Simple propagation method for resident macrophages by co-culture and subculture, and their isolation from various organs.
Resident macrophages (Mø) originating from yolk sac Mø and/or foetal monocytes colonise tissues/organs during embryonic development. They persist into adulthood by self-renewal at a steady state, independent of adult monocyte inputs, except for those in the intestines and dermis. Thus, many resident Mø can be propagated in vitro under optimal conditions; however, there are no specific in vitro culture methods available for the propagation of resident Mø from diverse tissues/organs. We provided a simple method for propagating resident Mø derived from the liver, spleen, lung, and brain of ICR male mice by co-culture and subculture along with the propagation of other stromal cells of the respective organs in standard culture media and successfully demonstrated the propagation of resident Mø colonising these organs. We also proposed a simple method for segregating Mø from stromal cells according to their adhesive property on bacteriological Petri dishes, which enabled the collection of more than 97.6% of the resident Mø from each organ. Expression analyses of conventional Mø markers by flow cytometry showed similar expression patterns among the Mø collected from the organs. This is the first study to clearly provide a practical Mø propagation method applicable to resident Mø of diverse tissues and organs. Thus, this novel practical Mø propagation method can offer broad applications for the use of resident Mø of diverse tissues and organs.


[The movement to represent Francophone minority groups: the future of health services in French].
The Action Plan for Official Languages launched in 2003 intends to revitalize the country's linguistic duality. Among the priority areas, health is the focus in order to ensure the training of health professionals to serve official language minority communities and to network the main actors concerned about the organization of services in the minority language. The aim of this paper is to report representations of Francophones in minority with respect to the future of health services in French. The study is based on a participatory methodology: concept mapping to identify the conceptual universe of a given problem.


Very Early Cytomegalovirus Infection After Renal Transplantation: A Single-Center 20-Year Perspective.
Cytomegalovirus (CMV) infection risk in the first month after transplantation is felt to be minimal; however, the epidemiology has not been specifically investigated, particularly in the modern era of potent immunosuppressive regimens and universal CMV prophylaxis. The aim of this study was to describe the incidence of and risk factors associated with CMV occurring less than 30 days after transplant and evaluate the effect of very early CMV on outcomes. Retrospective, single-center study of adult renal transplant (RTX) recipients between January 1, 1994 and December 31, 2014. A total of 5225 patients who received a renal transplant in the study time period were reviewed for the presence of CMV infection occurring less than 30 days after transplant. Of these, only 14 patients demonstrated this finding for an overall incidence of 0.27%. Half of these patients were considered to be at heightened risk due to being a recipient of a non-primary transplant or on chronic immunosuppression. This left seven patients without known risk factors for very early CMV to evaluate. In this group, time from transplant to CMV infection was 13.5 ± 7 days. The majority (57.1%, n = 4) were high-risk serostatus (CMV D+/R-) and occurred in the valganciclovir era (71.4%, n = 5). Lymphocyte-depleting induction predominated (57.1%, n = 4). Average cold ischemic time (CIT) was 19.7 ± 7.7 hours. Three patients had post-operative complications, two required exploratory-laparotomy for hemorrhage. When evaluating outcomes, 43% (n = 3) had subsequent episodes of CMV infection, 28.6% (n = 2) developed rejection, and 28.6% (n = 2) died. Outcomes between patients with CMV infection less than 30 days and those with CMV infection more than 30 days after transplant were not significantly different. In our review of over 5000 kidney transplants, the incidence of CMV infection in the first 30 days after renal transplant is 0.2%. Notable common patient characteristics include hemorrhage requiring re-operation and prolonged CIT. Outcomes were similar to CMV occurring more than 30 days after transplant. This study should provide the clinician with some reassurance; despite potent immunosuppressive therapy, CMV infection in the first 30 days is unlikely.


Is it safe to discharge blunt abdominal trauma patients with normal initial findings?
Trauma is the leading health concern among young adults. Blunt abdominal trauma (BAT) is the most common type of blunt traumas. BAT patients may prove normal in the initial clinical assessments, but since the time required for an intra-abdominal injury to be clinically apparent is not predictable, deciding when to safely discharge these patients could be a dilemma. The purpose of this study is to determine whether follow-up of the early discharged or further diagnostic assessment of the later discharged BAT patients with normal initial findings reveals any abnormal findings. Totally, 389 hemodynamically-stable patients suspected of BAT who arrived at the emergency department (ED) of two university hospitals in Tehran from September 2013 to September 2014 were included in this study. Upon arrival at the ED, all subjects underwent abdominal examination and FAST, and were assessed for hematocrit and base deficit levels and presence of hematuria. These assessments were repeated in the patients who were discharged after 6 h, at 6 or 12 h post-arrival. All patients were followed-up after 24 h and one week by phone call. Out of all study participants, 158 patients (40.6%) had normal findings in all initial assessments. These patients were discharged from the ED after a median of 5 h. After one week of follow-up, none of them had any symptom or complication, or had sought medical attention after being discharged from the study hospitals. Out of these patients, 78 patients (49.4%) were discharged after 6 hours by their physician's decision, and underwent the same diagnostic assessments for the second or third time. None of these assessments revealed any abnormal findings. A combination of normal abdominal exam, normal FAST, normal hematocrit, normal base deficit, and absence of hematuria rules out intra-abdominal injury in BAT patients. It is safe to discharge patients after they prove normal for these assessments. Longer observation and repeated diagnostic assessment of these patients does not yield any new findings, and seems to be unnecessary.


Integrating socially accountable health professional education and learning health systems to transform community health and health systems.
A learning health system aims to create value in health systems using data-driven innovations, quality improvement techniques, and collaborations between health system partners. Although the concept is mobilized through cycles of learning, most instantiations of the learning health system overlook the importance of formalized learning in educational settings. Social accountability in health professional education focuses on measurably improving people's health and health care, specifically through education and training activities. In this commentary, we argue that the idea of social accountability clearly articulates a rationale and a broad range of aspirations, whereas the learning health system offers an approach to achieve these goals. With a similar aim to a learning health system, social accountability promotes partnerships between health professional education, the health system, and communities in a way that allows for co-designed and contextualized interventions. On the other hand, learning health systems prioritize data, research, and analytic capacities to facilitate quality improvement. An integrative framework could enhance learning cycles by collectively designing interventions and innovations with people and communities from health, research, and education systems. As well as aspiring to improve population health and health equity, such a framework will consider broader impacts, including the degree of participation amongst a range of partners and the level of responsiveness to partners' priorities.


Proliferative and structural differences between male and female mouse submandibular glands.
Sexual dimorphism has been observed in salivary glands of many species. In this study, evidence for sexual differences in adult mouse submandibular gland is extended beyond parenchymal cell composition, size, and volumes to include patterns of DNA synthesis and complexity of ductal branching. Computer-assisted three-dimensional reconstructions also revealed differences in overall organization of secretory complexes. Consistent with observations by others, granular intercalated duct cells were absent, while striated granular duct cells were low in proportion in the male glands relative to female glands. When the mean of average cell volumes were compared, acinar (AC) cells were smaller than granular duct (GD) cells in the male, but in the female the reverse was true. Furthermore, in addition to differences in average volumes of GD cells, the average volume of AC cells was significantly greater in females than males. The most dramatic evidence for sexual dimorphism was observed following a 90-min labeling with 3H-thymidine. Though all cell types showed DNA replication activity, the intercalated duct (ID) cells were substantially more active than AC and GD cells in the female, while in the male the GD cells, ID cells, and AC cells all showed approximately equal activity. Three-dimensional reconstructions indicated that the female possessed a more highly branched intercalated duct system and that the GD usually terminated within a secretory complex, whereas in males the GD typically passes through a secretory complex and forms a prominent cap-like structure on the opposite side.


Domain sets and measurement instruments on participation and environmental factors in spinal cord injury research.
The understanding and measurement of participation and environmental context in spinal cord injury (SCI) is critically important. However, there is limited understanding of the environment-participation relationship in SCI research. There is little consensus on what is and on how to measure participation and its environmental determinants in the SCI. The objective of this article is to develop a set of International Classification of Functioning, Disability and Health (ICF)-based SCI Participation and Environment Domain Set and measurement instruments that intend to measure those domains. ICF categories from the ICF components of activities and participation and environmental factors based on the comprehensive ICF Core Set for SCI and the ICF Core Set for vocational rehabilitation were merged. Measurement instruments were selected based on published systematic reviews of measurement instruments in SCI. There were 128 ICF categories or domains in total (38 for environmental factors and 90 for activities and participation). There were six measurement instruments on environmental factors and six for participation based on existing systematic reviews. This article presents a domain set that is relevant to conducting research on the social and environmental perspectives, in an effort to understand and measure functioning in SCI (i.e., "SCI participation domain set" and "SCI environment domain set," respectively). The sample of SCI Participation and Environment Measurement Instruments gathered indicate the comprehensiveness and depth of the different domains. Guiding principles on the utilization of these measurement instruments depending on the purpose and design of a research study are highly recommended to investigators.


Three-dimensional architectures incorporating stereoregular donor-acceptor stacks.
We report the synthesis of two [2]catenane-containing struts that are composed of a tetracationic cyclophane (TC(4+)) encircling a 1,5-dioxynaphthalene (DNP)-based crown ether, which bears two terphenylene arms. The TC(4+) rings comprise either 1) two bipyridinium (BIPY(2+)) units or 2) a BIPY(2+) and a diazapyrenium (DAP(2+)) unit. These degenerate and nondegenerate catenanes were reacted in the presence of Cu(NO3)2⋅2.5 H2O to yield Cu-paddlewheel-based MOF-1050 and MOF-1051. The solid-state structures of these MOFs reveal that the metal clusters serve to join the heptaphenylene struts into grid-like 2D networks. These 2D sheets are then held together by infinite donor-acceptor stacks involving the [2]catenanes to produce interpenetrated 3D architectures. As a consequence of the planar chirality associated with both the DNP and hydroquinone (HQ) units present in the crown ether, each catenane can exist as four stereoisomers. In the case of the nondegenerate (bistable) catenane, the situation is further complicated by the presence of translational isomers. Upon crystallization, however, only two of the four possible stereoisomers--namely, the enantiomeric RR and SS forms--are observed in the crystals. An additional element of co-conformational selectivity is present in MOF-1051 as a consequence of the substitution of one of the BIPY(2+) units by a DAP(2+) unit: only the translational isomer in which the DAP(2+) unit is encircled by the crown ether is observed. The overall topologies of MOF-1050 and MOF-1051, and the selective formation of stereoisomers and translational isomers during the kinetically driven crystallization, provide evidence that weak noncovalent bonding interactions play a significant role in the assembly of these extended (super)structures.


