Administration of thyroxine in treated Graves' disease. Effects on the level of antibodies to thyroid-stimulating hormone receptors and on the risk of recurrence of hyperthyroidism.
Antibodies to thyroid-stimulating hormone (TSH) receptors that stimulate the thyroid gland cause hyperthyroidism in patients with Graves' disease, and their production during antithyroid drug treatment is an important determinant of the course of the disease. One factor that might contribute to the persistent production of antibodies to TSH receptors is stimulation of the release of thyroid antigens by TSH during antithyroid drug therapy. We therefore studied the effect of the suppression of TSH secretion by thyroxine on the levels of antibodies to TSH receptors after thyroid hormone secretion had been normalized by methimazole. The levels of antibodies to TSH receptors were measured during treatment with methimazole, either alone or in combination with thyroxine, in 109 patients with hyperthyroidism due to Graves' disease. The patients first received 30 mg of methimazole daily for six months. All were euthyroid after six months, and their mean (+/- SD) level of antibodies to TSH receptors decreased from 64 +/- 9 percent to 25 +/- 15 percent (P less than 0.01; normal, 2.9 +/- 1.4 percent). Sixty patients then received 100 micrograms of thyroxine and 10 mg of methimazole and 49 received placebo and 10 mg of methimazole daily for one year. In the thyroxine-treated group, the mean serum thyroxine concentration increased from 108 +/- 16 nmol per liter to 145 +/- 11 nmol per liter (P less than 0.01), and the level of antibodies to TSH receptors decreased from 28 +/- 10 percent to 10 +/- 3 percent after one month of combination therapy. In the patients who received placebo and methimazole, the mean serum thyroxine concentration decreased and the level of antibodies to TSH receptors did not change. Methimazole, but not thyroxine or placebo, was discontinued in each group 1 1/2 years after the beginning of treatment. The level of antibodies to TSH receptors further decreased (from 6.6 +/- 3.2 percent at the time methimazole was discontinued to 2.1 +/- 1.2 percent one year later) in the patients who continued to receive thyroxine, but it increased (from 9.1 +/- 4.8 percent to 17.3 +/- 5.8 percent during the same period) in the patients who received placebo. One patient in the thyroxine-treated group (1.7 percent) and 17 patients in the placebo group (34.7 percent) had recurrences of hyperthyroidism within three years after the discontinuation of methimazole. The administration of thyroxine during antithyroid drug treatment decreases both the production of antibodies to TSH receptors and the frequency of recurrence of hyperthyroidism.


Use of ferrets for electrophysiologic monitoring of ion transport.
Limited success achieved in translating basic science discoveries into clinical applications for chronic airway diseases is attributed to differences in respiratory anatomy and physiology, poor approximation of pathologic processes, and lack of correlative clinical endpoints between humans and laboratory animal models. Here, we discuss advantages of using ferrets (Mustela putorus furo) as a model for improved understanding of human airway physiology and demonstrate assays for quantifying airway epithelial ion transport in vivo and ex vivo, and establish air-liquid interface cultures of ferret airway epithelial cells as a complementary in vitro model for mechanistic studies. We present data here that establishes the feasibility of measuring these human disease endpoints in ferrets. Briefly, potential difference across the nasal and the lower airway epithelium in ferrets could be consistently assessed, were highly reproducible, and responsive to experimental interventions. Additionally, ferret airway epithelial cells were amenable to primary cell culture methods for in vitro experiments as was the use of ferret tracheal explants as an ex vivo system for assessing ion transport. The feasibility of conducting multiple assessments of disease outcomes supports the adoption of ferrets as a highly relevant model for research in obstructive airway diseases.


Enhanced tumor uptake in neuroendocrine tumors after intraarterial application of 131I-MIBG.
131I-labeled metaiodobenzylguanidine (MIBG) is an established treatment modality for neuroendocrine tumors. Because of low tumor doses, it has a predominantly palliative character. Our approach was to investigate whether intraarterial application of 131I-MIBG has the potential to enhance tumor uptake. Seventeen patients with primary or metastasized neuroendocrine tumors received intraarterial treatment with 131I-MIBG, and 12 of these patients also had intravenous treatment. Every patient underwent intravenous 131I-MIBG whole-body scanning before therapy. For quantification, a tumor-to-whole-body ratio was calculated from the diagnostic and 24-h posttreatment scans. Compared with the intravenous application, intraarterial 131I-MIBG treatment provided an up to 4-fold higher tumor uptake. Mean uptake was enhanced by 69%, but this varied widely between patients. We did not observe any immediate complications from catheterization. Carcinoid-related side effects were noted in 7 of 17 patients and were not different from those seen with intravenous application. Intraarterial treatment with 131I-MIBG is a safe alternative to intravenous application and provides a 69% higher mean tumor uptake. We propose to attempt intraarterial MIBG treatment in every patient to assess its potential benefit.


Molecular detection of respiratory pathogens and typing of human rhinovirus of adults hospitalized for exacerbation of asthma and chronic obstructive pulmonary disease.
Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and asthma are associated with a variety of precipitating factors including infection. This study assessed the infective viral etiologies by real-time multiplex polymerase chain reaction of patients hospitalized with AECOPD and asthma exacerbations. In addition, infective etiologies were assessed for association with the clinical outcome of the patients. Adults admitted with AECOPD and asthma exacerbations between August 2016 and July 2017 were recruited. Nasopharyngeal aspirate (NPA) samples were obtained from the patients within 1-2 days of admission and subjected to pathogen detection and human rhinovirus (HRV) typing. Altogether 402 patients with AECOPD, 80 stable COPD, 100 asthma exacerbation and 21 stable asthma subjects were recruited. Among those admitted for AECOPD and asthma exacerbations, 141(35.1%) and 45(45.0%) respectively had pathogens identified in the NPA specimens. The commonest virus identified was influenza A followed by HRV. HRV typing identified HRV-A and HRV-C as the more common HRV with a wide variety of genotypes. Identification of pathogens in NPA or HRV typing otherwise did not affect clinical outcomes including the hospital length of stay, readmission rates and mortality except that identification of pathogens in asthma exacerbation was associated with a lower rate of readmissions at 30 and 60 days. Many respiratory viruses were associated with AECOPD and asthma exacerbation. HRV-A and HRV-C were the more common HRV associated with exacerbations. Identification of pathogens in NPA was associated with less readmissions for asthma patients at 30 and 60 days. ClinicalTrials.gov NCT02866357 .


The Variant at TGFBRAP1 but Not TGFBR2 Is Associated with Antituberculosis Drug-Induced Liver Injury.
TGFBRAP1 and TGFBR2 play important roles in the TGF-β/smad signalling pathway and may disturb liver homeostasis by regulating liver injury and renewal. However, little is known about the association between their genetic polymorphisms and antituberculosis drug-induced liver injury (ATDILI), so we explored the association between their variants and the susceptibility to ATDILI. A total of 746 tuberculosis patients were prospectively enrolled, and fifteen selected SNPs were genotyped. The allele, genotype, and genetic model frequencies of the variants were compared between patients with or without ATDILI, as well as the joint effect analysis of SNP-SNP interactions. The odds ratio (OR) with the corresponding 95% confidence interval (CI) was calculated. The A variant at rs17687727 was significantly associated with an increased risk for ATDILI (OR 1.55; 95% CI: 1.08-2.22; p = 0.016), which is consistent with the results in the additive and dominant models. Other allele, genotype, and genetic model frequencies were similar in the two groups for the other fourteen SNPs (all p > 0.05). Our study first implied that the A variant of rs17687727 in TGFBRAP1 influenced the susceptibility to ATDILI in first-line antituberculosis combination treatment in the Han Chinese population in a dependent manner.


Human T lymphotropic virus (HTLV) type I and II DNA amplification in HTLV-I/II-seropositive blood donors of the French West Indies.
To confirm the presence of DNA from human T lymphotropic virus type I (HTLV-I), HTLV-II, or both in individuals found HTLV-I/II-positive through systematic screening of blood donations in Guadeloupe (French West Indies), 42 blood donors repeatedly positive for HTLV-I/II by ELISA were studied by polymerase chain reaction (PCR). Three primer pairs (env, pol, tax) targeted on conserved regions of HTLV-I or -II sequences (or both) and six probes (two generic, two HTLV-I-specific, two HTLV-II-specific) were used in a multiplex PCR. HTLV-I sequences were detected in 31 individuals (74%). All 31 subjects positive by Western blot (WB) harbored HTLV-I sequences. Fifteen individuals (48%) were positive with the three primer pairs used, 10 (32%) with two, and 6 (20%) with one. Subjects indeterminate or negative by WB were all negative by PCR. No HTLV-II sequences were detected with specific probes. The results indicate the absence of HTLV-I and -II infection in individuals with indeterminate WB, the presence of HTLV-I DNA in individuals positive for WB in the French West Indies, and the absence of HTLV-II infection in the cohort.


Identification of speech by cochlear implant recipients with the multipeak (MPEAK) and spectral peak (SPEAK) speech coding strategies II. Consonants.
The major objective of this study was to evaluate differences in consonant recognition with the Multipeak (MPEAK) and the Spectral Peak (SPEAK) speech coding strategies of the Nucleus-22 Cochlear Implant System. This objective was addressed by comparison of acoustic and electrode activation analyses of consonants with cochlear implant recipients' responses to these same consonant tokens when they used the two speech coding strategies. Nine subjects identified 14 English consonants with the MPEAK and SPEAK speech coding strategies. These strategies were compared with an ABAB design. Evaluation occurred during two weekly sessions after subjects used each strategy for at least 3 wk in everyday life. Group medial consonant [aCa] identification scores with the SPEAK strategy were significantly higher than with the MPEAK strategy (76.2% versus 67.5%; p < 0.001). This improvement was largely due to the significant increase in information transmitted for the place feature (p < 0.001) through accurate tracking of second formant transitions and spectrally specific stimulation patterns to differentiate [s] from [symbol see text] and [n] from [m], and the stop consonant bursts. For this reason, more nasal consonants were correctly identified with SPEAK, but there also were more non-nasal error responses when the nasal murmur was of unusually low amplitude. Consequently, significantly less information was transmitted for the nasality feature with SPEAK than MPEAK (p < 0.001). Electrical stimulation with the SPEAK strategy provided better spectral representation of the stop consonant bursts, tracking formant transitions into the following vowel, frication in the consonant [symbol see text], and the formants for the nasals [m] and [n] than with the MPEAK strategy. The marked improvement in recognition of the velar consonants, [g] and [k], which cannot be seen during speechreading, should allow greater ease and accuracy of communication with SPEAK than MPEAK.


