Efficacy and complications of argon plasma coagulation for hemorrhagic chronic radiation proctitis.
Chronic radiation proctitis (CRP) is a complication which occurs in 1%-5% of patients who undergo radiotherapy for pelvic malignancies. Although a wide range of therapeutic modalities are available, there is no literature to date showing any particularly appropriate therapeutic modality for each disease stage. Argon plasma coagulation (APC) is currently recommended as the first-choice treatment for hemorrhagic CRP, however, its indication based on long-term follow-up is still unclear. On the hypothesis that the long-term efficacy and safety of APC are not fully understood, we reviewed APC treatment for patients with hemorrhagic CRP from a single center. To assess the long-term efficacy and safety of APC for hemorrhagic CRP. This is a retrospective study of consecutive patients treated with APC for hemorrhagic CRP from January 2013 to October 2017. Demographics, clinical variables, and typical endoscopic features were recorded independently. Success was defined as either cessation of bleeding or only occasional traces of bloody stools with no further treatments for at least 12 mo after the last APC treatment. We performed univariate and multivariate analyses to identify factors associated with success and risk factors for fistulas. Forty-five patients with a median follow-up period of 24 mo (range: 12-67 mo) were enrolled. Fifteen (33.3%) patients required blood transfusion before APC. Successful treatment with APC was achieved in 31 (68.9%) patients. The mean number of APC sessions was 1.3 (1-3). Multivariate analysis showed that APC failure was independently associated with telangiectasias present on more than 50% of the surface area [odds ratio (OR) = 6.53, 95% confidence interval (CI): 1.09-39.19, P = 0.04] and ulcerated area greater than 1 cm2 (OR = 8.15, 95%CI: 1.63-40.88, P = 0.01). Six (13.3%) patients had severe complications involving rectal fistulation. The only factor significantly associated with severe complications was ulcerated area greater than 1 cm2 (P = 0.035). The long-term efficacy of APC for hemorrhagic CRP is uncertain in patients with telangiectasias present on > 50% of the surface area and ulceration > 1 cm2.


Deliberations and evaluations of the approaches, endpoints and paradigms for selenium and iodine dietary recommendations.
Information is presented regarding the approaches that have been used to establish dietary recommendations for selenium and iodine. In the case of selenium, activity of the selenoenzyme glutathione peroxidase has served as a convenient biochemical endpoint for judging nutritional status. However, there are differences of opinion among various nutritionists as to whether full expression of this enzymatic activity is required for adequate nutriture, thereby resulting in differences in dietary recommendations. Endpoints for assessing selenium overexposure are much less satisfactory, but toxicological standards for selenium have nevertheless been established. Thus far, no nutritionists have attempted to shift the paradigm for determining dietary selenium recommendations away from prevention of deficiency disease to prevention of chronic degenerative disease (e.g., cancer). In the case of iodine, urinary excretion of the element is the most widely used endpoint for judging nutritional status. Numerous epidemiological surveys have been conducted to determine the level of urinary iodine excretion that is consistent with prevention of goiter, the most common endpoint of iodine deficiency. Because dietary iodine is essentially quantitatively excreted in the urine, determination of the latter in goitrous areas will allow an almost direct estimation of those intakes at risk of developing deficiency disease. Iodine toxicity is complicated by the fact that some persons are quite tolerant to the element whereas others are highly sensitive to it. There are relatively complete data sets concerning exposure vs. human health effects for both selenium and iodine so that sounder bases probably exist for their dietary recommendations than for many other trace elements.


Successful surgical treatment of craniopharyngioma in very young children.
Given the potential morbidity of cranial irradiation in young children, the risk-benefit analysis of limited surgery plus irradiation versus radical resection may favor the latter strategy. The purpose of this study was to assess the oncological, endocrinological, and functional outcomes of patients 5 years of age and younger who underwent radical resection of craniopharyngiomas. Between 1991 and 2008, 19 children age < or = 5 years were diagnosed with a craniopharyngioma and underwent radical resection by the senior author (J.H.W.). Data were retrospectively collected on these 19 patients (11 males, 8 females; mean age 3.2 years) to assess the efficacy and impact of surgical treatment. Eighteen (95%) of 19 patients underwent gross-total resection (GTR) confirmed by intraoperative inspection and postoperative imaging. There was no operative death and 18 of (95%) 19 patients were alive at a mean follow-up of 9.4 years (median 8.3 years). Six patients (31%) had a total of 7 tumor recurrences treated by repeat GTR in 5 patients and Gamma knife surgery in 1 patient. No patient required conventional, fractionated radiation therapy. Disease control was achieved surgically in 17 (89.5%) patients and with surgery and Gamma knife surgery in 1 patient, yielding an overall rate of disease control of 95% without the use of conventional radiotherapy. New-onset diabetes insipidus occurred in 50% of patients. Vision worsened in 1 patient, and there was no long-term neurological morbidity. In this retrospective series, children aged < or = 5 years with craniopharyngiomas can have excellent outcomes with minimal morbidity after radical resection by an experienced surgeon. Disease control in this population can be successfully achieved with GTR alone in the majority of cases, avoiding the detrimental effects of radiotherapy in this vulnerable population.


Is carbon dioxide as an insufflation agent for double contrast barium enema still worthwhile after a same-day flexible sigmoidoscopy?
The aim of the study was to evaluate the efficacy of a double-contrast barium enema (DCBE) with CO(2) as a distending gas after a screening flexible sigmoidoscopy for reducing abdominal distension after an examination. A total of 165 DCBEs for patients with positive faecal occult blood tests were randomly allocated to a CO(2) group (n = 83) and a control group (n = 82) using air. Abdominal radiograph were taken before the DCBE, immediately following it, and 30 minutes later to determine residual bowel gas. The degree of abdominal discomfort was recorded using a scoring system. The patients in the CO(2) group had significantly smaller amounts of residual gas 30 minutes after the DCBE than did the control group, both in the colon (P < 0.02) and in the small intestine (P < 0.001). There was significantly less abdominal distension after the DCBE in the CO(2) group compared to the control group (P < 0.001). The abdominal discomfort score at 30 minutes after CO(2) correlated with the residual gas in the small intestine (r = 0.390,P = 0.003) but not in the colon (r = 0.155, P = 0.15). The quality of the images and the number of polyps detected did not differ between two groups. We concluded that using CO(2) when administering a DCBE after a screening sigmoidoscopy was useful for relieving abdominal discomfort following the examination; furthermore, it did not impair the diagnostic ability of the DCBE.


The distribution of mitochondrial activity in relation to optic nerve structure.
The observation of a buildup of mitochondria at the level of the lamina cribrosa in the optic nerve head has traditionally been attributed to axoplasmic stasis. However, this region is also the transition zone for myelination, resulting in differing energy requirements. To investigate the relationship between myelination and mitochondrial activity in optic nerve tissue. Histological, histochemical, and immunocytochemical techniques were used to demonstrate the distribution of myelin, cytochrome-c oxidase activity, and laminar structure in human optic nerve tissue. A study of rabbit optic nerve and retina and unmyelinated human pituitary stalk was also performed. Cytochrome-c oxidase activity in the human optic nerve tissue was measured using microphotometry. There was a striking inverse relationship between myelination and mitochondrial distribution in all tissue studied. Statistical analysis of microphotometric data showed this distribution to be highly significant. We caution against the previous inference of a process of axoplasmic stasis and suggest that, instead, the distribution of mitochondria reflects the functional requirement of different regions of the ganglion cell axon. Optic neuropathy is associated with several inherited disorders of mitochondria. We suggest that a fine balance exists between energy demand and tissue function in the optic nerve, which may explain why optic nerve pathological features are seen in those with mitochondrial disease.


The expression of erythropoietin triggered by danggui buxue tang, a Chinese herbal decoction prepared from radix Astragali and radix Angelicae Sinensis, is mediated by the hypoxia-inducible factor in cultured HEK293T cells.
Danggui buxue tang (DBT), a Chinese medicinal decoction that is being commonly used as hematopoietic medicine to treating woman menopausal irregularity, contains two herbs: radix Astragali and radix Angelicae Sinensis. Pharmacological results indicate that DBT can stimulate the production of erythropoietin (EPO), a specific hematopoietic growth factor, in cultured cells. In order to reveal the mechanism of DBT's hematopoietic function, this study investigated the activity of the DBT-induced EPO expression and the upstream regulatory cascade of EPO via hypoxia-induced signaling in cultured kidney fibroblasts (HEK293T). DBT-induced mRNA expressions were revealed by real-time PCR, while the change of protein expressions were analyzed by Western blotting. For the analysis of hypoxia-dependent signaling, a luciferase reporter was used to report the transcriptional activity of hypoxia response element (HRE). The plasmid containing HRE, being transfected into HEK293T, was highly responsive to the challenge of DBT application. To account for the transcriptional activation of HRE, DBT treatment was shown to increase the mRNA and protein expressions of hypoxia-inducible factor-1α (HIF-1α). In addition, the activation of Raf/MEK/ERK signaling pathway by DBT could also enhance the translation of HIF-1α, suggesting the dual actions of DBT in stimulating the EPO expression in kidney cells. Our study indicates that HIF pathway plays an essential role in directing DBT-induced EPO expression in kidney. These results provide one of the molecular mechanisms of this ancient herbal decoction for its hematopoietic function.


[Intravenously-administered immunoglobulins as first-choice agent in juvenile dermatomyositis].
Dermatomyositis is an acquired disease characterised by symmetric predominantly proximal muscle weakness of the arms and legs, and misery. It may be associated with myalgia and there is often a characteristic rash. The mainstay of therapy is corticosteroids. Recently efficacy of intravenous immunoglobulin (IVIg) in chronic refractory dermatomyositis was reported. Because corticosteroids can cause serious side effects, we treated a seven-year-old girl suffering from dermatomyositis with IVIg as initial therapy. After two courses of IVIg infusions at a dose of 0.4 g/kg/day for five consecutive days, the patient made a rapid and complete recovery. This case shows that IVIg may be effective as initial therapy in patients with dermatomyositis. Whether IVIg is really a better treatment than corticosteroids should be investigated in a randomised study.


Odontogenic tumors that mimic a dentigerous cyst.
Hyperplastic follicular tissue and a dentigerous cyst are the two most common entities associated with the crown of an impacted tooth. However, other diagnostic possibilities, including odontogenic tumors should also be considered in the differential diagnosis of a pericoronal radiolucency. This article presents three cases of radiolucent lesions that were histologically diagnosed as an odontogenic tumor, and stresses the importance of histological evaluation of all pericoronal radiolucencies.


