[Study on the three-dimensional mapping to reduce the X-ray exposure dose of interventional doctors in radiofrequency catheter ablation of atrioventricular nodal reentry tachycardia].
Objective: To explore the advantage of radiofrequency catheter ablation under the three-dimensional mapping in the treatment of atrioventricular nodal reentrant tachycardia (AVNRT) in reducing the X-ray exposure dose of interventional doctors. Methods: 79 patients with AVNRT, in the first hospital of Shanxi Medical University from January 2015 to June 2016, performed to do radiofrequency catheter ablation treatment were selected, and according to the random number method were divided into two-dimensional mapping group and three-dimensional mapping group. The two-dimensional mapping group was mapped the ablation target at the X-ray, while the ablation target was mapped by CARTO 3 system in the three-dimensional mapping group. Compare the X-ray fluoroscopy time, success rate, complications rate and doctor's X-ray exposure dose between the two groups. Results: Compared with the two-dimensional mapping group, acute success rate and complication rate of the three dimensional mapping group were not statistically significant (P>0.05) , while the X-ray fluoroscopy time and the X-ray dose of the three-dimensional mapping group decreased significantly, the difference was statistically significant (P<0.05) . Conclusion: Three-dimensional mapping can significantly reduce the X-ray irradiation time and interventional doctor's X-ray exposure dose in radiofrequency catheter ablation of AVNRT patients and the potential hazards of ionizing radiation on the human body.


Psychomotor development and learning difficulties in preschool children with probable attention deficit hyperactivity disorder: An epidemiological study in Navarre and La Rioja.
ADHD symptoms begin to appear at preschool age. ADHD may have a significant negative impact on academic performance. In Spain, there are no standardized tools for detecting ADHD at preschool age, nor is there data about the incidence of this disorder. To evaluate developmental factors and learning difficulties associated with probable ADHD and to assess the impact of ADHD in school performance. We conducted a population-based study with a stratified multistage proportional cluster sample design. We found significant differences between probable ADHD and parents' perception of difficulties in expressive language, comprehension, and fine motor skills, as well as in emotions, concentration, behaviour, and relationships. Around 34% of preschool children with probable ADHD showed global learning difficulties, mainly in patients with the inattentive type. According to the multivariate analysis, learning difficulties were significantly associated with both delayed psychomotor development during the first 3 years of life (OR: 5.57) as assessed by parents, and probable ADHD (OR: 2.34) CONCLUSIONS: There is a connection between probable ADHD in preschool children and parents' perception of difficulties in several dimensions of development and learning. Early detection of ADHD at preschool ages is necessary to start prompt and effective clinical and educational interventions.


A placebo-controlled study comparing the efficacy of intra-articular injections of hyaluronic acid and a novel hyaluronic acid-platelet-rich plasma conjugate in a canine model of osteoarthritis.
The objective of this study was to assess the efficacy of intra-articular injections of hyaluronic acid (HA) and a novel, on-site conjugate of HA with autologous fibrinogen in platelet-rich plasma (HA-PRP) in a canine model of osteoarthritis (OA) METHODS: Twelve beagle dogs underwent a unilateral resection of the cranial cruciate ligament (CrCL) of the stifle joint. Clinical and radiographic signs of OA were confirmed in all dogs 8 weeks following CrCL resection and prior to treatment. The dogs were randomized into three groups: saline (n = 4), HA (n = 4), and HA-PRP (n = 4). Each dog received intra-articular injections of the respective substance into the affected joint at pre-determined time points. The dogs were assessed for adverse effects for 3 days after each injection and for lameness, pain, range of motion, kinetics, and radiographic OA severity prior to treatment and 3 months after injection. OA severity as determined by radiographic examination was not significantly different among the groups at any time point. The dogs were then humanely euthanatized and the stifle joint assessed by gross and histological examinations. Dogs treated with four weekly injections of HA or two biweekly injections of HA-PRP were significantly (p < 0.05) better than dogs treated with four weekly injections of saline at 2-, 4-, and 12-week time points based on a comfortable range of motion (CROM) and clinical lameness score. Gait analysis measuring symmetry and weight distribution on pressure sensor walkway showed significantly (p < 0.05) improved limb function for dogs treated with HA and HA-PRP compared with dogs treated with saline yet with better clinical outcome for the HA-PRP-treated group at 12 and 20 weeks follow-up. Gross and histological analysis of synovium and articular cartilage demonstrated significant (p < 0.05) improvement by both treatments groups compared to controls. There was however significantly (p < 0.05) less damage to the cartilage in the HA-PRP group compared to the HA-treated group. These data suggest that while injection of HA and HA-PRP may be sufficient for short-term amelioration of the symptoms associated with OA, treatment with HA-PRP conjugates may be superior, providing significantly better long-term cartilage preservation.


THE VALIDITY AND RELIABILITY OF THE HANDHELD OXIMETER TO DETERMINE LIMB OCCLUSION PRESSURE FOR BLOOD FLOW RESTRICTION EXERCISE IN THE LOWER EXTREMITY.
The limb occlusion pressure (LOP) is determined to calculate the relative LOP. The different levels of relative LOP (percentage of LOP) influence the treatment effect and perceived discomfort during low-load blood flow restriction (BFR) strength training. Thus, determining the LOP is of the utmost importance when using BFR in clinical practice. The objective of this study was to investigate the concurrent validity and intra-rater (test-retest), intra-day reliability of an inexpensive, portable, easy-to-use handheld (HH) oximeter compared to a high-resolution Doppler ultrasound scanner in detecting LOP in the lower extremity. Cross-sectional validity and reliability study. Two raters who were blinded from each other simultaneously assessed 50 healthy participants (mean age of 25.8 years). A 20 cm-wide thigh cuff with an attached sphygmomanometer was inflated until the raters independently registered the LOP with the HH oximeter and the Doppler ultrasound scanner. The test session was repeated once after a five-minute time interval. The HH oximeter recorded a non-significantly higher LOP than the Doppler ultrasound scanner, with a mean difference of 6.3 mmHg in the test session (95% limits of agreement (LoA): -16.2 to 28.8, p = 0.13) and 5.4 mmHg in the retest session (95% LoA: -13.3 to 24.0, p = 0.10). The intra-rater reliability for both devices was moderate (ICC = 0.72-0.79). The measured LOP was significantly lower (p < 0.005) in the retest session than in the test session for both the HH oximeter (mean difference: -5.7 mmHg) and the Doppler ultrasound scanner (mean difference: -4.8 mmHg). The HH oximeter is a valid and reliable measuring device for determining the LOP in the lower extremity in healthy adults. The authors recommend performing at least two LOP measurements with a one-minute rest interval. 2, Validity and reliability study.


Syphilis resembling human papilloma virus associated oropharyngeal cancer: case report and literature review of recent incidence trends.
The yearly incidence of syphilis has risen markedly in Japan and worldwide. There has also been an increased incidence of human papilloma virus associated oropharyngeal cancer, which presents with clinical features similar to those of syphilis. A case of syphilis with clinical manifestation resembling that of human papilloma virus associated oropharyngeal cancer is reported, along with a literature review of similar cases. Clinical case reports and review of previous literature. Syphilis may cause irregular mucosal lesions of the oropharynx and cystic lymphadenopathy. It is difficult to diagnose syphilis only by examining pathological specimens, without clinical information such as Treponema pallidum antibody findings. It is necessary to correctly understand the characteristics of syphilis and human papilloma virus associated oropharyngeal cancer to ensure prompt diagnosis and treatment.


Integrated databases--the foundation for the information linking of the actors in the national health care and health insurance systems.
Among the characteristics of the present time, we meet the ranking of information among the key resources of effective management of business systems. Up to date, integral and accurate information have gained precedence over conventional economic resources. This applies particularly in the case of large and complex business systems, including the national health care and health insurance systems. High quality and unified databases form the foundation for rational and quality procedures ranging from the operative level to the national strategy level. The goal of this paper is to demonstrate, on the example of Slovene experience, the importance of keeping quality databases for the purposes of health care and health insurance system management. The paper reviews the achieved level and the plans of further development of unified databases in this sector in Slovenia. The key emphasis in the development of an integrated system has been laid upon establishing uniform primary databases and providing appropriate integration in the area of data interchange among the actors of the health care and health insurance systems and other national systems.


[The pavement lining of the vessels in the earthworm (Lumbricus terrestris)].
Effect of some preparatory methods to make ready earthworm tissues for electron microscopical investigation has been studied in order to reveal structural components of the vascular wall. The method for an immediate fixation of the earthworm tissues in liquid nitrogen with a subsequent additional fixation in cooled 2.5% glutar aldehyde, applied in combination with OsO4-thiocarbohydroside-OsO4 method is optimal. This method of samples preparation gives a reliable information concerning existence of an internal--endothelial--lining in the earthworm vessels. A conclusion is made on a qualitatively new level of cell differentiation of the internal vascular lining in the earthworm, which is called phase of blast transformation of endotheliocytes.


Utilization of house fly-maggots, a feed supplement in the production of broiler chickens.
Recent studies have suggested the utilization of maggots as a feed supplement forenhanced broiler performance. Maggots, which are a major dietary source of protein, appear during the biodegradation of chicken droppings using house flies. The objective ofthe present study was to investigate the effect of maggot supplementation on the meat quality and growth performance of broiler chickens. A total of 600 one-day-old male commercial broiler chicks (Ross) were randomly assigned into 5 treatment groups consisting of 40 replicates of 3 birds. The birds were fed either a basal diet or the basal diet supplemented with 5.0, 10.0, 15.0 and 20.0% maggots. Overall, broiler chicken performance was influenced by the optimal amino acid profile; high protein (63.99%) and essential amino acid content (29.46%), or high protein digestibility (98.50%) of the maggots. Maggot supplementation caused linear increases in live weight gain but not the feed conversion ratio. The diets of 10 and 15% maggots was the most efficient in terms of average weight gain forthe 4-5 week old broiler chickens (p<0.05). It also significantly increased dressing percentage, breast muscle, and thigh muscle (p<0.05). No differences were observed forliver abdominalfat, or meat color, and the crude protein contents of breast muscle were constant. However, in the maggot-fed broilers, breast muscle lysine and tryptophan levels increased significantly as compared to the birds fed the basal diet (p<0.05). These results indicate that feeding diets containing 10 to 15% maggots in chicken dropping after biodegradation can improve the carcass quality and growth performance of broiler chickens.