HDAC6 Interacts With Poly (GA) and Modulates its Accumulation in c9FTD/ALS.
The aberrant translation of a repeat expansion in chromosome 9 open reading frame 72 (C9orf72), the most common cause of frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS), results in the accumulation of toxic dipeptide repeat (DPR) proteins in the central nervous system We have found that, among the sense DPR proteins, HDAC6 specifically interacts with the poly (GA) and co-localizes with inclusions in both patient tissue and a mouse model of this disease (c9FTD/ALS). Overexpression of HDAC6 increased poly (GA) levels in cultured cells independently of HDAC6 deacetylase activity, suggesting that HDAC6 can modulate poly (GA) pathology through a mechanism that depends upon their physical interaction. Moreover, decreasing HDAC6 expression by stereotaxic injection of antisense oligonucleotides significantly reduced the number of poly (GA) inclusions in c9FTD/ALS mice. These findings suggest that pharmacologically reducing HDAC6 levels could be of therapeutic value in c9FTD/ALS.


Data-Independent Acquisition Proteomics Reveals Long-Term Biomarkers in the Serum of C57BL/6J Mice Following Local High-Dose Heart Irradiation.
Background and Purpose: Cardiotoxicity is a well-known adverse effect of radiation therapy. Measurable abnormalities in the heart function indicate advanced and often irreversible heart damage. Therefore, early detection of cardiac toxicity is necessary to delay and alleviate the development of the disease. The present study investigated long-term serum proteome alterations following local heart irradiation using a mouse model with the aim to detect biomarkers of radiation-induced cardiac toxicity. Materials and Methods: Serum samples from C57BL/6J mice were collected 20 weeks after local heart irradiation with 8 or 16 Gy X-ray; the controls were sham-irradiated. The samples were analyzed by quantitative proteomics based on data-independent acquisition mass spectrometry. The proteomics data were further investigated using bioinformatics and ELISA. Results: The analysis showed radiation-induced changes in the level of several serum proteins involved in the acute phase response, inflammation, and cholesterol metabolism. We found significantly enhanced expression of proinflammatory cytokines (TNF-α, TGF-β, IL-1, and IL-6) in the serum of the irradiated mice. The level of free fatty acids, total cholesterol, low-density lipoprotein (LDL), and oxidized LDL was increased, whereas that of high-density lipoprotein was decreased by irradiation. Conclusions: This study provides information on systemic effects of heart irradiation. It elucidates a radiation fingerprint in the serum that may be used to elucidate adverse cardiac effects after radiation therapy.


An extracorporeal warm perfusion device for basic research: possibility of avoiding some animal experiments.
An advantage of development of an extracorporeal warm perfusion device is that some animal experiments can be saved because investigations can be carried out on isolated blocks of body tissue which would otherwise entail an animal experiment. It is possible that several teams work with different flaps of one animal. The liquid medium for perfusion is an aqueous solution which combines a culture medium for keratinocytes, neonatal calf serum, L-glutamine, antibiotics, and an antimycotic. Pedicled flaps from animals killed in a slaughterhouse can also be used. The oxygenation of the nutritive medium is achieved through an aqueous phase gas exchange. This method is stable and easily reproducible. Perfused porcine flaps have been reimplanted for vital assessment.


Imaging characteristics of hypertrophic pachymeningitis due to ANCA-associated vasculitis.
Hypertrophic pachymeningitis (HP) is a rare disorder that causes localized or diffuse inflammatory fibrosis and thickening of the dura mater. Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV)-related HP is the most frequent form of HP. Otitis media with AAV (OMAAV) patients with HP are associated with higher rates of both ANCA-negative phenotypes and disease-related mortality. However, few studies have reported the imaging characteristics of HP due to AAV/OMAAV. Therefore, we investigated this issue in the present study. This retrospective study included patients diagnosed with HP between 2011 and 2020 at our hospital. Age, sex, causative disease, serum C-reactive protein (CRP) level, and MRI data were collected from medical records. We compared the locations of MRI enhancement depending on the causative diseases. Of the 18 included patients with HP (mean age, 64.1 ± 2.6 years; range, 33-77 years), 10 (55.6%) were female, 12 (66.7%) were diagnosed with AAV/OMAAV, four (22.2%) were diagnosed as idiopathic, two (11.1%) were diagnosed with invasive Aspergillus mastoiditis. Eleven (61.1%) had cranial neuropathies. Facial nerve paralysis was common in AAV/OMAAV, while abducent nerve paralysis was common in idiopathic HP. Cranial fossa enhancement was most common presentation in patients with HP, whereas inner acoustic canal (IAC) enhancement was seen only in patients with AAV/OMAAV, while HP involving the cavernous sinus was seen only in patients with idiopathic and mastoiditis. HP involving the IAC may be a key factor in diagnosing AAV/OMAAV.


An in vitro Study of Diffusibility and Degradation of Three Calcium Hydroxide Pastes.
Aims and objectives : The aim of this in vitro study is to assess the diffusibility and degradation of three calcium hydroxide pastes. Materials and methods : Three pastes were prepared by mixing calcium hydroxide powder with three different vehicles namely water, propylene glycol and CMCP for the investigation. The three pastes were sealed in porcelain caps and immersed in distilled water for the diffusion study. The change in the pH of the surrounding water indicated the rate and degree of diffusion in the degradation study (1 to 7 days, 14th day, 21st day and 30th day). The pastes were exposed to an atmosphere of carbon dioxide in the degradation study to assess the degree to which they can undergo degradation by carbonation. Mordant Black or Solochrome Black indicator was used for the estimation. Results and conclusion : Calcium hydroxide readily diffuses from all the three pastes. Calcium hydroxide diffuses marginally less from a paste made with propylene glycol as compared to CMCP paste. The comparative stability of Ca(OH)2 was studied and the results showed that consistently significant protection is imparted to Ca(OH)2 by CMCP over widely ranging periods.


The driving force for life's emergence: kinetic and thermodynamic considerations.
The principles that govern the emergence of life from non-life remain a subject of intense debate. The evolutionary paradigm built up over the last 50 years, that argues that the evolutionary driving force is the Second Law of Thermodynamics, continues to be promoted by some, while severely criticized by others. If the thermodynamic drive toward ever-increasing entropy is not what drives the evolutionary process, then what does? In this paper, we analyse this long-standing question by building on Eigen's "replication first" model for life's emergence, and propose an alternative theoretical framework for understanding life's evolutionary driving force. Its essence is that life is a kinetic phenomenon that derives from the kinetic consequences of autocatalysis operating on specific biopolymeric systems, and this is demonstrably true at all stages of life's evolution--from primal to advanced life forms. Life's unique characteristics--its complexity, energy-gathering metabolic systems, teleonomic character, as well as its abundance and diversity, derive directly from the proposition that from a chemical perspective the replication reaction is an extreme expression of kinetic control, one in which thermodynamic requirements have evolved to play a supporting, rather than a directing, role. The analysis leads us to propose a new sub-division within chemistry--replicative chemistry. A striking consequence of this kinetic approach is that Darwin's principle of natural selection: that living things replicate, and therefore evolve, may be phrased more generally: that certain replicating things can evolve, and may therefore become living. This more general formulation appears to provide a simple conceptual link between animate and inanimate matter.


Major obstacles to control of irregular migrations: prerequisites to policy.
This paper examines 3 basic obstacles thwarting all attempts to reduce irregular migration. The 1st, rather well known and analyzed, underscores the dependency of all regulation of migratory flows on the system of economic and political relations between developed and developing countries. The 2nd obstacle resides in the persistance and growth of subsequent dependent irregular migration. This obstacle also reveals the relative autonomy of population movements compared with the employment situation in the labor market. The 3rd generally ignored obstacle is the role played by migration itself, particularly the discriminatory status of foreign workers in the labor market, in producing irregular migration.


Observation of acoustically induced modulation instability in a Brillouin photonic crystal fiber laser.
We report the experimental observation of self-induced modulation instability (MI) in a Brillouin fiber laser made with a solid-core photonic crystal fiber (PCF) with strong anomalous dispersion. We identify this MI as the result of parametric amplification of optical sidebands generated by guided acoustic modes within the core of the PCF. It is further shown that MI leads to passive harmonic mode locking and to the generation of a picosecond pulse train at a repetition rate of 1.15 GHz which matches the acoustic frequency of the fundamental acoustic mode of the PCF.


[Hemophagocytic syndrome in late-onset SLE patients].
We report two elderly male patients with hemophagocytic syndrome (HPS) associated with systemic lupus erythematosus (SLE). They were admitted to the hospital because of general malaise. At admission, they showed fever of unknown origin and hematological abnormalities without typical symptoms for SLE such as arthralgia or malar rash. Chest X-rays, computed tomography and cardiac sonogram demonstrated unilateral pleural and pericardial effusions. Bone marrow aspiration revealed hypocellular marrow with increased macrophages phagocytosing blood cells in the both cases. One patient had positive reactivity for direct Coombs's test and high level of platelet-associated antibody, whose symptoms were ameliorated only by 20 mg per day of prednisolone. The other patient, however, progressive worsened and died regardless of intensive treatment containing methyl-prednisolone pulse therapy. Late-onset lupus (LO-SLE) patients tend to have a more insidious onset of disease, and less frequently show typical symptoms of early-onset SLE such as malar rash. So it seems to be important that clinicians make a fast diagnosis and proper treatment for LO-SLE and associated HPS by careful observation for the latent symptoms and laboratory findings.


Intramolecular Alkene Aminocarbonylation Using Concerted Cycloadditions of Amino-Isocyanates.
The ubiquity of nitrogen heterocycles in biologically active molecules challenges synthetic chemists to develop a variety of tools for their construction. While developing metal-free hydroamination reactions of hydrazine derivatives, it was discovered that carbazates and semicarbazides can also lead to alkene aminocarbonylation products if nitrogen-substituted isocyanates (N-isocyanates) are formed in situ as reactive intermediates. At first this reaction required high temperatures (150-200 °C), and issues included competing hydroamination and N-isocyanate dimerization pathways. Herein, improved conditions for concerted intramolecular alkene aminocarbonylation with N-isocyanates are reported. The use of βN-benzyl carbazate precursors allows the effective minimization of N-isocyanate dimerization. Diminished dimerization leads to higher yields of alkene aminocarbonylation products, to reactivity at lower temperatures, and to an improved scope for a reaction sequence involving alkene aminocarbonylation followed by 1,2-migration of the benzyl group. Furthermore, fine-tuning of the blocking (masking) group on the N-isocyanate precursor, and reaction conditions relying on base catalysis for N-isocyanate formation from simpler precursors resulted in room temperature reactivity, consequently minimizing the competing hydroamination pathway. Collectively, this work highlights that controlled reactivity of aminoisocyanates is possible, and provides a broadly applicable alkene aminocarbonylation approach to heterocycles possessing the β-aminocarbonyl motif.


