Frequency of obesity and metabolic syndrome in childhood leukemia and lymphoma survivors.
In this study, it was aimed to determine the prevalence and clinical features of obesity and metabolic syndrome, which are long-term effects of survivors after treatment in children with leukemia and lymphoma. Patients with leukemia and lymphoma, who were diagnosed between 2000 and 2012 (at least 2 two years after remission) were included. Data obtained through reviewing the family history, demographic characteristics, anthropometric measurements, and laboratory parameters (blood glucose, lipid, and insulin levels) were analyzed and compared at the time of diagnosis, after the treatment and at time of the study. Eighty nine patients (45 boys, 44 girls) were included (mean age: 14.7 ± 4.3 years): 77.5% had acute lymphoblastic leukemia, 11.2% had acute myeloid leukemia, and 11.2% had lymphoma. Overall, 46% patients had received radiotherapy, 7% had undergone surgery, and 2.2% had received stem cell transplantation in addition to chemotherapy. The mean duration of treatment was 2.4 years, and the time elapsed after treatment was 4.9 years. While only one had obesity at the diagnosis, a significant increase in obesity (20%), hypertension (15.7%), hyperglycemia (15%), insulin resistance (35%) were observed at the time of study, and family history of hypertension, dyslipidemia, and cardiovascular diseases were significantly higher in this subgroup. The prevalence of metabolic syndorme is higher in children with leukemia and lymphoma after treatment, and begins to increase with the initiation of treatment and continues to increase over time. These children should be followed-up for late-effects including metabolic syndrome through life-long period.


Intricacies in characterizing positivity in pooled sample testing for SARS-CoV-2.
The unprecedented demand for testing for the ongoing coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 has led to an acute shortage and limited availability of test reagents for which pooling of samples has been recommended in areas with low prevalence. Considering the possibility of dilution factor in pool testing, an attempt was made to find out possibility of any true positive samples in pools with late amplification. The study was conducted on samples received from various collection centers in different districts of Odisha as well as from patients attending the screening clinic or admitted in COVID ward of the hospital. Nasal/nasopharyngeal/throat swabs received in viral transport media in cold chain were subjected to Real-time polymerase chain reaction (RT-PCR) testing in a Biosafety Laboratory level-2 by including uniform volume of four units (samples) per pool. All confirmed and probable positive pools in screening assay were de-convoluted and individual samples tested for confirmatory assay. Inclusion of an additional criteria of probable positive pool (Ct value >35 with non-sigmoid amplification curve or showing a line of amplification towards the end of the cycle) yielded 39 (15.5%) more true positive samples out of a total of 251 positive samples that would otherwise have been missed if only the classical criteria of positive (Ct within 35 with proper sigmoid curve) had been considered. The study highlights the importance of considering any indication of late amplification in the RT-PCR test to label a pool as positive to avoid missing any true positive sample in the pool.


Syndromal obesity due to paternal duplication 6(q24.3-q27).
The likelihood of a paternally expressing imprinted gene in chromosome region 6(q23-24) has been highlighted by cases of transient neonatal diabetes mellitus (TNDM) in which paternal uniparental disomy (UPD) for chromosome 6 or paternal duplication 6(q23-qter) was detected. We present the case of a 38-year-old man with moderate to severe intellectual delay, short stature, small hands and feet, eye abnormality, small mouth, and obesity (without hyperphagia) beginning in mid-childhood. The perinatal and neonatal histories were normal. The patient had a duplication within 6q. Fluorescence in situ hybrisation studies were performed with single and dual hybridisations using a chromosome 6 library probe, short and long arm subregional probes, 6q23-24, 6q25.3-6qter locus-specific probes, and a 6q telomere probe. The hybridisation results defined an inverted duplication of 6q24.3 to 6q27. DNA studies with microsatellite markers from 6p and 6q showed regular biparental inheritance of chromosome 6 and confirmed that the duplication was paternal in origin. Our patient appears to be the first one known to have paternal duplication of chromosome area 6(q24-q27) who did not have TNDM as an infant. He has remained nondiabetic, although obesity, without hyperphagia, has been a constant problem since its onset in mid-childhood.


Predicting the longer-term outcomes of total hip replacement.
The objective of this study was to identify the patient-level predictors (age, sex, body mass index, mental health, and comorbidity) for a sustained functional outcome at a minimum 1 year of followup after total hip replacement (THR). We reviewed data from our registry on 636 consecutive patients from 1998 to 2005. Demographic data and the outcome scores of the Western Ontario McMaster University Osteoarthritis Index (WOMAC) and Medical Outcomes Study Short-form 36 (SF-36) scores were extracted from the database. Longitudinal regression modeling was performed to identify the predictive factors of interest. Fourteen percent of patients were missing outcomes data at 1 year of followup. The mean followup in our cohort was 3.3 years (range 1-6 yrs) and there were no revisions for aseptic loosening performed during this time. Mean clinical outcome scores were found to be relatively constant for the 6 years after surgery. Older age, year of followup, and greater comorbidity were identified as negative prognostic factors for a sustained functional outcome following THR (p < 0.05). Understanding of longterm surgical outcomes should be appropriately used to set realistic patient expectations of surgery.


Incidence and clinical impact of lower extremity vascular injuries in the setting of whole body computed tomography for trauma.
The aims of this study are to determine the incidence of lower extremity fractures and/or vascular injuries in the setting of whole body computed tomography (WBCT) for trauma and to determine lower extremity injury outcomes in this patient population. This is a retrospective observational study performed at a large urban Level 1 trauma center. Our institutional trauma registry was queried for patients who were evaluated with WBCT and lower extremity CT angiography (CTA) as a part of their initial imaging evaluation over a 43-month period. Patients with lower extremity fractures and/or vascular injuries were identified. Those patients with both lower extremity vascular injury and fracture were then analyzed to determine the physical relationship of the fracture to the vascular injury. Physical exam findings were extracted from the medical record. Interventions and long-term outcomes were determined from the medical record. A total of 370 patients met the inclusion criteria, with 98% experiencing blunt trauma. Of these, 290 (78.4%) were positive for lower extremity injury, including 266 (71.9%) with isolated fractures, 2 (0.6%) with isolated vascular injury, and 22 (5.9%) with vascular injury associated with long bone fracture. Of the 22 patients with combined fracture and vascular injury, 8 received vascular intervention and 10 had long-term complications as a result of their injuries. Physical exam findings were insufficient to diagnose 57% of the vascular injuries. The inclusion of lower extremity CTA as part of a WBCT imaging exam for trauma allows for the identification of vascular injuries that otherwise may have gone undetected or resulted in delayed diagnosis. Clinically occult lower extremity vascular injuries may be associated with poor outcomes.


Detection of Helicobacter pylori carriers by discriminant analysis of urea and pH levels in gastric juices.
An alternative approach to the problems inherent in current methods for detecting Helicobacter pylori carriers--that of being generally time-consuming, expensive, and not sufficiently sensitive--was devised by using the urea concentration and pH levels of gastric juices. A linear discriminant analysis of these variables, measured in 54 patients submitted to digestive endoscopy for gastritis, provided a mathematical formula for assigning the subjects (previously classified by other standard methods) to groups of either positive or negative H pylori carriers. The results obtained showed a correct classification in 52 out of 54 cases with only one false negative and one false positive case.


Comparative transcriptome analysis reveals the impact of the daily rhythm on the hemolymph of the Chinese mitten crab (Eriocheir sinensis).
The daily rhythm affects a series of physiological functions in crustaceans. To study its effect on the physiological function in Eriocheir sinensis, a crustacean species of high economic value, we analyzed the hemolymph transcriptome during the daily rhythm by high-throughput sequencing. We sampled the hemolymph from crabs at four time points in a single day (06:00, 12:00, 18:00, and 24:00 h) and identified 3,01,661 and 1,03,998 transcripts and unigenes, respectively; some of the unigenes were annotated as core clock genes. Moreover, 15,564 differentially expressed genes (DEGs) were divided into nine different clusters. Functional enrichment analysis of DEGs indicated that the molting, metabolism, and immunity processes in E. sinensis were impacted by its daily rhythm. In addition, we mapped the DEGs involved in the daily entrainment pathway. To the best of our knowledge, this is the first comparative transcriptome analysis of crustacean hemolymph during the day-night cycle, and provides multi-level information for unraveling the finer regulatory effects of the daily cycle in crustaceans.


Ventral mesencephalon-enriched genes that regulate the development of dopaminergic neurons in vivo.
Mesodiencephalic dopaminergic (mDA) neurons are critical for movement control and other physiological activities. However, the molecular mechanisms underlying their development are poorly understood. We aimed to establish the expression profiles of genes involved in this process and unravel genetic programs that control late development of mDA neurons. We compared genome-wide gene expression profiles of developing mouse ventral mesencephalon (VM) using microarrays. We identified a set of genes that show spatially and temporally restricted expression in the VM in an Ngn2 (neurogenin 2)-dependent manner and are potentially important for mDA neuron development. Functional analysis on mice lacking the VM-specific gene early B-cell factor 1 (Ebf1) revealed that Ebf1 is essential for the terminal migration of mDA neurons in the substantia nigra pars compacta. Thus, we identified a set of VM-enriched genes that are important for mDA neuron development. Our analysis also provides a genetic framework for further investigation of the molecular mechanisms mediating mDA neuron development.


Screening for detection of methicillin-resistant Staphylococcus aureus in Doon Valley Hospitals, Uttarakhand.
Present study was conducted to assess the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) among patients at various hospitals in Doon Valley, Uttrakhand. A total of 300 nasal swabs (male patients: 177, female patients: 123) were subjected to bacteriological investigation following established protocol. Isolates were verified by mannitol fermentation, Gram staining, DNAse test and coagulase positivity. S aureus was isolated in 111 (37%) participants (M: 37%, F: 36.5%). Out of 111 S. aureus isolates, 38 (34.2%) were methicillin resistant (MRSA). Among them, 25 (38%) were male and 13 (29%) were from female. Highest MRSA colonization rate was found among dialysis ward patients (55.5%), followed by burn ward (32.5%) and general medical ward (22.7%) patients. The study also revealed that administration of recent antibiotic was chief predisposing factor for MRSA colonization. High MRSA carriage rate found in this study indicates demand for standard infection control to curb transmission.