Trans-Oral Robotic Surgery: 14 Cases of Pleomorphic Adenoma of the Parapharyngeal Space.
The aim of this study has been to describe our experience with pleomorphic adenomas of the parapharyngeal space (PPS) treated with trans-oral robotic surgery (TORS). Tumors arising from the PPS comprise less than 0.5% of all head and neck tumors. Salivary gland tumors account for 40% to 50% of PPS lesions with pleomorphic adenomas representing the most common salivary tumors (80%-90%). Parapharyngeal space tumors cause nonspecific symptoms and may be difficult to diagnose. In our study a preoperative diagnosis was conducted by fine needle aspiration biopsy and magnetic resonance imaging and the results were used to plan the correct surgical approach. In all cases we were able to employ TORS, a minimally invasive procedure that allows us to operate in narrow and anatomically complex spaces that we can only reach thanks to the use of well-articulated hand pieces. This report indicates that TORS is a safe surgical procedure for the excision of benign tumors of the PPS in selected cases.


Free radical formation from the antineoplastic agent VP 16-213.
Free radical formation from VP 16-213 was studied by ESR spectroscopy. Incubation of VP 16-213 with the one-electron oxidators persulphate-ferrous, myeloperoxidase (MPO)/hydrogen peroxide and horseradish peroxidase (HRP)/hydrogen peroxide readily led to the formation of a free radical. The ESR spectra obtained in the last two cases, were in perfect accord with that of a product obtained by electrochemical oxidation of VP 16-213 at +550 mV. The half-life of the free radical in 1 mM Tris (pH 7.4), 0.1 M NaCl at 20 degrees C, was 257 +/- 4 s. The signal recorded on incubation with HRP/H2O2 or MPO/H2O2 did not disappear on addition of 0.3 - 1.2 mg/ml microsomal protein. From incubations with rat liver microsomes in the presence of NADPH, no ESR signals were obtained.


Optimizing magnetically shielded solenoids.
An important consideration when designing a magnetostatic cavity for various applications is to maximize the ratio of the volume of field homogeneity to the overall size of the cavity. We report a design of a magnetically shielded solenoid that significantly improves the transverse field gradient averaged over a volume of 1000 cm3 by placing compensation coils around the holes in the mu-metal end caps rather than the conventional design in which the compensation coils are placed on the main solenoid. Our application is polarized 3He-based neutron spin filters, and our goal was to minimize the volume-averaged transverse field gradient, thereby the gradient induced relaxation time, over a 3He cell. For solenoids with end cap holes of different sizes, additional improvements in the field gradient were accomplished by introducing non-identical compensation coils centered around the non-identical holes in the end caps. The improved designs have yielded an overall factor of 7 decrease in the gradient in the solenoid, hence a factor of 50 increase in the gradient induced relaxation time of the 3He polarization. The results from both simulation and experiments for the development of several such solenoids are presented. Whereas our focus is on the development of magnetically shielded solenoids for 3He neutron spin filters, the approach can be applied for other applications demanding a high level of field homogeneity over a large volume.


Non-dystrophic 129 REJ mice are susceptible to i.p. infection with Listeria monocytogenes despite an ability to recruit inflammatory neutrophils to the peritoneal cavity.
In this study we compared the host response to Listeria monocytogenes in 129 REJ mice with listeria-resistant (C57Bl/6j) and susceptible (Balb/c) mouse strains. In all experiments mice were inoculated by the i.p. route. 129 REJ mice and Balb/c mice were sensitive to listeriosis whilst C57Bl/6j mice were relatively resistant to i.p. infection. Relatively large numbers of viable bacteria could be detected in the spleens of 129 REJ mice as early as 6 h following i.p. inoculation suggesting that dissemination of listeria from the peritoneal cavity is rapid in this mouse strain. This contrasted with Balb/c mice which exhibited an early lag phase during which only low numbers of bacteria could be isolated from the spleens of infected animals. In response to both proteose peptone and live listeria, 129 REJ mice demonstrated a greater capacity to recruit neutrophils to the peritoneal cavity than Balb/c and C57Bl/6j mice. In addition, inflammatory phagocytes from 129 REJ mice were as bactericidal in vitro as phagocytes from the Balb/c and C57Bl/6j strains. However, in vivo, inflammatory neutrophils elicited by proteose peptone prior to i.p. infection with L. monocytogenes were not protective in the three mouse strains tested. Despite the apparent inadequacy of peritoneal neutrophils in controlling early bacterial proliferation, depletion of neutrophils in 129 REJ mice severely exacerbated i.p. infection with L. monocytogenes. The results indicate that neutrophils provide an inefficient but essential means of controlling early outgrowth of listeria in the peritoneal cavity of 129 REJ mice. The excessive inflammatory response seen in 129 REJ mice may facilitate the early dissemination of L. monocytogenes from the peritoneal cavity to peripheral sites.


Role of the carboxyl-terminal domain of TolA in protein import and integrity of the outer membrane.
The TolA protein is involved in maintaining the integrity of the outer membrane of Escherichia coli, as mutations in tolA cause the bacteria to become hypersensitive to detergents and certain antibiotics and to leak periplasmic proteins into the medium. This protein also is required for the group A colicins to exert their effects and for many of the filamentous single-stranded bacteriophage to infect the bacterial cell. TolA is a three-domain protein, with the amino-terminal domain anchoring it to the inner membrane. The helical second domain is proposed to span the periplasmic space to allow the carboxyl-terminal third domain to interact with the outer membrane. A plasmid that allowed the synthesis and transport of the carboxyl-terminal third domain into the periplasmic space was constructed. The presence of an excess of this domain in the periplasm of a wild-type cell resulted in an increased sensitivity to deoxycholate, the release of periplasmic alkaline phosphatase and RNase into the medium, and an increased tolerance to colicins E1, E2, E3, and A. There was no effect on the cells' response to colicin D, which depends on TonB instead of TolA for its action. The presence of the free carboxyl-terminal domain of TolA in the periplasm in a tolA null mutation did not restore the wild-type phenotype, suggesting that this domain must be part of the intact TolA molecule to perform its function. Our results are consistent with a model in which the carboxyl-terminal domain of TolA interacts with components in the periplasm or on the inner surface of the outer membrane to function in maintaining the integrity of this membrane.


Comparing the Performance of Different AMBER Protein Forcefields, Partial Charge Assignments, and Water Models for Absolute Binding Free Energy Calculations.
Identifying chemical starting points is a vital first step in small molecule drug discovery and can take significant time and money. For this reason, computational approaches to virtual screening are of great interest as they can lower the cost and shorten timeframes. However, simple approaches such as molecular docking and pharmacophore screening are of limited accuracy and provide a low probability of success. Alchemical binding free energies represent a promising approach for virtual screening as they naturally incorporate the key effects of water molecules, protein flexibility, and binding entropy. However, the calculations are technically very challenging, with performance depending on the specific forcefield used. For this reason, it is important that the community has access to benchmark test sets to assess prediction accuracy. In this paper, we present an approach to alchemical binding free energies using OpenMM. We identify effective simulation parameters using an existing BRD4(1) test set and present two new benchmark sets (cMET and PDE2A) that can be used in the community for validation purposes. Our findings also highlight the effectiveness of some AMBER forcefields, in particular, AMBER ff15ipq.


Epizootic hemorrhagic disease virus serotype 6 experimentation on adult cattle.
Epizootic hemorrhagic disease virus (EHDV), an arthropod-borne orbivirus (family Reoviridae), is an emerging pathogen of wild and domestic ruminants closely related to bluetongue virus (BTV). EHDV serotype 6 (EHDV6) has recently caused outbreaks close to Europe in Turkey and Morocco and a recent experimental study performed on calves inoculated with these two EHDV6 strains showed that the young animals have remained clinically unaffected. The aim of this study was to investigate the pathogenicity of an EHDV6 strain from La Reunion Island in adult Holstein (18-month-old heifers). This EHDV6 strain has induced clinical signs in cattle in the field. Samples taken throughout the study were tested with commercially available ELISA and real-time RT-PCR kits. Very mild clinical manifestations were observed in cattle during the experiment although high levels of viral RNA and virus were found in their blood. EHDV was isolated from the blood of infected animals at 8 dpi. Antibodies against EHDV were first detected by 7 dpi and persisted up to the end of the study. Virus was detected in various tissue samples until 35 dpi, but was not infectious. In view of the recent circulation of different arboviruses in Europe, this study demonstrates what the EHD induces a strong viraemia in adult Holstein cattle and shows that a spread of EHD on European livestock cattle is possible.


Limitations in the use of dielectric interference filters in wide angle optical receivers.
Along a clear line-of-sight optical signal path through the atmosphere, the usefulness of interference filters in rejecting unwanted background light is limited mainly by the technology of fabrication. If the signal to be observed is strongly scattered by fog or aerosols, the received signal appears to come from a wide angular subtense. In such a case it is found that the interference filter is not a very useful device for separating signal and background. The optimum photoelectron counting receiver equipped with such a filter performs not much better than a receiver without any filter. The difficulty is an interdependence between the effective bandwidth and field of view of such filters, which results in an optimum receiver performance in which neither parameter specifically appears. The results also apply to other wavelength-dependent filters, such as the liquid crystal, and filters using polarization anisotropy along a path between polarizers.


Antioxidants inhibit JNK and p38 MAPK activation but not ERK 1/2 activation by angiotensin II in rat aortic smooth muscle cells.
Angiotensin II (Ang II) induces vascular smooth muscle cell (VSMC) hypertrophy, which results in several cardiovascular diseases. Ang II-induced cellular events have been mediated, in part, by reactive oxygen species (ROS) which also involve activation of mitogen-activated protein (MAP) kinases. Although it has been proposed that the therapeutic administration of antioxidants is useful for vascular diseases, the precise mechanisms which regulate ROS-sensitive signaling events have not been well characterized. Thus, we hypothesized that antioxidants may affect ROS-mediated MAP kinases activation induced by Ang II. The present findings showed that Ang II stimulated rapid and significant activation of ERK 1/2, JNK and p38 MAPK in cultured rat aortic smooth muscle cells (RASMC). Ang II-induced ERK 1/2 activation was not affected by all antioxidants examined, whereas JNK was sensitive to all antioxidants. In contrast, p38 MAPK activation was inhibited by DPI and ascorbic acid concentration-dependently, but by NAC only at high concentration. DETC and Trolox C had no effects on p38 MAPK activation by Ang II. We further examined the effects of antioxidants on Ang II-induced increases in oxygen consumption as an index of ROS generation in RASMC. DPI strongly inhibited Ang II-induced increases in oxygen consumption. DETC also inhibited Ang II-induced oxygen consumption, whereas ascorbic acid markedly augmented it. These findings suggest that the inhibitory effects of antioxidants on MAP kinases activation in VSMC are attributable, in part, to their modulating effects on ROS generation by Ang II in VSMC. Thus, inhibition of MAP kinases by antioxidants may imply their usefulness for relief of cardiovascular diseases.