Sunlight-Induced Topochemical Photodimerization and Switching of the Conductivity of a Metal-Organic Compound.
A metal-organic compound [Cd(quin)2(4-nvp)2] [1; Hquin = quinoline-2-carboxylic acid and 4-nvp = 4-(1-naphthylvinyl)pyridine] undergoes topochemical [2 + 2] cycloaddition by sunlight irradiation to generate a one-dimensional coordination polymer. This reaction is thermally reversible, and switching between two crystalline forms can be monitored by conductivity measurements.


[Biology of human immunodeficiency virus infection].
This review will describe the current state of basic knowledge on the acquired immune deficiency syndrome (AIDS), which has now spread worldwide becoming an acute public health problem in western countries and in Africa. AIDS is a viral infection, due to a retrovirus designated human immune deficiency virus (HIV), which affects the immune system resulting in a wide array of secondary manifestations which include opportunistic infections, neoplasia, autoimmune phenomena, neurologic disorders, and hematologic abnormalities. AIDS has now been recognized in the pediatric population, and infection occurs by perinatal and blood-borne transmission. As a consequence, pediatricians are no more involved only by a theoretical point of view (AIDS is a perfect model of interaction of virus with the immune system), but also by an operative point of view. Knowledges on immunological modifications in AIDS and on the underlaying features of the HIV are essential for the clinical approach. This goal may be difficult, if one considers that the pace of research in AIDS and the progress attained to date are unprecedent. However, clinicians must be aware that the ultimate solution of clinical problems in AIDS exclusively depends on sound basic research.


Life without tRNAArg-adenosine deaminase TadA: evolutionary consequences of decoding the four CGN codons as arginine in Mycoplasmas and other Mollicutes.
In most bacteria, two tRNAs decode the four arginine CGN codons. One tRNA harboring a wobble inosine (tRNA(Arg)ICG) reads the CGU, CGC and CGA codons, whereas a second tRNA harboring a wobble cytidine (tRNA(Arg)CCG) reads the remaining CGG codon. The reduced genomes of Mycoplasmas and other Mollicutes lack the gene encoding tRNA(Arg)CCG. This raises the question of how these organisms decode CGG codons. Examination of 36 Mollicute genomes for genes encoding tRNA(Arg) and the TadA enzyme, responsible for wobble inosine formation, suggested an evolutionary scenario where tadA gene mutations first occurred. This allowed the temporary accumulation of non-deaminated tRNA(Arg)ACG, capable of reading all CGN codons. This hypothesis was verified in Mycoplasma capricolum, which contains a small fraction of tRNA(Arg)ACG with a non-deaminated wobble adenosine. Subsets of Mollicutes continued to evolve by losing both the mutated tRNA(Arg)CCG and tadA, and then acquired a new tRNA(Arg)UCG. This permitted further tRNA(Arg)ACG mutations with tRNA(Arg)GCG or its disappearance, leaving a single tRNA(Arg)UCG to decode the four CGN codons. The key point of our model is that the A-to-I deamination activity had to be controlled before the loss of the tadA gene, allowing the stepwise evolution of Mollicutes toward an alternative decoding strategy.


Activated Type I and Type II Process for Two-Photon Promoted ROS Generation: The Coordinated Zn Matters.
The construction of novel classes of photosensitizers for efficient reactive oxygen species (ROS) generation is of great interest, yet it is a challenge. In this work, a bis(terpyridine)zinc(II) complex (namely, ZnL1) with two-photon absorption activity as an efficient ROS photogenerator was synthesized. Benefiting from the coordinated Zn, the decreased singlet-triplet energy gap favors the intersystem crossing process facilitating the singlet oxygen (1O2) generation via energy transfer. In addition, it makes the superoxide radical (O2·-) generation easier. This is an extremely rare study on two-photon excited ROS generation by activating type I and type II processes based on a cheaper and bioaccessible Zn complex.


Medical technology in the United Kingdom.
This article describes and explains the impact of the National Health Service bureaucracy on the diffusion of medical technology in the United Kingdom. Through case studies of six medical technologies, the author demonstrates how health care authorities may exercise control by using the central financing system to dampen the general diffusion of technology. However, the United Kingdom has less control in specific cases due to the absence of a bureaucratic body to coordinate the evaluation and introduction of new technology.


The influence of dietary history on the production of free radicals in rat liver microsomes.
Free radicals have been trapped in microsomal fractions from rat livers by the use of alpha-(4-pyridyl-l-oxide)-N-tert-butylnitrone (4-POBN) and detected by ESR spectroscopy. Using this technique we have investigated the effects of low dietary concentrations of vitamin E and selenium (Se) on free radical production. When the microsomal fractions were incubated with Fe, ADP and NADPH significantly greater amounts of radicals were initially trapped when rats were deficient in vitamin E (whether combined with Se deficiency or not) than from Se-deficient animals or Se- and vitamin E-supplemented controls. After prolonged incubation (ca. 30-45 mins) the free radicals trapped from the microsomes from the Se-deficient animals rose to amounts comparable to those seen in the vitamin E-deficient microsomes. Over the same period of incubation approximately half this quantity of radicals were trapped in liver microsomes from Se- and vitamin E-supplemented rats. The effects of 4-POBN on the levels of peroxidation in the various microsomal fractions were assessed by measuring the thiobarbituric acid reactive substances (TBARS). The presence of 4-POBN significantly reduced the amounts of TBARS formed on incubation and there was a clear distinction between the groups on the basis of the vitamin E status of their diets.


Anaesthesia for Antenatal Diagnosed Duodenal Atresia with Undiagnosed Persistent Pulmonary Hypertension of Neonate.
Conversion of fetal circulation to adult-type occurs immediately after birth but neonates with problems in the development of pulmonary vasculature are prone to revert back to fetal circulation. This phenomenon is known as flip-flop circulation which may be induced perioperatively and as such anesthesiologist are central to its management. We report a case of term neonate planned for repair of duodenal atresia that despite having no respiratory symptom preoperatively developed severe hypoxemia under anesthesia that was even unresponsive to 100% oxygen. The intraoperative hemodynamics of the neonate was managed along with supportive care successfully. A postoperative echocardiogram confirmed the evidence of persistent pulmonary hypertension of the newborn. Keywords: Duodenal atresia; flip flop circulation; neonates; persistent pulmonary hypertension of newborn.


Dual-fiber microfluidic chip for multimodal manipulation of single cells.
On-chip single-cell manipulation is imperative in cell biology and it is desirable for a microfluidic chip to have multimodal manipulation capability. Here, we embedded two counter-propagating optical fibers into the microfluidic chip and configured their relative position in space to produce different misalignments. By doing so, we demonstrated multimodal manipulation of single cells, including capture, stretching, translation, orbital revolution, and spin rotation. The rotational manipulation can be in-plane or out-of-plane, providing flexibility and capability to observe the cells from different angles. Based on out-of-plane rotation, we performed a 3D reconstruction of cell morphology and extracted its five geometric parameters as biophysical features. We envision that this type of microfluidic chip configured with dual optical fibers can be helpful in manipulating cells as the upstream process of single-cell analysis.


Can we win the war on obesity with pharmacotherapy?
Obesity is a major health concern for several countries. The United States (U.S.) has arguably led the world in the percentage of overweight and/or obese per capita for several decades. As a result, numerous FDA-approved pharmacotherapeutic options are available for the long-term treatment of obesity. Although most of these medications have been on the U.S. market for a few years and have demonstrated efficacy for long-term weight loss in clinical trials, the impact of these medications on obesity in the U.S. has yet to be realized. Areas covered: We will review and evaluate why pharmacotherapy for obesity has not produced a meaningful reduction in the number of overweight and obese adults in the U.S. Expert commentary: Several obstacles, such as adverse drug effects, poor insurance coverage, not treating obesity as a chronic disease, and availability of other weight loss alternatives, has resulted in poor performance of pharmacotherapy for obesity in the U.S. market.


Pylorus preserving pancreatoduodenectomy: an overview.
Pylorus preserving pancreatoduodenectomy (PPPD) was reintroduced 12 years ago. Since that time, over 400 patients have undergone PPPD with approximately 41 per cent having chronic pancreatitis and 54 per cent having pancreatic and other periampullary malignancies. Reported 5-year survivals in this latter group have been comparable to those achieved by the classic Whipple procedure. The postoperative mortality rate in 339 reported patients has been 3.8 per cent. Postoperative morbidity, including delayed gastric emptying, has been similar to that of the classic Whipple operation. However, PPPD has been associated with fewer late problems with dumping, diarrhoea, delayed gastric emptying (8.6 per cent), and marginal ulceration (3.6 per cent). Moreover, most patients undergoing PPPD have been able to return to their preoperative and preillness weight. The additional advantage of decreased operative time makes PPPD an attractive alternative to the classic pancreatoduodenectomy.


Long-Term Exposure to Ambient PM2.5, Sunlight, and Obesity: A Nationwide Study in China.
Accumulated researches revealed that both fine particulate matter (PM2.5) and sunlight exposure may be a risk factor for obesity, while researches regarding the potential effect modification by sunlight exposure on the relationship between PM2.5 and obesity are limited. We aim to investigate whether the effect of PM2.5 on obesity is affected by sunlight exposure among the general population in China. A sample of 47,204 adults in China was included. Obesity and abdominal obesity were assessed based on body mass index, waist circumference and waist-to-hip ratio, respectively. The five-year exposure to PM2.5 and sunlight were accessed using the multi-source satellite products and a geochemical transport model. The relationship between PM2.5, sunshine duration, and the obesity or abdominal obesity risk was evaluated using the general additive model. The proportion of obesity and abdominal obesity was 12.6% and 26.8%, respectively. Levels of long-term PM2.5 ranged from 13.2 to 72.1 μg/m3 with the mean of 46.6 μg/m3. Each 10 μg/m3 rise in PM2.5 was related to a higher obesity risk [OR 1.12 (95% CI 1.09-1.14)] and abdominal obesity [OR 1.10 (95% CI 1.07-1.13)]. The association between PM2.5 and obesity varied according to sunshine duration, with the highest ORs of 1.56 (95% CI 1.28-1.91) for obesity and 1.66 (95% CI 1.34-2.07) for abdominal obesity in the bottom quartile of sunlight exposure (3.21-5.34 hours/day). Long-term PM2.5 effect on obesity risk among the general Chinese population are influenced by sunlight exposure. More attention might be paid to reduce the adverse impacts of exposure to air pollution under short sunshine duration conditions.


