Lost airway during anesthesia induction: alternatives for management.
Pediatric and adult patients with upper airway obstruction pose several challenges to the anesthesiologist and otolaryngologist--head and neck surgeon. The initiation of general anesthesia and endotracheal intubation may progress to complete life-threatening respiratory decompensation with failure to achieve endotracheal intubation or mask ventilation. Hurried invasive maneuvers such as large-bore needle tracheal entry and cricothyrotomy are recognized salvage techniques, but other modes of extratracheal ventilation are now possible before surgical airway procedures are required. The laryngeal mask airway and esophagotracheal Combitube (Kendall Sheridan Health Care Products Co., Argyle, NY) are described, with examples of their clinical application. The combined technique of anterior commissure laryngoscopy and intubation with the gum elastic bougie is the preferred alternative for achieving tracheal entry when extratracheal ventilation cannot be accomplished. An algorithm for joint management of the problem airway by anesthesiologist and otolaryngologist--head and neck surgeon is illustrated.


Development and application of an HILIC-MS/MS method for the quantitation of nucleotides in infant formula.
A method for the quantitation of nucleotides (adenosine 5'-monophosphate (AMP), guanosine 5'-monophosphate (GMP), uridine 5'-monophosphate (UMP), cytidine 5'-monophosphate (CMP), and inosine 5'-monophosphate (IMP)) in infant formula was developed by hydrophilic interaction chromatography with tandem mass spectrometry (HILIC-MS/MS). The internal standards used (AMP-13C10, 15N5; GMP-13C10, 15N5; UMP-13C9, 15N2; CMP-13C9, 15N3) were prepared with centrifugal ultrafiltration (CUF). Data acquisition was achieved by using multiple reaction monitoring (MRM) of product ions of protonated molecules of the five nucleotides generated by the positive-ion ESI. HILIC conditions were performed with 30 mmol/L ammonium formate in water (pH 2.5, adjusted with formic acid) and methanol. The LOD and LOQ were 5-10 μg/mL and 10-30 μg/mL for standard solution, respectively. Recovery for intra- and interday assays ranged from 98.1 to 108.9% (RSD: 0.7-5.4%) spiked with three concentration levels (5, 25, and 250 μg/g powder infant formula). This method could be applied for the determination of nucleotides in infant formula samples. The detected concentrations of five nucleotides ranged from not detected (n.d.) to 278 μg/g powder infant formula. The total nucleotide level ranged from n.d. to 600.2 μg/g powder infant formula.


Three-dimensional co-cultures of osteoblasts and endothelial cells in DegraPol foam: histological and high-field magnetic resonance imaging analyses of pre-engineered capillary networks in bone grafts.
Tissue engineering of bone grafts was addressed in a critical-sized model on the chick chorioallantoic membrane model, using DegraPol(®) foam as scaffold material. The scaffolds were seeded with cultures of human osteoblasts and human endothelial cells, respectively, or with a co-culture of the two cell types (control: no cells). In vitro samples (7 days cultivation) and ex vivo chorioallantoic membrane model samples at incubation day 15 were analyzed by high-field magnetic resonance imaging (MRI) and histology. The co-culture system performed best with respect to perfusion, as assessed by contrast-enhanced MRI using gadolinium-diethylene-triamine-pentaacetic acid (DTPA). The scaffold seeded by the co-culture supported an increased vascular ingrowth, which was confirmed by histological analysis. DegraPol foam is a suitable scaffold for bone tissue engineering and the MRI technique allows for nondestructive and quantitative assessment of perfusion capability during early stages of bone forming constructs.


Noncontact knee dislocation in a female basketball player: a case report.
Knee ligamentous injuries occur during sport, and when there is extensive injury, they can be associated with subluxation or dislocation. We present the case of a female basketball player who sustained a knee dislocation during noncontact play. An immediate angiogram confirmed vascular integrity, and surgical treatment with ligamentous reconstruction was performed. Peroneal nerve injury was present but resolved in 42 weeks. A review of the literature discussing knee dislocation is presented.


[Residual renal function and nutritional status in patients on continuous ambulatory peritoneal dialysis].
During the last years, an increasing number of patients with end-stage renal failure caused by various underlying diseases, all over the world, is treated by renal replacement therapy. NUTRITIONAL STATUS: Malnutrition is often found in patients affected by renal failure; it is caused by reduced intake of nutritional substances due to anorexia and dietary restrictions hormonal and metabolic disorders, comorbid conditions and loss of proteins, amino-acids, and vitamins during the dialysis procedure itself. Nutritional status significantly affects the outcome of patients on chronic dialysis treatment. Recent epiodemiological trials have proved that survival on chronic continuous ambulatory peritoneal dialysis program depends more on residual renal function (RRF) than on peritoneal clearances of urea and creatinine. The aim of the study was to analyze the influence of RRF on common biochemical and anthropometric markers of nutrition in 32 patients with end-stage renal failure with various underlying diseases during the first 6 months on continuous ambulatory peritoneal dialysis (CAPD). The mean residual creatinine clearance was 8,3 ml/min and the mean RRF was 16,24 l/week in our patients at the beginning of the chronic peritoneal dialysis treatment. During the follow-up, the RRF slightly decreased, while the nutritional status of patients significantly improved. Gender and age, as well as the leading disease and peritonitis didn't influence the RRF during the first 6 months of CAPD treatment. We found several positive correlations between RRF and laboratory and anthropometric markers of nutrition during the follow-up, proving the positive influence of RRF on nutritional status of patients on chronic peritoneal dialysis.


Implications of thrombocytopenia and platelet course on pediatric intensive care unit outcomes.
Thrombocytopenia has been shown to be an independent predictor of mortality and prolonged hospital length of stay in critically ill adults. Studies are lacking in the pediatric intensive care unit population. We evaluated the relationship between platelet counts at admission, platelet course, and outcomes. 1) Thrombocytopenia at the time of admission to the pediatric intensive care unit is a risk factor for increased mortality and prolonged length of stay. 2) Thrombocytopenia at any point during pediatric intensive care unit stay is associated with increased mortality and length of stay. 3) Falling platelet counts during a pediatric intensive care unit course are associated with greater mortality and longer length of stay. Prospective observational study. All patients admitted to a multidisciplinary tertiary care pediatric intensive care unit in a University Hospital over the course of a year. ANALYSIS OF DATA: Data were analyzed using logistic and linear regression. Thrombocytopenia (platelet count <150 x 10/L) was present in 17.3% of pediatric intensive care unit patients on admission. Mortality was higher in thrombocytopenic patients (17.6% vs. 2.47%, p < 0.001). The median length of stay in the thrombocytopenia and nonthrombocytopenia groups was 4 days vs. 1.6 days, respectively (p < 0.001). The pediatric intensive care unit patients (25.3%) were thrombocytopenic at some point in their stay. They had higher mortality (17.1% vs. 0.9%, odds ratio [OR] 23.8, 95% confidence interval [CI] 5.2-108.6, p < 0.0005) and longer length of stay (median 6.6 days vs. 1.5 days, p < 0.0005) compared with those who were never thrombocytopenic. For every 10% fall in platelet count from the time of admission, the OR for mortality was 1.4 (95% CI 1.1-1.8) and the length of stay was longer (p < 0.0005). Patients with normal platelet counts at admission who later developed thrombocytopenia had increased mortality (OR 18.6, 95% CI 3.2-107.3) and longer length of stay (p < 0.0005) compared with those who did not develop thrombocytopenia. Thrombocytopenia and falling platelet counts are associated with increased risk of mortality and length of stay in the pediatric intensive care unit.


The association between a Darc gene polymorphism and clinical outcomes in African American patients with acute lung injury.
Acute lung injury (ALI) mortality is increased among African Americans compared with Americans of European descent, and genetic factors may be involved. A functional T-46C polymorphism (rs2814778) in the promoter region of Duffy antigen/receptor for chemokines (Darc) gene, present almost exclusively in people of African descent, results in isolated erythrocyte DARC deficiency and has been implicated in ALI pathogenesis in preclinical and murine models, possibly because of an increase in circulating Duffy-binding, proinflammatory chemokines like IL-8. We sought to determine the effect of the functional rs2814778 polymorphism, C/C genotype (Duffy null state), on clinical outcomes in African Americans with acute lung injury. Clinical data and biologic specimens from African American patients with ALI who enrolled in three randomized controlled trials were analyzed. Multivariate analysis accounted for proportion of African ancestry, sex, cirrhosis, and severity of illness on presentation. Among 132 subjects, 88 (67%) were Duffy null (C/C genotype). The Duffy null state was associated with a 17% absolute risk increase (95% CI, 1.4%-33%) in mortality at 60 days, a median of 8 fewer ventilator-free days (95% CI, 1-18.5), and 4.5 fewer organ failure-free days (95% CI, 0-18) compared with individuals with the C/T or T/T genotypes (all P values < .05). Estimates were similar on multivariate analysis. In African Americans without the null variant, clinical outcomes were similar to those in patients of European descent. A subgroup analysis suggested that plasma IL-8 levels are increased in Duffy null individuals. Our results provide evidence that the functional rs2814778 polymorphism in the gene encoding DARC is associated with worse clinical outcomes among African Americans with ALI, possibly via an increase in circulating IL-8.


Induced hypothermia in the management of cerebral oedema secondary to fulminant liver failure.
The use of mild hypothermia in the management of blunt head trauma has been shown to significantly improve clinical outcomes. The use of moderate controlled hypothermia in the patient with severely raised intracranial pressure (ICP) secondary to fulminant hepatic failure (FHF) has similar potential benefits, but is not a widely accepted practice. We report a case where the use of hypothermia in the management of severely raised ICP both before and after liver transplantation was thought to effect a beneficial outcome.


Mathematical Modeling Predicts That Strict Social Distancing Measures Would Be Needed to Shorten the Duration of Waves of COVID-19 Infections in Vietnam.
Coronavirus disease 2019 (COVID-19) emerged in Wuhan, China in 2019, has spread throughout the world and has since then been declared a pandemic. As a result, COVID-19 has caused a major threat to global public health. In this paper, we use mathematical modeling to analyze the reported data of COVID-19 cases in Vietnam and study the impact of non-pharmaceutical interventions. To achieve this, two models are used to describe the transmission dynamics of COVID-19. The first model belongs to the susceptible-exposed-infectious-recovered (SEIR) type and is used to compute the basic reproduction number. The second model adopts a multi-scale approach which explicitly integrates the movement of each individual. Numerical simulations are conducted to quantify the effects of social distancing measures on the spread of COVID-19 in urban areas of Vietnam. Both models show that the adoption of relaxed social distancing measures reduces the number of infected cases but does not shorten the duration of the epidemic waves. Whereas, more strict measures would lead to the containment of each epidemic wave in one and a half months.