The macromolecular basis of the hydraulic conductivity of the arterial wall.
The question of what components of the artery wall determine its hydraulic conductivity is approached in two different ways. Firstly, the hydraulic properties of an individual component, hyaluronate, are measured. It is shown that hyaluronate alone cannot account for the high resistance of the artery but hyaluronate entangled in a restraining filter has a hydraulic conductivity similar to that measured for the whole artery. Secondly, the hydraulic properties of porcine thoracic aortae which have been subjected to various extraction procedures are measured. Freezing and autoclaving have little effect, but alkali extraction increases the hydraulic conductivity by three orders of magnitude.


Comparison of PCR and Conventional Serological Methods for Detection of Brucella spp. in Ovine and Caprine Blood Serum.
Brucellosis is an anthropozoonotic disease. Infection of livestock with Brucella is endemic in most parts of Iran. Sistan-Baluchestan is bordered on the east by the countries of Afghanistan and Pakistan. The high prevalence of brucellosis in livestock in the eastern neighboring countries results in transmission of the disease to this province. The present research aimed to determine the prevalence of brucellosis in small ruminants in the Sistan region of Iran and to compare serological and molecular tests for the detection of brucellosis. Blood samples were taken from 150 randomly selected sheep and goats, and sera were separated. All sera were analyzed by serological (Wright and 2-ME) and molecular (Polymerase Chain Reaction (PCR)) tests. Serological tests were carried out according to the instructions of the Iranian Veterinary Organization The degree of agreement between serological tests and PCR was determined by kappa value. In this study, 17 cases (11.3%) were identified as positive by the PCR method. Wright and 2-ME tests had the highest agreement with PCR in titers ≥2/80 and ≥2/40, respectively. The results of this study show that the brucellosis in sheep and goats has a greater prevalence in the Sistan region than in most other parts of Iran, and this is important in terms of public health. It is suggested that brucellosis vaccination coverage in livestock be increased in this area and that the people in Sistan region must be notified about methods for preventing brucellosis. Also, further studies to compare conventional serologic tests with the gold standard test are recommended.


Are all patients with short segment Hirschsprung's disease equal? A retrospective multicenter study.
Short segment Hirschsprung's disease (HSCR) carries a better prognosis than long segment disease, but the definition of short is controversial. The objective of this study is to determine anatomically the extent of disease involvement that would be associated with a better functional outcome. This is a retrospective multicenter (n = 3) study with patients (≥ 3 years) who had transanal pullthrough operation done for aganglionosis limited to the recto-sigmoid colon were reviewed. The extent of disease involvement and bowel resection was retrieved by reviewing the operative records as well as histopathological reports of the resected specimens. Clinical assessment was performed according to the criteria of a seven-itemed bowel function score (BFS) (maximum score = 20). Manometric assessment was performed with anorectal manometry. The study period started from 2003 to 45 patients were studied with median age at assessment = 52.0 months and operation = 3.0 months. The disease involvement was categorized into upper sigmoid-descending colon (DC) (n = 8), sigmoid colon (SC) (n = 12), upper rectum (UR) (n = 14) and lower rectum (LR) (n = 11) according to the level of normal biopsy result. There was no significant difference in the age of assessment between the four groups. The median BFSs in the DC, SC, UR and LR were 13, 15, 17 and 17, respectively (p = 0.01). Nine patients from the DC and SC groups reported soiling for more than twice per week. Sub-group analysis comparing patients with and without the entire sigmoid colon resected revealed worse functional outcomes in terms of the incidence of soiling (40.7 vs 22.2%, p = 0.05) and the BFS (14 vs 18, p = 0.04) in the former group. Anorectal manometry did not reveal any significant difference between the four groups, but a higher proportion of patients in the UR and LR groups appeared to have a normal sphincter resting pressure (DC vs SC vs UR vs LR = 62.5 vs 75.0 vs 85.7 vs 80.0%, p = 0.10). Patients with short segment HSCR are not equal at all. HSCR patients with aganglionosis limited to the rectum without the need of removing the entire sigmoid colon have a better bowel control and overall functional score. Less bowel loss and colonic dissection maybe the underlying reasons. Although future studies with a larger sample size and a longer follow-up period are required to validate the results of this study, it has provided a new insight to the current understanding of short segment disease in HSCR.


Squamous cell carcinoma of the lung with highly proliferating fibromatosis-like stroma: a rare phenomenon.
Few cases of carcinoma with exuberant stromal proliferation have been documented, apart from scirrhous carcinoma. To the best of our knowledge, previous cases of carcinoma exhibiting exuberant stromal proliferation have exclusively been reported in the thyroid gland, specifically as papillary carcinoma. The exuberant stromal proliferation has been recognized to be similar to either fibromatosis or nodular fasciitis. Herein, we report a case of a 74-year-old Japanese man whose tumor in the upper lobe of his right lung displayed highly proliferating stroma with dispersed, poorly differentiated squamous cell carcinoma nests. The stromal spindle cells (fibroblasts/myofibroblasts) had similar molecular profiles to those typically observed in fibromatosis rather than nodular fasciitis, resulting in the designation of "fibromatosis-like" stroma. The presence of carcinoma cells, along with stromal cells, expressing TGF-β in this case likely fostered continuous stromal proliferation, presumably in conjunction with the unique microenvironment in which the carcinoma cells were present.


Midterm results of anatomic repair in a subgroup of corrected transposition.
Anatomic repair has become the preferred option in the subgroup of patients with congenitally corrected transposition of the great arteries with ventricular septal defect and pulmonary obstruction. We report our 14-year experience with this approach. From April 2001 to February 2014, 22 patients with congenitally corrected transposition with ventricular septal defect and pulmonary obstruction underwent anatomic repair. Nineteen patients had a modified Senning-Rastelli procedure, 2 had a Mustard-Rastelli procedure, and one had a hemi-Mustard-Glenn-Rastelli procedure. The mean age was 10.9 years, and 8 (36.4%) patients were male. There were 2 early deaths from sepsis and ventricular failure at 18 and 81 days postoperatively, and 3 late deaths from ventricular failure at 4, 33, and 113 months postoperatively. Left ventricular failure with mitral valve regurgitation was present in 3 of the 5 patients who died. Among the survivors, 3 underwent 4 transcatheter interventions for right ventricular outflow tract obstruction and 3 underwent 4 reoperations for atrial pathway obstruction, left and right ventricular outflow tract obstruction, or residual shunt. At a median follow-up of 64 months (range 14-167 months), 15 of 17 survivors were in functional class I. One patient had severe mitral valve regurgitation and was awaiting valve replacement. Another patient had right ventricular outflow conduit obstruction and was scheduled for reoperation. Results of atrial switch-Rastelli procedures in this subgroup of patients with corrected transposition are satisfactory but still imperfect. Mitral regurgitation might predict a poor outcome. Long-term follow-up is necessary.


Effect of supra-ambient oxygen on nitrogenase activity (c(2)h(2)) and root respiration of soybeans and isolated soybean bacteroids.
Isolated soybean (Glycine max [L.] Merr. cv Wilkin) bacteroids have O(2)-dependent nitrogenase activity which is strongly inhibited by supraoptimal O(2) concentrations. Oxygen-inhibited nitrogenase activity is recovered by addition of 10 millimolar sodium succinate or by lowering the O(2) concentration.Brief treatment of roots of intact soybean plants with 1.0 atmosphere O(2) reduces nitrogenase activity (C(2)H(2)). There is a rapid partial recovery of activity within 2 to 3 hours, and a slower return to near normal levels by 36 hours. The drop and recovery of nitrogenase activity is accompanied by a parallel drop and increase in root respiration. There is a direct relationship between the change in respiration and the change in acetylene reduction following O(2) treatment. The O(2)-mediated changes in nitrogenase activity and root respiration are not affected by the planting medium. The ratio of the change in respiration to the change in nitrogenase activity was the same in 13 soybean cultivars.


Visual Analysis of Swallowing Efficiency and Safety (VASES): Establishing Criterion-Referenced Validity and Concurrent Validity.
The primary aim of this study was to examine the criterion-referenced validity of the Visual Analysis of Swallowing Efficiency and Safety (VASES). As a secondary aim, we examined the concurrent validity of using verbal numerical ratings for VASES as a potential substitute for visual analog scale ratings. Fifty-seven novice raters were prospectively recruited to rate 26 flexible endoscopic evaluations of swallowing (FEES) images (2 times each, randomized)-once using VASES and once using a criterion-referenced scale. Ratings were made for the valleculae, piriforms, epiglottis, laryngeal vestibule, vocal folds, and subglottis. Criterion validity was determined by examining the correlation between VASES and the criterion-referenced scales. The novice raters also provided visual analog scale ratings following verbal numerical ratings. Concurrent validity of using verbal numerical ratings as a potential substitute for visual analog scale ratings was determined by examining the correlation and absolute agreement between both rating methods. Three thousand five hundred eighty-seven ratings were analyzed. Spearman's correlation revealed strong correlations between VASES ratings and criterion-referenced ratings across all anatomic landmarks (ρ = .882-.915). Lin's concordance revealed substantial agreement between numerical ratings and visual analog scale ratings (ρc = .986). The strong correlations between VASES and the criterion-referenced scales suggest that VASES is a valid method for interpreting pharyngeal residue, penetration, and aspiration during FEES. Furthermore, numerical ratings exhibited substantial agreement with visual analog scales. This suggests that clinicians could provide verbal numerical ratings in lieu of visual analog scale ratings as a potential way to enhance the ease and feasibility of implementing VASES into clinical practice. https://doi.org/10.23641/asha.18737072.


Alkali-activated slag concrete with paper industry waste.
Pulp and paper manufacturing and recycling industries are a resource-intensive sector, generating 25-40% of the annual municipal solid waste worldwide. Waste includes abundant volumes of paper sludge, as well as the product of its incineration, namely paper sludge ash. These two waste materials are both predominantly landfilled. There is thus a drive for additional valorisation routes for these materials. This short communication focuses on the potential use of paper sludge ash in alkali-activated cement concrete; this type of concrete was estimated to potentially reduce CO2 emissions by up to 5-6 times, while it can also incorporate waste materials or industrial by-products in its composition. The paper presents a laboratory study assessing the feasibility of structural alkali-activated cement concrete with ground granulated blastfurnace slag (a by-product of steel production) and paper sludge ash. Paper sludge ash is used mainly as a source of Ca(OH)2 in the alkaline activator solution, and secondly as an additional source of aluminosilicates. A number of factors potentially affecting the activation process and the resulting concrete quality were investigated, including different dosage of activators, curing conditions and curing time. Mixes with paper sludge ash in the activator system developed high early concrete strengths at ambient temperatures and maintained adequate strengths for structural concrete. Further mix optimisation and mechanical and durability testing, accompanied by material characterisation, are required to establish the advantages of using this waste material in structural alkali-activated cement concrete.