Sexuality among middle-aged and older adults with diagnosed and undiagnosed diabetes: a national, population-based study.
To describe sexual activity, behavior, and problems among middle-age and older adults by diabetes status. This was a substudy of 1,993 community-residing adults, aged 57-85 years, from a cross-sectional, nationally representative sample (N = 3,005). In-home interviews, observed medications, and A1C were used to stratify by diagnosed diabetes, undiagnosed diabetes, or no diabetes. Logistic regression was used to model associations between diabetes conditions and sexual characteristics, separately by gender. The survey response rate was 75.5%. More than 60% of partnered individuals with diagnosed diabetes were sexually active. Women with diagnosed diabetes were less likely than men with diagnosed diabetes (adjusted odds ratio 0.28 [95% CI 0.16-0.49]) and other women (0.63 [0.45-0.87]) to be sexually active. Partnered sexual behaviors did not differ by gender or diabetes status. The prevalence of orgasm problems was similarly elevated among men with diagnosed and undiagnosed diabetes compared with that for other men, but erectile difficulties were elevated only among men with diagnosed diabetes (2.51 [1.53 to 4.14]). Women with undiagnosed diabetes were less likely to have discussed sex with a physician (11%) than women with diagnosed diabetes (19%) and men with undiagnosed (28%) or diagnosed (47%) diabetes. Many middle-age and older adults with diabetes are sexually active and engage in sexual behaviors similarly to individuals without diabetes. Women with diabetes were more likely than men to cease all sexual activity. Older women with diabetes are as likely to have sexual problems but are significantly less likely than men to discuss them.


The redox-sensitive DNA binding sites responsible for age-related downregulation of SMP30 by ERK pathway and reversal by calorie restriction.
It was recently found that age-related changes in SMP30 expression can be modulated by antioxidative action. In the current study, the modulation of SMP30 gene expression was explored by (a) antioxidative calorie restriction (CR), (b) proinflammatory lipopolysaccharide (LPS), in aged rat, (c) oxidative stress promoter, tert-butylhydroperoxide (t-BHP)-injected mouse, and (d) t-BHP-treated Ac2F cells. Utilizing EMSA, particular attention was given to the binding activity of unidentified transcription factor in sites 3 and 5 that are located in -800 bp of the SMP30 promoter. Results showed that CR prevented the age-related decrease in SMP30 expression, and also showed that SMP30 gene expression and binding activities of sites 3 and 5 decreased with treatments of t-BHP or LPS. These findings were confirmed by the antioxidant NAC and ERK-specific inhibitor PD098059 that blunted decreased SMP30 gene expression and binding activity of sites 3 and 5 by t-BHP in Ac2F cell system. Our data strongly indicate that the SMP30 transcriptional process is redox-sensitive and its modulation occurs at DNA binding sites 3 and 5 in the promoter region. Perhaps a more significant finding of the present study is that the downregulation of SMP30 is likely involved in ERK signal pathway.


A Combinatorial Protein Microarray for Probing Materials Interaction with Pancreatic Islet Cell Populations.
Pancreatic islet transplantation has become a recognized therapy for insulin-dependent diabetes mellitus. During isolation from pancreatic tissue, the islet microenvironment is disrupted. The extracellular matrix (ECM) within this space not only provides structural support, but also actively signals to regulate islet survival and function. In addition, the ECM is responsible for growth factor presentation and sequestration. By designing biomaterials that recapture elements of the native islet environment, losses in islet function and number can potentially be reduced. Cell microarrays are a high throughput screening tool able to recreate a multitude of cellular niches on a single chip. Here, we present a screening methodology for identifying components that might promote islet survival. Automated fluorescence microscopy is used to rapidly identify islet derived cell interaction with ECM proteins and immobilized growth factors printed on arrays. MIN6 mouse insulinoma cells, mouse islets and, finally, human islets are progressively screened. We demonstrate the capability of the platform to identify ECM and growth factor protein candidates that support islet viability and function and reveal synergies in cell response.


Stereotactic navigation in anterior cervical spine surgery: surgical setup and technique.
Intraoperative stereotactic navigation in spine surgery is quickly becoming popularized for accurate placement of spinal instrumentation as well as assisting in the verification of anatomic landmarks. Navigation is less commonly utilized in anterior cervical spine surgery due to instrumentation being able to be placed under direct visualization. The utility of navigation in anterior cervical spine surgery is its ability to aid in the verification of anatomic location, particularly when anatomy is distorted or pathology comes close to critical neurovascular structures. We present a technique guide for anterior cervical spine navigation that we have applied at our institution and have found to be very beneficial in select patients, particularly those with complex anatomy, large body mass index, undergoing revision surgery, sustained spinal trauma and those patients with severe anterior ossification where depth or medial-lateral landmarks are difficult to visualize. We describe utilization of the technique using a case examples and specifically in a patient with significant ossification of the posterior longitudinal ligament and severe spinal cord compression that underwent multilevel cervical corpectomy. The described technique was found to be reproducible and effective, allowing cervical spine surgeons to perform more complex or minimally invasive procedures with safety and accuracy. We emphasize that navigation does not replace knowledge of anatomy or technical aspects of the procedure.


Dissimilation of the C2 sulfonates.
Organosulfonates are widespread in the environment, both as natural products and as xenobiotics; and they generally share the property of chemical stability. A wide range of phenomena has evolved in microorganisms able to utilize the sulfur or the carbon moiety of these compounds; and recent work has centered on bacteria. This Mini-Review centers on bacterial catabolism of the carbon moiety in the C2-sulfonates and the fate of the sulfonate group. Five of the six compounds examined are subject to catabolism, but information on the molecular nature of transport and regulation is based solely on sequencing data. Two mechanisms of desulfonation have been established. First, there is the specific monooxygenation of ethanesulfonate or ethane-1,2-disulfonate. Second, the oxidative, reductive and fermentative modes of catabolism tend to yield the intermediate sulfoacetaldehyde, which is now known to be desulfonated to acetyl phosphate by a thiamin-diphosphate-dependent acetyltransferase. This enzyme is widespread and at least three subgroups can be recognized, some of them in genomic sequencing projects. These data emphasize the importance of acetyl phosphate in bacterial metabolism. A third mechanism of desulfonation is suggested: the hydrolysis of sulfoacetate.


Mapping coastal circulations using moving vehicle acoustic tomography.
With the increased availability of highly maneuverable unmanned surface/underwater vehicles, abundant ocean data can now be collected. This study uses tomographic techniques to extend the survey area covered by moving vehicles. An acoustic reciprocal transmission experiment was conducted using three tomographic sensors installed on an autonomous underwater vehicle, a fishing ship, and a buoy. The distributed sensing method is applied for currents estimation. The estimated currents near the ship show consistent results with the direct measurements. In particular, an anticyclonic circulation was revealed. Further, a general least-squares method is employed to improve the estimate of this vortical structure.


Ventral intradural endodermal cyst in the cervical spine treated with anterior corpectomy--case report.
A 14-year-old girl who presented with an endodermal cyst manifesting as severe neck and shoulder pain along with vesicorectal disturbances. Cervical magnetic resonance imaging showed a slightly enhanced intradural cyst at the C6-7 level in the ventral side of the spinal canal, with significant dorsal shortening and thinning of the spinal cord. Anterior corpectomy was chosen because of the dorsal effacement of the spinal cord. The cyst wall was subtotally removed to avoid damage to the normal spinal cord. After cyst removal, the iliac bone and an anterior cervical plate were used for anterior fusion. Postoperatively, her pain subsided without neurological deficits. The histological diagnosis was endodermal cyst. The cyst did not recur during a follow-up period of 18 months. Endodermal cysts are rare congenital lesions of the spine lined by endodermal epithelium. The natural history of this lesion is unclear, and the surgical strategy for the approach route and the extent of removal of the cyst wall remain controversial. We suggest that the anterior approach may allow a safer and more effective surgical route for the treatment of ventrally located endodermal cyst compared to the posterior approach.


Effect of energy resolution on scatter fraction in scintigraphic imaging: Monte Carlo study.
The effect of energy resolution in detector systems on scatter fractions in scintigraphic imaging through Monte Carlo simulation is investigated. A 10-cm Tc-99m line source within a cylindrical water phantom 20 cm in diameter and 20 cm in length was modeled and energy spectra were calculated at three different line source positions. The energy resolution was changed from 8% to 16% FWHM at 140 keV and a symmetrical energy window width was varied from 8% to 23% on the photopeak of 140 keV in energy spectra corresponding to each energy resolution. The relationship between the scatter fraction and the symmetrical energy window width, and the relationship between the scatter fraction and the primary counts were presented for all energy resolutions investigated. Furthermore, the effect of the asymmetrical energy window on reducing the scatter fraction was also studied and compared with the narrow symmetrical energy window. The results quantitatively showed that improved energy resolution can considerably decrease the scatter fraction with a narrow symmetrical energy window or an asymmetrical energy window without significant primary count-loss compared to that obtained with lower quality energy resolution. The asymmetrical energy window could reduce scatter fraction as compared with the narrow symmetrical energy window when the same number of primary counts was required for both energy windows. Knowing the relationship between the scatter fraction and the primary counts is important in scintigraphic imaging to select the optimum energy window corresponding to the energy resolution.


Dementia in Latin America: Paving the way toward a regional action plan.
Across Latin American and Caribbean countries (LACs), the fight against dementia faces pressing challenges, such as heterogeneity, diversity, political instability, and socioeconomic disparities. These can be addressed more effectively in a collaborative setting that fosters open exchange of knowledge. In this work, the Latin American and Caribbean Consortium on Dementia (LAC-CD) proposes an agenda for integration to deliver a Knowledge to Action Framework (KtAF). First, we summarize evidence-based strategies (epidemiology, genetics, biomarkers, clinical trials, nonpharmacological interventions, networking, and translational research) and align them to current global strategies to translate regional knowledge into transformative actions. Then we characterize key sources of complexity (genetic isolates, admixture in populations, environmental factors, and barriers to effective interventions), map them to the above challenges, and provide the basic mosaics of knowledge toward a KtAF. Finally, we describe strategies supporting the knowledge creation stage that underpins the translational impact of KtAF.