VP8* antigen produced in tobacco transplastomic plants confers protection against bovine rotavirus infection in a suckling mouse model.
Group A rotavirus is a major leading cause of diarrhea in mammalian species worldwide. In Argentina, bovine rotavirus (BRV) is the main cause of neonatal diarrhea in calves. VP4, one of the outermost capsid proteins, is involved in various virus functions. Rotavirus infectivity requires proteolytic cleavage of VP4, giving an N-terminal non-glycosilated sialic acid-recognizing domain (VP8*), and a C-terminal fragment (VP5*) that remains associated with the virion. VP8* subunit is the major determinant of the viral infectivity and one of the neutralizing antigens. In this work, the C486 BRV VP8* protein was produced in tobacco chloroplasts. Transplastomic plants were obtained and characterized by Southern blot, northern blot and western blot. VP8* was highly stable in the transplastomic leaves, and formed insoluble aggregates that were partially solubilized by sonication. The recombinant protein yield was 600 μg/g of fresh tissue (FT). Both the soluble and insoluble fractions of the VP8* plant extracts were able to induce a strong immune response in female mice as measured by ELISA and virus neutralization test. Most important, suckling mice born to immunized dams were protected against oral challenge with virulent rotavirus. Results presented here contribute to demonstrate the feasibility of using antigens expressed in transplastomic plants for the development of subunit vaccines.


Hypoxemia alters erythrocyte perfusion pattern in the cerebral capillary network.
The effect of acute hypoxemia on erythrocyte perfusion rates in individual capillaries of the rat cerebral cortex was studied by intravital video microscopy. The motion of erythrocytes in subsurface capillaries of the frontoparietal cortex was visualized through a closed cranial window using fluorescently labeled red blood cells (FRBC) as markers of flow. FRBC velocity and FRBC supply rate were measured in each capillary at rest, moderate hypoxemia (PaO(2) = 40 mm Hg), and severe hypoxemia (PaO(2) = 26 mm Hg). Lineal density of FRBC in the capillaries was calculated as the ratio of supply rate and velocity. Hypoxemia increased erythrocyte perfusion in virtually all capillaries. Average FRBC supply rate increased by 104% in moderate hypoxemia and by 281% in severe hypoxemia. Average FRBC velocity increased by 66 and 173%, respectively. During severe hypoxemia, FRBC supply rate increased significantly more in capillaries with low resting supply rate compared to those with high resting supply rate. Changes in FRBC velocity exhibited a similar pattern. Lineal density of FRBC increased by 28% in moderate hypoxemia and by 48% in severe hypoxemia. The results suggest that acute hypoxemia promotes perfusion homogeneity and recruitment of erythrocytes in the cerebral capillary network.


Angiotensin-converting enzyme (ACE) serum levels and gene polymorphism in Egyptian patients with systemic lupus erythematosus.
To investigate the association of angiotensin-converting enzyme (ACE) gene polymorphism and serum ACE level among Egyptian SLE patients and its relation to disease activity parameters. We enrolled 50 Egyptian female systemic lupus erythematosus (SLE) patients and 29 healthy controls. Measurement of serum ACE level was done using ELISA, and the ACE genotype was determined by polymerase chain reaction using genomic DNA from peripheral blood. A significant difference was found in ACE genotypes between SLE patients and controls (χ(2 )= 7.84, p = 0.02). The frequency of ACE DD versus (DI and II) genotypes was significantly higher in SLE patients compared with controls (χ(2 )= 5.57, p = 0.018 and OR for risk of SLE was 3.1 with 95% confidence interval: 1.198.06). Mean serum ACE level was significantly higher in the SLE group compared with controls (p = 0.006). Subjects with DD genotype had a significantly higher mean level than those with DI (p = 0.015) and II genotypes (p = 0.02). Lupus nephritis patients had a significantly higher frequency of DD versus DI and II genotypes compared with lupus patients without nephritis (Fisher's exact test, p = 0.025) and controls (χ (2) =8.74, p = 0.003). SLE patients with vasculopathy had a significantly higher frequency of DD versus DI/II genotypes compared with SLE patients without vasculopathy (Fisher's exact test, p = 0.04) and controls (χ(2 )= 9.84 and p = 0.002). Mean serum ACE level was significantly higher in the lupus nephritis and SLE patients with vasculopathy compared with controls (p = 0.008, p = 0.001, respectively). Significant positive correlations were found between serum ACE level and serum creatinine and 24 h proteinuria (p = 0.03, 0.009, respectively). SLE patients with DD genotype had a statistically significant higher mean SLEDAI score than those with (DI/II) genotypes (p = 0.02). Significant positive correlation was found between serum ACE levels and SLEDAI scores (p = 0.04). ACE genotype and subsequently serum ACE level could be associated with the disease activity of Egyptian SLE patients; in addition, ACE deletion polymorphism might be used as one of the predictive factors for the activity of SLE. Further studies on a larger number of patients should be done to determine the exact prevalence of ACE gene polymorphism among Egyptian SLE patients.


[The measuring of ECP and IgE in middle ear effusion of patients with otitis media of effusion].
To study the relationship between otitis media of effusion (OME) and allergy by investigating eosinophil cationic protein in middle ear effusion ( MECP), middle ear effusion IgE (MIgE) and serum eosinophil cationic protein (SECP). The specimens drawn from 31 patients of OME were tested with Uni-CAP-100 allergic antigen testing system for the MECP, IgE and SECP. The results then were analyzed by statistical methods. MECP were found in all the effusion specimens of 31 patients, the average concentration of which was 56.88 microg/L. The MECP concentration level in nine specimens (28.1%) was significantly elevated. The average concentration of MIgE was 27.2 ku/L. The MIgE concentration level in three specimens (9.7%) was remarkably increased. There was a positive correlation between the MECP level and the MIgE level( P <0.05). The average concentration of SECP was 5.6 microg/L. ECP exists in the middle ear effusion of OME. OME is an allergic inflammatory process more localized in middle ear itself in some patients. There may be a complicated allergic mechanism in OME.


Paleomagnetism and gondwanaland.
Lower Paleozoic data now available for all the southern continents enable a unique reconstruction of Gondwanaland to be determined from paleomagnetic measurements alone. This reconstruction is corroborated by the computerized fit of the continental shelves and the matching of geological age provinces.


Microbubble contrast agent for color Doppler US: effect on breast masses. Work in progress.
To evaluate the effects of a new microbubble contrast agent for ultrasound (US) on breast masses. Thirty-four patients underwent color Doppler US before and after intravenous injection of a "contrast agent" containing microbubbles. The authors subjectively evaluated the increase in intensity of the Doppler signals, the changes in the vascular patterns, and the timing of the transit of the microbubble bolus. The diagnostic confidence was assessed before and after administration of contrast material. After contrast material injection, there was greater and longer signal enhancement in the cancers than in the benign lesions. The cancers displayed characteristic vascular morphologic features, with more additional vessels visualized in relation to the lesion and a greater increase in vascular tortuousity. Shunts between vessels were demonstrated in all cancers but were not seen in any benign lesion. The diagnostic confidence increased with use of the contrast agent. The appearance at contrast-enhanced US led to a change in the US diagnosis in four patients. This increased both sensitivity and specificity to 100%. Injection of a microbubble agent enabled accurate differentiation of benign masses from carcinomas.


Global stability analysis of the role of multi-therapies and non-pharmaceutical treatment protocols for COVID-19 pandemic.
In this paper, we sought and presented an 8-Dimensional deterministic mathematical COVID-19 dynamic model that accounted for the global stability analysis of the role of dual-bilinear treatment protocols of COVID-19 infection. The model, which is characterized by human-to-human transmission mode was investigated using dual non-pharmaceutical (face-masking and social distancing) and dual pharmaceutical (hydroxylchloroquine and azithromycin) as control functions following the interplay of susceptible population and varying infectious population. First, we investigated the model state-space and then established and computed the system reproduction number for both off-treatment ℜ 0 ( 1 ) = 10.94 and for onset-treatment ℜ 0 ( 2 ) = 3.224 . We considered the model for off-treatment and thereafter by incorporating the theory of LaSalle's invariant principle into the classical method of Lyapunov functions, we presented an approach for global stability analysis of COVID-19 dynamics. Numerical verification of system theoretical predictions was computed using in-built Runge-Kutta of order of precision 4 in a Mathcad surface. The set approach produces highly significant results in the main text. For example, while rapid population extinction was observed by the susceptible under off-treatment scenario in the first t f ≤ 18 days, the application of non-pharmaceuticals at early stage of infection proved very effective strategy in curtailing the spread of the virus. Moreso, the implementation of dual pharmacotherapies in conjunction with non-pharmaceuticals yields tremendous rejuvenation of susceptible population ( 0.5 ≤ S p ( t ) ≤ 3.143 c e l l s / m l 3 ) with maximal reduction in the rates of isolation, super spreaders and hospitalization of the infectives. Thus, experimental results of investigation affirm the suitability of proposed model for the control and treatment of the deadly disease provided individuals adheres to treatment protocols.


Quantitative volumetric perfusion mapping of the microvasculature using contrast ultrasound.
Contrast-enhanced ultrasound imaging has demonstrated significant potential as a noninvasive technology for monitoring blood flow in the microvasculature. With the application of nondestructive contrast imaging pulse sequences combined with a clearance-refill approach, it is possible to create quantitative time-to-refill maps of tissue correlating to blood perfusion rate. One limitation to standard two-dimensional (2D) perfusion imaging is that the narrow elevational beamwidth of 1- or 1.5-D ultrasound transducers provides information in only a single slice of tissue, and thus it is difficult to image exactly the same plane from study to study. We hypothesize that inhomogeneity in vascularization, such as that common in many types of tumors, makes serial perfusion estimates inconsistent unless the same region can be imaged repeatedly. Our objective was to evaluate error in 2D quantitative perfusion estimation in an in vivo sample volume because of differences in transducer positioning. To mitigate observed errors due to imaging plane misalignment, we propose and demonstrate the application of quantitative 3-dimensional (3D) perfusion imaging. We also evaluate the effect of contrast agent concentration and infusion rate on perfusion estimates. Contrast-enhanced destruction-reperfusion imaging was performed using parametric mapping of refill times and custom software for image alignment to compensate for tissue motion. Imaging was performed in rats using a Siemens Sequoia 512 imaging system with a 15L8 transducer. A custom 3D perfusion mapping system was designed by incorporating a computer-controlled positioning system to move the transducer in the elevational direction, and the Sequoia was interfaced to the motion system for timing of the destruction-reperfusion sequence and data acquisition. Perfusion estimates were acquired from rat kidneys as a function of imaging plane and in response to the vasoactive drug dopamine. Our results indicate that perfusion estimates generated by 2D imaging in the rat kidney have mean standard deviations on the order of 10%, and as high as 22%, because of differences in initial transducer position. This difference was larger than changes in kidney perfusion induced by dopamine. With application of 3D perfusion mapping, repeatability in perfusion estimated in the kidney is reduced to a standard deviation of less than 3%, despite random initial transducer positioning. Varying contrast agent administration rate was also observed to bias measured perfusion time, especially at low concentrations; however, we observed that contrast administration rates between 2.7 × 10(8) and 3.9 × 10(8) bubbles/min provided results that were consistent within 3% for the contrast agent type evaluated. Three-dimensional perfusion imaging allows a significant reduction in the error caused by transducer positioning, and significantly improves the reliability of quantitative perfusion time estimates in a rat kidney model. When performing perfusion imaging, it is important to use appropriate and consistent contrast agent infusion rates to avoid bias.