Intracranial Hemorrhage Associated With Listeria monocytogenes Bacteremia in an Elderly Patient on Mycophenolate Mofetil.
Listeria monocytogenes is an important foodborne bacterial pathogen in immunosuppressed patients, pregnant women, and individuals at the extremes of age, including neonates and older adults. Invasion of the central nervous system (CNS) and bacteremia are the principal clinical manifestations of infection in these hosts. In contrast, normal hosts who ingest high numbers of Listeria may develop self-limited febrile gastroenteritis. Hydrocephalus and intracranial hemorrhage (ICH) are very rare and severe complications of L. monocytogenes infection. ICH associated with L. monocytogenes has been reported even less frequently than hydrocephalus, with most cases occurring in the pediatric population. In this paper, we present a case of L. monocytogenes bacteremia in a 71-year-old male, complicated by intracranial hemorrhage. He presented at first with nonspecific symptoms of generalized weakness and fatigability and later developed drowsiness, disorientation, and fever, which prompted further investigations that revealed the presence of ICH and L. monocytogenes bacteremia.


Staying on and getting back on the wagon: age-related improvement in self-regulation during a low-calorie diet.
In the present study, we investigated whether self-regulation improves across adulthood, especially regarding the mastery of setbacks and failure in an important health-related behavior, namely, staying on a low-calorie diet when overweight. Overweight women (N = 126; 19-77 years of age, M = 47.2) filled out weekly questionnaires on the outcomes of behavioral, emotional, and cognitive self-regulation during a dieting program; outcomes included deviations from the diet, weight loss, affect, and rumination. Confirming hypotheses, multilevel analyses revealed that-even after controlling for prior dieting attempts-age was associated with better self-reported self-regulation (i.e., fewer deviations from the diet, lower disinhibition and rumination after failure, and higher affective well-being) but not with more weight loss. Results suggest that self-regulation improves with age and shows positive effects on subjective indicators of successfully coping with setbacks but does not directly influence the target-outcome weight loss.


CTGF and apoptosis in mouse osteocytes induced by tooth movement.
It is known that experimental tooth movement stimulates the gene expression of connective tissue growth factor (CTGF) and induces apoptosis in osteocytes in rats. We hypothesized that there is a relationship between CTGF expression and the induction of apoptosis in osteocytes, to play a significant role in triggering bone remodeling during experimental tooth movement. In this study, CTGF mRNA expression was detected at 2 hours in osteocytes on the pressure side, followed by apoptosis at 6 hours after tooth movement in mice. The number of empty lacunae significantly increased on day 1 after mechanical stimulation. Thereafter, the number of osteoclasts significantly increased on the pressure side of the alveolar bone on day 3. Tooth movement increased rapidly on day 10. These findings suggest that CTGF expression, followed by apoptosis in osteocytes in response to mechanical stimulation, might play a significant role in triggering bone remodeling during tooth movement.


Chronic pain, functionality and quality of life in cancer survivors.
The increasing number of cancer survivors associated to a longer average life-span after diagnosis of an oncological disease facilitates the observation of deleterious long-term effects of both oncological disease and its treatment. Among these effects, chronic pain emerges as one of the most prevalent and, with its onset, there is a decrease in these patients' functionality and quality of life. The main focus in oncological disease treatment has been tumour eradication and average life expectancy extension after diagnosis, neglecting these deleterious long-term effects. This study aims at assessing the prevalence and characteristics of chronic pain in cancer survivors as well as pain interference in their quality of life and functionality. The study selected cancer survivors (n = 85) after dismissal from oncology service to assess the presence and characteristics of chronic pain, their health-related quality of life (HRQoL) and pain-related disability through a combination of different questionnaires. Chronic pain prevalence was 23.5%. In total, 85% of patients reported neuropathic pain descriptors and 45% presented diagnostic criteria for neuropathic pain. Of these patients, 45% were followed-up for pain surveillance and 35% underwent analgesic medication. There was a median pain disability index of 20.50 (14.50-35.00) and an average HRQoL of 0.5338 in chronic pain patients and 0.8872 in patients without pain. We found that chronic pain was the main negative predictor of HRQoL and was associated with decreased functionality. This study also concluded that these patients often were not offered the appropriate long-term medical follow-up. These findings highlight a need to raise awareness among health professionals to the importance of timely diagnosis and treatment of pain and its impact on HRQoL and functionality of long-term cancer survivors as well as the need to change clinical practice in order to improve healthcare provided to these patients.


[How do working conditions of hospital personnel affect patients?].
This study was performed to investigate to which extent job satisfaction and psychosocial working environment could explain variations in patient satisfaction with treatment and care. Questionnaires were mailed to nursing staff and to patients in 17 in-patient treatment units within two Norwegian hospitals. 2408 patients (61 per cent) replied on detailed questions concerning satisfaction with care, and 488 employees (78 per cent) replied on detailed questions concerning job satisfaction and psychosocial working conditions. Associations between 77 factors related to job satisfaction and 14 domains of patient satisfaction were assessed by simple correlations and multiple regression procedures using patient, employee and treatment ward as unit of analysis. Job satisfaction concerning bureucracy/organization, information from superiors, level of knowledge among leadership, economic constraints, collaboration, backup, stress, autonomy, skill, in-service training and fighting spirit were all significantly associated with various domains of patient satisfaction (all p values < 0.05). The study strengthens the hypothesis that job satisfaction play an important role for patient care and satisfaction. Leadership, organisation and continuity seem crucial.


Appearance of morphological novelty in a hybrid zone between two species of land snail.
On the small oceanic island of Chichijima, two endemic species of land snails, Mandarina mandarina and M. chichijimana, have discrete distributions separated by a hybrid zone. This study investigates the potential of hybridization as a source of morphological novelty in these snails. Mandarina mandarina possesses a shell with a higher whorl expansion rate and a smaller protoconch than M. chichijimana, relative to shell size. The number of whorls and shell size of M. mandarina do not differ from those of M. chichijimana, because the effect of higher expansion rate on number of whorls and size of the former is compensated for by its smaller protoconch. The whorl expansion rate and protoconch diameter of the individuals from the hybrid populations are intermediate or typical of either of the two species, and their average values show clinal changes along the hybrid zone. However, the hybrid populations include exceptionally high shells with many whorls and flat shells with few whorls, which are never found in the pure populations of either species. In addition, gradual increases in variance in shell height and number of whorls were found from the edges to the center of the hybrid zone. A combination of low expansion rate (typical of M. chichijimana) and a small protoconch (typical of M. mandarina) produces a shell with an extremely large number of whorls because of the geometry of shell coiling. However, the combination of high expansion rate and a large protoconch produces a shell with an extremely small number of whorls. Because of the correlation between the number of whorls and shell height, shells with an exceptional number of whorls possess an extraordinarily high or flat spire. Hybrids can inherit a mosaic of characters that, as they play out during growth, lead to novel adult morphologies. These findings emphasize the importance of hybridization as a source of morphological variation and evolutionary novelty in land snails.


[Ectopic mediastinal parathyroid adenoma].
We experienced 3 surgical cases with ectopic mediastinal parathyroid adenoma. All patients checked elevated serum calcium levels and parathyroid hormone levels above normal range so we diagnosed their illness as primary hyperparathyroidism. Two had treated urinary tract lithiasis for long time, and the other had no symptoms by hypercalcemia. To determine the location of abnormal parathyroid glands, 99mTc-methoxy-isobutyl-isonitrile (MIBI) scintigraphy, chest computed tomography (CT) scan and/or magnetic resonance imaging (MRI) were done, then posterior and anterior mediastinal tumors were revealed. Especially MIBI scintigraphy was very useful as diagnostic procedure for small ectopic parathyroid adenoma. It's considered that large tumor in the posterior mediastinum like case 1 is originated from upper parathyroid gland, and small tumor in the anterior mediastinum like case 2, 3 is originated from lower parathyroid gland. Tumors were resected via small thoracotomy with thoracoscope, cervical incision and partial median sternotomy respectively. Serum calcium and parathyroid hormone levels were normalized immediately. If we can detect the accurate location of small ectopic parathyroid adenoma using some intraoperative method, the tumor is resected by less invasive procedure.


Inactivating mutation in histone deacetylase 3 stabilizes its active conformation.
Histone deacetylases (HDACs), together with histone acetyltransferases (HATs), regulate gene expression by modulating the acetylation level of chromatin. HDAC3 is implicated in many important cellular processes, particularly in cancer cell proliferation and metastasis, making inhibition of HDAC3 a promising epigenetic treatment for certain cancers. HDAC3 is activated upon complex formation with both inositol tetraphosphate (IP4) and the deacetylase-activating domain (DAD) of multi-protein nuclear receptor corepressor complexes. In previous studies, we have shown that binding of DAD and IP4 to HDAC3 significantly restricts its conformational space towards its stable ternary complex conformation, and suggest this to be the active conformation. Here, we report a single mutation of HDAC3 that is capable of mimicking the stabilizing effects of DAD and IP4, without the presence of either. This mutation, however, results in a total loss of deacetylase activity, prompting a closer evaluation of our understanding of the activation of HDAC3.


Taurine attenuates renal disease in chronic puromycin aminonucleoside nephropathy.
Repeated administration of low doses of puromycin aminonucleoside (PAMN) to rats induces a proteinuric renal disease that resembles focal segmental glomerulosclerosis (FSGS). Reactive oxygen molecules may be involved in the progressive course of this nephropathy. Therefore we evaluated whether taurine, an endogenous antioxidant, could limit the extent of renal injury. Sprague-Dawley rats received low-dose injections of PAMN, 2 mg/100 g body wt, over a 12-wk period. Two groups were studied: 1) controls given tap water (n = 23), and 2) an experimental group that drank 1% taurine-supplemented water (n = 22). Taurine-treated nephrotic rats had a reduction in albuminuria, as assessed by the urinary albumin-to-creatinine ratio (26 +/- 4 vs. 44 +/- 4, P less than 0.0001). After 12 wk, creatinine clearance was 0.33 +/- 0.03 (experimental) vs. 0.17 +/- 0.03 ml.min-1.100 g body wt-1 (control) (P less than 0.001), and inulin clearance (n = 6 pairs) was 0.26 +/- 0.04 (experimental) vs. 0.13 +/- 0.02 ml.min-1.100 g body wt-1 (control) (P less than 0.025). Administration of taurine reduced the percentage of segmentally sclerosed glomeruli (9.8 +/- 1.7 vs. 16.2 +/- 1.8%, P less than 0.02) and the tubulointerstitial injury score (1.36 +/- 0.19 vs. 2.61 +/- 0.25, P less than 0.0025) in experimental vs. control rats. Taurine treatment normalized the elevated renal cortical malondialdehyde level in rats with PAMN nephropathy (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)


Laryngeal inflammation mimicking laryngeal carcinoma.
A case of severe inflammation with an exuberant granulation lesion of the larynx that mimicked laryngeal tumour is presented. A patient who was a chronic smoker, with a history of hoarse voice underwent multiple endoscopies and biopsies, confirmed histopathologically as acute and, subsequently, as chronic inflammation. The tumour-like tissue in the larynx responded dramatically to prolonged antibiotic treatment. We emphasize the importance of histological confirmation before embarking on removal of an essential organ or part of the body which could lead to physical or emotional scarring.


