increase in osmolarity, others were found to vary considerably. An increase in the osmolarity of the medium inhibits both fermentation and anaerobic respiratory pathways, though in a more dramatic fashion for the former. fnr expression is affected by osmolarity, but the repression of anaerobic gene expression was shown to be independent of FNR regulatory protein, at least for hyd-17 and fdhF. This repression could be mediated by the intracellular concentration of potassium and is reversed by glycine betaine.


Long-Term Disease Control of Locally Invasive Epithelial-Myoepithelial Carcinoma of Parapharyngeal Salivary Glands With Definitive Radiotherapy.
Epithelial-myoepithelial carcinoma (EMC) is a rare clinical entity that affects glandular tissues, most commonly salivary glands. EMC of parapharyngeal space is exceedingly rare. Surgery is the mainstay of treatment with or without chemotherapy, radiotherapy, or both. Due to the rarity of the disease, select cases where surgery is not possible present a management conundrum. We present a case of locally advanced, stage IVa EMC of parapharyngeal space that was treated with upfront definitive radiotherapy. Radiotherapy treatment alone led to long-term disease control in both clinical and radiological follow-ups. The patient was followed for more than eight years posttreatment with no disease recurrence, enjoying the normal activities of life with no late toxicities including xerostomia. This case report highlights the role of radiotherapy in the management of such patients, and more studies are required in this context for surgical candidates with positive disease margins.


Rosacea fulminans or acute rosacea? Report of 5 cases and review of the literature.
Rosacea fulminans, previously called pyoderma faciale, is an inflammatory disease considered a dramatic form of rosacea rather than of acne. Typical features are: exclusive facial involvement of young women, sudden onset of large nodules without other signs of acne, remission without scarring or with minimal scars, no recurrences or systemic symptoms. Oral isotretinoin associated with a short course of systemic and topical corticosteroids represent the recommended treatment. Personal observation of 5 cases has induced us to make a review of worldwide literature in order to better define this clinical entity. In our opinion, rosacea fulminans is a valid diagnosis, but clinical criteria should be rigorously respected to fully exclude rosacea conglobata and acne fulminans.


Lithium therapy for mania and depression.
The literature on lithium carbonate was reviewed for clues to the processes involved in mania. Lithium has proved effective therapeutically and prophylactically for mania and depressive disorders. Children and adolescents as well as adults tolerate lithium well. Side effects rarely are serious enough to necessitate having lithium therapy. Some success with schizophrenia and schizoaffective disorders has broadened the scope of lithium's therapeutic efficacy but also blunted the expectation for a direct relationship between lithium and the processes involved in mania. Research points to neurotransmitters as contributing to the etiology and symptom pattern of mania.


Antecedents of emotion knowledge: Predictors of individual differences in young children.
Individual differences in emotion knowledge were examined among 188 4-year-old, predominantly African American children. Cognitive ability and negative emotionality, maternal characteristics (parenting, verbal intelligence, and depressive symptoms), environmental risk, and child sex were examined as predictors of emotion knowledge. Regression analyses indicated that cognitively skilled children who resided in relatively low risk environments with verbally intelligent mothers possessed greater emotion knowledge. Proximal (4-year) child cognitive ability was a stronger predictor than distal (2-year) cognitive ability. Positive parenting at 4 years was correlated with child emotion knowledge, but this relation disappeared when parenting was examined in the context of other predictors. These findings highlight the potential role of child cognitive ability, along with environmental risk and maternal verbal intelligence, in children's emotion knowledge and demonstrate the importance of examining a variety of predictors for their unique contribution to emotion knowledge.


Cementum matrix formation in vivo by cultured dental follicle cells.
Dental follicle is the fibrous tissue that surrounds the developing tooth germ, and it is believed to contain progenitors for cementoblasts, periodontal ligament cells, and osteoblasts. In this study, we report the presence of cementoblast progenitors in cultures of bovine dental follicle cells and demonstrate their differentiation capacity. Bovine dental follicle cells (BDFC) obtained from tooth germs by collagenase digestion were compared with bovine alveolar bone osteoblasts (BAOB) and bovine periodontal ligament cells (BPDL) in vitro and in vivo. In culture, BDFC exhibited low levels of alkaline phosphatase activity and expressed mRNA for osteopontin (OP) and type I collagen (COLI), as well as low levels of osteocalcin (OC) mRNA. In contrast, cultured BAOB exhibited high alkaline phosphatase activity levels and expressed mRNA for OC, OP, COLI, and bone sialoprotein (BSP). To elucidate the differentiation capacity of BDFC in vivo, cells were transplanted into severe combined immunodeficiency (SCID) mice and analyzed after 4 weeks. Transplanted BDFC formed fibrous tissue and cementum-like matrix, which stained positive for anti-cementum attachment protein (CAP) monoclonal antibody (3G9), and expressed mRNA for OC, OP, COLI, and BSP. On the other hand, transplanted BAOB formed bone-like matrix, but were negative for anti-CAP monoclonal antibody. The BPDL transplants formed fibrous tissue that contained a few cells expressing CAP. These results indicate that cementoblast progenitors are present in BDFC, which can provide a useful model for investigating the molecular mechanisms of cementogenesis.


Network migration of ethnic Germans.
"This study has argued that network migration is central to actual migratory movements, which suggests that its determinants should be carefully investigated. The analysis demonstrates that the network behavior of ethnic Germans can be explained, to a large degree, by observable characteristics. Two crucial variables were investigated, namely the connections to friends from the country of origin and the settlement close to relatives and friends. East Europeans, especially from Rumania, are significantly more connected to friends from the same country of origin than are East Germans. These connections strongly decline with duration of residence and presence in rural areas. Older people are more likely to settle close to friends or relatives at the time of immigration. Population density increases, education, length of stay in a reception camp, and per capita government expenditures decrease the likelihood of such a settlement."


Sonographic diagnosis of ovarian torsion: accuracy and predictive factors.
The purpose of this study was to determine the accuracy of sonographic diagnosis of ovarian torsion and the predictive value of typical sonographic signs. The study included 63 women attending an ultrasound unit of a tertiary obstetrics and gynecology department in 2002 through 2008 who had suspected ovarian torsion on sonography and subsequently underwent laparoscopy. Sonography had diagnostic accuracy of 74.6% for ovarian torsion. Abnormal ovarian blood flow and the presence of free fluid were the most diagnostically accurate isolated sonographic signs (positive predictive values, 80.0% and 89.2%, respectively; negative predictive values, 46.2% and 46.2%). Using combinations of sonographic signs yielded higher specificity and positive predictive values and lower sensitivity and negative predictive values for ovarian torsion. The diagnostic accuracy was largely affected by the ultrasound operator (mean ± SD, 78.8% ± 16.0%; range, 60.0%-100%). In the setting of a specialized ultrasound unit, sonographic diagnosis of ovarian torsion had high (74.6%) accuracy compared with previous reports. The absence of typical sonographic signs does not rule out ovarian torsion, especially when the clinical presentation is suggestive. Basing assessments on multiple sonographic signs, including Doppler evaluation, increases the diagnostic specificity.


[Factors Influencing Patient Decisions Regarding Cancer Clinical Trial Participation: A Systematic Review].
Cancer is the top cause of death in Taiwan. Cancer clinical trials are crucial for developing new treatments. Understanding the motivations and barriers related to the factors of influence on patient decisions regarding participation in cancer clinical trials may help clinical researchers improve patients' understanding of clinical trials and improve their ability to make autonomous decisions regarding informed consent. This study was designed to explore the factors affecting patient decisions regarding cancer clinical trial participation using a systematic review of the literature. A systematic review was used. Articles were retrieved from electronic databases including Cochrane Library, Embase, PubMed, CINAHLE, and Scopus. The following keywords and MeSH terms were used to search for articles on cancer, clinical trials, participation, factors or motivations, and decision making. A total of 9353 articles published from 2011 to January 2021 that matched the search criteria were extracted. After screening the topics, deleting repetitions, and doing critical appraisals, 40 articles were selected for analysis. Research quality was assessed using Joanna Briggs Institute Levels of Evidence criteria. Eight motivations and nine barriers were found to significantly influence patient participation in cancer clinical trials. These motivations were: (1) trust in health professionals, (2) hope for therapeutic benefits, (3) the last treatment option, (4) altruism, (5) family support, (6) extra care, (7) patients' or others' past therapy experience, and (8) other demographic factors. The barriers to participation identified were: (1) fear of side effects or treatment efficacy, (2) concerns about trial requirements and randomization, (3) heavy financial burden, (4) inability to maintain quality of life, (5) inability to participate due to disease progression, (6) having treatment preferences, (7) health professionals' negative attitudes toward clinical trials, (8) family opposition, and (9) providing trial information at an inappropriate time. Eight motivational factors and nine barriers influencing patient decisions regarding cancer clinical trial participation were extracted from the selected articles. In addition to personal and situational factors, family and health professionals were found to influence patient decisions regarding cancer clinical trial participation. The authors hope that the findings of this study help clinical researchers further improve patient understanding of clinical trials and help patients make autonomous decisions with regard to informed consent.