Pneumothorax during laparoscopic repair of giant paraesophageal hernia.
Giant paraesophageal hernia is an uncommon morbid disorder which may present a risk of catastrophic complications and should be repaired electively as soon as possible. Laparoscopic fundoplication is the mainstay of surgical management of this disorder due to several advantages such as lower post-operative morbidity and pain. We report a case of a 70-year-old patient with a giant paraesophageal hernia, who developed subcutaneous emphysema with pneumothorax during laparoscopic fundoplication. Early diagnosis was possible by close clinical evaluation and simultaneous monitoring of end-tidal carbon dioxide levels and airway pressures. Although positive end-expiratory pressure application is an effective way of managing pneumothorax secondary to the passage of gas into the interpleural space, insertion of an intercostal drain may be used in an emergent situation.


Native molecular state of adeno-associated viral vectors revealed by single-molecule sequencing.
The single-stranded genome of adeno-associated viral (AAV) vectors is one of the key factors leading to slow-rising but long-term transgene expression kinetics. Previous molecular studies have established what is now considered a textbook molecular model of AAV genomes with two copies of inverted tandem repeats at either end. In this study, we profiled hundreds of thousands of individual molecules of AAV vector DNA directly isolated from capsids, using single-molecule sequencing (SMS), which avoids any intermediary steps such as plasmid cloning. The sequence profile at 3' ends of both the regular and oversized vector did show the presence of an inverted terminal repeat (ITR), which provided direct confirmation that AAV vector packaging initiates from its 3' end. Furthermore, the vector 5'-terminus profile showed inconsistent termination for oversized vectors. Such incomplete vectors would not be expected to undergo canonical synthesis of the second strand of their genomic DNA and thus could function only via annealing of complementary strands of DNA. Furthermore, low levels of contaminating plasmid DNA were also detected. SMS may become a valuable tool during the development phase of vectors that are candidates for clinical use and for facilitating/accelerating studies on vector biology.


Maternal lean body mass and birth-weight.
Maternal lean body mass at booking was estimated according to a formula employing the body mass index and maternal age in a sample of 511 women who booked in the first trimester of pregnancy. The significance of this parameter in comparison with established predictors of birth-weight such as maternal weight, height, smoking, parity, gestational age and sex of the infant was examined using bivariate correlations and multiple regression analysis. Maternal lean body mass was found to be the most important determinant of birth-weight for gestation percentile. Cigarette smoking had a negative effect on birth-weight which was independent of maternal physique. The effect of maternal size on birth-weight is largely mediated through constitutional and genetic factors rather than nutrition.


[Effects of Y-20811, a specific thromboxane A2 synthetase inhibitor, on chemical mediator-induced bronchoconstriction in guinea pigs].
We investigated the effects of Y-20811 on chemical mediator-induced bronchoconstriction and the release of chemical mediators into lung perfusion fluid during arachidonic acid (AA)-induced bronchoconstriction in guinea pigs. Y-20811 (0.01-1 mg/kg, i.v.), like acetylsalicylic acid or indomethacin, dose-dependently suppressed arachidonic acid- and LTD4-induced bronchoconstriction, and it (1 mg/kg, i.v.) also inhibited PAF-induced bronchoconstriction in guinea pigs. However, at a dose of 1 mg/kg, i.v., it was inactive against the bronchoconstriction induced by histamine, serotonin and acetylcholine in guinea pigs. Y-20811 (0.3-10 mg/kg) administered orally also prevented the LTD4-induced bronchoconstriction in a dose-dependent manner. This protective effect of Y-20811 (10 mg/kg, p.o.) persisted for at least 24 hr. Y-20811 (10 mg/kg, p.o.) also inhibited antigen-induced bronchoconstriction in guinea pigs passively sensitized with anti-ovalbumin guinea pig serum and pretreated with mepyramine. In the perfused and ventilated guinea pig lungs, Y-20811 inhibited AA-induced bronchoconstriction, decreased the release of TXA2 (estimated as TXB2) and increased the release of PGE2 into the perfused lung fluid, significantly (TXB2 and PGE2 were measured by HPLC). Therefore, Y-20811 suppressed various stimulant-induced bronchoconstrictions through the decrease of TXA2 production and the increase of PGE2 production. Thus, Y-20811 should prove useful as an anti-asthmatic drug.


Investigation of Chitosan Nanoparticles Loaded with Protocatechuic Acid (PCA) for the Resistance of Pyricularia oryzae Fungus against Rice Blast.
In this study, chitosan nanoparticles were used as a carrier for Protocatechuic acid (PCA) to resist Pyricularia oryzae against rice blast. The final compound was characterized using zeta potentials for its surface electricity, Fourier transform infrared (FT-IR) analysis and transmission electron microscopy (TEM) were conducted for functional groups and for particle sizes and shape, respectively. The zeta potential results showed that loading PCA causes chitosan nanoparticle (CSNP) to decrease in surface electrons. The TEM images revealed that the particle size of chitosan (CS), although increasing in size when carrying PCA molecules, showed sufficient size for reasonable penetration into fungal cells. The FT-IR analysis showed that all functional group in CSNP carried PCA matched with previous studies. The antifungal test showed that diameters of inhibition zone of CS increases significantly after loading PCA, exhibiting the strongest antimicrobial effect on the Pyricularia oryzae fungus compared with weaker effects exhibited by CSNP alone or PCA. Our results suggested that CSNP loaded with PCA could be a potential compound for eradication of Pyricularia oryzae and that further testing on in vitro rice plants is recommended to reaffirm this possibility.


Cell death by pyruvate deficiency in proliferative cultured calvarial osteoblasts.
Cell survival was significantly decreased in primary cultured rat calvarial osteoblasts in vitro at Day 0, 1, and 3 by replacement of the standard culture medium (alpha-modified minimum essential medium; alpha-MEM) with Dulbecco's modified eagle's medium (DMEM). Decreased cell survival was also observed following medium replacement in cultures of murine calvaria-derived osteoblastic cell line MC3T3-E1. Staining with Hoechst33342 revealed apoptotic cells with fragmented or condensed nuclei, while a fraction of the cell culture was stained with propidum iodide, indicating necrosis. Marked increases in DNA binding of both activator protein-1 and nuclear factor-kappaB were found in nuclear extracts of cells following medium replacement. The addition of either pyruvate or cysteine at each concentration found in alpha-MEM almost entirely prevented cell death associated with medium replacement at Day 3. These results suggest that pyruvate and cysteine may be essential factors for cell growth and survival in osteoblast cultures at the proliferative phase.


The association between serum 25-hydroxyvitamin D concentrations and serum lipids in the Southern Thai population.
Dyslipidaemia is a major risk factor for cardiovascular diseases (CVD). Vitamin D deficiency has been found to be associated with CVD. However, the relationships between vitamin D and lipids are inconsistent. The aim of this study was to investigate the relationship between vitamin D status and serum lipids in Southern Thai subjects. A total of 726 healthy subjects in Southern Thailand were enrolled in the study. Serum 25-hydroxyvitamin D (25(OH)D), lipid profiles, fasting plasma glucose, anthropometric data, blood pressure, and body composition were measured. The relationship between serum 25(OH)D levels and biochemical data was evaluated by partial correlation and multiple linear regression analyses. The association of serum 25(OH)D levels with dyslipidaemia was analysed using multivariate regression analysis. Serum 25(OH)D levels were negatively correlated with body mass index (BMI), total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and body composition parameters after adjusting for age in women. Multiple linear regression analysis showed that TC and BMI were independent predictors for 25(OH)D concentrations in women. Multivariate logistic regression analysis showed that the odds ratio of hypertriglyceridaemia (OR = 0.51; 95% CI: 0.32-0.80, p = 0.004) and reduced high-density lipoprotein cholesterol (HDL-C) (OR = 0.43; 95% CI: 0.26-0.71, p = 0.001) were significantly lower in vitamin D sufficiency when compared with hypovitaminosis D in women. Vitamin D sufficiency could reduce risk of hypertriglyceridaemia and reduced HDL-C, particularly in women, suggesting that vitamin D sufficiency may have beneficial effects on lipids and a decreased risk for CVD in Thai women.


Comment on "Slow adaptation in the face of rapid warming leads to collapse of the Gulf of Maine cod fishery".
Pershing et al (Science, 13 November 2015, p. 809) concluded that recent warming in the Gulf of Maine contributed to the collapse of Gulf of Maine cod. We argue that this conclusion is based on a flawed analysis of the population dynamics of this cod stock. We believe that understanding the potential role of climate change in the collapse of this stock requires more defensible analyses.


H-1 MR spectroscopic imaging of white matter signal hyperintensities: Alzheimer disease and ischemic vascular dementia.
To investigate the association of white matter signal hyperintensities (WMSHs) with changes in hydrogen-1 metabolites. T2-weighted magnetic resonance (MR) imaging and H-1 MR spectroscopic imaging were performed in 21 elderly control subjects without or with minimal WMSHs, eight elderly subjects with substantial WMSHs, 11 probable Alzheimer disease patients with WMSHs, and eight ischemic vascular dementia (IVD) patients with WMSHs. N-acetylaspartate (NAA), choline-containing metabolites (Cho), and creatine-containing metabolites (Cr) were analyzed. Differences in regional metabolite levels were found within the supraventricular brain of elderly control subjects. In Alzheimer disease patients, extensive WMSHs showed a lower percentage of NAA and a higher percentage of Cho compared with contralateral normal-appearing white matter (NAWM); in IVD patients, extensive and large WMSHs were associated with a higher percentage of Cho and a lower percentage of Cr compared with contralateral NAWM. Regional metabolite variation and the presence of WMSHs are important covariants that must be accounted for in analysis of MR spectroscopic data.


Lignocellulose solubilization and conversion by extremely thermophilic Caldicellulosiruptor bescii improves by maintaining metabolic activity.
The extreme thermophile Caldicellulosiruptor bescii solubilizes and metabolizes the carbohydrate content of lignocellulose, a process that ultimately ceases because of biomass recalcitrance, accumulation of fermentation products, inhibition by lignin moieties, and reduction of metabolic activity. Deconstruction of low loadings of lignocellulose (5 g/L), either natural or transgenic, whether unpretreated or subjected to hydrothermal processing, by C. bescii typically results in less than 40% carbohydrate solubilization. Mild alkali pretreatment (up to 0.09 g NaOH/g biomass) improved switchgrass carbohydrate solubilization by C. bescii to over 70% compared to less than 30% for no pretreatment, with two-thirds of the carbohydrate content in the treated switchgrass converted to acetate and lactate. C. bescii grown on high loadings of unpretreated switchgrass (50 g/L) retained in a pH-controlled bioreactor slowly purged (τ = 80 hr) with growth media without a carbon source improved carbohydrate solubilization to over 40% compared to batch culture at 29%. But more significant was the doubling of solubilized carbohydrate conversion to fermentation products, which increased from 40% in batch to over 80% in the purged system, an improvement attributed to maintaining the bioreactor culture in a metabolically active state. This strategy should be considered for optimizing solubilization and conversion of lignocellulose by C. bescii and other lignocellulolytic microorganisms.


