Transcriptome Profiles of Leaves and Roots of Goldenrain Tree (Koelreuteria paniculata Laxm.) in Response to Cadmium Stress.
Cadmium (Cd) pollution is a widespread environmental problem. In this study, we explored the transcriptome and biochemical responses of goldenrain tree (Koelreuteria paniculata Laxm.) leaves and roots to Cd stress. Leaf and root growth decreased substantially under Cd stress (50 mg/L CdCl2), but leaf and root antioxidant mechanisms were significantly activated. In RNA-seq analysis, roots treated with 25 mg/L CdCl2 featured enriched GO terms in cellular components related to intracellular ribonucleoprotein complex, ribonucleoprotein complex, and macromolecular complex. In leaves under Cd stress, most differentially expressed genes were enriched in the cellular component terms intrinsic component of membrane and membrane part. Weighted gene co-expression network analysis and analysis of module-trait relations revealed candidate genes associated with superoxide dismutase (SOD), peroxidase (POD), and catalase (CAT) activities and malondialdehyde (MDA). Ten transcription factors responded to Cd stress expression, including those in C2H2, MYB, WRKY, and bZIP families. Transcriptomic analysis of goldenrain tree revealed that Cd stress rapidly induced the intracellular ribonucleoprotein complex in the roots and the intrinsic component of membrane in the leaves. The results also indicate directions for further analyses of molecular mechanisms of Cd tolerance and accumulation in goldenrain tree.


Efficacy of vitamin E-bonded polysulfone dialyzer and polysulfone dialyzer on a series of non-anticoagulant hemodialysis.
Non-anticoagulant hemodialysis is conducted occasionally at limited numbers of hospitals on an empirical basis. This study examines the efficacy of polysulfone and vitamin E-bonded polysulfone dialyzer for non-anticoagulant hemodialysis. These dialyzers were assigned one after the other for a vintage hemodialysis patient complicated with uncontrollable bleeding. The patient's vital and console data throughout non-anticoagulant hemodialysis were monitored serially. Both dialyzers were reasonably applicable to hemodialysis without major clotting. The scheduled treatment period was completed. Vitamin E-bonded polysulfone dialyzer was superior to non-anticoagulant hemodialysis based on venous pressure observed during treatment.


Development of a hepatitis B vaccine from transformed yeast cells.
The production in yeast cells of the recombinant DNA hepatitis B vaccine of SmithKline Biologicals involves an optimized fermentation process followed by cell disruption and extraction, together with other soluble yeast components of the surface antigen of the hepatitis B virus. The subsequent purification process includes precipitation steps, ion exchange and gel permeation chromatography, and caesium chloride ultracentrifugation. The yeast-derived antigen occurs as spherical particles containing the non-glycosylated HBsAg polypeptide, lipid, and Tween 20. The purity of the polypeptide is above 95% and confirmed by the absence of an immune response to yeast-derived contaminants in vaccinees. Yeast DNA levels were less than 10 pg/vaccine dose. Various biochemical analyses showed that the recombinant polypeptide was faithfully expressed and did not undergo unwanted processing or degradation during fermentation or purification. These results indicate that the recombinant HBsAg can be effectively produced in yeast and processed to a high degree of purity to yield HBsAg particles displaying most of the characteristic properties of plasma-derived HBsAg.


Photoresponsive superhydrophobic surfaces for effective wetting control.
Dynamically tuning the surface wettability has long been a scientific challenge, but of great importance in surface science. Robust superhydrophobic surfaces, displaying switchable and tunable extreme wetting behaviors, are successfully developed by spraying photoresponsive hydrophobic nanoparticles onto various substrates. The surface wettability can be intelligently adjusted by applying irradiation with UV or visible light, which is assumed to initiate large conformation changes of azobenzene units at the coating surface, resulting in distinct surface energy change and thus controlled wetting behaviors. The underlying wetting mechanism about the resulting surfaces is systematically investigated and supported by the estimation of water contact angles using newly rewritten Cassie-Baxter and Wenzel relations and also by the evaluation of solid surface free energy adopting the Owens-Wendt approach. The methodology proposed may provide a novel way of tuning surface wettability and investigating the wetting transition mechanism and also promote applications in self-cleaning and smart fluid control.


Increasing cardiac contractility after myocardial infarction exacerbates cardiac injury and pump dysfunction.
Myocardial infarction (MI) leads to heart failure (HF) and premature death. The respective roles of myocyte death and depressed myocyte contractility in the induction of HF after MI have not been clearly defined and are the focus of this study. We developed a mouse model in which we could prevent depressed myocyte contractility after MI and used it to test the idea that preventing depression of myocyte Ca(2+)-handling defects could avert post-MI cardiac pump dysfunction. MI was produced in mice with inducible, cardiac-specific expression of the β2a subunit of the L-type Ca(2+) channel. Myocyte and cardiac function were compared in control and β2a animals before and after MI. β2a myocytes had increased Ca(2+) current; sarcoplasmic reticulum Ca(2+) load, contraction and Ca(2+) transients (versus controls), and β2a hearts had increased performance before MI. After MI, cardiac function decreased. However, ventricular dilation, myocyte hypertrophy and death, and depressed cardiac pump function were greater in β2a versus control hearts after MI. β2a animals also had poorer survival after MI. Myocytes isolated from β2a hearts after MI did not develop depressed Ca(2+) handling, and Ca(2+) current, contractions, and Ca(2+) transients were still above control levels (before MI). Maintaining myocyte contractility after MI, by increasing Ca(2+) influx, depresses rather than improves cardiac pump function after MI by reducing myocyte number.


Gliogenic Potential of Single Pallial Radial Glial Cells in Lower Cortical Layers.
During embryonic development, progenitor cells are progressively restricted in their potential to generate different neural cells. A specific progenitor cell type, the radial glial cells, divides symmetrically and then asymmetrically to produce neurons, astrocytes, oligodendrocytes, and NG2-glia in the cerebral cortex. However, the potential of individual progenitors to form glial lineages remains poorly understood. To further investigate the cell progeny of single pallial GFAP-expressing progenitors, we used the in vivo genetic lineage-tracing method, the UbC-(GFAP-PB)-StarTrack. After targeting those progenitors in embryonic mice brains, we tracked their adult glial progeny in lower cortical layers. Clonal analyses revealed the presence of clones containing sibling cells of either a glial cell type (uniform clones) or two different glial cell types (mixed clones). Further, the clonal size and rostro-caudal cell dispersion of sibling cells differed depending on the cell type. We concluded that pallial E14 neural progenitors are a heterogeneous cell population with respect to which glial cell type they produce, as well as the clonal size of their cell progeny.


Tendon injuries of the lower extremity: magnetic resonance assessment.
MR is rapidly establishing itself as a premiere imaging modality for the assessment of musculoskeletal trauma. Its utility in the evaluation of the menisci and ligaments of the knee is well known, but there is far less known about the use of MR for evaluation of the tendons. MR, by virtue of its unmatched soft tissue resolution capability, can determine not only the contour of an affected tendon, but the tendon sheath and internal signal alterations that accompany tendonitis, partial and complete ruptures. Injuries to the Achilles tendon are well known to the athlete and the imager alike; however, abnormalities of the posterior tibial tendon, peroneal tendon, and flexor hallucis longus also result in significant clinical symptoms, as well as imaging abnormalities.


Zymophore identification enables the discovery of novel phenylalanine ammonia lyase enzymes.
The suite of biological catalysts found in Nature has the potential to contribute immensely to scientific advancements, ranging from industrial biotechnology to innovations in bioenergy and medical intervention. The endeavour to obtain a catalyst of choice is, however, wrought with challenges. Herein we report the design of a structure-based annotation system for the identification of functionally similar enzymes from diverse sequence backgrounds. Focusing on an enzymatic activity with demonstrated synthetic and therapeutic relevance, five new phenylalanine ammonia lyase (PAL) enzymes were discovered and characterised with respect to their potential applications. The variation and novelty of various desirable traits seen in these previously uncharacterised enzymes demonstrates the importance of effective sequence annotation in unlocking the potential diversity that Nature provides in the search for tailored biological tools. This new method has commercial relevance as a strategy for assaying the 'evolvability' of certain enzyme features, thus streamlining and informing protein engineering efforts.


Traffic exposure, air pollution and children's physical activity at early childhood education and care.
A significant number of children attend Early Childhood Education and Care (ECEC). ECEC is an important environment and behaviour setting for young children. Time spent outdoors is positively associated with children's physical activity levels, yet increased time spent physically active outdoors may expose young children to traffic-related air pollution, particularly in ECEC centres located in high traffic areas. This study was part of the Play Spaces and Environments for Children's Physical Activity (PLAYCE) study, Perth, Western Australia. Data from 22 ECEC centres and 478 children were collected. Continuous measures of indoor and outdoor fine particulate matter (PM2.5) were conducted for 48-72 h in each ECEC. Children wore ActiGraph GT3X + accelerometers to measure their physical activity at ECEC. The total length of high traffic roads within a 300m road network service area buffer around each ECEC was used to identify high and low traffic centres. Outdoor PM2.5 concentrations peaked in the afternoon (1pm, 2pm and 6pm) at ECEC centres. Outdoor and indoor PM2.5 concentrations were significantly higher for centres located in high compared with low traffic areas (both p < 0.05). There was no significant association between a centre being located in a high or low traffic area and the time preschoolers spent outdoors or their physical activity levels. Time periods when air pollution concentrations in ECECs are highest correspond with times when preschoolers are likely to be physically active outdoors. Children's potential exposure to traffic-related air pollutants is occurring during a period of rapid lung development. Given there is no evidence of a safe level of exposure to PM2.5 or a threshold below which no adverse health effects occur, careful planning should be a consideration to avoid locating ECEC centres in high traffic areas.


Passive surveillance for Kawasaki disease in San Diego County.
Kawasaki disease (KD) is the most common cause of acquired heart disease in children in the United States. Epidemiologic surveillance is conducted to monitor baseline incidence of the disease and to identify epidemics. The aim of this study was to evaluate a passive surveillance system for reporting cases of KD in San Diego County to the local, state and national health authorities. We performed a retrospective review of a 2-year period to identify the number of patients who met criteria of the Centers for Disease Control and Prevention for diagnosis of KD and who were successfully reported to the county, state and national databases. The total number of KD patients for 1994 and 1995 was determined by retrospective review of medical record discharge diagnosis codes. Of the 28 San Diego County residents diagnosed with KD in 1994, 24 (86%) met CDC criteria and 15 (63%) of these eligible patients were reported to the county and state health authorities. Of the 41 residents in 1995, 34 (83%) met CDC criteria and 22 (65%) were reported to the above agencies. No patient in either 1994 or 1995 was reported by local or state health authorities to the CDC. Passive surveillance for KD in San Diego County resulted in the reporting of approximately two-thirds of the eligible patients at the county and state levels but completely failed to report any documented cases to the CDC. Implementation of a sentinel hospital reporting system should be considered as a preferred alternative to national passive surveillance in the effort to track total numbers of patients and to follow disease trends over time.