Catalytic Mechanisms of Nanozymes and Their Applications in Biomedicine.
The research on nanozymes has increased dramatically in recent years and a new interdiscipline, nanozymology, has emerged. A variety of nanomaterials have been designed to mimic the characteristics of natural enzymes, which connects an important bridge between nanotechnology and biological science. Unlike natural enzymes, the nanoscale properties of nanozymes endow them with the potential to regulate their enzymatic-like activity from different perspectives. The mechanisms behind those methods are intriguing. In this Review, we introduce these mechanisms from the aspects of surface chemistry, surface modification, molecular imprinting, and hybridization and then focus attention on some specific catalytic mechanisms of several representative nanozymes. The applications of nanozymes ranging from bioassay, imaging, to disease therapy are also discussed in detail to prove the fact that the inherent physicochemical properties of nanomaterials not only make nanozymes the analogues of biological enzymes, but also endow them with incomparable advantages and broad prospects in biomedical fields. Finally, four characteristics and some challenges of nanozymes are summarized.


Association between C677T polymorphism of MTHFR gene and risk of amyotrophic lateral sclerosis: Polish population study and a meta-analysis.
Genetic factors play a role in pathogenesis of amyotrophic lateral sclerosis (ALS). A few studies demonstrated that the TT genotype of C677T polymorphism of the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene can increase the risk of sporadic ALS. The aim of our study was to determine the relationship between C677T polymorphism of MTHFR gene and the risk of sporadic ALS in Polish population and to perform the meta-analysis assessing the significance this polymorphism for the risk of ALS in Caucasian population. We included 251 patients with ALS and 500 control subjects recruited from Polish population and performed the meta-analysis of published data from Caucasian population. MTHFR C677T polymorphism was genotyped using a TaqMan assay and 7900HT Fast real Time PCR System. The frequency of genotypes did not differ significantly between Polish ALS patients and control subjects (CC: 45.0 vs 45.8%, CT: 48.2 vs 45.0%, TT: 6.8 vs 9.2%, P=0.46). The meta-analysis including 863 ALS patients and 1362 controls revealed that TT genotype increases the risk of sporadic ALS in Caucasian population. Although we did not find the association between C677T polymorphism of MTHRF gene and risk of ALS in Polish population, the results of meta-analysis suggest that the TT genotype can be a genetic risk factor for ALS in Caucasian population.


Enhancing control of multidrug-resistant plasmid and its host community with a prolonged thermophilic phase during composting.
The plasmid-mediated horizontal transfer of antibiotic resistance genes (ARGs) among bacteria facilitates the evolution and dissemination of antibiotic resistance. Broad-host-range plasmids can be transferred to different bacterial hosts in soil, plant rhizospheres, and wastewater treatment plants. Although composting is an effective way to convert organic waste into fertilizer and reduce some ARGs, few studies have focused on its effects on the spread of ARG-carrying plasmids and their bacterial host communities during composting. In this study, a fluorescently labeled Pseudomonas putida (P. putida) harboring a broad-host-range plasmid RP4 carrying three ARGs was inoculated into a raw material microcosm and composted with different durations of the thermophilic phase. The fate of the donor and RP4 in composting was investigated. The prolonged thermophilic composting removed 95.1% of dsRed and 98.0% of gfp, and it inhibited the rebound of P. putida and RP4 during the maturation phase. The spread potential of RP4 decreased from 10-4 to 10-6 transconjugants per recipient after composting. In addition, we sorted and analyzed the composition of RP4 recipient bacteria using fluorescence-activated cell sorting combined with 16S rRNA gene amplicon sequencing. The recipient bacteria of RP4 belonged to eight phyla, and Firmicutes, accounting for 75.3%-90.1%, was the dominant phylum in the transconjugants. The diversity and richness of the RP4 recipient community were significantly reduced by prolonged thermophilic periods. Overall, these findings provide new insights for assessing the contribution of composting in mitigating the dissemination of plasmid-mediated ARGs, and the prolonged thermophilic phase of composting can limit the transfer of multidrug-resistant plasmids.


Perfluoropyridine: Discovery, Chemistry, and Applications in Polymers and Material Science.
Perfluoropyridine (PFPy) is an organofluorine compound that has been employed for a variety of applications, from straightforward chemical synthesis to more advanced functions, such as fluorinated networks and polymers. This can be directly attributed to the highly reactive nature of PFPy, especially towards nucleophilic aromatic substitution (SNAr). The aim of this review is to highlight the discovery and synthesis of PFPy, discuss its reactive nature towards SNAr, and to summarize known reports of the utilization and thermal analysis of PFPy containing fluoropolymers and fluorinated network materials.


Contralaterally controlled functional electrical stimulation for upper extremity hemiplegia: an early-phase randomized clinical trial in subacute stroke patients.
Contralaterally controlled functional electrical stimulation (CCFES) is an experimental treatment intended to improve hand function after stroke. To compare the effects of 6 weeks of CCFES versus cyclic neuromuscular electrical stimulation (NMES) on upper extremity impairment and activity limitation in patients ≤6 months poststroke. Twenty-one participants were randomized to CCFES or cyclic NMES. Treatment for both groups consisted of daily stimulation-assisted repetitive hand-opening exercise at home plus twice-weekly lab sessions of functional task practice. Assessments were made at pretreatment and posttreatment and at 1 month and 3 months posttreatment. They included maximum voluntary finger extension angle, finger movement tracking error, upper extremity Fugl-Meyer score, Box and Blocks test, and Arm Motor Abilities test. Treatment effects were estimated using a 2-factor repeated measures analysis of variance with the value of the baseline measure as a covariate. Seventeen patients completed the treatment phase (9 CCFES, 8 cyclic NMES). At all posttreatment time points, CCFES produced larger improvements than cyclic NMES on every outcome measure. Maximum voluntary finger extension showed the largest treatment effect, with a mean group difference across the posttreatment time points of 28° more finger extension for CCFES. The results favor CCFES over cyclic NMES though the small sample size limits the statistical power of the study. The effect size estimates from this study will be used to power a larger trial.


Comparison of O-specific polysaccharide responses in patients following infection with Vibrio cholerae O139 versus vaccination with a bivalent (O1/O139) oral killed cholera vaccine in Bangladesh.
Cholera caused by Vibrio cholerae O139 emerged in the early 1990s and spread rapidly to 11 Asian countries before receding for unclear reasons. Protection against cholera is serogroup-specific, which is defined by the O-specific polysaccharide (OSP) component of lipopolysaccharide (LPS). V. cholerae O139 also expresses the OSP-capsule. We, therefore, assessed antibody responses targeting V. cholerae O139 OSP, LPS, capsule, and vibriocidal responses in patients in Bangladesh with cholera caused by V. cholerae O139. We compared these responses to those of age-gender-blood group-matched recipients of the bivalent oral cholera vaccine (OCV O1/O139). We found prominent OSP, LPS, and vibriocidal responses in patients, with a high correlation between these responses. OSP responses primarily targeted the terminal tetrasaccharide of OSP. Vaccinees developed OSP, LPS, and vibriocidal antibody responses, but of significantly lower magnitude and responder frequency (RF) than matched patients. We separately analyzed responses in pediatric vaccinees born after V. cholerae O139 had receded in Bangladesh. We found that OSP responses were boosted in children who had previously received a single dose of bivalent OCV 3 yr previously but not in vaccinated immunologically naïve children. Our results suggest that OSP-specific responses occur during cholera caused by V. cholerae O139 despite the presence of capsules, that vaccination with bivalent OCV is poorly immunogenic in the short term in immunologically naïve individuals, but that OSP-specific immune responses can be primed by previous exposure, although whether such responses can protect against O139 cholera is uncertain. IMPORTANCE Cholera is a severe dehydrating illness in humans caused by Vibrio cholerae serogroups O1 or O139. Protection against cholera is serogroup-specific, which is defined by the O-specific polysaccharide (OSP) of V. cholerae LPS. Yet, little is known about immunity to O139 OSP. In this study, we assessed immune responses targeting OSP in patients from an endemic region with cholera caused by V. cholerae O139. We compared these responses to those of the age-gender-blood group-matched recipients of the bivalent oral cholera vaccine. Our results suggest that OSP-specific responses occur during cholera caused by V. cholerae O139 and that the OSP responses primarily target the terminal tetrasaccharide of OSP. Our results further suggest that vaccination with the bivalent vaccine is poorly immunogenic in the short term for inducing O139-specific OSP responses in immunologically naïve individuals, but OSP-specific immune responses can be primed by previous exposure or vaccination.


Standards of care for Kasabach-Merritt phenomenon in China.
Kasabach-Merritt phenomenon (KMP) is a rare disease that is characterized by severe thrombocytopenia and consumptive coagulation dysfunction caused by kaposiform hemangioendothelioma or tufted hemangioma. This condition primarily occurs in infants and young children, usually with acute onset and rapid progression. This review article introduced standardized recommendations for the pathogenesis, clinical manifestation, diagnostic methods and treatment process of KMP in China, which can be used as a reference for clinical practice.