[Finite element analysis of determining corneal biomechanical properties in vivo based on Corvis ST].
The decrease of corneal stiffness is the key factor leading to keratoconus, and the corneal collagen fiber stiffness and fiber dispersion are closely related to the corneal biomechanical properties. In this paper, a finite element model of human cornea based on corneal microstructure, namely collagen fiber, was established before and after laser assisted in situ keratomileusis (LASIK). By simulating the Corvis ST process and comparing with the actual clinical results, the hyperelastic constitutive parameters and corneal collagen fiber stiffness modulus of the corneal material were determined before and after refractive surgery. After LASIK, the corneal collagen fiber stiffness modulus increased significantly, and was highly correlated with central corneal thickness (CCT). The predictive relationship between the corneal collagen fiber stiffness modulus and the corresponding CCT before and after surgery was: k 1 before = exp(9.14 - 0.009CCT before), k 1 after = exp(8.82 - 0.008CCT after). According to the results of this study, the central corneal thickness of the patient can be used to estimate the preoperative and postoperative collagen fiber stiffness modulus, and then a personalized corneal model that is more consistent with the actual situation of the patient can be established, providing a theoretical reference for more accurately predicting the safe surgical cutting amount of the cornea.


Lessons from a training needs assessment to strengthen the capacity of routine immunization service providers in Nigeria.
Health workers (HWs) providing routine immunization (RI) services play a crucial role in influencing vaccine uptake, a key determinant of improved immunization coverage. Over the years, Training Needs Assessments (TNAs) have not been routinely utilized in Nigeria to determine unmet needs of health workers offering immunization services and what approaches should be adopted to meet their training needs. The objective was to assess the level of Expanded Program on Immunization (EPI) knowledge among RI service providers and tutors in pre-service institutions in three Nigerian states, to identify unfulfilled training needs and their implications. It also sought HWs perception on a pilot training approach, where tutors will be used for in-service training. TNA survey tools were designed to obtain knowledge-based information on the fundamental EPI concepts through key informant interviews and focus group discussions with 90 HWs and 27 pre-service tutors. Quantitative data was also obtained, hence utilizing a mixed method approach for the study. In spite of several previous trainings, HWs knowledge on basic immunization concepts including Reaching Every Ward (REW) strategy was varied and suboptimal. 83% of the HWs could not differentiate between the live attenuated and killed vaccines. In addition, pre-service tutors knowledge of fundamental EPI concepts, as well as HW perception of the new training approach also varied across the states. TNAs are valuable in determining specific training approaches to improve HWs skills needed to implement strategies required to increase vaccine uptake. However, EPI managers must be mindful of contextual factors beyond training needs such as finance and security, that can affect HW performance.


Multiplex PCR assay for the identification of nivalenol, 3- and 15-acetyl-deoxynivalenol chemotypes in Fusarium.
The ability to rapidly distinguish trichothecene chemotypes in a given species/population of the genus Fusarium is important due to significant differences in the toxicity of these secondary metabolites. A multiplex PCR assay, based on primer pairs derived from the Tri3, Tri5 and Tri7 genes of the trichothecene gene cluster was established for the identification of the different chemotypes among Fusarium graminearum, F. culmorum and F. cerealis. Using the selected primers, specific amplification products of 625, 354 and 708 bp were obtained from Fusarium isolates producing nivalenol, 3-acetyl-deoxynivalenol and 15-acetyl-deoxynivalenol, respectively. Moreover, the multiplex PCR was successfully used to identify the chemotype of the Fusarium species contaminating wheat kernels. Four picograms of fungal DNA were found to be necessary to obtain a visible amplification product.


Real-Time Telerehabilitation in Older Adults With Musculoskeletal Conditions: Systematic Review and Meta-analysis.
Real-time telerehabilitation (TR) is a new strategy for delivering rehabilitation interventions to older adults with musculoskeletal conditions, to provide continuity to conventional services and mitigate travel-related barriers. We aimed to examine the effectiveness of treatment delivered via real-time TR services compared to conventional services among older adults with musculoskeletal conditions, in terms of physical performance, treatment adherence, and cost-effectiveness. A literature search of randomized controlled trials (RCTs) published from January 2000 to April 2022 was conducted in six online databases: Cochrane Library, PubMed (ie, MEDLINE), PEDro, ClinicalKey, EBSCO, and ProQuest. The main eligibility criterion for articles was the use of real-time TR among older adults with musculoskeletal conditions to improve physical performance. Two reviewers screened 2108 abstracts and found 10 studies (n=851) that met the eligibility criteria. Quality assessment was based on version 2 of Cochrane's risk-of-bias tool for RCTs, in order to assess the methodological quality of the selected articles. Results were pooled for meta-analyses, based on the primary outcome measures, and were reported as standardized mean differences (SMDs) with 95% CIs. A fixed model was used, and subgroup analysis was performed to check for possible factors influencing TR's effectiveness based on different treatments, controls, and outcome measures. The search and screening process identified 10 papers that collectively reported on three musculoskeletal conditions in older adults and three types of TR programs. Aggregate results suggested that real-time TR, compared to conventional treatment, was more effective at improving physical performance regarding balance (SMD 0.63, 95% CI 0.36-0.9; I2=58.5%). TR was slightly better than usual care at improving range of motion (SMD 0.28, 95% CI 0.1-0.46; I2=0%) and muscle strength (SMD 0.76, 95% CI 0.32-1.2; I2=59.60%), with moderate to large effects. Subgroup analyses suggested that real-time TR had medium to large effects favoring the use of smartphones or tablets (SMD 0.92, 95% CI 0.56-1.29; I2=45.8%), whereas the use of personal computers (SMD 0.25, 95% CI -0.16 to 0.66; I2=0%) had no effect on improving balance and was comparable to conventional treatment. We found that real-time TR improved physical performance in older adults with musculoskeletal conditions, with an effectiveness level equal to that of conventional face-to-face treatment. Therefore, real-time TR services may constitute an alternative strategy for the delivery of rehabilitation services to older adults with musculoskeletal conditions to improve their physical performance. We also observed that the ideal device for delivering TR is the smartphone. Results suggested that the use of smartphones for TR is driven by ease of use among older adults. We encourage future studies in areas related to rehabilitation in older adults, in addition to examination of physical performance outcomes, to gain additional knowledge about comprehensive care. PROSPERO CRD42021287289; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=287289.


Seasonal Abundance of Deer and Horse Flies (Diptera: Tabanidae) in the Northern Part of Gyeonggi-do, Republic of Korea.
The seasonal abundance of horse and deer flies (family Tabanidae) was analyzed using Mosquito Magnet(®) traps at 5 sites located near/in the demilitarized zone, northern Gyeonggi-do, Republic of Korea from late April to early October for 4 consecutive years (2010-2013). A total of 2,999 horse and deer flies (tabanids) belonging to 5 genera and 20 species were collected. Chrysops mlokosiewiczi (90.9%) was the most frequently collected, followed by Haematopota koryoensis (4.8%) and C. suavis (1.0%). The remaining 17 species comprised only of 3.3% of all species collected. C. mlokosiewiczi demonstrated bimodal peak populations during mid-June and early August, while H. koryoensis demonstrated a unimodal peak during mid-July. Overall numbers of tabanids collected were influenced by the previous year's winter temperatures and precipitation. Population abundance was influenced by habitat with most of tabanids collected from habitats near forested areas, followed by rice paddies, and a beef farm.


Expression of the thermostable beta-galactosidase gene from the archaebacterium Sulfolobus solfataricus in Saccharomyces cerevisiae and characterization of a new inducible promoter for heterologous expression.
The lacS gene from the extremely thermoacidophilic archaebacterium Sulfolobus solfataricus encodes an enzyme with beta-galactosidase activity that, like other enzymes from this organism, is exceptionally thermophilic (optimal activity above 90 degrees C), thermostable, and resistant to common protein denaturants and proteases. Expression of the gene in mesophilic hosts is needed to uncover the molecular nature of these features. We have obtained expression of beta-galactosidase in Saccharomyces cerevisiae under the control of the galactose-inducible upstream activating sequence of the yeast genes GAL1 and GAL10. The expressed enzyme is identical in molecular mass, thermostability, and thermophilicity to the native enzyme, showing that these features are intrinsic to the primary structure of the enzyme. We also present a new promoter for the expression of thermostable proteins in S. cerevisiae. This promoter contains a sequence isolated from the nematode Caenorhabditis elegans that works as a strong, heat-inducible upstream activating sequence in S. cerevisiae. Transcription of the lacS gene under the control of this sequence is rapidly and efficiently induced by heat shock. The availability of a plate assay for monitoring beta-galactosidase activity in S. cerevisiae may allow screening for mutants affecting the efficiency and activity of the enzyme.


Amplifying inorganic chirality using liquid crystals.
Chiral inorganic nanostructures have drawn extensive attention thanks to their unique physical properties as well as multidisciplinary applications. Amplifying inorganic chirality using liquid crystals (LCs) is an efficient way to enhance the parented inorganic asymmetry owing to chirality transfer. Herein, the universal synthetic methods and structural characterizations of chiral inorganic-doped LC hybrids are introduced. Additionally, the current progress and status of recent experiment and theory research about chiral interactions between inorganic nanomaterials (e.g. metal, semiconductor, perovskite, and magnetic oxide) and LCs are summarized in this review. We further present representative applications of these new hybrids in the area of encryption, sensing, optics, etc. Finally, we provide perspectives on this field in terms of material variety, new synthesis, and future practice. It is envisaged that LCs will act as a pivotal part in the amplification of inorganic chirality with versatile applications.