Lysophosphatidic acid in airway function and disease.
Lysophosphatidic acid (LPA) is a bioactive lipid mediator and important component of serum. Studies over the past several years which have documented diverse effects of LPA on multiple types of airway cells and which suggest possible involvement of LPA in lung disease are reviewed here. LPA enhances contractility of airway smooth muscle. It also stimulates proliferation of cultured airway smooth muscle cells and exhibits a striking synergism with epidermal growth factor (EGF) for stimulating mitogenesis. Recent studies of the molecular components and signaling pathways mediating synergism are described, including LPA-induced upregulation of EGF receptors and activation of multiple transcription factors by both LPA and EGF. A model for the effects of LPA and EGF on mitogenesis that includes EGF receptor upregulation and synergism between Ras and Rho for activation of the transcription factor AP-1 is presented. LPA stimulates fibronectin secretion and filopodia extension in airway epithelial cells as well as proliferation and collagen gel contraction by lung fibroblasts. A hypothesis for LPA involvement in the airway repair and remodeling, which contribute to the pathology of asthma and other airway diseases, is presented, and future directions for research into the roles of LPA in airway function and disease are suggested.


The influence of double-credit evidence-based continuing medical education on presenters and learners.
Medical specialties are adopting methods to improve continuing medical education (CME). A "double credit" option, sponsored by the American Academy of Family Physicians, is now available for presentations submitted and approved as evidence based (EB). To compare usual and double-credit CME presentations to determine differences in preparation resources and time, and to compare conference attendees' satisfaction. Those not submitting double-credit applications were asked about perceived barriers. Three pretested, written surveys were administered at a 2.5 day CME conference held annually in Southeastern Wisconsin. Subjects were 38 presenters and 172 attendees, mostly primary care physicians. Twelve presentations were approved for double-credit; these presenters used a greater percentage of on-line EB resources to prepare their talks (64% versus 23%), and preparation required an additional 4.75 hours on average. Over 90% of attendees perceived greater conference quality due to the EB emphasis. Top barriers to double-credit EB applications were time limits and perceptions that topics were inappropriate. Double-credit presenters use a greater percentage of EB resources, while their counterparts used more professional experience to prepare CME presentations. Attendees reported improved quality and value with increased EB CME. Time is a perceived and real factor in preparing double-credit applications.


Using food as a tool to teach science to 3 grade students in Appalachian Ohio.
The Food, Math, and Science Teaching Enhancement Resource (FoodMASTER) Initiative is a compilation of programs aimed at using food as a tool to teach mathematics and science. In 2007-2008, a foods curriculum developed by professionals in nutrition and education was implemented in 10 3(rd)-grade classrooms in Appalachian Ohio; teachers in these classrooms implemented 45 hands-on foods activities that covered 10 food topics. Subjects included measurement; food safety; vegetables; fruits; milk and cheese; meat, poultry, and fish; eggs; fats; grains; and meal management. Students in four other classrooms served as the control group. Mainstream 3(rd)-grade students were targeted because of their receptiveness to the subject matter, science standards for upper elementary grades, and testing that the students would undergo in 4(th) grade. Teachers and students alike reported that the hands-on FoodMASTER curriculum experience was worthwhile and enjoyable. Our initial classroom observation indicated that the majority of students, girls and boys included, were very excited about the activities, became increasingly interested in the subject matter of food, and were able to conduct scientific observations.


[A penetrating injury of the extracranial vertebral artery: a case report].
Penetrating injury to the vertebral artery is a very rare accident and no case except ours has been reported to date in Japan. We reported a case of successful treatment of a penetrating injury by a nail to the left vertebral artery with the use of interventional radiologic procedure. A 27-year-old man was admitted to our hospital with a complaint of penetrating injury in his neck. Left vertebral angiography revealed that a nail had penetrated into the vertebral artery at the C6 level. Considering the possibility of thrombus formation around the metallic foreign body and the risk of uncontrollable bleeding, we performed embolization of the injured vertebral artery with Interlocking Detachable Coil.


CT scan findings of probable usual interstitial pneumonitis have a high predictive value for histologic usual interstitial pneumonitis.
The current usual interstitial pneumonitis (UIP)/idiopathic pulmonary fibrosis CT scan classification system excludes probable UIP as a diagnostic category. We sought to determine the predictive effect of probable UIP on CT scan on histology and the effect of the promoter polymorphism in MUC5B (rs35705950) on histologic and CT scan UIP diagnosis. The cohort included 201 subjects with pulmonary fibrosis who had lung tissue samples obtained within 1 year of chest CT scan. UIP diagnosis on CT scan was categorized as inconsistent with, indeterminate, probable, or definite UIP by two to three pulmonary radiologists. Tissue slides were scored by two expert pulmonary pathologists. All subjects with available DNA (N = 200) were genotyped for rs35705950. The proportion of CT scan diagnoses were as follows: inconsistent with (69 of 201, 34.3%), indeterminate (72 of 201, 35.8%), probable (34 of 201, 16.9%), and definite (26 of 201, 12.9%) UIP. Subjects with probable UIP on CT scan were more likely to have histologic probable/definite UIP than subjects with indeterminate UIP on CT scan (82.4% [28 of 34] vs 54.2% [39 of 72]; P = .01). CT scan and microscopic honeycombing were not associated with each other (P = .76). The minor (T) allele of the MUC5B polymorphism was associated with concordant CT scan and histologic UIP diagnosis (P = .03). Probable UIP on CT scan is associated with a higher rate of histologic UIP than indeterminate UIP on CT scan suggesting that they are distinct groups and should not be combined into a single CT scan category as currently recommended by guidelines. CT scan and microscopic honeycombing may be dissimilar entities. The T allele at rs35705950 predicts a UIP diagnosis by both chest CT scan and histology.


Antifungal agents from Pseudallescheria boydii SNB-CN73 isolated from a Nasutitermes sp. termite.
Defense mutualisms between social insects and microorganisms have been described in the literature. The present article describes the discovery of a Pseudallescheria boydii strain isolated from Nasutitermes sp. The microbial symbiont produces two antifungal metabolites: tyroscherin and N-methyltyroscherin, a compound not previously described in the literature. Methylation of tyroscherin has confirmed the structure of N-methyltyroscherin. Both compounds are effective antifungal agents with favorable selectivity indices for Candida albicans and Trichophyton rubrum.


[Attenuated mRNA induction of molecules associated with neutrophil migration by 14-membered ring macrolides inhibits bleomycin induced acute lung injury in mice].
Although the pathogeneses of interstitial pneumonia are not well understood, it has been reported that inflammatory cells, especially neutrophils, and their injurious substances play important roles in the progression of interstitial pneumonia. Erythromycin and other 14-membered ring macrolides (14-MRMLs) have been reported to inhibit chronic airway inflammation by mechanisms of anti-neutrophil and several other anti-inflammatory activities. The present study was undertaken to investigate the effects and mechanisms of 14-MRMLs (erythromycin: EM; clarithromycin: CAM; roxithromycin: RXM) on an experimental model of bleomycin (BLM) -induced acute lung injury in mice. BLM was administered intravenously to ICR mice. For the evaluation of early-phase inflammation, cell populations in broncho-alveolar lavage fluid (BALF) and induction of mRNA of adhesion molecules (E-selectin, P-selectin, ICAM-1, VCAM-1) and TNF-alpha tested by RT-PCR in lung tissues were examined at 0 to 13 days after BLM. These parameters were also compared with those of the control (NS alone), 14-MRMLs-untreated (BLM alone) and-pre-treated (BLM+pre 14-MRMLs) groups. The number of neutrophils, macrophages, and lymphocytes significantly increased in BAL. Neutrophils especially increased with two peaks after BLM administration. 14-MRMLs significantly inhibited both peaks of neutrophil. The increase in number of macrophages in BALF was significantly attenuated by EM and RXM, and slightly attenuated by CAM. Number of lymphocytes in BALF was significantly attenuated by EM and CAM, and slightly attenuated by RXM. Changes in mRNA expression of E-selectin, P-selectin, ICAM-1, VCAM-1, and TNF-alpha were associated with the number of neutrophils migrating into the airspace. 14-MRMLs clearly inhibited the induction of VCAM-1 mRNA, and tended to attenuate the induction of ICAM-1 and TNF-alpha mRNA, but did not inhibit the induction of E-selectin and P-selectin mRNA. These findings show that 14-MRMLs clearly attenuated the expression of VCAM-1mRNA, and tended to attenuate the induction of ICAM-1 and TNF-alpha mRNA, and subsequently inhibited leucocyte, especially neutrophil migration into the airspace during the early phase of BLM-induced lung injury and finally inhibited lung fibrosis. This might be one potent mechanism of the anti-inflammatory effects of 14-MRMLs in BLM-induced acute lung injury. The findings suggest that prophylactic administration of 14-MRMLs may be clinically efficacious in preventing acute exacerbation of interstitial pneumonia and acute lung injury.