Purification of L-alpha glycerylphosphorylcholine by column chromatography.
Colorless L-alpha glycerylphosphorylcholine (L-α-GPC) was obtained at 99.8% purity, 69.8% recovery, and with a specific rotation of -2.5° via a five-step procedure. L-α-GPC was first produced by phospholipase A(1) hydrolysis of soy lecithin powder. Ca(2+) and Cl(-) were then effectively removed using two successive 001×7 cation and D311 anion exchange resin column chromatography procedures. Silica gel column chromatography and decoloration with active carbon were then applied to remove remaining impurities and colorant. Characterization of the L-α-GPC product was well in agreement with the standard. The resin and silica gel showed remarkable ability for L-α-GPC isolation after 10 uses. Thus, this study presents a simple and cost-effective method for preparing L-α-GPC with high yield and purity, low cost, and environmental friendliness, and encourages future investigation into its adaptation for industrial applications.


Enzymatic antioxidant system and endothelial function in patients with metabolic syndrome.
This study examined the relationship between serum glutathione peroxidase 1 (GPx-1) activity and endothelial dysfunction in the subjects with and without metabolic syndrome (MetS). This case-control study was conducted on 76 subjects, 38 were patients with MetS and 38 were without MetS. The demographic, clinical, and laboratory features of the subjects were measured and then compared. The MetS was diagnosed according to the definitions of the National Cholesterol Education Program (NCEP) and International Diabetes Federation (IDF). Serum GPx-1 activity was measured by standard methods. Endothelial dysfunction was assessed with flow-mediated dilation (FMD) technique. In case-control study of 76 subjects, all of MetS risk factors including abdominal obesity, triglyceride (TG), low serum level of high-density lipoprotein cholesterol (HDL-C), hypertension (HTN), and fasting plasma glucose (FPG) were significantly higher than healthy individuals (P < 0.050). FMD was significantly lower than normal subjects (P < 0.050). Serum GP-1 activity was significantly lower in patients with MetS compared to normal subjects (21.7 ± 13.5 vs. 79.0 ± 38.6, respectively) (P = 0.001). The value of GPx-1 was significantly correlated with diastolic blood pressure (DBP) (r = -0.249, P = 0.040), C-reactive protein (CRP) (r = -0.409, P = 0.014), and FMD (r = 0.293, P = 0.050) in patients with MetS. The results of logistic regression showed that a unite increase in CRP (mg/dl), FMD (%), and endothelin-1 (ET-1) (pg/ml) and a unit decrease in GPx significantly increased the odds ratio (OR) of MetS; after adjusting for age and sex the results remained significant except for FMD (P < 0.050). Endothelial dysfunction is related to serum GPx-1 activity in patients with MetS. GPX-1 activity is associated with risk of cardiovascular diseases (CVDs) and peripheral vascular diseases (PVDs) in patients with MetS.


Indole-3-carbinol protects against pressure overload induced cardiac remodeling via activating AMPK-α.
Indole-3-carbinol (I3C), a monomer component extracted from leaves and stems of cruciferous vegetables, has inhibitory effects on tumors, obesity, and liver fibrosis, but its effects on the development of cardiac remodeling remain completely unknown. We determined the effects of I3C on cardiac remodeling and heart function using an aortic banding (AB) mouse model. Male 8- to10-wk-old wild-type and 5' adenosine monophosphate-activated protein kinase (AMPK)-α2 knockout mice fed with or without I3C were subjected to AB or a sham operation and were phenotyped, accordingly. I3C both prevented and reversed cardiac remodeling induced by AB, as assessed by heart weight/body weight, lung weight/body weight, and heart weight/tibia length ratios, echocardiographic and hemodynamic parameters, histological analysis, and gene expression of hypertrophic and fibrotic markers. The inhibitory effect of I3C on cardiac remodeling was mediated by AMPK-α and extracellular signal-regulated kinases 1/2 (ERK1/2) signaling. Moreover, AMPK-α2 gene deficiency completely blocked the inhibitory effects of I3C on cardiac remodeling, preventing the improvements in heart weight/body weight, lung weight/body weight, heart weight/tibia length, cardiac function, gene expression of hypertrophic and fibrotic markers, and phosphorylation of mammalian target of rapamycin and ERK1/2 signaling components. I3C both prevents and reverses cardiac remodeling by activating AMPK-α signaling. I3C is a potential therapeutic drug for heart failure.


Pharmacomechanical thrombolysis for phlegmasia cerulea dolens.
Phlegmasia cerulea dolens (PCD) is limb-threatening. Traditional treatments are very morbid. We examine the efficacy of percutaneous treatment of PCD. Between May 2005 and September 2008, we treated 21 limbs in 20 patients with lower extremity PCD who were candidates for thrombolysis. Diagnosis was by clinical examination and duplex ultrasound. Catheter access to the deep venous system was obtained through a popliteal vein. Therapy used pulse spray thrombolysis with tissue plasminogen activator (tPA). Infusion catheters and adjunctive percutaneous techniques were used as indicated. Postoperatively, patients were treated with systemic anticoagulation, compression hose, and interval follow-up. Limbs were graded according to the CEAP classification. Twenty patients (13 male) were treated with a mean age of 55.8 years. Nine patients had hypercoagulable states, four May Thurner syndrome, three a history of cancer, one postcolon resection, one acute myocardial infarction, and one postfemoral vein puncture. All patients had resolution of PCD without the need for open surgery. The initial tPA dose was 19.5 mg with pulse spray thrombolysis. Infusion catheters were required in 18 patients and used for 16.1 hours (range, 8 to 36 hours) until complete thrombolysis. Venous angioplasty was necessary in 14 patients with nine of these requiring venous stents. One patient required above-knee amputation despite successful treatment of her PCD. Mean follow-up was 10.7 months (range, 1 to 39 months). All patients demonstrated no or minimal residual thrombus and intact valvular function and a mean clinical CEAP score of 2.4. Percutaneous treatment of PCD produced excellent results with minimal morbidity.


Panic disorder: a review of DSM-IV panic disorder and proposals for DSM-V.
This review covers the literature since the publication of DSM-IV on the diagnostic criteria for panic attacks (PAs) and panic disorder (PD). Specific recommendations are made based on the evidence available. In particular, slight changes are proposed for the wording of the diagnostic criteria for PAs to ease the differentiation between panic and surrounding anxiety; simplification and clarification of the operationalization of types of PAs (expected vs. unexpected) is proposed; and consideration is given to the value of PAs as a specifier for all DSM diagnoses and to the cultural validity of certain symptom profiles. In addition, slight changes are proposed for the wording of the diagnostic criteria to increase clarity and parsimony of the criteria. Finally, based on the available evidence, no changes are proposed with regard to the developmental expression of PAs or PD. This review presents a number of options and preliminary recommendations to be considered for DSM-V.


The risks and benefits of human donor breast milk.
CME EDUCATIONAL OBJECTIVES: 1.Review the advantages and disadvantages of donor-banked milk over informal milk sharing.2.List disadvantages of proprietary infant formula for use as supplementation.3.Determine the primary ethical concerns when electing to use donor human milk versus propriety infant formula for supplementation. The benefits of breast-feeding, as well as the risks of some artificial formula, are well known. This growing recognition of the advantages of breast-feeding is reflected in the increased incidence of breast-feeding in recent years. However, one of the most common reasons for premature weaning is low milk supply, perceived or real, followed by nipple or breast pain. Given the increased awareness of the superiority of breast milk, however, more parents are turning to human donor milk to supplement their babies after they have been weaned.


[Electroglottography in patients operated for thyroid gland malignancies].
Electroglottography (EGG) was performed in 9 patients with vocal fold paresis (VFP) arisen after thyroid gland surgery performed for malignant tumours. Clinical symptoms, EGG waveforms and % Irregularity were analysed and correlation between dysphonia and % Irregularity computed. % Irregularity proved to be an effective measure of vocal fold dysfunction, significantly correlated with dysphonia.


A comparison of concept formation strategies in pattern recognition tasks.
We used two experiments to explore the effects of two kinds of strategies (nonanalytic and analytic) in concept formation. In Experiment 1, nonsense shapes were used as stimuli, which created ill-defined categories of concepts to be discovered by the subjects. In Experiment 2, highly recognizable geometrical patterns were used as stimuli, hereby placing an emphasis on the identification of highly salient categories of concepts. Subjects were better able to classify stimuli correctly in both experiments relying on memory (nonanalytic strategy) than on rule learning (analytic strategy). Here we discuss implications of nonanalytic strategy for understanding the nature of creativity.


Plasma 11-hydroxycorticosteroid and growth hormone levels in acute medical illnesses.
Adrenal cortical response in acute medical illness has been studied by measuring the plasma 11-hydroxycorticosteroid (11-OHCS) concentration in 178 patients. Those with unbalanced diabetes, acute infections, and severe myocardial infarction had high levels. The results obtained suggest that in a patient with a severe infection and hypotension a plasma 11-OHCS level of less than 15 mug./100 ml. indicates an inadequate adrenal cortical response, and one patient with septicaemia and temporary adrenal cortical insufficiency is described. Growth hormone levels were increased in patients with severe diabetic ketosis but not in those with hyperosmolar non-ketotic diabetic coma.


Transport of sugars and amino acids in the intestine: evidence for a common carrier.
D-Galactose, L-arginine, and their respective actively transported analogs are partially competitive inhibitors of the active transport of neutral amino acids in the small intestine of hamsters. Since the aforesaid classes of compounds are all transported by similar, sodium-ion-dependent mechanisms and elicit countertransport of each other, all may share a common, polyfunctional carrier in which a series of separate binding sites, namely, one each for sugars, neutral amino acids, basic amino acids, and Na(+) are joined together, as in a mosaic.