Topical capsaicin for treatment of hemodialysis-related pruritus.
Pruritus is a significant problem for many patients undergoing long-term hemodialysis. Topical capsaicin depletes and prevents the reaccumulation of substance P in peripheral sensory neurons. Substance P functions in the transmission of pain and probably itch sensations. An open-label, uncontrolled trial and a double-blind, vehicle-controlled trial were conducted to evaluate the efficacy and safety of capsaicin 0.025% cream in the treatment of localized areas of pruritus in patients undergoing long-term hemodialysis. Eight of nine evaluable patients in the open-label trial reported marked relief or complete resolution of itching during the study period, and two of five evaluable patients in the double-blind trial reported complete resolution of itching in the capsaicin-treated arm with no or minimal improvement in the vehicle-treated arm. Twelve patients in the open-label trial and two in the double-blind trial were unevaluable. No serious treatment-related adverse reactions occurred.


[Application of sedimentation at 1 g on a Ficoll gradient to the separation of bone marrow cells].
Sedimentation at unit gravity of human bone marrow, during 15 hours at 4 degrees C on a linear density gradient of Ficoll in culture medium ranging from 1.020 to 1.065 g/ml shows that it exists a differential migration of bone marrow cells subpopulation with a precise mean densities : we find successively : 1.021 +/- 1.10(-3) g/ml for the lymphocytes, 1.024 +/- 2.5.10(-3) g/ml for the non eosinophil granulocytes, 1.025 +/- 2.5.10(-3) g/ml for the metamyelocytes, 1.030 +/- 3.5.10(-3) g/ml for the immature myeloid cells (myeloblasts, promyelocytes, myelocytes), 1.040 +/- 3.10(-3) g/ml for the eosinophil granulocytes, 1.055 +/- 10.10(-3) g/l for the megakaryocytes. The highest percentages of S phase cells, G2 and M phase cells determinated with a cytofluorograph correspond to peaks of immature myeloid cells (myeloblasts, promyelocytes and myelocytes). This method of bone marrow cells separation may be used to study the cell cycle in pathological bone marrows (leukaemia in particular) and to determine the effects and the efficiency of some antimitotics.


[Clinicopathological features of small intestinal tumors].
Small intestinal neoplasms are rare, accounting for only 1-2% of all gastrointestinal neoplasms. Variable neoplasms are recognized in the small intestine. Comparatively frequent malignant lesions are carcinoma, carcinoid tumor, malignant lymphoma, and GIST (gastrointestinal stromal tumor). The prognosis of small intestinal cancer is poor, because preoperative diagnosis is difficult and it is usually discovered at the advanced stage. In addition, it is thought that there are few small intestinal cancers of an adenoma origin, but dysplasia is considered to be associated with that complicated by Crohn's disease. The incidence of carcinoid tumor is lower in Japan than in Western countries. Although it is often discovered at the advanced stage, its prognosis is relatively good in spite of the high incidence of metastasis because of its low-grade malignancy. Among malignant lymphomas of the small intestine, the incidence of MALT lymphoma is lower, and those of T cell and follicular ones are higher than in the stomach. Lymphomas with minimal cellular atypia are often encountered, and in such cases biopsy diagnosis is difficult. The prognosis of small intestinal lymphoma is better than for small intestinal cancer. It must be recalled that multiple GIST occurs in specific disorders such as von Recklinghausen's disease and familial disease among small intestinal GIST, although very rarely. The prognosis of malignant small intestinal disease will improve through early diagnosis with the recent progress in the procedures for detecting small intestinal disease.


Exploring the Correspondence Between General Correctional Programming and Inmate Misconduct Using a Time-Course Framework.
Inmate misconduct continues to threaten safety and order within correctional institutions. Yet few studies have examined its longitudinal nature. In this paper we explore the correspondence between correctional programming and inmate misconduct. To do this, we draw from Linning et al.'s time-course framework devised to improve the design and evaluation of interventions by considering effects that can occur before, during, and after programming. We provide the first empirical demonstration of their framework using prisoner misconduct data collected from all Ohio prisons between January 2008 and June 2012. A cross-lagged panel analysis provides support for the use of a time-course framework. Results show that misconduct decreased during programming. However, we observed increases in misconduct prior to and following exposure to programming. Our results suggest that future work needs to improve our understanding of causal mechanisms of inmate misconduct and when their effects are expected.


Isolation and properties of photochemically active reaction center complexes from the green sulfur bacterium Prosthecochloris aestuarii.
A new and rapid procedure was developed for the isolation of the reaction center core (RCC)-complex from the green sulfur bacterium Prosthecochloris aestuarii. Reaction center preparations containing the Fenna Matthews Olson (FMO) protein were also obtained. The procedure involved incubation of broken cells with the detergents Triton X-100 and SB12, sucrose gradient centrifugation and hydroxyapatite chromatography. Three different pigment protein complexes were obtained: one containing (about) three FMO trimers per RCC, one with one FMO per RCC and one consisting of RCC only. The last one contained polypeptides with apparent molecular masses of 64 kDa (pscA) and 35 kDa (pscB, the FA/FB, FeS subunit), but no cytochrome. Bacteriochlorophyll a and the chlorophyll a isomer functioning as primary electron acceptor were present at a ratio of 4.8:1. The complexes were also characterized spectroscopically and in terms of photochemical activity, at room temperature as well as at cryogenic temperatures. Illumination caused oxidation of the primary donor P840, with the highest activity in the RCC complex (DeltaA840/A810 = 0.06). At room temperature in the RCC complex essentially all of the P840+ produced in a flash was re-reduced slowly in the dark (several seconds). At low temperatures (150-10 K) a triplet was formed in a fraction of the reaction centers, presumably by a reversal of the charge separation, whereas in others P840+ formed in the light was re-reduced in 40-50 ms.


Dutch variant of Bellini metaphyseal dysplasia: report of two siblings.
Two sibling girls with cone-shaped knee epiphyses and metaphyses are described. Bone dysplasia with this rare, distinctive, radiographic finding, was first reported by Bellini and Bardare with only few cases reported thereafter. Velores et al. divided bone dysplasias with cone-shaped epiphyses and metaphyses of the knee in two entities which they named trichoscyphodysplasia and metaphyseal acroscyphodysplasia. Although the authors agree that there is more than one bone dysplasia that presents with these distinctive radiographic knee appearances, they consider that two few cases have been reported to satisfactorily classify this group of disorders.


Identification of a diagnostic model and molecular subtypes of major depressive disorder based on endoplasmic reticulum stress-related genes.
Major depressive disorder (MDD) negatively affects patients' behaviours and daily lives. Due to the high heterogeneity and complex pathological features of MDD, its diagnosis remains challenging. Evidence suggests that endoplasmic reticulum stress (ERS) is involved in the pathogenesis of MDD; however, relevant diagnostic markers have not been well studied. This study aimed to screen for ERS genes with potential diagnostic value in MDD. Gene expression data on MDD samples were downloaded from the GEO database, and ERS-related genes were obtained from the GeneCards and MSigDB databases. Differentially expressed genes (DEGs) in MDD patients and healthy subjects were identified and then integrated with ERS genes. ERS diagnostic model and nomogram were developed based on biomarkers screened using the LASSO method. The diagnostic performance of this model was evaluated. ERS-associated subtypes were identified. CIBERSORT and GSEA were used to explore the differences between the different subtypes. Finally, WGCNA was performed to identify hub genes related to the subtypes. A diagnostic model was developed based on seven ERS genes: KCNE1, PDIA4, STAU1, TMED4, MGST1, RCN1, and SHC1. The validation analysis showed that this model had a good diagnostic performance. KCNE1 expression was positively correlated with M0 macrophages and negatively correlated with resting CD4+ memory T cells. Two subtypes (SubA and SubB) were identified, and these two subtypes showed different ER score. The SubB group showed higher immune infiltration than the SubA group. Finally, NCF4, NCF2, CSF3R, and FPR2 were identified as hub genes associated with ERS molecular subtypes. Our current study provides novel diagnostic biomarkers for MDD from an ERS perspective, and these findings further facilitate the use of precision medicine in MDD.


Paecilomyces varioti fungemia in a bone marrow transplant patient.
Paecilomyces varioti, a fungus resembling penicillium spp, has been described in conjunction with impaired host defence or foreign body implants. We report a case of Paecilomyces varioti catheter-related fungemia that occurred during neutropenia in an allogeneic BMT patient receiving antifungal prophylaxis with fluconazole. Successful treatment was achieved by removal of central venous catheter, intravenous amphotericin B and oral itraconazole.


Transitional cell carcinoma of the endometrium.
Only one case of endometrial transitional cell carcinoma (TCC) has been previously reported in the literature. We report a second case. In both the previously reported case and in this case there was a separate focus of TCC in the adnexa. Both patients were treated with adjuvant whole pelvic radiation and are alive and without evidence of disease at 5 years and 15 months, respectively. Study of more cases of endometrial TCC is needed to determine whether this type of endometrial carcinoma has a more favorable response to radiation therapy than other types of endometrial carcinoma with extrauterine spread.


New Imidazolidineiminothione, Imidazolidin-2-one and Imidazoquinoxaline Derivatives: Synthesis and Evaluation of Antibacterial and Antifungal Activities.
A series of new 5-imino-4-thioxo-2-imidazolidinone derivatives 3 with various halogenated and alkylated aromatic substituents at N1 and N3 was synthesized. Imidazolidineiminothione derivatives 3 were prepared from the reaction of N-arylcyanothioformamide derivatives with aryl isocyanates. These compounds were used as key synthons for the preparation of wide variety of new substituted imidazole compounds. Imine hydrolysis of 3 with ethanolic HCl produced the corresponding 4-thioxo-2,5-imidazolidindiones 4. Condensation of 3 with benzophenonhydrazone furnished the corresponding 4-azine derivatives 5. Monohydrazono and dihydrazono derivatives 6 and 8 were obtained upon treatment of imidazolidinone derivatives 3 with hydrazine hydrate. Finally, imidazolidinones 3 were reacted with o-phenylenediamines or pyrazol-5(4H)-ones and afforded the corresponding imidazoquinoxaline and imidazolidin-4-ylidenepyrazolone-5(4H)-one derivatives 11 and 12, respectively. Evaluation of the antibacterial and antifungal activities for the synthesized compounds was carried out to probe their activities. Most of the tested compounds showed significant activities. The best antimicrobial activity was observed for 1-(3-ethoxyphenyl)-6-methyl-1-phenyl-1H-imidazo[4,5-b]quinoxalin-2(3H)-ones (11c) followed by 5-imino-3-(3-methoxy- phenyl)-1-phenyl-4-thioxoimidazolidin-2-one (3f).