The clinical utility of prostate-specific antigen and bone scintigraphy in prostate cancer follow-up.
To assess the value of serum prostate-specific antigen (PSA) in prostate cancer follow-up, we prospectively studied 107 consecutive patients with: (1) pathologically confirmed prostate cancer; (2) definitive prostatectomy and/or radiation therapy greater than or equal to 3 mo prior to bone scanning; and (3) one bone scan and serum PSA sampling within 3 mo of each other. The mean and range of patient follow-up since definitive therapy was 1.6 and 0.5-8 yr, respectively. Abnormal bone scans were correlated with pertinent radiographs. Of 107 bone scans, 16 demonstrated metastatic bone disease. A PSA value of less than or equal to 8 ng/ml excluded bone metastases with a predictive value of a negative test of 98.5%. Without radiographic correlation, abnormal bone scans rarely represented metastases if the PSA value was less than or equal to 8 ng/ml. In summary, serum PSA concentration determines the need for follow-up bone scanning and assists in scan interpretation in patients status post definitive therapy for prostate cancer.


Ecological Validation and Reliability of Hexoskin Wearable Body Metrics Tool in Measuring Pre-exercise and Peak Heart Rate During Shuttle Run Test in Professional Handball Players.
The aim of the study was to assess the validity and reliability of wearable body metric Hexoskin "smart shirt" in measuring heart rate (HR) at pre-exercise and during peak effort in a field test incorporating vigorous movements of the upper body. Measurements were recorded simultaneously using the Hexoskin and Polar Team Pro. Nine male professional handball players (age: 21.8 ± 2.4 years; weight: 83 ± 10.26 kg; height: 1.81 ± 0.09 m; and BMI: 25.17 ± 2.23) volitionally participated in the study by completing two 400 m shuttle run test trials (10 shuttles), each separated by a 48 to 72 h recovery period. Results indicated significant correlations between Hexoskin and Polar Team Pro system in pre-exercise HR. Hexoskin provided erroneous measurements in four of the nine athletes during peak effort. Subsequent correction yielded no consistency between the Polar Team Pro system and Hexoskin between the first and the second trial. Hexoskin showed significant reliability in pre-exercise HR. However, Hexoskin picked up excessive artifact during vigorous physical activity in four of the nine athletes rendering the results in these cases useless. Nevertheless, in athletes where artifact was not an issue, ICC yielded a good estimate. The main findings indicate that Hexoskin has good validity and reliability in measuring pre-exercise HR in handball players and hence may be used with high confidence in slow motion activities. However, vigorous physical activity with jarring multidirectional upper body movements posed a challenge for Hexoskin.


Shift of grey seal subspecies boundaries in response to climate, culling and conservation.
Identifying the processes that drive changes in the abundance and distribution of natural populations is a central theme in ecology and evolution. Many species of marine mammals have experienced dramatic changes in abundance and distribution due to climatic fluctuations and anthropogenic impacts. However, thanks to conservation efforts, some of these species have shown remarkable population recovery and are now recolonizing their former ranges. Here, we use zooarchaeological, demographic and genetic data to examine processes of colonization, local extinction and recolonization of the two northern European grey seal subspecies inhabiting the Baltic Sea and North Sea. The zooarchaeological and genetic data suggest that the two subspecies diverged shortly after the formation of the Baltic Sea approximately 4200 years bp, probably through a gradual shift to different breeding habitats and phenologies. By comparing genetic data from 19th century pre-extinction material with that from seals currently recolonizing their past range, we observed a marked spatiotemporal shift in subspecies boundaries, with increasing encroachment of North Sea seals on areas previously occupied by the Baltic Sea subspecies. Further, both demographic and genetic data indicate that the two subspecies have begun to overlap geographically and are hybridizing in a narrow contact zone. Our findings provide new insights into the processes of colonization, extinction and recolonization and have important implications for the management of grey seals across northern Europe.


Some results on extensions and modifications of the Theil-Sen regression estimator.
Many robust regression estimators have been proposed that have a high, finite-sample breakdown point, roughly meaning that a large proportion of points must be altered to drive the value of an estimator to infinity. But despite this, many of them can be inordinately influenced by two properly placed outliers. With one predictor, an estimator that appears to correct this problem to a fair degree, and simultaneously maintain good efficiency when standard assumptions are met, consists of checking for outliers using a projection-type method, removing any that are found, and applying the Theil-Sen estimator to the data that remain. When dealing with multiple predictors, there are two generalizations of the Theil-Sen estimator that might be used, but nothing is known about how their small-sample properties compare. Also, there are no results on testing the hypothesis of zero slopes, and there is no information about the effect on efficiency when outliers are removed. In terms of hypothesis testing, using the more obvious percentile bootstrap method in conjunction with a slight modification of Mahalanobis distance was found to avoid Type I error probabilities above the nominal level, but in some situations the actual Type I error probabilities can be substantially smaller than intended when the sample size is small. An alternative method is found to be more satisfactory.


[Infliximab in the treatment of Wegener's granulomatosis: case report].
to evaluate the efficacy of monoclonal anti-tumor necrosis factor alpha antibody infliximab in treatment of refractory Wegene's granulomatosis. Clinical manifestations of Wegener's granulomatosis at the time of infliximab initiation were: proptosis of both eyes due to progressive retrobulbar granulomas, visual impairment, optic disc edema, progressive diplopia, sinus and renal involvement. The disease was refractory to a treatment with various immunosuppressants, including intravenous cyclophosphamide or high doses of mycophenolate mofetil in combination with corticosteroids. Observational case report. the patient received six infusions of infliximab (3 mg/kg) in addition to low doses of oral cyclophosphamide and corticosteroids. The interval between the first two infusions was 1 week. The interval between the second and third infusions was 4 weeks, thereafter 8, 12 and 34 weeks. Following the third infusion of infliximab the remission of Wegener's granulomatosis was seen. After the regression of retrobulbar granulomas visual acuity increased, ocular motility improved, diplopia and optic disc edema decreased. Remission has been maintained for 17 months. Infliximab was well tolerated during the short-term follow-up. Infliximab successfully induced remission in case of sight-threatening Wegener's granulomatosis in our patient. It seems that infliximab provides more effective therapeutic option in treatment of Wegener's granulomatosis refractory to standard immunosuppression and offers better perspectives for patients with previously poor prognosis. Furthermore, it enables reducing the exposure to immunosuppressive drugs.


The effect of water extract of sumac (Rhus coriaria L.) and lactic acid on decontamination and shelf life of raw broiler wings.
In an attempt to improve the bacteriological quality and refrigerated shelf life of broiler meat, 10-min surface wash treatments with sterile distilled water (DW), 8% (wt/vol) water extract of sumac (Rhus coriaria L.) fruits (WES), and 2% (vol/vol) lactic acid (LA) were compared by using a broiler wing model. The aerobic plate counts (log10 cfu/g) of psychrotrophs, mesophilic aerobes, Enterobacteriaceae, coliforms and presumptive fecal coliforms on the samples were determined. Immediately after a 10-min decontaminaton, the mean count of all the bacterial groups was determined to be 3.9, 2.6, and 1.7 (log10 cfu/g) for DW, WES, and LA, respectively. Because the postdecontamination population level of psychrotrophs, mesophiles, and Enterobacteriaceae were low in the LA-treated group compared to the WES group, an equity between the 2 groups in the point of view of the 3 bacterial groups existed at d 10 of cold storage (3 +/- 1 degrees C). Shelf life was 7 and 14 d for wings treated with DW and WES, respectively, whereas the LA-treated wings did not spoil after 14 d of cold storage (3 +/- 1 degrees C). Nevertheless, an undesirable pale color and an acidulous odor occurred in the LA-treated wings. In contrast, a good color appeared on the WES-treated wings, which was also superior to the color of the DW-treated wings. Such advantages of WES may be important for poultry processors and for consumers. However, the immediate decontamination and refrigerated shelf life extension potential of WES should be intensively studied in antimicrobial interventions in poultry processing plants.


The radiologic work-up in thyroid surgery: fine-needle biopsy versus scintigraphy and ultrasound.
To compare the effectiveness and predictive value of radiologic studies with fine-needle aspiration biopsy (FNAB) in correctly diagnosing thyroid lesions, we reviewed the medical records of 441 patients who had been treated surgically for thyroid disease from 1987 through 1999. We compared the results of thyroid scintigraphy, ultrasound, and FNAB with findings on final surgical pathology. The data were analyzed according to the chi-squared (chi 2) test. Of 189 thyroid scintigraphy scans that showed a hypofunctional (cold) nodule, 52 (27.5%) were found to be cancerous, and of 35 hyperfunctional (hot) nodules, two (5.7%) were malignant (sensitivity = 91%; specificity = 19%; accuracy = 38%; chi 2 = 7.67; p = 0.006). Of 66 ultrasounds that detected a solid or a mixed solid-cystic mass, 16(24.2%) were cancerous, while none of the eight sonograms that showed a purely cystic lesion was malignant (sensitivity = 100%; specificity = 14%; accuracy = 32%; chi 2 = 2.47; p = 0.116 [not statistically significant]). Of the 119 patients whose FNABs were diagnostic, 55 biopsies revealed follicular cells. Of the remaining 64 biopsies, cancer was correctly predicted in 35 of 44 patients (79.5%) and benign disease was correctly diagnosed in 18 of 20 patients (90.0%) (sensitivity = 95%; specificity = 67%; accuracy = 83%; chi 2 = 27.3; p = 0.00). We conclude that in the evaluation of thyroid lesions, FNAB is superior to imaging studies, which yield a relatively high rate of false-positive results.