[Questionnaire on the attitude of the physicians in educating the elderly patients with chronic obstructive pulmonary disease about smoking cessation].
Smoking status, the extent of recognition of the relationship between smoking and COPD, and actual nature of education for smoking cessation by physicians have not yet been fully elucidated. To investigate perceptions about education for smoking cessation in the elderly by physicians who work in the clinic, questionnaires were sent to the 1,012 physicians who belong to the Yokohama City Medical Association. Of these, 311 respond and their data (31%) were included in the analysis. The questionnaire included questions on the importance of smoking cessation in the elderly, on the perception about the relationship between smoking and various diseases, and actual education for smoking cessation. The smoking status of the physicians themselves was also investigated. The distribution of current smokers, ex-smokers, and non-smokers among the physicians was 13%, 33%, and 54%, respectively. Seventy-five percent of ex-smokers answered that their experience of smoking cessation influenced their patient education for smoking cessation, and 39% of smokers answered that their smoking status did not influence it. Only 53% of the physicians replied that they actually performed education for smoking cessation to the elderly, and 8% of them replied that they hardly perform any or do not perform it. Smoking cessation is thought to be the only way to prevent the development of COPD. However, only a half of physicians recognized the importance of smoking cessation for the treatment and control of COPD in the elderly. In addition, less than one third of physicians perform nicotine replacement therapy for smoking cessation. Enlightenment for physicians should be needed to make them perform education for smoking cessation more aggressively.


Natural history, prognosis, and lipid abnormalities of idiopathic ischemic childhood stroke.
A study was performed to assess the natural history, prognostic factors, and lipid and apolipoprotein abnormalities of idiopathic ischemic childhood stroke. A case series of 42 children, retrospectively identified with idiopathic ischemic strokes, were reassessed an average of 7.4 years (range, 1 to 19 years) after presentation. Patients were interviewed and examined, and fasting serum was obtained for lipid and apolipoprotein analysis. Poor outcome was defined as moderate to severe hemiparesis, special educational needs, epilepsy, recurrent stroke, or stroke-related death. Eighteen (43%) of the patients had a poor outcome. Among them were moderate to severe hemiparesis in 14 (78%), recurrent strokes in seven (39%), and one death. Poor outcome was evident early in their clinical course. Independent of outcome, lipid abnormalities including an elevated triglyceride and low-density lipoprotein cholesterol, and a depressed high-density lipoprotein cholesterol were seen in one third of all patients. A depressed ratio of apolipoprotein A-1 to apolipoprotein B (using adult normative values) was seen in half of the entire cohort. Clinical features of children with unexplained ischemic strokes at presentation and their subsequent course are described. Significant risk factors for a poor outcome include (1) persistence of hemiparesis 1 month after the stroke, (2) cortical as opposed to subcortical location, and (3) bilateral occlusive disease with telangiectasia on cerebral angiography. Previously described risk factors for an unfavorable prognosis, including occurrence during infancy and presentation with seizures, were not substantiated. Lipid abnormalities occur at an increased frequency in children after unexplained ischemic strokes. Prospective assessment of lipoprotein profiles are needed to further assess clinical significance. Assessing apolipoproteins may provide further insight than lipid values alone.


A closer look at bioaccumulation of petroleum hydrocarbon mixtures in aquatic worms.
Petroleum hydrocarbons (oils) are ubiquitous in the aquatic environment, and adequate risk assessment is thus essential. Bioaccumulation plays a key role in risk assessment, but the current knowledge on bioaccumulation of oils is limited. Therefore, this process was studied in detail, using the aquatic worm, Lumbriculus variegatus, and 14 field-contaminated sediments. The main focus during the present study was on uptake kinetics, the relationship between oil boiling point fraction and uptake, and effects of sediment characteristics. Uptake kinetics became slower with increasing boiling point fraction, but 70 to 90% of the equilibrium situation was reached within the standard exposure duration of 28 d. Worms accumulated sedimentary petroleum hydrocarbons in the range of C(10) to C(34), a range much wider than expected. Biota-to-sediment accumulation factors (BSAFs) for separate boiling point fractions were constant and around the proposed value of 1 to 2 up to C(22), but gradually decreased beyond this point. The decrease was probably caused by a combination of nonequilibrium conditions and enhanced sorption of higher boiling point fractions to sediments; the latter possibly due to the presence of strongly sorbing separate oil phases or black carbon. A negative relationship was observed between BSAF and oil concentration in sediment, which was explained by the presence of separate oil phases at high oil concentrations. These strongly sorbing phases may limit their own availability, particularly when being highly weathered; worms may also avoid them. The observed phenomena have obvious implications for bioaccumulation assessment of oils and suggest that the current risk assessment procedure for oils in sediments may lead to erroneous results.


Identification of trkH, encoding a potassium uptake protein required for Francisella tularensis systemic dissemination in mice.
Francisella tularensis is a highly infectious bacterium causing the zoonotic disease tularaemia. During its infectious cycle, F. tularensis is not only exposed to the intracellular environment of macrophages but also resides transiently in extracellular compartments, in particular during its systemic dissemination. The screening of a bank of F. tularensis LVS transposon insertion mutants on chemically defined medium (CDM) led us to identify a gene, designated trkH, encoding a homolog of the potassium uptake permease TrkH. Inactivation of trkH impaired bacterial growth in CDM. Normal growth of the mutant was only restored when CDM was supplemented with potassium at high concentration. Strikingly, although not required for intracellular survival in cell culture models, TrkH appeared to be essential for bacterial virulence in the mouse. In vivo kinetics of bacterial dissemination revealed a severe defect of multiplication of the trkH mutant in the blood of infected animals. The trkH mutant also showed impaired growth in blood ex vivo. Genome sequence analyses suggest that the Trk system constitutes the unique functional active potassium transporter in both tularensis and holarctica subspecies. Hence, the impaired survival of the trkH mutant in vivo is likely to be due to its inability to survive in the low potassium environment (1-5 mM range) of the blood. This work unravels thus the importance of potassium acquisition in the extracellular phase of the F. tularensis infectious cycle. More generally, potassium could constitute an important mineral nutrient involved in other diseases linked to systemic dissemination of bacterial pathogens.


IKBKB expression in clear cell renal cell carcinoma is associated with tumor grade and patient outcomes.
Inhibitor of nuclear factor kappa B kinase subunit B (IKBKB or IKKβ) is a key activator of the nuclear factor κB transcription factor pathway. Increased expression and/or aberrant activity of IKBKB have been observed in various types of human cancer. Three independent techniques, reverse transcription‑quantitative polymerase chain reaction, western blotting and immunohistochemistry, were used to demonstrate that IKBKB expression is decreased in clear cell renal cell carcinoma (ccRCC). Notably, the patients with upregulated IKBKB protein expression were characterized by higher nuclear grade tumors and significantly shorter survival. The findings indicate that IKBKB protein may be of clinical relevance in ccRCC, serving as a marker of poor prognosis and as potential target for adjuvant chemotherapies. Further studies are required to validate the prognostic and predictive value of IKBKB.


Clinical manifestations and pathogen characteristics in children admitted for suspected COVID-19.
Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has spread around the world. However, approaches to distinguish COVID-19 from pneumonia caused by other pathogens have not yet been reported. We retrospectively analyzed the clinical data of 97 children with probable COVID-19. A total of 13 (13.4%) patients were confirmed positive for SARS-CoV-2 infection by nucleic acid RT-PCR testing, and 41 (42.3%) patients were found to be infected with other pathogens. Notably, no pathogen was detected in 43 (44.3%) patients. Among all patients, 25 (25.8%) had familial cluster exposure history, and 52 (53.6%) had one or more coexisting conditions. Fifteen (15.5%) patients were admitted or transferred to the PICU. In the 11 confirmed COVID-19 cases, 5 (45.5%) and 7 (63.6%) were positive for IgM and IgG against SARS-CoV-2, respectively. In 22 patients with suspected COVID-19, 1 (4.5%) was positive for IgG but negative for IgM. The most frequently detected pathogen was Mycoplasma pneumonia (29, 29.9%). One patient with confirmed COVID-19 died. Our results strongly indicated that the detection of asymptomatic COVID-19 or coexisting conditions must be strengthened in pediatric patients. These cases may be difficult to diagnose as COVID-19 unless etiologic analysis is conducted. A serologic test can be a useful adjunctive diagnostic tool in cases where SARS-CoV-2 infection is highly suspected but the nucleic acid test is negative.


Two highly related regulatory subunits of PP2A exert opposite effects on TGF-beta/Activin/Nodal signalling.
We identify Balpha (PPP2R2A) and Bdelta (PPP2R2D), two highly related members of the B family of regulatory subunits of the protein phosphatase PP2A, as important modulators of TGF-beta/Activin/Nodal signalling that affect the pathway in opposite ways. Knockdown of Balpha in Xenopus embryos or mammalian tissue culture cells suppresses TGF-beta/Activin/Nodal-dependent responses, whereas knockdown of Bdelta enhances these responses. Moreover, in Drosophila, overexpression of Smad2 rescues a severe wing phenotype caused by overexpression of the single Drosophila PP2A B subunit Twins. We show that, in vertebrates, Balpha enhances TGF-beta/Activin/Nodal signalling by stabilising the basal levels of type I receptor, whereas Bdelta negatively modulates these pathways by restricting receptor activity. Thus, these highly related members of the same subfamily of PP2A regulatory subunits differentially regulate TGF-beta/Activin/Nodal signalling to elicit opposing biological outcomes.