Comparative pharmacokinetics of a new benzamide neuroleptic drug in rats, dogs and monkeys using a stable isotope technique.
Comparative pharmacokinetics of a new benzamide neuroleptic drug, cis-N-(1-benzyl-2-methylpyrrolidine-3-yl)-5-chloro-2-methoxy-4-met hylamino benzamide (NBND) was studied in rats, dogs and monkeys using two deuterium-labelled compounds. NBND and 2H3-NBND, which showed no biological isotope effect, were co-administered p.o. and i.v. to rats, dogs and monkeys, and the plasma concentrations of unchanged drugs were simultaneously determined by g.l.c.-chemical ionization mass spectrometry with 2H7-NBND as an internal standard. The plasma half-lives (t1/2 beta) after i.v. administration were 1.6, 4.7 and 2.2 h in rats, dogs and monkeys at a dose of 0.2 mg/kg. Plasma clearances were 4.3, 1.7 and 1.4 l/h per kg in rats, dogs and monkeys. Absorption rate constants (Kab) were 1.1, 0.58 and 0.54 per h in rats, dogs and monkeys, at doses of 10, 3 and 5 mg/kg, respectively. Absolute bioavailabilities were 0.8, 9.5 and 1.3% in rats, dogs and monkeys, suggesting that all these species showed large first-pass effects, probably due to hepatic metabolism.


Integrating Substance Abuse Content into an HIV Risk-Reduction Intervention: A Pilot Study with Middle School-Aged Hispanic Students.
A pilot study of a school-based HIV/AIDS risk reduction program with integrated components on substance abuse was conducted to determine: 1) its effectiveness in Hispanic, middle school-aged children and 2) if differences in effectiveness are found in students who report risky behaviors. Activity-oriented training on decision-making, HIV/AIDS illness, risky behaviors, and abstinence was provided to 125 students. Participants were classified into risk groups, based on reported sexual and alcohol/drug (AOD) activity. Effectiveness was analyzed by comparing the risk group's knowledge, beliefs, and perceived-risk scores pre/post-program in sexual activity, AOD use, disease course, and casual contact categories. This program improved some knowledge, few beliefs, and few perceived risks. The perceived-risk scores of the high-risk group did not reflect their higher risk for HIV/AIDS. School-based programs should measure actual HIV/AIDS risks, including AOD, to identify participants who need focused interventions. Further research is needed to understand how AOD influences risky sexual behaviors, and what content and interventions are useful.


Localised oral histoplasmosis lesions associated with HIV infection.
Opportunistic fungal infections account for a significant amount of morbidity associated with HIV disease. We report here a case of localised oral histoplasmosis without evidence of disseminated disease in a patient who lacked stigmata of HIV disease at the time of initial presentation. The diagnosis is based on histology with special stains, complement fixing antibodies in serum, and culture of the organism from fresh tissues. Activation of subclinical disease following an infection in Uganda may explain the development of these exophytic oral lesions in this British resident.


Future prospects for reconstructive surgery in breast cancer.
Reconstructive surgery has become an integral part of primary breast cancer therapy in patients requiring total mastectomy. State-of-the-art reconstructions with autogenous tissue are transverse rectus abdominis (TRAM) flap procedures. Superior aesthetic results in terms of both appearance and consistency, seem to outweigh the disadvantages of impaired abdominal wall competence and donor site scars. The "free," microvascular TRAM flap may be the way to minimize abdominal wall weakness, since only a little portion of the rectus abdominis muscle must be sacrificed. Despite all discussions, breast reconstruction using silicone (gel) implants is a safe and reliable method and will be in the future. However, not every patient may be the right candidate for silicone reconstruction. Advantages of using silicone implants include (relatively) simple technique, short operation time, and no donor site morbidity. In patients suffering from breast-conserving therapy failures, plastic surgery has to address skin and parenchymal loss in an irradiated environment. Oncoplastic surgery, such as volume shrinking or volume replacement techniques, are useful for immediate reconstruction in breast-conserving therapy.


Imaging of bladder cancer: update on current approaches for diagnosis.
Imaging plays a mainstay role in evaluation of patients with bladder cancer, especially for diagnosis, local and distant staging and treatment follow up. In this article, we aim to review and to update conventional and functional imaging methods used in clinical management of bladder cancer.


Cutaneous polyarteritis nodosa: revisiting its definition and diagnostic criteria.
Polyarteritis nodosa (PN) is a classical collagen disease with poor prognosis that demonstrates systemic necrotizing vasculitis of small and medium-sized arteries. Cutaneous symptoms are observed in 25-60% of PN patients. On other hand, cutaneous polyarteritis nodosa (CPN) is designated for the cutaneous limited form of PN and demonstrates benign prognosis. However, there has been much debate on whether or not CPN can progress to PN. Although CPN lesions are fundamentally limited to skin, some CPN cases show extracutaneous symptoms such as peripheral neuropathy and myalgia. According to PN diagnostic criteria, which were established by the Ministry of Health, Labour and Welfare of Japan, a disease with both cutaneous and at least one extracutaneous symptom with appropriate histopathological findings can be diagnosed as PN. The same is true according to diagnostic criteria established by the American College of Rheumatology. In addition, there are no specific diagnostic criteria for CPN. In this study, CPN cases were retrospectively collected from multiple Japanese clinics, and analyzed for detailed clinical and histopathological manifestations, in order to redefine the clinical entity of CPN and to propose appropriate diagnostic criteria for CPN and PN. According to the CPN description in Rook's Textbook of Dermatology, we collected 22 cases with appropriate histopathological findings. Of the 22 cases, none progressed to PN or death during the follow-up period, 32% had peripheral neuropathy and 27% had myalgia. Regarding extracutaneous symptoms with CPN, 17 dermatological specialists in vasculitis sustained the opinion that CPN can be accompanied by peripheral neuropathy and myalgia but these symptoms are limited to the same area as skin lesions. Based on these results, we devised new drafts for CPN and PN diagnostic criteria. Our study shows the efficacy of these criteria and most dermatologists recognized that our new diagnostic criteria for CPN and PN are appropriate at the present time. In conclusion, this study suggests that CPN does not progress to PN, and introduces new drafts for CPN and PN diagnostic criteria.


Decreased resistance to N,N-dimethylated anthracyclines in multidrug-resistant Friend erythroleukemia cells.
Doxorubicin-resistant Friend erythroleukemia cells, line F4-6 ADM2R, were selected by exposure of wild-type F4-6 cells to doxorubicin concentrations of up to 1 microgram/ml. In these cells, increased expression of multidrug resistance (MDR) genes was demonstrated by Northern blot analysis. The growth-inhibitory effect of doxorubicin, daunorubicin, N,N-dimethyldoxorubicin, N,N-dimethyldaunorubicin, morpholinodoxorubicin, and pyrromycin was comparatively investigated in resistant and wild-type cells. The doxorubicin-resistant F4-6 cells showed approx. 200-fold resistance to doxorubicin and about 100-fold resistance to daunorubicin with respect to the drug-sensitive counterpart. A dramatic decrease in resistance was observed for the N,N-dimethylated derivatives of doxorubicin and daunorubicin as well as for the N,N-dimethylated natural anthracycline pyrromycin and for morpholinodoxorubicin. Uptake studies using [14C]-daunorubicin and [14C]-N,N-dimethyldaunorubicin in resistant F4-6 cells showed a decreased accumulation of daunorubicin but no significant reduction in N,N-dimethyldaunorubicin accumulation as compared with the wild-type cells. Treatment with verapamil led to increased intracellular levels of daunorubicin in resistant cells, whereas an excess of N,N-dimethyldaunorubicin did not have this effect. Thus, the decreased resistance of the doxorubicin-resistant F4-6 cells to the N-alkylated anthracyclines may at least in part be due to a reduced affinity of these compounds for the efflux pump. The results indicate that the dimethylation of the amino group of the anthracycline sugar moiety and its incorporation within a morpholinyl ring may overcome MDR by similar mechanisms.


Application of Monte Carlo simulation to cavity theory based on the virtual electron source concept.
A cavity theory based on the application of the electron transport equation in the cavity and the surrounding medium, referred to as L-L cavity theory in this paper, is discussed. The L-L cavity theory is a very detailed theory that considers electron production in the cavity as well as in the wall, and is applicable to all cavity sizes. The main idea of this cavity theory is that the effect of the cavity on the energy deposition of electrons inside it can be attributed to a virtual electron source uniformly distributed in the cavity. Monte Carlo calculations have been used to determine the effect of the virtual electron source on the relative ionization density in the cavity. In particular, the Monte Carlo method has been used to compute the parameter k(E, a), which is the fraction of the energy deposited in the cavity relative to the initial energy of electrons, given an electron source uniformly distributed in the cavity. The total energy deposition of the virtual electron source in the cavity may also be obtained. The calculated results agree well with the experimental results from Attix et al (Attix F H, Vergne L D and Ritz V H 1958 J. Res. NBS 60 235-43) and show that the L-L cavity theory gives a more accurate prediction of the cavity response at low energies than do other cavity theories.