MTA1--a stress response protein: a master regulator of gene expression and cancer cell behavior.
Gene mutation's role in initiating carcinogenesis has been controversial, but it is consensually accepted that both carcinogenesis and cancer metastasis are gene-regulated processes. MTA1, a metastasis-associated protein, has been extensively researched, especially regarding its role in cancer metastasis. In this review, I try to elucidate MTA1's role in both carcinogenesis and metastasis from a different angle. I propose that MTA1 is a stress response protein that is upregulated in various stress-related situations such as heat shock, hypoxia, and ironic radiation. Cancer cells are mostly living in a stressful environment of hypoxia, lack of nutrition, and immune reaction attacks. To cope with all these stresses, MTA1 expression is upregulated, plays a role of master regulator of gene expression, and helps cancer cells to survive and migrate out of their original dwelling.


Human luteal phase function following oocyte aspiration from the immediately preovular graafian follicle of spontaneous ovular cycles.
Human luteal phase function as evaluated by peripheral venous blood steroid levels does not appear to be impaired following the aspiration of follicular fluid together with a cumulus enclosed oocyte and a number of granulosal cells from the immediate preovular follicle in women having otherwise spontaneous ovular cycles. The day to day levels of luteinising hormone, oestradiol-17 beta, 17 alpha-hydroxy-progesterone, progesterone and basal temperatures in 14 women who had their preovular follicle aspirated were compared with a control group of 28 spontaneously ovulating women. It was concluded that a carefully performed single aspiration of the contents of a preovular follicle, for the purpose of extra-corporeal fertilisation of the mature oocyte, did not lead to impaired steroid function of the subsequent corpus luteum, although the prolactin levels were increased due to the effects of the relaxant anaesthetic and/or the laparoscopic procedure. A safe and simple laparoscopic procedure is also described, which is particularly suitable for women with a likelihood of extensive pelvic adhesions.


Cilia-related diseases.
There are at least eight categories of cilia in the human body and malfunctioning of any one or several of them will have different consequences for the patient. A genetic error of the respiratory cilia (9 + 2) is the cause of the airways disease named immotile-cilia syndrome (or PCD), whereas defective ependymal cilia (9 + 2) carries an increased risk of hydrocephalus. When the so-called nodal cilia (9 + 0) of the early embryo are malfunctioning, there is a random determination of asymmetry of the heart and visceral organs ('a 50% risk of situs inversus'). Some genes are responsible for the synthesis, transport, and assembly of the cilia, and mutations in these genes may lead to progressive degeneration of ciliary structures, such as the connecting cilium (9 + 0) of the photoreceptor cells-this is the cause of retinitis pigmentosa. Ciliary malfunctions due to genetic errors tend to be systemic and life-long, whereas acquired diseases are local and may be temporary only.


Laboratory Capacity for Antimicrobial Susceptibility Surveillance of Neisseria gonorrhoeae-District of Columbia, 2007-2012.
In the District of Columbia (DC), Neisseria gonorrhoeae (gonorrhea) infections accounted for more than 25% of 9321 incident sexually transmitted infections reported in 2011; untreated infections can lead to reproductive complications and a higher risk for HIV transmission. In DC, limited capacity to measure the prevalence of antibiotic-resistant N. gonorrhoeae is available; culture-based antibiotic susceptibility testing (AST) is needed to monitor antimicrobial resistance. We examined the capacity of laboratories that report to the DC Department of Health to perform AST for ongoing surveillance of antibiotic-resistant N. gonorrhoeae and to identify suspected treatment failures. We created a survey about diagnostic methods for gonorrhea testing and identified 33 laboratories that reported gonorrhea results to Department of Health in 2007 to 2012. Laboratories were assessed for use of bacterial culture or nucleic acid amplification testing (NAAT) for gonorrhea testing, prevalence of AST on gonorrhea-positive cultures, and types of antibiotics tested during AST. We estimated the prevalence of laboratory practices on the basis of self-report by staff. Nineteen (58%) laboratories completed the survey, representing 92% of the gonorrhea reporting. Seventeen (89%) of 19 laboratories conducted testing by culture; only 6 (35%) performed AST; 79% performed NAAT. Barriers to AST included longer completion times and limited number of provider requests for AST. Commercial laboratories (32%) were more likely to conduct both culture and NAAT, compared with health care facilities (11%). We report a low prevalence of laboratories performing AST because of multiple barriers. State-specific strategies addressing these barriers are needed to improve detection of antibiotic-resistant gonorrhea stains circulating among the population.


Hundreds of LncRNAs Display Circadian Rhythmicity in Zebrafish Larvae.
Long noncoding RNAs (lncRNAs) have been shown to play crucial roles in various life processes, including circadian rhythms. Although next generation sequencing technologies have facilitated faster profiling of lncRNAs, the resulting datasets require sophisticated computational analyses. In particular, the regulatory roles of lncRNAs in circadian clocks are far from being completely understood. In this study, we conducted RNA-seq-based transcriptome analysis of zebrafish larvae under both constant darkness (DD) and constant light (LL) conditions in a circadian manner, employing state-of-the-art computational approaches to identify approximately 3220 lncRNAs from zebrafish larvae, and then uncovered 269 and 309 lncRNAs displaying circadian rhythmicity under DD and LL conditions, respectively, with 30 of them are coexpressed under both DD and LL conditions. Subsequently, GO, COG, and KEGG pathway enrichment analyses of all these circadianly expressed lncRNAs suggested their potential involvement in numerous biological processes. Comparison of these circadianly expressed zebrafish larval lncRNAs, with rhythmically expressed lncRNAs in the zebrafish pineal gland and zebrafish testis, revealed that nine (DD) and twelve (LL) larval lncRNAs are coexpressed in the zebrafish pineal gland and testis, respectively. Intriguingly, among peptides encoded by these coexpressing circadianly expressed lncRNAs, three peptides (DD) and one peptide (LL) were found to have the known domains from the Protein Data Bank. Further, the conservation analysis of these circadianly expressed zebrafish larval lncRNAs with human and mouse genomes uncovered one lncRNA and four lncRNAs shared by all three species under DD and LL conditions, respectively. We also investigated the conserved lncRNA-encoded peptides and found one peptide under DD condition conserved in these three species and computationally predicted its 3D structure and functions. Our study reveals that hundreds of lncRNAs from zebrafish larvae exhibit circadian rhythmicity and should help set the stage for their further functional studies.


Comparison of various insulin sensitivity indices in psoriatic patients and their relationship with type of psoriasis.
We aimed to identify insulin resistance and its possible association with types, duration and severity of psoriasis, and to evaluate various simple insulin-sensitivity indices and beta-cell function in psoriasis. A cross-sectional study was performed in 110 non-obese adults (18-50 years old): 70 with psoriasis (53 type I, 17 type II psoriasis) and 40 healthy individuals. Blood glucose, insulin and C-peptide levels were measured. Oral glucose tolerance test (OGTT); insulin sensitivity and beta-cell function indices derived from a single sample and OGTT were determined and compared in three groups. Total, type I and type II psoriatics had IGT rates of 18.6%, 13.2% and 40%, respectively. In the control group IGT was only 2.5%. Homeostasis Model Assessment (HOMA) beta cell index, fasting insulin, Raynaud index, HOMA-IR and FIRI results were higher in total, type I and type II psoriatics than in controls (P < 0.05, for all). Fasting Belfiore index, QUICKY index, ISI HOMA and FIRI(-1) results were lower in total, type I and type II psoriatics than in controls (P < 0.05, for all), and type I psoriatics had higher levels of these indices than type II psoriatics (P < 0.05, for all). Our study showed that psoriatic patients were more insulin resistant than healthy subjects and type II psoriatics were more susceptible than type I psoriatics to develop IGT. We suggest that beta-cell function and insulin sensitivity indices are useful methods for measuring insulin resistance in psoriatics. We propose that OGTT should be applied especially in type II psoriatics because of increased rate of IGT in this group.


An analysis of migratory systems: 1. Theory.
This is the first of a planned series of three papers in which the authors attempt to combine evolutionary migration models with stochastic utility theory. This first paper deals with the evolution of migratory systems. Such systems are first defined, and the foundations upon which their evolution is based are described. The paper concludes with a discussion of disequilibrium, which is central to the series. "Disequilibrium is related to the concept of a steady state, the existence of which is established for nonlinear migratory systems of the type discussed here."


A Functional Review of Research on Clarity, Immediacy, and Credibility of Teachers and Their Impacts on Motivation and Engagement of Students.
The interpersonal communication behaviors of teachers have been substantiated to affect motivation, engagement, and success of students in the academic arena. Aiming to provide a systematic review of some teacher-related constructs in this domain, the present article was a bid to explain the crucial pillars of clarity, credibility, and immediacy of teachers in juxtaposition with theories and models of motivation and engagement of students. More particularly, this article presents some theoretical underpinnings to justify its claims using the ideas of positive psychology, the broaden-and-build theory, the rhetorical/relational goal theory, social cognitive theory, the attachment theory, some popular motivational theories, and the engagement theory. These theories signify the importance of clarity, credibility, and immediacy of teachers in the classroom and depict their association and impact on motivation and engagement of students. Later, the arguments are defended through a quick glance at the available empirical studies on each of the constructs. Afterward, the findings and implications of this review article are discussed. Finally, research gaps and future directions are presented for avid researchers to make new explorations.


Probing the electronic properties of self-organized poly(3-dodecylthiophene) monolayers by two-dimensional scanning tunneling spectroscopy imaging at the single chain scale.
Regioregular poly(3-dodecylthiophene) films self-organized on highly oriented pyrolytic graphite have been investigated by scanning tunneling microscopy and two-dimensional scanning tunneling spectroscopy (STS). Simulated spectra in very good agreement with the experimental data have been obtained by a method combining ab initio and semiempirical approaches, which allows a careful discussion of the polymer electronic states. From the experimental data, with the support of modeling, it is shown that the STS spectra give a direct access to the polymer semiconducting band gap without noticeable charge-transfer effects from the substrate. Spectroscopic images are achieved at the single chain scale, which allows scrutinizing the electronic consequences of chain folds and pi-stacking effects through spectroscopic contrasts. While chain folds do not locally increase the polymer band gap more than a few tens of millielectonvolt, a striking widening of the STS conductance gap is observed in the case of electronic tunneling through two interacting polymer layers. Scenarios based on nonplanar configuration of thiophene cycles within the second layer or variations of the charge screening effects are proposed to explain this phenomenon.