Research Note: Storage period and prewarming temperature effects on synchronous egg hatching from broiler breeder flocks during the early laying period.
The effects of the storage period and prewarming temperature on embryonic mortality, hatchability, and synchronous hatching of broiler eggs were investigated. Eggs were obtained from commercial flocks of Ross 308 broiler breeders at 27 and 28 wk of age for trials 1 and 2, respectively. In both trials, 2,400 eggs were stored for 4 d (short) or 11 d (long) at 18°C (64.4°F) and 75% RH and were randomly assigned to 2 groups at either a prewarming temperature of 26.1°C (79°F, low) or 29.4°C (85°F, high) for 8 h before setting. The eggs were transferred from setters to hatching baskets at 444 h (18.5 d) of incubation. The hatched chicks were counted at 6-h intervals between 468 h and 516 h of incubation and categorized as early, middle, or late hatching. The eggs stored for 4 d hatched earlier than the eggs stored for 11 d (P < 0.05). An increased prewarming temperature (29.4°C) resulted in a 1.0-h shorter incubation duration, but this difference was not significant (P = 0.064). An interaction between the storage period and prewarming temperature was observed for middle- and late-hatched chicks (P < 0.05). No interactions between the storage period and prewarming temperature were observed for hatchability of fertile eggs or embryonic mortality; however, a significant interaction was found between the storage period and prewarming temperature on the second-quality chick percentage (P < 0.05). The eggs stored for 11 d had a significantly reduced hatchability of fertile eggs owing to increased embryonic mortality than short-stored eggs (P < 0.05). The interaction effect indicated that eggs held for 8 h with prewarming at 29.4°C after 11 d of storage had more middle- and fewer late-hatched chicks and improved chick quality than those that received the 26.1°C prewarming treatment (P < 0.05), but no significant difference was found among the prewarming treatments for eggs stored for 4 d. This study demonstrated that prolonged egg storage resulted in reduced hatchability, increased incubation duration, and an asynchronous hatching time. Moreover, increasing the prewarming temperature could be used to promote uniformity among embryos through synchronous hatching, thus improving broiler flock uniformity and performance of the prolonged stored eggs.


The Conometric Concept: Coupling Connection for Immediately Loaded Titanium-Reinforced Provisional Fixed Partial Dentures-A Case Series.
The aim of this prospective study was to demonstrate the feasibility of the conic coupling connection as a novel approach for the retention of immediately loaded, titanium-reinforced, temporary fixed partial restorations. The patients received a fixed, immediate partial restoration, attached using the conic coupling connection to two implants placed in a fresh extraction socket. Changes in marginal peri-implant bone level or probing depth measurements, biologic or technical complications, and any other adverse event were recorded at yearly follow-ups up to 3 years after implantation. A total of 78 implants placed in 39 patients reached the 3-year follow-up. A trend of bone overgrowth over the implant platform (mean: 0.2 mm) and a complete fill of the vertical gap between the implant platform level and the first point of contact of the bone with the implant surface was seen after the 6-month follow-up. No disconnection of any prosthesis was noted during 3 years of full occlusal function. The results of this study suggest that titanium-reinforced, temporary partial restorations with conic coupling retention supported by immediate implants provide a successful, cost-effective treatment modality.


Case of interstitial lung disease possibly induced by exposure to iron dust.
Interstitial lung diseases are primarily attributable to occupational or environmental exposures to dusts and irritants. We report on a case of interstitial lung disease, possibly secondary to iron exposure. Our male patient presented with cough and shortness of breath of more than 20 years' duration after his occupational exposure had ended. A chest radiograph showed patchy shadows throughout both lower fields, and computed tomography showed ground-glass-like opacification, with fibrosis in the lower lobes. A lung biopsy revealed foamy cells in the alveolar spaces, with bronchiolitis obliterans. Microelemental analysis showed an increased level of iron in the lung tissue. After treatment with N-acetyl cysteine effervescent tablets, the patient's symptoms gradually improved. This probable case of iron-induced interstitial lung disease suggests the importance of obtaining a patient's history of occupational and environmental exposures for the sake of an accurate diagnosis.


Overwrite fabrication and tuning of long period gratings.
The central wavelengths of the resonance bands are critical aspect of the performance of long period gratings (LPGs) as sensors, particularly for devices designed to operate near the phase matching turning point (PMTP), where the sensitivity to measurements can vary rapidly. Generally, LPGs are characterized by their period, but the amplitude of the amplitude of the index modulation is also an important factor in determining the wavelengths of the resonance bands. Variations in fabrication between LPG sensors can increase or decrease the sensitivity of the LPG to strain, temperature or surrounding refractive index. Here, the technique of overwritten UV laser fabrication is demonstrated. It is shown that, on repeated overwriting, the resonance bands of an LPG exhibit significant wavelength shift, which can be monitored and which can be used to tune the resonance bands to the desired wavelengths. This technique is applied to periods in the range 100 to 200 µm, showing the cycle-to-cycle evolution of the resonance bands near the PMTPs of a number of cladding modes. The use of online monitoring is shown to reduce the resonance band sensor-to-sensor central wavelength variation from 10 nm to 3 nm.


Comparison of the Performance of Two Galactomannan Detection Tests: Platelia Aspergillus Ag and Aspergillus Galactomannan Ag Virclia Monotest.
The use of nonculture-based biomarkers such as the determination of galactomannan is sought for the diagnosis of invasive aspergillosis. To investigate the comparative yield of two tests for the detection of galactomannan in patients with or without proven or probable invasive aspergillosis. Overall, 327 samples (327 patients) were analyzed in a retrospective/prospective study performed in 3 hospitals in Madrid, comparing the determination results in serum or bronchoalveolar lavage of two techniques for galactomannan detection, namely, Platelia Aspergillus Ag (Bio-Rad) and Aspergillus galactomannan Ag Virclia Monotest (Vircell S.L.), following the manufacturer's instructions. Both techniques can automate the process, but the second technique has the advantage of individual processing and assembly of each sample without the need for the additional expense of single-dose strips in controls. In total, 288 of the 327 tests performed showed concordant results between both techniques. The agreement between both methods was к = 0.722, and the correlation between indices was ρ = 0.718. Only 39 samples showed discordant results. In those 39 cases, there were 15 patients with proven or probable invasive aspergillosis criteria. For the samples with clinical criteria as a reference, the areas under the curve of the receiver operating characteristic (ROC) curve were 0.962 for Platelia and 0.968 for VirClia. The VirClia test has been proven to be an alternative for diagnosis due to its friendlier automated format than that of the usual Platelia routine test. The VirClia test also allows individual action and, therefore, a more immediate clinical response. IMPORTANCE Invasive mycoses are increasingly present in immunosuppressed or hospitalized patients with serious illnesses, leading to high rates of morbidity and mortality. Invasive aspergillosis is an infection caused, in a percentage greater than 50%, by the genus Aspergillus. It is vitally important to make an early diagnosis that leads to the application of antifungals in the initial stage of the infection. Therefore, tools are required to help with the early diagnosis of the infection. This comparative study of two enzyme immunoassays is based on the detection of galactomannan antigen in serum and bronchoalveolar lavage samples. A new design based on chemiluminescence and presented in an automated single-dose format is compared to a conventional ELISA technique marketed for years. The results obtained from the prospective and retrospective study indicate a high correlation and degree of agreement between both techniques, as well as in their diagnostic performance.


Refined One-Stage Oriented Object Detection Method for Remote Sensing Images.
Multi-class object detection in remote sensing images plays an important role in many applications but remains a challenging task because of scale imbalance and arbitrary orientations of the objects with extreme aspect ratios. In this paper, the Asymmetric Feature Pyramid Network (AFPN), Dynamic Feature Alignment (DFA) module, and Area-IoU regression loss are proposed on the basis of a one-stage cascaded detection method for the detection of multi-class objects with arbitrary orientations in remote sensing images. The designed asymmetric convolutional block is embedded into the AFPN for handling objects with extreme aspect ratios and improving the space representation with ignorable increases in calculation. The DFA module is proposed to dynamically align mismatched features, which are caused by the deviation between predefined anchors and arbitrarily oriented predicted boxes. The refined Area-IoU regression loss, which reconciles two new regression loss functions, the area-guided regression loss and IoU-guided regression loss, is proposed to simultaneously solve the scale imbalance problem and angle sensitivity problem. Experiments on three publicly available datasets, DOTA, HRSC2016, and ICDAR2015, show the effectiveness of the proposed method.


Topographic Distribution of Amyloid-β, Tau, and Atrophy in Patients With Behavioral/Dysexecutive Alzheimer Disease.
To determine the associations between amyloid-PET, tau-PET, and atrophy with the behavioral/dysexecutive presentation of Alzheimer disease (AD), how these differ from amnestic AD, and how they correlate to clinical symptoms. We assessed 15 patients with behavioral/dysexecutive AD recruited from a tertiary care memory clinic, all of whom had biologically defined AD. They were compared with 25 patients with disease severity- and age-matched amnestic AD and a group of 131 cognitively unimpaired (CU) elderly individuals. All participants were evaluated with amyloid-PET with [18F]AZD4694, tau-PET with [18F]MK6240, MRI, and neuropsychological testing. Voxelwise contrasts identified patterns of frontal cortical tau aggregation in behavioral/dysexecutive AD, with peaks in medial prefrontal, anterior cingulate, and frontal insular cortices in contrast to amnestic AD. No differences were observed in the distribution of amyloid-PET or atrophy as determined by voxel-based morphometry. Voxelwise area under the receiver operating characteristic curve analyses revealed that tau-PET uptake in the medial prefrontal, anterior cingulate, and frontal insular cortices were best able to differentiate between behavioral/dysexecutive and amnestic AD (area under the curve 0.87). Voxelwise regressions demonstrated relationships between frontal cortical tau load and degree of executive dysfunction. Our results provide evidence of frontal cortical involvement of tau pathology in behavioral/dysexecutive AD and highlight the need for consensus clinical criteria in this syndrome.