Modeling peptide mass fingerprinting data using the atomic composition of peptides.
The peptide mass fingerprinting technique is commonly used for identifying proteins analyzed by mass spectrometry (MS) after enzymatic digestion. Our goal is to build a theoretical model that predicts the mass spectra of such digestion products in order to improve the identification and characterization of proteins using this technique. We present here the first step towards a full MS model. We have modeled MS spectra using the atomic composition of peptides and evaluated the influence that this composition may have on the MS signals. Peptides deduced from the SWISS-PROT protein sequence database were used for the calculation. To validate the model, the variability of the peptide mass distribution in SWISS-PROT was compared to two theoretical, randomly generated databases. Functions have been built that describe the behavior of the isotopic distribution according to the mass of peptides. The variability of these functions was analyzed. In particular, the influence of sulfur was studied. This work, while representing only a first step in the construction of an MS model, yields immediate practical results, as the new isotopic distribution model significantly improves peak detection in MS spectra used by protein identification algorithms.


Contributions of CYP2D6, CYP2C9 and CYP2C19 to the biotransformation of E- and Z-doxepin in healthy volunteers.
In-vitro data indicated a contribution of cytochrome P450 enzymes 1A2, 3A4, 2C9, 2C19 and 2D6 to biotransformation of doxepin. We studied the effects of genetic polymorphisms in CYP2D6, CYP2C9 and CYP2C19 on E- and Z-doxepin pharmacokinetics in humans. Doxepin kinetics was studied after a single oral dose of 75 mg in healthy volunteers genotyped as extensive (EM), intermediate (IM) and poor (PM) metabolizers of substrates of CYP2D6 and of CYP2C19 and as slow metabolizers with the CYP2C9 genotype *3/*3. E-, Z-doxepin and -desmethyldoxepin were quantified in plasma by HPLC. Data were analyzed by non-parametric pharmacokinetics and statistics and by population pharmacokinetic modeling considering effects of genotype on clearance and bioavailability. Mean E-doxepin clearance (95% confidence interval) was 406 (390-445), 247 (241-271), and 127 (124-139) l h(-1) in EMs, IMs and PMs of CYP2D6. In addition, EMs had about 2-fold lower bioavailability compared with PMs indicating significant contribution of CYP2D6 to E-doxepin first-pass metabolism. E-doxepin oral clearance was also significantly lower in carriers of CYP2C9*3/*3 (238 l h(-1) ). CYP2C19 was involved in Z-doxepin metabolism with 2.5-fold differences in oral clearances (73 l h(-1) in CYP2C19 PMs compared with 191 l h(-1) in EMs). The area under the curve (0-48 h) of the active metabolite -desmethyldoxepin was dependent on CYP2D6 genotype with a median of 5.28, 1.35, and 1.28 nmol l h(-1) in PMs, IMs, and EMs of CYP2D6. The genetically polymorphic enzymes exhibited highly stereoselective effects on doxepin biotransformation in humans. The CYP2D6 polymorphism had a major impact on E-doxepin pharmacokinetics and CYP2D6 PMs might be at an elevated risk for adverse drug effects when treated with common recommended doses.


Iron depletion in the remnant kidney.
Urinary and proximal tubular iron are increased after subtotal nephrectomy, and iron depletion has been shown to be beneficial in proteinuric models of chronic renal disease in rats. In this study, iron depletion by low iron pair-fed diet and periodic phlebotomy was induced for 6 months in rats with partial (5/6) nephrectomy, resulting in a reduction in hematocrit and serum iron in all iron-deficiency subgroups. Tubular iron, assessed by energy dispersive analysis and electron microscopy, was reduced in quantity but not number of iron-containing lysosomes only within 1 subgroup of severe iron deficiency (p < 0.05). There was no improvement in serial isotopic glomerular filtration rate measurements, urinary protein and transferrin excretion, tubular damage scores, serum creatinine, or measures of reactive oxygen species (ROS) generation. In a subgroup of rats with no supplementation of sulfhydryl amino acids (cysteine and methionine) which can act as ROS scavengers, iron deficiency increased urinary protein excretion (213.3 +/- 23.0 mg/24 h, mean +/- SEM, vs. 87.4 +/- 16.1, p < 0.001), urinary transferrin excretion (p < 0.05), kidney weight (p < 0.05) and tissue malondialdehyde, a lipid peroxidation product (0.78 +/- 0.16 nmol/mg protein vs. 0.57 +/- 0.19, p < 0.05), consistent with increased ROS generation. Hence, no beneficial effect of iron-deficiency was demonstrated by any measure of structure of function in the remnant kidney, and it may enhance damage if sulfhydryl repletion is not provided.


Evaluation of fluoride release from teeth after topical application of NaF, SnF2 and APF and antimicrobial activity on mutans streptococci.
The objectives of this study were to evaluate and compare the amount and pattern of fluoride release from teeth after topical application of 2% NaF, 8% SnF2 and 1.23% APF at different time intervals. The growth inhibitory effects of this released fluoride ion was assessed on mutans streptococci (MS) and correlated with the fluoride release. Forty premolars divided into four groups were subjected to different topical fluoride treatments. All the teeth were immersed individually in deionized water and were transferred to containers at 1 hour, 1 day and 1 week time intervals. 240 samples in total were used for fluoride estimation by ion selective electrode method and the samples from the other subgroup were used for evaluation of antimicrobial activity on mutans streptococci (MS) by bacterial inhibition assay method. The results showed that the highest fluoride release (7.83 +/- 0.55 ppm) was seen in SnF2 treated specimens, as compared to that of NaF (3.71 +/- 0.60ppm) and APF (3.30 +/- 0.51ppm), the difference being statistically significant (P<0.01). This was observed immediately after 1 hour, followed by a drastic reduction thereafter. No zones of inhibition were observed at the released fluoride concentrations at different time intervals in the different groups. 8% SnF2 is expected to have greater anticaries property from the high fluoride releasing property for prolonged period of time.


Signalling pathways in schistosomes: novel targets for control interventions against schistosomiasis.
Over the last decade, there has been accumulating evidence showing that signalling pathways are involved in extensive biological and physiological processes in the human blood fluke schistosomes, playing essential roles in environmental sensing, host penetration, growth, development, maturation, embryogenesis, tissue self-renewal and survival. Owing to the likelihood of resistance developing against praziquantel, the only drug currently available that is effective against all the human schistosome species, there is an urgent requirement for an alternative treatment, arguing for continuing research into novel or repurposed anti-schistosomal drugs. An increasing number of anticancer drugs are being developed which block abnormal signalling pathways, a feature that has stimulated interest in developing novel interventions against human schistosomiasis by targeting key cell signalling components. In this review, we discuss the functional characterization of signal transduction pathways in schistosomes and consider current challenges and future perspectives in this important area of research.


Hybrid thyroid carcinoma with a coarse chromatin pattern and nuclear features of papillary thyroid carcinoma.
Hybrid follicular carcinoma (FC) and papillary thyroid carcinoma (PTC) have not been previously well described. Consecutive cases of 29 FC, 12 Hurthle cell carcinomas (HC), 247 PTC and 13 Hurthle cell PTC (HPTC) were reviewed with special attention to the coarse (CC) and fine chromatin patterns (FIC), as well as to the presence of nuclear grooves, pseudoinclusions or optically clear appearance. Limited nuclear features of PTC (LNF-PTC) are defined as areas of tumor with FIC in addition to some other nuclear features, but insufficient for the diagnosis of PTC. Tumors with nuclei showing an admixture of CC and PTC or LNFPTC were submitted for immunostaining for cytokeratin 19, HBME and Ret/PTC. FC and HC contained areas of LNFPTC in 25 tumors and focal PTC in 3 tumors. None of these cases was associated with lymph node metastasis. Areas with CC were found in 54 PTC and 3 HPTC. The rates of vascular invasion and distant metastasis tended to be higher for PTC with areas of coarse chromatin pattern than for PTC without such areas; however, the difference was not statistically significant. Immunoreactivity for cytokeratin 19 and HBME was moderate to strong for PTC and focal areas of PTC or LNFPTC in FC without Hurthle cell changes. Ret/PTC immunostaining was positive in areas of LNFPTC or focal PTC in three FC. Focal PTC or areas of LNFPTC are frequently seen in FC. Likewise, areas of CC are often present in PTC. The presence of these focal areas does not appear to change the clinical behavior of the tumor and therefore does not warrant a change of nomenclature.


[Knowledge of stroke among the Israeli population].
Stroke and its long-term neurological sequelae can be prevented by management of risk factors and seeking medical care as early as possible following the onset of stroke symptoms. This study aimed to investigate the scope of knowledge on stroke, and to assess the perceived risk of stroke among the Israeli population. A telephone survey was conducted of a sample study of 300 men and women, 40 years of age or older, that represent the Hebrew speaking population in Israel of this age range. The best known risk factor for stroke was arterial hypertension, but 24% of the study population could not spontaneously recall any risk factor. Nearly half of the study sample (46%) was aware of the fact that a healthy lifestyle may contribute to stroke prevention, but only 24% mentioned that medical follow-up and control of hypertension, dyslipidemia and diabetes mellitus reduce the risk of stroke. Among interviewed subjects who reported the existence of at least one risk factor of stroke, only 14% recognized that they belong to a group at risk of having a stroke. Awareness of neurological disabilities resulting from stroke was relatively high, with only 15% of responders unable to name any disability. Our study demonstrates the lack of knowledge on stroke among the Israeli population. Knowledge is particularly poor regarding the possibility of stroke prevention through risk factor management, and with respect to recognition of symptoms of acute stroke. A program directed at raising the awareness and knowledge of stroke by the Israeli public is required for effective stroke prevention and therapy.


[Fluorescence cytology of the urinary bladder].
5-aminolevulinic acid induced fluorescence cystoscopy is invaluable for diagnosing urinary bladder carcinoma and its precursors. Because neoplastic cells of the urinary bladder possess striking fluorescent properties due to protoporphyrin IX, we initiated a study to evaluate the use of fluorescence microscopy in urinary sediments. In 27 patients suspected of having bladder carcinomas, we instilled 5-aminolevulinic acid into their urinary bladders before transurethral therapy and compared thereafter our studies of standard cytological sediments with those made under fluorescence microscopy. The results of fluorescence cystoscopy and those using urinary sediments for neoplastic cells under fluorescence microscopy correlated extremely well. In this pilot study using fluorescence microscopy, we found that we could diagnose with precision urinary neoplasms of different grades of differentiation. Accordingly, we regard fluorescence microscopy as a valuable complement for standard urinary cytology, especially since with fluorescence microscopy we can readily recognize fluorescing cells of highly differentiated urinary tumors and flat premalignant dysplasias.