Biogenic Iron-Rich Filaments in the Quartz Veins in the Uppermost Ediacaran Qigebulake Formation, Aksu Area, Northwestern Tarim Basin, China: Implications for Iron Oxidizers in Subseafloor Hydrothermal Systems.
Fe-(oxyhydr)oxide-encrusted filamentous microstructures produced by microorganisms have been widely reported in various modern and ancient extreme environments; however, the iron-dependent microorganisms preserved in hydrothermal quartz veins have not been explored in detail because of limited materials available. In this study, abundant well-preserved filamentous microstructures were observed in the hydrothermal quartz veins of the uppermost dolostones of the terminal-Ediacaran Qigebulake Formation in the Aksu area, northwestern Tarim Basin, China. These filamentous microstructures were permineralized by goethite and hematite as revealed by Raman spectroscopy and completely entombed in chalcedony and quartz cements. Microscopically, they are characterized by biogenic filamentous morphologies (commonly 20-200 μm in length and 1-5 μm in diameter) and structures (curved, tubular sheath-like, segmented, and mat-like filaments), similar to the Fe-oxidizing bacteria (FeOB) living in modern and ancient hydrothermal vent fields. A previous study revealed that quartz-barite vein swarms were subseafloor channels of low-temperature, silica-rich, diffusive hydrothermal vents in the earliest Cambrian, which contributed silica to the deposition of the overlying bedded chert of the Yurtus Formation. In this context, this study suggests that the putative filamentous FeOB preserved in the quartz veins might have thrived in the low-temperature, silica- and Fe(II)-rich hydrothermal vent channels in subseafloor mixing zones and were rapidly fossilized by subsequent higher-temperature, silica-rich hydrothermal fluids in response to waning and waxing fluctuations of diffuse hydrothermal venting. In view of the occurrence in a relatively stable passive continental margin shelf environment in Tarim Block, the silica-rich submarine hydrothermal vent system may represent a new and important geological niche favorable for FeOB colonization, which is different from their traditional habitats reported in hydrothermal vent systems at oceanic spreading centers or volcanic seamounts. Thus, these newly recognized microfossils offer a new clue to explore the biological signatures and habitat diversity of microorganisms on Earth and beyond.


Comprehensive study of the effects of methylation on tautomeric equilibria of nucleic acid bases.
Minor tautomers of nucleic acid bases can result by intramolecular proton transfer. These rare tautomers could be stabilized through the addition of methyl groups to DNA bases. A comprehensive theoretical study of tautomers of methylated derivatives of guanine, adenine, cytosine, thymine, and uracil was performed. Molecular geometries of all tautomers were obtained at the density functional theory and MP2 levels with the 6-31G(d,p) basis set, and single-point calculations were performed at the CCSD(T)/6-311G(d,p) level. Tautomers obtained by protonation at the preferred protonation site for methylated isolated bases were compared to their nonmethylated counterparts. The effects of methylation on the relative stabilities of nucleic acid base tautomers are also studied and discussed in this work. The results suggest that some sites on the bases may not be mutagenic and may even stabilize the canonical Watson-Crick form. The results also indicate that a number of methylation sites can stabilize the tautomers, suggesting possible mechanisms for mutagenic changes.


Novel Structures of Type 1 Glyceraldehyde-3-phosphate Dehydrogenase from Escherichia coli Provide New Insights into the Mechanism of Generation of 1,3-Bisphosphoglyceric Acid.
Glyceraldehyde-3-phosphate dehydrogenase (GAPDH) is a highly conserved enzyme involved in the ubiquitous process of glycolysis and presents a loop (residues 208-215 of Escherichia coli GAPDH) in two alternative conformations (I and II). It is uncertain what triggers this loop rearrangement, as well as which is the precise site from which phosphate attacks the thioacyl intermediate precursor of 1,3-bisphosphoglycerate (BPG). To clarify these uncertainties, we determined the crystal structures of complexes of wild-type GAPDH (WT) with NAD and phosphate or G3P, and of essentially inactive GAPDH mutants (C150S, H177A), trapping crystal structures for the thioacyl intermediate or for ternary complexes with NAD and either phosphate, BPG, or G3P. Analysis of these structures reported here lead us to propose that phosphate is located in the "new Pi site" attacks the thioester bond of the thioacyl intermediate to generate 1,3-bisphosphoglyceric acid (BPG). In the structure of the thioacyl intermediate, the mobile loop is in conformation II in subunits O, P, and R, while both conformations coexist in subunit Q. Moreover, only the Q subunit hosts bound NADH. In the R subunit, only the pyrophosphate part of NADH is well defined, and NADH is totally absent from the O and P subunits. Thus, the change in loop conformation appears to occur after NADH is produced, before NADH is released. In addition, two new D-glyceraldehyde-3-phosphate (G3P) binding forms are observed in WT.NAD.G3P and C150A+H177A.NAD.G3P. In summary, this paper improves our understanding of the GAPDH catalytic mechanism, particularly regarding BPG formation.


Percutaneous biopsy of left adrenal masses: prevalence of pancreatitis after anterior approach.
Acute pancreatitis is an unusual but recognized complication of percutaneous aspiration biopsy of the pancreas. As the pancreatic tail is located anterior to the left adrenal gland, percutaneous biopsy of a left adrenal mass via the anterior approach may result in needle passage through the tail of the pancreas with subsequent potential development of pancreatitis. To evaluate this risk, we retrospectively reviewed 48 CT-directed percutaneous aspiration biopsies of left adrenal masses done between 1984 and 1989 at two institutions. Positioning of the patient, the course of the needle, the number of needle passes, and the size of the needle were analyzed. Thirty-three (69%) of 48 biopsies of a left adrenal mass were performed by using the anterior approach. The pancreas was traversed by one or more needles in 32 of 33 cases. Biopsies were performed with 20- to 22-gauge needles, and the number of needle passes varied widely. The medical records of the 33 patients in whom the anterior approach was used also were reviewed for complications. Acute pancreatitis, which required 11-13 days of hospitalization, developed in two patients (6%). None of the other 31 patients suffered a complication. We conclude that the pancreatic tail is routinely traversed by the biopsy needle when biopsy of a left adrenal mass is done via the anterior approach and that severe acute pancreatitis can occur as a result.


Simulation exercises to strengthen polio outbreak preparedness: experience of the World Health Organization European Region.
Poliovirus importations and related outbreaks continue to occur in polio-free countries, including those in the World Health Organization (WHO) European Region. National preparedness plans for responding to poliovirus introduction are insufficient in many countries of the European Region. We describe a series of polio outbreak simulation exercises that were implemented to formally test polio outbreak preparedness plans in the European Region. We designed and implemented the exercises, reviewed the results, made recommendations, and assessed the role of outbreak simulation exercises in maintaining regional polio-free status. In addition, we performed a comprehensive review of the national plans of all WHO Member States in the European Region. Three exercises, delivered during 2011-2013 (for the Balkans, United Kingdom, and the Caucasus and Ukraine), revealed that participating countries were generally prepared for poliovirus introduction, but the level of preparedness needed improvement. The areas in particular need of strengthening were national preparedness plans, initial response, plans for securing vaccine supply, and communications. Polio outbreak simulation exercises can be valuable tools to help maintain polio-free status and should be extended to other high-risk countries and subnational areas in the European Region and elsewhere.


High coercivity SmCo5 synthesized with assistance of colloidal SiO2.
SmCo5 is one of the most promising candidates for achieving a hard magnet with a high coercivity. Usually, composition, morphology, and size determine the coercivity of a magnet, however, it is challenging to synthesize phase pure SmCo5 with optimal size and high coercivity. In this paper, we report on the successful synthesis of phase pure SmCo5 with spherical/prolate spheroids shape. Size control is obtained by utilizing colloidal SiO2 as a template preventing aggregation and growth of the precursor. The amount of SiO2 nanoparticles (NPs) in the precursor tunes the average particle size (APS) of the synthesized SmCo5 with particle dimension from 740 to 504 nm. As-prepared pure SmCo5 fine powder obtained from using 2 ml SiO2 suspension possesses an APS of 625 nm and exhibits an excellent coercivity of 2986 kA m-1 (37.5 kOe) without alignment of the particles prior to magnetisation measurements. Comparing with a reference sample prepared without adding any SiO2 NPs, an enhancement of 35% of the coercivity was achieved. The improvement is due to phase purity, stable single-domain (SSD) size, and shape anisotropy originating from the prolate spheroid particles.


Knife to Skin Time in Orthopaedics- A New Sub-Speciality Selection Tool
Several selection methods have been used to aid selection into orthopaedic training programs but no process exists to aid in sub-speciality selection. A process which is continuous, unbiased and encompasses technical skill and decision making would be the gold standard. This paper analyses the use of a daily clinical task that assesses many of the desirable traits of a prospective trainee. A retrospective review of 13,474 orthopaedic procedures was under taken. The results showed a clear distinction between orthopaedic sub-specialities in time taken to perform this task. The authors suggest that this could provide a low cost insight into the appropriate subspecialty for orthopaedic trainees.


New Design Process for Anatomically Enhanced Osteosynthesis Plates.
This study evaluated the implementation and effectiveness of an iterative process aimed to quantify and enhance the anatomical fit of an osteosynthesis plate design for the fifth metacarpal bone regarding a defined shape-based acceptance criterion (SAC) while complying with basic clinical requirements and engineering limitations. The process was based on employing virtual tools (a database of individual three-dimensional bone models, statistical analysis of the bone geometry, and proprietary software tools) to evaluate conformity between plate designs and bone shape. The conformity was quantified by the mean distance between plate and bone (MBP). The enhancement was completed when the median MBP of the population was below the SAC threshold. This was fulfilled by the third plate design (two enhancement iterations). The intentionally abstract enhancement process may serve as a guideline for development of plate designs for other indications. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:1508-1517, 2019.


Exophthalmometric values in a normal Indian population.
PURPOSE. The purpose of this study was to establish a set of exophthalmometric values in a normal Indian population and to compute a regression equation for calculating these values. METHODS. Twenty-five-hundred clinically normal Indians of both sexes in the age group of 3-80 years, who did not have local or systemic disease likely to affect orbital or ocular structures, were enrolled in this study. Hertel's exophthalmometer was used to measure the degree of protrusion of the eyes. Statistical methods were used to calculate the mean values in the right and left eye in either sex and to compute a regression equation for calculating the exophthalmometric values. RESULTS. The range of exophthalmometric values in a normal Indian population aged 3-80 years was 7-19 mm for males and 7-21 mm for females. The exophthalmometric values were higher in the first decade, decreased in the second decade, and increased again in the third decade. They then remained stable for the next three to four decades. The peak was reached in the seventh decade in males and in the sixth decade in females. The lowest values in both sexes were attained in the eighth decade. The regression equations for the calculation of the exophthalmometric values are: In males for the right eye: Exophthalmometric value = 12.43 + 0.25 x age; In males for the left eye: Exophthalmometric value = 12.30 + 0.029 x age; In females for the right eye: Exophthalmometric value = 13.30 - 0.003 x age; In females for the left eye: Exophthalmometric value = 13.17 - 0.0003 x age. CONCLUSIONS. The trend of the normal exophthalmometric values for Indian subjects, by and large, was found to be similar to that quoted for other races. A knowledge of the normal values for this population subgroup can help clinicians in the early diagnosis and follow-up of patients with endocrine diseases, orbital tumors, craniofacial trauma and deformities and severe myopia.