Fluidity of the lipid domain of cell wall from Mycobacterium chelonae.
The mycobacterial cell wall contains large amounts of unusual lipids, including mycolic acids that are covalently linked to the underlying arabinogalactan-peptidoglycan complex. Hydrocarbon chains of much of these lipids have been shown to be packed in a direction perpendicular to the plane of the cell surface. In this study, we examined the dynamic properties of the organized lipid domains in the cell wall isolated from Mycobacterium chelonae grown at 30 degrees C. Differential scanning calorimetry showed that much of the lipids underwent major thermal transitions between 30 degree C and 65 degrees C, that is at temperatures above the growth temperature, a result suggesting that a significant portion of the lipids existed in a structure of extremely low fluidity in the growing cells. Spin-labeled fatty acid probes were successfully inserted into the more fluid part of the cell wall. Our model of the cell wall suggests that this domain corresponds to the outermost leaflet, a conclusion reinforced by the observation that labeling of intact cells produced electron spin resonance spectra similar to those of the isolated cell wall. Use of stearate labeled at different positions showed that the fluidity within the outer leaflet increased only slightly as the nitroxide group was placed farther away from the surface. These results are consistent with the model of mycobacterial cell wall containing an asymmetric lipid bilayer, with an internal, less fluid mycolic acid leaflet and an external, more fluid leaflet composed of lipids containing shorter chain fatty acids. The presence of the low-fluidity layer will lower the permeability of the cell wall to lipophilic antibiotics and chemotherapeutic agents and may contribute to the well-known intrinsic resistance of mycobacteria to such compounds.


Results of balloon angioplasty in the carotid arteries.
To report the experiences to date with percutaneous transluminal angioplasty (PTA) of the carotid artery and other supra-aortic vessels. A new coaxial dilatation system for carotid angioplasty with temporary balloon occlusion to avoid cerebral embolization is presented. PTA was performed in 220 patients with 245 stenosed or occluded supra-aortic arteries; among these were 74 carotid stenoses in the proximal common (n = 5), distal common (n = 1), internal (n = 65), and external (n = 3) carotid arteries. Duplex and B-mode ultrasonography, computed tomography, magnetic resonance imaging, single-photon emission computed tomography, indium 111-labeled platelet scintigraphy, and/or angiography were used before and after PTA. Intravascular ultrasound imaging was also recently added for monitoring angioplasty results. All patients but one with carotid lesions had symptoms of cerebrovascular insufficiency. Angioplasty was successful in 69 of the 74 carotid stenoses: proximal common (n = 5), distal common (n = 1), internal (n = 60), and external (n = 3). There were only 1 major (hemiparesis) and 2 minor complications. During the average 70-month observation period, restenosis has not occurred in any treated carotid artery. In a literature review of > 500 patients undergoing carotid angioplasty, the complication rate appears very low (mortality 0%; morbidity 2.1%) and comparable to that for carotid endarterectomy. Results of this review suggest that percutaneous transluminal angioplasty of the carotid artery is an effective alternative method to vascular surgery, particularly for patients with comorbidities that elevate the risks of surgery.


Differentiation of migrainous positional vertigo (MPV) from horizontal canal benign paroxysmal positional vertigo (HC-BPPV).
This article presents an approach to differentiation of migrainous positional vertigo (MPV) from horizontal canal benign paroxysmal positional vertigo (HC-BPPV). Such an approach is essential because of the difference in intervention between the two disorders in question. Results from evaluation of the case study presented here revealed a persistent ageotropic positional nystagmus consistent with MPV or a cupulolithiasis variant of HC-BPPV. The patient was treated with liberatory maneuvers to remove possible otoconial debris from the horizontal canal in an attempt, in turn, to provide further diagnostic information. There was no change in symptoms following treatment for HC-BPPV. This case was diagnosed subsequently as MPV, and the patient was referred for medical intervention. Treatment has been successful for 22 months. Incorporation of HC-BPPV treatment, therefore, may provide useful information in the differential diagnosis of MPV and the cupulolithiasis variant of HC-BPPV.


[Urachal carcinoma accompanied with calcification: report of a case].
Carcinoma of urachus accompanied with calcification is rarely encountered. A 37-year-old man presented with the complaint of mucus discharge on voiding. A plain X-ray film of his abdomen showed the presence of calcification at the urinary bladder. A hemispheric tumor at the top of the urinary bladder was seen on cystoscopic examination. The results of urine cytology and cold-punch biopsy supported the diagnosis; carcinoma of urachus. En bloc segmental resection was performed. Histopathologically, the tumor was composed of moderately differentiated adenocarcinoma producing mucus. Now, he is alive and has no evidence of recurrence. This is the 9th report on carcinoma of urachus with calcification in the Japanese literature.


Prognostic Significance of Clinicopathological Factors Influencing Overall Survival and Event-Free Survival of Patients with Cervical Cancer: A Systematic Review and Meta-Analysis.
BACKGROUND Cervical cancer (CC) is the most frequent type of cancer among women and its poor prognosis is a main concern, while the prognostic factors for CC have still remained controversial. We conducted this systematic review and meta-analysis to identify the prognostic significance of clinicopathological factors, influencing overall survival (OS), and event-free survival (EFS) of CC patients. MATERIAL AND METHODS The electronic databases of PubMed, EmBase, and the Cochrane library were systematically searched for identification of eligible studies published until June 2021. The pooled hazard ratio (HR) with 95% confidence interval (CI) were calculated using the random-effects model. Sensitivity and subgroup analyses and assessment of publication bias were also conducted. RESULTS We selected 140 studies that involved 47 965 patients for the meta-analysis. The results revealed that age, cell type, depth of tumor invasion, the International Federation of Gynecology and Obstetrics stage, hemoglobin level, histological grade, leukocytosis, lymph node involvement, lymph-vascular space invasion, neutrophil-to-lymphocyte ratio, parametrial invasion, platelet-to-lymphocyte ratio, resection margin, squamous cell carcinoma antigen level, thrombocytosis, tumor grade, tumor size, and tumor volume were clinicopathological factors influencing OS and EFS of CC patients (P<0.05). CONCLUSIONS This study comprehensively identified the prognostic significance of clinicopathological factors, influencing OS, and EFS of CC patients. However, further large-scale prospective studies should be conducted to verify our findings and develop more accurate prognostic models for CC.


Metronidazole lacks antibacterial activity in guinea pigs infected with Mycobacterium tuberculosis.
Metronidazole, which is used for the treatment of infections caused by anaerobic organisms, was evaluated in Mycobacterium tuberculosis-infected guinea pigs. M. tuberculosis can adapt to hypoxia, which is present in the primary lesions of infected guinea pigs. Metronidazole treatment (for 6 weeks at 100 mg/kg of body weight) resulted in no reduction in the bacillary burden and significantly worsened lesion inflammation.


Studies on Haemonchus contortus. IX. The effect of Trichostrongylus axei in Merinos on natural pasture.
Four groups of 6-7-month-old Merino lambs were each dosed with 40 000 infective larvae of Trichostrongylus axei on 2 November 1976 and subsequently exposed to challenge with Haemonchus contortus on natural grazing at the University of Pretoria's Experimental Farm in the eastern suburbs of Pretoria. One of these groups and one group of controls were killed every 8 weeks from the end of December 1976-June 1977. Predosing with T. axei was greater than 50% effective against 5th stage and adult H. contortus in greater than 50% of sheep for 164 days (Class C), improving to greater than 60% in greater than 60% of sheep (Class B) 220 days after dosing T. axei. The numbers of retarded 4th stage larvae (L4) of H. contortus in the undosed controls as well as in the sheep predosed with T. axei rose from a low level in summer (December) to a peak in late Autumn (June).


Exogenous Application of Proteoglycan to the Cell Surface Microenvironment Facilitates to Chondrogenic Differentiation and Maintenance.
Osteoarthritis (OA), a disease that greatly impacts quality of life, has increasing worldwide prevalence as the population ages. However, its pathogenic mechanisms have not been fully elucidated and current therapeutic treatment strategies are inadequate. In recent years, abnormal endochondral ossification in articular cartilage has received attention as a pathophysiological mechanism in OA. Cartilage is composed of abundant extracellular matrix components, which are involved in tissue maintenance and regeneration, but how these factors affect endochondral ossification is not clear. Here, we show that the application of aggrecan-type proteoglycan from salmon nasal cartilage (sPG) exhibited marked proliferative capacity through receptor tyrosine kinases in chondroprogenitor cells, and also exhibited differentiation and three-dimensional structure formation via phosphorylation of Insulin-like Growth Factor-1 Receptor and Growth Differentiation Factor 5 expression. Furthermore, sPG inhibited calcification via expression of Runx2 and Col10 (factors related to induction of calcification), while increasing Mgp, a mineralization inhibitory factor. As a result of analyzing the localization of sPG applied to the cells, it was localized on the surface of the cell membrane. In this study, we found that sPG, as a biomaterial, could regulate cell proliferation, differentiation and calcification inhibition by acting on the cell surface microenvironment. Therefore, sPG may be the foundation for a novel therapeutic approach for cartilage maintenance and for improved symptoms in OA.


Effects of a cardio-selective beta-adrenergic blocker (I.C.I. 50172) at exercise in angina pectoris.
A cardio-selective beta-adrenergic blocking agent (I.C.I. 50172), which has been studied both in normal subjects and in patients with angina pectoris during and after a standardized work test, produced a significant increase in the exercise tolerance of the patients. These favourable effects are comparable with those of propranolol.One patient with severe bronchial asthma and coronary insufficiency treated with I.C.I. 50172 improved and his respiratory function was not impaired.


Smooth muscle archvillin is an ERK scaffolding protein.
ERK influences a number of pathways in all cells, but how ERK activities are segregated between different pathways has not been entirely clear. Using immunoprecipitation and pulldown experiments with domain-specific recombinant fragments, we show that smooth muscle archvillin (SmAV) binds ERK and members of the ERK signaling cascade in a domain-specific, stimulus-dependent, and pathway-specific manner. MEK binds specifically to the first 445 residues of SmAV. B-Raf, an upstream regulator of MEK, constitutively interacts with residues 1-445 and 446-1250. Both ERK and 14-3-3 bind to both fragments, but in a stimulus-specific manner. Phosphorylated ERK is associated only with residues 1-445. An ERK phosphorylation site was determined by mass spectrometry to reside at Ser132. A phospho-antibody raised to this site shows that the site is phosphorylated during alpha-agonist-mediated ERK activation in smooth muscle tissue. Phosphorylation of SmAV by ERK decreases the association of phospho-ERK with SmAV. These results, combined with previous observations, indicate that SmAV serves as a new ERK scaffolding protein and provide a mechanism for regulation of ERK binding, activation, and release from the signaling complex.