Twistable dipolar aryl rings as electric field actuated conformational molecular switches.
The ability to control the chemical conformation of a system via external stimuli is a promising route for developing molecular switches. For eventual deployment as viable sub-nanoscale components that are compatible with current electronic device technology, conformational switching should be controllable by a local electric field (i.e. E-field gateable) and accompanied by a rapid and significant change in conductivity. In organic chemical systems the degree of π-conjugation is linked to the degree of electronic delocalisation, and thus largely determines the conductivity. Here, by means of accurate first principles calculations, we study the prototypical biphenyl based molecular system in which the dihedral angle between the two rings determines the degree of conjugation. In order to make this an E-field gateable system we create a net dipole by asymmetrically functionalising one ring with: (i) electron withdrawing (F, Br and CN), (ii) electron donating (NH2), and (iii) mixed (NH2/NO2) substituents. In this way, the application of an E-field interacts with the dipolar system to influence the dihedral angle, thus controlling the conjugation. For all considered substituents we consider a range of E-fields, and in each case extract conformational energy profiles. Using this data we obtain the minimum E-field required to induce a barrierless switching event for each system. We further extract the estimated switching speeds, the conformational probabilities at finite temperatures, and the effect of applied E-field on electronic structure. Consideration of these data allow us to assess which factors are most important in the design of efficient gateable electrical molecular switches.


Nippostrongylus brasiliensis can induce B7-independent antigen-specific development of IL-4-producing T cells from naive CD4 T cells in vivo.
Th2 immune responses to a number of infectious pathogens are dependent on B7-1/B7-2 costimulatory molecule interactions. We have now examined the Th2 immune response to Nippostrongylus brasiliensis (Nb) in B7-1/B7-2(-/-) mice and show that Th2 effector cells develop that can mediate worm expulsion and produce substantial Th2 cytokines comparable with wild-type infected mice; however, in marked contrast, B cell Ag-specific Ab production is abrogated after B7 blockade. To examine the mechanism of T cell activation, OVA-specific DO11.10 T cells were transferred to recipient mice, which were then immunized with a combination of Nb plus OVA or either alone. Only the combination of Nb plus OVA triggered T cell differentiation to OVA-specific Th2 cells, suggesting that Nb acts as an adjuvant to stimulate Ag-specific naive T cells to differentiate to effector Th2 cells. Furthermore, using the DO11.10 TCR-transgenic T cell adoptive transfer model, we show that blocking B7-1/B7-2 interactions does not impair nonparasite Ag-specific DO11.10 Th2 cell differentiation; however, DO11.10 T cell cycle progression and migration to the B cell zone are inhibited.


Partial restriction in the developmental potential of late emigrating avian neural crest cells.
Trunk neural crest cells migrate along two major pathways: a ventral pathway through the somites whose cells form neuronal derivatives and dorsolateral pathway underneath the ectoderm whose cells become pigmented. In avian embryos, the latest emigrating neural crest cells move only along the dorsolateral pathway. To test whether late emigrating neural crest cells are more restricted in developmental potential than early migrating cells, cultures were prepared from the neural tubes of embryos at various stages of neural crest cell migration. "Early" and "middle" aged neural crest cells differentiated into many derivatives including pigmented cells, neurofilament-immunoreactive cells, and adrenergic cells. In contrast, "late" neural crest cells differentiated into pigment cells and neurofilament-immunoreactive cells, but not into adrenergic cells even after 10-14 days. To further challenge the developmental potential of early and late emigrating neural crest cells, they were transplanted into embryos during the early phases of neural crest cell migration, known to be permissive for adrenergic neuronal differentiation. The cells were labeled with the vital dye, DiI, and injected onto the ventral pathway at stages 14-17. Two and three days after injection, some early neural crest cells were found to express catecholamines, suggesting they were adrenergic neuroblasts. In contrast, DiI-labeled late neural crest cells never became catecholamine-positive. These results suggest that the late emigrating neural crest cell population has a more restricted developmental potential than the early migrating neural crest cell population.


Prevalence of Candida spp., xerostomia, and hyposalivation in oral lichen planus--a controlled study.
To determine the frequency of Candida spp., xerostomia, and salivary flow rate (SFR) in three different groups: patients with OLP (OLP group), patients with oral mucosal lesions other than OLP (non-OLP group), and subjects without oral mucosal lesions (control group). Xerostomia as well as SFR was investigated in the three groups. Samples for isolation of Candida spp. were collected from OLP lesions (38 patients), non-OLP lesions (28 patients), and healthy subjects (32 subjects). There was no statistically significant difference regarding the frequency of xerostomia and hyposalivation among the three groups (P > 0.05). A higher prevalence for colonization by Candida spp. was found in the healthy subject as compared to that of patients with OLP (P = 0.03) and non-OLP (P = 0.02) groups. Low SFR was not a factor for colonization by Candida spp. Xerostomia and hyposalivation occur with similar frequency in subjects with and without oral lesions; also, the presence of oral lesions does not increase the susceptibility to colonization by Candida spp. It seems that any study implicating Candida spp. in the malignant transformation of oral lesions should be carried out mostly on a biochemical basis, that is, by testing the capability of Candida spp. to produce carcinogenic enzyme.


[Reevaluation of the scale of psychological resilience for middle and primary school students].
To evaluate the feasibility of applying the self-rating scale of psychological resilience for middle school students among students of grade four to six in primary school and grade one to three in middle school in Changfeng county, Anhui province. To provide evidence for future study on mental health of middle and primary school students and left-behind children in Changfeng county. The cluster sampling method were used to select three middle schools and five primary schools from Changfeng County in Hefei City. The psychological resilience among 2655 students of grade four to six were evaluated. The reliability and validity were analyzed. The self-rating scale of psychological resilience measures six dimensions included problem solving, cooperation and communication, self-efficacy, goals and aspirations, self-awareness, and empathy. The coefficient of Cronbach's a of the total scale scores was 0.944, that of grade four to six in primary school and grade one to three in middle school were from 0.932 to 0.947, and that of six factors were from 0.772 to 0.883. The correlation coefficient of split-half of the total scores was 0.874, and that of grade four to six in primary school and grade one to three in middle school were from 0.848 to 0.892. The test-retest reliability of the total scores was 0.894, and that of six factors were from 0.753 to 0.839, all correlations were significant statistically. Varimax rotation factor analysis was adopted and got six factors. Their accumulative contribution to total variance was 64.532%. The correlation coefficients between each item and the total scores were from 0.434 to 0.717, between each item and corresponding factors scores were from 0.683 to 0.876, between the total scores and six factors scores were from 0.692 to 0.846, among six factors scores were from 0.401 to 0.689, all correlations were significant statistically. The correlation coefficient between the total scores of the scale and depression was -0.493, and anxiety was -0.290, all correlations were significant statistically at the level of 0.01 with both side. The reliability and validity of the self-rating scale of psychological resilience for middle school students are well among students of grade four to six in primary school and grade one to three in middle school and it can be used to evaluate the psychological resilience level of these people including left-behind children.


Influence and compensation of patient motion in electromagnetic tracking based quality assurance in interstitial brachytherapy of the breast.
Electromagnetic tracking (EMT) is a versatile and viable technique for various quality assurance (QA) tasks in interstitial brachytherapy (iBT). As the duration of EMT measurements in iBT is on the order of minutes, they can be strongly affected by patient motion, especially breathing, which gives rise to motion artefacts. Since the centrepiece of EMT-related QA in iBT is to assess the geometry of the iBT implant or applicator, the absence of adequate motion compensation techniques could impede the use of EMT for QA purposes. A common way to compensate for this is to reference the data to either external or internal reference sensors (ERS, IRS) which are fixated on the patient's body or inside the applicator and therefore move with the patient. The purpose of the presented study is to provide a quantitative and in-depth analysis on the use of reference sensors for motion compensation. First, the need for adequate motion compensation is identified both qualitatively and quantitatively using a phantom subjected to simulated breathing motion. An evaluation routine is developed to assess the influence of motion compensation using reference sensors on the acquired EMT data. The evaluation metric is based on the observed displacement of the EMT sensor from its mean position while dwelling at a dwell position (DP) for a dwell time of 1 s. After that, the routine is applied to a cohort of 54 breast cancer patients treated with iBT, and the quality of an ERS based compensation approach is assessed. In a subgroup of four patients, an IRS is inserted into the iBT implant and IRS-based compensation is compared to the ERS-based approach. Moreover, a correlation analysis of the ERS and IRS approach is performed, also including respiratory signals derived from the trajectories of the different reference sensors. It was found that motion compensation with ERS effectively reduced the mean sensor displacement per DP to median values as low as 0.11 mm in both phantom and patient measurements, which is below the precision of the EMT system (0.48 mm). Compensation using the IRS yielded comparable results and was as good as compensation with ERS. The results obtained from both approaches showed a strong correlation. Also the respiratory signals calculated from the different reference sensors were well correlated in most cases. These results indicate that motion compensation with ERS can effectively remove motion artefacts in EMT data. While compensation with an IRS leads to comparable results, the IRS occupies one catheter whose geometry hence cannot be assessed. The use of ERS has proven to be both effective and practical in clinical routine.


A specific deficit in visuospatial simultaneous working memory in Down syndrome.
Recent studies have demonstrated that individuals with Down syndrome (DS) present both central and verbal working memory deficits compared with controls matched for mental age, whereas evidence on visuospatial working memory (VSWM) has remained ambiguous. The present paper uses a battery of VSWM tasks to test the hypothesis that individuals with DS can also encounter specific difficulties in VSWM. Four tasks were administered to 34 children and adolescents with DS and 34 controls matched for verbal mental age. In two of these tasks, participants had to remember a series of locations sequentially presented on a matrix (spatial-sequential WM); in another two, they had to remember locations simultaneously presented (spatial-simultaneous WM). Results showed that individuals with DS are poorer than controls in the spatial-simultaneous tasks, but not in the spatial-sequential tasks. These findings were not due to a difference in speed of visuospatial processing. In fact, when performances of the two groups in VSWM were compared using speed measures as covariates, differences between groups remained. It is suggested that the simultaneous VSWM deficit of individuals with DS could be due to the request for processing more than one item at a time.


