Novosphingobium naphthalenivorans sp. nov., a naphthalene-degrading bacterium isolated from polychlorinated-dioxin-contaminated environments.
Three strains of strictly aerobic, Gram-negative, naphthalene-degrading bacteria isolated from polychlorinated-dioxin-contaminated soil and sediment were characterized. These isolates grew well with naphthalene as the sole carbon and energy source, degrading it completely within 24 h of incubation. The isolates also degraded dibenzofuran co-metabolically in the presence of naphthalene with the concomitant production of yellow intermediate metabolite(s). A 16S rRNA gene sequence analysis revealed that the isolates affiliated to the genus Novosphingobium with Novosphingobium pentaromativorans and Novosphingobium subarcticum as their nearest phylogenetic neighbors (97.4-97.5% similarity). The isolates had a genomic DNA G+C ratio of 64.5-64.6 mol% and formed a genetically coherent group distinguishable from any established species of the genus Novosphingobium at a DNA-DNA hybridization level of less than 46%. The cellular fatty acids were characterized by the predominance of 18 : 1omega7c with significant proportions of 16 : 0, 16 : 1omega7c, 17 : 1omega6c and 2-OH 14 : 0. Sphingoglycolipids were present. The major respiratory quinone was ubiquinone-10. Spermidine was detected as the major polyamine. The distinct taxonomic position of the isolates within the Novosphingobium was also demonstrated by physiological and biochemical testing. Based on these phylogenetic and phenotypic data, we propose Novosphingobium naphthalenivorans sp. nov. to accommodate the novel isolates. The type strain is strain TUT562(T) (DSM 18518(T), JCM 13951(T), NBRC 102051(T)).


Peptides from live yeast cell derivative stimulate wound healing.
Live yeast cell derivative is an alcoholic extract from yeast (Saccharomyces cerevisiae) that has previously been shown by three groups of workers to stimulate wound healing. Live yeast cell derivative is a complex mixture, and it was not known which of its many components was responsible for the biological activity. This study describes the separation and analysis of the major components, one of which is a peptide fraction that stimulates wound healing. The fraction consists of a mixture of peptides from 6000 to 17,000 d. It causes angiogenesis in a chick embryo yolk sac membrane assay and in a rabbit cornea assay, and it dramatically stimulates wound healing in the "Schilling/Hunt" wire mesh cylinder model at concentrations 25-fold lower than those required for the intact live yeast cell derivative.


Metastasizing pleomorphic adenoma presenting as an asymptomatic kidney tumor twenty-nine years after parotidectomy - urological viewpoint and overview of the literature to date.
Pleomorphic adenomas (benign mixed tumors) are the most common tumors of glandular origin in the head and neck and are one of the few benign neoplasms that can undergo malignant transformation.(1) Mixed tumors that are seemingly benign at the microscopic level but metastasize have been termed metastasizing mixed tumors (MZMTs). The entity of metastasizing benign mixed tumors has been reported since the early 1940s, with up to approximately 50 cases described in the literature to date. Despite their bland morphologic appearance, MZMTs have been associated with an overall mortality rate of about 20-40%. We report the case of a MZMT of the kidney almost 30 years after lateral parotidectomy owing to the same tumor entity. For benign mixed tumors, we are unaware of more than two other cases of metastasis to the kidney that have been published, whereas metastases to the bone, lung, and lymph nodes are more common. Parotidectomy is widely accepted as the first choice of treatment,(13) but once metastases have occurred the therapeutic strategy is uncertain with surgery being the only curative option in cases with resectable disease. This case report provides information about the rare event of metastatic disease to the kidney and points out therapeutic strategies. However, in view of the general lack of adequate information in the literature, the best therapy for systemic disease still remains unresolved.


Prevalence and incidence of possible vascular dementia among Mexican older adults: Analysis of the Mexican Health and Aging Study.
Vascular dementia is the second most common cause of dementia. Physical disability and cognitive impairment due to stroke are conditions that considerably affect quality of life. We estimated the prevalence and incidence of possible vascular dementia (PVD) in older adults using data from the Mexican Health and Aging Study (MHAS 2012 and 2015 waves). The MHAS is a representative longitudinal cohort study of Mexican adults aged ≥50 years. Data from 14, 893 participants from the 2012 cohort and 14,154 from the 2015 cohort were analyzed to estimate the prevalence and incidence of PVD. Self-respondents with history of stroke were classified as PVD if scores in two or more cognitive domains in the Cross-Cultural Cognitive Examination were ≥ 1.5 standard deviations below the mean on reference norms and if limitations in ≥ 1 instrumental activities of daily living were present. For proxy respondents with history of stroke, we used a score ≥3.4 on the Informant Questionnaire on Cognitive Decline in the Elderly. Crude and standardized rates of prevalent and incident PVD were estimated. Prevalence of PVD was 0.6% (95% CI, 0.5-0.8) (0.5 with age and sex- standardization). Rates increased with age reaching 2.0% among those aged 80 and older and decreased with educational attainment. After 3.0 years of follow-up, 87 new cases of PVD represented an overall incident rate of 2.2 (95% CI, 1.7-2.6) per 1,000 person-years (2.0 with age and sex- standardization). Incidence also increased with advancing age reaching an overall rate of 9.4 (95% CI, 6.3-13.6) per 1,000 person-years for participants aged >80 years. Hypertension and depressive symptoms were strong predictors of incident PVD. These data provide new estimates of PVD prevalence and incidence in the Mexican population. We found that PVD incidence increased with age. Males aged 80 years or older showed a greater incidence rate when compared to females, which is comparable to previous estimates from other studies.


