Effects of different dietary oils on egg quality and reproductive performance in rainbow trout Oncorhynchus mykiss.
The study was conducted to evaluate effects of different dietary oils on egg quality and reproductive performance in rainbow trout. Broodfish (≈ 870 g) were fed four iso-nitrogenous and iso-lipidic diets differing in lipid sources: fish oil (FO), linseed oil (LO) and sesame oil (SO) as well as a commercial trout diet (CD) for about 5 months prior to spawning. Growth performance did not differ among the trout in the treatment groups. Mean diameter, volume and weight of eggs did not differ among the dietary treatments. Absolute fecundity, relative fecundity and gonadosomatic index were not affected by dietary treatment. A sub-set of eggs from females fed the experimental diets were fertilized to assess the reproductive performance of broodfish. When diets were fed, devoid of fish oil, fertilization rates were 89.2 ± 5.8 and 92.1 ± 4.9 %, eyeing rates were 87.3 ± 5.3 and 84.1 ± 4.4 % and hatching rates were 81.2 ± 4.3 and 78.3 ± 3.4 % in LO and SO fed fish, respectively. Fatty acid content of the eggs from broodstocks with a different nutritional history was affected by the dietary lipid sources. Eicosapentaenoic acid (EPA), arachidonic acid (ARA), and docosahexaenoic acid (DHA) concentrations in females fed vegetable oil based diets were greater than the dietary concentrations. Overall, results from the present study indicate there can be inclusion of LO or SO as dietary lipid sources without compromising egg quality and reproductive performance. Furthermore, there is efficient bioconversion of 18C fatty acids to 20-22 C fatty acids in rainbow trout.


Bioreactor-based 3D human myocardial ischemia/reperfusion in vitro model: a novel tool to unveil key paracrine factors upon acute myocardial infarction.
During acute myocardial infarction (AMI), Ischemia/Reperfusion (I/R) injury causes cardiomyocyte (CM) death and loss of tissue function, making AMI one of the major causes of death worldwide. Cell-based in vitro models of I/R injury have been increasingly used as a complementary approach to preclinical research. However, most approaches use murine cells in 2D culture setups, which are not able to recapitulate human cellular physiology, as well as nutrient and gas gradients occurring in the myocardium. In this work we established a novel human in vitro model of myocardial I/R injury using CMs derived from human induced pluripotent stem cells (hiPSC-CMs), which were cultured as 3D aggregates in stirred tank bioreactors. We were able to recapitulate important hallmarks of AMI, including loss of CM viability with disruption of cellular ultrastructure, increased angiogenic potential, and secretion of key proangiogenic and proinflammatory cytokines. Conditioned medium was further used to probe human cardiac progenitor cells (hCPCs) response to paracrine cues from injured hiPSC-CMs through quantitative whole proteome analysis (SWATH-MS). I/R injury hiPSC-CM conditioned media incubation caused upregulation of hCPC proteins associated with migration, proliferation, paracrine signaling, and stress response-related pathways, when compared to the control media incubation. Our results indicate that the model developed herein can serve as a novel tool to interrogate mechanisms of action of human cardiac populations upon AMI.


Greater consumption of noodle is associated with higher serum phosphorus levels: a cross-sectional study on healthy participants.
Higher serum phosphorus levels are associated with mortality and cardiovascular events, both in healthy individuals and those with chronic kidney disease. Owing to the increasing westernization of eating habits, a decrease in rice consumption and an increase in the intake of bread and noodle products were observed in Japan. This cross-sectional study investigated the influence of staple food (rice, bread, and noodle) consumption patterns on the serum levels of phosphorus and phosphate-regulating factors in 103 healthy young participants. Fasting blood and 24-h urine samples were collected; data about dietary habits were collected using a brief-type self-administered diet history questionnaire. Cluster analysis was conducted to assess subgroups classified according to staple food consumption patterns. Serum levels of phosphorus and phosphate-regulating factors did not significantly differ between subgroups classified based on the frequency of rice or bread consumption. However, the serum levels of phosphorus and fibroblast growth factor 23 were more significantly elevated in the higher than in the lower noodle consumption frequency subgroup. Cluster analysis defined three clusters, and the serum phosphorus levels in the high-noodle cluster were significantly higher than that in the high-bread and high-rice clusters. A high consumption of noodles was associated with elevated serum phosphorus levels. The trial was registered in the University Hospital Medical Information Network (UMIN) Center system (The name of the trial register: Hidekazu Arai, and UMIN accession number: UMIN000034352).


Anaerobic infections of the soft tissue and bones.
Severe soft tissue infections, usually necrotizing, are associated with a mortality of 40-60% and with amputations where the bones and joints are involved. The anaerobic bacteria associated with these infections are usually present in patients with underlying predisposing conditions (diabetes, vascular problems, immunosuppression). They are in the majority polymicrobial, endogenous or exogenous. There are many clinical and laboratory characteristics to establish the diagnosis of the different forms of these infections. Treatment of necrotizing soft tissue and bone infections requires early and aggressive surgical debridment. Timing of diagnosis and surgery influence essentially the outcome. Colostomy can be helpful in cases of perineal involvement. Antibiotic covering (broad spectrum) is mandatory as well as the systemic support of the patient.


Functional respiratory imaging identifies redistribution of pulmonary blood flow in patients with COVID-19.
An increasing observation is that some patients with COVID-19 have normal lung compliance but significant hypoxaemia different from typical acute respiratory distress syndrome (ARDS). We hypothesised that changes in pulmonary blood distribution may be partially responsible and used functional respiratory imaging on CT scans to calculate pulmonary blood volume. We found that patients with COVID-19 had significantly reduced blood volume in the smaller calibre blood vessels (here defined as <5 mm2 cross-sectional area) compared with matched ARDS patients and healthy controls. This suggests that using high levels of PEEP may not alone be enough to oxygenate these patients and that additional management strategies may be needed.


Brief Report: Atypical Visual Exploration in Autism Spectrum Disorder Cannot be Attributed to the Amygdala.
Prior studies have emphasized the contribution of aberrant amygdala structure and function in social aspects of autism. However, it remains largely unknown whether amygdala dysfunction directly impairs visual attention and exploration as has been observed in people with autism spectrum disorders (ASD). Here, gaze patterns were directly compared between a rare amygdala lesion patient and adults with ASD when they freely viewed static images of complex natural scenes. The amygdala lesion patient showed a gaze pattern that was more similar to controls rather than that of the ASD group, which was independent of image content (social vs. objects) or complexity. This finding was further corroborated by analysis of temporal aspects of the gaze patterns and semantic category analysis. Together, the present results suggest that abnormal visual exploration observed in people with ASD is not likely primarily attributed to the amygdala.


Blood-culture techniques. A survey in Australasian laboratories.
The blood-culture methods of participants in the Microbiology Quality Assurance Programme were surveyed in late 1983; 183 participants from Australasia and S.E. Asia completed a questionnaire, the results of which are discussed. The choice of skin disinfectants varied widely. Conventional broth media were used by 85 participants; one or more diphasic bottles by 56; Roche Septi-Chek was used by 25; and BACTEC by 17. Only 80% of respondents reported the use of sodium polyanethol sulfonate. Contamination rates ranged from 0 to greater than 10%. Cultures were kept for as little as five days or as long as three weeks and were examined by inspection and/or Gram stain and/or subculture at widely varying intervals. While a great diversity of methods was used, in most cases these were adequate. The workload involved in some of the more laborious routines was considerable. It would be desirable to evaluate the cost-effectiveness of many blood culture practices.


Unsupervised layer-wise feature extraction algorithm for surface electromyography based on information theory.
Feature extraction is a key task in the processing of surface electromyography (SEMG) signals. Currently, most of the approaches tend to extract features with deep learning methods, and show great performance. And with the development of deep learning, in which supervised learning is limited by the excessive expense incurred due to the reliance on labels. Therefore, unsupervised methods are gaining more and more attention. In this study, to better understand the different attribute information in the signal data, we propose an information-based method to learn disentangled feature representation of SEMG signals in an unsupervised manner, named Layer-wise Feature Extraction Algorithm (LFEA). Furthermore, due to the difference in the level of attribute abstraction, we specifically designed the layer-wise network structure. In TC score and MIG metric, our method shows the best performance in disentanglement, which is 6.2 lower and 0.11 higher than the second place, respectively. And LFEA also get at least 5.8% accuracy lead than other models in classifying motions. All experiments demonstrate the effectiveness of LEFA.


The release of factor VIII and tissue plasminogen activator can not be blocked by specific antagonists to vasopressin.
Vasopressin and in particular 1-deamino-8-D-arginine vasopressin (DDAVP) can release factor VIII (FVIII) and tissue plasminogen activator (tPA) to the blood. In the present study DDAVP was injected in conscious dogs which had been preloaded with specific antagonists either against vasopressin's vasopressor response (V1-receptors) or its antidiuretic response (V2-receptors). The presence in the blood of either of the antagonists had no effect on the increase of FVIII or tPA following stimulation with DDAVP. It is therefore concluded that the effect of DDAVP on coagulation and fibrinolysis is elicited via a new class of receptors different from the known V1- and V2-receptors.


Time in range-A1c hemoglobin relationship in continuous glucose monitoring of type 1 diabetes: a real-world study.
The availability of easily accessible continuous glucose monitoring (CGM) metrics can improve glycemic control in diabetes, and they may even become a viable alternative to hemoglobin A1c (HbA1c) laboratory tests in the next years. The REALISM-T1D study (REAl-Life glucoSe Monitoring in Type 1 Diabetes) was aimed at contributing, with real-world data, to a deeper understanding of these metrics, including the time in range (TIR)-HbA1c relationship, to facilitate their adoption by diabetologists in everyday practice. 70 adults affected by type 1 diabetes were monitored for 1 year by means of either flash (FGM) or real-time (rtCGM) glucose monitoring devices. Follow-up visits were performed after 90, 180 and 365 days from baseline and percentage TIR70-180 evaluated for the 90-day time period preceding each visit. HbA1c tests were also carried out in the same occasions and measured values paired with the corresponding TIR data. A monovariate linear regression analysis confirms a strong correlation between TIR and HbA1c as found in previous studies, but leveraging more homogeneous data (n=146) collected in real-life conditions. Differences were determined between FGM and rtCGM devices in Pearson's correlation (rFGM=0.703, rrtCGM=0.739), slope (β1,FGM=-11.77, β1,rtCGM=-10.74) and intercept (β0,FGM=141.19, β0,rtCGM=140.77) coefficients. Normality of residuals and homoscedasticity were successfully verified in both cases. Regression lines for two patient groups monitored through FGM and rtCGM devices, respectively, while confirming a linear relationship between TIR and A1c hemoglobin (A1C) in good accordance with previous studies, also show a statistically significant difference in the regression intercept, thus suggesting the need for different models tailored to device characteristics. The predictive power of A1C as a TIR estimator also deserves further investigations.