Dynamics of ion exchange between self-assembled redox polyelectrolyte multilayer modified electrode and liquid electrolyte.
A probe beam deflection (PBD) study of ion exchange between an electroactive polymer poly(allylamine)-bipyridyl-pyridine osmium complex film and liquid electrolyte is reported. The PBD measurements were made simultaneously to chronoamperometric oxidation-reduction cycles, to be able to detect kinetic effects in the ion exchange. Layer-by-layer (LbL) self-assembled redox polyelectrolyte films with osmium bipyridyl complex covalently attached to poly(allylamine) (PAH-Os) and poly(styrene sulfonate) (PSS) have been built by alternate electrostatic adsorption from soluble polyelectrolytes. The ionic exchange during initial conditioning of the film ("break-in") undergoing oxidation-reduction cycles and recovery after equilibration in the reduced state have shown an exchange of anions and cations with time lag between them. The effect of the nature of cation on the ionic exchange has been investigated with dilute HCl, LiCl, NaCl, and CsCl electrolytes. The ratio of anion to cation exchanged at the film-electrolyte interface has a strong dependence on the nature of charge in the topmost layer, that is, when negatively charged PSS is the capping layer, a larger proportion of cation exchange is observed. This demonstrates that the electrical potential distribution at the redox polyelectrolyte multilayer (PEM)/electrolyte interface determines the ionic flux in response to charge injection in the film.


Relationship between glycosylated hemoglobin and the prevalence of proteinuria in Japanese men.
A total of 5,174 Japanese men were included in a cross-sectional study to examine the relationship between the glycated hemoglobin (HbA1C) level and the prevalence of proteinuria as determined using a reagent strip. The prevalence of proteinuria rose significantly at HbA1C levels above 5.9%, whereas no relationship was observed at HbA1C levels below 5.9%. Multiple logistic regression analysis showed that blood pressure and a family history of diabetes were independent factors associated with proteinuria in subjects with a HbA1C below 5.9% who were not under medication for diabetes. In contrast, HbA1C, obesity and smoking were associated with proteinuria in subjects who were under medication for diabetes and/or have a HbA1C above 5.9%. These findings suggest that maintaining a HbA1C level below 5.9%, non-smoking and a standard body weight may reduce the prevalence of proteinuria in Japanese men. Healthy life-style and standard body weight are especially important for subjects with a family history of diabetes.


Ascaris lumbricoides infection and environmental risk factors in an urban African setting.
Identification of appropriate strategies for controlling gastro-intestinal nematodes in communities depends, in part, on an understanding of the conditions that increase risk of exposure to infective stages. The present study was conducted in Lubumbashi, Zaire. The objectives were to identify features of the environment and living conditions that were significant predictors of Ascaris lumbricoides infection, and to determine whether the same predictors were important in populations living in subdivisions of lower (LSES) and higher (HSES) socio-economic status. Forty-two households from each of three subdivisions (two LSES and one HSES) were selected at random. Mothers were interviewed, observations on the environment around the home were recorded, and single stool samples, collected from all children and mothers, were examined for nematode eggs. Maternal education was a significant predictor of A. lumbricoides intensity in both LSES and HSES subdivisions. Factors related to poor sanitation (open defecation and high number of people using the same toilet) were important in the LSES subdivisions but not in the HSES subdivision. In contrast, the ratio of relatives to direct family members per household was a significant predictor of high intensity of infection in the HSES subdivision, but not in the LSES subdivisions, indicating that relatives and live-in visitors contribute to Ascaris transmission in the HSES population.


Application of a hybrid 3D-2D laser scanning system to the characterization of slate slabs.
Dimensional control based on 3D laser scanning techniques is widely used in practice. We describe the application of a hybrid 3D-2D laser scanning system to the characterization of slate slabs with structural defects that are difficult for the human eye to characterize objectively. Our study is based on automating the process using a 3D laser scanner and a 2D camera. Our results demonstrate that the application of this hybrid system optimally characterizes slate slabs in terms of the defects described by the Spanish UNE-EN 12326-1 standard.


[Prevalence of sarcopenia in older age hospitalized persons, as determined by different sets of diagnostic criteria.]
Sarcopenia is a geriatric syndrome characterised by the progressive loss of skeletal muscle mass, muscular strength, and physical performance; it carries the risk of physical incapacity and reduced quality of life. This work reported the prevalence of sarcopenia in people aged ≥65 years, all in-patients at the Hospital Central de la Defensa Gómez Ulla, as determined by three sets of diagnostic criteria. The suitability of the indistinct use of these criteria sets was discussed. This was a cross sectional study. Sarcopenia was diagnosed depending on muscle mass, strength and functionality according to the European Working Group on Sarcopenia in Older People (EWGSOP), EWSOP2 and SARCF criteria. This study involved 295 people, all aged ≥65 years, and all of whom had been admitted to the above hospital between 1st March and 30th September 2018. Sampling was consecutive and performed at the internal medicine ward. The overall prevalence of sarcopenia was 43.7% [95%CI 38-49.4%] according to the EWGSOP criteria, 28.5% [23.3-33.7%] according to EWGSOP2, and 37.6% [32-43.1%] according to SARCF. The EWGSOP criteria showed sarcopenia to be significantly more common among men than women (p<0.05). The prevalence of sarcopenia recorded differed depending on the set of criteria used; they cannot, therefore, be used indistinctly for the diagnosis of this condition. Rather, given the results obtained, it would seem reasonable, in Europe, to continue using the EGSWOP criteria while research continues in this area.


Risk and predictors for pregnancy-related complications in women with heart disease.
The physiological changes of pregnancy can result in cardiovascular complications in the mother, which in turn may have fetal implications. Prior studies have focused on specific cardiac lesions or identified univariate predictors. There is a need to refine the risk stratification of women with heart disease so they can receive appropriate obstetrical counseling and care. We examined the outcomes of 221 women with heart disease who underwent 276 pregnancies and received their obstetrical care at three Toronto hospitals from 1986 through 1994. Those who underwent therapeutic abortions were excluded. Among the study participants, there were 24 miscarriages and 252 completed pregnancies (pregnancies not ending in miscarriage). Maternal heart failure, arrhythmia, or stroke occurred in 45 completed pregnancies (18%). There were no maternal deaths. Poor maternal functional class or cyanosis, myocardial dysfunction, left heart obstruction, prior arrhythmia, and prior cardiac events were predictive of maternal cardiac complications. These predictors were incorporated into a point score that can be used to estimate the probability of a cardiac complication in the mother. The rate of cardiac complications for a patient with 0, 1, and >1 of the above factors was 3%, 30%, and 66%, respectively. Neonatal complications occurred in 42 completed pregnancies (17%). Neonatal events included death (2), respiratory distress syndrome (16), intraventricular hemorrhage (2), premature birth (35), and small-for-gestational-age birth weight (14). Poor maternal functional class or cyanosis was predictive of neonatal events. Despite low maternal and neonatal mortality, pregnancy in women with heart disease is associated with significant cardiac and neonatal morbidity. The probability of maternal cardiac or neonatal events can be predicted from baseline characteristics of the mother.


Newer diagnostic techniques for tuberculosis.
Diagnosis of tuberculosis is mainly based on clinical features, histopathology, demonstration of acid fast bacilli (AFB) and isolation of Mycobacterium tuberculosis from the clinical specimens. These techniques have limitations of speed, sensitivity and specificity. During the last two decades several rapid techniques for detection of early growth (5-14 days as compared to 2-8 wk with conventional methods) have been described which can help in obtaining the culture and sensitivity reports relatively early. Prominent among such methods are BACTEC, mycobacterial growth indicator tuber (MGIT), Septi-chek, MB/ BacT systems. This growth can be established by rapid methods based on lipid analysis and specific gene probes, PCR-RFLP methods and ribosomal RNA sequencing. Advances in knowledge about genetic structure of tubercle bacillus helped develop gene probes and gene amplification methods for identification and detection of tubercle bacillus, from culture or directly in clinical specimens and molecular detection of drug resistance. While the gene probes can help in rapid identification of isolates, gene amplification methods (PCR as well as isothermal) developed for diagnosis of tuberculosis are demonstrably highly sensitive specially in culture negative specimens from different paucibacillary forms of disease. With these molecular methods drug resistant mutants for drugs like rifampicin can be detected with reasonable certainty within hours. These gene probes, gene amplification methods and in situ approaches offer unparalleled capability to enhance the diagnosis of tuberculosis in near future.