Comparison of Low-Molecular-Weight Heparins Prepared From Ovine Heparins With Enoxaparin.
Heparin and its low-molecular-weight heparin derivatives are widely used clinical anticoagulants. These drugs are critical for the practice of medicine in applications, including kidney dialysis, cardiopulmonary bypass, and in the management of venous thromboembolism. Currently, these drugs are derived from livestock, primarily porcine intestine and less frequently bovine intestine and bovine lung. The worldwide dependence on the pig as a single dominant animal species has made the supply chain for this critical drug quite fragile, leading to the search for other sources of these drugs, including the expanded use of bovine tissues. A number of laboratories are now also examining the similarities between heparin and low-molecular-weight heparins prepared from porcine and ovine tissues. This study was designed to compare low-molecular-weight heparin prepared from ovine heparin through chemical β-elimination, a process currently used to prepare the low-molecular-weight heparin, enoxaparin. Using top-down, bottom-up, and compositional analyses as well as bioassays, low-molecular-weight heparin derived from ovine intestine was shown to closely resemble enoxaparin. Moreover, the compositions of daughter low-molecular-weight heparins prepared from three unfractionated ovine parent heparins were compared. Ovine enoxaparins had similar molecular weight and in vitro anticoagulant activities as Lovenox. Some disaccharide compositional, oligosaccharide composition at the reducing and nonreducing ends and intact chain compositional differences could be observed between porcine enoxaparin and ovine low-molecular-weight heparin. The similarity of these ovine and porcine heparin products suggests that their preclinical evaluation and ultimately clinical assessment is warranted.


Cervical tumors.
Imaging the cervix for benign and malignant disease can be achieved using transvaginal ultrasound, computed tomography (CT), magnetic resonance imaging, and 18-fluorodeoxyglucose positron emission tomography. The best established role of imaging is in cervical carcinoma where magnetic resonance imaging, CT and increasingly positron emission tomography-CT are the most frequently used imaging modalities. These have a role in staging, treatment selection, recurrent disease, and imaging complications of treatment. Histopathological diagnosis of cervical disorders cannot be made on the basis of imaging alone but certain imaging features may provide an indication as to the underlying diagnosis. We describe the imaging features of some malignant tumor subtypes in which a preoperative diagnosis may alter management. Benign lesions of the cervix are usually detected incidentally or during investigations for dysfunctional vaginal bleeding. We describe the imaging features of the commonly encountered benign cervical lesions.


Proctolaelaps species (Acari: Mesostigmata: Melicharidae) from Egypt, with description of a new species and complementary descriptions of other five species.
The objective of this paper is to provide a taxonomic appraisal of the melicharids from Egypt, based on specimens previously collected by different authors and on specimens newly collected by the first author of this paper, all belonging to the genus Proctolaelaps Berlese. A new species, Proctolaelaps gizaensis n. sp., is described, thus raising to six the number of Proctolaelaps species recorded from Egypt. Complementary descriptions of the following species are also provided: Proctolaelaps aegyptiacus Nasr, 1986; Proctolaelaps holoventris Moraes, Britto, Mineiro & Halliday, 2016; Proctolaelaps pygmaeus (Müller, 1859); Proctolaelaps drosophilae Karg, Baker & Jenkinson, 1995 and Proctolaelaps regalis De Leon, 1963. The latter two species were not found in Egypt, but they are related to the new species described here. They were re-described based on the type specimens from Europe and North America. A dichotomous key is given to help the separation of the Proctolaelaps species concluded to be found in Egypt.


Evaluation of T cell subsets in myasthenia gravis using anti-T cell monoclonal antibodies.
Functional T cell subsets have been evaluated in the peripheral blood of patients with myasthenia gravis using monoclonal anti-T cell antibodies and a suppressor cell assay based on the suppression of the mixed-lymphocyte reaction by concanavalin A-activated lymphocytes. A significant decline of suppressor cells was found in a large proportion of patients, both by direct count using the anti-suppressor-cytotoxic T cell antibody (OKT8) and by the suppressor assay. Patients also showed an increase in immature T cells defined by their simultaneous reaction with the anti-helper cell (OKT4) and anti-suppressor cell (OKT8) antibody. Thymectomy tended to enhance the deficit in suppressor cells, and to induce the disappearance of double-labelled cells.


Evaluation of a segmentation procedure to delineate organs for use in construction of a radiation therapy planning atlas.
This paper evaluates a semi-automatic segmentation procedure to enhance utilizing atlas based treatment plans. For this application, it is crucial to provide a collection of 'reference' organs, restorable from the atlas so that they closely match those of the current patient. To enable assembling representative organs, we developed a semi-automatic procedure using an active contour method. The 3D organ volume was identified by defining contours on individual slices. The initial organ contours were matched to patient volume data sets and then superimposed on them. These starting contours were then adjusted and refined to rapidly find the organ outline of the given patient. Performance was evaluated by contouring organs of different size, shape complexity, and proximity to surrounding structures. We used representative organs defined on CT volumes obtained from 12 patients and compared the resulting outlines to those drawn by a radiologist. A strong correlation was found between the area measures of the delineated liver (r = 0.992), lung (r = 0.996) and spinal cord (r = 0.81), obtained by both segmentation techniques. A paired Student's t-test showed no statistical difference between the two techniques regarding the liver and spinal cord (p > 0.05). This method could be used to form 'standard' organs, which would form part of a whole body atlas (WBA) database for radiation treatment plans as well as to match atlas organs to new patient data.


Evaluation of urine composition and calcium salt crystallization properties in standardized volume-adjusted 12-h night urine from normal subjects and calcium oxalate stone formers.
The volume of 12-h night urine from ten normal men (NM), ten normal women (NW) and 31 male calcium stone formers (SFM) was adjusted to 750 ml and analysed with respect to supersaturation with calcium oxalate (CaOx) and calcium phosphate (CaP), inhibition of CaOx crystal growth and aggregation, as well as the CaOx and CaP crystallization propensity. Concentrations of oxalate and glycosaminoglycans and AP(CaOx) index, an estimate of the CaOx ion-activity product, were higher and the concentration of citrate lower in NM than in NW. In SFM the directly assessed risk of CaOx crystallization was higher and the inhibition of CaOx crystal growth lower than in NM. There were no differences between the groups regarding inhibition of CaOx crystal growth by 74% dialysed urine or inhibition of CaOx crystal aggregation. SFM with mixed CaOxCaP stones had a higher concentration of phosphate and a higher AP(CaP) index at pH 7.0 than SFM with CaOx stones.


The journey from precontemplation to action: Transitioning between electronic medical record systems.
Health care organizations, in response to federal programs, have sought to identify electronic medical record (EMR) strategies that align well with their visions for success. Little exists in the literature discussing the transition from one EMR strategy to another. The analysis and planning process used by a major academic medical center in its journey to adopt a new strategy was described in this study. We use the transtheoretical model of change to frame the five phases through which the organization transitioned from a best-of-breed system to an enterprise system. We explore the five phases of change from the perspective of a maturing approach to new technology adoption. Data collection included archival retrieval and review as well as interviews with key stakeholders. Although there was always a focus on some enterprise capabilities such as computerized physician order entry, the emphasis on EMR selection tended to be driven by specialty requirements. Focusing on the patient across the continuum of care, as opposed to focusing on excessive requirements by clinical specialties, was essential in forming and deploying a vision for the new EMR. This research outlines a successful pathway used by an organization that had invested heavily in EMR technology and was faced with evaluating whether to continue that investment or start with a new platform. Rather than focusing on the technology alone, efforts to reframe the discussion to one that focused on the patient resulted in less resistance to change.


The screen for cognitive impairment in psychiatry in patients with borderline personality disorder.
Cognitive deficits are common in borderline personality disorder (BPD) and appear to be associated with psychopathology, functioning and outcome. The availability of a cognitive screening instrument could be of use in clinical settings in order to assess neurocognition in BPD patients. The Screen for Cognitive Impairment for Psychiatry (SCIP) proved to be reliable in different psychiatric populations, but it has not yet been validated in personality disorders. The purpose of this study is therefore to evaluate its psychometric properties in a sample of 58 BPD patients. The SCIP was validated against the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the Trail Making Test A and B (TMT A and B). The receiver operator curve analysis displayed an acceptable convergent validity (total score AUC: 0.78, 95% CI: 0.70-0.86; Se: 75%, Sp: 72%). A cut-off total score of 80 identified 81% of patients as cognitively impaired. The exploratory factor analysis displayed a one-factor solution explaining 55.8% of the total variance. The SCIP displayed adequate psychometric properties in BPD and could be integrated in the routine clinical assessment to provide a preliminary evaluation of cognitive features for BPD.


Verbal episodic memory and endogenous estradiol: an association in patients with mild cognitive impairment and Alzheimer's disease.
In the continuum of patients with Alzheimer's disease (AD), mild cognitive impairment (MCI), and normal controls, a possible association of verbal memory and endogenous estradiol (E(2)) levels was investigated. Verbal episodic memory was measured with a german version of the California verbal memory test (CVLT). Results were controlled for apolipoprotein E (ApoE) phenotype. We studied 37 controls, 32 MCIs and 117 ADs. Groups differed in all trials of the CVLT (P < 0.001) and in E(2) levels (P < 0.001). E2 levels differed significantly between groups only among females (P < 0.001). In females correcting for age and ApoE, there was an overall correlation between CVLT delayed recall and level of E(2) (P = 0.025). Stepwise regression analyses found E(2) level to be a significant predictor for CVLT delayed recall (P < 0.001). It may be concluded that lower E(2) levels occur more in the course of the disease than may be considered as a risk factor per se.


Fat mass index and hip bone mineral density in a group of Lebanese adolescents and young adults.
The main aim of this study was to explore the relationship between fat mass index and hip bone mineral density in a group of Lebanese adolescents and young adults. 91 females and 111 males (aged 13 to 30) participated in this study. Body composition (lean mass, fat mass and bone mineral content) and bone mineral density (BMD) of whole body (WB), total hip (TH) and femoral neck (FN) were assessed by dual-energy X-ray absorptiometry (DXA). Weight and height were measured, and body mass index (BMI), lean mass index (LMI) and fat mass index (FMI) were calculated. Body weight, BMI, lean mass and LMI were positively correlated to TH BMD and FN BMD in females and males. Fat mass and FMI were positively correlated to TH BMD and FN BMD in females but not in males. This study suggests that FMI is a positive determinant of TH BMD and FN BMD in adolescent girls and young women but not in adolescent boys and young men while LMI is a positive determinant of TH BMD and FN BMD in both genders.


Flexible gold electrode array for multiplexed immunoelectrochemical measurement of three protein biomarkers for prostate cancer.
In this work, we report a simple and novel electrochemical multiplexed immunosensor on a flexible polydimethylsiloxane (PDMS) slice deposited with 8 × 8 nano-Au film electrodes for simultaneous detection of prostate specific antigen (PSA), prostate specific membrane antigen (PSMA), and interleukin-6 (IL-6). Primary antibodies linked with magnetic beads (Ab1-MBs) were modified on the nano-Au film electrodes via magnetic force. In the presence of corresponding antigen, horse radish peroxidase-secondary antibody-conjugated gold nanorods (HRP-Ab2-gold NRs) were brought into the surface of electrodes, generating obvious electrochemical signals of H2O2 reduction reactions. Based on this, the designed immunosensor provide good performance in sensitivity and specificity during the detection of above three biomarkers for prostate cancer. The electrochemical multiplexed immunosensor was verified for selective and accurate detection of complex samples in human serum. Data suggested that the reported multiplexed immunosensing strategy holds great promise for applications in clinical assay and diseases diagnosis.