Microbiological evaluation of endodontic files after cleaning and steam sterilization procedures.
Infection control procedures are essential for modern dental practice and they are continually evolving to meet the dental profession's high standards. The present study evaluated the efficacy of two cleaning procedures to reduce bacterial numbers on endodontic files, and evaluated the effect of biological debris on the subsequent sterilization of files. Stainless steel and nickel-titanium (NiTi) files were examined upon removal from the manufacturer's packaging, after instrumentation in root canals of human teeth inoculated with a broth containing two anaerobic species and one facultative anaerobic species of bacteria, and after instrumentation and cleaning with either an ultrasonic bath or a thermal disinfector. For each file, the bacterial numbers were quantified using routine microbiological techniques in an anaerobic chamber. No bacteria were detected from files direct from their packets. The size, taper and type of file did not affect the ability of either of the cleaning procedures to reduce bacterial numbers. However, an absence of bacteria was more likely when files were cleaned in the thermal disinfector. No bacteria were detected from files that were-subjected to steam sterilization irrespective of the type of prior cleaning procedure. Steam sterilization eliminated all bacteria from the endodontic files irrespective of the presence of biological debris. The majority of bacteria were eliminated from endodontic files after either ultrasonic cleaning or using a thermal disinfector.


Histopathological studies on senile plaques in brains of patients with Down's syndrome.
Senile plaques (SPs) as a hallmark of Alzheimer's pathology were studied in the brains of 5 cases of Down's syndrome (DS), using silver stains including modified Bielschosky and new methenamine silver method which had been reported to show almost the same staining pattern as that of beta-protein immunostaining. SPs were observed in the CA1, the subiculum, the molecular layer of the gyrus dentatus, and the cerebral neocortices of all cases examined. In the striatum and the cerebellum, SPs were found in 2 out of 4 cases, both over the age of 30. In the cerebral cortex and the hippocampal formation, SPs were almost exclusively composed of the diffuse type below the age of 30, while primitive and classical plaques first appeared over the age of 30. In case 1 (aged 16), the cerebral cortex contained a few perivascular plaques associated with amyloid angiopathy known as dyshoric angiopathy. Our results suggest that diffuse plaques and dyshoric angiopathy are possibly earliest stages of SP formation in DS brains.


Dakin's solution: is there a place for it in the 21st century?
Dakin's solution (DS) is a time-honoured antiseptic that still remains part of the wound care armamentarium. In spite of its cytotoxicity, some question its use in the current era. We report the case of a 52-year-old diabetic woman who was admitted for sepsis because of a severely infected diabetic foot. Urgent surgical drainage and debridement left a 9 × 9-cm deep, complex, infected wound with both bone and tendon involvement. Treatment with local negative pressure was unsuccessful. DS was regularly instilled through a tube left in the wound dressing. A marked improvement was observed with this strategy as the wound bed was much cleaner and fully granulated after 6 weeks. No adverse effects were noted. This case debunks the myth that topical antiseptics necessarily impair wound healing. DS can still be considered an option for difficult-to-treat, complex and heavily infected wounds.


[Observation on TXB2 and 6-keto-PGF1 alpha in serum of patients with cor pulmonale].
To know the changes of TXA2 and PGI2 in serum of patients with cor pulmonale, the levels of their stable metabolites TXB2 and 6-keto-PGF1 alpha in serum were examined in 28 patients with cor pulmonale during alleviation, 29 patients with cor pulmonale during exacerbation before and after treatment and 10 healthy subjects. TXB2 and 6-keto-PGF1 alpha were 109.74 +/- 56.14 ng/L and 54.76 +/- 35.62 ng/L respectively in healthy subjects; TXB2/6-keto-PGF1 alpha = 2.004. The TXB2 level of patients with cor pulmonale at every stage was higher than that of healthy subjects (P < 0.05-0.01). Patients with cor pulmonale during exacerbation had the highest TXB2 level of 709.22 +/- 354.49 ng/L, which decreased to 408.24 +/- 289.41 ng/L (P < 0.05) after treatment with traditional Chinese medicine combined with western medicine and the decreased level as such was not significantly different from that during alleviation (333.14 +/- 324.14 ng/L). The 6-keto-PGF1 alpha level in patients with cor pulmonale at every stage was not significantly different from that of healthy subjects. Since TXB2 increased, the value TXB2/6-keto-PGF1 alpha of patients with cor pulmonale was greater than that of healthy subjects. It is most likely that chronic hypoxia and hypercapnia lead to prostaglandin release in the lung of patients with cor pulmonale; hypoxia and hypercapnia become more severe during exacerbation resulting from infection; which lead to increased prostaglandin release, then high TXB2 level ensue as the result. TXB2 decreases after amelioration of hypoxia during treatment. But the change of 6-keto-PGF1 alpha is not obvious.


Associations between eating frequency and energy intake, energy density, diet quality and body weight status in adults from the USA.
To investigate associations between eating frequency and energy intake, energy density, diet quality and body weight status in adults from the USA, combined data from the 2009-2010 and 2011-2012 National Health and Nutrition Examination Survey (NHANES) were used in this study. The first 24-h dietary recall data from eligible participants (4017 men and 3774 women) were used to calculate eating frequency, as well as energy intake, energy density and the Healthy Eating Index 2010 (HEI-2010), as a measure of diet quality. BMI and waist circumference were obtained from the NHANES body measures data. Adjusting for confounding socio-demographic characteristics and lifestyle factors, a higher eating frequency was significantly associated with higher energy intake in both men and women (both P<0·001). A higher eating frequency was also significantly associated with lower energy density in both men and women, regardless of whether beverage or water intake was included in the calculation of energy density (all P<0·01). Moreover, there was a significant positive association between eating frequency and the HEI-2010 total score in both men and women (both P<0·001). Eating frequency was inversely associated with BMI in women (P=0·003), as well as waist circumference in both men (P=0·032) and women (P=0·010). Results from the present study suggested that adults with a higher eating frequency in the USA had a healthier diet with lower energy density and better diet quality, and eating frequency was inversely associated with body weight status.


Effects of a single session of prolonged plantarflexor stretch on muscle activations during gait in spastic cerebral palsy.
Activations of the triceps surae (TS) and tibialis anterior (TA) muscles during gait were studied in children with spastic cerebral palsy (CP) immediately before and after 30 min of standing on a tilt-table with the ankle dorsiflexed to stretch the TS in the experimental group (n = 8) or after a rest period in the control group (n = 11). The EMG activity from the TS and TA was recorded concomitantly with electronic footswitch signals by a computer. Video records were made of the sagittal gait movements. Effects of PMS were determined by comparing change scores for selected spatiotemporal and muscle activation parameters between the groups. The change scores defined for the muscle activations were: a post-test/pre-test ratio of the EMG activity in specific segments of the gait cycle and a locomotor spasticity index. PMS did not significantly (p greater than 0.05) affect any of the spatiotemporal parameters nor did it alter any of the TS and most of the TA activation parameters or the SI indexes for the TS and TA. Only the TA post/pre activation ratio for the 0-16% segment of the gait cycle was smaller (p less than 0.01), indicating a decrease in TA activation post-PMS.


Role of Flavonoids in Neurodegenerative Disorders with Special Emphasis on Tangeritin.
Flavonoids are naturally occurring plant polyphenols found universally in all fruits, vegetables and medicinal plants. They have emerged as a promising candidate in the formulation of treatment strategies for various neurodegenerative disorders. The use of flavonoid rich plant extracts and food in dietary supplementation have shown favourable outcomes. The present review describes the types, properties and metabolism of flavonoids. Neuroprotective role of various flavonoids and the possible mechanism of action in the brain against the neurodegeneration have been described in detail with special emphasis on the tangeritin.


Comparison of different systems to classify the neurological level of lesion in patients with myelomeningocele.
In 73 patients with myelomeningocele (mean 17.2 years, range 5 to 40 years) the classification of level of lesion was studied according to six commonly used classification systems and to the ambulation groups of Hoffer. The distribution of the patients into classes of thoracic-level lesions was the same for four classification systems in 10 patients and for two classification systems into categories of level L3 in 14 patients. For the other patients discrepancies occurred between systems for lesions of level L3 and downward. None of the patients was consistently categorized in the functional ambulation groups of Hoffer using all classification systems. The results show that it is not possible to compare neurological lesion levels classified according to the different systems described in this study and consequently that the distribution into the functional ambulation groups of Hoffer varies. To enhance communication and facilitate comparing the results of treatment we suggest using some basic criteria for patient documentation.


Comparative studies on activation of latent herpes simplex virus in rabbits.
Latent infection was established in 113 rabbits by inoculation of herpes simplex virus type 1 (HSV-1) strain Kupka into the right scarified cornea. In animals succumbed from 88-387 days post-infection (p.i.), HSV-1 was detected in the cultured right cornea (RC) fragments of 2 out 45 rabbits (4.4%), while the cultured right trigeminal ganglion (RTG) fragments yielded virus in 60 out 70 animals (85.7%). Spontaneous virus shedding occurred nearly in the half (35) of 74 animals followed for a mean of 211 days; providing that swabbing of both eyes was made 1-2 times weekly, the positive isolation rate was 1.3% (73 out total 5648 samples). The following treatments were used for provocation: cyclophosphamide (CPA) alone, mechanical trauma to cornea in association with local administration of either xylene or adrenalin, and a combination of both CPA administration and corneal irritation. In the course of these treatments continued for 4-8 days, virus was reisolated in 9 out 59 rabbits, the average positive isolation rate from RC being 6.9% (29 out 420 samples). HSV-specific antigens were searched for in about 56 000 semiserial sections prepared from noncultured as well as cultured samples of RC, both Gasserian ganglia and brainstem coming from 87 rabbits with established latency, of which 42 underwent provocation. By direct fluorescent antibody (FA) staining single neurons positive for structural HSV antigens were found in 14% of noncultured RTG samples from untreated rabbits as compared to 37% of such samples from animals subjected to provocation. In the course of above treatments, explanted RC fragments were positive in 17 out of 42 animals (40.4%) indicating a 9-fold increase in comparison to non-stimulated rabbits. The results confirm the absence of any virus, either infectious or covert, at the inoculation site in 95.6% of rabbits autopsied later than 12 weeks p.i. They also imply that a reversed transport of HSV occurred upon either spontaneous of artificial virus activations.


Stochastic transitions in a bistable reaction system on the membrane.
Transitions between steady states of a multi-stable stochastic system in the perfectly mixed chemical reactor are possible only because of stochastic switching. In realistic cellular conditions, where diffusion is limited, transitions between steady states can also follow from the propagation of travelling waves. Here, we study the interplay between the two modes of transition for a prototype bistable system of kinase-phosphatase interactions on the plasma membrane. Within microscopic kinetic Monte Carlo simulations on the hexagonal lattice, we observed that for finite diffusion the behaviour of the spatially extended system differs qualitatively from the behaviour of the same system in the well-mixed regime. Even when a small isolated subcompartment remains mostly inactive, the chemical travelling wave may propagate, leading to the activation of a larger compartment. The activating wave can be induced after a small subdomain is activated as a result of a stochastic fluctuation. Such a spontaneous onset of activity is radically more probable in subdomains characterized by slower diffusion. Our results show that a local immobilization of substrates can lead to the global activation of membrane proteins by the mechanism that involves stochastic fluctuations followed by the propagation of a semi-deterministic travelling wave.