Bone formation induced by BMP-2 in human osteosarcoma cells.
Our previous studies demonstrated that BMP-2 inhibits the tumorigenicity of cancer stem cells identified as cells with high aldehyde dehydrogenase activity (ALDH(br) cells) from the human osteosarcoma cell line OS99-1. We further investigated whether BMP-2 is capable of inducing bone formation in OS99-1 cells. Flow cytometry sorting was used to isolate tumorigenic ALDH(br) and non-tumorigenic ALDH(lo) cells. qRT-PCR was used to quantify the gene expression. A xenograft model was used to verify the bone formation in vivo. There was significantly higher mRNA expression of BMPR1B and BMPR2 in ALDH(lo) cells compared with that in ALDH(br) cells and the BMPR1B expression in ALDH(lo) cells was ~8-fold higher compared to that in ALDHbr cells. BMP-2 was also found to induce higher transcription of osteogenic markers Runx-2, Osterix (Osx), alkaline phosphatase (ALP) and collagen type I in ALDH(lo) cells compared to ALDH(br) cells, which were mediated by the canonical Smad signaling pathway. In vivo, BMP-2 was identified to induce bone formation in both ALDH(br) and ALDH(lo) cells. All animals receiving 1 x 10()4 ALDH(lo) cells treated with 30 µg of BMP-2 per animal showed bone formation within 1-2 weeks after injection in mice. Bone formation induced by BMP-2 in ALDH(lo) cells showed significantly more bone mineral content compared to that in ALDH(br) cells. BMP-2 induces bone formation in heterogeneous osteosarcoma cells and BMP-2 may have a promising therapeutic role for treating human osteosarcoma by inducing differentiation along an osteogenic pathway.


Intimate partner violence perpetration by court-ordered men: distinctions among subtypes of physical violence, sexual violence, psychological abuse, and stalking.
This study continues previous work documenting the structure of violence perpetrated by males against their female intimate partners. It assesses the construct validity of a measurement model depicting associations among eight subtypes of perpetration: moderate physical violence, severe physical violence, forced or coerced sexual violence, sexual violence where consent was not possible, emotional/verbal psychological abuse, dominance/isolation psychological abuse, interactional contacts/surveillance related stalking, and stalking involving mediated contacts. Data were obtained from a sample of 340 men arrested for physical assault of a female spouse or partner, and court ordered into batterer intervention programs. Men were surveyed before starting the intervention. Confirmatory factor analyses (CFA) supported the validity of model as evidenced by good model to data fit and satisfaction of requirements for fit statistics. In addition, the eight factor solution was characterized by a slightly better model to data fit than a four factor higher order solution described in the author's previous work. Latent variable correlations across the broader categories of intimate partner violence (IPV) revealed that the violence subtypes were mostly moderately positively correlated and ranged from .381 (emotional/verbal psychological abuse with interactional contacts/surveillance related stalking) to .795 (dominance/isolation psychological with abuse with forced sex). Future studies should determine whether there are distinct risk factors and health outcomes associated with each of the eight IPV perpetration subtypes and identify possible patterns of co-occurrence.


[Myofibromatosis in children. Histopathologic and ultrastructural study of a localized form with a spontaneously regressive course].
Report of a case of the localized form of infantile myofibromatosis, in a three-month-old boy with a brachial mass and osteolytic lesion of the adjacent humerus at radiographic examination. Diagnosis is made on the histopathological features of the lesion at biopsy. Ultrastructurally, the tumor cells have myofibroblastic differentiations. Evolution is regressive without any treatment. The anatomical, clinical, pathological, ultrastructural and evolutive features are discussed.


Production of an anti-idiotypic antibody single chain variable fragment vaccine against Edwardsiella tarda.
Edwardsiella tarda is the pathogen responsible for edwardsiellosis, a serious infectious disease of freshwater and marine fish species, and currently recognized to be the species pathogenic for human. An anti-idiotypic monoclonal antibody (mAb), 1E11, has been developed. It mimics the protective epitope of E. tarda and can prevent fish from infection of E. tarda. In this study, the correct variable heavy (VH) and variable light (VL) genes were obtained from 1E11 by using bioinformatics methods, and a 15 amino acid (Gly4Ser)3 linker was used to hold the two V domains together for the construction of VL-linker-VH form of single chain variable fragment (scFv) gene. Then, the scFv was subcloned into the vector pET-28a, expressed in the Escherichia coli BL21 cells, and identified by SDS-PAGE and western blotting. Red drum (Sciaenops ocellatus L.) weighing about 50 g was subjected to challenge with different E. tarda strains after 4 weeks followed by vaccination, the mortality rates and relative percentage survival were recorded and calculated, and the survival rate of fish in the scFv subgroups was obviously higher than that of control subgroups (P<0.01). Enzyme-linked immunosorbent assay results show that after 4 weeks of post-vaccination, the level of specific antibody in fish sera of scFv groups was significantly higher than control groups. This study indicates that the recombinant antibody scFv was successfully developed, and it may serve as an effective vaccine candidate against E. tarda.


[An elderly case of idiopathic thrombocytopenic purpura associated with acute myocardial infarction].
We report a rare case of idiopathic thrombocytopenic purpura (ITP) associated with acute myocardial infarction (AMI). A 72-year-old woman with hypertension and hemorrhoids was admitted because of chest pain, severe anemia (RBC 340 x 10(4)/microliter, Hb 5.4 g/dl, Ht 21.7%) and thrombocytopenia (0.2 x 10(4)/microliter). AMI was diagnosed by electrocardiogram (ST elevation and negative T in V2-5), echocardiogram (hypokinesis in anteroseptal wall) and laboratory (CPK 470 U/l) findings and was treated with only blood transfusion. Chest pain disappeared the day after admission, and neither heart failure nor arrhythmia occurred. Based on bone marrow findings (hyperplasia of erythroblast and megakaryocyte), endoscopic (internal hemorrhoids) and laboratory (antiplatelet antibody positive, platelet associated IgG 257.8 ng/10(7) cells) findings, iron deficiency anemia and ITP were diagnosed. Anemia improved after blood transfusion, but thrombocytopenia (< 1.0 x 10(4)/microliter) without active bleeding continued after steroid and gamma-globulin therapy. At discharge, electrocardiogram showed a negative T in I, aVL and V2-5, and T1 and BMIPP myocardial scintigram showed defects in the anteroseptal and apical wall.


Spontaneous healing capacity of calvarial bone defects in mdx mice.
The mdx mouse is an experimental model widely used for the study of Duchenne muscular dystrophy, which is characterized by the lack of dystrophin and cycles of muscle degeneration/regeneration. Studies demonstrated elevated levels of growth factors and accelerated skin wound repair in these animals. We therefore raised the hypothesis that the bone repair process might also be altered in these animals. Thus, the objective of this study was to evaluate the spontaneous healing of calvarial defects in mdx mice by histomorphometric analysis. Animals (45 days old) were divided into mdx and control groups. A defect measuring 2 mm in diameter was produced surgically in the right parietal bone of each animal. The animals were sacrificed 15, 30, and 60 days after surgery, and the skulls were processed by routine histological procedures. No difference in the volume of new bone inside the defect was observed between the two groups at any of the three postoperative time points. There was also no difference between the different periods of healing when each group was analyzed separately. The lower quality of femoral and calvarial bone in mdx mice reported in previous studies and the similar bone regeneration rates seen in two groups suggest that the healing capacity of calvarial defects was more expressive in mdx mice than in control animals. An increase in the amount of osteogenic factors released by damaged myofibers may have favored osteogenesis during bone defect healing in mdx mice.


Senescence in Wound Repair: Emerging Strategies to Target Chronic Healing Wounds.
Cellular senescence is a fundamental stress response that restrains tumour formation. Yet, senescence cells are also present in non-cancerous states, accumulating exponentially with chronological age and contributing to age- and diabetes-related cellular dysfunction. The identification of hypersecretory and phagocytic behaviours in cells that were once believed to be non-functional has led to a recent explosion of senescence research. Here we discuss the profound, and often opposing, roles identified for short-lived vs. chronic tissue senescence. Transiently induced senescence is required for development, regeneration and acute wound repair, while chronic senescence is widely implicated in tissue pathology. We recently demonstrated that sustained senescence contributes to impaired diabetic healing via the CXCR2 receptor, which when blocked promotes repair. Further studies have highlighted the beneficial effects of targeting a range of senescence-linked processes to fight disease. Collectively, these findings hold promise for developing clinically viable strategies to tackle senescence in chronic wounds and other cutaneous pathologies.


Detection of the tuberculosis biomarker mannose-capped lipoarabinomannan in human serum: Impact of sample pretreatment with perchloric acid.
The development of an accurate and rapid diagnostic test for tuberculosis (TB) to use at point of need is vital to efforts aimed at reducing the global burden from this disease. This paper builds on our previous studies of mannose-capped lipoarabinomannan (ManLAM) as a serum biomarker for active TB infection by means of a heterogeneous immunoassay. That work found that complexation with components in serum (e.g., proteins) sterically hindered the capture and/or labeling of ManLAM in an immunoassay at levels <10 ng mL-1, compromising the clinical utility of this biomarker for detection of active TB infection. We also showed that the acidification of ManLAM-containing serum samples with perchloric acid improved the detectability of ManLAM by 250× by complex disruption when compared to measurements of untreated serum. The present study examined what effects the PCA treatment of serum samples may have on the recovery and structural integrity of ManLAM, owing to its potential susceptibility to acid hydrolysis. Recovery was assessed with an enzyme-linked immunosorbent assay (ELISA). The possible impact of acid hydrolysis on the ManLAM structure was investigated by gas chromatography-mass spectrometry and carbohydrate chemical degradation methods. The ELISA study indicated that while the signal strength for ManLAM in the serum spike-in experiments was significantly stronger after PCA pretreatment when compared to untreated human serum, it was only ∼20% of the ManLAM measured in physiological buffer. This loss in detectability was shown by structural analysis to arise mainly from the acid-induced degradation of the arabinan domains of ManLAM that are targeted by antibodies used for antigen capture and/or tagging. The implications of these findings in terms of the detection of this important biomarker for TB are also discussed.