A single monooxygenase, ese, is involved in the metabolism of the organochlorides endosulfan and endosulfate in an Arthrobacter sp.
In this paper we describe isolation of a bacterium capable of degrading both isomers of the organochloride insecticide endosulfan and its toxic metabolite, endosulfate. The bacterium was isolated from a soil microbial population that was enriched with continuous pressure to use endosulfate as the sole source of sulfur. Analysis of the 16S rRNA sequence of the bacterium indicated that it was an Arthrobacter species. The organochloride-degrading activity was not observed in the presence of sodium sulfite as an alternative sulfur source, suggesting that the activity was part of the sulfur starvation response of the strain. A gene, ese, encoding an enzyme capable of degrading both isomers of endosulfan and endosulfate was isolated from this bacterium. The enzyme belongs to the two-component flavin-dependent monooxygenase family whose members require reduced flavin for activity. Nuclear magnetic resonance analyses identified the metabolite of endosulfan as endosulfan monoalcohol and the metabolite of endosulfate as endosulfan hemisulfate. The ese gene was located in a cluster of 10 open reading frames encoding proteins with low levels of sulfur-containing amino acids. These open reading frames were organized into two apparent divergently orientated operons and a gene encoding a putative LysR-type transcriptional regulator. The operon not containing ese did contain a homologue whose product exhibited 62% amino acid identity to the ese-encoded protein.


Genomic expression dominance in allopolyploids.
Allopolyploid speciation requires rapid evolutionary reconciliation of two diverged genomes and gene regulatory networks. Here we describe global patterns of gene expression accompanying genomic merger and doubling in inter-specific crosses in the cotton genus (Gossypium L.). Employing a micro-array platform designed against 40,430 unigenes, we assayed gene expression in two sets of parental diploids and their colchicine-doubled allopolyploid derivatives. Up to half of all genes were differentially expressed among diploids, a striking level of expression evolution among congeners. In the allopolyploids, most genes were expressed at mid-parent levels, but this was achieved via a phenomenon of genome-wide expression dominance, whereby gene expression was either up- or down-regulated to the level of one of the two parents, independent of the magnitude of gene expression. This massive expression dominance was approximately equal with respect to direction (up- or down-regulation), and the same diploid parent could be either the dominant or the recessive genome depending on the specific genomic combination. Transgressive up- and down-regulation were also common in the allopolyploids, both for genes equivalently or differentially expressed between the parents. Our data provide novel insights into the architecture of gene expression in the allopolyploid nucleus, raise questions regarding the responsible underlying mechanisms of genome dominance, and provide clues into the enigma of the evolutionary prevalence of allopolyploids.


Tropheryma whipplei detection by metagenomic next-generation sequencing in bronchoalveolar lavage fluid: A cross-sectional study.
Tropheryma whipplei is the bacterium associated with Whipple's disease (WD), a chronic systemic infectious disease primarily involving the gastrointestinal tract. T. whipplei can also be detected in different body site of healthy individuals, including saliva and feces. Traditionally, Tropheryma whipplei has a higher prevalence in bronchoalveolar lavage fluid (BALF) of immunocompromised individuals. Few studies have explored the significance of the detection of T. whipplei in BALF. Herein, we retrospectively reviewed 1725 BALF samples which detected for metagenomic next-generation sequencing (mNGS) from March 2019 to April 2022 in Zhuhai, China. Seventy BALs (70/1725, 4.0%) from 70 patients were positive for T. whipplei. Forty-four patients were male with an average age of 50 years. The main symptoms included cough (23/70), expectoration (13/70), weight loss (9/70), and/or dyspnea (8/70), but gastrointestinal symptoms were rare. Chronic liver diseases were the most common comorbidity (n=15, 21.4%), followed by diabetes mellitus (n=13, 18.6%). Only nine patients (12.9%) were immunocompromised. Twenty-four patients (34.3%) were finally diagnosed with reactivation tuberculosis and 15 patients (21.4%) were diagnosed with lung tumors, including 13 primary lung adenocarcinoma and two lung metastases. Fifteen patients (21.4%) had pneumonia. Among the 20 samples, T. whipplei was the sole agent, and Mycobacterium tuberculosis complex was the most common detected other pathogens. Among the non-tuberculosis patients, 31 (31/46, 67.4%) had ground glass nodules or solid nodules on chest CT. Our study indicates that T. whipplei should be considered as a potential contributing factor in some lung diseases. For non-immunocompromised patients, the detection of T. whipplei also needs attention. The mNGS technology improves the detection and attention of rare pathogens. In the future, the infection, colonization, and prognosis of T. whipplei in lung still need to be studied.


Home Total Parenteral Nutrition for Intestinal Failure in Patients with Advanced Small Intestinal Neuroendocrine Neoplasms.
The role of total parenteral nutrition (TPN) in cancer patients is controversial, but it may be a treatment option for some patients with indolent but advanced small intestinal neuroendocrine neoplasms (SI-NENs). The aim of this study is to investigate whether home TPN was associated with long-term survival and to assess the indications, duration and complications of TPN in patients with advanced SI-NENs. Patients with advanced SI-NENs who received home TPN were retrospectively included. Electronic records were reviewed for clinical information. Five patients receiving home TPN were identified out of 1011 patients with SI-NENs in our center. The median duration of TPN administration was 12 mo. Small bowel obstruction was the most common reason for TPN initiation. TPN-related complications included two catheter infections, one thrombosis and one episode of TPN-related transaminitis. At the last follow-up, three patients had died and two were alive. The median survival was 12 mo. Overall estimated 1-yr probability of survival on home TPN by Kaplan-Meier analysis was 40%. In conclusion, home TPN may be a treatment option in highly selected advanced SI-NEN patients with severe gastrointestinal tract dysfunction. The initiation of home TPN is associated with long-term survival (≥1 yr), and complication rates appear acceptable.


Patch clamp analysis of Na channel gating in mammalian myocardium: reconstruction of double pulse inactivation and voltage dependence of Na currents.
Isolated ventricular cells of the mouse heart were prepared by an enzyme digestion procedure. Unitary Na currents were recorded with the patch clamp technique from cell attached patched. Macroscopic Na currents were obtained as mean of 38 consecutive sweeps of cell attached patches with up to 100 channels each. Double pulse inactivation of macroscopic currents showed an increase of the test current amplitude at test pulse potential Vt = -30 mV after short prepulses at prepulse potential Vp = -50 mV. The open time distribution of single channels could be fitted monoexponentially yielding a mean open time tau 0. Between -70 mV and -20 mV tau 0 showed a bell shaped voltage dependence. The probability to record an empty sweep PA (0) had a minimum value at -50 mV and increased towards less negative potentials. The current-voltage relation of the unitary current was linear between -60 mV and -20 mV yielding a slope conductance of 18.5 pS at room temperature. There was no indication of the existence of more than a single unitary current level. For the apparent peak open probability of a Na channel a sigmoidal voltage dependence was found between -70 mV and -20 mV. Single channel recording reveals that the time course of double pulse inactivation coincides with the increase in the number of empty sweeps leaving tau 0 unchanged. The Markov models with two closed states, one open and one inactivated, were used for quantitative analysis. Useful were only models allowing inactivation both from at least one of the closed states and from the open state. For both model types a set of rate constants was calculated from single channel data and from the time course of the opening probability at -50 mV and -30 mV, respectively. The model with the allowed inactivation from the second closed state (M1) was superior to that with the allowed inactivation from the first closed state (M3) by the prediction of the time course of the early double pulse inactivation at Vp = 50 mV and Vt = 30 mV and, based on these data, by the prediction of the amplitude of Na currents at -40 mV and -60 mV.


Age-associated Cognitive Decline: Insights into Molecular Switches and Recovery Avenues.
Age-associated cognitive decline is an inevitable phenomenon that predisposes individuals for neurological and psychiatric disorders eventually affecting the quality of life. Scientists have endeavored to identify the key molecular switches that drive cognitive decline with advancing age. These newly identified molecules are then targeted as recovery of cognitive aging and related disorders. Cognitive decline during aging is multi-factorial and amongst several factors influencing this trajectory, gene expression changes are pivotal. Identifying these genes would elucidate the neurobiological underpinnings as well as offer clues that make certain individuals resilient to withstand the inevitable age-related deteriorations. Our laboratory has focused on this aspect and investigated a wide spectrum of genes involved in crucial brain functions that attribute to senescence induced cognitive deficits. We have recently identified master switches in the epigenome regulating gene expression alteration during brain aging. Interestingly, these factors when manipulated by chemical or genetic strategies successfully reverse the age-related cognitive impairments. In the present article, we review findings from our laboratory and others combined with supporting literary evidences on molecular switches of brain aging and their potential as recovery targets.


A New Setup for Simulating the Corrosion Behavior of Orthodontic Wires.
The aim of this study was to create a new reliable setup to evaluate commercially available orthodontic wires used during orthodontic treatment. The setup includes various techniques applied for testing metal alloy materials. The materials were tested under extreme conditions to simulate their behavior in the mouth. The alloy composition of each wire was tested. The electrochemical (EC) testing and characterization of the corrosion performance of the wires was calculated by the electrochemical curves at pH = 1 in two different applied potentials to test the reaction of the material. The liquid collected after the EC measurements was analyzed by inductively coupled plasma-mass spectrometry (ICP-MS) to verify the reliability of the EC curves and for a more accurate evaluation of the corrosion behavior of the wires. Therefore, the EC measurements were compared to the actual values obtained from the released ions found in the solution. At the end, a surface analysis was performed to detect corrosion on the wires. In conclusion, this study developed a setup to test and better understand the corrosion behavior and ion release of the orthodontic wires, metal alloy dental materials, and other metals used in the oral cavity. This method can contribute to dental material selection in patients with underlying health conditions.