Biocatalytic Production of 2-α-d-Glucosyl-glycerol for Functional Ingredient Use: Integrated Process Design and Techno-Economic Assessment.
Advanced biomanufacturing builds on production processes that are both profitable and sustainable. Integrated design of process unit operations, geared to output efficiency and waste minimization and guided by a rigorous techno-economic assessment, is essential for development aligned to these central aims. Here, we demonstrate such a development for the biocatalytic production of the biological extremolyte 2-O-α-d-glucosyl-glycerol (2-GG) for functional ingredient application. The process was aligned in scale over all steps (∼180 g product; ∼2.5 L reaction mixture) and involved continuous enzymatic synthesis from sucrose and glycerol interlinked with reactive extraction and nanofiltration for product isolation (purity of ∼80 wt %) and side stream recovery. Glycerol used in ∼6-fold excess over sucrose was recycled, and hydrothermal conversion into 5-(hydroxymethyl)furfural was evaluated for the fructose by-product released from sucrose. Based on a process mass intensity (total mass input/mass product) of 146, ∼80% of the total mass input was utilized and an E-factor (mass waste/mass product) of 28 was obtained. EcoScale analysis revealed a penalty point score of 44, suggesting an acceptable process from a sustainability point of view. Process simulation for an annual production of 10 tons 2-GG was used for the techno-economic assessment with discounted cash flow analysis. The calculated operating costs involved 35 and 47% contributions from materials and labor, respectively. About 91% of the material costs were due to chemicals for the reactive extraction-acidic stripping step, emphasizing the importance of material reuse at this step. Glycerol recycling involved a trade-off between waste reduction and energy use for the removal of water. Collectively, the study identifies options and boundaries of a profitable 2-GG process. The minimum selling price for 2-GG was calculated as ∼240 € kg-1 or smaller. The framework of the methodology presented can be generally important in applied bio-catalysis: it facilitates closing of the gap between process design and implementation for accelerated development.


A study of the hearing and receptive vocabulary of the trainees of an adult training centre.
Hearing and receptive vocabulary (E.P.V.T. full-range version) of the trainees of an adult training centre have been studied. A high incidence of hearing loss (47.1 per cent) was found. The correlation between receptive vocabulary and hearing loss was significant at the five per cent level for the adult Down syndrome subjects in the study. Recommendations are made on the services required, particularly with reference to audiology, that could significantly contribute to the reduction in the number of hearing-impaired mentally handicapped subjects who are at present in hospital care.


The positive transcription elongation factor activity of the vaccinia virus J3 protein is independent from its (nucleoside-2'-O-) methyltransferase and poly(A) polymerase stimulatory functions.
Previous genetic and biochemical experiments have shown that the vaccinia virus J3 protein has three different roles in mRNA synthesis and modification. First, J3 is a (nucleoside-2'-O-)methyltransferase which methylates the 2' position of the first transcribed nucleotide, thus converting a cap-0 to a cap-1 structure at the 5' ends of mRNAs. Second, J3 is a processivity factor for the virus coded poly(A) polymerase. Third, J3 has recently been shown to have intermediate and late gene positive transcription elongation factor activity in vivo. Previous experiments have shown that the poly(A) polymerase stimulatory activity and the (nucleoside-2'-O-)methyltransferase activity are two independent functions of the protein that can be genetically separated through site-directed mutagenesis. In this article, the relationship between the J3-mediated transcription elongation activity and the two other functions of the protein was investigated by constructing several site-directed mutant viruses that contain specific defects in either methyltransferase or poly(A) polymerase processivity functions. The results demonstrate that the J3 positive transcription elongation factor activity is a third independent function of the protein that is genetically separable from its two other functions in mRNA modification. The results also show that neither the poly(A) polymerase stimulatory nor the methyltransferase activities of the J3 protein is essential for virus growth in cell culture.


Cervical Chymopapain Chemonucleolysis.
Cervical chemonucleolysis probably represents the treatment of choice in case of a C6-C7 radiculalgia. This technique must be performed by specialists, given the particular anatomy which is in front of the cervical disk, within the soft tissues. For the future it is necessary to delete the manufacturer's restrictions concerning chymopapain use at the cervical level.


A bladder-to-bladder cooling reflex in the cat.
1. Reflex effects of cold stimulation of the lower urinary tract were studied in cats anaesthetized with alpha-chloralose. The bladder and the urethra were catheterized for separate fluid instillations and the bladder pressure was monitored together with the evoked efferent nerve responses in pelvic nerve filaments. 2. A bladder cooling reflex could be evoked from both the bladder and the urethra. The response was an efferent discharge in preganglionic pelvic motor fibres to the bladder. 3. Bladder mechanoreceptors that drive the normal micturition reflex were not directly involved in the cooling reflex. Their tension sensitivity was decreased by cooling and the efferent reflex response typically occurred before any activation of these receptors. The efferent activity of the cooling reflex also survived an intentional unloading of the mechanoreceptors, a manipulation that abolishes the normal micturition reflex. 4. The dynamic threshold temperature of the cooling reflex was about 30-32 degrees C, which was at the thermal neutral point of the bladder in our experimental situation. 5. The bladder-evoked component of the reflex was greatly reduced or abolished by an intravesical infusion of the local anaesthetic Xylocaine. It was also abolished by total bladder denervation. 6. The vesical component of the reflex was unchanged by bilateral transections of the hypogastric nerves but abolished by pelvic nerve transection. The cooling reflex from the distal urethra was abolished by transection of the pudendal nerves. 7. It was proposed that the cooling reflex originates from cold receptors in the bladder and urethral walls and that the responsible afferent fibres are unmyelinated C fibres. The function of the reflex may be to rid the body of a thermal ballast when under cooling stress.


Effect of external Cd2+ and other divalent cations on carbachol-activated non-selective cation channels in guinea-pig ileum.
1. Inhibitory actions of the external divalent cations, Cd2+, Ni2+, Mn2+ and Co2+ on carbachol (CCh)-induced inward current (Ins,ACh) were investigated in caesium aspartate-loaded single longitudinal smooth muscle cells of guinea-pig ileum, using a rapid solution-switching device, under voltage-clamped conditions. 2. Cd2+ (20-1000 microM), when added to the external solution, reduced Ins,ACh rapidly and reversibly. This effect occurred dose dependently, the relationship being adequately described by a Michaelis-Menten equation with a Hill coefficient (n) of 1.0 and a dissociation constant (Kd) of 98 microM. 3. The inhibitory action of Cd2+ was associated neither with agonist concentration (CCh) nor with changes in reversal potential, and was voltage independent. 4. The appearance and removal of the effect of Cd2+ were both rapid (a few hundred milliseconds), in sharp contrast with a relatively slow time course of atropine or CCh action (of the order of seconds). 5. Other divalent cations (Ni2+, Mn2+, Co2+, Mg2+) applied externally also suppressed Ins,ACh, but less potently. The sequence of apparent potency was Cd2+ (98 microM) greater than or equal to Ni2+ (131 microM) much greater than Co2+ (700 microM) greater than or equal to Mn2+ (1000 microM) much greater than Mg2+ (approximately 10 mM). 6. External Ca2+ increased Ins,ACh dose dependently and antagonized the inhibitory effect of Cd2+. However, this effect may not be a simple competition with Cd2+. 7. These results show that external divalent cations strongly modulate Ins,ACh channels, possibly through direct interaction with the channel protein.


Prevalence and Pattern of Accessory Teeth (Hyperdontia) in Permanent Dentition of Iranian Orthodontic Patients.
Awareness of hyperdontia pattern/prevalence can be useful in early diagnosis and prevention by general practitioners, pediatric dentists, and orthodontists. Since the previous results regarding the pattern of hyperdontia (supernumerary teeth) are controversial, this study aimed to assess this subject among Iranian orthodontic patients. All approved panoramic radiographs of 3374 orthodontic patients (aged 10 to 20 years old) who had visited orthodontic departments of all Tehran dentistry universities and 10 private clinics during the years 1999-2009 were investigated to establish the prevalence/pattern of hyperdontia in permanent dentition (excluding third molars). The data were analyzed using a chi-square, a chi-square goodness-of-fit, and a Fisher exact test (α=0.05). Of the patients, 2012 were female and 1362 were male. The prevalence of hyperdontia was 0.72% (14 females [0.69% of females], 10 males [0.73% of males], female-to-male ratio=1:1.055). The difference between the genders was not significant (P = 0.896). No double or multiple supernumeraries were found. The most common accessory teeth were mesiodens (58.3%), maxillary laterals (25%), and maxillary premolars (16.7%). Hyperdontia was significantly more common (P=0.000) in maxilla (there was only one mandibular accessory tooth). It was more frequent in the anterior segment (P=0.000). However the occurrence was not significantly different between bimaxillary right and left quadrants (P=0.6). Hyperdontia was more common in premaxilla, and the most common accessory tooth was mesiodens. Unlike earlier studies, no bilateral accessory teeth were found. Also no gender dimorphism was discerned.


Palladium-Catalyzed Direct Cyclopropylation of Heterocycles.
Many 1,3-azoles and thiophenes are directly cyclopropylated in the presence of a simple palladium catalyst. The relative configuration on the three-membered rings is retained in the products. Thus, the cyclopropyl-halide bond undergoes concerted oxidative addition to palladium(0) and cyclopropyl radicals are not involved in the productive pathway.


Prostaglandin receptor EP(4) mediates the bone anabolic effects of PGE(2).
Prostaglandin (PG) E(2) is a potent inducer of cortical and trabecular bone formation in humans and animals. Although the bone anabolic action of PGE(2) is well documented, the cellular and molecular mechanisms that mediate this effect remain unclear. This study was undertaken to examine the effect of pharmacological inactivation of the prostanoid receptor EP(4), one of the PGE(2) receptors, on PGE(2)-induced bone formation in vivo. We first determined the ability of EP(4)A, an EP(4)-selective ligand, to act as an antagonist. PGE(2) increases intracellular cAMP and suppresses apoptosis in the RP-1 periosteal cell line. Both effects were reversed by EP(4)A, suggesting that EP(4)A acts as an EP(4) antagonist in the cells at concentrations consistent with its in vitro binding to EP(4). We then examined the effect of EP(4) on bone formation induced by PGE(2) in young rats. Five- to 6-week-old rats were treated with PGE(2) (6 mg/kg/day) in the presence or absence of EP(4)A (10 mg/kg/day) for 12 days. We found that treatment with EP(4)A suppresses the increase in trabecular bone volume induced by PGE(2). This effect is accompanied by a suppression of bone formation indices: serum osteocalcin, extent of labeled surface, and extent of trabecular number, suggesting that the reduction in bone volume is due most likely to decreased bone formation. The pharmacological evidence presented here provides strong support for the hypothesis that the bone anabolic effect of PGE(2) in rats is mediated by the EP(4) receptor.