[Analysis of changes in peripheral and central nervous system in irregularly treated adult patients with primary congenital hypothyroidism].
Lack of thyroid hormones in the womb and the first years of life causes changes in the nervous system and mental retardation. The aim of the study was to assess changes in peripheral and central nervous system in 29 adult patients with primary congenital hypothyroidism (PCH) depending on the cause of the disease and systematic treatment of L-thyroxine. The analysis was performed in 29 adult patients with PCH (16 women, 13 men) on the basis of the results of neurological examination, EEG, SPECT (Computer tomography single photon emission) of the brain. Changes in the nervous system were found in 72% of respondents. Patients who had implemented replacement therapy L-thyroxine after completing 12 months of age showed the most neurological disorders. There were variations in the cranial nerves III, IX, IV and VI. In 34% of respondents revealed paraneoplastic cerebellar symptoms, while the pyramid, and extrapyramidal symptoms in 10% and 3% of the people. EEG showed changes in brain bioelectrical activity in the entire study group. In the 83% found a significant asymmetry in regional cerebral blood flow (rCBF). Hypoperfusion outbreak occurred mainly in the stands and leading occipital. The relationship between time of initiation of treatment, and the presence of a systematic change in the nervous system was inversely proportional. In turn, analyzing the causes of most PCH deviations were found in the nervous system in patients with athyreosis. Brain SPECT study in these patients confirmed the organic changes in brain development. CONCLUSIONS. The presence and extent of changes in peripheral and central nervous system depends on the cause PCH, pending the implementation of L-thyroxine treatment and systematic. Studies of brain SPECT and EEG confirmed the existence of developmental changes of the brain in patients with PCH.


Sociodemographic predictors of recall and recognition of colorectal cancer symptoms and anticipated delay in help- seeking in a multiethnic Asian population.
Colorectal cancer is the second most common cancer in Malaysia. The prognosis of the disease is excellent if detected at an early stage, but the majority of Malaysian patients present at late stages. We aimed to assess the awareness of cancer warning signs and anticipated delay in help-seeking as possible contributors to this phenomenon. A population-based cross-sectional survey using the Colorectal Cancer Awareness Measure was initiated in Perak, Malaysia. A total of 2,379 respondents aged 18 years and above were recruited using a multi-stage sampling in five locations. Analysis of covariance was used to examine independent sociodemographic predictors of scores for symptom awareness. Younger age, being female, a higher education, and higher income were significantly associated with better scores for both recall and recognition of warning symptoms. Among the ethnic groups, Malays had better recognition of symptoms whereas Chinese recalled the most symptoms. Passing bloody stool was associated with the least anticipated delay and unexplained anal pain had the highest anticipated delay. The level of awareness across all ethnicities in Malaysia is generally low, especially among minorities. Targeted public education, which is culturally and linguistically appropriate, should be developed to encourage early help-seeking and improve clinical outcomes.


Risk assessment of human infection with a novel bunyavirus in China.
To assess the public health risk of human infection from a novel bunyavirus - severe fever with thrombocytopenia syndrome virus (SFTSV) - in China. The likelihood of disease spread and the magnitude of public health impact were assessed to clarify overall risk. Literature about hazard, exposure and contextual factors associated with SFTSV infection was collected and reviewed. Information on SFTSV cases and the population in six provinces under surveillance was compared. SFTSV is a member of the Phlebovirus genus of the Bunyaviridae family. A widely distributed tick species, Haemaphysalis longicornis, can act as the vector; thus the disease is likely to spread in China. Symptoms of SFTSV infection are nonspecific, but have led to multiorgan dysfunction in severe cases. High-risk populations include farmers and older females. Evidence of human-to-human transmission within family and hospital has been reported. The capacity for treatment and diagnosis of SFTSV are adequate in rural communities in China, and community awareness of the disease should be high. There is a low to moderate public health risk related to SFTSV human infection in China. There is potential for an increase in the number of cases reported as awareness increases and when surveillance is expanded.


Nursing research at Rampton Hospital.
The growth of nursing research activity in Rampton Hospital is outlined in this paper. David Robinson, who has held the position of Nurse Researcher in the hospital since 1986, describes the evolution of the post and how the introduction of English National Board courses related to research have excited great interest among nursing staff. Work is currently underway to establish the effect the rise in research projects has had on practice, with initial results providing grounds for optimism.


Glucocorticoid Receptor Polymorphisms in Children Undergoing Congenital Heart Surgery with Cardiopulmonary Bypass.
We conducted a candidate gene association study to test the hypothesis that different gene polymorphisms will be associated with corticosteroid responsiveness and study outcomes among children undergoing congenital heart surgery. This is a prospective observational cohort study at a large, tertiary pediatric cardiac center on children undergoing corrective or palliative congenital heart surgery. A total of 83 children were enrolled. DNA was isolated for three polymorphisms of interest namely N363 (rs56149945) and 9β (rs6198) associated with increased sensitivity to corticosteroids and Bcl I (rs41423247) associated with decreased sensitivity to corticosteroids. Duration of inotropic use, low cardiac output scores (LCOS), and vasoactive inotrope scores were examined in relation to these three polymorphisms. Using Kaplan-Meier analysis, heterozygous individuals showed longer transcriptional intermediary factor (TIF) compared with wild type for N363 polymorphism ( p = 0.05). In multivariable Cox regression, heterozygous alleles for 9β polymorphism showed significantly shorter TIF compared with wild type (hazard ratio = 2.04 [1.08-3.87], p = 0.03). The relationship between lower LCOS scores and alleles groups was significant for 9β heterozygous polymorphism only (1.5 [1-2.2], p = 0.01) in comparison to wild type and homozygous. The presence of heterozygote alleles for the increased corticosteroid sensitivity is associated with longer TIF compared with wild type. Conversely, the presence of heterozygous alleles for the decreased sensitivity to corticosteroids is associated with shorter TIF compared with wild type.


Merkel Cell Carcinoma with Gastric Metastasis, a Rare Presentation: Case Report and Literature Review.
Merkel cell carcinoma (MCC) is an infrequent, but highly aggressive neuroendocrine neoplasm of the skin with a propensity for recurrence and metastasis. We report a rare case of gastric metastatic localization of this cancer by focusing on the diagnostic, clinical, and surgical approach to the patient. Clinical presentation begins with a peripheral lymphadenopathy whose immunohistochemical characterization identifies the lymphatic dissemination of the disease. Gradually, the patient develops a severe anaemic state which requires several blood transfusions and surgical gastric resection to remove a large bleeding lesion of the antral region. The histopathological analysis of the specimen confirms the metastatic origin from MCC, but the primitive lesion remains unknown. Since this clinical situation is very rare, we conducted a review of the literature selecting the few cases reported, in order to evaluate the current knowledge on this topic. Metastatic involvement of the stomach from Merkel cell carcinoma is a rare presentation of this disease progression with a frequent delay in formulating the correct diagnosis and in further treatment which may be life-threatening for the patient. As regards the local treatment, there is no specific guideline, and the therapeutic indication should be tailored on the specific case.


Milkability of Holstein cows is significantly affected by the incidence of clinical mastitis for weeks after diagnosis.
The main objective of this research communication was to explore the extent of milkability changes caused by the incidence of clinical mastitis. Our second objective was to investigate if the milkability of cows shortly before mastitis incidence significantly differed in comparison with healthy cows. Milk yield, milking time, average milk flow, partial milk flows and the occurrence of bimodal milk flows were monitored during the first 120 d in milk for all cows that calved on the farm during the experimental period (n = 127). A veterinarian diagnosed 27 cows with clinical mastitis, while the remaining healthy cows served as a control group. The period surrounding the mastitis was monitored in a timeline from 2 weeks before to 4 weeks after the diagnosis. We did not observe any significant differences in milkability between the healthy cows and the cows in the pre-mastitis period, which suggests that monitoring these might not be useful for early mastitis detection. Milk yield and milk flow were significantly decreased in the week of mastitis diagnosis compared to the pre-mastitis period. Milking time was not affected in the week of diagnosis, but was significantly increased in the following week, because milk yield returned to pre-mastitis values, but average milk flow was still significantly decreased. Milk yield was normalized to pre-mastitis values as the first of monitored parameters. Milk flow returned to pre-mastitis values in the fourth week after mastitis diagnosis. Milking time was the only parameter that was significantly affected up to a month after diagnosis. Our results showed that milkability changes caused by mastitis are significant and should not be ignored. The ability to adjust milking settings for cows diagnosed with mastitis could become a useful tool for improving mastitis treatment.


Cooperativity in ionic liquids.
Cooperativity in ionic liquids is investigated by means of static quantum chemical calculations. Larger clusters of the dimethylimidazolium cation paired with a chloride anion are calculated within density functional theory combined with gradient corrected functionals. Tests of the monomer unit show that density functional theory performs reasonably well. Linear chain and ring aggregates have been considered and geometries are found to be comparable with liquid phase structures. Cooperative effects occur when the total energy of the oligomer differs from a simple sum of monomer energies. Cooperative effects have been found in the structural motifs examined. A systematic study of linear chains of increasing length (up to nine monomer units) has shown that cooperativity plays a more important role than expected and is stronger than in water. The Cl...H distance of the chloride to the most acidic proton increases with an increasing number of monomer units. The average bond distance approaches 218.9 pm asymptotically. The dipole moment grows almost linearly and the dipole moment per monomer unit reaches the asymptotic value of 16.3 D. The charge on the chloride atoms decreases with an increasing chain length. In order to detect local hydrogen bonding in the clusters a new parametrization of the shared-electron number method is introduced. We find decreasing hydrogen bond energies with an increasing cluster size for both the first hydrogen bond to the most acidic proton and the average hydrogen bond.


Climate Change and Health Equity.
Physical environment, income, and access to education and food are all health determinants that situate whether, when, and to what extent patients or their communities have equitable access to wellness and health care services. Because climate change will likely exacerbate national and international health inequity, this comic considers our future.