Comparison of Ventricular and Lumbar Cerebrospinal Fluid Composition.
Objective Cerebrospinal fluid (CSF) analysis is a common diagnostic tool used to evaluate diseases of the central nervous system (CNS). We sought to determine whether there is a difference between the composition of CSF sampled from an external ventricular drain (EVD) and lumbar drain (LD) and whether this made a difference in guiding therapeutic decisions. Patients and Methods This study was a retrospective analysis from a single neurosurgery service between the dates of January 2011 and April 2019. A total of 12,134 patients were screened. Inclusion criteria were ages 18-80 and the presence of both an EVD and LD. Exclusion criteria were not having both routes of CSF sampling and the inability to determine which samples originated from which compartment. Results Six patients underwent simultaneous spinal and ventricular routine CSF sampling <24 hours apart and were analyzed for their compositions. There were 42 samples, but only 20 paired EVD-LD samples that could be analyzed. When comparing the EVD and LD sample compositions, there were statistically significant differences in white blood cells (WBCs; p = 0.040), total protein (p = 0.042), and glucose (p = 0.043). Red blood cells (RBCs; p = 0.104) and polymorphonuclear leukocytes (PMN; p = 0.544) were not statistically significant. We found a statistically significant correlation between cranial and spinal CSF WBC (r = 0.944, p < 0.001), protein (r = 0.679, p = 0.001), and glucose (r = 0.805, p < 0.001). We also found that there was a significant correlation between CSF and serum glucose (r = 0.502, p = 0.040). There was no statistically significant correlation between RBCs (r = 0.276, p = 0.252). Conclusion Our results demonstrate a correlation between the cranial and spinal CSF samples, except for RBCs, with statistically significant differences in WBC, glucose, and protein values between the two sites. This confirms that sampling CSF via lumbar puncture, which carries less risk than a ventriculostomy and provides accurate data to help establish a diagnosis for intracranial pathologies.


Assessment of Functional Characteristics of Amnestic Mild Cognitive Impairment and Alzheimer's Disease Using Various Methods of Resting-State FMRI Analysis.
Resting-state functional magnetic resonance imaging (RS FMRI) has been widely used to analyze functional alterations in amnestic mild cognitive impairment (aMCI) and Alzheimer's disease (AD) patients. Although many clinical studies of aMCI and AD patients using RS FMRI have been undertaken, conducting a meta-analysis has not been easy because of seed selection bias by the investigators. The purpose of our study was to investigate the functional differences in aMCI and AD patients compared with healthy subjects in a meta-analysis. Thus, a multimethod approach using regional homogeneity, amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), and global brain connectivity was used to investigate differences between three groups based on previously published data. According to the choice of RS FMRI approach used, the patterns of functional alteration were slightly different. Nevertheless, patients with aMCI and AD displayed consistently decreased functional characteristics with all approaches. All approaches showed that the functional characteristics in the left parahippocampal gyrus were decreased in AD patients compared with healthy subjects. Although some regions were slightly different according to the different RS FMRI approaches, patients with aMCI and AD showed a consistent pattern of decreased functional characteristics with all approaches.


Giant-cell tumor of the second cervical vertebra treated by cryosurgery and irradiation.
A 17-year-old female presented with a large, destructive, giant-cell tumor of the second cervical vertebra. The lesion was obviously life-threatening. Owing to its proximity to the spinal cord and the danger of a pathologic fracture with cord transection and because of the effectiveness of cryosurgical methods in treating giant cell tumors of long bones, we decided to attempt local freezing of the lesion using a cryoprobe via a transoral approach. To further ensure tumor destruction, we followed cryosurgery with a course of radiotherapy (4600 rads). At this writing, 30 months later, healing has been excellent with no signs of recurrence, pain, tenderness or neurologic problems. To the best of our knowledge, this represents the first time a vertebral body bone tumor has been treated by cryosurgery.


Spatial and temporal change in trace element profiles in seawater, sediment and mussels associated with an earthquake rubble sea-fill.
Elemental profiles in seawater, sediment and green-lipped mussels (Perna canaliculus) were determined, following the deposition of earthquake demolition rubble into a newly developed sea-fill located adjacent to a busy commercial port with a history of diverse contaminant inputs. Zinc and lead displayed environmental concentrations that varied over time during sea-fill construction, and which declined with distance from the sea-fill, indicating that the sea-fill activity was the source of these two contaminants. A transplantation study using reference site mussels caged near the sea-fill, supported this finding. However, none of the trace metal burdens in resident or transplanted mussels were of regulatory concern. An integrated approach comprising the monitoring of multiple environmental matrices, examination of contaminant burdens as a function of time and distance from a putative point source, and the use of active biomonitoring techniques, is necessary to robustly identify novel contamination inputs in historically-polluted marine settings.


Case report: Paraneoplastic neurologic syndrome associated with squamous cell carcinoma of the tonsil.
Paraneoplastic syndromes include a variety of disorders that affect the neurologic, endocrine, mucocutaneous, hematologic, and other systems as a result of neoplastic disease. Although their presentations vary, syndromes occur when tumor antigens exhibit cross-reactivity to similar antigens expressed by these systems. The antigens in the nervous system are called "onconeural" antigens. Although many disorders are associated with a comparatively high incidence of paraneoplastic neurologic syndromes, only a few cases have been associated with squamous cell carcinoma (SCC) of the tonsil. We report the case of a 69-year-old man who initially presented with weakness and spastic gait. He was subsequently found to have a characteristic paraneoplastic tractopathy on thoracic magnetic resonance imaging. The subsequent workup and operative intervention identified a T2N0M0 SCC of the tonsil. Following resection, the patient's overall symptoms were significantly alleviated, and his gait improved. A thorough literature search yielded no other report of a tonsillar SCC with associated paraneoplastic thoracic spine tractopathy.


Genetic risk: women's understanding of carrier risks in Duchenne muscular dystrophy.
This paper reports a study of 48 women (16 mothers and 32 daughters representing 28 families) who had lived with Duchenne muscular dystrophy (DMD) in their family. It looks at the way the women talked about their carrier risks during the course of an unstructured interview. It points to a significant difference between lay and health professionals' perspectives, in particular the thresholds they used to distinguish between high and low risk. A number of women, when quoting their risk in a mathematical form, confused their reproductive risks with their carrier risk, another indication of differential perceptions between the women and health professionals. There was evidence that several of the women did not retain their risk in a mathematical form but had translated it into a descriptive category which resolved their risk into greater certainty.


Phase behaviour and conductivity study on multi-component mixtures for electrodeposition in supercritical fluids.
Electrochemistry in supercritical CO(2) (scCO(2)) is difficult because the very low dielectric constant of the fluid restricts the solubility of ionic species and the conductivity of dissolved electrolytes. To overcome this problem to allow us to carry out electrodeposition at macroelectrodes from scCO(2) we have investigated the use of co-solvents and modified electrolyte salts chosen to increase their solubility and dissociation in the supercritical fluid. Here we report results of phase behaviour studies for mixtures of CO(2) with [NBu(n)(4)][BF(4)] and either methanol (CH(3)OH) or acetonitrile (CH(3)CN) as the co-solvent. These show that the solubility of [NBu(n)(4)][BF(4)] is approximately 5 times larger when CH(3)CN is the co-solvent rather than CH(3)OH. Consequently the phase behaviour of the ternary of CO(2)-[NBu(n)(4)][BF(4)]-CH(3)CN was studied in greater detail over a range of compositions. To enhance the conductivity of scCO(2)-CH(3)CN a range of electrolyte salts was synthesised in which the [NBu(n)(4)](+) and/or [BF(4)](-) ion were replaced by different derivatives. Results for the phase behaviour and conductivity of these modified electrolyte salts in scCO(2)-CH(3)CN are reported for several different compositions. We find that increasing the degree of fluorination and size of the ions increases the solubility of the electrolyte salt in scCO(2)-CH(3)CN. Of the 11 electrolytes investigated [NBu(n)(4)][B{3,5-C(6)H(3)(CF(3))(2)}(4)] appears the most suitable for use in scCO(2)-CH(3)CN with a molar conductivity of 22-26 S cm(2) mol(-1) and a maximum measured conductivity of approximately 3 mS cm(-1) for 0.07 M [NBu(n)(4)][B{3,5-C(6)H(3)(CF(3))(2)}(4)] dissolved in scCO(2)-CH(3)CN (molar ratio CH(3)CN : CO(2) approximately 0.12) at 20 MPa and 328.15 K. This is an order of magnitude improvement over similar results for the [NBu(n)(4)][BF(4)] parent. Studies of the conductance as a function of the electrolyte concentration suggest that triple ions make an important contribution to the conductivity of the supercritical fluid.