[Interbody spacers in the treatment of cervical spine disorders].
Degenerative conditions of the spine represent a group of most common lifestyle associated diseases with significant medical and important social impact. Clinical symptoms and syndromes of surgically considerable degenerative diseases of the spine mostly result from nerve root or spinal cord compression caused by a herniated intervertebral disc or a dorsal osteophyte. Therefore, the main goal of the surgical treatment is decompression of the neural structures by complete removal of the intervertebral disc and the osteophytes followed by insertion of an artificial disc spacer into the remaining space. The most frequently used procedure for treating such findings is called anterior cervical discectomy. Since its first introduction in 1950, several modifications of the original technique have been introduced. Their common feature is that removal of the degenerated intervertebral disc or the osteophytes requires stabilization of the adjacent segments by fusion. Thus, implantation of an interbody spacer results not only in intervertebral space reconstruction, but by immobilizing the adjacent vertebral bodies also in forming a firm bony bridging between them--and ultimately a solid bony block. Our paper provides a review of cervical interbody spacers in the order of their evolution from auto- and allografts, through compact materials, cages and dynamic artificial disks. Furthermore, different types of cage filling materials used for fusion augmentation are also discussed.


Serum thyroglobulin is associated with orbitopathy in Graves' disease.
Serum thyroglobulin levels are often elevated in Graves' disease (GD) and in most cases decrease during treatment. Its relation to Graves' orbitopathy (GO) has not been clarified. Previously, a risk of GO has been linked to smoking, TSH receptor stimulation, high TSH-receptor antibodies (TRAb), low thyroid peroxidase and thyroglobulin antibodies (TPOAb, TgAb). We examined Tg levels in 30 consecutive patients with GD were given drug therapy (methimazole + thyroxine) for up to 24 months. GO was identified by clinical signs and symptoms. 17 patients had GO, 11 of whom had it at diagnosis while 6 developed GO during treatment. During the study, 5 subjects were referred to radioiodine treatment, 3 to surgery. The remaining 22 subjects (GO n = 12, non-GO n = 10) completed the drug regimen. At diagnosis, Tg levels in GO patients (n = 11) were higher (84, 30-555 µg/L, median, range) than in non-GO patients (n = 19) (38, 3.5-287 µg/L), p = 0.042. Adding the 6 subjects who developed eye symptoms during treatment to the GO group (n = 17), yielded p = 0.001 vs. non-GO (n = 13). TRAb tended to be higher, while TPOAb and TgAb tended to be lower in the GO group. For the 22 patients who completed the drug regimen, Tg levels were higher in GO (n = 12) vs. non-GO (n = 10), p = 0.004, whereas TRAb levels did not differ. The data may suggest that evaluation of thyroglobulin levels in GD could contribute to identify patients at increased risk of developing GO. Possibly, thyroidal release of Tg in GD reflects a disturbance that also impacts retroorbital tissues.


Platelet-to-Lymphocyte Ratio as an Indicator to Predict Decreased Carbon Monoxide Diffusion of the Lung in Patients with Testicular Cancer.
To investigate whether the use of diffusing capacity of the lungs for carbon monoxide (DLCO) and neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) could be used to predict bleomycin-induced pulmonary toxicity in patients with testicular cancer (TCa). Descriptive study. Ankara Oncology Training and Research Hospital, Turkey, between 2017 and 2020. Data of 40 patients with TCa, who were followed at cancer centre from 2017-2020 and received 3-4 cycles of BEP protocol were retrospectively screened and included who met the criteria for inclusion in the study. All patients with TCa, who were older than 18 years of age and had no secondary malignancy and comorbidity, were included in this study. A statistically significant negative correlation was found between DLCO change and NLR, PLR (r:-0.558, p:0.002 for NLR; r:-0.462 p:0.012 for PLR). A statistically significant positive correlation was found between DLCO change and lymphocyte level (r:0.436, p:0.018). The NLR and PLR were statistically higher in the group with a decrease of ≥10% in DLCO compared to the group with no decrease or a decrease of ≤10% in DLCO (for NLR; 3.03 ± 1.45 and 1.68 ± 0.73, respectively, p = 0.005; for PLR 187.72 ± 66.90 and 124.72 ± 47.99, respectively, p = 0.008). Multivariate regression analysis showed a statistically significant relationship between PLR increase and a decrease of ≥10% in DLCO. PLR and LDH could be used as independent predictive biomarkers for DLCO decline which is used to identify bleomycin-induced pulmonary toxicity. Key Words: Bleomycin, Markers of inflammation, Platelet-to-lymphocyte ratio (PLR), Pulmonary diffusing capacity, Testicular cancer.


Mobile application recovery support for patients with an alcohol use disorder. Acceptance, usability, and perceived helpfulness.
The aim of this study was to qualitatively explore the experiences of patients of abstinence-oriented treatment programs, who were using a mobile application (mWSPARCIE) after completing a 6-week inpatient treatment program, and to assess its role as a tool supporting the process of recovery initiated in the treatment facility. Telephone in-depth interviews were conducted after six months of application use among a convenience sample of former patients of the inpatient treatment (n = 33). Transcriptions of the interviews were analyzed and coded sentence-by-sentence. The coding procedure allowed researchers to establish the main analytical categories. Most respondents did not install the application or did not use it despite installing it, due to individual preferences and needs as well as to technical limitations. However, two thirds of the respondents who downloaded the application, used it on a regular basis, and four out of five considered it helpful in their recovery process. The application was used primarily for self-observation, allowing subjects to monitor their abstinence as well as the frequency and intensity of their alcohol craving. Acceptance of mHealth is low among patients of abstinence-oriented treatment programs. Therefore, this is clearly not a solution for all patients, because of individual preferences and needs as well as technical and financial barriers. However for those who use it, the tested application was an attractive source of additional support, a tool to maintain the motivation to change and to monitor abstinence and craving during the six months following their completion of treatment.


Prevalence of overactive bladder and its related factors in Japanese patients with diabetes mellitus.
The objectives of this study were to examine the prevalence of overactive bladder (OAB), including both with and without urinary incontinence, in patient with diabetes, and to explore factors related to the presence of OAB. This was a single-center, cross-sectional prospective survey. Patients with diabetes aged ≥18 years were consecutively enrolled in this study. Items related to OAB symptoms, neuropathic symptoms, clinical characteristics regarding diabetes management, and demographics were collected. The presence of OAB was assessed using the Overactive Bladder Symptoms Score (OABSS). Relationships between presence of OAB and potential related factors were explored by logistic regression analysis. The prevalence of OAB in the study cohort (n=652) was 24.2%, of which 71.5% was dry OAB (without urgency incontinence). Multivariate analysis showed that age (odds ratio [OR] 1.64, 95% confidence interval [CI] 1.07-2.50) and symptomatic diabetic polyneuropathy (DPN) (OR 2.41, 95% CI 1.64-3.54) were significantly related to the presence of OAB. The OAB prevalence in our sample of patients with diabetes was approximately 2-fold higher than that of the Japanese general population, which was based on results obtained from questionnaires similar to the present study, although the OAB prevalence of 24.2% may slightly differ from the true value due to assessment of OAB using the questionnaire only. As OAB which is deteriorated QOL can be identified and treated, screening of OAB in patients with diabetes who have DPN or aged ≥65 years may contribute to achieving the therapeutic aim of maintaining QOL.


Effects of DA-1- and DA-2-dopamine antagonists on apomorphine-induced inhibition of peripheral sympathetic neurotransmission.
1. Apomorphine, a dopamine receptor agonist, caused a dose-dependent inhibition of the electrically induced increase in diastolic blood pressure in the pithed rat. The anti-apomorphine effects of a range of dopamine antagonists with different DA-1/DA-2 selectivities were evaluated to characterize the dopamine receptor subtype(s) involved in this response. 2. Selective DA-2 antagonists domperidone and (-)-sulpiride and combined DA-2/DA-1 antagonists haloperidol, fluphenazine and (+)-sulpiride were active in this model, whereas the DA-1 antagonist SCH 23390 and the alpha-2 adrenoceptor antagonist idazoxan (RX-781094) were inactive. The rank order of potency of the dopamine antagonists was domperidone greater than fluphenazine greater than or equal to (-)-sulpiride greater than or equal to haloperidol greater than (+)-sulpiride much greater than SCH 23390. (-)-Sulpiride was about 25 times more potent than the (+)-isomer. 3. The observed antagonist profile suggests that the apomorphine-induced inhibition of neurogenic vasoconstriction in the pithed rat is mediated via dopamine receptors of the DA-2 subtype. The sympatho-inhibitory dopamine receptors in the cat heart have similar pharmacological characteristics. 4. The dopamine antagonists were devoid of influences on the vasoconstrictor response to electrical stimulation in the absence of apomorphine, whereas idazoxan potentiated it. This provides evidence against the participation of dopamine receptors in the modulation of the vasoconstrictor response to sympathetic stimulation in the pithed rat model.


Trends in compliance with the national colposcopy guidelines.
This study aims to assess trends in compliance with current colposcopy guidelines in 10 gynaecological units in four English counties since 1996; to identify constraints on compliance and suggest change in practice. All 10 gynaecology units in Oxfordshire, Buckinghamshire, Northamptonshire and Berkshire participated. Data were collected prospectively by colposcopists from 23,500 new referrals across a 55-month period from September 1996 to March 2001. The Oxford Cancer Intelligence Unit performed collation, quality assurance and retrieval of data for incomplete records. Audit results were disseminated annually to colposcopists via the Regional Colposcopy Group. Colposcopy waiting times exceeded the standards, but waiting times for high-grade referrals showed statistically significant improvement. Six standards were achieved; relating to accuracy, appropriateness of management and outcomes. The seven unmet standards relate to waiting times, colposcopist's caseload, follow-up policy and the proportion of cervical epithelial neoplasia (CIN) on histology. Changes in practice are suggested, constraints on compliance are identified and the appropriateness of some guidelines is questioned.


Polymeric Membranes for Oil-Water Separation: A Review.
This review is devoted to the application of bulk synthetic polymers such as polysulfone (PSf), polyethersulfone (PES), polyacrylonitrile (PAN), and polyvinylidene fluoride (PVDF) for the separation of oil-water emulsions. Due to the high hydrophobicity of the presented polymers and their tendency to be contaminated with water-oil emulsions, methods for the hydrophilization of membranes based on them were analyzed: the mixing of polymers, the introduction of inorganic additives, and surface modification. In addition, membranes based on natural hydrophilic materials (cellulose and its derivatives) are given as a comparison.