Genetic and Environmental Determinants of Beef Quality-A Review.
The flavor, quality, and composition of beef changes with the cattle diet regimen. The quality of meat varies, and that variability is determined by both individual and environmental factors: age, breed, live weight, fatness degree, plane of nutrition, and concentrate/roughage ratio. The strategy for the rearing and feeding of cattle for slaughter should therefore aim at reducing the saturated fatty acid content and increasing the polyunsaturated fatty acid and monounsaturated fatty acid levels. Many diseases in humans, like atherosclerosis and cardiovascular diseases, are associated with dietary fat, and their development process could take a year, the results of which can be a shorter life and its lower quality. The objective of this review was to describe the factors affecting the meat quality and fatty acid profile of the intramuscular fat of European cattle fed various diets.


[Research advances in behavioral ecology of penaeid shrimps. I. Behavior of penaeid shrimps].
The behavioral ecology of penaeid shrimps has been studied extensively in many countries due to their special ecological habit and important position in sea water aquaculture. This paper reviewed the recent literatures on the behavior of penaeid shrimps, including feeding, locomotion, defense, mating, spawning, molting, burrowing and emergence, with the differences of the behavior in different habitats discussed. The existing research problems, and the study directions of penaeid shrimps in the future, e. g., the feeding strategies and mechanisms in various circumstances, the selection and adaptability to environmental factors, and the practical application of penaeid shrimps behavior theory, were put forward.


Modulation of junctional permeability.
Changes in intercellular coupling can be accomplished by continuous synthesis and destruction of intercellular channels and through a modulation of unit channel permeability. The increase in free [Ca2+]i caused by activation of sodium-calcium exchange or by metabolic inhibition leads to cell decoupling. In embryonic cells the conductance of the gap junction is strongly dependent on pHi. The exact role of Ca2+ and H+ in the physiological modulation of junctional conductance remains unknown. The cyclic AMP (cAMP)-calcium hypothesis is presented. According to this view, cAMP modulates the junctional permeability through specific kinases. A feedback mechanism between calcium and cAMP might be relevant in the physiological control of junctional conductance.


Cooperative action of NC2 and Mot1p to regulate TATA-binding protein function across the genome.
Promoter recognition by TATA-binding protein (TBP) is an essential step in the initiation of RNA polymerase II (pol II) mediated transcription. Genetic and biochemical studies in yeast have shown that Mot1p and NC2 play important roles in inhibiting TBP activity. To understand how TBP activity is regulated in a genome-wide manner, we profiled the binding of TBP, NC2, Mot1p, TFIID, SAGA, and pol II across the yeast genome using chromatin immunoprecipitation (ChIP)-chip for cells in exponential growth and during reprogramming of transcription. We find that TBP, NC2, and Mot1p colocalize at transcriptionally active pol II core promoters. Relative binding of NC2alpha and Mot1p is higher at TATA promoters, whereas NC2beta has a preference for TATA-less promoters. In line with the ChIP-chip data, we isolated a stable TBP-NC2-Mot1p-DNA complex from chromatin extracts. ATP hydrolysis releases NC2 and DNA from the Mot1p-TBP complex. In vivo experiments indicate that promoter dissociation of TBP and NC2 is highly dynamic, which is dependent on Mot1p function. Based on these results, we propose that NC2 and Mot1p cooperate to dynamically restrict TBP activity on transcribed promoters.


Circadian clock gene Period2 suppresses human chronic myeloid leukemia cell proliferation.
Circadian clock genes (CCGs) are reported to serve pivotal roles in regulating the development of certain tumors, including lung cancer and colon cancer . However, their expression patterns and function in chronic myeloid leukemia (CML) remains poorly understood. The present study aimed to investigate the expression and function of circadian clock gene Period2 (Per2) in human CML. Per2 expression levels in neutrophils isolated from patients with CML and healthy donors were measured via reverse transcription-quantitative PCR. Subsequently, through lentivirus transduction, Per2 was stably overexpressed in human CML cell line KCL22 cells, which were injected into nude mice to investigate the in vivo role of Per2 by measuring CML tumor size and weight. Additionally, Per2 expression levels in patients with acute myeloid leukemia (AML) or chronic lymphocytic leukemia (CLL) were analyzed by re-analyzing microarray data in the Gene Expression Omnibus database. Per2 expression was significantly lower in neutrophils isolated from patients with CML patients compared with healthy donors, and was negatively correlated with the expression level of c-Myc. Similarly, patients with AML or CLL displayed lower Per2 expression levels compared with healthy controls. Per2 overexpression inhibited KCL22 cell proliferation in nude mice and in vitro, and induced cell cycle arrest at the G1 phase. By contrast, the results also indicated that KCL22 cell apoptosis was not regulated by Per2. The present study identified Per2 as a potential tumor suppressor in human CML.


A patent review of antibiofilm fungal drugs (2002-present).
Fungal biofilms, such as Candida albicans biofilms, are capable of surviving in hostile environments owing to their remarkable ability to adhere to surfaces and their tolerance to chemical interventions. Currently, therapeutic treatment options are few, making these biofilm-based infections problematic particularly due to their great tolerance to conventional antimicrobial drugs, thus causing serious health and economic problems. Therefore, the development of new drugs and antibiofilm specific therapies for the prevention and treatment of antifungal to eradicate biofilms are needed. This study was aimed at carrying out a patent review analysis to identify the innovation trends, and to explore the latest antifungal drugs and the specific therapeutic strategies available for the treatment of fungal biofilms. The present patent review was carried out using the Espacenet database, using the key words "biofilm and antifungal," from 2002 to December 2019. Through this review, it was possible to identify that most of the patent contents refer to new synthetic drugs derived from natural products and associations thereof with existing antifungal drugs. Methods and biomaterials for the treatment and prevention of fungal biofilms, mainly for C. albicans biofilms, which is the most isolated and studied fungal species, were also disclosed. The lack of scientific and technical information on the biofilm eradication subject is remarkable and further confirmed by the small number of patents identified in this survey.


Dosimetry of a novel focused monoenergetic beam for radiotherapy.
Objective. A novel treatment modality is currently being developed that produces converging monoenergetic x-rays. Conventional application of dosimetric calibration as presented in protocol TG61 is not applicable. Furthermore, the dosimetry of the focal point of the converging beam is on the order of a few millimeters, requiring a high-resolution dosimeter. Here we present a procedure to calibrate radiochromic film for narrow-beam monoenergetic 60 keV photons as well as absolute dosimetry of monoenergetic focused x-rays. A study of the focal spot dose rate after passing through a bone-equivalent material was also done to quantify the effects of heterogeneous materials.Approach.This was accomplished by configuring a polyenergetic beam of equivalent energy using a clinical orthovoltage machine. Calibrated films were then used to perform absolute dosimetry of the converging beam by measuring the beam profile at various depths in water. Main Results.A method for calibrating radiochromic film has been developed and detailed that allows absolute dosimetry of a monoenergetic photon beam. Absolute dosimetry of a focused, mono-energetic beam resulted in a focal spot dose rate of ∼30 cGy min-1at a depth of 5 cm in water.Significance.This work serves to establish a dosimetry protocol for mono-energetic beam absolute dosimetry as well as the use of such a method for measurement of a novel teletherapy modality.


Rapid cycling of autophosphorylation of a ca-calmodulin regulated plasma membrane located protein kinase from pea.
Plasma membrane vesicles from pea (Pisum sativum L.) seedlings contain an autophosphorylating calcium-activated protein kinase of relative molecular weight 18,000 (phosphoprotein 18, pp 18). Pulse chase analysis revealed that pp 18 autophosphorylation exhibited very rapid turnover. pp 18 was the only detectable plasma membrane protein to have this property. pp 18 has been highly purified by affinity chromatography and the final preparation contains peptides of relative molecular weight 67,000, 48,000, and 18,000. Highly purified pp 18 still showed rapid cycling of autophosphorylated phosphate attached to pp 18. Turnover of pp 18 autophosphorylation was accelerated by ADP, but this effect did not appear to be the back reaction of the kinase since inorganic phosphate accumulation is increased by ADP. A rapid cycling of phosphorylation is an ideal control point in signal transduction.


Separation of curcuminoids enriched fraction from spent turmeric oleoresin and its antioxidant potential.
The rhizomes of turmeric are processed to obtain oleoresin and subsequently curcuminoids are isolated. The mother liquor, after partial isolation of curcuminoids, known as spent turmeric oleoresin (STO), is considered as industrial waste. Curcuminoids enriched spent turmeric oleoresin (CSTO) is prepared by removal of nonantioxidant constituents, and investigated for its antioxidant potential using in vitro methods, and also the total curcuminoids and phenolic contents were determined. CSTO has a total phenolic content of 267.27 +/- 5.75 mg GAE/g that is almost double the amount present in STO (118.3 +/- 3.0 mg GAE/g). The total amount of curcuminoids in CSTO is found to be 39 +/- 1.2%, whereas STO had 15 +/- 2.0%. CSTO possessed radical scavenging activity of 84% at 50 microg/mL, antioxidant activity of 74% at 25 microg/mL, high antioxidant capacity, and moderate total reducing power. These results provide scope for utilization of CSTO/STO as natural antioxidant/preservative as well as colorant in various foods.


The great imitator revisited: the spectrum of atypical cutaneous manifestations of secondary syphilis.
Syphilis is a well-known sexually transmitted infection infamous for its protean cutaneous manifestations. Over the last decade, the rate of infection in the USA has risen, particularly among human immunodeficiency virus (HIV)-infected individuals and certain ethnic groups. Although the primary chancre developing at the site of inoculation usually has typical and well-characterized features, cutaneous manifestations of secondary syphilis span a wide spectrum and mimic those of other dermatoses. This may be particularly evident in patients with HIV. Such deviations from the expected typical papulosquamous eruption may present a diagnostic challenge and delay diagnosis and therapy. Given the increasing incidence of syphilis among the immunosuppressed patient population, recognition of atypical cutaneous manifestations is critical for adequate management. We review a range of cutaneous manifestations of secondary syphilis and the skin diseases it may mimic.