Tissue-selective inhibition of prostaglandin synthesis in rat by tepoxalin: anti-inflammatory without gastropathy?
Inhibition of prostaglandin synthesis is likely a primary mechanism for both the anti-inflammatory and ulcerogenic effects of nonsteroidal anti-inflammatory drugs (NSAIDs). The present study examined the mechanism underlying the ability of a novel anti-inflammatory drug, tepoxalin, to suppress prostaglandin synthesis without inducing gastric mucosal injury. The effects on prostaglandin synthesis by various tissues of tepoxalin, diclofenac, and indomethacin were examined in vivo and in vitro. These compounds were also studied in two inflammation models. The capacity of indomethacin and tepoxalin to induced antral ulceration in the rabbit was compared. In most tissues, tepoxalin was a weaker inhibitor of prostaglandin synthesis than the two NSAIDs. However, at a site of peripheral inflammation, tepoxalin was comparable with the NSAIDs in suppressing prostaglandin synthesis and in exerting anti-inflammatory effects. Indomethacin induced penetrating antral ulcers in rabbits whereas tepoxalin produced no detectable mucosal injury. The ability of tepoxalin to suppress inflammation without causing gastric mucosal injury appears to be related to its differential suppression of prostaglandin synthesis in various tissues. Compounds that selectively inhibit prostaglandin synthesis at sites of inflammation may represent a class of anti-inflammatory drugs without detrimental effects on the stomach.


Pythium insidiosum: an overview.
Pythium insidiosum is an oomycete pathogenic in mammals. The infection occurs mainly in tropical and subtropical areas, particularly in horses, dogs and humans. Infection is acquired through small wounds via contact with water that contains motile zoospores or other propagules (zoospores or hyphae). The disease, though described as emerging has in fact already been described since 1884. Depending on the site of entry, infection can lead to different forms of pythiosis i.e. a cutaneous, vascular, ocular, gastrointestinal and a systemic form, which is rarely seen. The infection is not contagious; no animal-animal or animal-human transmission has been reported so far. Therapy includes radical surgery, antifungal drugs, immunotherapy or a combination of these therapies. The prevention to contract the disease in endemic areas is difficult. Avoiding stagnant waters could be of help, although the presence of P. insidiosum on grass and soil in enzootic areas renders this practice useless.


A novel localized amyloidosis associated with lactoferrin in the cornea.
We report a novel localized amyloidosis associated with lactoferrin. To elucidate the precursor protein of corneal amyloidosis associated with trichiasis, we analyzed amyloid deposits from three patients by histopathology and biochemistry. Amyloid deposits showed immunoreactivity, confirmed by electron microscopy, for only anti-human lactoferrin antibody. Electrophoresis of amyloid fibrils revealed lactoferrin with and without sugar chains; N-terminal sequence analysis revealed full-length lactoferrin and a truncated tripeptide of N-terminal amino acids, Gly-Arg-Arg. Carboxymethylated wild-type lactoferrin formed amyloid fibrils in vitro. Lactoferrin gene analysis in the three patients revealed a Glu561Asp mutation in all of the patients and a compound heterozygote of Ala11Thr and Glu561Asp mutations in one patient. A heterozygotic Glu561Asp mutation appeared in 44.8% of healthy Japanese volunteers, suggesting that the mutation may not be an essential mutation for amyloid formation (p = 0.104). Results thus suggest that lactoferrin is this precursor protein.


An antigenic determinant common to human chorionic somatomammotropin and human growth hormone revealed by limited proteolysis of immune complexes.
An epitope of human chorionic somatomammotropin for one of the monoclonal antibodies raised against the whole antigen has been identified. We compared the release of peptides from limited proteolysis of the antigen in the presence and absence of the related antibody. Using enzymes of different specificity, we could determine the amino acid sequence that can be considered at least inclusive of the epitope. The monoclonal antibody selected is 100% cross-reactive with human growth hormone, so the antigenic determinant identified is shared by the two protein hormones.


Does aprotinin preserve platelets in children with acyanogenic congenital heart disease undergone surgery with cardiopulmonary bypass?
Evaluation of the hemostatic and platelets effects in children with acyanogenic congenital heart disease undergone on-pump surgery who received aprotinin. A prospective randomized study was performed on children aged 30 days to 4 years who had undergone correction of acyanogenic congenital heart disease using cardiopulmonary bypass (CPB) and were divided into two groups: Control (n=9) and Aprotinin (n=10). In the Aprotinin Group the drug was administered before and during CPB and the hemostatic dysfunction was analyzed by clinical and biochemical markers. Differences were considered to be significant when P<0.05. The groups were similar regarding demographic and intraoperative variables, except for a greater hemodilution in the Aprotinin Group. The drug presented no benefit regarding time of mechanical pulmonary ventilation, stay in the postoperative intensive care unit and hospital, or regarding the use of inotropic drugs and renal function. Platelet concentration was preserved with the use of Aprotinin, whereas thrombocytopenia occurred in the Control Group since the initiation of CPB. Blood loss was similar for both groups. There were no complications with the use of Aprotinin. Aprotinin quantitatively preserved the blood platelets in children with acyanogenic congenital heart disease.


Hepatitis C Virus in North Africa: An Emerging Threat.
Hepatitis C virus is a major public health threat associated with serious clinical consequences worldwide. North Africa is a unique region composed of seven countries that vary considerably in the predisposing factors to microbial diseases both historically and at the present time. The dynamics of HCV in the region are not well documented. The data are both limited and controversial in most of the countries in the region. In North Africa, the epidemiology of HCV is disparate and understanding it has been hampered by regional "epidemiological homogeneity" concepts. As the dynamics of HCV vary from country to country, context-specific research is needed. In this review, we assess studies performed in each country in the general populations as well as among blood donors and groups exposed to the HCV infection. The reported prevalence of HCV ranges from 0.6% to 8.4% in the Maghreb countries and is predominated by genotype 1. In the Nile valley region, it ranges from 2.2% to 18.9% and is dominated by genotype 4. In North African countries, HCV seems to be a serious problem that is driven by different vectors even in different geographical locations within the same country. Efforts should be combined at both the national and regional levels to implement efficient preventive and treatment strategies.


[Comparison of flow cytometric, static cytometry and tumor cytogenetic investigation results human renal cell carcinomas].
Published data about the frequency of DNA-aneuploidy of renal cell tumours show a great variation. The own study was performed to clarify whether this fact is due to methodological discrepancies or to intratumoural heterogeneity of DNA ploidy. The comparison of DNA ploidy assessed by flow cytometry (fresh and paraffin-embedded tissue) and static cytometry (paraffin-embedded tissue) in equivalent tumour regions showed identical results. 71% of clear cell renal carcinomas showed intratumoural heterogeneity of DNA ploidy. In 55% there was either a combination of diploid and aneuploid stem lines and/or a combination of different aneuploid stem lines ("heterogenous aneuploidy"). The rate of aneuploidy was found to be higher with increasing cytoplasmic eosinophilia of the clear cell renal carcinoma cells. Studies which address the prognostic significance of DNA ploidy of renal carcinomas should specifically investigate on the significance of heterogenous aneuploidy for prognosis.


The efficacy of autologous platelet-rich plasma combined with erbium fractional laser therapy for facial acne scars or acne.
The aim of this study was to evaluate the efficacy of autologous platelet-rich plasma (PRP) combined with erbium fractional laser therapy for facial acne or acne scars. PRP combined with erbium fractional laser therapy was used for the treatment of 22 patients, including 16 patients who suffered from facial acne scars and 6 patients who suffered from acne scars concomitant with acne. Whole blood (40 ml) was collected from each patient, and following differential centrifugation, PRP was harvested. After using an erbium fractional laser, we applied PRP to the entire face of every patient. Digital photos were taken before and after the treatment for evaluation by dermatologists and the patients rated the efficacy on a 5-point scale. The erythema was moderate or mild, while its total duration was <3 days; after receiving the treatment three times, 90.9% of the patients showed an improvement of >50%, and 91% of the patients were satisfied; no acne inflammation was observed after treatment. PRP combined with erbium fractional laser therapy is an effective and safe approach for treating acne scars or acne, with minimal side-effects, and it simultaneously enhanced the recovery of laser-damaged skin.


Idiopathic Aortic Root to Right Atrial Fistula.
An aorta to right atrium fistula is rare. We report a case of idiopathic aortic root to right atrial fistula with right heart failure and review the literature. doi: 10.1111/jocs.12751 (J Card Surg 2016;31:373-375).


The evolution of the management of "CIN" lesions.
During the years 1961-1986 a total of 378 CIN lesions were diagnosed among 4875 women screened for cervical pathology; 285 of them were followed-up for a minimum of 5 years. All 169 cases diagnosed as CIN-3 and 18 classified as CIN-2 were treated surgically, whereas 89 patients diagnosed as CIN-1 and 65 classified as CIN-2 were treated conservatively. Finally, 37 cases (23 diagnosed as CIN-1 and 14 diagnosed as CIN-2) did not receive any treatment. Of the 187 women treated surgically, 6 (3.8%) showed, within the five year follow-up period, progression or recurrence of the disease, which necessitated either additional surgery or radiation; 5 of these cases had been classified as severe dysplasia (CIN-3). Recurrence or progression necessitating major surgery, occurred in 8 (5.1%) of the 154 patients treated conservatively; 5 of these cases were classified as moderate dysplasia (CIN-2). The data indicate that present diagnostic procedures allow a better selection of patients to be submitted to surgery, increasing the proportion of those treated conservatively, without jeopardizing their prognosis.


[Diagnosis of lung cancer]
Lung cancer is the most common malignant tumor among male and second among female. The most effective diagnostic tool would be the early detection of the lung cancer. The diagnosis of tumors has to be based on patho-morphological findings. The invasive diagnostic tools can be used if the proved lung process has any therapeutic consequence. Only an experienced team has the chance to examine quickly and effectively the patients.In Hungary there are pulmonological centers where these teams consisting of pneumonologist, radiologists and pathologists are working effectively.


Cardiovascular disease in early stages of chronic kidney disease in a Chinese population.
Cardiovascular disease (CVD) is one of the most serious complications of kidney disease, yet studies of CVD in early stage of chronic kidney disease (CKD) in Asian patients are very limited. Therefore, this study determined the prevalence and the spectrum of CVD in individuals with early-stage CKD and compared them with data of individuals without CKD. Compared with individuals with estimated GFR (eGFR) >90 ml/min per 1.73 m2, the prevalence of myocardial infarction, stroke, and total CVD of individuals with eGFR 60 to 89 ml/min per 1.73 m2 was increased by 91.4, 71.7, and 67.6%, respectively. For individuals with eGFR 30 to 59 ml/min per 1.73 m2, the percentage was 105.2, 289.1, and 200.7%, respectively. For each eGFR category, stroke was more prevalent than myocardial infarction. Compared with individuals with eGFR >90 ml/min per 1.73 m2, participants with eGFR 60 to 89 and 30 to 59 ml/min per 1.73 m2 tended to have more cardiovascular risk factors, and there were strong unadjusted and adjusted associations between CVD with different stages of eGFR (eGFR >90 ml/min per 1.73 m2 as reference). This is the first report on the prevalence and the spectrum of CVD in early stages of CKD in a community-based Chinese population. The spectrum of CVD in this Chinese population is different from reports of Western countries. Individuals with subtle decreased renal function seem much more likely to have multiple cardiovascular risk factors and have higher prevalence of CVD than those without CKD.