Selection within and across populations in livestock improvement.
Genetic evaluations within and across populations (countries, breeds, herds) allow ranking on estimated genetic merit and selecting breeding individuals across populations. Selection within and across populations (combined selection) should by definition always be as good as, or better than, within-population selection, the limiting case. The advantage depends on the sizes of the populations, the number of populations, the initial genetic means, and the correspondence of the breeding objectives in the different populations, as measured by the genetic correlation for economic merit. The advantages of combined selection are evaluated deterministically for a simple case of selecting the best males for use across populations by using a common truncation line over the distributions of EBV for the different populations. Combined selection increases overall response rates in the cooperating populations. Where the initial genetic means are the same, small populations (100 males tested) benefit greatly from combined selection. Large populations (500 to 1,000 males tested) also benefit, but less. The results depend on the increased selection response to scale, response being approximately linear with the logarithm of the number tested. When the initial means differ, the genetically poorer population can catch up in three to five generations and then contribute to the increased responses with combined selection. When breeding objectives differ, selection usually gradually pulls the populations apart and they make less and less contribution to each other and finally become separate. These results have implications for breeding strategies. Their application would affect structures of populations and rates of genetic change possible by selection.


Common cardiovascular problems in the young: Part II. Hypertension, hypercholesterolemia and preparticipation screening of athletes.
Blood pressure should be measured during health maintenance visits in all children three years of age and older. Cholesterol levels should be obtained in children with a family history of hypercholesterolemia or premature coronary artery disease and in children with other risk factors, such as hypertension, smoking or obesity. Preparticipation screening for sports participation should include a detailed questionnaire regarding the athlete's personal or family history of syncope, sudden death or arrhythmia, as well as measurement of blood pressure, auscultation of the heart and evaluation of upper and lower extremity pulses.


Incidence and Risk Factors of Deep Vein Thrombosis in Hospitalized COVID-19 Patients.
Deep vein thrombosis (DVT) is prevalent in patients with coronavirus disease 2019 (COVID-19). However, the risk factors and incidence rate of DVT remains elusive. Here, we aimed to assess the incidence rate and risk factors of DVT. All patients diagnosed with COVID-19 and performed venous ultrasound by ultrasound deparment between December 2019 and April 2020 in Wuhan Jin Yin-tan hospital were enrolled. Demographic information and clinical features were retrospectively collected. Notably, a comparison between the DVT and the non-DVT groups was explored. The incidence rate of venous thrombosis was 35.2% (50 patients out of 142). Moreover, the location of thrombus at the proximal extremity veins was 5.6% (n = 8), while at distal extremity veins was 35.2% (n = 50) of the patients. We also noted that patients with DVT exhibited a high level of D-dimer (OR 10.9 (95% CI, 3.3-36.0), P < 0.001), were admitted to the intensive care unit (OR 6.5 (95% CI, 2.1-20.3), P = 0.001), a lower usage of the anticoagulant drugs (OR 3.0 (95% CI, 1.1-7.8), P < 0.001). Finally, this study revealed that a high number of patients with COVID-19 developed DVT. This was observed particularly in critically ill patients with high D-dimer levels who required no anticoagulant medication.


Key thermally dimorphic fungal pathogens: shaping host immunity.
Exposure to fungal pathogens from the environment is inevitable and with the number of at-risk populations increasing, the prevalence of invasive fungal infection is on the rise. An interesting group of fungal organisms known as thermally dimorphic fungi predominantly infects immunocompromised individuals. These potential pathogens are intriguing in that they survive in the environment in one form, mycelial phase, but when entering the host, they are triggered by the change in temperature to switch to a new pathogenic form. Considering the growing prevalence of infection and the need for improved diagnostic and treatment approaches, studies identifying key components of fungal recognition and the innate immune response to these pathogens will significantly contribute to our understanding of disease progression. This review focuses on key endemic dimorphic fungal pathogens that significantly contribute to disease, including Histoplasma, Coccidioides and Talaromyces species. We briefly describe their prevalence, route of infection and clinical presentation. Importantly, we have reviewed the major fungal cell wall components of these dimorphic fungi, the host pattern recognition receptors responsible for recognition and important innate immune responses supporting adaptive immunity and fungal clearance or the failure thereof.


Improved Lanczos algorithms for blackbox MRS data quantitation.
Magnetic resonance spectroscopy (MRS) has been shown to be a potentially important medical diagnostic tool. The success of MRS depends on the quantitative data analysis, i.e., the interpretation of the signal in terms of relevant physical parameters, such as frequencies, decay constants, and amplitudes. A variety of time-domain algorithms to extract parameters have been developed. On the one hand, there are so-called blackbox methods. Minimal user interaction and limited incorporation of prior knowledge are inherent to this type of method. On the other hand, interactive methods exist that are iterative, require user involvement, and allow inclusion of prior knowledge. We focus on blackbox methods. The computationally most intensive part of these blackbox methods is the computation of the singular value decomposition (SVD) of a Hankel matrix. Our goal is to reduce the needed computational time without affecting the accuracy of the parameters of interest. To this end, algorithms based on the Lanczos method are suitable because the main computation at each step, a matrix-vector product, can be efficiently performed by means of the fast Fourier transform exploiting the structure of the involved matrix. We compare the performance in terms of accuracy and efficiency of four algorithms: the classical SVD algorithm based on the QR decomposition, the Lanczos algorithm, the Lanczos algorithm with partial reorthogonalization, and the implicitly restarted Lanczos algorithm. Extensive simulation studies show that the latter two algorithms perform best.


Short-term cryotherapy did not substantially reduce pain and had unclear effects on physical function and quality of life in people with knee osteoarthritis: a randomised trial.
Does short-term cryotherapy improve pain, function and quality of life in people with knee osteoarthritis (OA)? Randomised controlled trial with concealed allocation, blinded assessment of some outcomes, and intention-to-treat analysis. People living in the community with knee OA. The experimental group received cryotherapy, delivered as packs of crushed ice applied to the knee with mild compression. The control group received the same regimen but with sham packs filled with sand. The interventions were applied once a day for 4 consecutive days. Participants were assessed at baseline and on the day after the 4-day intervention period. The primary outcome was pain intensity according to a visual analogue scale. Secondary outcomes were baseline to post-intervention changes according to the Western Ontario and McMaster Universities Osteoarthritis, Knee injury and Osteoarthritis Outcome; Timed Up and Go test; and 30-Second Chair to Stand test. Sixty participants were randomised into the experimental group (n = 30) or the control group (n = 30). Twenty-nine participants from each group completed the trial. The mean between-group difference in change in pain severity was -0.8 cm (95% CI -1.6 to 0.1), where negative values favour the experimental group. This result did not reach the nominated smallest worthwhile effect of 1.75 cm. The secondary outcomes had less-precise estimates, with confidence intervals that spanned worthwhile, trivial and mildly harmful effects. Short-term cryotherapy was not superior to a sham intervention in terms of relieving pain or improving function and quality of life in people with knee OA. Although cryotherapy is considered to be a widely used resource in clinical practice, this study does not suggest that it has an important short-term effect, when compared with a sham control, as a non-pharmacological treatment for people with knee osteoarthritis. NCT02725047.


Anxiety and depression in maintenance dialysis patients: preliminary data of a cross-sectional study and brief literature review.
Anxiety and depression affect the quality of life of maintenance dialysis (MD) patients. There is little information concerning the extent to which the experience of individual hemodialysis treatments engenders anxiety in this patient population. This preliminary study examined the prevalence and severity of anxiety and depression in MD patients and the incidence of anxiety related to dialysis treatment. One hundred seventy patients, 155 undergoing maintenance hemodialysis and 15 undergoing chronic peritoneal dialysis, were examined. Inclusion criteria included dialysis vintage of at least 6 months. Patients completed the Beck Anxiety Inventory and Beck Depression Inventory and questionnaires that examined their feelings of anxiety related to individual hemodialysis sessions. Patients' mean age was 56 ± standard deviation of 16 years; dialysis vintage, 55 ± 48 months; 46% were female. The data confirmed a high prevalence of anxiety and depression in MD patients. Many MD patients become anxious, often severely, by merely going for routine hemodialysis treatment and also owing to such common events as being connected to the hemodialyzer by a new person or on hearing their hemodialyzer alarm sound. Anxiety and depression are common in MD patients. Many patients who are well established on MD experience anxiety during individual maintenance hemodialysis treatments.


Effect of actinomycin D on immune antibody, normal antibody, and complement.
Muschel, Louis H. (University of Minnesota, Minneapolis), Jean L. Jackson, and Karen Schmoker. Effect of actinomycin D on immune antibody, normal antibody, and complement. J. Bacteriol. 91:270-272. 1966.-The effect of actinomycin D on the immune response, when the antibiotic was administered to rabbits simultaneously with antigen, and its effect on naturally occurring levels of antibody and complement were determined. Those amounts of the antibiotic that effected a significant suppression of the immune response against deliberately injected antigens did not cause a decline in levels of naturally occurring antibody. Complement titers were also refractory to the antibiotic.


Dexamethasone and interleukin-1 potently synergize to stimulate the production of granulocyte colony-stimulating factor in differentiated THP-1 cells.
The human monocytic leukemic cell line, THP-1, which differentiates toward macrophages in response to phorbol 12-myristate 13-acetate (PMA) was investigated for its ability to produce granulocyte colony-stimulating factor (G-CSF). G-CSF protein was neither produced during PMA-induced differentiation nor in response to dexamethasone (Dex) alone. However, when combined, PMA and Dex synergistically stimulated THP-1 cells to produce G-CSF. The synergistic interaction between PMA and Dex on G-CSF production appeared to be mediated through the production of interleukin-1 (IL-1) since neutralization of IL-1 activity completely inhibited G-CSF production. Further experiments demonstrated that in THP-1 cells pretreated with PMA, Dex potently synergized with IL-1 to stimulate G-CSF production.


When do nurses refer patients to professional chaplains?
Nursing has historically realized the importance of spirituality in patient care, and more than other healthcare staff, they also have recognized the integral role of chaplains in meeting the spiritual needs of patients. The present study examines specific patient and family issues for which nurses make referrals to chaplains. A previously piloted questionnaire asking how often nurses and allied staff refer patients to chaplains was distributed to 133 staff members at a New York area hospital, the majority of whom were registered nurses (RNs). ANOVA revealed significant differences with respect to the kinds of issues that nurses are likely to refer to chaplains, with referrals being most likely for family issues and least likely for treatment-related issues. A significant interaction between staff type (nurses vs allied staff) and issues was also found. The results are discussed in relation to the nurses' desire to meet patients' spiritual needs and how this can be achieved.