Fever induction by localized subcutaneous inflammation in guinea pigs: the role of cytokines and prostaglandins.
In guinea pigs, dose-dependent febrile responses can be induced by injection of a high (100 micro g/kg) or low (10 micro g/kg) dose of bacterial lipopolysaccharide (LPS) into artificial subcutaneously implanted Teflon chambers. In this fever model, LPS does not enter the systemic circulation from the site of localized tissue inflammation in considerable amounts but causes a local induction of the proinflammatory cytokines tumor necrosis factor (TNF) and interleukin-6 (IL-6), which can be measured in lavage fluid collected from the chamber area. Only in response to the high LPS dose, small traces of TNF are measurable in blood plasma. A moderate increase of circulating IL-6 occurs in response to administration of both LPS doses. To investigate the putative roles of TNF and prostaglandins in this fever model, a neutralizing TNF binding protein (TNF-bp) or a nonselective inhibitor of cyclooxygenases (diclofenac) was injected along with the high or low dose of LPS into the subcutaneous chamber. In control groups, both doses of LPS were administered into the chamber along with the respective vehicles for the applied drugs. The fever response to the high LPS dose remained unimpaired by treatment with TNF-bp despite an effective neutralization of bioactive TNF in the inflamed tissue area. In response to the low LPS dose, there was an accelerated defervescence under the influence of TNF-bp. Blockade of prostaglandin formation with diclofenac completely abolished fever in response to both LPS doses. In conclusion, prostaglandins seem to be essential components for the manifestation of fever in this model.


Rhinovirus associated severe respiratory failure in immunocompetent adult patient.
Rhinovirus infection is typically associated with the common cold and has rarely been reported as a cause of severe pneumonia in immunocompetent adults. A 55-year-old previous healthy woman, who consumed half a bottle of alcohol daily, presented with respiratory failure after one week of upper respiratory infection symptoms. Radiography revealed bilateral, diffuse ground glass opacity with patchy consolidation in the whole lung field; bronchoalveolar lavage fluid analysis indicated that rhinovirus was the causative organism. After five days of conservative support, the symptoms and radiographic findings began to improve. We report this rare case of rhinovirus pneumonia in an otherwise healthy host along with a review of references.


Expression of the ethylene biosynthetic machinery in maize roots is regulated in response to hypoxia.
Ethylene regulates plant growth in response to many adverse environmental conditions, including the induction of aerenchyma, i.e. the formation of air spaces, in flooded roots in an effort to maintain oxygen levels. In this work, quantitative RT-PCR and in situ RNA hybridization were used to determine how the expression of the ethylene biosynthetic machinery in maize roots is spatially and temporally regulated following exposure to 4% oxygen (i.e. hypoxia) for up to 24 h, conditions that induced aerenchyma formation in the fully-expanded region of the root and reduced cytoplasmic density throughout the root. Expression of ACC oxidase, the ethylene forming enzyme, was observed in the root cap, protophloem sieve elements, and companion cells associated with metaphloem sieve elements. Exposure to 4% oxygen induced ACC oxidase expression in these cell types as well as in the root cortex. ACC synthase, which generates the ethylene precursor, was expressed in the root cap and the cortex and its expression was induced in cortical cells following low oxygen treatment. The induction of expression of the ethylene biosynthetic machinery was accompanied by an induction of ethylene evolution and a reduced rate of root growth. These results suggest that maize roots respond to conditions of hypoxia by inducing the spatially restricted expression of the ethylene biosynthetic machinery, resulting in increased ethylene production.


Intestinal microsporidiosis: a hidden risk in rheumatic disease patients undergoing anti-tumor necrosis factor therapy combined with disease-modifying anti-rheumatic drugs?
Immunosuppressed patients are at risk of microsporidiosis, and this parasitosis has an increased rate of dissemination in this population. Our objective was to evaluate the presence of microsporidiosis and other intestinal parasites in rheumatic disease patients undergoing anti-tumor necrosis factor/disease-modifying anti-rheumatic drug treatment. Ninety-eight patients (47 with rheumatoid arthritis, 31 with ankylosing spondylitis and 11 with psoriatic arthritis) and 92 healthy control patients were enrolled in the study. Three stool samples and cultures were collected from each subject. The frequency of microsporidia was significantly higher in rheumatic disease patients than in control subjects (36 vs. 4%, respectively; p<0.0001), as well as in those with rheumatic diseases (32 vs. 4%, respectively; p<0.0001), ankylosing spondylitis (45 vs. 4%, respectively; p<0.0001) and psoriatic arthritis (40 vs. 4%, respectively; p<0.0001), despite a similar social-economic class distribution in both the patient and control groups (p = 0.1153). Of note, concomitant fecal leukocytes were observed in the majority of the microsporidia-positive patients (79.5%). Approximately 80% of the patients had gastrointestinal symptoms, such as diarrhea (26%), abdominal pain (31%) and weight loss (5%), although the frequencies of these symptoms were comparable in patients with and without this infection (p>0.05). Rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis disease activity parameters were comparable in both groups (p>0.05). The duration of anti-tumor necrosis factor/disease-modifying anti-rheumatic drugs and glucocorticoid use were also similar in both groups. We have documented that microsporidiosis with intestinal mucosa disruption is frequent in patients undergoing concomitant anti-tumor necrosis factor/disease-modifying anti-rheumatic drug therapy. Impaired host defenses due to the combination of the underlying disease and the immunosuppressive therapy is the most likely explanation for this finding, and this increased susceptibility reinforces the need for the investigation of microsporidia and implementation of treatment strategies in this population.


[Management of asymptomatic elevated serum aminotransferase levels, particularly in nonalcoholic steatohepatitis].
At routine determination of serum activities of transaminases (aspartate aminotransferase (ASAT) and alanine aminotransferase (ALAT) increased levels are frequently found. An algorithm may be used in the analysis of elevated transaminase levels: after elimination of the most frequent causes of hepatitis (alcoholic hepatitis, chronic hepatitis B and C) and some rare conditions (autoimmune hepatitis, alpha 1-antitrypsin deficiency, haemochromatosis and Wilson's disease), the diagnosis will often be nonalcoholic steatohepatitis. Although nonalcoholic steatohepatitis is considered a stable disease, recent literature shows a progression to cirrhosis in 8-17%. So far, no effective therapeutic strategies are available for nonalcoholic steatohepatitis.


Serum free amino acid concentration in hepatic lipidosis of dairy cows in the periparturient period.
Blood samples were taken from eight multiparous cows at a dairy farm on eight occasions between the prepartum period and peak lactation to study the serum concentrations of amino acids and biochemical constituents. The cows were classified as having either severe hepatic lipidosis (HL) or non-hepatic lipidosis (non-HL) according to their clinical condition after calving and changes in serum biochemical parameters. The serum concentrations of beta-hydroxybutyric acid were higher in the HL group than in the non-HL group (ANOVA: p<0.01). The serum concentrations of methionine (Met), phenylalanine, and arginine were significantly different between the two groups (ANOVA: p<0.05). In particular, the Met levels were significantly low for 14 days after calving in the HL group (p<0.05), although Met levels in the HL group tended to be lower than the values in the non-HL group until 30 days after calving, starting 14 days before calving. The results suggest that an insufficiency of Met during the periparturient period is related to the development of hepatic lipidosis.


Metastatic Tumor Cell-Specific FABP7 Promotes NSCLC Metastasis via Inhibiting β-Catenin Degradation.
Metastasis accounts for 90% of cancer-related deaths and represents a prominent malignant feature in non-small cell lung cancer (NSCLC), while tumor cell-specific mechanisms and molecules pivotal for the metastatic capacity remain unclear. By analyzing single-cell RNA sequencing data, we found that fatty acid binding protein 7 (FABP7) was specifically up-regulated in tumor cells of metastatic NSCLC patients and might be a prognostic indicator for poor survival. Experimental studies based on NSCLC cell lines showed that FABP7 promoted the metastatic competencies of NSCLC cells in vitro and in vivo. Mechanistically, we demonstrated that FABP7 was important to canonical Wnt signaling activation and competitively inhibited the interaction between β-catenin and components of its cytoplasmic degradation complex, thereby repressing the phosphorylation-dependent ubiquitination and degradation of β-catenin. Our present study identifies FABP7 as a metastatic tumor cell-specific pro-metastatic gene and uncovers a previously unknown regulatory mechanism underlying Wnt hyperactivation via FABP7-impaired cytoplasmic β-catenin degradation, implicating a novel molecule in regulating NSCLC metastasis.


[Bambuí Project: an evaluation of private, public and unionized dental services].
Since one of the goals of dental services is to reduce the effects of social inequality on dental health, it was assessed whether there are inequalities among those seeking dental care from private, public and unionized services. The study population consisted of adults aged 18 years or more living in the city of Bambuí, Brazil. Participants were interviewed using a structured questionnaire. Data analysis was carried out using Pearson's chi-square test, odds ratio and 95% confidence intervals (Woolf's method). There were included 656 subjects who met the study's inclusion criteria. Adjusted results using multiple logistic regression showed that those using private services were more likely to be satisfied with their teeth's looks (OR=3.03; 95%CI =1.70-5.39) and chewing ability (OR=2.27; 95%CI=1.17-4.40) compared to those using public services. Also, they were less likely to perceive their need for dental treatment (OR=0.39; 95%CI=0.18-0.86) and were more likely to have had restorative (OR=9.57; 95%CI=4.72 - 19.43) and/or preventive (OR=5.57; 95%CI=2.31 - 13.40) treatment in their last visit to the dentist's. Those using unionized services were more likely to have had restorative (OR=8.51; 95%CI=2.80 - 25.92) and/or preventive treatment (OR=11.42; 95%CI=3.49 - 37.43) in their last visit to the dentist's when compared to those using public services. However, there were no differences regarding satisfaction with their teeth's looks, chewing ability, and perceived treatment needs. Public dental care services have not been able to reduce social inequalities related to oral health care.


Antimuscarinics and bladder outlet obstruction: From a contraindication to an indication?
To review if the existing data support the new concept that antimuscarinic agents can be used for the treatment of bladder outlet obstruction (BOO) with coexisting overactive bladder (OAB). A literature search of Medline publications (up to 2008) on use of antimuscarinic agents for treatment BOO was performed and all data were presented. All relevant data from published studies in congress abstracts were as well included. The existing data show that this treatment effectively improves patient quality of life. Concerns about the possibility of urinary retention were shown to be unfounded. It seems that antimuscarinic agents do not affect voiding pressures and the use of antimuscarinic agents for BOO seems safe. The combination of an alpha-blocker and antimuscarinic agent for the treatment of BOO with concomitant OAB seems promising.