The dynamic range of useful temporal fine structure cues for speech in the presence of a competing talker.
Within an auditory channel, the speech waveform contains both temporal envelope (E(O)) and temporal fine structure (TFS) information. Vocoder processing extracts a modified version of the temporal envelope (E') within each channel and uses it to modulate a channel carrier. The resulting signal, E'(Carr), has reduced information content compared to the original "E(O) + TFS" signal. The dynamic range over which listeners make additional use of E(O) + TFS over E'(Carr) cues was investigated in a competing-speech task. The target-and-background mixture was processed using a 30-channel vocoder. In each channel, E(O) + TFS replaced E'(Carr) at either the peaks or the valleys of the signal. The replacement decision was based on comparing the short-term channel level to a parametrically varied "switching threshold," expressed relative to the long-term channel level. Intelligibility was measured as a function of switching threshold, carrier type, target-to-background ratio, and replacement method. Scores showed a dependence on all four parameters. Derived intensity-importance functions (IIFs) showed that E(O) + TFS information from 8-13 dB below to 10 dB above the channel long-term level was important. When E(O) + TFS information was added at the peaks, IIFs peaked around -2 dB, but when E(O) + TFS information was added at the valleys, the peaks lay around +1 dB.


3-D echo planar (1)HMRS imaging in MS: metabolite comparison from supratentorial vs. central brain.
To determine if metabolite ratios as measured by 3-dimensional echo planar spectroscopy imaging (3D-EPSI) from central brain regions of interest (ROI) centered at the corpus callosum reflect imaging metrics of large volumes of supratentorial brain (STB) from patients with multiple sclerosis. 48 MS patients with relapsing-remitting, secondary progressive, and primary progressive disease underwent a 3D-EPSI sequence covering large volumes of STB. Metabolite ratios were first estimated from all voxels within a STB mask using a linear regression of N-acetylaspartate (NAA) over Creatine (Cr), NAA over choline (Cho) and Cho over Cr. Secondly, spectroscopic voxels from a central brain (CB) ROI centered at the corpus callosum were selected within the STB. Ratios were compared using Bland-Altman regression analysis and Spearman's correlation coefficients between STB versus central brain. Ratios from studied ROIs were correlated with the EDSS and compared to normal controls. Very strong correlations ranging from 0.884 and 0.938 (p < 0.0001) were found for all metabolite ratios between STB versus central brain. NAA/Cr ratios were similarly and negatively correlated with the EDSS across all ROIs, trends ranging from -0.257 to -0.314 (p < 0.1). NAA/Cr from all MS patients was similarly decreased compared to controls across all ROIs (p < 0.01). Metabolite ratios from a central brain ROI were statistically equivalent and highly correlated with ratios from the STB. The study of NAA/Cr using (1)HMRS from a central brain ROI centered at the corpus callosum seems to be representative of brainwide axonal changes in patients with MS.


Selective inhibition of the duck hepatitis B virus by a new class of tetraazamacrocycles.
The antiviral activity of a new class of N,N,N',N",NA'''-pentakis (omega-aminoalkyl) tetraazamacrocycles was evaluated in primary duck hepatocyte cultures infected with the duck hepatitis B virus (DHBV). Three of the four tested compounds were able to selectively inhibit DHBV replication by acting at an early step of the hepadnavirus infection but were associated with significant toxicity.


Systematic review: Effectiveness of combination of lactic acid attractants for control of dengue vector Aedes spp.
This study aimed to review the effectiveness of lactic acid when combined with other types of attractants for Aedes spp. A systematic review was conducted according to the protocol for a systematic review and meta-analysis (PRISMA). Literature search used Cinahl, Medline/PubMed, ScienceDirect, ProQuest and Ebsco electronic databases. Research articles used in the systematic review were experimental articles that reported the effectiveness of mosquito traps using lactic acid or a combination of lactic acid with other attractants. From a total of 42 articles reviewed, there were 6 articles fulfilling the inclusion criteria. The highest synergistic combination of lactic acid in the ketone group was shown in the acetone compound, in the sulfides class, dimethyl sulfides, and in the chloroalkanes group, chloroform. The combination of lactic acid with two effective attractants can be seen in the incorporation of ammonia + caproic acid, and for the incorporation of lactic acid with three other effective attractants illustrated by combining ammonia + caproic acid + CO2. Lactic acid as an attractant can be combined with other various compounds (ketone compounds, sulfides and chloroalkanes). Lactic acid increases its effectiveness in trapping Ae. aegypti and/or Ae. albopictus if combined with acetone, dimethyl sulfides, and/or chloroform.


Through-Space Interactions in Clusteroluminescence.
Conventional π-conjugated luminophores suffer from problems such as emission quenching, biotoxicity, environmental pollution, etc. The emerging nonconjugated and nonaromatic clusteroluminogens (CLgens) are expected to overcome these stubborn drawbacks, so research of CLgens shows great significance not only for practical application but also for the construction of fundamental photophysical theories. This perspective summarizes the unusual features of CLgens in comparison to traditional chromophores, such as nonconjugated molecular structures, unmatched absorption and excitation, excitation-dependent luminescence, multiple emission peaks, and room-temperature phosphorescence. Different from the theory of through-bond conjugation in π-conjugated luminophores, through-space interactions, including through-space n···n interaction and through-space n···π interaction, are regarded as the emitting sources of nonconjugated CLgens. In addition, the formation of network clusters is proposed as an efficient strategy to improve the performance of CLgens, and their potential applications of anticounterfeiting, photoelectronic devices, and bioimaging are prospected.


Synthesis of (-)-Astrogorgiadiol.
Astrogorgiadiol is a naturally occurring Vitamin D analogue that, in cell culture, downregulates the production of the cytokine osteopontin (OPN). OPN has been implicated in virulent asthma, and OPN knockout mice do not develop osteoporosis. As we have pursued whole animal studies with astrogorgiadiol, we have increased the scale of the synthesis. We report an improved preparation of the A-ring synthon and the scale-up of the diasteromerically pure D-ring/sidechain chiron.


Genetic diversity among local mango (Mangifera indica L.) germplasm using morphological, biochemical and chloroplast DNA barcodes analyses.
In this study, the genetic diversity of local mango (Mangifera indica L.) germplasm including 14 genotypes were evaluated by using morphological, biochemical markers and DNA barcoding technique. Morphological characterization is the first step towards utilizing these germplasm in crop improvement studies. The advanced chloroplast based DNA barcode method can be utilized to assess the genetic diversity and phylogenetic structure in such populations. The study was carried out during 2018-2019 years to evaluate local mango germplasm including 14 diverse genotypes based on a number of morphological and biochemical traits and chloroplast DNA barcoding as well. The experiment was laid out in one way ANOVA design with fourteen germplasm indicated with indigenous collection number. Among local mango germplasm, IC 589756 was found to be the most promising with respect to high magnitudes of fruit length, fruit width, fruit weight, pulp weight, soluble solid content (SSC)/Acidity ratio, pH and low acidity followed by IC 589746 exhibiting the highest pulp percentage and SSC accompanied with lowest stone weight and stone percent as compared to the other genotypes. Further, the dendrogram and cluster analyses based on sequencing of chloroplast marker i.e., trnH- psbA and trnCD depicted the relationship among mango genotypes and clearly clustered them into two main clusters at a similarity coefficient 0.035 and 0.150, respectively. The first cluster includes only one genotype and cluster-II contains 13 genotypes. Particularly results revealed that DNA barcoding of local mango germplasm can assist not only in molecular identification but also help in elucidation of their phylogenetic relationship and thus important in maintaining biodiversity inventories.


[Application of auricle skin degloving technique in correction surgery of prominent ears].
To investigate the effect of helix and antihelix skin degloving technique in correction surgery of prominent ears. Twenty-three cases of prominent ears were corrected by helix and antihelix skin degloving technique. The clinical results were observed. All the prominent ears were corrected with natural appearance and good symmetry results. The distance from the helix to the skull was decreased obviously (P<0.05). Cranial ear angle, the angle of helix and ear boat were significantly reduced (P<0.05). No complications such as infection, hematoma, skin flap necrosis and deformity recurrence occurred. The auricle skin degloving technique has advantages of exact suture position, good shape, no obvious cartilage hurt and simple operation procedure.


Clinical outcomes and changes in aqueous vascular endothelial growth factor levels after intravitreal bevacizumab for iris neovascularization and neovascular glaucoma: a retrospective two-dose comparative study.
To evaluate the clinical outcomes and biologic effects on the aqueous humor concentrations of vascular endothelial growth factor (VEGF) in patients with neovascular glaucoma (NVG) treated with intravitreal bevacizumab (IVB). Twenty-nine consecutive patients (35 eyes) treated with 1.0- or 0.1-mg injections of IVB for NVG between January and December 2009 were enrolled in this retrospective, interventional pilot study. The visual prognosis and changes in intraocular pressure (IOP) were followed for >6 months after the initial injection. Aqueous humor samples were obtained at the initial IVB injection from all study eyes and 1 week after the first injection in eyes undergoing a second intervention to measure the VEGF concentration. The VEGF concentrations in the 35 eyes significantly correlated (r=0.535, P<0.001) with the pretreatment IOP. The mean reductions of the VEGF levels 1 week after IVB did not differ significantly between the 1.0- and 0.1-mg groups (P=0.738). Despite more repeated injections in the 0.1-mg group and additional medical or surgical interventions in both groups, both dosages inhibited the neovascular activity. The ability to control the IOP after IVB did not differ significantly between groups at 1 week (P=0.625) and 6 months (P>0.99). Visual improvements also did not differ significantly between groups during the 6-month follow-up (P=0.437). Aqueous humor levels of VEGF were significantly correlated with the IOP. Low-dose (0.1 mg) IVB was as effective as the currently used higher dose (1.0 mg) for treating NVG within at least 6 months after the initial injection.