Tumor necrosis factor-alpha reduces ketamine- and propofol-induced anesthesia time in rats.
Tumor necrosis factor-alpha (TNFalpha) is a crucial neuromodulator in the brain. TNFalpha is involved in many physiological events including pain response and sleep. However, the interactions between TNFalpha and anesthetics have not been elucidated yet. In the present study, we investigated the effects of four intracerebroventricular (ICV) doses (1, 10, and 100 pg, and 1 ng) and two intraperitoneal (IP) doses (10 and 100 ng) of TNFalpha on anesthesia time of ketamine (100 mg/kg IP) and propofol (80 mg/kg IP) in rats. All ICV doses of TNFalpha reduced anesthesia time of ketamine and propofol compared with the saline ICV group (ketamine control group, 45.4 +/- 6.5 min; propofol control group, 43.5 +/- 11.0 min). The maximum effect was obtained after the ICV injection of 10 pg of TNFalpha (76% and 54% of ketamine and propofol control groups, respectively). Anesthesia time of ketamine or propofol was also decreased by IP injection of TNFalpha in a dose-dependent manner. Injection of 100 ng of TNFalpha IP reduced anesthesia time of ketamine and propofol by 67% and 64% of each control group, respectively. These data show that TNFalpha can modulate the anesthesia time of IV anesthetics, suggesting that anesthetic requirements might be altered in the presence of cerebral or systemic inflammation. Tumor necrosis factor alpha (TNFalpha) regulates many physiological events in the brain. We investigated the effects of TNFalpha on anesthesia time in rats. Both central and peripheral administration of TNFalpha decreased anesthesia time induced by ketamine and propofol.


Effects of septum and pericardium on heart-lung interactions in a cardiopulmonary simulation model.
Mechanical heart-lung interactions are often overlooked in clinical settings. However, their impact on cardiac function can be quite significant. Mechanistic physiology-based models can provide invaluable insights into such cardiorespiratory interactions, which occur not only under external mechanical ventilatory support but in normal physiology as well. In this work, we focus on the cardiac component of a previously developed mathematical model of the human cardiopulmonary system, aiming to improve the model's response to the intrathoracic pressure variations that are associated with the respiratory cycle. Interventricular septum and pericardial membrane are integrated into the existing model. Their effect on the overall cardiac response is explained by means of comparison against simulation results from the original model as well as experimental data from literature.


Patient choice improves self-efficacy and intention to complete tuberculosis preventive therapy in a routine HIV program setting in Uganda.
A 12-dose weekly regimen of rifapentine plus isoniazid (3HP) is recommended for the prevention of active tuberculosis (TB); however, it is unclear whether 3HP should be provided by directly observed therapy (DOT) or self-administered therapy (SAT). In addition, the introduction of patient informed choice between delivery modalities may have a positive impact on factors leading to treatment completion. The authors randomized 252 participants with HIV to a hypothetical scenario of providing preventive therapy by either DOT or an informed choice between DOT and SAT. Out of 104 participants who were randomized to a choice between DOT and SAT, 103 chose therapy by SAT. Participants rated their level of confidence and intention to complete therapy. Compared to those assigned to the DOT scenario, patients assigned to the choice scenario expressed greater confidence and intention to complete preventive therapy. Convenience and travel required to complete 3HP therapy were important factors in deciding between delivery modalities. Those assigned to DOT identified more barriers to completing therapy than those given a choice. Empowering patients to make informed decisions about how they receive TB preventive therapy may improve completion rates.


[Expression and its Clinical Significance of NOK, EGFR in NSCLC.].
NOK (Novel Oncogene with Kinase-domain) is a newly identified receptor protein-tyrosine kinases (RPTKs) subfamily, which possesses strong oncogenic potential including enhancing cell transformation, tumorigenesis, invasion and metastasis. However, NOK protein lacks extracellular domain, and how the NOK is activated by the membrane receptor and the expression of NOK in non small cell lung cancer (NSCLC) are not clear. Our aim of this study was to investigate the expressions of NOK, EGFR proteins in NSCLC. The expression rates of NOK, EGFR proteins in 155 cases with NSCLC was deteced by immunohistochemical stain; The clinical correlations between two proteins were analyzed by statistics. The NOK positive expression was mainly located in cytoplasm and EGFR was mainly located in the plasma membrane and cytoplasm. NOK, EGFR proteins were high expressed in NSCLC and there were extremely differences comparing the expression of NOK, EGFR proteins in squamous cell lung cancer, lung adenocarcinoma with those in corresponding normal tissue respectively (P<0.001); and there were no significant differences between the two kinds of the cancers for their comparison of NOK, EGFR expression (P=0.099; P=0.23); however, there were significant differences for NOK and EGFR expression among histological grades and TNM stages in squamous cell lung cancers, lung adenocarcinoma (P<0.01). There were correlation between positive and intensity of NOK and EGFR expression in whatever total NSCLC or squamous cell lung cancer or lung adenocarcinoma (P<0.001), while the correlation coefficients(rs) were 0742, 0.722, 0.756 respectively. The NOK proteins are highly expressed in the NSCLC, and the expression rates of NOK proteins are correlated with the cancers' histological grades and TNM stages, which may be concern with tumorgenesis and progression; the positive expression rate and intensity of NOK protein correlate well with the expression of EGFR protein in NSCLC, which the activation of NOK probably owe to EGFR activation, all that would provide evidence for further study on the effective mechanism of NOK in the tumorigenesis or tumor progression.


Extramedullary fixation implants for extracapsular hip fractures.
Extramedullary fixation of hip fractures refers to the application of a plate and screws to the lateral side of the proximal femur. To compare different types of extramedullary fixation implants for the surgical treatment of extracapsular hip fracture in adults. We searched the Cochrane Musculoskeletal Injuries Group specialised register and reference lists of relevant articles. Date of the most recent search: January 2001. All randomised or quasi-randomised trials comparing extramedullary implants used in the fixation of extracapsular hip fracture in adults. Two reviewers independently assessed trial quality, using a ten item scale, and extracted data. Additional information was sought from all trialists. Wherever appropriate and possible, data from comparable trials were pooled. A newly identified trial investigating the RAB plate (a fixed angle blade plate with an oblique connecting strut) is included in this update. All eight included trials (involving 1173 participants) had methodological flaws which may have resulted in serious bias. Three trials involving 355 patients compared a fixed nail plate (Jewett or McLaughlin) with the sliding hip screw (SHS). The limited data presented indicated an increased risk of fixation failure outcomes for fixed nail plates. The two trials, involving 433 patients, comparing the RAB plate with the SHS had contrasting results, notably in terms of operative complications, fixation failure and anatomical restoration. One trial involving 100 patients compared the Pugh nail and the SHS. There was no significant difference between implants for the outcome measures reported. One trial involving 178 patients with 182 fractures, compared the Medoff plate with the SHS. A significantly higher mean operative blood loss and longer mean operative time were reported for the Medoff plate. There was however a tendency to a lower risk of fixation failure for unstable trochanteric fractures fixed with the Medoff plate. One trial involving 107 patients with subtrochanteric fractures compared the Medoff plate with three different screw plate systems. There was a tendency to a lower fixation failure rate for the Medoff plate, but no evidence for differences in longer-term outcomes. The fixed nail plate has higher risks of implant breakage and fixation failure than the SHS. Though insufficient evidence on other outcomes is available from randomised trials, the increased fixation failure rate is a major consideration and thus the SHS appears preferable. Insufficient information is available to draw firm conclusions of the clinical significance of differences between the SHS and either the RAB plate, the Pugh nail or the Medoff plate.


Distribution and Migration of Trace Elements during Flotation in Ge-Rich Low-Rank Coal from Wulantuga Coal Mine, Inner Mongolia, China.
The high-Ge low-rank coal in Wulantuga Coal Mine, Inner Mongolia, China, has a high utilization value due to its enrichment of critical element Ge. However, it is also enriched with toxic elements such as Be, F, As, and Hg; therefore, the coal should be cleaned before use. In this study, the flotation experiment, X-ray diffraction (XRD), X-ray fluorescence (XRF), Fourier transform infrared (FTIR) analysis, and the release experiment for the high-Ge low-rank coal from Wulantuga were carried out, and the results are as follows. (1) The total mineral content of the feed coal is higher than that of the cleaned coal and tailing, and the content of the functional group -OH is also increased, indicating that the moisture in the cleaned coal is increased after flotation. (2) Argillation occurred and some minerals (dihydrate gypsum and kaolinite) and elements were released into the water during flotation, so the ash yield and the percentage of TiO2, Al2O3, Fe2O3, MgO, and CaO of the cleaned coal and tailing are lower than those of feed coal. (3) The concentrations of elements Li, Be, F, Mn, Zn, Sr, Hg, Tl, and Pb of the cleaned coal are higher than those of tailing, indicating that these elements are more likely to occur in organic matter or fine-grained mineral embedded in organics, but the concentration of other elements such as Ge, As, Sb, and W in the cleaned coal is lower than that of tailing, suggesting that these elements are weakly associated with organics or occur in minerals. (4) After flotation, trace elements Be, Cs, Ti, Ge, Sb, and W enriched in the feed coal were removed in large quantities, while F, As, and Hg were difficult to remove; therefore, other preparation methods should be tried. (5) The release experiment showed that the release rate of chalcophile and siderophile elements and rare earth elements and yttrium (REY) is relatively higher. In addition to those of Be, Ga, Sr, and Cs, the release rate of most elements is relatively low.


T-dependent destruction of thyroid isografts exposed to IFN-gamma.
Several autoimmune diseases are accompanied by tissue-specific expression of class II molecules of the MHC, and it has been suggested that this elicits a T cell response against tissue-specific Ag to which the individual is not tolerant. However, recent transgenic studies have indicated that non-lymphoid expression of class II genes in the pancreas, liver, and kidney is either innocuous or induces peripheral tolerance. To test this hypothesis in another organ-specific autoimmune disease, we attempted to induce autoimmune thyroiditis in normal mice with class II+ thyroid tissue. Normal thyroid lobes were cultured with and without IFN-gamma and then transplanted to adult isogeneic recipients. The thyroid that had been induced to express class II genes by IFN-gamma was destroyed in normal mice, whereas the control cultured thyroid and the native cervical gland survived. Both types of transplants remained intact and functional in congenic nu/nu recipients, indicating that neither exposure to IFN-gamma nor expression of class II genes compromised the thyroid. Thus, in some tissues, exposure to IFN-gamma and/or the induction of class II expression can lead to T-dependent autoimmune disease.