Marital status, cohabitation, and risk of preterm birth in Europe: where births outside marriage are common and uncommon.
This article explores whether the impact of marital status on the risk of preterm birth varies in relation to marital practices in the population, defined by the proportion of out-of-marriage births. Data come from a case-control study of the determinants of preterm birth in 16 European countries (5456 cases and 8234 controls). There is a significantly elevated risk of preterm birth associated with both cohabitation (OR = 1.29 [1.08, 1.55]) and single motherhood (OR = 1.61 [1.26, 2.07]) for women living in countries where fewer than 20 of births occur outside marriage. In contrast, there is no excess risk associated with marital status when out-of-marriage births are more common. This overall result does not apply to all subgroups of preterm births: different patterns emerge for early preterm births and preterm births induced for medical reasons. It is important to consider social context in the analysis of individual risk factors.


Specific amino acid substitutions in the S protein prevent its excretion in vitro and may contribute to occult hepatitis B virus infection.
Occult hepatitis B virus (HBV) infection (OBI) is defined as low plasma level of HBV DNA with undetectable HBV surface antigen (HBsAg) outside the preseroconversion window period. The mechanisms leading to OBI remain largely unknown. The potential role of specific amino acid substitutions in the S protein from OBI in HBsAg production and excretion was examined in vitro. HBsAg was quantified in culture supernatants and cell extracts of HuH-7 cells transiently transfected with plasmids containing the S gene of eight HBsAg(+) controls and 18 OBI clones. The intracellular (IC)/extracellular (EC) HBsAg production ratio was ∼1.0 for the majority of controls. Three IC/EC HBsAg patterns were observed in OBI strains clones: pattern 1, an IC/EC ratio of 1.0, was found in 5/18 OBI clones, pattern 2, detectable IC but low or undetectable EC HBsAg (IC/EC, 7.0 to 800), was found in 6/18 OBIs, and pattern 3, low or undetectable IC and EC HBsAg, was found in 7/18 clones. Intracellular immunofluorescence staining showed that in pattern 2, HBsAg was concentrated around the nucleus, suggesting retention in the endoplasmic reticulum. The substitution M75T, Y100S, or P178R was present in 4/6 pattern 2 OBI clones. Site-directed-mutagenesis-corrected mutations reversed HBsAg excretion to pattern 1 and, when introduced into a control clone, induced pattern 2 except for Y100S. In a control and several OBIs, variants of a given quasispecies expressed HBsAg according to different patterns. However, the P178R substitution present in all cloned sequences of two OBI strains may contribute significantly to the OBI phenotype.


Pseudo-accommodation with intraocular lenses implanted in the bag.
To evaluate the accommodation potential in eyes after intraocular lens in-the-bag implantation. Fifty-one consecutive patients were included in the study. Group 1 included 26 eyes that had phacoemulsification with continuous curvilinear capsulorhexis and in-the-bag implanted foldable IOL. Twenty-five eyes in Group 2 had capsulotomy with extracapsular cataract extraction and were implanted with polymethylmethacrylate IOL. Time elapsed from surgery was at least 6 months. There was no significant difference for age or gender between groups (P > .05). We measured accommodation amplitude and depth of the anterior chamber at distance and near fixation with an ultrasonic biometry device. The results were compared using the unpaired Student t-test. The anterior chamber depths while fixating at a distant object were not significantly different between groups (P>.05), however, at near the difference was statistically significant (P=.008). The change in depths between far and near fixation was significantly different (P=.002) and was more pronounced in the the capsulorhexis group (P < .001). The accommodation amplitudes in this group were significantly greater than in the capsulotomy group (P = .025). Patients who had uncomplicated small incision phacoemulsification surgery with continuous curvilinear capsulorhexis and in-the-bag implanted lens seemed to preserve some pseudo-accommodation after surgery.


Functional evaluation of professional athletes treated with a mini-open technique for achilles tendon rupture.
in this study we report the functional results of 36 professional athletes treated with a combined percutaneous and mini-open technique. patients were evaluated with Victorian Institute of Sports Assessment-Achilles questionnaire (VISA-A), the objective 100-points Hannover scale and the Ergo-jump Bosco System device. at a mean 28- month follow-up no re-rupture cases were observed. Six patients had minor complications. The Ergo-jump Bosco System device showed no significant differences in the side-to-side evaluation in regard to strength (-0.94%) and elasticity (+2.44%), while a significant post-operative loss was detected in the endurance trials (-6.78%). The Hannover scale showed an average score of 94.5, while the VISA-A had an average of 93.1. Thirty-one patients resumed their pre-operative sports activity level within five months from surgery. our results showed that the combined mini-open and percutaneous repair is an effective treatment for professional athletes, with satisfactory clinical and functional results, lack of major complications and a quick return to professional sports activity.


Atomistic simulations reveal structural disorder in the RAP74-FCP1 complex.
We report atomically detailed molecular dynamics simulations characterizing the interaction of the RAP74 winged helix domain with the intrinsically disordered C-terminal of FCP1. The RAP74-FCP1 complex promotes the essential dephosphorylation of RNA polymerase II prior to initiation of transcription. Although disordered in solution, the C-terminal of FCP1 forms an amphipathic helix when bound to RAP74. Our simulations demonstrate that this interaction also reorganizes and stabilizes RAP74. These simulations illuminate the significance of hydrophobic contacts for stabilizing disordered protein complexes, provide new insight into the mechanism of protein binding by winged helix domains, and also reveal "dynamic fuzziness" in the complex as FCP1 retains significant flexibility after binding. In conjunction with our recent NMR experiments identifying residual structure in unbound FCP1, these simulations suggest that FCP1 loses relatively little conformational entropy upon binding and that the associated coupled folding-binding transition may be less sharp than expected.


The effects of dentine bonding agents on marginal leakage of composite restorations--long-term studies.
The aim of this study was to compare the effects upon marginal leakage of a number of dentine bonding agents when used with a posterior composite resin, Occlusin, after storage for periods of up to 2 years. The bonding agents used were Gluma, Scotchbond, Topaz and an experimental material. The results were compared with a glass ionomer, Chemfil II. Class V cavities with or without a bevelled cavo-surface margin were prepared in the buccal surfaces of extracted premolar teeth. Following restoration, the teeth were stored for periods of up to 2 years and then thermally cycled. Marginal leakage was subsequently demonstrated using a radioactive isotope containing 45Ca, and an auto-radiographic technique. Image analysis was used to determine the total amount of linear leakage for each specimen. The results showed that some leakage occurred for all materials at each time interval. The bevelled design of cavity allowed significantly less leakage than the unbevelled cavity. Overall, there was little difference between the various dentine bonding agents. The glass ionomer restorations showed significantly less leakage than the composite resin and dentine bonding agent combinations in unbevelled cavities.


Transference, relationship and the analyst as object: Findings from the North American Comparative Clinical Methods Working Party.
Data from the North American Comparative Clinical Methods (CCM) Working Party a is used to 1) explore how psychoanalysts in North America conceive and address the transference and the relationship between analyst-analysand and 2) to study what kinds of 'objects' psychoanalysts become, explicitly and implicitly, within psychoanalytic treatments. The North American CCM Working Party closely studied 17 clinical cases presented by North American psychoanalysts across the spectrum of analytic schools at their meetings. We found that the 17 analysts fell into three different groupings according to the internal consistency of their method and their approaches to transference, relationship and analyst-as -object. We also found that analysts' individual work, while heavily influenced by their schools of thought, also involved unique interpretations of their particular paradigms.


Targeting estrogen/estrogen receptor alpha enhances Bacillus Calmette-Guérin efficacy in bladder cancer.
Recent studies showed the potential linkage of estrogen/estrogen receptor signaling with bladder tumorigenesis, yet detailed mechanisms remain elusive. Here we found a new potential therapy with the combination of Bacillus Calmette-Guerin (BCG) and the anti-estrogen ICI 182,780 led to better suppression of bladder cancer (BCa) than BCG alone. Mechanism dissection found ICI 182,780 could promote BCG attachment/internalization to the BCa cells through increased integrin-α5β1 expression and IL-6 release, which may enhance BCG-induced suppression of BCa cell growth via recruiting more monocytes/macrophages to BCa cells and increased TNF-α release. Consistently, in vivo studies found ICI 182,780 could potentiate the anti-BCa effects of BCG in the carcinogen-induced mouse BCa models. Together, these in vitro and in vivo results suggest that combining BCG with anti-estrogen may become a new therapeutic approach with better efficacy to suppress BCa progression and recurrence.


Treatment of knee chondropathy with platelet rich plasma. Preliminary results at 6 months of follow-up with only one injection.
Application of new biological treatments in orthopaedics is controversial nowadays. Surgeons and practitioners know how difficult can be to choose a solution for chondral injuries. Joint damages are from little contusions, osteochondral fractures, avascular necrosis, osteochondritis and degenerative processes like osteoarthritis and rheumatisms. All mentioned have a common problem: the lack of regenerating hyaline cartilage by themselves. Recently, PRP have been used to treat early moderate chondropathies. Here we show the preliminary results of 30 patients affected by chondropathy of the knee after 6 months treated with a single intrarticular injection of PRP. Thirty patients, 18-65 years old, with a diagnosis of I to III Outerbridge chondropathy in the knee, pain for more than 3 months following conservative treatment and no bone axial defect, were treated with one intraarticular injection of PRP (GPS mini set, BIOMET), after written consent and Ethic and Legal Committee approval. VAS and KOOS scores were evaluated before PRP injection and at 1, 3 and 6 months after the treatment. ANOVA with repeated measures using the SPSS showed significantly better results in term of KOOS and VAS scores at 1, 3 and 6 months respect to the pre-injection value (p less than 0,05) We think that PRP treatment is a promising alternative for the treatment of knee chondropathy; however its efficacy has to be demonstrated with more clinical works, with longer follow up and with greater number of patients, even with controlled and randomized trials. In our study only one injection of PRP has been able to allow a clinical improvement, suggesting the possibility to avoid multiple injections protocols, and consequently reducing the health expenses. Until the efficacy of PRP will not be definitely demonstrated, surgeon should be very prudent in indications.