Endoscopic Transsphenoidal Resection of Suprasellar Histiocytosis in a Patient with Erdheim-Chester Disease: A Case Report.
Erdheim-Chester disease (ECD) is a rare systemic disease characterized by non-Langerhans histiocytosis. Pituitary involvement, often manifesting as diabetes insipidus, is the most common central nervous system (CNS) lesion. However, significant mass formation compressing the optic apparatus is rarely reported. We present a case of ECD-related suprasellar mass treated with an endoscopic transnasal approach, with emphasis on the surgical strategy and the intraoperative findings. The mass was fibrous, significantly hard, and strongly adhered to the optic nerves, causing visual impairment. A subtotal resection was performed with preserving the adhesion between the mass and the optic nerves, and her visual symptoms improved remarkably after surgery. We highlight the surgical procedure of ECD-related suprasellar mass, from an endoscopic point of view. Due to strong adhesion of the mass to the surrounding optic apparatus and perforators, complete resection may be harmful; judicious mass reduction with preserving such adhesion would contribute to better visual outcomes.


Apoptosis and acute lymphocytic leukemia in children.
We examined in vivo spontaneous and prednisolone-induced apoptosis in peripheral blood samples of 23 children with ALL by flow cytometric and morphologic methods. There was no significant spontaneous apoptosis before the therapy. Six hours after prednisolone therapy, increased apoptosis was found in 19 of 23 cases. In one case, the apoptosis of blast cells could not be compared with the clinical data, because the patient died in sepsis during the induction therapy. In 18 of 22 evaluable cases, the in vivo apoptosis correlated with the decrease of leukemic blasts during the first 8 days of prednisolone monotherapy. In 20 of 22 children, a correlation was found between in vivo prednisolone-induced apoptosis and clinical outcome. The p53 gene expression was elevated in 2 of 10 patients. No elevation in the expression of bcl-2 gene was observed. In 6 of 23 cases, the glucocorticoid receptors were measured. The correlation of clinical responsiveness and gcR mRNA shows less parallelism than does the apoptosis correlation.


Resistance to lymphoid engraftment in lpr recipients of normal bone marrow: characterization of chimeric stem cell, monocyte and peripheral lymphoid lineages.
Lethally irradiated MRL/lpr mice reconstituted with T cell-depleted bone marrow stem cells from the non-autoimmune strain A. Thy had been shown to develop a state of long-term split chimerism; erythrocytes were derived from the A. Thy donor, while peripheral lymphocytes were derived from the lpr recipient. In contrast, recipients of the non-lpr-congenic strain, MRL/+, were fully repopulated in both lineages by donor-derived hematopoietic cells. In order to more fully understand the mechanisms responsible for this type of split chimerism, we have investigated additional genetic and developmental parameters. We found that histocompatible normal B cell precursors engrafted C3H/HeJ and C57BL/6/+ mice much better than they engrafted the corresponding lpr congenic strains, indicating that resistance to lymphoid engraftment was not unique to the MRL background. Bone marrow cells and peritoneal macrophages were found to express the donor H-2 phenotype in both non-lpr and lpr recipients, limiting resistance to the lymphoid lineage. Moreover, we showed that normal bone marrow stem cells passaged in an lpr host environment were subsequently able to repopulate the B cell lineage of non-lpr secondary recipients, proving that prelymphoid stem cells were intact. Although lymph node cells from A. Thy----MRL/lpr chimeras were lpr-derived, they did not show the abnormal surface marker expression associated with the lpr phenotype, nor did they develop lymphoid hyperplasia or elevated autoantibody levels. However, A. Thy----MRL/lpr chimeras differed from normal mice in that their spleens were markedly deficient in IgM+ B cells.


Purity of Chloroplasts Prepared from the Siphonous Green Alga, Caulerpa simpliciuscula, as Determined by Their Ultrastructure and Their Enzymic Content.
The ultrastructure and enzyme distribution in chloroplasts and other subcellular fractions isolated from the siphonous green alga, Caulerpa simpliciuscula, are described. The isolated chloroplasts were similar in appearance to those in the tissue from which they were derived, and in typical preparations 70% or more were intact. Chloroplasts which had lost their outer envelopes could be separated from intact plastids by centrifugation at low speeds through gradients of colloidal silica. Intact chloroplasts separated in this way retained their photosynthetic capacity and were impermeable to ferricyanide ions. The chloroplast preparations separated by differential centrifugation and refractionated using either discontinuous or continuous Percoll gradients contained non-chloroplast material. It was estimated that this amounted to a maximum of 10% of the mitochondrial population and 6% of cytoplasm extracted from the plant. The contaminating material surrounded the chloroplasts in a thin layer and was surrounded by a membrane.


MM-UNet: A multimodality brain tumor segmentation network in MRI images.
The global annual incidence of brain tumors is approximately seven out of 100,000, accounting for 2% of all tumors. The mortality rate ranks first among children under 12 and 10th among adults. Therefore, the localization and segmentation of brain tumor images constitute an active field of medical research. The traditional manual segmentation method is time-consuming, laborious, and subjective. In addition, the information provided by a single-image modality is often limited and cannot meet the needs of clinical application. Therefore, in this study, we developed a multimodality feature fusion network, MM-UNet, for brain tumor segmentation by adopting a multi-encoder and single-decoder structure. In the proposed network, each encoder independently extracts low-level features from the corresponding imaging modality, and the hybrid attention block strengthens the features. After fusion with the high-level semantic of the decoder path through skip connection, the decoder restores the pixel-level segmentation results. We evaluated the performance of the proposed model on the BraTS 2020 dataset. MM-UNet achieved the mean Dice score of 79.2% and mean Hausdorff distance of 8.466, which is a consistent performance improvement over the U-Net, Attention U-Net, and ResUNet baseline models and demonstrates the effectiveness of the proposed model.


Histochemistry to detect Helix pomatia lectin binding in breast cancer: methodology makes a difference.
A number of studies have shown that altered cellular glycosylation, as detected by binding of Helix pomatia lectin to paraffin sections, is associated with metastatic disease and consequent poor patient prognosis in breast and other cancers. In a 24-year retrospective study, sections of 373 primary breast cancers were stained for binding of the lectin using two different histochemical techniques: a direct method (using peroxidase-conjugated lectin) and an indirect method (using native, unconjugated lectin). Similar percentages of cases were positive (79%) and negative (21%) for lectin binding with either technique, but there was enormous inconsistency when individual cases were examined. A total of 38/373 (10.2%) cases that were negative by the indirect method were positive by the direct method, and 37/373 (9.9%) cases that were negative by the direct method were positive by the indirect method. Life tables calculated for lectin staining vs nonstaining cases showed a very strong correlation between lectin binding and long-term survival (p < 0.0001) when staining was performed by the indirect method, but only very weak correlation with prognosis (p < 0.03, borderline significance) when the direct technique was employed. SDS-PAGE revealed that there were differences in breast cancer glycoproteins recognized by native lectin and peroxidase-conjugated lectin immobilized on Sepharose 4B affinity beads. Helix pomatia lectin binding appears to be an intriguing and potentially valuable marker of biological behavior in breast cancer. This study emphasizes the importance of selecting an appropriate immunohistochemical technique for its visualization.


Influence of Cell Age on Chlorophyll Formation in Light-grown and Etiolated Wheat Seedlings.
A method is described for relating the age of a cereal leaf cell to its distance from the leaf base. The rates of chlorophyll synthesis per plastid in the first leaf of light-grown and of greening etiolated seedlings of wheat (Triticum aestivum, var. Maris Dove) increase with cell age. Normally developing plastids of light-grown wheat take over 24 hours to reach the chlorophyll a/b ratio characteristic of mature wheat chloroplasts (4.5), but mature etioplasts need only 8 hours light to achieve this a/b ratio. Plastid greening potential depends only on cell age, whereas the chlorophyll a/b ratio is influenced both by cell age and by light.


Sex-chromosome linked gene expression in in-vitro produced bovine embryos.
The expression of XIST, G6PD, HPRT, ZFX and ZFY were investigated in in-vitro produced bovine embryos. Transcripts of these genes were assayed by RT-PCR in pools of pre-compaction stage embryos and sexed pools of morulae and blastocysts. The expression of XIST, G6PD, HPRT and ZFX in female and male morulae and blastocysts were compared using a semi-quantitative RT-PCR. G6PD, HPRT and ZFX transcripts were noted in all pre-compaction stage embryos and in female and male blastocysts. ZFY transcripts were detected in unsexed pools of 8-16-cell stage embryos and in male blastocysts. XIST transcripts were detected in unsexed pools at the 8-16 cell stage, in male and female morulae, and in female blastocysts. The level of XIST RNA was significantly higher in female morulae than in males. Levels of G6PD and HPRT RNA were also higher in female morulae and blastocysts than in males, but only G6PD levels were significantly different between the sexes. The expression of ZFX was also significantly higher in female than in male blastocysts. These results show sexually dimorphic expression of sex chromosome linked genes prior to the blastocyst stage in in-vitro produced bovine embryos.


Refining PRRSV-2 genetic classification based on global ORF5 sequences and investigation of their geographic distributions and temporal changes.
In this study, comprehensive analysis of 82,237 global porcine reproductive and respiratory syndrome virus type 2 (PRRSV-2) open reading frame 5 sequences spanning from 1989 to 2021 refined PRRSV-2 genetic classification system, which defines 11 lineages and 21 sublineages and provides flexibility for growth if additional lineages, sublineages, or more granular classifications are needed in the future. Geographic distribution and temporal changes of PRRSV-2 were investigated in detail. This is a thorough study describing the molecular epidemiology of global PRRSV-2. In addition, the reference sequences based on the refined genetic classification system are made available to the public for future epidemiological and diagnostic applications worldwide. The data from this study will facilitate global standardization and application of PRRSV-2 genetic classification.