[Measure of quality of life in patients with metastatic colorectal cancer: techniques and main results].
Until the 1990s, the patient's duration of life was the main measure for determining the value of palliative chemotherapy for colorectal cancer. Quality of life recently appeared as a main end point. The aim of this article is to provide an overview of the instruments used to measure quality of life in patients with metastatic colorectal cancer, to review the published data and to analyse the bias and methodological problems. QoL is a multidimensional subjective concept, which can be measured using psychometric instruments. Quality of life measurement has a descriptive and prognostic value. Results from quality of life assessment in randomized trials have given useful information and help patients and physicians to choose between treatment options. More than half of the patients with palliative chemotherapy had at least stabilization of quality of life. Response to chemotherapy and side-effects influence quality of life. Quality of life assessment clearly requires methodological improvement. Missing data are a particularly difficult problem, which should be improved by a better organization. Psychometric properties of EORTC QLQ-CR38 et FACT-C should be checked in French language. An international consensus on methods of measurement of quality of life in oncology is warranted to enhance compliance, to better interpret quality of life results et to optimize publications of precise quality of life data.


In-vitro evaluation of the shear bond strength and fluoride release of a new bioactive dental composite material.
The aim of this study was (1) to determine and compare the shear bond strength (SBS) of a bioactive composite "Activa Bioactive Restorative" with and without bonding agent and a nanocomposite "Filtek Z350 XT/Z350" and (2) to measure and compare the amount of fluoride release from a bioactive composite "Activa Bioactive Restorative" and a glass ionomer "Equia forte". Forty two dentin surfaces from freshly extracted human molars were prepared for shear bond strength testing. The specimens were randomly divided into three equal groups. The restorative materials were applied to all dentin surfaces according to the manufacturer's instructions, using a special jig (Ultradent) in the following manner : Group 1 (Activa Bioactive Restorative with adhesive), Group 2 (Activa Bioactive Restorative without adhesive) and Group 3 (Filtek Z350 XT/Z350). The bonded specimens were subjected to thermocycling in 5°C and 55°C water baths then tested for SBS in a universal testing machine (1 mm/minute). Kolmogorov-Smirnov and Levene tests were used to evaluate the distribution of the variable and the equality of variances respectively and a Student's T- test was applied to compare the mean strength between the groups. In the next test, thirty disc shaped specimens were fabricated using Activa BioActive restorative and Equia Forte; 15 specimens from each material. The specimens of each group were immersed separately in 5 ml of deionized water. Fluoride release was measured daily throughout 15 days using a fluoride-specific ion electrode and an ion-analyzer. Repeated measures analysis of variance with one within-subject factor (time) and one between-subject factor (Activa Bioactive / Equia Forte) was applied to compare the amount of released fluoride between groups and within time. It was followed by univariate analyses and Bonferroni multiple comparisons tests. The mean shear bond strength of Activa Bioactive Restorative with adhesive was found to be 17.379 (± 8.5043) MPa and 19.443(± 8.3293) MPa for the Filtek Z350 XT/Z350 group. There was no significant difference between both groups. Regarding fluoride release, the amount of Fluoride released was significantly greater in the Equia Forte group compared to the Activa Bioactive group (-p-value<0.05). The mean amount of Fluoride has significantly decreased over time with Activa Bioactive group (-p-value<0.001); it showed the highest fluoride release during the first 24 hours post-setting. Also in the Equia Forte group, the mean amount of Fluoride release showed a progressive and significant decrease over time (-p-value<0.001), although the amount of Fluoride released was significantly greater in the Equia Forte group compared to the Activa Bioactive group (-p-value<0.05). Activa Bioactive Restorative with adhesive and a nanocomposite showed similar bond strengths. Activa Bioactive Restorative doesn't have the self-adhesive property. The fluoride ion release profile of Activa was lower than that of the Equia Forte. Key words:Bioactive composite, nanocomposite, glass ionomer, fluoride release, shear bond strength, thermocycling.


Evaluation of Power Production Asymmetry during Cycling in Persons with Multiple Sclerosis.
Lower limb asymmetries have been observed in persons with multiple sclerosis (PwMS), and have been associated with mobility impairment. An incremental cycling test was performed on a cycle ergometer to determine peak power output (PPO) and peak oxygen consumption (VO2peak). Then, participants cycled at 50%, 60%, and 70% of their PPO to assess the contribution of each lower limb to power production. Two-way repeated measures ANOVA was used to detect group × intensity differences in power production asymmetry. Eight PwMS and six healthy individuals (Non-MS) completed the study. No statistically significant (p > 0.05) group × intensity interactions or main effects were present when examining between-limb differences in power production. The current data do not indicate a statistically significant difference in power production asymmetry between groups and exercise intensities. Previous research has established a 10% difference between contralateral limbs as a threshold for asymmetry. The average asymmetry in power production in PwMS exceeded the 10% threshold at all measured outputs, suggesting the presence of asymmetry in power production.


Dilatation symmetry in higher dimensions and the vanishing of the cosmological constant.
A wide class of dilatation symmetric effective actions in higher dimensions leads to a vanishing four-dimensional cosmological constant. This requires no tuning of parameters and results from the absence of an allowed potential for the scalar dilaton field. The field equations admit many solutions with flat four-dimensional space and nonvanishing gauge couplings. In a more general setting, these are candidates for asymptotic states of cosmological runaway solutions, where dilatation symmetry is realized dynamically if a fixed point is approached as time goes to infinity. Dilatation anomalies during the runaway can lift the degeneracy of solutions and lead to an observable dynamical dark energy.


Review of barriers and interventions to promote treatment engagement for pediatric attention deficit hyperactivity disorder care.
Attention deficit hyperactivity disorder (ADHD) is a common and impairing behavioral health disorder, impacting over 5% of children worldwide. There are multiple evidence-based pharmacological and psychosocial treatments for ADHD, and greater service utilization is associated with improved acute and long-term outcomes. However, long-term outcomes are suboptimal as multimodal treatments are often not accessed and most care ends prematurely. This narrative review discusses barriers to engagement for children and adolescents with ADHD and their families as well as interventions to overcome these barriers. Families face a variety of structural and attitudinal barriers, ranging from cost and access to stigma and low self-efficacy to successfully implement change. There are multiple interventions that may enhance engagement with ADHD care including psychoeducation, integration of behavioral services in general medical settings, telehealth as well as specific adaptations to existing ADHD treatments, such as the use of motivational interviewing or shared decision making. Integration of behavioral health into general medical settings and telehealth have been found in controlled studies to increase access by reducing both structural and attitudinal barriers. Adding motivational interviewing, shared decision making and other engagement interventions to evidence-based ADHD treatments has been found to reduce attitudinal barriers that translates into improved participation and satisfaction while enhancing outcomes. However, little is known about how to promote extended engagement with ADHD services even though a chronic care model for ADHD is recommended.


De novo refractory ventricular tachyarrhythmias after coronary revascularization.
Twelve of 1,675 patients who underwent coronary artery bypass grafting during a 2.5-year period had new onset, recurrent, sustained ventricular tachyarrhythmia a mean of 27 days (range 2 to 150) postoperatively. No patient had an intra- or perioperative myocardial infarction and all patients were hemodynamically stable and had normal metabolic and electrolytic indexes at the time of ventricular tachyarrhythmia. Preoperative ejection fraction was 39 +/- 10% (mean +/- standard deviation) and all patients had Lown grade II or less ventricular ectopic activity on ambulatory monitoring. Postoperative angiography demonstrated occluded saphenous vein grafts in 3 of 7 patients studied, none of whom had symptoms suggestive of myocardial ischemia. Treatment with conventional antiarrhythmic therapy was unsuccessful in all but 1 patient, and 10 patients were treated with amiodarone and 1 patient with propafenone. Four of these patients also received an automatic implantable defibrillator. Thus, de novo ventricular tachyarrhythmia can occur unexpectedly after coronary artery bypass grafting and may be the result of several factors related to either subclinical graft occlusion or increased dispersion of repolarization secondary to reperfusion.


High-risk percutaneous coronary intervention with the TandemHeart and Impella devices: a single-center experience.
Intra-aortic balloon pumps (IABPs) are indicated during high-risk percutaneous coronary intervention (HR-PCI) to reduce major procedural complications. The clinical utility of the newer Impella and TandemHeart devices is not clear. This study determined the baseline characteristics, hemodynamics, and outcomes of patients treated with prophylactic percutaneous left ventricular assist devices (PLVADs) during HR-PCI. A retrospective analysis at a private, tertiary referral hospital was conducted of all cases involving prophylactic PLVAD during HR-PCI between January 1, 2008 and June 30, 2010. General practice in this institution involves a tiered approach to PLVAD whereby patients with the least, intermediate, and highest risk of left ventricular failure are treated with an IABP, Impella, or TandemHeart, respectively. Fifty cases were identified (5 IABP, 13 Impella, 32 TandemHeart). Mean ejection fraction was 31 ± 17%. All devices (100%) were initiated successfully. Angiographic success was achieved in 96% (80% IABP, 100% Impella, 97% TandemHeart). Of the 38 patients not in cardiogenic shock, death occurred in 1 (2.6%), recurrent ischemia in 3 (8%), and stroke in 0%. Shortly after device removal, systolic blood pressure (mean increase, +5 ± 22 mmHg) and ejection fraction (mean increase, +7.4 ± 11%; p = 0.0006) increased in all 3 groups, suggesting a beneficial effect on the myocardium. In patients undergoing HR-PCI with Impella and TandemHeart support, angiographic success was high and major complication rates were low. A tiered approach where patients with the least, intermediate, and highest risk of left ventricular failure are treated with an IABP, Impella, or Tandem- Heart, respectively, theoretically maximizes appropriate hemodynamic support and minimizes complications. Further studies are warranted.


The Parallel Auditory Brainstem Response.
The frequency-specific tone-evoked auditory brainstem response (ABR) is an indispensable tool in both the audiology clinic and research laboratory. Most frequently, the toneburst ABR is used to estimate hearing thresholds in infants, toddlers, and other patients for whom behavioral testing is not feasible. Therefore, results of the ABR exam form the basis for decisions regarding interventions and hearing habilitation with implications extending far into the child's future. Currently, responses are elicited by periodic sequences of toneburst stimuli presented serially to one ear at a time, which take a long time to measure multiple frequencies and intensities, and provide incomplete information if the infant wakes up early. Here, we describe a new method, the parallel ABR (pABR), which uses randomly timed toneburst stimuli to simultaneously acquire ABR waveforms to five frequencies in both ears. Here, we describe the pABR and quantify its effectiveness in addressing the greatest drawback of current methods: test duration. We show that in adults with normal hearing the pABR yields high-quality waveforms over a range of intensities, with similar morphology to the standard ABR in a fraction of the recording time. Furthermore, longer latencies and smaller amplitudes for low frequencies at a high intensity evoked by the pABR versus serial ABR suggest that responses may have better place specificity due to the masking provided by the other simultaneous toneburst sequences. Thus, the pABR has substantial potential for facilitating faster accumulation of more diagnostic information that is important for timely identification and treatment of hearing loss.