Glucocorticoids affect male testicular steroidogenesis.
Through their receptors at each level of hypothalamo-pituitary-gonadal axis glucocorticoid excess, either endogenous or administered or stress-induced, could affect steroid production in the testis and thus male fertility. The main ways by which glucocorticoids act are as follows: 1) Affecting gonadoliberin and LH synthesis and release through glucocorticoid receptors in hypothalamic neurons and pituitary gonadotropes. 2) By so far not clearly evidenced reduction of the number of LH receptors on the membrane of Leydig cells. 3) By affecting expression and function of steroidogenic enzymes in the testis. 4) By regulation of in situ access of glucocorticoid to its target cells in the testis. 5) By promotion Leydig cell apoptosis. The review provides a survey of physiological and molecular mechanisms staying behind these effects. It does not deal with the clinical effects of glucocorticoid treatment which would substantially exceed the scope of the pater.


Sialyl Lewis X moiety on rat polymorphonuclear leukocytes responsible for binding to rat E-selectin.
We investigated the presence of the carbohydrate ligand for E-selectin on the cell surface of rat polymorphonuclear leukocytes (PMN). Rat PMN, isolated from peripheral blood, adhered to recombinant rat E-selectin-coated microplates. The adhesion was inhibited either by an anti-rat E-selectin monoclonal antibody (MAb), a sialyl Lewis X (SLex) oligosaccharide or neuraminidase digestion. FACS analysis revealed the expression of SLex as well as other adhesion molecules such as L-selectin, CD11a, CD11b and CD18 on the cell surface of rat PMN. The binding of an anti-SLex MAb KM93 to rat PMN was inhibited competitively by a SLex but not by a Lewis X (Lex). The reactivities of two anti-SLex MAbs, KM93 and CSLEX-1, or an anti-Lex MAb BC90/45 to rat PMN differed from those to human PMN. These results suggest that rat PMN contain the SLex-moiety, which binds to rat E-selectin and is different from that of human PMN.


Changed Landscapes of Surgical Education During COVID-19 Pandemic: Implications on Future Surgeons' Competence.
There has been a substantial impact on surgical education globally due to COVID-19 pandemic. The subtle and overt changes in surgical training programs during this pandemic along with its possible implications on the competence of future surgeons needs to be analyzed. If the essential measures are not taken in time, the surgical training programs are in a probable risk of failing to help surgery trainees successfully transition to the next phase of their surgical career. With a timely intervention for remediation, the surgery education programs will be sending surgical graduates into the community and society with the level of competency, expected from a surgeon despite COVID-19 pandemic. Keywords: COVID-19; surgical education; surgical simulation training.


Biodegradable Polymeric Architectures via Reversible Deactivation Radical Polymerizations.
Reversible deactivation radical polymerizations (RDRPs) have proven to be the convenient tools for the preparation of polymeric architectures and nanostructured materials. When biodegradability is conferred to these materials, many biomedical applications can be envisioned. In this review, we discuss the synthesis and applications of biodegradable polymeric architectures using different RDRPs. These biodegradable polymeric structures can be designed as well-defined star-shaped, cross-linked or hyperbranched via smartly designing the chain transfer agents and/or post-polymerization modifications. These polymers can also be exploited to fabricate micelles, vesicles and capsules via either self-assembly or cross-linking methodologies. Nanogels and hydrogels can also be prepared via RDRPs and their applications in biomedical science are also discussed. In addition to the synthetic polymers, varied natural precursors such as cellulose and biomolecules can also be employed to prepare biodegradable polymeric architectures.


Electrooptic Laser Scanner for TV Projection Display.
An experimental laser TV projection system was constructed using electrooptic prisms of ammonium dihydrogen phosphate to furnish high speed horizontal scanning. Horizontal resolution comparable to 300 TV lines was achieved without a bothersome temperature rise in the electrooptic elements. The drive power required for the electrooptic scanner is about 65 W delivered through a transistorized electronic switch.


Hepatic resection for hepatocellular carcinoma in Taiwan.
We examined the clinical features and outcome of 80 patients with hepatocellular carcinoma (HCC) who had undergone hepatic resection; 32 patients were under 30 years old (younger-HCC), and 48 patients were over 70 years (elderly-HCC). Clinical features of 32 cases of younger-HCC (less than 30 years old) and 48 elderly-HCC (over 70 years old) were reviewed between 1986 and 1999. The clinical features, pathological findings and outcome of the younger and elderly HCC patients were summarized for comparison. Of 573 HCC patients who underwent hepatic resection, 32 were younger than 30 years old and 48 older than 70 years. Less hepatitis B infection, higher hepatitis C infection, more liver cirrhosis development, and a higher ICG 15min retention ratio than the younger group. The younger group tended to have a larger tumor size, more major hepatectomy, more operative blood loss during operation, more perioperative blood transfusion, and more recurrence when compared with the elderly-HCC group. The elderly-HCC group had a significantly better disease-free survival rate than the younger-HCC group. The younger-HCC group had a similar overall survival rate to the elderly-HCC group. These results seem to indicate a possible difference in the HCC carcinogenesis between younger and elderly patients. The overall survival of the younger HCC patients who undergone hepatic resection was as favorable as that of the elderly.


Hydrogels: From Controlled Release to a New Bait Delivery for Insect Pest Management.
Here, we review the literature on the development and application of hydrogel compounds for insect pest management. Researchers have used hydrogel compounds for the past few decades to achieve the controlled release of various contact insecticides, but in recent years, hydrogel compounds have also been used to absorb and deliver targeted concentrations of toxicants within a liquid bait to manage insect pests. The highly absorbent hydrogel acts as a controlled-release formulation that keeps the liquid bait available and palatable to the target pests. This review discusses the use of various types of hydrogel compounds in pest management based on different environmental settings (e.g., agricultural, urban, and natural areas), pest systems (e.g., different taxa), and modes of insecticide delivery (e.g., spray vs bait). Due to their unique physicochemical properties, hydrogel compounds have great potential to be developed into new and efficacious pest management strategies with minimal environmental impact. We will also discuss the future research and development of hydrogels in this review.


Cationic channels activated by extracellular ATP in rat sensory neurons.
Single channels activated by externally applied ATP were investigated in cultured sensory neurons from nodosal and spinal ganglia of rat using patch clamp and concentration clamp methods. Mean conductance of single ATP-activated channels was 17 pS when measured at a holding potential of -75 mV in saline containing 3 mM Ca2+ and 1 mM Mg2+. Sublevels of conductance were detected in some cases. The current-voltage relationship for a single channel is highly non-linear and demonstrates inwardly directed rectification. The I-V curve obtained for single channels was identical to that for macroscopic current. ATP activated the channels in the absence of divalent cations (in ethylenediaminetetra-acetate-containing medium) as well as in their presence. This indicates that ATP as a free anion can activate the receptor. Ca2+ ions decreased both macro- and microscopic ATP-activated currents. The concentration dependence of this Ca2+ effect does not fit a single site binding isotherm. The single channel current demonstrated prominent fluctuations. When measured in the 0-4 kHz frequency band the amplitude of fluctuations evaluated as a double r.m.s. was about 30% of the mean amplitude of current. The autocorrelation function for the current fluctuations in an open channel could be approximated by a single exponential with the time constant of 0.4 ms. These fluctuations did not depend on the presence of divalent cations in the external medium. The open time distribution for the investigated channels could be described by a sum of two exponentials. Presumably this reflects the existence of two subtypes of ATP-activated channels.


Nitrogen Balance and Protein Requirements for Critically Ill Older Patients.
Critically ill older patients with sarcopenia experience greater morbidity and mortality than younger patients. It is anticipated that unabated protein catabolism would be detrimental for the critically ill older patient. Healthy older subjects experience a diminished response to protein supplementation when compared to their younger counterparts, but this anabolic resistance can be overcome by increasing protein intake. Preliminary evidence suggests that older patients may respond differently to protein intake than younger patients during critical illness as well. If sufficient protein intake is given, older patients can achieve a similar nitrogen accretion response as younger patients even during critical illness. However, there is concern among some clinicians that increasing protein intake in older patients during critical illness may lead to azotemia due to decreased renal functional reserve which may augment the propensity towards worsened renal function and worsened clinical outcomes. Current evidence regarding protein requirements, nitrogen balance, ureagenesis, and clinical outcomes during nutritional therapy for critically ill older patients is reviewed.


Heat exchanges in fast, high-performance liquid chromatography. A complete thermodynamic study.
The successive physical transformations of the mobile phase that take place in very high pressure liquid chromatography were studied based on the formalism of classical thermodynamics. The eluent is initially under atmospheric pressure ( P (0)) and at ambient temperature ( T ext). In a first step, it is compressed to a high pressure ( P max of the order of 1 kbar) in the pump heads of the chromatograph. In a second step, the pressurized eluent is transferred to the inlet of the chromatographic column, along which, in a third step, it is decompressed to atmospheric pressure. Both the compression and the decompression of the fluid were considered to take place under conditions that can be either adiabatic or nonadiabatic and either reversible or irreversible. Applications of the first and second principles of thermodynamics allow the determination of the heat and energy exchanged between the eluent and the external surroundings during each transformation. Experimental data were acquired using acetonitrile as the mobile phase. The true state equation, rho( P, T), of liquid acetonitrile was used in the theoretical calculations. A series of four different flow rates (0.55, 0.85, 1.15, and 1.45 mL/min, corresponding to inlet pressures of 357.2, 559.5, 765.1, and 972.9 bar, respectively), were applied to a 2.1 x 100 mm column packed with 1.7-mum bridged ethane-silicon hybrid particles. Thermocouples were used to measure the eluent temperature before and after its passage through the column. These data provide estimates of the variation of the internal energy of the eluent. The heat lost through the external wall of the column during the eluent decompression was estimated by measuring the surface temperature of the column tube under steady state. Both the compression and the decompression of acetonitrile were found to be nonadiabatic and irreversible transformations. The results showed that, during the eluent decompression, the heat released by the friction forces serves four different purposes: (1) it increases the eluent entropy at constant temperature (for approximately 35%); (2) it increases the temperature of the eluent (for approximately 5%); (3) it provides heat to the laboratory atmosphere (for approximately 5%); and (4) it provides some work inside the column (for approximately 5%). This quantitative heat balance description accounts well for the actual performance of the new, very high pressure liquid chromatographic technique.