Capillary C4d deposition in kidney allografts: a specific marker of alloantibody-dependent graft injury.
Capillary deposition of the complement split product C4d has been discussed as a marker for antibody-mediated kidney allograft rejection. The relationship between C4d staining and posttransplant alloantibody detection remains to be thoroughly investigated, however. In this study, C4d staining in peritubular capillaries (PTC) and the incidence of alloantibody formation, as detected with sensitive techniques, were evaluated among a cohort of transplant recipients who had undergone biopsies and had not been selected for a specific histologic diagnosis. One hundred thirteen biopsies, obtained from 58 cadaveric kidney transplant recipients, were tested. Serum samples obtained at the time of biopsy were evaluated by flow cytometric crossmatch (FCXM) testing and FlowPRA (One Lambda, Inc., Canoga Park, CA) analysis of anti-HLA panel reactivity. Most biopsies with C4d deposits in PTC (C4d(PTC)(+), n = 21 of 24) were associated with positive posttransplant FCXM results (T and/or B cell FCXM) and/or > or =5% FlowPRA (anti-HLA class I and/or II) reactivity. Approximately 50% of the C4d(PTC)(-) biopsies were observed to be associated with donor-specific alloantibodies. Accordingly, high specificity (93%) but low sensitivity (31%) were calculated for capillary C4d staining (with FCXM testing as the standard method). For clinical evaluation, three patient groups were defined, i.e., a group of recipients with positive C4d staining in at least one allograft biopsy (C4d(PTC)(+), n = 16) and two C4d(PTC)(-) groups, which were discriminated on the basis of posttransplant FCXM results as C4d(PTC)(-)/FCXM(+) (n = 22) and C4d(PTC)(-)/FCXM(-) (n = 20) groups. Univariate analyses revealed significant differences between these groups with respect to serum creatinine levels at 12 mo [median, 2.83 mg/dl (interquartile range, 1.93 to 4.2 mg/dl) versus 1.78 mg/dl (1.47 to 2.24 mg/dl) versus 1.59 mg/dl (1.2 to 1.71 mg/dl), P < 0.001]. Of the five immunologic graft losses, four occurred in the C4d(PTC)(+) group and one occurred in the C4d(PTC)(-)/FCXM(+) group. In a multivariate analysis, C4d positivity was observed to have an independent predictive value for inferior 12-mo graft function (P = 0.02), whereas the observed moderate difference between C4d(PTC)(-)/FCXM(+) and C4d(PTC)(-)/FCXM(-) recipients did not achieve significance. In conclusion, these data demonstrate that positive C4d staining, which is an independent predictor of kidney graft dysfunction, represents a reliable specific marker for antibody-dependent graft injury.


Clinical significance of antimonocyte antibody in kidney transplant recipients.
Monocytes appear to contain an antigen system very similar to the "cell-specific" antigen system previously identified on the vascular endothelial cell (VEC). By using a crossmatch technique with monocytes as the target cell, we tested for the presence of antibody to donor vascular endothelial cell antigens in kidney transplantation recipients, as well as performed mixed lymphocyte cultures, and T and B cytotoxicity testing. This technique detected clinically significant sensitization in some (living related) donor-recipient combinations not detected with standard T and B lymphocyte techniques. Patients with positive monocyte crossmatches but negative T or B lymphocyte crossmatches have a very high incidence of severe rejection and graft failure.


Effect of sonic and mechanical toothbrushes on subgingival microbial flora: a comparative in vivo scanning electron microscopy study of 8 subjects.
The purpose of this initial study was to evaluate the effects of both a sonic and a mechanical toothbrush versus the effects of no treatment on depth of subgingival penetration of epithelial and tooth-associated bacteria. Eight adult subjects exhibiting advanced chronic periodontitis with at least 3 single-rooted teeth that were in separate sextants with facial pockets > or = 4 mm and < or = 8 mm and that required extraction constituted the experimental sample. Teeth were either subjected to 15 seconds of brushing with a mechanical toothbrush or a sonic toothbrush or left untreated. The test tooth and the associated soft tissue wall of the periodontal pocket were removed as a single unit. Samples were processed and coded for blind examination by scanning electron microscopy. Distributional and morphologic characteristics of dominant bacteria with specific emphasis on spirochetes were evaluated for both epithelial- and tooth-associated plaque. No differences were found in morphotypes or distributional and aggregational characteristics of epithelial-associated microbes in the 1- to 3-mm subgingival zone between the mechanical and sonic toothbrush-treated groups and the control group. Both toothbrush groups featured disruption of microbes that extended up to 1 mm subgingivally. Root surfaces on the sonic-treated samples appeared plaque-free at low magnification; however, at 4,700x, a thin layer of mixed morphotypes and intact spirochetes was found subgingivally and slightly subgingivally. In comparison, mechanical brush samples featured incompletely removed plaque, both subgingivally and subgingivally, with intact spirochetes present on subgingival root surfaces. Results suggest similar effects for both sonic and mechanical toothbrushes on epithelial- and tooth-associated bacterial plaque in periodontal pockets and adjacent root surfaces that extend up to 1 mm subgingivally. Further, the presence of intact subgingival spirochetes suggests limited exposure to acoustical or mechanical energy from the toothbrushes evaluated.


Experience-based design, co-design and experience-based co-design in palliative and end-of-life care.
Experience-based design, co-design, and experience-based co-design can be used within healthcare to design services that improve the patient, carer and staff experience of the services. As palliative and end-of-life care centrally value person-centred care, we believe that service designers, commissioners and those tasked with making quality improvements will be interested in this growing field. This paper outlines these approaches-with a particular emphasis on experience-based co-design-and describes how they are and can be used within palliative and end-of-life care. Based on a rapid review and several case studies, this article highlights the key lessons learnt from previous projects using these approaches and discusses areas for improvement in current reporting of service design projects.


The influence of female education, labour force participation and age at marriage on fertility behaviour in Bangladesh.
"The purpose of this paper was to study the relationship between certain aspects of the status of women (i.e., education, work experience and age at marriage) and the use of contraception and fertility, using data collected by the Bangladesh Fertility Survey (BFS) of 1975...." The analysis is presented separately for rural and urban areas. "Results of the tests in brief are as follows: (a) Education is found to be strongly correlated with the use of contraception within each sub-group of the study population.... Education is positively related with use of contraception and negatively with fertility....(b) age at marriage is found to be the most important factor explaining fertility for every sub-group of the study population. Couples marrying at higher ages are likely to have fewer children....and (c) work experience has very little or no effect on current use of contraception and fertility...."


Altruistic moral judgment among older adults.
This study investigated altruistic moral judgment among the elderly, and examined its relationships to demographic and personality variables, self-reported helping, and subjective social integration (the perception that one is integrated into one's social milieu). The moral judgment interview included three stories, each of which contained a moral dilemma. Participants solved each dilemma and gave reasons for their solutions. The moral dilemmas and scoring system emphasized the positive, prosocial aspects of morality, rather than a prohibition-oriented approach. The categories used most often were, in descending order of frequency 1) pragmatic needs-of-others oriented reasons, 2) empathy-based reasons, 3) reasons based on internalized and/or abstract moral principles, and 4) hedonistic reasons. Of the higher levels of moral judgment, only reasoning based on abstract internalized principles had significant positive relationships with self-reported helping, the personality correlates of helping, and with subjective social integration into one's social milieu.


Results of low-dose methotrexate treatment of persistent gestational trophoblastic disease in Sheffield 1980-1987.
Between January 1980 and October 1987, 115 evaluable patients were treated in Sheffield for persistent gestational trophoblastic disease (GTD) with a low dose methotrexate regimen (LD-MTX). Each course comprised MTX 50 mg given by i.m. injection for 4 doses on alternate days. Courses were repeated every 2 weeks and serum beta-hCG was used to monitor response. Overall, 80/115 (70%) of patients attained durable complete remissions (CR). Twenty-nine patients received the 'AVC' salvage combination of actinomycin-D 0.5 mg i.v. for 5 days, sequenced with cyclophosphamide 500 mg i.v. and vincristine 1 mg i.v., both given for 3 doses on alternate days. Sixteen (55%) patients attained a durable CR but 11 (38%) required further measures, 7 ultimately requiring hysterectomy. Two (7%) died during treatment. With 4 deaths overall (3 from metastatic GTD and 1 from infarction of the bowel), actuarial survival is 94% at over 7.5 years. A new Charing Cross prognostic scale weighted especially for hCG levels, number and sites of metastases, interval between pregnancy and start of treatment (score 0-6 each factor), was applied retrospectively to obtain a total score for each patient. Thus, 21/26 (81%) patients who scored greater than 8, required additional treatment after LD-MTX, compared with 18/89 (20%) of lower scoring patients (p less than 0.001). Because of the frequent morbidity associated with prolonged chemotherapy as well as the development of drug-resistant GTD, it is concluded that the 'high-risk' patients should receive more intensive combination chemotherapy at the outset.


Sheng-Di-Da-Huang Decoction Inhibited Inflammation Expressed in Microglia after Intracerebral Hemorrhage in Rats.
Sheng-Di-Da-Huang Decoction was used as an effective hemostatic agent in ancient China. However, its therapeutic mechanism is still not clear. Inflammatory injury plays a critical role in ICH-induced secondary brain injury. After hemolysis, hematoma components are released, inducing microglial activation via TLR4, which initiates the activation of transcription factors (such as NF-κB) to regulate expression of proinflammatory cytokine genes. This study aimed to verify the anti-inflammatory effects of Sheng-Di-Da-Huang Decoction on ICH rats. Intracerebral hemorrhage was induced by injection of bacterial collagenase (0.2 U) in rats. Neurological deficits, brain water content, Evans blue extravasation, expression of TLR4, NF-κB, Iba-1 positive cells (activated microglia), tumor necrosis factor-α (TNF-α), and interleukin-1β (IL-1β) were examined 1, 3, 7, and 14 days after collagenase injection. MR images were also studied. Sheng-Di-Da-Huang Decoction remarkably improved neurological function, reduced brain water content as well as Evans blue extravasation, downregulated expression of TLR4, NF-κB, TNF-α, and IL-1β, and inhibited microglial activation. Sheng-Di-Da-Huang Decoction reduced inflammation reaction after ICH through inhibited inflammation expressed in microglia.