Multivariate symbolic dynamics for analysis of respiratory-cardiovascular interactions.
In this work, a nonlinear method to study multivariate interactions, called multivariate symbolic dynamics (MSD), was introduced. The usefulness of this technique was studied on respiratory-cardiovascular data from young women with vasovagal syncope (VVS) and from healthy subjects. The study included 16 female patients diagnosed with VVS and 24 age-matched healthy subjects (12 women). All subjects were enrolled in a head-up tilt (HUT) test, breathing normally, including 5 min of supine position and 18 to 28 min of 70° orthostatic phase. The MSD parameters were dynamically obtained for 5-min windows shifted by 1 min during HUT test. In supine position there were no considerable differences. During orthostatic phase, parameters from MSD showed a highly significantly (p=0.00005) increased occurrence of impaired respiratory-cardiovascular interactions in female patients susceptible to vasovagal syncope. This study provided promising results for a new multivariate method to investigate respiratory-cardiovascular interactions.


Chaperone-like features of bovine serum albumin: a comparison with alpha-crystallin.
The chaperone behaviour of bovine serum albumin was compared with that of alpha-crystallin. The chaperone activity was assessed by measuring: (i) the ability to antagonize protein aggregation induced by heat; (ii) the capability to protect the activity of thermally stressed enzymes and (iii) the effectiveness in assisting the functional recovery of chemically denatured sorbitol dehydrogenase. Despite the lack of structural analogies, both proteins show several functional similarities in preventing inactivation of thermally stressed enzymes and in reactivating chemically denatured sorbitol dehydrogenase. As with alpha-crystallin, the chaperone action of bovine serum albumin appears to be ATP independent. Bovine serum albumin appears significantly less effective than alpha-crystallin only in preventing thermally induced protein aggregation. A possible relationship between chaperone function and structural organization is proposed. Together, our results indicate that bovine serum albumin acts as a molecular chaperone and that, for its particular distribution, can be included in the extracellular chaperone family.


[Investigation of a phantom for diffusion weighted imaging that controlled the apparent diffusion coefficient using gelatin and sucrose].
When studying diffusion weighted imaging(DWI), it is important to create a phantom that has a reliably controlled diffusion coefficient. In this study, we investigated phantoms to control both the diffusion coefficient and the T2-value by changing the concentration of gelatin or sucrose and MnCl(2), respectively. The results showed that the diffusion coefficient decreased linearly with increases in the gelatin or sucrose concentration, and decreasing of their relaxation times was observed. By properly adjusting the MnCl(2) concentrations, we were able to equalize the T2-values between phantoms having different gelatin or sucrose concentrations. Temperature dependence of the diffusion coefficient was also revealed. This phantom can be made stable for a few months by adding a small amount of NaN(3) as an antiseptic agent, has a diffusion coefficient similar to that of neural tissue or clinical tumor, and is able to control the T2-value properly. We consider this phantom suitable for studying SE-type DWI and contributes to elucidation of this technique.


[A case of advanced esophageal cancer with liver metastases: efficacy of combination therapy of docetaxel/cisplatin/5-FU].
The combination chemotherapy with docetaxel/CDDP/5-FU(DCF)for head and neck squamous carcinoma(SCC) has been widely accepted. It seems quite natural that DCF therapy is expected to be equally effective against esophageal SCC because of their histological similarity. In this report, we present a case of unresectable advanced esophageal SCC with multiple liver metastases which showed remarkable regression by DCF therapy, with relatively slight adverse effects. The patient was a 46-year-old female, who underwent upper gastrointestinal fiber-optic endoscopy for dysphasia and was diagnosed to have upper middle thoracic esophageal SCC. Abdominal CT scan showed multiple liver metastases with para-aortic lymph node involvement. The clinical stage diagnosis was T3N4M1, Stage IVB, obviously non-resectable far-advanced esophageal SCC. Systemic chemotherapy with DCF was started as the initial treatment. The chemotherapy regimen was as follows. 5-FU 500 mg/m(2) was administered as continuous intravenous infusion through day 1 to 5, while docetaxl 60 mg/m(2) and cisplatin 50 mg/m(2) were given intravenously on day 2. Each course was followed by a 23-day drug-free period, and the entire course was repeated every 28 days. Ten cycles of this DCF chemotherapy were carried out. After 4 cycles, primary lesion was judged as complete response(CR)by endoscopy. After 8 cycles, the liver metastases were judged as CR and para-aortic lymph nodes showed a partial response(PR)by CT scan. After 10 cycles, all we could detect was a small local recurrence of the primary tumor, which was then treated with chemoradiotherapy at the outpatient clinic. Until this writing, we added 2 more cycles of DCF therapy for the recurrent para-aortic and inguinal lymph node metastasis. Three years have passed from her first visit, and the patient is still in a stable disease state. The adverse effects were grade 3 at most in both hematological and non-hematological toxicity. We conclude that DCF therapy is potentially very effective for advanced esophageal SCC.


OPA1-associated disorders: phenotypes and pathophysiology.
The OPA1 gene, encoding a dynamin-like mitochondrial GTPase, is involved in autosomal dominant optic atrophy (ADOA, OMIM #165500). ADOA, also known as Kjer's optic atrophy, affects retinal ganglion cells and the axons forming the optic nerve, leading to progressive visual loss. OPA1 gene sequencing in patients with hereditary optic neuropathies indicates that the clinical spectrum of ADOA is larger than previously thought. Specific OPA1 mutations are responsible for several distinct clinical presentations, such as ADOA with deafness (ADOAD), and severe multi-systemic syndromes, the so-called "ADOA plus" disorders, which involve neurological and neuromuscular symptoms similar to those due to mitochondrial oxidative phosphorylation defects or mitochondrial DNA instability. The study of the various clinical presentations of ADOA in conjunction with the investigation of OPA1 mutations in fibroblasts from patients with optic atrophy provides new insights into the pathophysiological mechanisms of the disease while underscoring the multiple physiological roles played by OPA1 in energetic metabolism, mitochondrial structure and maintenance, and cell death. Finally, OPA1 represents an important new paradigm for emerging neurodegenerative diseases affecting mitochondrial structure, plasticity and functions.


The mechanism of moxibustion: ancient theory and modern research.
THE MOXIBUSTION HAS A DUAL EFFECT OF TONIFICATION AND PURGATION IN TCM THEORIES, WHICH ARE BASED ON TWO ASPECTS: the actions of the meridian system and the roles of moxa and fire. Modern research works of the moxibustion mechanism mainly relate to the thermal effects, radiation effects, and pharmacological actions of moxa and its combustion products. Experimental results showed that moxibustion thermal stimulation affects both shallow and deep tissues of the skin, and the warm-heat effects of moxibustion have a close relation to the warm receptors or/and the polymodal receptor. The burning moxa radiation spectrum ranges from 0.8 to 5.6 μ m; peak is nearby 1.5 μ m, lying within the near infrared portion. There is an amazing consistency in the infrared spectrums of three types of indirect moxibustion and the unified spectrum of acupoints; all have their peaks of radiation near 10 μ m. Lots of ingredients had been identified from mugwort leaves and moxa smoke, which have a variety of biological activities; they were considered to participate in the comprehensive effects of moxibustion. Although lots of research works have been carried out and made some progress, there is still a great distance from fully understanding the mechanism of moxibustion.


Increased frequency of detection of Chlamydophila pneumoniae in asthma.
Previous studies have suggested that chronic Chlamydophila pneumoniae infection may play a role in the pathogenesis of asthma. However, most studies have been based on serology and have been unable to differentiate acute from chronic infection. The present authors assessed the presence of acute and chronic C. pneumoniae infection in 74 spouse pairs, each consisting of one atopic asthmatic and one nonatopic nonasthmatic. Nasal secretions were sampled every 2 weeks from October to December and actively replicating C. pneumoniae infection was detected by specific RT-PCR. C. pneumoniae was detected in 31 out of 709 samples analysed, 23 (6.4%) were positive in 362 samples from asthmatic participants and in eight out of 347 (2.3%) samples from their normal spouses (with a significant difference in infection rates, 95% confidence interval: 4.2%, 1.2-7.2%). A total of 16 (22%) asthmatic and seven (9%) normal participants were positive at least once during the study. These data confirm that Chlamydophila pneumoniae infection is detected more frequently among asthmatic participants than normal control participants. Further studies are required to confirm whether infections are also present in the lower airway and whether Chlamydophila pneumoniae infection plays a role in disease pathogenesis.


Inhibition of hepatic stellate cell contraction during activation in vitro by vascular endothelial growth factor in association with upregulation of FLT tyrosine kinase receptor family, FLT-1.
Activated hepatic stellate cells produce vascular endothelial growth factor (VEGF). VEGF has been shown to act on mesenchymal cells as well. If hepatic stellate cells can express FLT tyrosine receptor family, flt-1 and KDR/flk-1, their function might be regulated by VEGF in an autocrine manner. This hypothesis was tested using hepatic stellate cells isolated from normal rats. Northern blot analysis and immunocytochemical study revealed that hepatic stellate cells cultured for 3 days on plastic dishes expressed both flt-1 and KDR/flk-1. When the culture was prolonged to 10 days, the flt-1 mRNA expression was increased, whereas both KDR/flk-1 mRNA and protein expressions diminished. DNA and collagen syntheses were minimal in the cells cultured for 3 days, but marked in those cultured for 10 days. Addition of recombinant human VEGF to the culture medium did not change both syntheses but attenuated an increase of smooth muscle alpha-actin expression in the cells during culture on plastic dishes and also contraction of collagen gels on which the cells were cultured. We conclude that VEGF may inhibit contraction of hepatic stellate cells appearing during activation by culture, probably through attenuation of smooth muscle alpha-actin expression via upregulated VEGF receptor, flt-1.