Application of a rotating bioreactor consisting of low-cost and ready-to-use medical disposables for in vitro evaluation of the endothelialization efficiency of small-caliber vascular prostheses.
The incomplete endothelialization of especially small-caliber vascular prostheses after implantation in patients is a major disadvantage in cardiovascular interventions. The lack of an endothelium leads to the occurrence of thrombosis at the luminal surface of artificial vascular prostheses. Thus, the development of new graft materials and coatings for induction of complete endothelialization on the implant surfaces is a promising approach to improve hemocompatibility and maintain long-term graft patency. In this study, we designed a rotation model to evaluate the early endothelial cell (EC) seeding efficiency of different small-caliber vascular devices, such as stents and vascular grafts. The suitability of the designed rotation model for endothelialization studies was investigated by seeding and cultivation of prostheses with ECs followed by scanning electron microscopy. Furthermore, the viability of attached ECs was determined by calcein acetoxymethyl ester (AM) staining. The rotation model consisting of low-cost medical disposables enabled sterile incubation and cultivation of ECs with vascular devices. Simultaneously, the rotation of the bioreactor ensured a uniform distribution and adhesion of cells to the devices. Calcein AM staining of adherent cells on prostheses revealed excellent cell viability. Moreover, using the designed rotation model, an influence of different coatings and materials on the adhesion and spreading of ECs was demonstrated. The rotating bioreactor described and used in this study not only saves time and money but is also eminently useful for the accelerated preclinical evaluation of the endothelialization efficiency of different materials and surface coatings of small-caliber vascular devices.


Differences in hospitalisation between peritoneal dialysis and haemodialysis patients.
Dialysis is associated with frequent hospitalisations. Studies comparing hospitalisations between peritoneal dialysis (PD) and haemodialysis (HD) report conflicting results and mostly analyse data of patients that remain on their initial dialysis modality. This cohort study compares hospitalisations between PD and HD patients taking into account transitions between modalities. The Dutch nOcturnal and hoME dialysis Study To Improve Clinical Outcomes collected hospitalisation data of patients who started dialysis between 2012 and 2017. Primary outcome was hospitalisation rate, analysed with a multi-state model that attributed each hospitalisation to the current dialysis modality. In total, 695 patients (252 PD, 443 HD) treated in 31 Dutch hospitals were included. The crude hospitalisation rate for PD was 2.3 ( ± 5.0) and for HD 1.4 ( ± 3.2) hospitalisations per patient-year. The adjusted hazard ratio for hospitalisation rate was 1.1 (95%CI 1.02-1.3) for PD compared with HD. The risk for first hospitalisation was 1.3 times (95%CI 1.1-1.6) higher for PD compared with HD during the first year after dialysis initiation. The number of hospitalisations and number of hospital days per patient-year were significantly higher for PD. The most common causes of PD and HD hospitalisations were peritonitis (23%) and vascular access-related problems (33%). PD was associated with higher hospitalisation rate, higher risk for first hospitalisation and higher number of hospitalisations compared with HD. Since the PD hospitalisations were mainly caused by peritonitis, more attention to infection prevention is necessary for reducing the number of hospitalisations in the future.


Composition and maternal origin of the neonatal oral cavity microbiota.
Background: The origin of the initial oral microbiota in neonates still remains poorly understood. Objective: The aim of this study was to understand how the maternal microbiota contributes to the initial neonatal oral microbiota. Design: Twelve mother-neonate pairs with samples from the maternal oral mucosa, uterine cervix and placenta and the neonatal oral cavity immediately after birth were studied. The microbiota composition and diversity were characterized by 16S rRNA gene sequencing (V3-V4 region). The microbiota analyses and comparisons were carried out with Calypso software version 8.1 and with SourceTracker 1.0.1. Results: Samples from the neonatal oral cavity showed moderately high bacterial diversity and low richness. The neonatal oral cavity microbiota seems to share features mainly with the microbes detected in the placenta, followed by the cervical microbiota and the maternal oral microbiota. No statistically significant differences in diversity (Shannon index, p = 0.14), richness (Chao1, p = 0.53) or in microbial composition were observed according to delivery mode. Conclusion: The neonatal oral cavity microbiota is not significantly modulated by the birth canal or maternal oral microbiota but displays clear associations with microbes in the placenta. These results suggest that the neonatal oral microbiota may have a prenatal origin.


Inactivation of penicillin-induced staphylococcal L-forms by human serum high density lipoprotein.
In penicillin-susceptible bacteria, penicillin causes growth of a small fraction of cells as wall-deficient forms if an appropriate osmoprotection is provided (unstable L-forms). A subfraction of human serum high density lipoprotein (HDL3) was shown to have the ability to inactivate unstable L-forms of Staphylococcus aureus. The active principle was distinguishable from the well-documented trypanosome lytic factor 1 with respect to density, size, and other properties. This L-form cytotoxicity therefore seems to represent a novel antimicrobial entity in human serum.


Intraoperative tissue characterization and imaging.
As surgical operative technology improves, surgeons today have the ability to visualize fine structures and detailed anatomy. There are a number of advances that have been made to optimize patient outcomes with better tissue characterization in urologic procedures. This article focuses on advances in intraoperative imaging and tissue characterization for various urologic procedures. Each modality is presented with its corresponding applications in urology. The following techniques are covered: optical coherence tomography, confocal fluorescent microscopy, near infrared fluorescence imaging, elastography, intraoperative ultrasonography, and a neurovascular bundle surgical mapping aid.


Myelin basic protein binds to and inhibits the fibrillar assembly of Abeta42 in vitro.
The deposition of amyloid beta-protein (Abeta) fibrils into plaques within the brain parenchyma and along cerebral blood vessels is a hallmark of Alzheimer's disease. Abeta peptides are produced through the successive cleavage of the Abeta precursor protein by beta- and gamma-secretase, producing peptides between 39 and 43 amino acids in length. The most common of these are Abeta40 (the most abundant) and Abeta42. Abeta42 is more fibrillogenic than Abeta40 and has been implicated in early Abeta plaque deposition. Our previous studies determined that myelin basic protein (MBP) was capable of inhibiting fibril formation of a highly fibrillogenic Abeta peptide containing both E22Q (Dutch) and D23N (Iowa) mutations associated with familial forms of cerebral amyloid angiopathy [Hoos, M. D., et al. (2007) J. Biol. Chem. 282, 9952-9961]. In this study, we show through a combination of biochemical and ultrastructural techniques that MBP is also capable of inhibiting the beta-sheet fibrillar assembly of the normal Abeta42 peptide. These findings suggest that MBP may play a role in regulating the deposition of Abeta42 and thereby also may regulate the early formation of amyloid plaques in Alzheimer's disease.


Feasibility of collaborating with independent Latino-owned restaurants to increase sales of a healthy combo meal.
Americans spend the majority of their food dollars at restaurants and other prepared food sources, including quick-service and fast-food restaurants (PFS); independent small restaurants make up 66% of all PFS in the US. In this feasibility study, 5 independent and Latino-owned PFS in the Washington DC metro area worked with academic partners to start offering healthy combo meals with bottled water and promote these using on-site, community, and social media advertising. The number of healthy combos sold was collected weekly, showing that the new combos sold, and customers in all 5 sites were surveyed as they exited the PFS (n=50): >85% had noticed the combo meals; 100% thought it was a good idea to offer it, 68% had ordered the combo (of these, >94% of customers responded that they liked it). Results suggest that it is feasible to work with independent Latino-owned restaurants to promote healthy combos and collect data.


γδ T cells response to Mycobacterium tuberculosis in pulmonary tuberculosis patients using preponderant complementary determinant region 3 sequence.
The unique immunological functions of γδ T lymphocytes to contribute immunity against Mycobacterium tuberculosis attracted interest of researchers. However, little is known about the specificity of γδ Τ cell in tuberculosis patients and the lack of exact tuberculosis antigen recognized by γδ T cells limited its application. The analysis of complementary determinant region (CDR)3 sequence characteristic in γδ T cells of tuberculosis patients would contribute to understand the distribution specificity of γδ T cell. In present study, we investigated the diversity of the γ9/δ2 T cell immunorepertoire and analysed the specificity of the expressed CDR3 in pulmonary tuberculosis patients. The total RNA in peripheral blood mononuclear cell of 50 pulmonary tuberculosis patients and 10 healthy controls was extracted. The polymerase chain reaction was used to specifically amplify the CDR3 region of γ9 and δ2 chain. The PCR products were ligated into the pGEM-T easy vector. The plasmid DNA was sequenced using the ABI3700 and the T7 primer. Our findings showed that predominant CDR3 sequence of δ2 chain in pulmonary tuberculosis patients was CACDTLVSTDKLIFGKG. The sequence specifically exists in almost all pulmonary tuberculosis patients. The conserved hydrophobic acid residue in 97 positions is present in the γδ T cell reactive to M. tuberculosis. The length of δ2 CDR3 in pulmonary tuberculosis patients has no relation with the disease progress. Our results suggest that γδ T cells appear to use CDR3 sequence to recognise M. tuberculosis antigen. γδ T cells reactive to M. tuberculosis were diverse and polyclonal.


Stochasticity of gene products from transcriptional pulsing.
Transcriptional pulsing has been observed in both prokaryotes and eukaryotes and plays a crucial role in cell-to-cell variability of protein and mRNA numbers. An important issue is how the time constants associated with episodes of transcriptional bursting and mRNA and protein degradation rates lead to different cellular mRNA and protein distributions, starting from the transient regime leading to the steady state. We address this by deriving and then investigating the exact time-dependent solution of the master equation for a transcriptional pulsing model of mRNA distributions. We find a plethora of results. We show that, among others, bimodal and long-tailed (power-law) distributions occur in the steady state as the rate constants are varied over biologically significant time scales. Since steady state may not be reached experimentally we present results for the time evolution of the distributions. Because cellular behavior is determined by proteins, we also investigate the effect of the different mRNA distributions on the corresponding protein distributions using numerical simulations.


[Psychotherapy with violent neurotic patients].
The paper presents a model of interactional processes for analytical psychotherapy with violent neurotic patients. The starting point is a special situation of transference related to the negative therapeutic reaction: The interaction is reduced to the demand for being satisfied immediately by the therapist. A model of the conditions for the emerging of violent acting out is developed and the structure of transference with violent neurotic patients is exposed. Special difficulties in the managing of transference and the technique of interventions are discussed.