Extratemporal facial nerve paralysis after blunt trauma.
Presented are two patients in whom facial palsy developed after blunt trauma to the side of the face. Both patients made a complete and uneventful recovery. The etiology of a facial nerve lesion can be established through knowledge of the possible sites of injury to the facial nerve, good history taking and physical examination, together with appropriate tests. The prognosis of an injury secondary to blunt trauma is generally good.


Low-power microfluidic electro-hydraulic pump (EHP).
Low-power electrolysis-based microfluidic pumps utilizing the principle of hydraulics, integrated with microfluidic channels in polydimethylsiloxane (PDMS) substrates, are presented. The electro-hydraulic pumps (EHPs), consisting of electrolytic, hydraulic and fluidic chambers, were investigated using two types of electrodes: stainless steel for larger volumes and annealed gold electrodes for smaller-scale devices. Using a hydraulic fluid chamber and a thin flexible PDMS membrane, this novel prototype successfully separates the reagent fluid from the electrolytic fluid, which is particularly important for biological and chemical applications. The hydraulic advantage of the EHP device arises from the precise control of flow rate by changing the electrolytic pressure generated, independent of the volume of the reagent chamber, mimicking the function of a hydraulic press. Since the reservoirs are pre-filled with reagents and sealed prior to testing, external fluid coupling is minimized. The stainless steel electrode EHPs were manufactured with varying chamber volume ratios (1 : 1 to 1 : 3) as a proof-of-concept, and exhibited flow rates of 1.25 to 30 microl/min with electrolysis-based actuation at 2.5 to 10 V(DC). The miniaturized gold electrode EHPs were manufactured with 3 mm diameters and 1 : 1 chamber volume ratios, and produced flow rates of 1.24 to 7.00 microl/min at 2.5 to 10 V(AC), with a higher maximum sustained pressure of 343 KPa, suggesting greater device robustness using methods compatible with microfabrication. The proposed technology is low-cost, low-power and disposable, with a high level of reproducibility, allowing for ease of fabrication and integration into existing microfluidic lab-on-a-chip and analysis systems.


Multifocal neutrophilic meningoencephalitis: a novel disorder responsive to anakinra.
We report a 57-year-old man with recurrent meningoencephalitis resulting in bouts of altered consciousness, encephalopathy, tremors, focal seizures, and paraparesis. The neurological manifestations were accompanied by fever and leukocytosis in the absence of other systemic manifestations. MRI abnormalities of the brain, brainstem, spinal cord and meninges and CSF pleocytosis and elevated protein were observed. Exhaustive studies failed to reveal an etiology. Brain biopsy revealed nodules of neutrophils and macrophages, but no vasculitis. The lesions were not vasocentric as would be expected with neuro-Behcet's disease and neuro-Sweet's disease. The disorder was responsive to high-dose corticosteroid therapy and, ultimately, to anakinra, an IL-1α and IL-1β receptor antagonist.


Efficacy and acceptability of two iron supplementation schedules in adolescent school girls in Lima, Peru.
To assess the efficacy and acceptability of a daily and intermittent iron supplementation, a double-blind, placebo-controlled trial was conducted in a public school located in periurban Lima, Peru. Adolescent girls (n = 312), 12-18 y old, were randomly assigned to one of the following three groups: 1) 60 mg iron as ferrous sulfate daily from Monday to Friday; 2) 60 mg iron as ferrous sulfate 2 d/wk and 3 d placebo (intermittent); 3) placebo, from Monday to Friday. Field workers gave the girls supplements during school hours for 17 wk; 296 girls completed the trial. Girls took 94% of the expected dose of 85 pills. Few side effects were reported. Postintervention, hemoglobin (Hb), serum ferritin (SF) and free erythrocyte protoporphyrin (FEP) were improved significantly in the iron-supplemented groups compared with placebo (P<0.05). Daily supplements led to higher Hb increases than intermittent supplements (P<0.05), but SF and FEP were similar between the two groups. Thus, both iron supplementation schedules were efficacious in preventing iron deficiency in adolescent girls through the school system, and the daily schedule was better than the intermittent schedule at increasing Hb values and reducing anemia.


Doubling the far-field resolution in mid-infrared microscopy.
The spatial resolution in far-field mid-infrared (λ>2.5 µm) microscopy and micro-spectroscopy remains limited with the full-width at half maximum of the point-spread function ca. λ/1.3; a value that is very poor in comparison to that commonly accessible with visible and near-infrared optics. Hereafter, it is demonstrated however that polymer beads that are centre-to-centre spaced by λ/2.6 can be resolved in the mid-infrared. The more than 2-fold improvement in resolution in the far-field is achieved by exploiting a newly constructed scanning microscope built around a mid-infrared optical parametric oscillator and a central solid-immersion lens, and by enforcing the linear polarization unidirectional resolution enhancement with a novel and robust specimen error minimization based on a particle swarm optimization. The method is demonstrated with specimens immersed in air and in water, and its robustness shown by the analysis of dense and complex self-assembled bead islands.


[Anterior ischemic optic neuropathy associated with giant cell arteritis. Case report].
Giant cell arteritis is a systemic vasculitis that affects large- and medium sized arteries. The most common ophthalmic manifestation of this disease is anterior ischemic optic neuropathy, leading to acute, painless visual loss in one or both eyes. It is caused by ischemia of the optic nerve head, which is mainly supplied by the short posterior ciliary arteries. Early diagnosis is the key to correct management and prevention of visual loss in the second eye. The treatment of choice for arteritic ischemic optic neuropathy is high dose of systemic corticosteroids. Only such treatment may prevent blindness. The authors presented a case of a 62 years man with anterior ischemic neuropathy in one eye, which was diagnosed as arteritic form caused by giant cell arteritis. The correct diagnosis was based on typical clinical signs of ischemic changes in the optic nerve head and diagnostic criteria for giant cell arteritis, advocated by American College of Rheumatologists.


In vitro biological assessment of the stability of cigarette smoke aqueous aerosol extracts.
Cigarette smoke aqueous aerosol extracts (AqE) have been used for assessing tobacco products, particularly with in vitro models such as oxidative stress and inflammation. These test articles can be generated easily, but there are no standardised methods for the generation and characterisation or stability. We investigated the effects of pro-oxidant smoke-derived chemicals by using 3R4F AqE generated under standardised conditioning and smoking regimes and assessed the stability over 31-week timeframe. Twenty batches generated from ten puffs per cigarette bubbled through 20 ml cell culture media were used fresh and thawed from frozen aliquots stored at - 80 ºC. Nicotine levels quantified by gas chromatography/mass spectrometry and optical density at 260 nm showed chemical and physical stability from week 0 (fresh sample) to weeks 1, 4, 8 and 31 (frozen samples). No significant change in H292 human bronchial epithelial cell viability or oxidative stress were observed between fresh AqE at week 0 and frozen AqE at 31 weeks. AqEs generated by our protocol were stable for up to 31 weeks for all tested end points, suggesting that it may not be necessary to use freshly generated AqE for each study, thus reducing batch-to-batch variability.


How to Investigate Within-Subject Associations between Physical Activity and Momentary Affective States in Everyday Life: A Position Statement Based on a Literature Overview.
Several meta-analyses have investigated the association between physical activity and affective states and have found evidence suggesting that exercise exerts a positive effect on affective state. However, in this field of research, most studies have conducted between-subject analyses. Nonetheless, there is more and more interest in the within-subject associations between physical activity and momentary affective states in everyday life. This position statement pertains to this up-and-coming field of research and provides methodological recommendations for further studies. The paper is divided into three parts: first, we summarize and evaluate three methodological requirements necessary for the proper evaluation of within-subject associations between physical activity and momentary affective states in everyday life. We propose that the following issues should be considered: (a) to address the dynamic nature of such relationships, repeated assessments are necessary; (b) as activities performed in everyday life are mostly spontaneous and unconscious, an objective assessment of physical activity is useful; (c) given that recall of affective states is often affected by systematic distortions, real-time assessment is preferable. In sum, we suggest the use of ambulatory assessment techniques, and more specifically the combination of accelerometer-assessment of physical activity with an electronic diary assessment of the momentary affective state and additional context information. Second, we summarize 22 empirical studies published between 1980 and 2012 using ambulatory assessment to investigate within-subject associations between momentary affective states and physical activity in everyday life. Generally, the literature overview detects a positive association, which appears stronger among those studies that were of high methodological quality. Third, we propose the use of ambulatory assessment intervention (AAIs) strategies to change people's behavior and to enable people to be active as often as possible during the day (e.g., reducing sitting time, taking more steps per day).


A choice-based method to compare alternative alcohol warning labels.
Alternative alcohol warning labels were studied with a method used in magical-thinking research. In two studies (N = 111, N = 75), subjects completed a questionnaire. A "poison," "toxic" or "causes cancer" label on a beer can was shown to have substantial effects on self-reported choice behavior. In contrast, the alcohol warning label now mandated to appear on alcohol containers did not have nearly as powerful an effect. Explanations for the lack of strong effects of the mandated warning label center around label length, type of warning and salience of the warning. The methodology described in this article appears to test gut-level or conditioned responses to labels, which may be a valuable technique for evaluating warning labels.


Assessment of Serum VASPIN Levels among Type 2 Diabetes Mellitus Patients with or without Acute Coronary Syndrome.
Type 2 Diabetes Mellitus (DM) is on the verge of becoming a pandemic in India. Type 2 DM patient have two to four times increased risk of carotid artery disease. Adipokines have been regarded recently as direct link between diabetes and atherosclerosis. Visceral Adipose Tissue Derived Serine Protease Inhibitor (VASPIN); one of the most recently discovered adipokine, inhibits the proteases responsible for insulin resistance, carotid plaque development and rupture. In literature, few studies have addressed the role of VASPIN in pathogenesis of Acute Coronary Syndrome (ACS) in patients with type 2 DM. To find association between serum VASPIN with lipid profile, creatine kinase-total, creatine kinase-MB, troponin-I, age, height, weight, blood pressure, smoking, family history of ACS and to prove the hypothesis of low serum VASPIN level as predictor of ACS in patients with type 2 DM. Forty-one type 2 DM patients (controls) and 41 type 2 DM patients with ACS (cases) were enrolled in the study. Anthropometric measurements were performed and fasting serum biochemical parameters and VASPIN were measured. The results of cases and controls were compared by student t-test or Mann-Whitney test. All the parameters were correlated with serum VASPIN by Pearson's or Spearman's correlation. Fasting serum VASPIN concentration was significantly (p< 0.0001) lower in the cases (0.43±0.22 pg/ml) than in the controls (0.83±0.29 pg/ml). Correlation analysis undertaken on all type 2 DM showed that serum VASPIN concentration was negatively correlated with age, waist circumference, hip circumference, systolic and diastolic blood pressure, duration of diabetes, serum Creative Kinase-Total, CK-MB and urea (p< 0.05). Utilizing Receiver Operating Characteristic (ROC) curve, the serum VASPIN level of less than 0.594pg/ml showed greatest risk of ACS among type 2 DM patients (p< 0.0001). Type 2 DM patients with low serum vaspin concentration were at risk of ACS independent of other cardiovascular risk factors.