Field evaluation of carbon dioxide baits for sampling Ornithodoros turicata (Acari: Argasidae) in gopher tortoise burrows.
Field studies were conducted to assess the reliability of carbon dioxide baits in sampling Ornithodoros turicata Duges. Tick response to about 50 g of dry ice placed at various distances away from tick-infested burrows was monitored over a 2-h period. In addition, tick attraction to different flow rates of carbon dioxide was monitored. Tests were conducted over a 15-mo period, during which seasonal effects on O. turicata response to CO2 were assessed. The efficacy of the baits was evaluated at night and in daytime. Ticks responded to dry ice baits placed up to 8 m away from the burrows. There was no significant difference in the total number of ticks attracted in a 1-h period using 500 to 2,000 ml CO2/min. At night, ticks were attracted to CO2 bits throughout the year except in December and January. By contrast, ticks were attracted to CO2 baits during daytime only between May and mid-December.


A compressive gammachirp auditory filter for both physiological and psychophysical data.
A gammachirp auditory filter was developed by Irino and Patterson [J. Acoust. Soc. Am. 101, 412-419 (1997)] to provide a level-dependent version of the linear, gammatone auditory filter, with which to explain the level-dependent changes in cochlear filtering observed in psychophysical masking experiments. In this 'analytical' gammachirp filter, the chirp varied with level and there was no explicit representation of the change in filter gain or compression with level. Subsequently, Carney et al. [J. Acoust. Soc. Am. 105, 2384-2391 (1999)] reviewed Carney and Yin's [J. Neurophysiol. 60, 1653-1677 (1988)] reverse-correlation (revcor) data and showed that the frequency glide of the chirp does not vary with level in their data. In this article, the architecture of the analytical gammachirp is reviewed with respect to cochlear physiology and a new form of gammachirp filter is described in which the magnitude response, the gain, and the compression vary with level but the chirp does not. This new 'compressive' gammachirp filter is used to fit the level-dependent revcor data reported by Carney et al. (1999) and the level-dependent masking data reported by Rosen and Baker [Hear. Res. 73, 231-243 (1994)].


A consistent model for thermal fluctuations and protein-induced deformations in lipid bilayers.
We present an elastic Hamiltonian for membrane energetics that captures bilayer undulation and peristaltic deformations over all wavelengths, including the short wavelength protrusion regime. The model implies continuous functional forms for thermal undulation and peristaltic amplitudes as a function of wavelength and predicts previously overlooked relationships between these curves. Undulation and peristaltic spectra display excellent agreement with data from both atomistic and coarse-grained models over all simulated length scales. Additionally, the model accurately predicts the bilayer's response to a cylindrical protein inclusion as observed in coarse-grained simulation. This elastic response provides an explanation for gramicidin ion channel lifetime versus membrane thickness data that requires no fit constants. The physical parameters inherent to this picture may be expressed in terms of familiar material properties associated with lipid monolayers. Inclusion of a finite monolayer spontaneous curvature is essential to obtain fully consistent agreement between theory and the full range of available simulation/experimental data.


Dual-target synergistic antithrombotic mechanism of a dabigatran etexilate analogue (HY023016).
Thrombin has long been considered a desirable antithrombotic target, but anti-thrombin therapy without anti-platelet therapy has never achieved the ideal effect. HY023016, derived from dabigatran etexilate, exhibited a potent antithrombotic efficacy. In the present study, mechanisms underlying this effect were explored. HY023016 strongly decreased the binding of thrombin to recombinant GPIbα N-terminal sequence, which was confirmed by surface plasmon resonance. Flow cytometry revealed that HY023016 selectively decreased the binding of antibody to GPIbα and inhibited the washed human platelet aggregation induced by thrombin. Fluorescence experiment showed that HY023016 remarkably inhibited exosite II by a loss of affinity for the γ'-peptide of fibrinogen. Using intravital microscopy, we observed and recorded the dynamic process of thrombus formation and found that HY023016 effectively prevented thrombus formation in rat arteriovenous shunt thrombosis model. On the basis of these findings, we propose that HY023016 provides a novel insight into the antithrombotic mechanism, which exerts synergistic anticoagulant and antiplatelet effects through thrombin and GPIbα.


Postmenopausal bleeding from unusual endometrial polyps in women on chronic tamoxifen therapy.
There are recent reports of postmenopausal bleeding from endometrial polyps in women receiving tamoxifen therapy for breast cancer. We describe four additional patients who presented with vaginal bleeding, and emphasize the pathology. These polyps demonstrated cystically dilated glands in all cases and stromal decidualization in two; in one instance, metastatic breast carcinoma was present in the polyp. The mechanisms by which tamoxifen may affect the development of these polyps are discussed.


Use of Topical Tazarotene for the Treatment of Acne Vulgaris in Pregnancy: A Literature Review.
A concern with the increasing use of prescription drugs during pregnancy is teratogenic risk. This risk is undetermined for most drugs approved in the United States (US) from 2000 to 2010. Acne and psoriasis are chronic diseases that typically occur during the child-bearing years, and as topical retinoids are recommended for both acne and psoriasis treatment, is it possible for women to be exposed to a topical retinoid during pregnancy. Pharmacokinetic studies show relatively low systemic exposure from topical retinoids, but the exposure levels that could lead to teratogenicity in humans are unknown. Tazarotene, a topical retinoid, was US Food and Drug Administration (FDA) approved for both acne and psoriasis using pharmacokinetic data from psoriasis studies, which estimated the data based on use of tazarotene on up to 20% body surface area. As such, under both the previous and current FDA pregnancy labeling, tazarotene is not recommended for use during pregnancy. The goal of this literature review was to provide historical context for the pregnancy labeling rule for tazarotene compared with other approved retinoids and gather available data on tazarotene- and retinoid-related pregnancy outcomes. While there are case reports of topical tretinoin and adapalene exposure in utero, it is unclear if either affected fetal development. In terms of topical tazarotene, there are currently limited data regarding pregnancy outcomes after in-utero exposure. Additional case reports and outcomes studies are needed to further explore the safety of topical tazarotene in pregnancy.


Prevention of venous thromboembolic disease following primary total knee arthroplasty. A randomized, multicenter, open-label, parallel-group comparison of enoxaparin and warfarin.
Patients treated with total knee arthroplasty are at high risk for the development of venous thromboembolism postoperatively. This study compared the efficacy and safety of two common thromboprophylactic agents, enoxaparin (a low-molecular-weight heparin) and warfarin. Three hundred and forty-nine patients were included in a prospective, randomized, multicenter, open-label, parallel-group clinical trial. Treatment with enoxaparin (30 mg, administered subcutaneously twice daily) or warfarin (adjusted to an international normalized ratio of 2 to 3) was initiated during the immediate postoperative period, within eight hours after the surgery, and was continued for four to fourteen days. Venous thromboembolism was defined as deep-vein thrombosis documented by contrast venography, symptomatic deep-vein thrombosis documented by lower-extremity ultrasonography, or symptomatic pulmonary embolism confirmed by a positive lung scan or pulmonary angiography. In the all-treated-patients group, eighty (45%) of the 176 warfarin-treated patients had venous thromboembolism: fifty-nine (34%) had distal deep-vein thrombosis; twenty (11%), proximal deep-vein thrombosis; and one (0.6%), pulmonary embolism. Venous thromboembolism developed in significantly fewer (p = 0.0001) enoxaparin-treated patients (forty-four of 173; 25%): forty-one (24%) had distal deep-vein thrombosis, three (2%) had proximal deep-vein thrombosis, and none had pulmonary embolism. The enoxaparin-treated patients also had a significantly lower prevalence of proximal deep-vein thrombosis (p = 0.002). The estimated odds for the development of venous thromboembolism were 2.52 times greater (95% confidence interval, 2.00 to 3.19) with warfarin than they were with enoxaparin. Major hemorrhage occurred in four warfarin-treated patients and nine enoxaparin-treated patients; with the numbers available, this difference was not significant (p = 0.17). Clinically important operative-site hemorrhage occurred in six (3%) of the warfarin-treated patients and twelve (7%) of the enoxaparin-treated patients (p = 0.15). A fixed 30-mg subcutaneous dose of enoxaparin, administered twice daily, with the first dose administered within eight hours after the completion of surgery, was significantly more effective than adjusted-dose warfarin in reducing the occurrence of asymptomatic venous thromboembolism, including proximal deep-vein thrombosis, in patients undergoing total knee arthroplasty. With the numbers available, there was no significant difference between groups with regard to the occurrence of major hemorrhagic complications; however, the rate of overall hemorrhagic complications was higher in the enoxaparin group.


In Chile, improved services and counselling reduce abortion incidence.
A major abortion study was carried out in three peri-urban communities of metropolitan Santiago, Chile. Its aim was to assess ways of identifying women at high risk of induced abortion and to lower the rates of induced abortion in areas where the occurrence of induced abortion was known to be high. The first phase consisted of a baseline survey of three low-income urban communities in metropolitan Santiago. On the basis of the results of this survey a predictive instrument was devised that was later used to identify women at high risk of abortion. The survey and work on the predictive instrument was followed by an intervention phase which lasted 18 months. This included: improved family planning services and visits to households of women classified as being at a high risk of induced abortion in one of the communities; improved services but no special home counselling in the second community; and no intervention in the third (control) community. An important finding was that even with highly committed and very well trained interviewers women underreported induced abortions or reported them as spontaneous abortions. The study, however, demonstrated clearly the impact of the intervention. Over a two-year period, the abortion rate fell by 20%, and in the area of some intervention by 9%; the rate increased by 30% in the control community. These findings have been used to improve family planning services in low-income communities and in the design of reproductive health services for adolescents in poor areas of the city.


BiodentineTM is cytocompatible with human primary osteoblasts.
Calcium silicate-based materials have been widely studied due to their resemblance to, and similar applicability of, mineral trioxide aggregate (MTA). Among these, Biodentine™ (BD) was specifically designed as a "dentin replacement" material for applications such as root perforations, apexification, treatment of resorptive lesions, and as a retrograde filling material. The present study aimed to assess the in vitro response of human primary osteoblasts to BD using MTA AngelusTM as a reference material, by simultaneously analyzing three different cell viability parameters, namely mitochondrial activity, membrane integrity, and cell density. BD and MTA extracts were prepared by incubation on culture media for 24 h or 42 days after mixing. Primary human osteoblasts were exposed to extracts for 24 h, at 37oC with 5% CO2, and cell viability was evaluated by the XTT, NRU, and CVDE assays. Both materials induced cell viability levels higher than 70% when extracted for 24 h. However, when cells were exposed to extracts with increased conditioning times, MTA presented significant cytotoxic effects (p < 0.05) in comparison to the control and MTA at 24 h. After 42 days, the XTT assay identified a significant reduction in cell viability by BD when compared to the control (p<0.05), despite the fact that levels above the 70% viability cutoff were attained for biocompatible materials. It can be concluded that BD is cytocompatible with human primary osteoblasts, indicating its adequacy in direct contact with bone tissues.