Stable integration of large PAC constructs in keratinocytes.
Transfer of P1-derived artificial chromosome (PAC) deoxyribonucleic acid (DNA) into keratinocytes is an extremely important technique that enables functional studies of keratinocyte-specific genes to be performed and genomic gene therapy for inherited and acquired diseases to be attempted. Ex vivo gene therapy approaches are possible using well-established conditions for keratinocyte culture and grafting, whilst the skin is the most accessible organ for administering in vivo therapy. PAC vectors lack relevant reporter genes to distinguish transfected mammalian cells from the non-transfected background, or to select clones in which the PAC construct has stably integrated into the genome. In this chapter, protocols to retrofit a reporter gene cassette will be described, together with techniques for transfecting large PAC constructs into keratinocytes without breakage. Protocols to select for stable integrants and to assess the integration event(s) within the keratinocyte genome will also be provided.


Phytosanitary irradiation treatment of the aerial root mealybug, Pseudococcus baliteus (Hemiptera: Pseudococcidae).
The aerial root mealybug, Pseudococcus baliteus Lit (Hemiptera: Pseudococcidae), is an important invasive and quarantine pest that poses a potential threat to fruits, vegetables, and ornamental plants. As a result, phytosanitary treatments are necessary to ensure the commodities of international trade are free from these pests. To determine the minimum absorbed dose required for phytosanitary irradiation (PI) application, irradiation dose-response and large-scale confirmatory tests were conducted. Eggs that were 2, 4, and 6 days old and late gravid females (containing 0-day-old eggs) of P. baliteus were X-ray irradiated with doses of 10, 20, 40, 60, 80, 100, and 120 Gray (Gy). The efficacy of preventing egg-hatching (mortality) was compared using two-way ANOVA, 95% confidence interval overlapping and lethal dose ratio test in probit analysis. The radiotolerance sequence of mealybugs egg was found to be 0 < 2 ≈ 4 < 6-day-old eggs, and their estimated LD99.9968 values with 95% confidence interval were 132.0 (118.9-149.5), 137.6 (125.2-153.7), 145.5 (134.5-159.1), and 157.4 (144.6-173.6) Gy, respectively. Subsequently, target doses of 135 and 145 Gy were used in the confirmatory gamma radiation treatments. No F1 generation neonates developed from a total of 47,316 late females irradiated at the measured dose of 107.7-182.5 Gy, resulting in the treatment efficiency of 99.9937% at the 95% confidence level. Therefore, the highest dose of 183 Gy measured in the confirmatory tests is recommended as the minimum absorbed dose in PI treatment of P. baliteus for establishing national and international standards.


Multivariate growth trajectories of parenting practices in adolescence predicting young adult relationships with parents.
Guided by the life course perspective, this study investigated the developmental antecedents of contact, closeness/warmth, and negativity in young adults' relationships with their parents. Taking the developmental systems approach, we considered interindividual differences in not only initial levels of parenting quality in early adolescence (Grade 6) but also developmental changes in parenting quality across adolescence (Grades 6-12) as predictors of young adult-parent relationship quality. Data were from a large sample of young adults (N = 1,631; Mage = 22.84; 57% female; 90% White; 25% received free/reduced-price school lunch in Grade 6) followed from the fall of Grades 6 to 12 at eight time points, plus a young adult assessment. Using multivariate latent growth curve modeling, we identified a nuanced pattern of predictors of the three relationship dimensions. Higher initial levels of and lower rates of decline in parental involvement across adolescence predicted more young adult contact with mothers and fathers. Higher initial levels of parental warmth and parental involvement, as well as lower rates of decline in parental warmth, predicted greater closeness/warmth with mothers and fathers in young adulthood. Higher initial levels of and lower rates of decline in effective discipline predicted less young adult negativity toward mothers and fathers. These results held even when accounting for important adolescent and young adult covariates (adolescent sex and race, adolescent family income and structure, adolescent aggressive behavior tendencies, young adult living arrangement). The study offers new insights into how parenting practices in adolescence contribute to parent-child relationship in young adulthood. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


[Effects of hypertonic sodium chloride hydroxyethyl starch 40 on brain histopathology in rats with whole body hyperthermia].
To investigate the effects of hypertonic sodium chloride hydroxyethyl starch 40 (HSH) on brain edema and morphological changes during whole body hyperthermia (WBH) in rats. Sixty adult male SD rats were randomized into control group, WBH group without fluid infusion (group HT), WBH group with Ringer's infusion (group RL), WBH group with HAES + Ringer's infusion (group HRL) and WBH group with HSH infusion (group HSH). WBH was induced by exposure to 36 degrees celsius; for 3 h to achieve a rectal temperature of 41-42 degrees celsius;, and the corresponding fluids were administered intravenously within 30 min at the beginning of WBH. The control rats were housed at a controlled room temperature (22∓1) degrees celsius; for 4 h. After cooling at room temperature for 1 h, the rats were sacrificed and brain water content and morphological changes were evaluated. Compared with the control group, all the WBH groups had significantly increased brain water content (P<0.05 or 0.01), but group HSH showed a significantly lower brain water content than group HT (P<0.05). The rats in groups HT, RL and HRL showed serious to moderate structural changes of the brain tissue and nerve cells, but HSH group had only mild pathologies. HSH can reduce brain edema and ameliorate the damages to brain cells in rats exposed to WBH.


Bioinformatic analysis of Helicobacter pylori XGPRTase: a potential therapeutic target.
Xanthine-guanine phosphoribosyltransferase (XGPRTase) is an enzyme of purine nucleotide salvage synthesis. The gpt gene of Helicobacter pylori has been annotated as encoding an XGPRTase and proposed as essential for survival of the bacterium in vitro. The aims of this work were to investigate the structure of H. pylori XGPRTase and to compare the key features of the enzyme to other phosphoribosyltransferases employing computational, modelling, and bioinformatic tools. XGPRTase activity was measured in the cytosolic fraction of H. pylori by (31)P-nuclear magnetic resonance spectroscopy, and also in recombinant XGPRTase produced by a cell-free expression system. Bioinformatics was employed to analyze the phylogeny of XGPRTase, and a structural model of the XGPRTase was built using threading techniques. The observed interactions of purine phosphoribosyltransferases with immucillin-GP were used to study the theoretical interactions of H. pylori XGPRTase with this transition-state analog. It was demonstrated that the gpt gene of H. pylori encodes a functional XGPRTase enzyme. Analyses of the XGPRTase sequence showed that the enzyme is significantly divergent from equivalent mammalian enzymes. Modelling served to identify specific features of the enzyme and key residues involved in catalysis. The H. pylori XGPRTase is structurally similar to other phosphoribosyltransferase enzymes, but there were significant differences between the hood domain of H. pylori XGPRTase and other purine salvage phosphoribosyltransferases. Significant differences were found between the interactions of the H. pylori and human enzymes with a purine phosphoribosyltransferase inhibitor.


[Direct determination of ABO and cisAB blood group genotypes using polymerase chain reaction amplification of specific alleles (PASA)--method].
The genotypes of genomic DNAs of 20 normal subjects with ABO blood group and 12 subjects with cisAB blood group were directly determined using polymerase chain reaction (PCR) amplification of specific alleles (PASA)-method. This method is based on the fact that PCR amplification occurs only when the 3' endbase of the primer is matched to the nucleotide of No. 261, 526, 796 or 803 of ABO allelic cDNA. And three of five regions of allelic DNAs are co-amplified in a single PCR (multiplex-PCR) in this study. ABO and cisAB blood group genotypes are directly determined, based on the molecular size of allele specific amplification products that contain 261, 526, 796 and 803 nucleotide (the sites of amino acid substitutions). The method requires only about 4 hours from starting up of PCR to the results, so it is rapid, simple and useful for detecting the genotype of ABO and cisAB blood groups.


Producing experimental lesions of cutaneous candidiasis.
Dermatophyte parasitism in normal patients, and even in most immunodeficient patients, is strictly limited to the stratum corneum. The dermatophyte fungi do not readily invade deeper body tissues. Cutaneous candidiasis, however, seems to be strictly an opportunistic infection of ecologically suitable skin by a yeast that is normally present in the gastrointestinal tract and mucosal surfaces of many healthy persons.


Abdominal Adiposity Distribution Quantified by Ultrasound Imaging and Incident Hypertension in a General Population.
Abdominal obesity is a major risk factor for hypertension. However, different distributions of abdominal adipose tissue may affect hypertension risk differently. The main purpose of this study was to explore the association of subcutaneous abdominal adipose tissue (SAT) and visceral adipose tissue (VAT) with incident hypertension in a population-based setting. We hypothesized that VAT, rather than SAT, would be associated with incident hypertension. VAT and SAT were determined by ultrasound imagining in 3363 randomly selected Danes (mean age 49 years, 56% women, mean body mass index 25.8 kg/m2). We constructed multiple logistic regression models to compute standardized odds ratios with 95% confidence intervals per SD increase in SAT and VAT. Of the 2119 normotensive participants at baseline, 1432, with mean SAT of 2.8 cm and mean VAT of 5.7 cm, returned 5 years later for a follow-up examination and among them 203 had developed hypertension. In models including both VAT and SAT, the Framingham Hypertension Risk Score variables (age, sex, smoking status, family history of hypertension, and baseline blood pressure) and glycated hemoglobin, odds ratio (95% confidence interval) for incident hypertension for 1 SD increase in VAT and SAT was 1.27 (1.08-1.50, P=0.004) and 0.97 (0.81-1.15, P=0.70), respectively. Adjusting for body mass index instead of SAT attenuated the association between VAT and incident hypertension, but it was still significant (odds ratio, 1.22 [1.01-1.48, P=0.041] for each SD increase in VAT). In conclusion, ultrasound-determined VAT, but not SAT, was associated with incident hypertension in a random sample of Danish adults.


The organization and expression of the yeast retrotransposon, Ty.
The genome of the yeast Saccharomyces cerevisiae contains several copies of a mobile genetic element, Ty, which is representative of a group of eukaryotic transposable elements, retrotransposons. The organization and expression of Ty have several features in common with retroviral proviruses but they also show some important differences.