Early cortisol values and long-term outcomes in extremely low birth weight infants.
Both excess and insufficient levels of glucocorticoid in extremely low birth weight (ELBW) infants have been associated with adverse hospital outcomes, whereas excess glucocorticoid exposure has been associated with long-term adverse neurodevelopment. Our objective was to evaluate the relationship between neonatal cortisol concentrations and long-term outcomes of growth and neurodevelopment. As part of a multicenter randomized trial of hydrocortisone treatment for prophylaxis of relative adrenal insufficiency, cortisol concentrations were obtained at 12 to 48 h of postnatal age and at days 5 to 7 on 350 intubated ELBW infants, of whom 252 survived and returned for neurodevelopmental follow-up at 18 to 22 months corrected age. Cortisol values from each time point were divided into quartiles. Growth and neurodevelopmental outcome were compared for each quartile. Median cortisol value was 16.0 microg per 100 ml at baseline for all infants, and 13.1 microg per 100 ml on days 5 to 7 in the placebo group. Outcomes did not differ in each quartile between treatment and placebo groups. Low cortisol values at baseline or at days 5 to 7 were not associated with impaired growth or neurodevelopment at 18 to 22 months corrected age. High cortisol values were associated with an increase in cerebral palsy, related to the increased incidence of severe intraventricular hemorrhage (IVH) and periventricular leukomalacia. Low cortisol concentrations were not predictive of adverse long-term outcomes. High cortisol concentrations, although predictive of short-term adverse outcomes such as IVH and periventricular leukomalacia, did not additionally predict adverse outcome. Further analysis into identifying factors that modulate cortisol concentrations shortly after birth could improve our ability to identify those infants who are most likely to benefit from treatment with hydrocortisone.


The Effects of the Family Bereavement Program to Reduce Suicide Ideation and/or Attempts of Parentally Bereaved Children Six and Fifteen Years Later.
Findings concerning the long-term effects of the Family Bereavement Program (FBP) to reduce suicide ideation and/or attempts of parentally bereaved children and adolescents are presented. Parental death is a significant risk factor for suicide among offspring (Guldin et al., 2015). This study is a long-term follow-up of 244 children and adolescents who had participated in a randomized trial of the FBP, examining the intervention effects on suicide ideation and/or attempts as assessed through multiple sources. Results indicate a significant effect of the FBP to reduce suicide ideation and/or attempts at the 6- and 15-year follow-up evaluation. The findings support the potential benefits of further research on "upstream" suicide prevention.


Microtubule-active drugs suppress the closure of the permeability transition pore in tumour mitochondria.
We report the effects of anticancer drugs, inhibitors of microtubule organisation, on the mitochondrial permeability transition pore (PTP) in Ehrlich ascites tumour cells. Taxol (5-20 microM) and colchicine (100-500 microM) prevented closing of the cyclosporin A-sensitive PTP. No taxol or colchicine effects on oxidative phosphorylation were observed in the range of concentrations used. We suggest that either membrane-bound tubulin per se can be part of PTP and/or the attachment of mitochondria to the microtubular network is essential for PTP regulation. The taxol inhibition of PTP closure, mediated through interaction with the cytoskeleton, sheds new light on the cytotoxic properties of this anticancer drug.


Parry-Romberg syndrome (progressive hemifacial atrophy) with spasmodic dysphonia--a rare association.
Parry-Romberg syndrome is a rare clinical entity characterised by progressive hemifacial atrophy with appearance of 'saber'. Various neurological and otorhinolaryngological disorders are associated with this syndrome. The association of Parry -Romberg syndrome with Spasmodic dysphonia has rarely been reported. A 37 year old female presented with progressive atrophy of tissues of left side of face for 10 years and change in voice for 1 year. On examination, wasting and atrophy of tissues including tongue was noted on left side of the face. ENT examination revealed adductor spasmodic dysphonia. We report the rare association of Parry -Romberg syndrome with spasmodic dysphonia.


Image Registration based Cervical Cancer Detection and Segmentation Using ANFIS Classifier
Cervical cancer is the leading cancer in women around the world. In this paper, Adaptive Neuro Fuzzy Inference System (ANFIS) classifier based cervical cancer detection and segmentation methodology is proposed. This proposed system consists of the following stages as Image Registration, Feature extraction, Classifications and Segmentation. Fast Fourier Transform (FFT) is used for image registration. Then, Grey Level Co-occurrence Matrix (GLCM), Grey level and trinary features are extracted from the registered cervical image. Next, these extracted features are trained and classified using ANFIS classifier. Morphological operations are now applied over the classified cervical image to detect and segment the cancer region in cervical images. Simulations on large cervical image dataset demonstrate that the proposed cervical cancer detection and segmentation methodology outperforms the state of-the-art methods in terms of sensitivity, specificity and accuracy.


The rebuilding of normal venous circulation for transverse-sigmoid dural arteriovenous fistulas by percutaneous transluminal angioplasty. A case report.
The etiology of dural arteriovenous fistulas (DAVFs) remains controversial as is the issue of whether occlusion or stenosis of the transverse sinus and sigmoid sinus is a cause or a result of DAVFs. We report a case of DAVFs with transverse-sigmoid sinus occlusion and cortical venous reflux. In this case, the reconstruction of normal venous circulation by percutaneous transluminal angioplasty (PTA) for the occluded sinus was performed and cortical venous reflux diminished. PTA may be a useful treatment for DAVFs with occluded or stenotic sinus.


Auditory training for adults with cochlear implants: a systematic review.
To systematically review the peer-reviewed literature on the efficacy of auditory training (AT) on auditory outcomes in post lingually deafened adults with cochlear implants (CIs). A systematic review. Searches of five electronic databases yielded 10 studies published after 2010 that met the inclusion criteria. For post lingually deafened adults with CIs, the evidence is suggestive that some AT can improve some auditory outcomes compared to no training. More specifically, the evidence suggests that phonemic training can improve identification of trained phonemes, and nonsense word training can improve sentence recognition in noise in this population. While many AT interventions are currently being used with post lingually deafened adults with CIs, the evidence for AT improving auditory outcomes is suggestive with the best evidence being for nonsense word training improving sentence recognition in noise by an average of 10% with these improvements retained at 26 weeks post-training in this population. There remains a need for high quality studies that have the capacity to demonstrate, clearly and unequivocally, which AT is most effective for improving which auditory outcomes in this population.


Effects of "Chinese yam" on hepato-nephrotoxicity of acetaminophen in rats.
To study the effect of yam in Taiwan, which is a commonly used Chinese medicine, on hepato-nephro-toxicity in rats. Crude water extract of yam (Dioscorea alata L), was used to treat rats with an acute toxicity induced by acetaminophen (APAP) challenge. The pharmacological and biochemical studies showed the extract of yam had the effect of kidney secureness and liver fortification (P < 0.01). The pathologic sections showed good improvements in renal tubular degranulation changes, necrosis and disintegration. The extract of yam also possessed a good protection against the inflammation of central vein and necrosis of liver tissue. The liver and kidneys are originated from the same source. Pathologically, deficiency of the life essence in the kidney may lead to the blood deficiency in the liver. The results showed that the yam could prevent the damages of the liver and kidneys, thus preserving their functions. This could b e the reason why the yam was commonly used in traditional Chinese medicine, as seen in Liuwei Dihuang Wan be used in the case of deficiency of liver-yin and kidney-yin.


Changes in nutritional value and cytotoxicity of garden cress germinated with different selenium solutions.
The selenium supply in almost all European countries is below the recommended daily intake, and different strategies are followed to fortify foods. In the present work, the influence of germination of garden cress ( Lepidium sativum cv. Ogrodowa) in different selenium solutions (Na(2)SeO(3) and Na(2)SeO(4)) on Se uptake, total antioxidant capacity, glucosinolates, protein, and amino acids was studied. Cytotoxicity in HL-60 human leukemic cell line was also assessed. The addition of selenite (Na(2)SeO(3)) or selenate (Na(2)SeO(4)) led to a significant increment in Se uptake in garden cress sprouts, and the highest Se content was observed at 8 mg/L in both inorganic Se solutions (36-38 microg/g of dm). The Se-enriched sprouts presented a large total antioxidant capacity (142-157 mumol of Trolox/g of dm), total glucosinolate content (99-124 microg/g of dm), protein (36-37% dm), and total essential amino acid content (40-41 g/100 g of protein), and no cytotoxicity on HL-60 human leukemic cells was observed. Garden cress sprouts obtained with selenite solution at 8 mg/L presented the best nutritional qualities and might provide a substantial proportion of Se in European diets. Bearing in mind the high nutritional value of sprouts, these may serve for the production of functional foods.