Endovascular treatment of posterior cerebral artery aneurysms: a single center's experience of 55 cases.
OBJECTIVE Aneurysms of the posterior cerebral artery (PCA) are uncommon. To date, a limited number of studies have examined the outcomes of endovascular treatment for PCA aneurysms. The authors' aim in this study is to report their experience with the endovascular treatment of PCA aneurysms. METHODS Between January 2007 and December 2014, 55 patients with 59 PCA aneurysms were treated using the endovascular approach at the authors' institution. Twenty-three patients had 25 saccular aneurysms, and 32 patients had 34 fusiform/dissecting aneurysms. The endovascular modalities included the following: 1) selective occlusion of the aneurysm (n = 22); 2) complete occlusion of the aneurysm and the parent artery (n = 20); 3) parent artery occlusion (n = 6); 4) partial coiling of the aneurysm and the parent artery (n = 5); and 5) occlusion of the dissecting aneurysm sac (n = 2). RESULTS The immediate angiographic results included 45 complete occlusions (82%), 2 nearly complete occlusions (4%), and 8 incomplete occlusions (14%). The mean follow-up period of 21.8 months in 46 patients showed 37 stable results, 6 further thromboses, and 3 recurrences. The final results included 41 complete occlusions (89%), 2 nearly complete occlusions (4%), and 3 incomplete occlusions (7%). Procedure-related complications included the following: 1) rebleeding (n = 1); 2) infarction (n = 4); and 3) perforation (n = 1). There was 1 (1.8%) procedure-related death due to rebleeding, and 2 (3.6%) non-procedure-related deaths due to severe subarachnoid hemorrhage. Clinical outcomes were excellent (Glasgow Outcome Scale 5) in 47 of 49 patients at the long-term follow-up. CONCLUSIONS PCA aneurysms may be effectively treated by different endovascular approaches with favorable clinical and radiological outcomes. However, patients who present with severe SAH still have an overall poor prognosis. Partial coiling of the aneurysm and the parent artery is an attractive alternative treatment for patients who may not tolerate parent artery occlusion. Further study with a larger case series is necessary for validation of the durability and efficacy of this treatment.


[Causes and treatment of acute visual dysfunction after transsphenoidal surgery of pituitary adenoma].
Visual dysfunction is a sever complication of transsphenoidal surgery of pituitary adenoma. In this study, we explored the mechanisms and strategies of prevention and treatment of early acute visual deterioration after transsphenoidal surgery for removal of pituitary adenoma. Clinical data of 12 patients with transsphenoidal pituitary adenoma resection of early postoperative acute visual deterioration were analyzed retrospectively. All the cases were come from Peking Union Medical College Hospital during Jan 1991 to May 2014. Among 12 cases, 8 were with intrasellar haematoma, 2 with suprasellar haematoma, 2 with vascular spasm. After all these treatments, good recovery achieved in 10 cases, not so well in 1 with rupture of intracranial aneurysm, and 1 case death with suprasellar haematoma and intracranial infection. Blood circulation variation of the optic nerve and optic chiasma could be caused by long-term compressing with the pituitary adenoma, on this basis, combined with the intrasellar haematoma, direct injury during the operation, and acute ischemia of the optic chiasma and tamping too tight in the sella turcica, etc, resulting in acute visual function disorder after pituitary adenomas transsphenoidal surgery, find the reason and early treatment can be effective to save the patient's visual acuity.


"Out-in" position in the surgical treatment of three-column tibial plateau fractures: A technical note.
Three-column classification of tibial plateau fractures is based on computerized tomography (CT) images, and the patients with three-column fractures can be treated with posteromedial combined with anterolateral approach in the floating position. However, there are certain disadvantages to operating in a "floating position". Therefore, we proposed an "out-in" position for those fractures. The patient is placed in supine position on the operating table, and the healthy hip is elevated. For the posteromedial approach, the affected limb should be placed on a rectangular fluoroscopy table and kept in abduction and external rotation (out); for the anterolateral approach, the affected limb is retracted into the operating bed and kept in neutral position (in).This position has been shown to be highly effective for easy operation as well as intraoperative image monitoring. Furthermore, it highlights the advantage of anterior-posterior joint fracture reduction.


A parallel adaptive finite element simplified spherical harmonics approximation solver for frequency domain fluorescence molecular imaging.
Fluorescence molecular imaging/tomography may play an important future role in preclinical research and clinical diagnostics. Time- and frequency-domain fluorescence imaging can acquire more measurement information than the continuous wave (CW) counterpart, improving the image quality of fluorescence molecular tomography. Although diffusion approximation (DA) theory has been extensively applied in optical molecular imaging, high-order photon migration models need to be further investigated to match quantitation provided by nuclear imaging. In this paper, a frequency-domain parallel adaptive finite element solver is developed with simplified spherical harmonics (SP(N)) approximations. To fully evaluate the performance of the SP(N) approximations, a fast time-resolved tetrahedron-based Monte Carlo fluorescence simulator suitable for complex heterogeneous geometries is developed using a convolution strategy to realize the simulation of the fluorescence excitation and emission. The validation results show that high-order SP(N) can effectively correct the modeling errors of the diffusion equation, especially when the tissues have high absorption characteristics or when high modulation frequency measurements are used. Furthermore, the parallel adaptive mesh evolution strategy improves the modeling precision and the simulation speed significantly on a realistic digital mouse phantom. This solver is a promising platform for fluorescence molecular tomography using high-order approximations to the radiative transfer equation.


A case of congenital dyserythropoietic anemia type II, Gilbert's syndrome and malleolar trophic ulcers.
A case of a woman with congenital dyserythropoietic anemia type II (CDA-II), Gilbert's syndrome (GS) and trophic malleolar ulceration is described. The association of CDA-II and GS caused early gallstone formation that led the patient to undergo cholecystectomy at the age of 15. GS is typified by increased production of both unconjugated and monoconjugated bilirubin, which is more lithogenic. The development of ulcers is not typical of CDA-II, even though they are associated with many of the hemolytic anemias, and were thought in our patient to be due to a thrombophilic tendency which manifest with Antithrombin III and Protein C deficiency.


The solvation contribution to the binding energy of DNA with non-intercalating antibiotics.
The influence of the solvent on the binding energies to DNA of six non-intercalating antibiotics - netropsin, distamycin-3, distamycin-2, SN 18071, berenil and stilbamidine - is evaluated by combining the effect of the first hydration shell with that of bulk water. The first effect is computed by a methodology based on a spherical/point dipole model of water and limited to electrostatic interaction energies. Hydration shells are obtained which are energy optimized with respect to both water-solute and water-water interactions for the complexes and for the isolated DNA oligomers and ligands. The method allows even very large complexes to be studied in reasonable computation times. The second effect is introduced via a cavity treatment. It is shown that if the vacuum interaction energies already predict correctly the preference of the ligands for the minor groove of AT sequences of B-DNA, the introduction of the solvation effect is indispensable for reproducing the order of affinity of the ligands and for bringing the values of the complexation energies into close agreement with experimental data.


The association of single nucleotide polymorphisms in the 5'-regulatory region of the lumican gene with susceptibility to high myopia in Taiwan.
To study the relationships between single nucleotide polymorphisms (SNPs) of lumican, decorin, and DSPG3 genes and high myopia. One hundred and twenty adult patients with high myopia (< -10.0 D) and 137 controls were used to study the relationships between the decorin, lumican, and DSPG genes and high myopia. All subjects were free of ocular diseases, other than myopia, as well as of other systemic genetic diseases. Genotyping was performed by direct sequencing after PCR amplification of chromosomal DNA. Allele frequencies were tested for Hardy-Weinberg disequilibrium. The chi(2) or Fisher test was conducted to investigate the genotypic and allelic distribution between the high myopia and control groups. The genotyping success rate was 100%. Univariate analysis revealed significant differences between patients and control subjects with respect to one of the SNPs (rs3759223, C->T) of the lumican gene, with a p value of 0.000283. There was no significant relationship between other SNPs of lumican, decorin, and DSPG genes and high myopia. Our results indicate that an SNP (rs3759223), which is located in the promoter region of the lumican gene, may be worth further investigation to determine its association with development of high myopia.


The role of the glycine triad in human glutathione synthetase.
Experimental kinetics and computational modeling of human glutathione synthetase (hGS) support the significant role of the G-loop glycine triad (G369, G370, G371) for activity of this ATP-grasp enzyme. Enzyme kinetic experiments indicate that G369V and G370V mutant hGS have little activity (<0.7 and 0.3%, respectively, versus wild-type hGS). However, G371V retains ∼13% of the activity of wild-type hGS. With respect to G-loop:A-loop interaction in hGS, mutations at Gly369 and Gly370 decrease ligand binding and prevent active site closure and protection. This research indicates that Gly369 and Gly370 have essential roles in hGS, while Gly371 has a lesser involvement. Implications for glycine-rich ensembles in other phosphate-binding enzymes are discussed.


Identifying daily changes in circRNAs and circRNA-associated-ceRNA networks in the rat pineal gland.
Circular RNAs (circRNAs) are a new class of covalently closed circular RNA molecules that are involved in many biological processes. However, information about circRNAs in the pineal gland, particularly that of rats, is limited. To establish resources for the study of the rat pineal gland, we performed transcriptome analysis of the pineal glands during the day and night. In this study, 1413 circRNAs and 1989 miRNAs were identified in the pineal gland of rats during the night and day using the Illumina platform. Forty differentially expressed circRNAs and 93 differentially expressed miRNAs were obtained, among which 20 circRNAs and 37 miRNAs were significantly upregulated during the day and 20 circRNAs and 56 miRNAs were significantly upregulated during the night. As circRNAs have been reported to work as miRNA sponges, we predicted 15940 interactions among 40 circRNAs, 93 miRNAs and 400 mRNAs with differential diurnal expression using miRanda and TargetScan to build a ceRNA regulatory network in the rat pineal gland. The diurnal expression profile of circRNAs in the rat pineal gland may provide additional information about the role of circRNAs in regulating changes in melatonin circadian rhythms. The analyzed data reported in this study will be an important resource for future studies to elucidate the altered physiology of circRNAs in diurnal rhythms.