Two- and three-dimensional CT ventriculography: a new application of helical CT.
We propose a new application of helical CT, CT ventriculography, which can produce two-dimensional (2D) and three-dimensional (3D) images of different cardiac phases (plus animation). We sought to determine the accuracy of CT ventriculography for assessing left ventricular volumes. With a single breath-hold, the patient's entire heart was scanned with an ECG-gating technique (3-mm-thick collimation, 2 mm per rotation table speed, 0.8 sec per rotation, and 50 rotations through 10 cm in total). Using a 0.2-mm (0.08-sec) interval (10 slices per rotation) overlapping reconstruction, about 500 axial slices were obtained and reordered to separate different cardiac cycles. Then, 2D cardiac axes and 3D images were reconstructed and animated movies of the 2D and 3D images were produced. In 21 patients, the left ventricular end-diastolic volume, end-systolic volume, and ejection fraction were assessed and compared with left ventriculography. Correlations and agreements between CT and left ventriculography were determined. Close correlations between CT and left ventriculography were obtained (r = 0.95, 0.98, and 0.91, for end-diastolic volume, end-systolic volume, and left ventricular ejection fraction, respectively; p < 0.0001 for all values). The limits of agreement between CT and left ventriculography were 44.3 to -44.5 ml for end-diastolic volume, 19.8 to -29.0 ml for end-systolic volume, and 19.7% to -9.5% for left ventricular ejection fraction. This cardiac application of helical CT provides a clear morphology along the cardiac axes and 3D images and an assessment of left ventricular volumes (end-diastolic volume, end-systolic volume, and left ventricular ejection fraction).


Prognostic value of an autophagy-related long-noncoding-RNA signature for endometrial cancer.
This study retrieved the transcriptome profiling data of 552 endometrial cancer (EC) patients from the TCGA (The Cancer Genome Atlas) database, and identified 1297 lncRNAs (long noncoding RNAs) related to autophagy genes using Pearson correlation analysis. Univariate Cox regression analysis of the training data set revealed that 14 autophagy-related lncRNAs had significantly prognostic value for endometrial cancer (P < 0.01). Multivariate Cox regression analysis of these autophagy-related lncRNAs established the following autophagy-related lncRNA prognosis signature for endometrial cancer: PI = (0.255 × AC005229.4 expression) + (0.405 × BX322234.1 expression) + (0.169 × FIRRE expression value) + (-0.122 × RAB11B-AS1 expression) + (-0.338 × AC003102.1 expression). This signature was validated in both the testing data set and the entire data set. The areas under the receiver operating characteristics curves for the 1-, 3-, and 5-year overall survival rates in the entire data set were 0.772, 0.733, and 0.714, respectively. In addition, a gene set enrichment analysis confirmed that cancer-related and autophagy-related pathways were significantly up-regulated in the high-risk group. In summary, this study has demonstrated that a signature comprising five autophagy-related lncRNAs has potential as an independent prognostic indicator of endometrial cancer, and also that these lncRNAs may play a key role in the development of endometrial cancer.


The effect of secondary hyperparathyroidism and hemodialysis therapy on alveolar bone and periodontium.
Alveolar bone is particularly sensitive to increased levels of parathyroid hormone (PTH) from either primary or secondary hyperparathyroidism (HPT). The purpose of this study was to examine the effect of secondary HPT on the periodontium of patients on hemodialysis. The experimental group consisted of 35 patients with secondary HPT, with chronic renal failure treated by hemodialysis (E group). A control group (C group) was formed from 35 healthy age- and gender-matched subjects attending the maxillofacial outpatient clinic for a variety of reasons. Blood samples were taken from the E group, and the biologically active intact parathormone molecule, PTH(1-84), was assayed using two-site immunoradiometric assay (IRMA). The time of onset and the duration since diagnosis of HPT was also recorded. In addition, for a subgroup of 25 matched pairs of patients, a clinical periodontal examination was performed, and the Ramfjord index teeth were recorded for: Plaque index (PI); Gingival index (GI); Probing depth (PD); and Clinical attachment level (CAL). A standardized panoramic X-ray was taken from all patients and computer-based linear measurements were used to assess alveolar bone loss (BL). Unpaired Student's t-test served to compare the two groups. Pearson's correlation coefficient test was used to study the association between PI, PTH level, disease duration and BL. Demographically, both groups were similar with no statistical difference. PI was also similar in the C and E group (2.03 +/- 0.13 and 1.76 +/- 0.17, respectively). GI, however, was slightly greater in the C group (1.28 +/- 0.09) compared to the E group (0.97 +/- 0.01). PD in the E group (2.92 +/- 0.14 mm) was almost identical to that of the C group (2.90 +/- 0.12 mm). Likewise, CAL in the E group (4.43 +/- 0.29 mm) did not differ from CAL in the C group (4.03 +/- 0.25 mm). Mean BL was also similar in the E and C groups (3.60 +/- 0.23 mm and 3.85 +/- 0.24 mm, respectively). PI showed a positive, significant correlation with BL (r = 0.457, P = 0.0008). From this study it can be concluded that secondary HPT does not have an appreciable effect on periodontal indices and radiographic bone height.


Changes in peak systolic velocity induced by chronic therapy with phosphodiesterase type-5 inhibitor.
The aim of this study was to assess the influence of chronic therapy with phosphodiesterase type-5 inhibitor on penile haemodynamics at colour Doppler ultrasound. Thirty patients affected by erectile dysfunction (ED) of different aetiology tested with the International Index of Erectile Function (IIEF-5) were evaluated with penile colour Doppler ultrasound during basic and dynamic phases (10 microg PGE1) before and after chronic self-administration of sildenafil citrate (dosage: 100 mg as required, two to three times a week) for a period of 5-20 months (mean: 12.3). Treatment was interrupted 14-21 days before the second ultrasound evaluation. Peak systolic velocity (PSV) and end-diastolic velocity (EDV) were recorded by means of colour Doppler; cut off values were 25 and 5 cm s(-1) respectively. Data were compared by nonparametric tests. Twenty-two of the 30 patients showed normal pre-treatment PSV, while eight of 30 had an insufficient arterial flow. Mean pre-treatment EDV was 4.7 +/- 0.5. After chronic therapy with sildenafil, a global improvement of 10.5% on PSV was seen (P < 0.001), without any statistical difference between patients with normal pre-treatment peak and those with a borderline one. No statistically significant changes were found for EDV (P = 0.98). It is concluded that chronic therapy with phosphodiesterase-5 inhibitor results in a significant improvement in PSV values, probably due to a penile chronic vasoactive enhancement.


Significance of a negative exercise thallium test in the presence of a critical residual stenosis after thrombolysis for acute myocardial infarction.
After thrombolytic therapy for acute myocardial infarction, increasing emphasis is placed on early submaximal exercise testing, with further intervention advocated only for demonstrable ischemia. Although significant residual coronary artery lesions after successful thrombolysis are common, many patients paradoxically have no corresponding provokable ischemia. The relation between significant postthrombolytic residual coronary artery disease and a negative early, submaximal exercise thallium-201 tomogram was studied among 101 consecutive patients with uncomplicated myocardial infarction and at least 70% residual stenosis of the infarct artery. A negative test occurred in 49 (48.5%) patients with a mean 88% residual infarct artery stenosis. Further characteristics of the group were as follows: mean time to treatment was 3.1 hours; mean age was 54 +/- 10 years; 80% were male; 47% had anterior infarction; 39% had multivessel disease; mean left ventricular ejection fraction was 53 +/- 14%; and mean peak creatine kinase level was 3,820 +/- 3,123 IU/ml. A similar group of 52 (51.5%) patients, treated within 3.3 hours from symptom onset, with a mean postthrombolysis stenosis of 90%, had a positive exercise test. Characteristics of this group were as follows: age was 58 +/- 10 years; 92% were male; 56% had anterior infarction; 40% had multivessel disease; and mean left ventricular ejection fraction was 54 +/- 15%. The peak creatine kinase level associated with the infarction, however, was lower: 2,605 +/- 1,805 IU/ml (p = 0.04). There was no difference in performance at exercise testing with respect to peak systolic pressure, peak heart rate, or time tolerated on the treadmill between the two groups. By multivariate logistic regression, only peak creatine kinase level predicted a negative stress result in the presence of a significant residual stenosis (odds ratio, 4.2; 95% confidence interval, 1.1-16.3). The explanation for the relatively frequent finding of a negative early stress 201Tl tomogram after apparently successful reperfusion appears to be more extensive myocardial necrosis and not delay in therapy or inadequate exercise performance.


Ileosigmoid knot in a patient with Down syndrome: a unique surgical emergency.
The ileosigmoid knot (ISK) or double ileosigmoid volvulus is a wrapping of the small intestine around the base of the sigmoid colon. We report an unusual case in the digestive surgery department of the Ibn Tofail Hospital of CHU Mohammed VI Marrakech of a 28-year-old man with Down's syndrome who presented with symptoms and signs of intestinal obstruction. Abdominal CT scan revealed a whirl sing and significant distension of the sigmoid loop. Exploratory laparotomy revealed ISK resulting in gangrene of ileum and sigmoid colon. The surgical procedure was a necrotic digestive segments resection, with a double-barrelled ileostomy and a Hartmann procedure. One month afterwards, the patient was operated on to reestablish of the continuity. Through this observation and a review of the literature we define the diagnostic, therapeutic and prognosis aspects of this rare clinical entity.


Effects of prostaglandin E1 and hydralazine on the longitudinal distribution of pulmonary vascular resistance during vasoconstrictor pulmonary hypertension in sheep.
Pulmonary capillary pressure (Ppc) is dependent upon left atrial pressure, pulmonary venous resistance, and cardiac output. The effects of pulmonary vasodilators on Ppc will therefore depend upon any alterations in the longitudinal distribution of pulmonary vascular resistance (precapillary [arterial] and postcapillary [venous] components). We therefore studied the effects of two pulmonary vasodilators (prostaglandin E1 and hydralazine) on Ppc and the longitudinal distribution of pulmonary vascular resistance. Pulmonary hypertension was produced in sheep by the continuous administration of the thromboxane A2-mimetic U46619. Ppc was measured by analysis of pulmonary artery occlusion pressure decay curves. U46619 increased Ppc by 9 mmHg and increased both the arterial and venous components of pulmonary vascular resistance. Subsequent administration of prostaglandin E1 decreased Ppc by 5 mmHg and decreased both the arterial and venous components of pulmonary vascular resistance (by 50 and 69% respectively). Hydralazine produced smaller decreases in the arterial and venous components of pulmonary vascular resistance (by 35 and 49% respectively) and did not significantly reduce Ppc. We conclude that prostaglandin E1 but not hydralazine is effective in decreasing Ppc in this experimental model of pulmonary hypertension.