A novel all-trans retinoic acid derivative inhibits proliferation and induces differentiation of human gastric carcinoma xenografts via up-regulating retinoic acid receptor β.
This study is to investigate the in vivo effects of 4-amino-2-trifluoromethyl-phenyl retinate (ATPR) on gastric carcinomas (GC). Adult male nude mice were subcutaneously injected with SGC-7901 human gastric cancer cells. Tumor cell cycle was analyzed with flow cytometry. The expression levels of cycloxygenase 2 (COX-2) and carcinoembryonic antigen (CEA) in xenograft tumors were detected with immunohistochemistry. The mRNA and protein expression levels of nuclear retinoic acid receptor β (RARβ) were detected with RT-PCR and Western blot analysis, respectively. The mean survival time was dramatically increased in the ATPR treatment groups, in a dose-dependent manner. The in vivo results showed that, the xenograft tumor growth was significantly inhibited by the ATPR treatment. Moreover, the percentages of cells in the G0/G1 phase were significantly increased, while the percentages of cells in the S phase were significantly decreased, in the ATPR treatment groups. The serum levels of ALP and LDH were both dramatically decreased in the ATPR treatment groups. Furthermore, immunohistochemistry showed that, the expression levels of COX-2 and CEA were dramatically decreased in the ATPR treatment groups. Importantly, the mRNA and protein expression levels of RARβ in xenograft tumors were apparently increased by the ATPR treatment. ATPR could inhibit proliferation and induce differentiation of human gastric carcinoma xenografts via up-regulating RARβ expression. ATPR might be a potential effective antitumor agent for the treatment of GC.


A test of three alternative pathways for consumer regulation of primary productivity.
The pathways linking consumer effects to primary productivity (PPR) are likely to vary among taxa because of species-specific trophic and functional differences. Thus, it is necessary to understand the dynamics of consumer-PPR interactions so that effects of species loss on ecosystem function can be addressed from a mechanistic approach. In this study, I used three fish taxa (orangethroat darter, Etheostoma spectabile; western mosquitofish, Gambusia affinis; and bullhead minnow, Pimephales vigilax) as model consumers with different trophic and functional characteristics to test alternative mechanisms for consumer regulation of PPR (i.e., trophic cascade, terrestrial nutrient translocation, and sedimentary nutrient translocation). Experiments were conducted in stream mesocosms fitted with a combination of fish and terrestrial insect barriers to address relative importance of consumer-driven top-down and bottom-up control of PPR. A predatory invertivore, orangethroat darter, increased PPR through an apparent trophic cascade by localized reduction of benthic grazing invertebrate densities (i.e., top-down). A surface feeding insectivore, western mosquitofish, consumed terrestrial insects on the stream surface, increasing PPR by enhancing allochthonous nutrients in the mesocosms (i.e., bottom-up). A benthic omnivore, bullhead minnow, consumed benthic food items, resulting in increased PPR by enhancing availability of autochthonous nutrients via translocation of sedimentary nutrients (i.e., bottom-up). However, under specific environmental contexts, this species also consumed terrestrial invertebrates, potentially affecting PPR through terrestrial nutrient translocation as well. In this study, the trophic and functional characteristics of different species resulted in alternative pathways that increased PPR, suggesting that in natural ecosystems multiple consumer-driven pathways may be influencing PPR simultaneously and could potentially be important for temporal persistence of ecosystem function in changing environments.


End-of-life care in pediatrics: ethics, controversies, and optimizing the quality of death.
Hospitalized children constitute most annual pediatric deaths in the United States. The details of "how-to" provide end-of-life (EOL) care are not consistently taught to staff and therefore the actual delivery of EOL care is often inconsistent and invariably negatively associated with the long-term mental health of both the patient's family and care providers. This review describes the pertinent aspects of end-of-life care in pediatrics. Finally, a framework to optimize the quality of death is described, which underscores the importance of synchrony between the care team and the family at the end of a child's life.


Treadmill Exercise Ameliorates Depression-Like Behavior in the Rats With Prenatal Dexamethasone Exposure: The Role of Hippocampal Mitochondria.
Prenatal exposure to synthetic glucocorticoids (sGCs) can increase the risk of affective disorders, such as depression, in adulthood. Given that exercise training can ameliorate depression and improve mitochondrial function, we sought to investigate whether exercise can ameliorate depression-like behavior induced by prenatal sGC exposure and mitochondria function contributes to that behavior. At first, we confirmed that prenatal dexamethasone (Dex) administration in late pregnancy resulted in depression-like behavior and elevated level of circulatory corticosterone in adult offspring. We then found that mRNA and protein expression of a number of mitochondrial genes was changed in the hippocampus of Dex offspring. Mitochondria in the hippocampus showed abnormal morphology, oxidative stress and dysfunction in Dex offspring. Intracerebroventricular (ICV) injection of the mitochondrial superoxide scavenger mitoTEMPO significantly alleviated depression-like behavior but did not significantly affect circulatory corticosterone level in Dex offspring. The adult Dex offspring treated with treadmill exercise starting at four-weeks of age showed ameliorated depressive-like behavior, improved mitochondrial morphology and function and reduced circulatory corticosterone level. Our data suggest mitochondria dysfunction contributes to depression-like behavior caused by prenatal sGC exposure. Intervention with exercise training in early life can reverse depression caused by prenatal Dex exposure, which is associated with improvement of mitochondrial function in the hippocampus.


Bileaflet mechanical prostheses in mitral and multiple valve replacement surgery: influence of anticoagulant management on performance.
The St. Jude Medical (SJM) mechanical prosthesis has been the predominant mechanical prosthesis worldwide since its introduction in 1977. The CarboMedics (CM) mechanical prosthesis, also a bileaflet pyrolite carbon prosthesis, was introduced in 1986 and was approved by the Food and Drug Administration of the United States in 1993. The experience of the two prostheses was evaluated in a parallel, nonrandomized study commencing with the CM investigational study in 1989. The clinical performance of the two prostheses was evaluated in accordance with the Guidelines for Reporting Morbidity and Mortality After Cardiac Valvular Operations. The CM prosthesis was implanted in 239 mitral valve replacements (MVR) and 106 multiple valve replacements (MR), and the SJM prosthesis was implanted in 379 MVR and 137 MR. The CM and SJM populations were not distinguished within MVR and MR for mean age, previous surgery, concomitant surgery, mean follow-up, and late mortality (P=NS). The linearized occurrence rate for the combined experience for major thromboembolic and hemorrhage events >30 days was 3.4% of patients per year for MVR (inclusive of cerebral thromboembolism reversible, major; systemic; thrombosis; and fatal; and major systemic hemorrhage) and for MR was 3.9% of patients per year (P=NS between prostheses by position). The major crude event rate for < or =30 days was 1.3% for MVR and 1.2% for MR (P=NS between prostheses by position). The inadequacy of anticoagulation (as determined by international normalized ratio 2.5) for all thromboembolic events (major and minor) < or =30 days was 93%, and that for >30 days was 75%. The freedom from major thromboembolism for MVR at 3 years was 92.7+/-1.9% for CM and 94.0+/-1.5% for SJM; for MR, it was 94.2+/-3.0% for CM and 93.5+/-2.5% for SJM (P=NS). The freedom from major thromboembolism exclusive of early events for MVR at 3 years was 94.4+/-1.8% for CM and 94.8+/-1.4% for SJM, and for MR, it was 94.2+/-3.0% for CM and 95.0+/-2.2% for SJM (P=NS). The freedom from major thromboembolism and hemorrhage for prostheses (CM and SJM) by valve positions (MVR and MR) was also indistinguishable (P=NS). There are no distinguishing performance characteristics with regard to thromboembolic and hemorrhagic events between the CM and the SJM mechanical prostheses in MVR and MR. There was an identified need for improvement in the early and late anticoagulant management. A randomized trial with optimization of anticoagulant management between the CM and SJM mechanical prostheses is recommended.


[The "dangerous loop" of the internal carotid artery. An anatomic study].
Variations of the clinical course of the internal carotid artery in the parapharyngeal space were studied in order to define possible causes of acute hemorrhage during pharyngeal surgery. Four cases of sigmoid tortuosity involving the internal carotid artery were found in a total of 81 dissected carotid sheathes and 8 corrosion casts. In 2 cases the internal carotid artery was located in direct contact with the tonsillar fossa to form a clinically unsafe carotid tortuosity that was considered at risk during tonsil surgery.


Interorganellar DNA transfer in wheat: dynamics and phylogenetic origin.
A homology search of wheat chloroplast (ct) and mitochondrial (mt) genomes identified 54 ctDNA segments that have homology with 66 mtDNA segments. The mtDNA segments were classified according to their origin: orthologs (prokaryotic origin), xenologs (interorganellar DNA transfer origin) and paralogs (intraorganellar DNA amplification origin). The 66 mtDNA sequences with homology to ctDNA segments included 14 paralogs, 18 orthologs and 34 xenologs. Analysis of the xenologs indicated that the DNA transfer occurred unidirectionally from the ct genome to the mt genome. The evolutionary timing of each interorganellar DNA transfer that generated a xenolog was estimated. This analysis showed that 2 xenologs originated early in green plant evolution, 4 in angiosperm evolution, 3 in monocotyledon evolution, 9 during cereal diversification and 8 in the evolution of wheat. Six other xenologs showed recurrent transfer from the ct to mt genomes in more than one taxon. The two remaining xenologs were uninformative on the evolutionary timing of their transfer. The wheat mt nad9 gene was found to be chimeric, consisting of the cereal nad9 gene and its 291 bp 5'-flanking region that included a 58 bp xenolog of the ct-ndhC origin.