Is endoscopic ultrasonography still the modality of choice in preoperative staging of gastric cancer?
The treatment option for gastric cancer is usually based on preoperative staging by imaging modalities. Endoscopic ultrasonography (EUS) and computed tomography (CT) have been used as the diagnostic modality of choice in preoperative staging of gastric cancer. Magnetic resonance imaging (MRI) has been employed in several studies, and ((18)F) 2-Fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) has emerged as a new promising imaging modality. The purpose of this article is to provide summarized information on preoperative staging using EUS, multi-detector row CT (MDCT), MRI and PET for gastric cancer. In T staging, both EUS and MDCT show high accuracy. MRI seemed to have better performance, but the number of MRI studies is limited. FDG-PET is not able to properly evaluate the depth of invasion. In N staging, the diagnostic accuracy of EUS, MDCT and MRI is not sufficient. In preoperative M staging, MDCT and FDG-PET showed similar diagnostic accuracies. FDG-PET/CT fusion could be expected to show better performance in the future. Physicians should keep in mind that each diagnostic modality has advantages and limitations and choose an appropriate diagnostic strategy tailored for each patient.


A 47-Year-Old Woman with Immunoglobulin G4 (IgG4)-Related Disease Involving the Right Ovary.
BACKGROUND Immunoglobulin G4 (IgG4)-related disease is immune-mediated and was first proposed as a defined entity after studies on patients with autoimmune pancreatitis. Since then, it has been reported in many organs. Involvement of the ovaries is rare, and to our knowledge, only 2 cases have been reported in the literature. IgG4-related disease is associated with increased serum IgG4 levels. Organ involvement includes a lymphoplasmacytic infiltrate, fibrosis, and obliterative phlebitis, with immunohistochemistry showing IgG4-positive plasma cells. This report is of a case of IgG4-related disease involving the right ovary. CASE REPORT A 47-year-old woman presented with a right ovarian cyst. An ultrasound scan revealed a complex right ovarian cyst with multiple septations. The hormonal profile and tumor markers were unremarkable. Gross examination showed fragments of cyst wall. Histologic examination revealed a follicular cyst, surrounded by a dense lymphoplasmacytic infiltrate rich in eosinophils, partially obliterative phlebitis, and fibrosis. Immunohistochemically, IgG marked most of the plasma cells, of which 70% expressed IgG4, with a count >50 cells per high-power field. Subsequent testing of serum IgG4 showed that the level was elevated (330 mg/dL). A diagnosis of IgG4-related disease was made. CONCLUSIONS Ovarian involvement by IgG4-related disease is rarely described in the literature. Our patient is likely to be the third case. We believe that cumulative findings from our case along with the 2 already reported cases increase awareness and may establish a framework for building more objective criteria to define this entity in the ovaries, similar to what has been achieved in some other organs.


Repetitive transcranial magnetic stimulation for pain after spinal cord injury: a systematic review and meta-analysis.
The evidence regarding efficiency of repetitive transcranial magnetic stimulation (rTMS) on relief of neuropathic pain (NP) in patients with prior spinal cord injury (SCI) is controversial. The current meta-analysis aimed to assess the efficacy of rTMS in pain relieve in patients suffering from SCI associated NP. Medline, PubMed, Cochrane Database, EMBASE, Google Scholar databases were searched for clinical studies on effects of rTMS treatment on NP caused by prior SCI published before March 14th, 2016 with various combinations of following key words: "transcranial magnetic stimulation," "spinal injury," "pain." Standardized difference in means with 95% confidence interval was calculated for the change of pain scores after rTMS or sham rTMS treatments. A total of two randomized controlled studies (RCTs) and 4 crossover RCTs were included in the present meta-analysis. The RCTs recruited a total of 27 patients. The crossover RCTs recruited a total of 100 patients. The combined standardized difference in means indicated that patients who received rTMS intervention had better pain relief than those who received sham rTMS intervention, however, the results did not reach statistical significance (standardized mean difference -0.607, 95% CI: -1.29 to 0.075, P=0.081). rTMS might reduce SCI associated neuropathic pain; however, further studies are required to support our conclusions.


Delving into faults and earthquake behavior.
Seismologists attending last month's meeting of the American Geophysical Union in San Francisco heard much about how the irregularities on faults control their behavior and thus the generation of earthquakes. The identification of small crucial areas of a fault, such as the strong spot where a rupture can begin or the fault jog where it can end, is proving a challenge, but it also offers one of the best hopes of understanding and predicting fault behavior.


Nucleus caudalis DREZ lesions for facial pain.
The records of the first 18 patients with intractable facial pain treated with nucleus caudalis dorsal root entry zone lesions were reviewed. The pain etiology varied but the largest group was that of post-herpetic neuralgia. Within the immediate postoperative period 90% of patients had satisfactory pain relief in comparison to 58% on subsequent follow-up. Seventy-one percent of those with post-herpetic neuralgia had satisfactory relief on subsequent follow-up. Favorable results tended to correlate with a lesser preoperative sensory deficit, pain restricted to trigeminal distributions and pain of a burning or lancinating/penetrating quality.


Biochemical characterization of the alpha-amylase inhibitor in mungbeans and its application in inhibiting the growth of Callosobruchus maculatus.
The insect Callosobruchus maculatus causes considerable damage to harvested mungbean seeds every year, which leads to commercial losses. However, recent studies have revealed that mungbean seeds contain alpha-amylase inhibitors that can inhibit the protein C. maculatus, preventing growth and development of the insect larvae in the seed, thus preventing further damage. For this reason, the use of alpha-amylase inhibitors to interfere with the pest's digestion process has become an interesting alternative biocontrolling agent. In this study, we have isolated and purified the alpha-amylase inhibitor from mungbean seeds (KPS1) using ammonium sulfate precipitation, gel filtration chromatography and reversed phase HPLC. We found that the alpha-amylase inhibitor, isolated as a monomer, had a molecular weight of 27 kDa. The alpha-amylase inhibitor was purified 750-fold with a final yield of 0.4 mg of protein per 30 g of mungbean seeds. Its specific activity was determined at 14.5 U (mg of protein)(-1). Interestingly, we found that the isolated alpha-amylase inhibitor inhibits C. maculatus alpha-amylase but not human salivary alpha-amylase. After preincubation of the enzyme with the inhibitor, the mungbean alpha-amylase inhibitor inhibited C. maculatus alpha-amylase activity by decreasing V(max) while increasing the K(m) constant, indicating that the mungbean alpha-amylase is a mix noncompetitive inhibitor. The in vivo effect of alpha-amylase inhibitor on the mortality of C. maculatus shows that the alpha-amylase inhibitor acts on C. maculatus during the development stage, by reducing carbohydrate digestion necessary for growth and development, rather than during the end laying/hatching stage. Our results suggest that mungbean alpha-amylase inhibitor could be a useful future biocontrolling agent.


Flow and volume dependence of respiratory system mechanics during constant flow ventilation in normal subjects and in adult respiratory distress syndrome.
Seven control subjects and seven patients with adult respiratory distress syndrome (ARDS) were artificially ventilated and flow, volume, and tracheal pressure were monitored. Respiratory system resistance (Rrs,max) was partitioned into its homogeneous (Rrs,min) and uneven (Rrs,u) components. Respiratory system elastance (Ers) was also measured. In both groups Ers did not vary with different inspiratory flows and volumes, but was significantly higher in ARDS. With increasing volume (isoflow maneuvers), Rrs,max and Rrs,u increased but Rrs,min remained unaltered in ARDS. In control patients, however, resistances did not vary but Rrs,max and Rrs,u were smaller and Rrs,min equaled their corresponding values in ARDS. Hence, stress relaxation seems to be increased in ARDS. During isovolume maneuvers Rrs,max and Rrs,u decreased with increasing flows (both groups), although they were significantly higher in ARDS. Rrs,min was not modified by different flows and was similar in both groups. Thus, pendelluft is also increased in ARDS. In conclusion, the mechanical profile of ARDS is characterized by increased Ers and Rrs,max, the latter being secondary to augmented mechanical unevenness within the system.


Microcirculation After Trochanteric Femur Fractures: A Prospective Cohort Study Using Non-invasive Laser-Doppler Spectrophotometry.
Proximal femur fractures represent a major healthcare problem in the aging society. High rates of post-operative infections are linked to risk factors that seem to affect local microcirculation. Patterns and time courses of alterations in microcirculation have, however, not been previously investigated. The aim of this prospective cohort study was to evaluate perioperative changes in microcirculation after trochanteric femur fractures using non-invasive laser-Doppler spectrophotometry to analyze how oxygen saturation (SO2), hemoglobin content (Hb) and blood flow changed before and after surgery, and how these parameters were altered by implant type, gender, smoking, diabetes and age. Measurements were separately recorded for nine locations around the greater trochanter in 2, 8, and 15 mm depths, before surgery and 8, 24, 48 h, 4, 7, and 12 days after surgery in 48 patients. Three implants were compared: Dynamic Hip Screw, Gamma3 Nail, and Percutaneous Compression Plate. Surgery resulted in significant differences between the healthy and injured leg in SO2, Hb and flow. Each parameter showed comparable values for both legs prior to surgery. Significantly higher values in SO2 and flow were registered in women compared to men before and after surgery. Smoking caused significant increases in SO2, Hb, and flow only in the superficial layer of the skin after surgery. Diabetes decreased blood flow at 2 and 8 mm depth and increased SO2 at 8 and 15 mm depth after surgery. Age revealed a significant negative correlation with flow. The ability to increase the flow rate after surgery decreased with age. Comparison of implants indicated the minimally invasive implant PCCP altered microcirculation less than the DHS or the Gamma3 nail. Overall, the proximal femur fracture alone did not alter local skin microcirculation significantly in a way comparable to the effect caused by surgery. In conclusion, microcirculation after proximal femur fractures is highly affected by surgery, gender, smoking, diabetes, age and implant in ways specified in this study.


Beneficial influence of matching for D/DR antigens and treatment with cyclosporin-A on kidney graft survival in transfused rhesus monkeys.
The influence of matching for D/DR antigens and treatment with Cyclosporin-A (Cy-A) was investigated in rhesus monkeys given pretransplant blood transfusions. It was observed that the combination of D/DR matching and transfusions led to a higher percentage of animals with prolonged graft survival as well as a better kidney function in the early post-transplant period than was achieved with transfusions alone. Regarding the possible interference of Cy-A with the beneficial blood transfusion effect, it was found that transfused animals given Cy-A had survival times which were as good as those of transfused recipients without Cy-A or, sometimes, even slightly better.