Bio rapid prototyping by extruding/aspirating/refilling thermoreversible hydrogel.
This paper reports a method for rapid prototyping of cell tissues, which is based on a system that extrudes, aspirates and refills a mixture of cells and thermoreversible hydrogel as a scaffold. In the extruding mode, a cell-mixed scaffold solution in the sol state is extruded from a cooled micronozzle into a temperature-controlled substrate, which keeps the scaffold in the gel state. In the aspiration mode, the opposite process is performed by Bernoulli suction. In the refilling mode, the solution is extruded into a groove created in the aspiration mode. The minimum width of extruded hydrogel pattern is 114 +/- 15 microm by employing a nozzle of diameter 100 microm, and that of aspirated groove was 355 +/- 10 microm using a 500 microm-diameter nozzle. Gum arabic is mixed with the scaffold solution to avoid peeling-off of the gel pattern from the substrate. Patterning of Sf-9 cell tissue is demonstrated, and the stability of the patterned cell is investigated. This system offers a procedure for rapid prototyping and local modification of cell scaffolds for tissue engineering.


Changing gender roles of Egyptian females.
A high population growth rate in the Middle East is prompting investigators to look for cultural conditions and attitudes that can be encouraged to facilitate lower fertility rates. Population researchers find an inverse relationship between the educational level of females and their fertility, especially in Third World countries. This suggests that education can become an internal cultural mechanism for population control. The author explores this notion using data collected from interviews with 750 teenage girls and their mothers in Cairo, Egypt.


Interference by carbamazepine and oxcarbazepine with serum- and urine-screening assays for tricyclic antidepressants.
The purpose of this work was to evaluate the potential cross-reactivity of 2 antiepileptic medications containing 3-ringed structures, namely, carbamazepine and oxcarbazepine, with screening assays for tricyclic antidepressants. A cross-sectional study of 52 patients between 3 and 19 years of age who had been prescribed either carbamazepine or oxcarbazepine was conducted. A serum fluorescence-polarized immunoassay and a urine enzyme-linked immunoassay were used. The serum carbamazepine or oxcarbazepine level was measured. Gas chromatography/mass spectrometry, a confirmatory test for tricyclic antidepressant detection, was subsequently performed on the serum specimen. A linear dependency on medication level was observed with the serum fluorescence-polarized immunoassay assay. This relationship was stronger for carbamazepine (4.2 microg/L tricyclic antidepressant detected per microgram/liter of carbamazepine) than for oxcarbazepine (0.7 microg/L tricyclic antidepressant detected per milligram/liter). At higher carbamazepine levels (8.0-11.6 mg/L), 12 of 13 patients had a positive serum fluorescence-polarized immunoassay result; at lower levels (0.1-7.9 mg/L), only 1 of 20 had a positive result. None of the patients who were receiving oxcarbazepine showed significant tricyclic antidepressant activity on either assay. Carbamazepine interferes at a statistically significant level with serum fluorescence-polarized immunoassay assay and in a dose-dependent fashion. Neither carbamazepine nor oxcarbazepine exhibit significant tricyclic antidepressant activity on urine enzyme-linked immunoassay assay.


The Brassica juncea BjCdR15, an ortholog of Arabidopsis TGA3, is a regulator of cadmium uptake, transport and accumulation in shoots and confers cadmium tolerance in transgenic plants.
*A bZIP transcription factor from Brassica juncea (BjCdR15) was isolated by the cDNA-amplified fragment length polymorphism technique after cadmium treatment. Sequence analysis indicated high similarity between BjCdR15 and Arabidopsis TGA3. In Arabidopsis, TGA3 transcription is also induced by cadmium; hence, we investigated whether BjCdR15 is involved in cadmium tolerance and whether it can functionally replace TGA3 protein in Arabidopsis tga3-2 mutant plants. *BjCdR15 expression was detected mainly in the epidermis and vascular system of cadmium-treated plants, and increased in roots and leaves after cadmium treatment. The overexpression of BjCdR15 in Arabidopsis and tobacco enhanced cadmium tolerance: overexpressing plants showed high cadmium accumulation in shoots. Conversely, Arabidopsis tga3-2 mutant plants showed high cadmium content in roots and inhibition of its transport to the shoot. *We demonstrated that BjCdR15 can functionally replace TGA3: in 35S::BjCdR15-tga3-2 plants, the long-distance transport of cadmium from root to shoot was restored and these plants showed an increased cadmium content in shoots compared with all other assays. In addition, BjCdR15/TGA3 regulated the synthesis of phytochelatin synthase and the expression of several metal transporters. *The results indicate that BjCdR15/TGA3 transcription factors play a crucial role in the regulation of cadmium uptake by roots and in its long-distance root to shoot transport. BjCdR15/TGA3 may thus be considered as useful candidates for potential biotechnological applications in the phytoextraction of cadmium from polluted soils.


[Identification of human platelet specific functional antibody and its fragments].
To study the immunoreactivity of the specific anti-platelet glycoprotein (GP) IgG antibody and its F(ab')2 fragments from patients with chronic idiopathic thrombocytopenic purpura (ITP) and to investigate their effects on platelet aggregation function. Peripheral blood samples were collected from 84 patients with ITP. Modified monoclonal antibody immobilization of platelet antigen assays was used to detect the IgG antibodies specific for GP I b/II a, GP I b/IX and GP VI. The IgG antibody and its F(ab')2 fragments in the positive plasma inhibiting platelet aggregation function were prepared and purified. Plate-rich Peripheral blood sample was collected from a normal person with O type blood and platelet-rich plasma (PRP) and platelet-poor plasma (PPP) were prepared. Plasma pf ITP patient or purified IgG or F(ab')2 fragments of different concentrations were added into PRP, and then inducers of platelet aggregation ADP, ristocetin, or collagen were added. The platelet aggregation was measured. Platelet GP II b/III a specific human-rat chimeric antibody 7E3 and GP I b specific antibody SZ2 were used as positive controls and PBS was used as negative control. GP II b/III a and/or GP I b/IX and/or GP VI specific antibodies were found in 48 (57.1%) patients. The plasma, purified IgG and F(ab')2 fragments of 7 of these 48 patients (14.6%) with positive autoantibody showed significant activity against GP II b/III a (4 patients), GP I b/IX (2 patients), or GP VI (one patient). The purified IgG and F(ab')2 fragments of 2 patients positive in GP II b/ III a autoantibody out of the 7 patients significantly inhibited the platelet aggregation induced by ADP, the purified IgG and F(ab')2 fragments of 1 patients positive in GP I b/IX out of the 7 patients significantly inhibited the platelet aggregation induced by ristocetin, and the purified IgG and F(ab')2 fragments of 1 patients positive in GP VI out of the 7 patients significantly inhibited the platelet aggregation induced by collagen. A functional fragment, F(ab')2 portion of IgG is responsible for the autoantibody interaction with platelet GPs in ITP, and some of them also affect the platelet function. It can be used to develop completely humanized anti-GP small molecular phage antibody.


Photoresponse of ion-damaged germanium.
Ion implantation was used to create predetermined defect densities to examine photoresponse for optoelectronic switch applications. Ion-damaged germanium shows a significant decrease in photoresponsivity with implant dose, particularly with doses exceeding the critical amorphizing dose (D(c) approximately 1 x 10(14) cm(-2)).


Classification of accurate and misarticulated /ɑr/ for ultrasound biofeedback using tongue part displacement trajectories.
Ultrasound biofeedback therapy (UBT), which incorporates real-time imaging of tongue articulation, has demonstrated generally positive speech remediation outcomes for individuals with residual speech sound disorder (RSSD). However, UBT requires high attentional demands and may therefore benefit from a simplified display of articulation targets that are easily interpretable and can be compared to real-time articulation. Identifying such targets requires automatic quantification and analysis of movement features relevant to accurate speech production. Our image-analysis program TonguePART automatically quantifies tongue movement as tongue part displacement trajectories from midsagittal ultrasound videos of the tongue, with real-time capability. The present study uses such displacement trajectories to compare accurate and misarticulated American-English rhotic /ɑr/ productions from 40 children, with degree of accuracy determined by auditory perceptual ratings. To identify relevant features of accurate articulation, support vector machine (SVM) classifiers were trained and evaluated on several candidate data representations. Classification accuracy was up to 85%, indicating that quantification of tongue part displacement trajectories captured tongue articulation characteristics that distinguish accurate from misarticulated production of /ɑr/. Regression models for perceptual ratings were also compared. The simplest data representation that retained high predictive ability, demonstrated by high classification accuracy and strong correlation between observed and predicted ratings, was displacements at the midpoint of /r/ relative to /ɑ/ for the tongue dorsum and blade. This indicates that movements of the dorsum and blade are especially relevant to accurate production of /r/, suggesting that a predictive parameter and biofeedback target based on this data representation may be usable for simplified UBT.


Retrospective analysis of five-year and longer clinical and electrophysiological results of the world's first endoscopic management for carpal tunnel syndrome.
We have analyzed postoperative long-term follow-up results of five years or more from idiopathic carpal tunnel syndrome patients that underwent our complete carpal canal release and decompression procedure that uses the Universal Subcutaneous Endoscope system. In this series, 203 hands were followed up both clinically and electrophysiologically. Final follow-up times were determined by the most recent electrophysiological measurements. Mean follow-up period was nine years. Tingling, pain (using a 3 gm needle) and touch (using a 2 gm von Frey hair) at all median nerve distribution areas recovered to normal in 92.9, 98.2, 95.2%, respectively. Abductor pollicis brevis muscle power improved from preoperative manual muscle testing of 0, 1, 2 to post-operative 4 or 5 in 82.6%. Mean detectable distal sensory latency improved from 4.3 (n = 130) to 3.1 msec (n = 200). Mean detectable distal motor latency improved from 6.2 (n = 189) to 4.1 msec (n = 200). Complication and recurrence rates were 0% and 0.5% respectively.