Application of N-terminally truncated DNA polymerase from Thermus thermophilus (delta Tth polymerase) to DNA sequencing and polymerase chain reactions: comparative study of delta Tth and wild-type Tth polymerases.
N-Terminally truncated DNA polymerase from Thermus thermophilus (delta Tth polymerase) lacking 5'-3' exonuclease activity was used for DNA sequencing and polymerase chain reaction (PCR). In contrast to the high background of the sequencing ladder observed with the wild-type Tth polymerase, delta Tth polymerase gave readable sequencing patterns which extend up to more than 500 bases from the primer site on cycle sequencing and automated sequencing. The delta Tth polymerase was used for the standard and mutagenic PCR, and net amplification of the DNA and the mutations accumulated during PCR were analyzed. Under mutagenic PCR, the mutation rates were 7.0 x 10(-4) (Tth) and 8.3 x 10(-4) (delta Tth) per nucleotide per cycle of amplification, which were 4-9 times higher than the rates under standard PCR.


Hierarchical Classification of Cancers of Unknown Primary Using Multi-Omics Data.
A cancer of unknown primary (CUP) is a metastatic cancer for which standard diagnostic tests fail to locate the primary cancer. As standard treatments are based on the cancer type, such cases are hard to treat and have very poor prognosis. Using molecular data from the metastatic cancer to predict the primary site can make treatment choice easier and enable targeted therapy. In this article, we first examine the ability to predict cancer type using different types of omics data. Methylation data lead to slightly better prediction than gene expression and both these are superior to classification using somatic mutations. After using 3 data types independently, we notice some differences between the classes that tend to be misclassified, suggesting that integrating the data might improve accuracy. In light of the different levels of information provided by different omics types and to be able to handle missing data, we perform multi-omics classification by hierarchically combining the classifiers. The proposed hierarchical method first classifies based on the most informative type of omics data and then uses the other types of omics data to classify samples that did not get a high confidence classification in the first step. The resulting hierarchical classifier has higher accuracy than any of the single omics classifiers and thus proves that the combination of different data types is beneficial. Our results show that using multi-omics data can improve the classification of cancer types. We confirm this by testing our method on metastatic cancers from the MET500 dataset.


Cloning and Expression of Luffin-b cDNA from the Seeds of Luffa cylindrica.
Luffin-b with Mr. 28 kD, isolated from the seeds of Luffa cylindrica,is one of the most toxic single chain plant ribosome inactivating proteins. The cDNA sequence of luffin-b was already reported by Kataoka in 1992. In this work, the luffin-b gene(lufB) coding sequence was cloned from the fresh seeds of Luffa cylindrica by RT-PCR, and the coding sequence of the gene was shown to be identical with that determined by Kataoka. The lufB expression plasmid was constructed by inserting the lufB cDNA fragment into vector pET24a( ), and the pET24a( )- lufB vector was expressed in E.coli by 0.5 mmol/L IPTG induction. The recombinant product, which mainly existed in inclusion bodies, was identified by SDS-PAGE and Western blotting. The recombinant luffin-b, which was renatured by dialysis with step by step decreasing concentration of urea, showed high activity of ribosome inactivation.


ECHOCARDIOGRAPHIC EVALUATION OF THE RIGHT HEART IN THE PULMONARY HYPERTENSION.
Introduction: A comprehensive assessment of right ventricular size and function, as well as evaluation of pulmonary artery pressures is an integral part of every echocardiographic examination. It is important to know the relevant guidelines but also the pitfalls of echocardiography. The aim: To determine the significance of echocardiography in the diagnostic process, prognosis and evaluation of treatment effectiveness in pulmonary hypertension. Review and Discussion: The gold standard for evaluation of size, ejection fraction, and stroke volume of the right ventricle is cardiac magnetic resonance. Whereas, the gold standard for the assessments of pulmonary artery pressures is right heart catheterization. However, echocardiography is the first diagnostic modality in the assessment of size and function of the right heart. Conclusions: Echocardiographic evaluation of the right heart plays a fundamental role in the diagnostic process of pulmonary hypertension. Echocardiography is essential to predict the course of the disease and assess the treatment efficiency.


Sevoflurane Attenuates Ischemia-Reperfusion Injury in a Rat Lung Transplantation Model.
Sevoflurane is one of the most commonly used volatile anesthetic agents with the fastest onset and offset, replacing isoflurane in modern anesthesiology. Preconditioning and postconditioning using volatile anesthetics can attenuate ischemia-reperfusion injury (IRI). However, no previous studies have evaluated the effect of sevoflurane in lung transplantation after cold ischemic injury. We aimed to study the effects of donor and recipient treatment with sevoflurane in a rat lung transplantation model. Lewis rats were allocated to four groups: control, PreC (preconditioning), PostC (postconditioning), and PreC + PostC. Donor rats in the PreC and PreC + PostC groups were exposed to 1.5% sevoflurane for 30 minutes before donor operation. Donor lungs were flushed with Perfadex and stored for 12 hours at 4°C before transplantation. Recipients received orthotopic left lung transplantation. In the PostC and PreC + PostC groups, sevoflurane was initiated 2 minutes before reperfusion and maintained for 30 minutes. Two hours after reperfusion, lung function was evaluated, and samples were collected for histologic, inflammatory, and cell death assessment. Preconditioning and postconditioning using sevoflurane significantly improved the oxygenation of lung grafts (partial arterial gas pressure of oxygen: 198 mm Hg in control, 406.5 mm Hg in PreC, 472.4 mm Hg in PostC, and 409.7 mm Hg in PreC + PostC, p < 0.0001) and reduced pulmonary edema. Sevoflurane treatment reduced levels of interleukin-1β, interleukin-6, and tumor necrosis factor-α. Moreover, sevoflurane significantly inhibited apoptotic cells by a decrease in cytochrome c release into cytosol and caspase-3 cleavage. Preconditioning or postconditioning of lungs using sevoflurane exhibits a significant protective effect against early phase of ischemia-reperfusion injury in a rat lung transplantation model.


Exercise downregulates HIPK2 and HIPK2 inhibition protects against myocardial infarction.
Exercise can protect myocardial infarction (MI) and downregulate cardiac Homeodomain-Interacting Protein Kinase 2 (HIPK2). However, the role of HIPK2 in MI is unclear. HIPK2-/- mice and miR-222-/- rats, HIPK2 inhibitor (PKI1H) and adeno-associated virus serotype 9 (AAV9) carrying miR-222 were applied in the study. Animals were subjected to running, swimming, acute MI or post-MI remodeling. HIPK2 inhibition and P53 activator were used in neonatal rat cardiomyocytes (NRCMs) and human embryonic stem cell-derived cardiomyocytes (hESC-CMs) subjected to oxygen glucose deprivation/reperfusion (OGD/R). Serum miR-222 levels were analyzed in healthy people and MI patients that were survival or readmitted to the hospital and/or died. Cardiac HIPK2 protein levels were reduced by exercise while increased in MI. In vitro, HIPK2 suppression by lentiviral vectors or inhibitor prevented apoptosis induced by OGD/R in NRCMs and hESC-CMs. HIPK2 inhibitor-treated mice and HIPK2-/- mice reduced infarct size after acute MI, and preserved cardiac function in MI remodeling. Mechanistically, protective effect against apoptosis by HIPK2 suppression was reversed by P53 activators. Furthermore, increasing levels of miR-222, targeting HIPK2, protected post-MI cardiac dysfunction, whereas cardiac dysfunction post-MI was aggravated in miR-222-/- rats. Moreover, serum miR-222 levels were significantly reduced in MI patients, as well as in MI patients that were readmitted to the hospital and/or died compared to those not. Exercise-induced HIPK2 suppression attenuates cardiomyocytes apoptosis and protects MI by decreasing P-P53. Inhibition of HIPK2 represents a potential novel therapeutic intervention for MI. This work was supported by the grants from National Key Research and Development Project (2018YFE0113500 to JJ Xiao), National Natural Science Foundation of China (82020108002, 81722008, and 81911540486 to JJ Xiao, 81400647 to MJ Xu, 81800265 to YJ Liang), Innovation Program of Shanghai Municipal Education Commission (2017-01-07-00-09-E00042 to JJ Xiao), the grant from Science and Technology Commission of Shanghai Municipality (18410722200 and 17010500100 to JJ Xiao), the "Dawn" Program of Shanghai Education Commission (19SG34 to JJ Xiao), Shanghai Sailing Program (21YF1413200 to QL Zhou). JS is supported by Horizon2020 ERC-2016-COG EVICARE (725229).


Site of covalent labeling by a photoreactive batrachotoxin derivative near transmembrane segment IS6 of the sodium channel alpha subunit.
The binding site for batrachotoxin, a lipid-soluble neurotoxin acting at Na+ channel receptor site 2, was localized using a photoreactive radiolabeled batrachotoxin derivative to covalently label purified and reconstituted rat brain Na+ channels. In the presence of the brevetoxin 1 from Ptychodiscus brevis and the pyrethroid RU51049, positive allosteric enhancers of batrachotoxin binding, a protein with an apparent molecular mass of 240 kDa corresponding to the Na+ channel alpha subunit was specifically covalently labeled. The region of the alpha subunit specifically photolabeled by the photoreactive batrachotoxin derivative was identified by antibody mapping of proteolytic fragments. Even after extensive trypsinization, and anti-peptide antibody recognizing an amino acid sequence adjacent to Na+ channel transmembrane segment IS6 was able to immunoprecipitate up to 70% of the labeled peptides. Analysis of a more complete digestion with trypsin or V8 protease indicated that the batrachotoxin receptor site is formed in part by a portion of domain I. The identification of a specifically immunoprecipitated photolabeled 7.3-kDa peptide containing transmembrane segment S6 from domain I restricted the site of labeling to residues Asn-388 to Glu-429 if V8 protease digestion was complete or Leu-380 to Glu-429 if digestion was incomplete. These results implicate the S6 transmembrane region of domain I of the Na+ channel alpha subunit as an important component of the batrachotoxin receptor site.