Breast cancer screening prior to cosmetic breast surgery: ASPS members' Adherence to American Cancer Society Guidelines.
The goal of this study was to determine the self-reported breast cancer screening practices of American plastic surgeons and the degree to which those practices adhere to the American Cancer Society guidelines. An independent analysis of subgroups divided by gender, years in practice, and practice setting was performed and the implications of the results are discussed. The authors conducted an online survey of the members of the American Society of Plastic Surgeons. Questions assessed practice composition, American Cancer Society guideline familiarity, and preoperative breast cancer screening in patients seeking aesthetic breast surgery. Responses were summarized, subgroup comparisons were made, and logistic regression was used to determine predictors of physician practices. The 1066 respondents were predominantly male (82 percent) and consisted largely of private practitioners (73 percent). In total, 47 percent appeared to follow the American Cancer Society guidelines, while 64 percent claimed familiarity. Being male predicted more accurate guideline knowledge, but being female resulted in more aggressive screening and possibly more diagnoses. Number of years in practice and familiarity with the American Cancer Society guidelines also resulted in more perioperative diagnoses. Knowledge of the American Cancer Society guidelines is an essential component of effective cancer screening, but only two-thirds of plastic surgeons claim familiarity with them, and fewer than half report concordant practices. As plastic surgeons who often perform surgical procedures on the breast in women with no history of breast disease, we have an obligation to understand and apply consistent, reliable breast cancer screening practices to ensure the well-being of our patients.


Assessment of Regional Perfusion and Organ Function: Less and Non-invasive Techniques.
Sufficient organ perfusion essentially depends on preserved macro- and micro-circulation. The last two decades brought substantial progress in the development of less and non-invasive monitoring of macro-hemodynamics. However, several recent studies suggest a frequent incoherence of macro- and micro-circulation. Therefore, this review reports on interactions of macro- and micro-circulation as well as on specific regional and micro-circulation. Regarding global micro-circulation the last two decades brought advances in a more systematic approach of clinical examination including capillary refill time, a graded assessment of mottling of the skin and accurate measurement of body surface temperatures. As a kind of link between macro- and microcirculation, a number of biochemical markers can easily be obtained. Among those are central-venous oxygen saturation (ScvO2), plasma lactate and the difference between central-venous and arterial CO2 (cv-a-pCO2-gap). These inexpensive markers have become part of clinical routine and guideline recommendations. While their potential to replace parameters of macro-circulation such as cardiac output (CO) is limited, they facilitate the interpretation of the adequacy of CO and other macro-circulatory markers. Furthermore, they give additional hints on micro-circulatory impairment. In addition, a number of more sophisticated technical approaches to quantify and visualize micro-circulation including video-microscopy, laser flowmetry, near-infrared spectroscopy (NIRS), and partial oxygen pressure measurement have been introduced within the last 20 years. These technologies have been extensively used for scientific purposes. Moreover, they have been successfully used for educational purposes and to visualize micro-circulatory disturbances during sepsis and other causes of shock. Despite several studies demonstrating the association of these techniques and parameters with outcome, their practical application still is limited. However, future improvements in automated and "online" diagnosis will help to make these technologies more applicable in clinical routine. This approach is promising with regard to several studies which demonstrated the potential to guide therapy in different types of shock. Finally several organs have specific patterns of circulation related to their special anatomy (liver) or their auto-regulatory capacities (brain, kidney). Therefore, this review also discusses specific issues of monitoring liver, brain, and kidney circulation and function.


Diffuse alveolar hemorrhage: a rare manifestation of trauma.
Fat emboli syndrome (FES) is a disorder associated with both acute lung injury and acute respiratory distress syndrome. Both FES and diffuse alveolar hemorrhage (DAH) are bronchoscopically definable entities that may share a common etiology. We conducted a chart review analysis to examine the relationship between FES and DAH. Retrospective chart review. Three cases of concurrent FES and DAH were identified. Long bone fracture and/or orthopedic procedures preceded all the events and were the likely inciting source for eventual acute lung injury. Bronchoalveolar lavage-evident DAH and FES was found in all these cases in association with hemoptysis and lung-attributed blood loss. Lung-protective ventilation and standard supportive care approaches proved sufficient in attaining good outcomes. Combined FES and DAH can occur in association with orthopedic injury and repair and are likely an under-recognized entity.


Chronic liver herniation through a right Bochdalek hernia with acute onset in adulthood.
Congenital right diaphragmatic hernia of Bochdalek rarely occurs in adults and usually is asymptomatic. We report a right Bochdalek hernia with chronic liver herniation and intestinal malrotation in a 55-year old woman who presented with acute intestinal occlusion. The diagnosis required definitive confirmation by CT scan. With impending strangulation, emergency surgery through a thoracoabdominal approach resulted in an easy hernia repair and reduced the technical difficulties due to the intestinal malrotation.


Role of 11beta-hydroxysteroid dehydrogenase 2 renal activity in potassium homeostasis in rats with chronic renal failure.
Aldosterone concentrations vary in advanced chronic renal failure (CRF). The isozyme 11beta-hydroxysteroid dehydrogenase 2 (11beta-HSD2), which confers aldosterone specificity for mineralocorticoid receptors in distal tubules and collecting ducts, has been reported to be decreased or normal in patients with renal diseases. Our objective was to determine the role of aldosterone and 11beta-HSD2 renal microsome activity, normalized for glomerular filtration rate (GFR), in maintaining K+ homeostasis in 5/6 nephrectomized rats. Male Wistar rats weighing 180-220 g at the beginning of the study were used. Rats with experimental CRF obtained by 5/6 nephrectomy (N = 9) and sham rats (N = 10) were maintained for 4 months. Systolic blood pressure and plasma creatinine (Pcr) concentration were measured at the end of the experiment. Sodium and potassium excretion and GFR were evaluated before and after spironolactone administration (10 mg.kg-1.day-1 for 7 days) and 11beta-HSD2 activity on renal microsomes was determined. Systolic blood pressure (means +/- SEM; Sham = 105 +/- 8 and CRF = 149 +/- 10 mmHg) and Pcr (Sham = 0.42 +/- 0.03 and CRF = 2.53 +/- 0.26 mg/dL) were higher (P < 0.05) while GFR (Sham = 1.46 +/- 0.26 and CRF = 0.61 +/- 0.06 mL/min) was lower (P < 0.05) in CRF, and plasma aldosterone (Pald) was the same in the two groups. Urinary sodium and potassium excretion was similar in the two groups under basal conditions but, after spironolactone treatment, only potassium excretion was decreased in CRF rats (sham = 0.95 +/- 0.090 (before) vs 0.89 +/- 0.09 microEq/min (after) and CRF = 1.05 +/- 0.05 (before) vs 0.37 +/- 0.07 microEq/min (after); P < 0.05). 11beta-HSD2 activity on renal microsomes was lower in CRF rats (sham = 0.807 +/- 0.09 and CRF = 0.217 +/- 0.07 nmol.min-1.mg protein-1; P < 0.05), although when normalized for mL GFR it was similar in both groups. We conclude that K+ homeostasis is maintained during CRF development despite normal Pald levels. This adaptation may be mediated by renal 11beta-HSD2 activity, which, when normalized for GFR, became similar to that of control rats, suggesting that mineralocorticoid receptors maintain their aldosterone selectivity.


Chondroitin Sulfate as a Potential Modulator of the Stem Cell Niche in Cornea.
Chondroitin sulfate (CS) is an important component of the extracellular matrix in multiple biological tissues. In cornea, the CS glycosaminoglycan (GAG) exists in hybrid form, whereby some of the repeating disaccharides are dermatan sulfate (DS). These CS/DS GAGs in cornea, through their presence on the proteoglycans, decorin and biglycan, help control collagen fibrillogenesis and organization. CS also acts as a regulatory ligand for a spectrum of signaling molecules, including morphogens, cytokines, chemokines, and enzymes during corneal growth and development. There is a growing body of evidence that precise expression of CS or CS/DS with specific sulfation motifs helps define the local extracellular compartment that contributes to maintenance of the stem cell phenotype. Indeed, recent evidence shows that CS sulfation motifs recognized by antibodies 4C3, 7D4, and 3B3 identify stem cell populations and their niches, along with activated progenitor cells and transitional areas of tissue development in the fetal human elbow. Various sulfation motifs identified by some CS antibodies are also specifically located in the limbal region at the edge of the mature cornea, which is widely accepted to represent the corneal epithelial stem cell niche. Emerging data also implicate developmental changes in the distribution of CS during corneal morphogenesis. This article will reflect upon the potential roles of CS and CS/DS in maintenance of the stem cell niche in cornea, and will contemplate the possible involvement of CS in the generation of eye-like tissues from human iPS (induced pluripotent stem) cells.


Health outcomes and economic consequences of using angiotensin-converting enzyme inhibitors in comparison with angiotensin receptor blockers in the treatment of arterial hypertension in the contemporary Polish setting.
Arterial hypertension (AH) represents a public health problem in Poland, firstly due to the huge, still growing population of patients (10.45 million patients based on NATPOL 2011 and PolSenior Surveys), and secondly because of the substantial cost of reimbursement from the National Health Fund (NHF). The most commonly used drugs in the treatment of AH include angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs), the latter being associated with significantly higher unit reimbursement cost. Recent meta-analyses of randomised, controlled trials indicate that there is no medical reason to favour ARBs over ACEIs in AH treatment. To assess the clinical benefit of using ACEIs instead of ARBs and to calculate the potential savings for the payer and patients associated with changing the treatment paradigm to preferential use of ACEIs. The assessment of clinical consequences includes differences between ACEIs and ARBs in terms of average life expectancy and quality-adjusted life years (QALYs) gained. The impact of these drugs on general mortality was estimated based on the meta-analysis carried out by van Vark et al. in 2012. Patients' health-related quality of life was adjusted with Polish population utility norms derived for the EQ-5D-3L questionnaire and additionally for ACEI-induced cough-related utility decrease. Potential savings for the payer on a yearly basis were calculated for a hypothetical cohort of patients who are currently treated with ARBs and might be switched to ACEIs. The number of patients treated with ARBs and ACEIs was estimated based on NHF and IMS Health data. ACEIs were associated with a statistically significant 10% reduction in all-cause mortality, which results in extra life gained of 0.354 years (4.2 months) or an additional 0.201 QALY (2.4 months). Potential annual savings could amount to 112.0 million PLN (25.7 million EUR) and 10.5 million PLN (2.4 million EUR) for the public payer (NHF) and patients, respectively; and 1768 cardiovascular deaths per year could be prevented. Preferential use of ACEIs in comparison with ARBs in the treatment of AH is associated with substantial extension of life (including quality-adjusted life), reduction of cardiovascular deaths, and savings for the NHF and patients.