Oral healthcare-seeking behavior and perception of oral health and general healthcare among WHO indexed age groups in East-Coast India.
In a country where 30,570 dentists graduate per year, it is staggering to acknowledge that only 10% of dentists serve the rural people, who constitute around 68.8% of the country's population. To find out the oral healthcare-seeking behavior, profile, and pattern in Tenali Mandal among WHO recommended index age groups. A cross-sectional, multilocality, single-visit study was done to acknowledge the oral healthcare-seeking behavior, profile, and pattern in Tenali Mandal, Guntur, Andhra Pradesh. There are 9 villages, 2 peri-urban, and 1 town present in the Tenali Mandal and the study was conducted following the National Pathfinder Survey. Around 35.4% of the study participants utilized dental services while most of them sought care in the last 1-6 months (23.4%) and the main reason for the last dental visit was tooth pain (13.1%), followed by decayed tooth without pain (6.9%). Dental care-seeking behavior among the age group of 12 years was 1.611 times more when compared to 65-74 years age group which was statistically significant (P ≤ 0.010). For dental care-seeking behavior among gender, the males utilized 0.982 times less when compared to females which was not statistically significant (P ≤ 0.881), while for the place of residence, urban place was 2.707 times more utilizing the services when compared to rural place which was statistically significant (P ≤ 0.001). The results of the study indicates that the barriers of oral healthcare-seeking behavior among dental health conditions poses public health problems in the study area, as well as it is an important baseline indicator against which target for oral health improvement can be set and monitored.


Germline HVR-II mitochondrial polymorphisms associated with breast cancer in Tunisian women.
A high incidence of somatic mtDNA polymorphisms has been reported in a wide variety of human cancers; some of them have been proposed as markers for the early detection of breast cancer. However, little attention has been paid to the potential of germline mitochondrial sequence variations as genetic risk factors for cancer. We performed a case-control study of 70 unrelated Tunisian women with breast cancer and 80 healthy age- and gender-matched blood donors, taking into account clinicopathological data, to evaluate germline polymorphism of mitochondrial HVR-II region as a genetic risk factor for breast cancer. Through direct sequencing, we detected 351 polymorphisms in controls and 248 variants in patients, with 47 and 39 segregating sites, respectively. In both groups, more than 50% of the polymorphisms were due to four variants: 315 ins C, 309 ins C, 263 A>G, and 73 A>G. The HVR-II sequences were also classified into haplotypes on the basis of the polymorphisms. Fifty-nine different haplotypes were found, 20 of them shared between patients and controls. Both groups had specific haplotypes, 18 in breast cancer patients and 21 in controls. Statistical analysis revealed a weak protective effect against breast cancer risk for two mitochondrial polymorphisms - 152 T>C (odds ratio (OR) = 0.33, 95% confidence interval (CI) = 0.12-0.91) and 263 A>G (OR = 0.17, 95%CI = 0.06-0.47). In contrast, an increased risk of breast cancer was detected for the 315+C haplotype (OR = 11.66, 95%CI = 1.44-252.23). We conclude that mitochondrial variants can affect breast cancer risk. More extensive studies, involving different types of cancer and patients with different genetic makeup, will be required to improve our understanding of the effects of germline mtDNA polymorphisms on carcinogenesis.


Identification of Specific Trafficking Defects of Naturally Occurring Variants of the Human ABCG2 Transporter.
Proper targeting of the urate and xenobiotic transporter ATP-binding transporter subfamily G member 2 (ABCG2) to the plasma membrane (PM) is essential for its normal function. The naturally occurring Q141K and M71V polymorphisms in ABCG2, associated with gout and hyperuricemia, affect the cellular routing of the transporter, rather than its transport function. The cellular localization of ABCG2 variants was formerly studied by immunolabeling, which provides information only on the steady-state distribution of the protein, leaving the dynamics of its cellular routing unexplored. In the present study, we assessed in detail the trafficking of the wild-type, M71V-, and Q141K-ABCG2 variants from the endoplasmic reticulum (ER) to the cell surface using a dynamic approach, the so-called Retention Using Selective Hooks (RUSH) system. This method also allowed us to study the kinetics of glycosylation of these variants. We found that the fraction of Q141K- and M71V-ABCG2 that passes the ER quality control system is only partially targeted to the PM; a subfraction is immobile and retained in the ER. Surprisingly, the transit of these variants through the Golgi apparatus (either the appearance or the exit) was unaffected; however, their PM delivery beyond the Golgi was delayed. In addition to identifying the specific defects in the trafficking of these ABCG2 variants, our study provides a novel experimental tool for studying the effect of drugs that potentially promote the cell surface delivery of mutant or polymorphic ABCG2 variants with impaired trafficking.


Shoulder-Preserving Surgery in Case of Defect of more than half of the Joint Surface: A Case Report.
This report highlights chronic locked posterior shoulder dislocation, which is of special interest because the patient who had a reverse Hill-Sachs and Hill-Sachs lesion, with >50% joint surface defects was treated with a shoulder-preserving surgery. A 42-year-old man presented to our clinic with complaints of pain and limited movement in his left shoulder. The patient's complaints began after he experienced a fall 7 months ago. The patient was believed to have experienced posterior shoulder dislocation, and the clinical diagnosis was confirmed by radiological imaging. Computed tomography revealed a reverse Hill-Sachs lesion on the humeral head and on approximately 25% of the joint surface. During the McLaughlin procedure, because the osteoporotic humerus showed a collapse of approximately 30% on the posterior articular surface, an iatrogenic Hill-Sachs lesion was added to the reverse Hill-Sachs lesion at the beginning of the humeral head. The subscapularis tendon was transferred to the anterior defective area of the humeral head with three anchor sutures. Fixation was performed with a Kirschner wire, while the joint was in the reduction position. At the 62-month follow-up, constant shoulder score was calculated as 84. The patient was pleased with his results and was able to continue his routine activities. Arthroplasty is the recommended treatment for patients manifesting >50% defect on the humeral head joint surface. However, when these defects are evaluated, factors such as their localization, size, depth, and orientations with respect to the glenoid should be considered. Only after this multifaceted evaluation, appropriate surgical interventions can be planned.


Chemical vapor deposition of three aminosilanes on silicon dioxide: surface characterization, stability, effects of silane concentration, and cyanine dye adsorption.
Covalently bonded monolayers of two monofunctional aminosilanes (3-aminopropyldimethylethoxysilane, APDMES, and 3-aminopropyldiisopropylethoxysilane, APDIPES) and one trifunctional aminosilane (3-aminopropyltriethoxysilane, APTES) have been deposited on dehydrated silicon substrates by chemical vapor deposition (CVD) at 150 °C and low pressure (a few Torr) using reproducible equipment. Standard surface analytical techniques such as x-ray photoelectron spectroscopy (XPS), contact angle goniometry, spectroscopic ellipsometry, atomic force microscopy, and time-of-flight secondary ion mass spectroscopy (ToF-SIMS) have been employed to characterize the resulting films. These methods indicate that essentially constant surface coverages are obtained over a wide range of gas phase concentrations of the aminosilanes. XPS data further indicate that the N1s/Si2p ratio is higher after CVD with the trifunctional silane (APTES) compared to the monofunctional ones, with a higher N1s/Si2p ratio for APDMES compared to that for APDIPES. AFM images show an average surface roughness of 0.12- 0.15 nm among all three aminosilane films. Stability tests indicate that APDIPES films retain most of their integrity at pH 10 for several hours and are more stable than APTES or APDMES layers. The films also showed good stability against storage in the laboratory. ToF-SIMS of these samples showed expected peaks, such as CN(-), as well as CNO(-), which may arise from an interaction between monolayer amine groups and silanols. Optical absorption measurements on adsorbed cyanine dye at the surface of the aminosilane films show the formation of dimer aggregates on the surface. This is further supported by ellipsometry measurements. The concentration of dye on each surface appears to be consistent with the density of the amines.


To catheterise or not to catheterise: study in hip and knee primary arthroplasty.
This cross sectional study examines the rate of catheterisation of patients after elective primary hip and knee arthroplasty in an English district general hospital. 50 patients were included in this study, with 19 (37%) being catheterised pre-operatively. Of the remainder, 10 went into retention and had to be catheterised, while the other 21 were managed without a catheter. There was a trend towards more patients requiring catheterisation after axial anaesthetic (42%) compared to non-axial anaesthetic (21%), although this was not significant. We examine the rationale for catheterisation in hip and knee arthroplasty and review the available literature.


Clinical characteristics of peroneal nerve palsy by posture.
Posture induced common peroneal nerve (CPN) palsy is usually produced during the prolonged squatting or habitual leg crossing while seated, especially in Asian culture and is manifested by the onset of foot drop. Because of its similarity to discogenic foot drop, patients may be diagnosed with a lumbar disc disorder, and in some patients, surgeons may perform unnecessary examinations and even spine surgery. The purpose of our study is to establish the clinical characteristics and diagnostic assessment of posture induced CPN palsy. From June 2008 to June 2012, a retrospective study was performed on 26 patients diagnosed with peroneal nerve palsy in neurophysiologic study among patients experiencing foot drop after maintaining a certain posture for a long time. The inducing postures were squatting (14 patients), sitting cross-legged (6 patients), lying down (4 patients), walking and driving. The mean prolonged neural injury time was 124.2 minutes. The most common clinical presentation was foot drop and the most affected sensory area was dorsum of the foot with tingling sensation (14 patients), numbness (8 patients), and burning sensation (4 patients). The clinical improvement began after a mean 6 weeks, which is not related to neural injury times. Electrophysiology evaluation was performed after 2 weeks later and showed delayed CPN nerve conduction study (NCS) in 24 patients and deep peroneal nerve in 2 patients. We suggest that an awareness of these clinical characteristics and diagnostic assessment methods may help clinicians make a diagnosis of posture induced CPN palsy and preclude unnecessary studies or inappropriate treatment in foot drop patients.


Menstrual variation in experimental pain: correlation with gonadal hormones.
The results of studies examining the response to experimental pain during the menstrual cycle are conflicting because of differences in the definitions of the menstrual period, outcome measures and types of experimental pain stimulation. So far, there have been only a few studies correlating experimental pain with the levels of gonadal hormones over the menstrual cycle. Therefore, we assessed the responses to multiple experimental pain stimuli during the menstrual cycle and computed their correlations with the salivary concentrations of the gonadal hormones estrogen and testosterone. Twenty-four healthy and regularly menstruating women between 20 and 41 years old took part in the study. Detection thresholds (warmth, cold and electrical current) and pain thresholds (cold, heat, pressure and electrical current) were assessed on days 1, 4, 14 and 22 of the menstrual cycle. In each session, salivary samples were collected for the determination of the physiological estrogen 17beta-estradiol, progesterone and testosterone. Progesterone was used exclusively to verify regular menstrual cycling. Significant variations in pain thresholds for cold, pressure and electrical stimuli were observed over the menstrual cycle with the highest thresholds on day 22, except for the cold pain thresholds, which peaked on day 14. There were no such changes regarding heat pain and all the detection thresholds. The correlations separately computed for each of the 4 days between salivary estrogen as well as testosterone on the one hand and the detection or pain thresholds on the other hand failed to show significant levels, except for the coupling of testosterone and electrical pain thresholds on day 1. The pain thresholds for all the physical stressors increased after menstruation. The acrophases were located in the follicular (cold pain threshold) or in the luteal phase (pressure and electrical pain thresholds). The results of our correlation analyses indicate only minimal influences of the physiological levels of gonadal hormones on pain sensitivity in women.