Marked depression of radiation-induced emesis in frogs following prior exposure to a brief dose of X-rays.
Acute emesis response to harmful doses of X-rays on frogs (Rana porosa porosa) was examined. Results showed that the number of radioemesis events following exposure to 0.85 Gy was slightly higher than in the sham control animals. The increase in emesis action became more pronounced when the total dose of radiation was raised to 2.5 Gy. Only 1 frog out of a total of 12 did not show vomiting following radiation, while no response was observed in sham control animals. Note that animals in which the low dose rate of radiation was applied to whole body did not display any changes in the emesis response relative to control animals. The present studies, and those by others, showed that a brief dose of X-rays prior to a second exposure to a sub-lethal dose might induce a tolerance to radiation. An additional experiment was conducted to examine whether a small conditioning dose could induce a depression of radioemesis (tolerance) following an exposure to high dose X-ray. With prior exposure to 0.3 Gy, only 1 frog out of a total of 5 frogs vomited as a result of radiation exposure. Suppression of the emetic response became significant when the pre-radiation dose was decreased to 0.1 Gy. On the contrary, increasing the small conditioning dose to 0.5 Gy resulted in a remarkable rise of radiation-induced emesis. This results indicate that exposure to the smaller dose of X-rays elicits a tolerance effect to toxic dose level of radiation.


Transient cyst-like cortical defects following fractures in children. Medullary fat within the subperiosteal haematoma.
Asymptomatic cyst-like cortical defects appearing after fractures in children have been occasionally reported. Typically, these defects appear during fracture consolidation, within the newly formed subperiosteal bone, proximal to the fracture line, do not enlarge, and progressively disappear. We have previously shown a fatty density on CT scan within the early cortical defect. We now present two additional cases in which early CT scans appeared to confirm that these transient cortical defects may consist of fat, and probably result from the inclusion of medullary fat within the subperiosteal haematoma.


A rare case of Brown-Sequard syndrome caused by traumatic cervical epidural hematoma.
Brown-Sequard syndrome (BSS) is a well-known entity that is most commonly caused by a penetrating injury to the spinal cord (e.g., stab wound or gunshot wound). It is characterized by an ipsilateral weakness (damage to corticospinal tracts) and contralateral loss of pain and temperature two levels below the lesion (damage to lateral spinothalamic tracts). Although, rarely non-penetrating injuries, tumors, disc herniations, infections, autoimmune diseases, and epidural hematomas (non-penetrating trauma and spontaneous) have contributed to BSS syndromes, there are only four cases of BSS in the literature attributed to traumatic spinal epidural hematomas. Here, we add an additional case involving a 59-year-old male. A 59-year-old male presented with a Brown-Sequard syndrome (BSS) after a motor vehicle accident. The magnetic resonance imaging (MRI) demonstrated a cervical epidural hematoma at the C7-T1 level. Following a T1 laminectomy and C6-T1 fusion, his neurological deficit markedly improved. Within six postoperative months, he regained full motor function. For this patient and others with a traumatic cervical epidural hematoma (C7T1) resulting in a BSS, early decompression (within 48 hours) should result in marked postoperative neurological improvement.


Dendritic polyglycerol sulfates as new heparin analogues and potent inhibitors of the complement system.
Due to several limitations of heparin, a widely used antithrombotic drug, there is large interest to develop alternatives. The aim of the presented study was to produce fully synthetic highly branched heparin mimetics. For this purpose, a new type of 'treelike' polysulfated polymers based on dendritic polyglycerol was synthesized. An efficient synthetic approach has been chosen to prepare several polyglycerol sulfates with different molecular weights as well as a polyglycerol carboxylate analogue and to evaluate them for their anticoagulant and anticomplementary activities. In contrast to the nonderivatized and the carboxylated polyglycerols, the polyglycerol sulfates prolong the activated partial thromboplastin time (APTT) and thrombin time (TT) and inhibit both the classical (CCA) and alternative complement activation (ACA). Whereas their anticoagulant activity in the APTT and in the TT amounts to 5.7-8.1% and 15.7-33.6%, respectively, of that of unfractionated heparin (UFH), their CCA and ACA inhibitory activity is 13.4-23.9 and 2.7-3.7 times, respectively, higher. In contrast to sulfated polysaccharides, the activities are not clearly dependent on the molecular weight, which might be due to the globular 3D-structure of the dendritic molecules. Due to the coherence between coagulation, complement activation and inflammation in the pathophysiology of numerous diseases, polyglycerol sulfates with both anticoagulant and anticomplementary activities represent promising candidates for the development of potential drugs.


Design of controlled drug delivery system based on disulfide cleavage trigger.
The disulfide bond has drawn increasing attention for the application on controlled drug delivery systems (CDDSs) due to its high redox sensibility, which is derived from the fact that the concentration of glutathione (GSH), a disulfide-bond-breaking agent, in the tumor tissue is 1000-fold higher than that in the blood plasma and the normal tissue. Thus, a disulfide is an ideal candidate for serving as the drug release trigger of CDDSs, which would be stable in the blood circulation and be broken when it reached the tumor tissue. However, improvements are still required in designing the structure of CDDSs and the drug loading patterns for CDDSs, which are important to the performance of CDDSs. This Feature Article briefly summarizes our recent research progress on the design and construction of CDDSs based on disulfide cleavage triggers, with different drug loading strategies (covalent and noncovalent) and carriers (copolymer and mesoporous silica nanoparticle). The controlled drug release mechanism and behaviors of these CDDSs are also discussed.


Cocaine-induced microvascular vasoconstriction but differential systemic haemodynamic responses in Yucatan versus Yorkshire varieties of swine.
1. Systemic and coronary haemodynamics were measured in 6 Yorkshire swine and 6 Yucatan miniature swine under isoflurane anaesthesia to investigate the influence of cocaine following its intravenous administration at 1, 3 and 7 mg kg-1. 2. Cocaine in Yorkshire swine decreased mean arterial pressure and rate pressure product (systolic pressure x heart rate), suggesting a cardiac depressant effect, whereas cocaine in Yucatan miniature swine increased these parameters, consistent with a hyperadrenergic state. 3. Cocaine in both Yorkshire swine and Yucatan miniature swine decreased coronary blood flow and coronary flow reserve, and increased coronary vascular resistance. 4. A modest generalized epicardial coronary artery constriction was observed by angiography, without evidence of focal spasm. 5. Our results confirm a marked vasoconstrictor effect of cocaine on the coronary arterial circulation, predominantly distal to the epicardial coronary arteries, but also indicate important differences in the systemic cardiovascular responses to the drug between two closely related strains of animals within the same species. Due to the similarities between the swine and human coronary arterial vasculature, we suggest that vasoconstriction in the coronary microcirculation may produce cardiac toxicity in man.


Can we reduce ischemic cholangiopathy rates in donation after cardiac death liver transplantation after 10 years of practice? Canadian single-centre experience
Outcomes in liver transplantation with organs obtained via donation after cardiocirculatory death (DCD) have been suboptimal compared to donation after brain death, attributed mainly to the high incidence of ischemic cholangiopathy (IC). We evaluated the effect of a 10-year learning curve on IC rates among DCD liver graft recipients at a single centre. We analyzed all DCD liver transplantation procedures from July 2006 to July 2016. Patients were grouped into early (July 2006 to June 2011) and late (July 2011 to July 2016) eras. Those with less than 6 months of follow-up were excluded. Primary outcomes were IC incidence and IC-free survival rate. Among the 73 DCD liver transplantation procedures performed, 70 recipients fulfilled the selection criteria, 32 in the early era and 38 in the late era. Biliary complications were diagnosed in 19 recipients (27%). Ischemic cholangiopathy was observed in 8 patients (25%) in the early era and 1 patient (3%) in the late era (p = 0.005). The IC-free survival rate was higher in the late era than the early era (98% v. 79%, p = 0.01). The warm ischemia time (27 v. 24 min, p = 0.049) and functional warm ischemia time (21 v. 17 min, p = 0.002) were significantly lower in the late era than the early era. We found a significant reduction in IC rates and improvement in ICfree survival among DCD liver transplantation recipients after a learning curve period that was marked by more judicious donor selection with shorter procurement times.


Cloning of the BamHI repeat from Amaranthus and study of its methylation in genomic DNA during dedifferentiation.
A 670 bp BamHI repeat was isolated from the genomic DNA of Amaranthus paniculatus and was cloned in pUC19 vector (pABH3). The level of methylation of total genomic DNA and the BamHI repeat therein was studied by employing methylation sensitive enzymes to digest genomic DNA isolated from whole seedlings, hypocotyl, callus, and suspension culture of Amaranthus. The restriction pattern indicated double methylation of the target site CCGG. Methylation pattern of both the total genomic DNA and the cloned repeat was found to be similar during dedifferentiation indicating that there may not be a general relationship between hypomethylation and dedifferentiation.


The potential of DNA vaccination against tumor-associated antigens for antitumor therapy.
Conventional treatment approaches for malignant tumors are highly invasive and sometimes have only a palliative effect. Therefore, there is an increasing demand to develop novel, more efficient treatment options. Increased efforts have been made to apply immunomodulatory strategies in antitumor treatment. In recent years, immunizations with naked plasmid DNA encoding tumor-associated antigens have revealed a number of advantages. By DNA vaccination, antigen-specific cellular as well as humoral immune responses can be generated. The induction of specific immune responses directed against antigens expressed in tumor cells and displayed e.g., by MHC class I complexes can inhibit tumor growth and lead to tumor rejection. The improvement of vaccine efficacy has become a critical goal in the development of DNA vaccination as antitumor therapy. The use of different DNA delivery techniques and coadministration of adjuvants including cytokine genes may influence the pattern of specific immune responses induced. This brief review describes recent developments to optimize DNA vaccination against tumor-associated antigens. The prerequisite for a successful antitumor vaccination is breaking tolerance to tumor-associated antigens, which represent "self-antigens." Currently, immunization with xenogeneic DNA to induce immune responses against self-molecules is under intensive investigation. Tumor cells can develop immune escape mechanisms by generation of antigen loss variants, therefore, it may be necessary that DNA vaccines contain more than one tumor antigen. Polyimmunization with a mixture of tumor-associated antigen genes may have a synergistic effect in tumor treatment. The identification of tumor antigens that may serve as targets for DNA immunization has proceeded rapidly. Preclinical studies in animal models are promising that DNA immunization is a potent strategy for mediating antitumor effects in vivo. Thus, DNA vaccines may offer a novel treatment for tumor patients. DNA vaccines may also be useful in the prevention of tumors with genetic predisposition. By DNA vaccination preventing infections, the development of viral-induced tumors may be avoided.