Atomic Defects and Doping of Monolayer NbSe2.
We have investigated the structure of atomic defects within monolayer NbSe2 encapsulated in graphene by combining atomic resolution transmission electron microscope imaging, density functional theory (DFT) calculations, and strain mapping using geometric phase analysis. We demonstrate the presence of stable Nb and Se monovacancies in monolayer material and reveal that Se monovacancies are the most frequently observed defects, consistent with DFT calculations of their formation energy. We reveal that adventitious impurities of C, N, and O can substitute into the NbSe2 lattice stabilizing Se divacancies. We further observe evidence of Pt substitution into both Se and Nb vacancy sites. This knowledge of the character and relative frequency of different atomic defects provides the potential to better understand and control the unusual electronic and magnetic properties of this exciting two-dimensional material.


Diversity of the genus Terebellides (Polychaeta: Trichobranchidae) in the Adriatic Sea with the description of a new species.
Based on specimens collected during the sampling campaigns in the Northern Adriatic from 2003-2010, the diversity of genus Terebellides (Polychaeta; Trichobranchidae) was studied and three species are reported for the Northern Adriatic Sea: Terebellides gracilis Malm, 1874, Terebellides mediterranea spec. nov., and Terebellides stroemii Sars, 1835. Terebellides stroemii was the only species previously reported from the area. Terebellides gracilis is reported for the first time for the Mediterranean Sea and its geographical distribution is extended south. Terebellides mediterranea spec. nov., is characterised by the presence of long notopodia and notochaetae in the first thoracic chaetiger. These three species are compared to other Terebellides species described or reported from North Atlantic waters, and a key to Terebellides species of the North East Atlantic and Mediterranean is provided.


Revision of the acetabular component without cement after total hip arthroplasty. A follow-up note regarding results at seven to eleven years.
The results of revision of the acetabular component without cement, performed for aseptic loosening, were reported previously after a mean of forty-four months for 138 hips (132 patients). After an additional mean duration of follow-up of almost five years, twelve patients (twelve hips) had died before they could be followed long enough for the later study and nine patients (eleven hips) had been lost to follow-up; thus, a total of 111 patients (115 hips) were available for follow-up at a mean of 100 months (range, seventy-eight to 135 months). Between the earlier and later times of follow-up, six additional acetabuli had had a repeat revision: one, for recurrent dislocation; two, for infection; and three (which were stable), at the time of a revision of the femoral stem. No revision of the acetabular cup was performed because of aseptic loosening, and no cup was noted to have migrated. Radiographs were available for 105 patients (109 hips) at a mean of ninety-eight months (range, seventy-eight to 135 months). Five (5 per cent) of the 109 cups were surrounded by a complete radiolucent line and three (3 per cent), by a partial progressive radio-lucent line. A radiolucent line adjacent to a screw was seen in association with two cups (2 per cent), and osteolysis was noted at the margin of four cups (4 per cent). Revision of the acetabular component with a porous-coated, nearly hemispherical fiber-metal component inserted without cement was associated with a high rate of excellent results at the seven to eleven-year follow-up examination.


Differences in spinal distribution and neurochemical phenotype of colonic afferents in mouse and rat.
Visceral pain is a prevalent clinical problem and one of the most common ailments for which patients seek medical attention. Recent studies have described many of the physiological properties of visceral afferents, but not much is known regarding their anatomical characteristics. To determine the spinal distribution and neurochemical phenotype of colonic afferents in rodents, Alexa Fluor-conjugated cholera toxin-beta (CTB) was injected subserosally into the proximal and distal portions of the descending colon in Sprague Dawley rats and C57Bl/6 mice. Dorsal root ganglia (T10-S2) were processed for fluorescent immunohistochemistry and visualized by confocal microscopy. In the mouse, CTB-positive neurons were most numerous in the lumbosacral region (LS; L6-S1), with a smaller contribution in the thoracolumbar ganglia (TL; T13-L1). In contrast, CTB-positive neurons in the rat were most numerous in the TL ganglia, with a smaller contribution in the LS ganglia. The vast majority of CTB-positive neurons in both mouse and rat were positive for TRPV1 and CGRP and most likely unmyelinated, in that most colonic afferents were not positive for neurofilament heavy chain. In the mouse, the TL ganglia had a significantly higher percentage of TRPV1- and CGRP-positive neurons than did the LS ganglia, whereas no differences were observed in the rat. The high incidence of TRPV1-positive colonic afferents in rodents suggests that hypersensitivity from the viscera may be partially a TRPV1-mediated event, thereby providing a suitable target for the treatment of visceral pain.


Evaluation of susceptibility locus for response to interferon-α based therapy in chronic hepatitis B patients in Chinese.
In 2009, three independent genome-wide association studies reported that genetic variation in the interleukin 28B gene to be associated with the response to interferon-α/ribavirin therapy in hepatitis C virus genotype 1 infected patients. We carried out the present study to assess whether such polymorphisms also affect the therapy effect of another interferon-α responsive illness as chronic hepatitis B. Five hundred and twelve interferon-α treatment-naïve HBeAg seropositive chronic hepatitis B patients were enrolled in the present retrospective nested case-control study. All patients received PEG-IFN-α-2a based treatment and were examined for the therapy efficacy. SNP rs8099917 was genotyped using the MassArray system (Sequenom). Interestingly, the frequency of G allele of rs8099917 was significantly higher in response group than in non response group (8.3% vs. 3.9%, p=0.003, OR=0.44, 95%CI=0.25-0.79). The genotype distributions of this SNP also differed significantly between two groups (p=0.003). Our study suggested that the G allele of rs8099917 was associated with higher rate of response in HBeAg seropositive chronic hepatitis B patients treated with interferon α.


Clinical similarities and demographic differences between residency and private practice patients.
This study compared the clinical and demographic mix of patients at a family practice residency site in South Carolina to those from other regions and demonstrated the effectiveness of a computerized medical record in facilitating such analysis. Patient visits to Richland Family Practice Center (RFP), the outpatient care site for the University of South Carolina School of Medicine, were retrospectively sampled for the period July 1992-June 1993. Data analysis used descriptive statistics and contingency tables. A time test comparing manual and computerized data retrieval was also performed. The patients seen were predominantly female (75.2%) and African-American (68%). RFP treated proportionately more federally funded and minority patients than did community-based physicians. The top five principal diagnoses at RFP were hypertension, diabetes mellitus, general medical examination, normal pregnancy, and acute upper respiratory infection; the top 20 principal diagnoses accounted for 51.3% of all visits. When compared to the top 20 diagnoses for all family and general practice physicians in the southern United States, considerable overlap was present, confirming clinical similarity between patient populations at residency and private practice sites. Computerized data retrieval was faster and more complete than manual data retrieval. Diagnoses encountered at RFP and reported by other family practice residencies generally parallel those documented in family practice in various geographic regions. However, residencies differ from private practices in that they care for more economically disadvantaged patients. Computerized medical records systems facilitate research within a residency program.


[A prospective multicenter study of rituximab combined with high-dose chemotherapy and autologous peripheral blood stem cell transplantation for aggressive B-cell lymphoma].
To investigate the feasibility and efficacy of rituximab combined with high-dose chemotherapy supported by autologous peripheral blood stem cell transplantation (ASCT) in patients with aggressive B-cell non-Hodgkin lymphoma (NHL). Twenty-eight patients with aggressive B-cell NHL (22 newly diagnosed, 6 relapsed) were enrolled in this study. The high-dose chemotherapy included CHOP regimen (CTX + ADM + VCR + PDN) for the newly diagnosed patients and DICE (DEX + IFO + DDP + VP-16) or EPOCH (VP-16 + PDN + VCR + CTX + ADM) for the relapsed patients. Each patient received infusion of rituximab at a dose of 375 mg/m(2) for four times, on D1 before and on D7 of peripheral blood stem cell mobilization, and on D1 before and D8 after stem cell reinfusion. Complete remission was achieved in all patients after high dose chemotherapy and ASCT. At a median follow-up of 37 months, the estimated overall 4-year survival and progression-free survival rate for all patients were 75.0% and 70.3%, respectively, while both were 72.7% for the previously untreated patients. The therapy was generally well tolerated with few side-effects attributable to rituximab. These results suggest that adding rituximab to high-dose chemotherapy with peripheral blood stem cell transplantation is feasible and may be beneficial for patients with aggressive B-cell non-Hodgkin lymphoma.


Flow Diversion for Reconstruction of Intradural Vertebral Artery Dissecting Aneurysms Causing Subarachnoid Hemorrhage-A Retrospective Study From Four Neurovascular Centers.
Objective: Dissecting aneurysms (DAs) of the vertebrobasilar territory manifesting with subarachnoid hemorrhage (SAH) are associated with significant morbi-mortality, especially in the case of re-hemorrhage. Sufficient reconstruction of the affected vessel is paramount, in particular, if a dominant vertebral artery (VA) is impacted. Reconstructive options include stent-assisted coiling and flow diversion (FD). The latter is technically less challenging and does not require catheterization of the fragile aneurysm. Our study aims to report a multicentric experience with FD for reconstruction of DA in acute SAH. Materials and Methods: This retrospective study investigated 31 patients (age: 30-78 years, mean 55.5 years) who had suffered from SAH due to a DA of the dominant VA. The patients were treated between 2010 and 2020 in one of the following German neurovascular centers: University Hospital Leipzig, Katharinenhospital Stuttgart, BG Hospital Bergmannstrost Halle/Saale, and Heinrich-Braun-Klinikum Zwickau. Clinical history, imaging, implanted devices, and outcomes were reviewed for the study. Results: Reconstruction with flow-diverting stents was performed in all cases. The p64 was implanted in 14 patients; one of them required an additional balloon-expandable stent to reconstruct severe stenosis in the target segment. One case demanded additional liquid embolization after procedural rupture, and in one case, p64 was combined with a PED. Further 13 patients were treated exclusively with the PED. The p48MW-HPC was used in two patients, one in combination with two additional Silk Vista Baby (SVB). Moreover, one patient was treated with a single SVB, one with a SILK+. Six patients died [Glasgow Outcome Scale (GOS) 1]. Causes of death were periprocedural re-hemorrhage, thrombotic occlusion of the main pulmonary artery, and delayed parenchymal hemorrhage. The remaining three patients died in the acute-subacute phase related to the severity of the initial hemorrhage and associated comorbidities. One patient became apallic (GOS 2), whereas two patients had severe disability (GOS 3) and four had moderate disability (GOS 4). Eighteen patients showed a complete recovery (GOS 5). Conclusion: Reconstruction of VA-DA in acute SAH with flow-diverting stents is a promising approach. However, the severity of the condition is reflected by high overall morbi-mortality, even despite technically successful endovascular treatment.