Arbitrary-Scale Texture Generation From Coarse-Grained Control.
Existing deep-network based texture synthesis approaches all focus on fine-grained control of texture generation by synthesizing images from exemplars. Since the networks employed by most of these methods are always tied to individual exemplar textures, a large number of individual networks have to be trained when modeling various textures. In this paper, we propose to generate textures directly from coarse-grained control or high-level guidance, such as texture categories, perceptual attributes and semantic descriptions. We fulfill the task by parsing the generation process of a texture into the three-level Bayesian hierarchical model. A coarse-grained signal first determines a distribution over Markov random fields. Then a Markov random field is used to model the distribution of the final output textures. Finally, an output texture is generated from the sampled Markov random field distribution. At the bottom level of the Bayesian hierarchy, the isotropic and ergodic characteristics of the textures favor a construction that consists of a fully convolutional network. The proposed method integrates texture creation and texture synthesis into one pipeline for real-time texture generation, and enables users to readily obtain diverse textures with arbitrary scales from high-level guidance only. Extensive experiments demonstrate that the proposed method is capable of generating plausible textures that are faithful to user-defined control, and achieving impressive texture metamorphosis by interpolation in the learned texture manifold.


A double curve catheter for the left axillary artery approach to aortofemoral, selective renal and visceral angiography.
A double curve catheter for the left axillary artery approach to aortofemoral, selective renal and visceral angiography is described. The catheter shape enables a fast and easy catheterization of the abdominal aorta. Up till now no complications have been encountered.


A case of primary submandibular gland oncocytic carcinoma.
Primary submandibular gland oncocytic carcinoma is a rare pathology, with only 10 cases being reported to date. We encountered a case of primary submandibular gland oncocytic carcinoma and report it herein. The patient was a 69-year-old man who came to our hospital with right submandibular cancer as the main complaint. Based on the results of computed tomography and magnetic resonance imaging, submandibular gland tumor was diagnosed. Preoperative cytodiagnosis suggested class III oncocytic carcinoma. Resection of the right submandibular tumor was performed along with right neck dissection. Postoperative histopathological diagnosis was oncocytic carcinoma. As of 3 years following surgery, no recurrence has been identified.


Hydrogen Production and Storage on a Formic Acid/Bicarbonate Platform using Water-Soluble N-Heterocyclic Carbene Complexes of Late Transition Metals.
The synthesis and characterization of two water-soluble bis-N-heterocyclic carbene (NHC) complexes of rhodium and iridium is presented. Both compounds are active in H2 generation from formic acid and in hydrogenation of bicarbonate to formate. The rhodium derivative is most active in both reactions, reaching a TOF of 39 000 h-1 and a TON of 449 000 for H2 production. The catalytic hydrogenation reactions were carried out in an autoclave system and analyzed using the integrated peak areas in the 1 H NMR spectra. Decomposition of formic acid was investigated using a Fisher-Porter bottle equipped with a pressure transducer. Long-term stability for hydrogen evolution was tested by surveillance of the gas flow rate. The procedure does not require any additives like amines or inert gas conditions. Density functional theory calculations in agreement with experimental results suggest a bicarbonate reduction mechanism involving a second catalyst molecule, which provides an external hydride acting as reducing agent.


Enhanced Angiogenesis by 11βHSD1 Blockage Is Insufficient to Improve Reperfusion Following Hindlimb Ischaemia.
Background: Critical limb ischaemia (CLI), which is estimated to affect 2 million people in the United States, reduces quality of life, is associated with high morbidity and mortality, and has limited treatment options. Direct stimulation of angiogenesis using proangiogenic growth factors has been investigated as a therapeutic strategy to improve reperfusion in the ischaemic leg. Despite positive outcomes in animal studies, there has been little success in clinical translation. This investigation addressed the hypothesis that angiogenesis could be stimulated indirectly in the ischaemic hindlimb by blocking 11β-hydroxysteroid dehydrogenase 1 (11βHSD1)-mediated reactivation of anti-angiogenic glucocorticoids. Method and Results: Corticosterone suppressed ex vivo angiogenesis in the mouse aortic ring assay. 11βHSD1 deletion (Hsd11b1Del1/Del1) or pharmacological inhibition (with 300 nM UE2316) which block the reactivation of glucocorticoid (i.e., the conversion of 11-dehydrocorticosterone (11DHC) to bioactive corticosterone) significantly reduced 11DHC-induced suppression of angiogenesis. In a sponge implantation model, 11βHSD1 deletion, but not pharmacological inhibition, enhanced inflammation-induced angiogenesis. By contrast, in the mouse hindlimb ischaemia model, post-ischaemic reperfusion and vascular density were not affected by either deletion or pharmacological inhibition of 11βHSD1 in young or aged mice. 3D vascular imaging suggested that hind limb reperfusion in the 1st week following induction of ischaemia may be driven by the rapid expansion of collateral arteries rather than by angiogenesis. Conclusion: 11βHSD1-mediated glucocorticoid reactivation suppressed angiogenesis ex vivo and in vivo. However, regulation of angiogenesis alone was insufficient to promote reperfusion in hindlimb ischaemia. Future investigation of post-ischaemic reperfusion should include other aspects of systemic vascular remodeling including arteriogenesis and collateral formation.


Automatic morphological sieving: comparison between different methods, application to DNA ploidy measurements.
The aim of the present study is to propose alternative automatic methods to time consuming interactive sorting of elements for DNA ploidy measurements. One archival brain tumour and two archival breast carcinoma were studied, corresponding to 7120 elements (3764 nuclei, 3356 debris and aggregates). Three automatic classification methods were tested to eliminate debris and aggregates from DNA ploidy measurements (mathematical morphology (MM), multiparametric analysis (MA) and neural network (NN)). Performances were evaluated by reference to interactive sorting. The results obtained for the three methods concerning the percentage of debris and aggregates automatically removed reach 63, 75 and 85% for MM, MA and NN methods, respectively, with false positive rates of 6, 21 and 25%. Information about DNA ploidy abnormalities were globally preserved after automatic elimination of debris and aggregates by MM and MA methods as opposed to NN method, showing that automatic classification methods can offer alternatives to tedious interactive elimination of debris and aggregates, for DNA ploidy measurements of archival tumours.


Genetic basis of Alzheimer's dementia: role of mtDNA mutations.
Alzheimer's disease (AD) is the most common neurodegenerative disorder associated to dementia in late adulthood. Amyloid precursor protein, presenilin 1 and presenilin 2 genes have been identified as causative genes for familial AD, whereas apolipoprotein E epsilon4 allele has been associated to the risk for late onset AD. However, mutations on these genes do not explain the majority of cases. Mitochondrial respiratory chain (MRC) impairment has been detected in brain, muscle, fibroblasts and platelets of Alzheimer's patients, indicating a possible involvement of mitochondrial DNA (mtDNA) in the aetiology of the disease. Several reports have identified mtDNA mutations in Alzheimer's patients, suggesting the existence of related causal factors probably of mtDNA origin, thus pointing to the involvement of mtDNA in the risk contributing to dementia, but there is no consensual opinion in finding the cause for impairment. However, mtDNA mutations might modify age of onset, contributing to the neurodegenerative process, probably due to an impairment of MRC and/or translation mechanisms.


Soft Sensing of Non-Newtonian Fluid Flow in Open Venturi Channel Using an Array of Ultrasonic Level Sensors-AI Models and Their Validations.
In oil and gas and geothermal installations, open channels followed by sieves for removal of drill cuttings, are used to monitor the quality and quantity of the drilling fluids. Drilling fluid flow rate is difficult to measure due to the varying flow conditions (e.g., wavy, turbulent and irregular) and the presence of drilling cuttings and gas bubbles. Inclusion of a Venturi section in the open channel and an array of ultrasonic level sensors above it at locations in the vicinity of and above the Venturi constriction gives the varying levels of the drilling fluid in the channel. The time series of the levels from this array of ultrasonic level sensors are used to estimate the drilling fluid flow rate, which is compared with Coriolis meter measurements. Fuzzy logic, neural networks and support vector regression algorithms applied to the data from temporal and spatial ultrasonic level measurements of the drilling fluid in the open channel give estimates of its flow rate with sufficient reliability, repeatability and uncertainty, providing a novel soft sensing of an important process variable. Simulations, cross-validations and experimental results show that feedforward neural networks with the Bayesian regularization learning algorithm provide the best flow rate estimates. Finally, the benefits of using this soft sensing technique combined with Venturi constriction in open channels are discussed.


Immune function, stress response, and body condition in arctic-breeding common eiders in relation to cadmium, mercury, and selenium concentrations.
We examined relationships between trace metal concentrations in tissues of common eider ducks (cadmium, mercury, and selenium) and selected biomarkers of health (stress response, immune function, and body condition). This study was conducted at an eider nesting colony in the Canadian arctic in 1998 and 1999. Capture-induced stress, measured as the rise in corticosterone concentrations following capture, was positively related (P=0.03) to renal cadmium concentration in 1998 when incubating eiders were sampled, but not in 1999 when prenesting eiders were sampled. Stress response was inversely related (P=0.02) to selenium concentrations in 1999. Following capture and blood sampling in 1999, eiders were placed in a flight pen on-site for eight days in order to examine immune function. Cell-mediated immunity, measured as the skin-swelling response to an intradermal injection of phytohemagglutinin-P, (PHA-P), was positively related (P=0.003) to hepatic selenium. The heterophil:lymphocyte ratio was inversely related (P=0.08) to hepatic selenium. In 1998, selenium was positively related to body mass (P=0.01), abdominal fat mass (P=0.07), kidney mass (P=0.03), and liver mass (P=0.07). In 1999, hepatic mercury was negatively related to abdominal fat mass (P=0.01), spleen mass (P=0.07) and body mass at capture (P=0.09) in prenesting eiders.