The atypical Guanine-nucleotide exchange factor, dock7, negatively regulates schwann cell differentiation and myelination.
In development of the peripheral nervous system, Schwann cells proliferate, migrate, and ultimately differentiate to form myelin sheath. In all of the myelination stages, Schwann cells continuously undergo morphological changes; however, little is known about their underlying molecular mechanisms. We previously cloned the dock7 gene encoding the atypical Rho family guanine-nucleotide exchange factor (GEF) and reported the positive role of Dock7, the target Rho GTPases Rac/Cdc42, and the downstream c-Jun N-terminal kinase in Schwann cell migration (Yamauchi et al., 2008). We investigated the role of Dock7 in Schwann cell differentiation and myelination. Knockdown of Dock7 by the specific small interfering (si)RNA in primary Schwann cells promotes dibutyryl cAMP-induced morphological differentiation, indicating the negative role of Dock7 in Schwann cell differentiation. It also results in a shorter duration of activation of Rac/Cdc42 and JNK, which is the negative regulator of myelination, and the earlier activation of Rho and Rho-kinase, which is the positive regulator of myelination. To obtain the in vivo evidence, we generated Dock7 short hairpin (sh)RNA transgenic mice. They exhibited a decreased expression of Dock7 in the sciatic nerves and enhanced myelin thickness, consistent with in vitro observation. The effects of the in vivo knockdown on the signals to Rho GTPases are similar to those of the in vitro knockdown. Collectively, the signaling through Dock7 negatively regulates Schwann cell differentiation and the onset of myelination, demonstrating the unexpected role of Dock7 in the interplay between Schwann cell migration and myelination.


[Melanoma metastatic to the trachea and nasal cavity: description of a case and review of the literature].
Secondary tumors of the trachea are exceedingly rare, only 14 cases having been reported in the literature. Moreover, metastatic involvement of naso-paranasal cavities can be considered quite unusual. Approximately 150 cases have been drawn from the literature, most of which presented a metastatic deposit from a renal adenocarcinoma. Report is then made of a case of cutaneous melanoma metastatic to the trachea and nasal cavity. The tracheal lesion was repeatedly treated with Nd Yag laser, whereas no treatment was considered eligible for nasal metastasis. The patient succumbed to the tumor 16 months after diagnosis of tracheal involvement had been made. The tendency for malignant melanomas to metastasize to distant organs via the bloodstream is well known, yet trachea and nasoparanasal involvement by metastatic melanoma has been reported, respectively, in only three and six cases, including the present one. Prognosis is unfavorable due to the unusual coexistence of metastases to other organs and the lack of an adequate treatment.


Development of Small-Molecule Antivirals for Ebola.
Ebola hemorrhagic fever is a deadly disease caused by infection with one of the Ebola virus species. Although a significant progress has recently been made in understanding of Ebola virus biology and pathogenesis, development of effective anti-Ebola treatments has not been very productive, compared to other areas of antiviral research (e.g., HIV and HCV infections). No approved vaccine or medicine is available for Ebola but several are currently under development. This review summarises attempts in identification, evaluation, and development of small-molecule candidates for treatment of Ebola viral disease, including the most promising experimental drugs brincidofovir (CMX001), BCX4430, and favipiravir (T-705).


Low incidence rate of overt hypothyroidism compared with hyperthyroidism in an area with moderately low iodine intake.
In areas with relatively high iodine intake, the incidence rate of hypothyroidism is several-fold higher than that of hyperthyroidism. Recently, we found a similarly high prevalence rate of subclinical hypothyroidism compared with hyperthyroidism in a high iodine intake area, while a relatively low prevalence of subclinical hypothyroidism was observed in a low iodine intake area. In the present study we compared the incidence rate (newly diagnosed in primary care and at hospital) of overt hypothyroidism with that of hyperthyroidism in a well-defined geographical area in Jutland, Denmark, with an iodine intake around 60 microg/day. The number of personsxyears studied was 569,108. Data on hyperthyroidism have been published previously. The overall incidence of hypothyroidism was 13.5/100,000 per year (F/M 22.9/3.6), hyperthyroidism 38.7/100.000 per year (F/M 63.0/13.0). The incidence of hypothyroidism was steadily increasing with age up to 80/100,000 per year in subjects older than 70 years of age, but apart from congenital hypothyroidism it was lower than that of hyperthyroidism at all ages. The majority of patients (79%) was diagnosed to have spontaneous autoimmune hypothyroidism (16% with goiter, 84% with no thyroid visible or palpable). In conclusion, in an area with moderately low iodine intake, hypothyroidism was considerably less common than hyperthyroidism. This is in contrast to findings in high iodine intake areas. The iodine intake of an area seems to be of major importance for the pattern of thyroid disorders observed.


One, two or more species? Mitonuclear discordance and species delimitation.
Delimiting species boundaries is central to understand ecological and evolutionary processes, and to monitor biodiversity patterns over time and space. Yet, most of our current knowledge on animal diversity and phylogeny relies on morphological and mitochondrial (mt) DNA variation, a popular molecular marker also used as a barcode to assign samples to species. For morphologically undistinguishable sympatric species (cryptic species), the congruence of several independent markers is necessary to define separate species. Nuclear markers are becoming more accessible, and have confirmed that cryptic species are widespread in all animal phyla (Fišer, Robinson, & Malard, 2018). However, striking differences between the mitochondrial and nuclear variation patterns are also commonly found within single species. Mitonuclear discordance can result from incomplete lineage sorting, sex-biased dispersal, asymmetrical introgression, natural selection or Wolbachia-mediated genetic sweeps. But more generally, the distinct mode of transmission of these two types of markers (maternal vs. biparental) is sufficient to explain their distinct sensitivity to purely demographic events such as spatial range and population size fluctuations over time. In a From the Cover manuscript in this issue of Molecular Ecology, Hijonosa et al. (2019) show that highly divergent mtDNA lineages coexist in a widespread European butterfly (Figure 1). None of the hundreds of nuclear markers analyzed was associated with mt lineages, nor was Wolbachia variation. These findings rule out the presence of cryptic species but shed light on complex demographic history of lineage divergence/fusion during the Pleistocene climatic fluctuations, and pave the way to a better integration of both mt and nuclear information in demographic models.


Mechanism of vasorelaxant activity of a fraction of root extract of Sesamum indicum Linn.
The petroleum ether soluble fraction (SIPE) of the root extract of S. indicum was evaluated for the vasorelaxant activity using isolated rat aorta. SIPE up to 180 microg/ml concentration significantly inhibited phenylephrine- and KCl-induced contraction to the extent of 98.13 +/- 6.37 and 70.19 +/- 3.43% respectively in isolated rat aorta in a concentration dependent manner. The vasorelaxant activity was not blocked by propranolol (10 microM), atropine (1 microM) indomethacin (10 microM) and glibenclamide (10 microM). Influence of SIPE on phenylephrine-induced contractions in aortic preparations in absence of functional endothelium and on pre-incubating the tissue with L-NAME (300 microM) or methylene blue (10 microM) was also studied. SIPE at 180 microg/ml concentration could elicit partial relaxation in presence of L-NAME or methylene blue to the extent of 34.26 +/- 6.13 and 25.66 +/- 10.95% respectively. However, in absence of functional endothelium, SIPE exhibited little relaxation to the extent of 6.70 +/- 4.87%. These studies revealed that the vasorelaxant activity of SIPE was chiefly mediated through endothelium-dependent pathway.


Nano-structured materials produced from simple metallic alloys by phase separation.
A method which is able to produce different types of nano-structured materials, namely nano-particles, nano-structured surfaces and nano-porous membranes, from two-phase metallic alloys is reviewed. The new process first establishes nano-structures in the bulk alloy and then separates them by selective phase dissolution. Variation in processing makes it possible to produce different types of nano-structure even from the same alloy. The process can be applied to many different alloy systems. An overview is presented emphasizing the versatility of the process with examples of different nano-structure types that can be produced. Further, the new method is discussed in relation to similar processes (specifically, electrochemical processes) which have been used for nano-structure synthesis.


Case Report: Coil Occlusion of Two Congenital Coronary Cameral Fistulas Connecting Right and Left Circumflex Arteries to the Right Ventricle: An Innovative Stent-Assisted Technique.
Coronary cameral fistulas (CCFs) are rare congenital malformations consisting of abnormal vascular connections between coronary arteries and cardiac chambers, often incidentally found during cardiac catheterizations. A 66-year-old female asymptomatic patient, without cardiovascular risk factors and a history of varicose veins lower extremities and coronavirus disease 2019 (COVID-19) pneumonia in December 2020, was diagnosed by coronary angiography with two large coronary cameral fistulas connecting the distal right coronary artery (RCA) and the distal left circumflex artery (LCx) to the right ventricle (RV). Additional imaging modalities such as two-dimensional transthoracic/transesophageal echocardiography and three-dimensional multidetector CT angiography were required to confirm the fistula's pathway (location, number, and size), which was difficult to delineate using selective coronary angiography alone. After heart team discussion, with the aim to reduce the risk of embolization, an innovative stent-assisted coil occlusion antegrade technique was used with optimal immediate results. Even though our otherwise asymptomatic patient was not the best suitable candidate for an interventional procedure (large vessels, multiple fistulas without distal narrowing, distal portion of the fistula not accessible with the closure device), the innovative stent-assisted fistula coil occlusion technique to stabilize the first coil and deploy safely the additional ones resulted to be key for successful and complete obliteration of the abnormal congenital vascular connections.


A Colorimetric Strategy Based on Aptamer-Catalyzed Hairpin Assembly for the On-Site Detection of Salmonella typhimurium in Milk.
Salmonella typhimurium (S. typhimurium) is a foodborne pathogen that has caused numerous outbreaks worldwide, necessitating the development of on-site strategy to prevent early contamination. Here, we set up an enzyme-free strategy for aptamer-catalyzed hairpin assembly in which salt-induced aggregation of unmodified gold nanoparticles (AuNPs) served as a colorimetric signal output, allowing on-site detection of S. typhimurium in milk. The aptamer-functionalized magnetic beads were used as a vehicle of specifically enriching target bacteria which conjugated with target aptamer to trigger the "Y" shape catalytic hairpin assembly (Y-CHA) circuit. Due to the hairpins desorbing from the surface of AuNPs to the formation of a large amount of double-stranded DNA (dsDNA), AuNPs turned from dispersion to aggregation in the presence of S. typhimurium, resulting in a change of the colorimetric signal from red to blue-gray. The signal output showed a linear relationship for S. typhimurium over a concentration range of 102 to 106 CFU/mL, with a sensitivity of 2.4 × 102 CFU/mL under optimal conditions. The visual protocol has excellent selectivity even in the presence of other competitive bacteria and has been validated in real milk samples with a sensitivity of 2.8 × 103 CFU/mL.