Effect of Glyoxylate on the Sensitivity of Net Photosynthesis to Oxygen (the Warburg Effect) in Tobacco.
The addition of glyoxylate to tobacco (Nicotiana tabacum) leaf discs inhibited glycolate synthesis and photorespiration and increased net photosynthetic (14)CO(2) fixation. This inhibition of photorespiration was investigated further by studying the effect of glyoxylate on the stimulation of photosynthesis that occurs when the atmospheric O(2) level was decreased from 21 to 3% (the Warburg effect). The Warburg effect is usually ascribed to the increased glycolate synthesis and metabolism that occurs at higher O(2) concentrations. Photosynthesis in control discs increased from 59.1 to 94.7 micromoles of CO(2) per gram fresh weight per hour (a 60% increase) when the O(2) level was lowered from 21 to 3%, while the rate for discs floated on 15 millimolar glyoxylate increased only from 82.0 to 99.7 micromoles of CO(2) per gram fresh weight per hour (a 22% increase). The decrease in the O(2) sensitivity of photosynthesis in the presence of glyoxylate was explained by changes in the rate of glycolate synthesis under the same conditions.The rate of metabolism of the added glyoxylate by tobacco leaf discs was about 1.35 micromoles per gram fresh weight per hour and was not dependent on the O(2) concentration in the atmosphere. This rate of metabolism is about 10% the amount of stimulation in the rate of CO(2) fixation caused by the glyoxylate treatment on a molar carbon basis. Glyoxylate (10 millimolar) had no effect on the carboxylase/oxygenase activity of isolated ribulose diphosphate carboxylase. Although the biochemical mechanism by which glyoxylate inhibits glycolate synthesis and photorespiration and thereby decreases the Warburg effect is still uncertain, these results show that cellular metabolites can regulate the extent of the Warburg effect.


Cefaclor therapy in uncomplicated cystitis.
Thirty patients with acute urinary tract infection were treated orally with 500 mg of cefaclor three times a day for 7 days. Urine cultures were made before treatment and after therapy. In 97 per cent (29/30) of these patients clinical success was achieved and in 90 per cent (27/30) of them, pathogens were eradicated. Our study showed that cefaclor was still active against most Enterobacteriaceae, such as Escherichia coli and Klebsiella species, the principle pathogens of urinary tract infection. No adverse effects of cefaclor were observed in this study.


Reverse transcription and kinetic complexity analysis of mRNA from lupin root nodules.
Complementary DNA (cDNA) synthesis was performed using mRNA from lupin root nodules and from lupin uninfected roots as templates. Optimal conditions for the synthesis of 700 nucleotides long cDNA were established. Hybridization kinetics of mRNA-cDNA were performed in a homologous system from root nodules as well as in a heterologous system. Hybridization analysis revealed the presence of four frequency abundance classes within the root nodule mRNA population. In order to enrich the cDNA population in leghaemoglobin sequences, two synthetic pentadecanucleotide fragments complementary to the putative 3' ends of leghaemoglobin mRNAs were used as primers for the reverse transcription of nodule poly(A)-RNA. The resultant cDNA was enriched in rapidly hybridizing components which may contain leghaemoglobin sequences.


Salmonella choleraesuis bacteremia in southern Taiwan.
Within a 6-year period from January 1991 to December 1996, 19 patients with Salmonella choleraesuis bacteremia were enrolled for clinical and microbiological analysis. Young children, the elderly and patients with hematological malignancy (36.8%), liver cirrhosis (26.3%), systemic lupus erythematosus (10.5%), chronic renal impairment (10.5%), and peptic ulcer (10.5%) were at high risk of this infection. The ratio of male to female was 3:1. Three cases (15.8%) were nosocomially acquired. Fever (89.5%), chills (57.9%) and anorexia (52.6%) were the most common clinical manifestations. Seven patients (36.8%) presented no gastrointestinal manifestations. Normal white blood cell count was noted in seven patients (36.8%), and neutropenia caused by underlying diseases or severe infection was found in six cases (31.6%). Various types of metastatic focal infections were found, such as septic arthritis, cutaneous infection, spontaneous bacterial peritonitis, and pneumonia. The severe immunocompromised status of patients and the high virulence of this pathogen may contribute to the high case fatality rate (21%). Higher resistance rate to commonly used antimicrobial agents was noted in ampicillin (94.7%), chloramphenicol (89.5%), and TMP/SMZ (63.8%). All strains of S. choleraesuis were susceptible to third-generation cephalosporins and fluoroquinolones. Generally, S. choleraesuis bacteremia should be taken into account in the differential diagnosis of sepsis in immunocompromised patients, even without gastrointestinal manifestations. The third-generation cephalosporins and fluoroquinolones may be the first choice for treatment of this invasive infections.


[Production of ligninolytic enzymes in bioreactor].
Production of ligninolytic enzymes under nitrogen limited conditions(C/N = 56/2.2) was studied in a 5-L stirred tank bioreactor with a working volume of 2 L for obtaining higher production of ligninolytic enzymes by white rot fungus Phanerochaete chrysosporium BKM-F-1767 and its control strategy. Results show that the manganese peroxidase (MnP) and laccase (Lac) reached peak at the sixth day and the seventh day, respectively, and the variation of them with time in a batch cultivation are similar to the results by agitated Erlenmeyer flasks; however higher enzyme activity was not achieved by applying a fed-batch strategy, in which nitrogen limited medium was fed to the reactor. In addition, variation of pH during cultivation was related to the growth of P. chrysosporium and enzymes production during both batch and fed-batch cultivation. The pH value of liquid medium began to decline when the enzyme activity occurred in the system, and the decline became more and more slow along with the decrease of enzyme activity at the end of fermentation. So, pH would be as a control parameter to find out the growth of P. chrysosporium and enzymes production during incubating P. chrysosporium. However, fed-batch strategy still need further study.


Nevirapine and/or co-trimoxazole induced Stevens Johnson syndrome in HIV infected patient--a case report.
A 46 years old HIV reactive patient developed Stevens Johnson syndrome (SJS) probably due to nevirapine and/or co-trimoxazole. Patient was on zidovudine + lamivudine + nevirapine along with Co-trimoxazole since last two months. After 15 days, zidovudine was replaced with stavudine due to development of anemia. All these drugs were stopped after development of reaction. Temporal association was found between stavudine, lamivudine, nevirapine, cotrimoxazole and development of the reaction. Nevirapine and Co-trimoxazole were suspected to cause this reaction most probably due to associated hepatotoxicity and their common potential to cause SJS. In our case, patient died despite stopping of all medications.


Modifiable Risk Factors Identify People Who Transition from Non-fallers to Fallers in Community-Dwelling Older Adults: A Prospective Study.
To identify modifiable risk factors associated with the transition from non-faller to faller in community-dwelling older adults. A prospective study design was used. Adults aged 60 to 90 years (n=90, mean age=79.7 years, 63% male) who did not report falling in the past year were included. A comprehensive geriatric assessment was performed at study baseline, and daily falls data were collected monthly for 1 year. Multivariable regression using a modified Poisson model on fall status (yes/no) and a Cox proportional hazards model for time to first fall were used to identify risk factors. Twenty-four people (27%) fell. Modifiable risk factors were present in 67% of study participants, and fall risk increased as the number of risk factors increased. The most common activities performed prior to falling were walking and using stairs. Fall risk doubled ([relative risk=2.00; 95%CI: 1.13-3.56) per unit increase in the number of risk factors (lower-extremity weakness, balance impairment, and ≥4 prescription medications). Among older adults who were self-reported non-fallers, falls were a common outcome, and modifiable risk factors were present in the majority of the sample. The absence of a fall history does not rule out the need to screen for other risk factors for falls. Functional lower-extremity weakness, balance impairment as measured by the Berg Balance Scale (score <50), and number of risk factors were independent predictors for the transition in status from non-faller to faller. Further research is required to define effective interventions to prevent first falls.


Fat Metabolism in Higher Plants: LXII. Stearl-acyl Carrier Protein Desaturase from Spinach Chloroplasts.
Stearyl-acyl carrier protein desaturase (EC 18.104.22.168), present in the stroma fraction of spinach (Spinacia oleracea) chloroplasts, rapidly desaturated enzymatically prepared stearyl-acyl carrier protein to oleic acid. No other substrates were desaturated. In addition to stearyl-acyl carrier protein, reduced ferredoxin was an essential component of the system. The electron donor systems were either ascorbate, dichlorophenolindophenol, photosystem I and light, or NADPH and ferredoxin-NADP reductase. The desaturase was more active in extracts prepared from chloroplasts obtained from immature spinach leaves than from mature leaves. Stearyl-acyl carrier protein desaturase also occurs in soluble extracts of avocado (Persea americana Mill.) mesocarp and of developing safflower (Carthamus tinctorius) seeds.


Differential effects of n-3 fatty acid deficiency on phospholipid molecular species composition in the rat hippocampus.
In this study, we have examined the effects of n-3 fatty acid deficient diets on the phospholipids (PL) molecular species composition in the hippocampus. Female rats were raised for two generations on diets containing linoleic acid (18:2n-6), with or without supplementation of alpha-linolenic acid (18:3n-3) or 18:3n-3 plus docosahexaenoic acid (22:6n-3). At 84 days of age, the hippocampal phospholipids were analyzed by reversed phase HPLC-electrospray ionization mass spectrometry. Depleting n-3 fatty acids from the diet led to a reduction of 22:6n-3 molecular species in phosphatidylcholine (PC), phosphatidylethanolamine (PE), PE-plasmalogens (PLE), and phosphatidylserine (PS) by 70-80%. In general, 22:6n-3 was replaced with 22:5n-6 but the replacement at the molecular species level did not always occur in a reciprocal manner, especially in PC and PLE. In PC, the 16:0,22:6n-3 species was replaced by 16:0,22:5n-6 and 18:0,22:5n-6. In PLE, substantial increases of both 22:5n-6 and 22:4n-6 species compensated for the decreases in 22:6n-3 species in n-3 fatty acid deficient groups. While the total PL content was not affected by n-3 deficiency, the relative distribution of PS decreased by 28% with a concomitant increase in PC. The observed decrease of 22:6n-3 species along with PS reduction may represent key biochemical changes underlying losses in brain-hippocampal function associated with n-3 deficiency.