The effects of accumulated experience on radiofrequency ablation of accessory pathways.
Increasing experience in radiofrequency ablation for accessory pathways appears to reduce the procedure time, radiation time and radiofrequency pulse number, and results in a higher success rate. However, the effect of a learning curve on this procedure from the perspective of location and conduction direction of accessory pathways has not been reported before. The purpose of this study was to determine the effect of accumulated experience on the outcomes of radiofrequency ablation for accessory pathways and on the duration of the procedure parameters by analyzing the results of a dedicated ablation team. The first 512 patients with a single accessory pathway treated in this laboratory were included for analysis of the procedure parameters with respect to locations and conduction directions of accessory pathways. The results showed that the average procedure time, radiation time, and radiofrequency pulse number differed significantly among the different subgroups (left free wall, right free wall, posteroseptal and anteromidseptal location; manifest or concealed conduction). All subgroups except the anteromidseptal pathways showed a significant improvement of the procedure parameters with increased ablation experience. Although the initial rate of improvement was similar among the different subgroups, the rate of improvement in left free wall pathways nearly reached a plateau after 120 ablation procedures. Thus it was concluded that a certain number of ablation procedures was necessary before achievement of a high success rate with shorter procedure and radiation times and a lower radiofrequency pulse number.


Retinal inner nuclear layer microcystic changes in optic nerve atrophy: a novel spectral-domain OCT finding.
Optic atrophy constitutes the final stage in the evolution of optic neuropathy. The aim of this study was to describe the presence of macular microcystic changes or pseudocysts in patients with advanced optic atrophy. The medical records of 24 patients who had retinal pseudocysts in association with optic atrophy have been analyzed. All patients underwent a complete neuro-ophthalmologic assessment; peripapillary retinal nerve fiber layer thickness and macular screening with spectral-domain optical coherence tomography and optical coherence tomography "en face" imaging analysis were also performed. A total of 36 eyes were included in the study. Patients' mean age was 37 years. The major cause of optic atrophy was glaucoma (12 cases). The retinal pseudocysts were observed as hyporeflective lesions in the internal nuclear layer. Infrared images revealed a hyporeflective circular or semilunar shape corresponding to the location of the pseudocysts in all cases. In eyes with pseudocysts, mean thickness of the peripapillary retinal nerve fiber layer was statistically significantly less than that of fellow eyes (P = 0.0003), whereas macular thickness was statistically significantly higher compared with fellow eyes (P < 0.005). The presence of pseudocystic lesions always associated with severe optic nerve fiber loss is reported. The reason why pseudocystic lesions develop within the retina is not well understood. They might constitute the translation of degeneration of Muller cells in severe optic nerve fiber loss. Recognizing these pseudocysts is crucial because they may be confused with cystoid macular edema. Their prognostic value and role in the therapeutic process need to be further evaluated with prospective studies and molecular experiments in vivo.


Ability of Lactobacillus plantarum LS/07 to modify intestinal enzymes activity in chronic diseases prevention.
The ability of probiotic strain Lactobacillus plantarum LS/07 to modify the activity of intestinal bacterial enzymes - β-glucuronidase (β-GLUCUR), β-galactosidase (β-GAL), and β-glucosidase (β-GLU) in prevention of chronic diseases - cancer, atherosclerosis and dysbiosis was investigated. The male Sprague-Dawley rats were randomly divided into 12 experimental groups: controls groups - C (control), AT (atherosclerotic), CC (carcinogenic), dysbiotic groups - each group in combination with antibiotics (ATB), probiotics groups - in combinatioan with probiotic (PRO) alone, and each group with combination of antibiotic and probiotic (ATB+PRO). In the control group the β-glucuronidase activity did not change throughout the experiment. High fat diet in atherosclerotic group significantly increased the activity of β-glucuronidase (P<0.001) and β-glucosidase (P<0.01). Azoxymethane application in carcinogenic group significantly increased β-glucuronidase (P<0.01), but reduced β-glucosidase (P<0.01) activity. Daily application of probiotics alone and in combination with antibiotic increased β-galactosidase, of β-glucosidase, and decreased β-glucuronidase activity. In control antibiotic group we observed significant increase in β-glucuronidase (P<0.05) and decreased β-glucosidase (P<0.01) activity which can be caused by the change of microflora in favor of coliform bacteria. These findings indicate the positive effects of probiotic Lactobacillus plantarum LS/07 and suggest its use in disease prevention in human medicine and some animal species.


Hyaline-vascular castleman disease: a rare cause of solitary subcutaneous soft tissue mass.
Castleman disease (CD) is a rare lymphoproliferative disorder that primarily affects mediastinal, retroperitoneal, and cervical lymph nodes. Clinically, these lesions occur as a localized (unicentric) or less frequently as a systemic (multicentric) disease. Two main distinct histologic variants are recognized, the more common hyaline-vascular (HV) type and the plasma cell (PC) type. Extranodal Castleman disease, HV type (HVCD) is even less common. We describe a case of subcutaneous HVCD in a 57-year-old woman with a palpable chest mass and without systemic symptoms. Although the histologic findings are similar to those of HVCD in lymph nodes and other sites, a plethora of differential diagnosis is raised particularly with the more commonly occurring lymphoproliferative lesions in this location. This is one of the few bona fide cases of HVCD in subcutaneous location published to date. A review of the literature with an emphasis on pathogenesis of the disease subtypes is presented.


Early Rhythm Control Therapy for Atrial Fibrillation in Low-Risk Patients : A Nationwide Propensity Score-Weighted Study.
Rhythm control is associated with lower risk for adverse cardiovascular outcomes compared with usual care among patients recently diagnosed with atrial fibrillation (AF) with a CHA2DS2-VASc score of approximately 2 or greater in EAST-AFNET 4 (Early Treatment of Atrial Fibrillation for Stroke Prevention Trial). To investigate whether the results can be generalized to patients with low stroke risk. Population-based cohort study. Nationwide claims database of the Korean National Health Insurance Service. 54 216 patients with AF having early rhythm control (antiarrhythmic drugs or ablation) or rate control therapy that was initiated within 1 year of the AF diagnosis. The effect of early rhythm control on the primary composite outcome of cardiovascular death, ischemic stroke, hospitalization for heart failure, or myocardial infarction was compared between eligible and ineligible patients for EAST-AFNET 4 (CHA2DS2-VASc score, approximately 0 to 1) using propensity overlap weighting. In total, 37 557 study participants (69.3%) were eligible for the trial (median age, 70 years; median CHA2DS2-VASc score, 4), among whom early rhythm control was associated with lower risk for the primary composite outcome than rate control (hazard ratio, 0.86 [95% CI, 0.81 to 0.92]). Among the 16 659 low-risk patients (30.7%) who did not meet the inclusion criteria (median age, 54 years; median CHA2DS2-VASc score, 1), early rhythm control was consistently associated with lower risk for the primary outcome (hazard ratio, 0.81 [CI, 0.66 to 0.98]). No significant differences in safety outcomes were found between the rhythm and rate control strategies regardless of trial eligibility. Residual confounding. In routine clinical practice, the beneficial association between early rhythm control and cardiovascular complications was consistent among low-risk patients regardless of trial eligibility. The Ministry of Health and Welfare and the Ministry of Food and Drug Safety, Republic of Korea.


Unidentified bacterial microorganisms entrapped within blood capillary spaces of tissue from different epidemiological types of Kaposi's sarcoma.
Tissue specimens of different epidemiological types of Kaposis sarcoma (KS) from various geographical regions were investigated by transmission electron microscopy. Freshly fixed KS biopsies originated from 9 German patients: 3 classic KS cases, 5 AIDS-associated KS cases, and 1 atypical classic KS case. Additionally, KS autopsy material from the brain of a German AIDS patient was examined. Further biopsies came from 29 Ugandan patients: 16 endemic KS cases and 13 AIDS-associated KS cases. While investigating the ultrastructure, we discovered relatively small-sized bacterial microorganisms within blood capillary spaces of tumor tissue from 5 KS cases of different epidemiological type. The microorganisms often occurred in clusters. They were of coccoid-bacillary form and limited by a wrinkled multilayered cell wall. Many of them were encapsulated. They were not observed outside of the capillary lumen. The bacterial structures were often seen attached to capillary endothelial cells, which sometimes showed blistering into the capillary lumen. The observed bacterial microorganisms obviously represented agents of a bloodstream infection and must have been entrapped and accumulated within capillary spaces of KS tissue. The bacteria, which had an almost identical morphology in all 5 KS cases, could not be identified. If they are of pathogenic significance, it remains unknown.


Transcriptome Profiling across Five Tissues of Giant Panda.
Gene differential expression studies can serve to explore and understand the laws and characteristics of animal life activities, and the difference in gene expression between different animal tissues has been well demonstrated and studied. However, for the world-famous rare and protected species giant panda (Ailuropoda melanoleuca), only the transcriptome of the blood and spleen has been reported separately. Here, in order to explore the transcriptome differences between the different tissues of the giant panda, transcriptome profiles of the heart, liver, spleen, lung, and kidney from five captive giant pandas were constructed with Illumina HiSeq 2500 platform. The comparative analysis of the intertissue gene expression patterns was carried out based on the generated RNA sequencing datasets. Analyses of Gene Ontology (GO) enrichment, Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment, and protein-protein interaction (PPI) network were performed according to the identified differentially expressed genes (DEGs). We generated 194.52 GB clean base data from twenty-five sequencing libraries and identified 18,701 genes, including 3492 novel genes. With corrected p value <0.05 and |log2FoldChange| >2, we finally obtained 921, 553, 574, 457, and 638 tissue-specific DEGs in the heart, liver, spleen, lung, and kidney, respectively. In addition, we identified TTN, CAV3, LDB3, TRDN, and ACTN2 in the heart; FGA, AHSG, and SERPINC1 in the liver; CD19, CD79B, and IL21R in the spleen; NKX2-4 and SFTPB in the lung; GC and HRG in the kidney as hub genes in the PPI network. The results of the analyses showed a similar gene expression pattern between the spleen and lung. This study provided for the first time the heart, liver, lung, and kidney's transcriptome resources of the giant panda, and it provided a valuable resource for further genetic research or other potential research.


Oxygen and Nitrogen Transfer in Furnaces in Crystal Growth of Silicon by Czochralski and Directional Solidification Processes.
Impurity concentrations of oxygen, carbon, nitrogen, iron, and other heavy metals should be well controlled in silicon crystals to maintain the crystal quality for application in electronic and solar cell devices. Contamination by impurities occurs during the melting of raw materials and during the crystal growth process. Quantitative analysis of impurity transfer using numerical and experimental analysis is important to control impurity concentrations. This paper reviews the analysis of the impurity transport phenomena in crystal growth furnaces of Czochralski and directional solidification methods by a model of global analysis and an experiment during the crystal growth of silicon.