A placental sub-proteome: the apical plasma membrane of the syncytiotrophoblast.
As a highly vascularized tissue, the placenta mediates gas and solute exchange between maternal and fetal circulations. In the human placenta, the interface with maternal blood is a unique epithelial structure known as the syncytiotrophoblast. Previously we developed a colloidal-silica based method to generate highly enriched preparations of the apical plasma membrane of the syncytiotrophoblast. Using similar preparations, a proteomics assessment of this important sub-proteome has identified 340 proteins as part of this apical membrane fraction. The expression of 38 of these proteins was previously unknown in the human placental syncytiotrophoblast. Together with previous studies, the current proteomic database expands our knowledge of the proteome of the syncytiotrophoblast apical plasma membrane from normal placentas to include more than 500 proteins. This database is a valuable resource for future comparisons to diseased placentas. Additionally, this data set provides a basis for further experimental studies of placenta and trophoblast function.


Inferior alveolar nerve injury resulting from overextension of an endodontic sealer: non-surgical management using the GABA analogue pregabalin.
To describe a case of endodontic sealer (AH Plus) penetration within the mandibular canal after root canal treatment with resolution of pain and paraesthesia after a non-surgical approach, including treatment with prednisone and pregabalin. A 37-year-old woman underwent root canal treatment of the left mandibular second molar tooth. Postoperative periapical radiographs revealed the presence of radiopaque canal sealer in the mandibular canal. The day after, the patient reported severe pain in the tooth and paraesthesia/anaesthesia in the region innervated by the left inferior alveolar and mental nerve. Diagnosis of injury to the inferior alveolar nerve because of extrusion of AH Plus was established. The non-surgical management included 1 mg kg(-1) per day prednisone, two times per day, in a regimen on a daily basis, and 150 mg per day pregabalin, two doses per day, monitoring the progress with periodic follow-up visits. One month after the incident, the signs and symptoms were gone. This case illustrates the care required when performing root canal treatment, especially when the root apices are in close proximity to the inferior alveolar nerve canal. The complete resolution of paraesthesia and the control of pain achieved in the present case suggests that a non-surgical approach combining prednisone and pregabalin is a good option in the management of the inferior alveolar when it is contacted by extruded root filling material.


Complete resection and untethering of the cervical and thoracic spinal dermal sinus tracts in adult patients.
Dermal sinus tracts (DSTs) of the cervical and thoracic spine are extremely rare, particularly in adult patients because diagnosis is typically made in the early stage after birth by pediatricians. These cases should be treated surgically as soon as possible to prevent neurological sequelae. This report describes two rare adult cases with cervical and thoracic spine DSTs. The first patient presented with back pain and headache, whose skin lesion had been long known, but disregarded since birth. The second patient had long suffered from residual cervical myelopathy from the prior incomplete surgical treatment. Both cases had these sinus tracts excised completely and had spinal cord untethered successfully without any neurological deterioration. There has been a trend toward earlier diagnosis of these entities, but still some cases that were diagnosed in a delayed fashion or underwent incomplete treatment are reported. Improper management during childhood could lead to irreversible neurological deficit caused by spinal cord tethering and/or direct compression due to DSTs-associated tumors. The early detection and prompt surgical intervention improve the chance of a good surgical outcome. Furthermore, complete excision of the sinus tracts and associated tumors could help prevent future bacterial contamination and recurrence.


Liver tumors in children with chronic liver diseases.
Liver tumors are rare in children, but the incidence may increase in some circumstances and particularly in chronic liver diseases. Most liver tumors consequent to chronic liver diseases are malignant hepatocellular carcinoma. Other liver tumors include hepatoblastoma, focal nodular hyperplasia, adenoma, pseudotumor, and nodular regenerative hyperplasia. Screening of suspected cases is beneficial. Imaging and surrogate markers of alpha-fetoprotein are used initially as noninvasive tools for surveillance. However, liver biopsy for histopathology evaluation might be necessary for patients with inconclusive findings. Once the malignant liver tumor is detected in children with cirrhosis, liver transplantation is currently considered the preferred option and achieves favorable outcomes. Based on the current evidence, this review focuses on liver tumors with underlying chronic liver disease, their epidemiology, pathogenesis, early recognition, and effective management.


Standardized Competencies for Parenteral Nutrition Administration: The ASPEN Model.
Parenteral nutrition (PN) is a highly complex medication and its provision can be prone to a variety of errors. Safe administration of this therapy requires that the competency of clinicians, particularly nurses, be demonstrated using a standardized process. In this document, a standardized model for PN administration competency is proposed based on a competency framework, the ASPEN-published interdisciplinary core competencies, discipline-specific standards of practice, safe practice recommendations, and clinical guidelines. ASPEN recognizes that all healthcare institutions may not currently meet the aspirational goals of this document. This framework will guide institutions and agencies in developing tools and procedures and maintaining competency of staff members around safe PN administration. The ASPEN Board of Directors has approved this document.


Sex-based differences in the behavioral and neuronal responses to food.
Sex-based differences in food intake related behaviors have been observed previously. The objective of this study was to examine sex-based differences in the behavioral and neuronal responses to food. 22 women and 21 men were studied. After 6 days of controlled eucaloric feeding, ad libitum energy intake (EI) was measured for 3 days. Appetite ratings using visual analog scales were obtained before and after each meal. Functional magnetic resonance imaging was performed in the overnight fasted state on the last day of eucaloric feeding while subjects were presented visual stimuli of food and neutral non-food objects. While hunger and prospective consumption were not different between sexes, women had higher post-meal satiety ratings and dietary restraint than men. Images of hedonic foods resulted in significantly greater activation of lateral and dorsolateral prefrontal cortex (DLPFC) and parietal cortex in women as compared to men. No brain regions were more activated in men as compared to women. Men increased their EI during the ad libitum diet phase. While measures of appetite or feeding behaviors did not correlate with either neuronal activation or subsequent EI, DLPFC activation in response to hedonic foods was negatively correlated with EI. In summary, greater prefrontal neuronal responses to food cues in women may suggest increased cognitive processing related to executive function, such as planning, guidance or evaluation of behavior. Finally, increased DLPFC activation, perhaps relating to inhibitory cognitive control in response to food cues may be a better predictor of food intake than behavioral measures.


Olivocochlear innervation of inner and outer hair cells during postnatal maturation: evidence for a waiting period.
Reconstructions of the efferent innervation of the hamster (Mesocricetus auratus) cochlea were done during postnatal development. Efferent neurons were labeled via injections of biocytin and horseradish peroxidase into the crossed olivocochlear (OC) bundles using an in vitro brainstem technique. Such injections retrogradely labeled cell bodies in ventral periolivary regions of the superior olive consistent with their being medial OC neurons. Anterogradely labeled axons were traced to the cochlea, where they terminated on or below inner hair cells (IHCs) prior to postnatal day 5 (P5). After P5, labeled axons terminated on IHCs and outer hair cells (OHCs) and after P10, the majority of labeled axons terminated on the OHCs. In the electron microscope, small labeled terminals containing densely packed synaptic vesicles were found both adjacent to IHCs (axosomatic) as well as apposed to afferent and efferent fibers below IHCs prior to P5. By P10, large labeled terminals were axosomatic to OHCs and no longer found on IHCs. Consistent with previous reports, these data suggest that medial OC axons form part of an early primary innervation on and below IHCs before terminating on OHCs. This raises the possibility that OC neurons demonstrate a period of waiting below an intermediate target similar to that described in the development of thalamocortical projections.


The relationship between circadian and hemicircadian components of human endogenous temperature rhythms.
A review of constant routine data from normative and phase-shifted subjects shows that the hemicircadian and circadian components of fitted temperature data are only weakly linked. In these data sets, on average, hemicircadian amplitude is one-third of the circadian amplitude and the hemicircadian minimum occurs 1.7 h earlier than the circadian minimum. However, their variations about these means are largely independent. In addition the hemicircadian component was much less affected by bright light stimuli which strongly reduced the circadian component. The circadian and hemicircadian processes represented in these temperature data correspond to those reported in studies of human sleep/wake propensity.


[Sudden cardiac death in athletes].
Sudden deaths occurring during exercise are rare and are most commonly due to cardiac arrest. It is most commonly underlain by symptomless cardiomyopathy or coronary artery disease. Preventive work comes up against a diagnostic problem in distinguishing adaptational changes of the athletic heart from a heart disorder. To reveal the danger of cardiac arrest and reduce human tragedies international sports organizations and cardiologic expert groups recommend screening of cardiac disorders among competing athletes.


Effect of drinking water chlorination on Campylobacter spp. colonization of broilers.
The main source for Campylobacter spp. transmission from the environment to broiler chickens is still unclear. One implicated reservoir for the organism has been untreated broiler drinking water. This study was conducted with broilers first using experimental conditions (isolation units) and second under commercial conditions. We compared the rate of intestinal colonization in chickens provided 2 to 5 parts per million (ppm) chlorinated drinking water in relation to the frequency of colonization in chickens given unsupplemented drinking water. No significant difference (P > 0.05) was detected in isolation frequency or level of Campylobacter spp. colonization in birds provided chlorinated drinking water and control birds provided water without supplemental chlorine. In the isolation unit experiments, 86.3% (69/80) of the control and 85.0% (68/80) of the treated birds were colonized at levels corresponding to an average of 10(5.2) and 10(5.1) log colony-forming units (cfu) Campylobacter spp./g of cecal contents, respectively. Additionally, two sets of paired 20,000 bird broiler houses, with and without chlorination (2-5 ppm chlorine), were monitored in a commercial field trial. Effectiveness of chlorination was judged by prevalence of Campylobacter spp. in fecal droppings (960 samples) taken from the flocks in treated and control houses. Birds from the control houses were 35.5% (175/493) Campylobacter spp. positive, while 45.8% (214/467) of the samples from the houses having chlorinated drinking water yielded the organism. Chlorination of flock drinking water at the levels tested in this study was not effective in decreasing colonization by Campylobacter spp. under commercial production practices presently used in the United States.


Incidence density and relative risk of nosocomial infection in Taiwan's Only Children's Hospital, 1999-2003.
We report on 2,688 nosocomial infection episodes involving 3,238 pathogens in Taiwan's only children's hospital. The mean annual incidence density was 4.06 cases per 1,000 patient-days. The relative risk was highest in intensive care units, oncology wards, and neonatal observation wards. Very young, low-birth-weight, critically ill, and oncology patients were most at risk.