Evaluation of flow electromyography in patients with benign prostatic hyperplasia.
Combined uroflowmetry and external sphincter electromyography studies were done both preoperatively and postoperatively in patients with benign prostatic hyperplasia. In 56 patients preoperative electromyography during voiding showed silent or markedly suppressed activity in 41 patients (73.2%), while the remaining 15 patients (27.8%) revealed active electromyography. In the postoperative studies, 12 patients revealed active electromyography even after the release of obstruction. The urine flow rate following operation was not drastically improved in the active electromyography group compared to the silent electromyography group. We suppose that long-term urethral obstruction with prostatic adenoma could influence the function of relaxation of the external sphincter muscle in some patients with benign prostatic hyperplasia.


Angiogenesis by capillary endothelial cells in culture.
Capillary endothelial cells cloned from bovine and human tissues were grown in long-term culture. In the presence of tumor-conditioned medium, capillary tubes formed when the cells became confluent. Each tube began as a longitudinal vacuole in one cell and then appeared to be extruded and connected from one cell to the next. Branches appeared, and a capillary network developed over a period of 2 to 3 weeks. By light and electron microscopy, the tubes were nearly identical to capillaries in vivo. These experiments: (1) Demonstrate angiogenesis in vitro; (2) Show that all the information necessary to develop an entire capillary in vitro can be expressed by one cell type; (3) Suggest a mechanism for lumen formation by capillaries in vivo; (4) Offer a possibility of distinguishing between direct and indirect angiogenesis factors.


miR-184-5p inhibits cell proliferation, invasion and predicts prognosis of clear cell renal cell carcinoma by targeting NUS1 dehydrodolichyl diphosphate synthase subunit: Results from large-scale comprehensive identification and validation.
Clear cell renal cell carcinoma (ccRCC) has become a common malignant cancer with increasing incidence rate and high recurrence risk in genitourinary oncology around the world. Recently, miRNAs were identified to affect pathogenesis, development, molecular functions, and prognosis of ccRCC. In this study, microRNA-184-5p (miR-184-5p) was identified from three independent ccRCC cohorts and was determined as a significantly distinct prognostic biomarker. Relative miR-184-5p expression was found in A-498 and 786-O ccRCC cells compared with HK-2 cells. After ccRCC cells were transfected with miR-184-5p mimics or inhibitor, biological abilities of miR-184-5p in tumor cell proliferation, cycle, apoptosis and invasion were determined. Additionally, we confirmed the direct relationship between miR-184-5p and NUS1 dehydrodolichyl diphosphate synthase subunit (NUS1) by using the Luciferase reporter and rescue assays. These results indicated that the expression level of miR-184-5p in human ccRCC cells and tissues was reduced, and the up-regulation of miR-184-5p regulated A-498 and 786-O cell proliferation, invasion and apoptosis by directly targeting NUS1. These findings may provide new theoretical targets for treatment strategies and drug development of ccRCC.


A practical algorithmic approach to the diagnosis and management of solitary pulmonary nodules: part 1: radiologic characteristics and imaging modalities.
The solitary pulmonary nodule (SPN) is frequently encountered on chest imaging and poses an important diagnostic challenge to clinicians. The differential diagnosis is broad, ranging from benign granulomata and infectious processes to malignancy. Important concepts in the evaluation of SPNs include the definition, morphologic characteristics via appropriate imaging modalities, and the calculation of pretest probability of malignancy. Morphologic differentiation of SPN into solid or subsolid types is important in the choice of follow-up and further management. In this first part of a two-part series, we describe the morphologic characteristics and various imaging modalities available to further characterize SPN. In Part 2, we will describe the determination of pretest probability of malignancy and an algorithmic approach to the diagnosis of SPN.


Repeatability and contact stress gradient detection of sealed pressure-sensitive film when used in a physiological joint model.
Sealed pressure-sensitive film is frequently used to record contact characteristics in physiological joints. However, the effect on the pressure-recording characteristics of sealing the film when used in these circumstances has never been studied. This study compares the coefficient of variation, the standardized coefficient of variation, the tangent and secant contact stress gradients, and the actual pressures between unsealed and sealed Fuji film, in a simplified physiological joint model with a full-thickness surface defect. Unsealed film and sealed film were loaded through a range of nominal loads and the resulting stains were analysed by use of custom-made macros for the ImageJ image-processing program. The coefficient of variation did not exceed 5.7 per cent (sealed film), and the standardized coefficient of variation did not exceed 1.8 per cent (unsealed and sealed film). Contact stress gradients did not differ significantly. The recorded pressure at the level of surface defects was always about 0.2 MPa higher in the case of sealed film, and therefore predictable. It is concluded that sealing the film will not change the pressure-recording characteristics.


Disruptive or dangerous patients (sample policy and procedure).
This sample policy and procedure assumes there is a practice compliance officer and compliance committee. However, in some offices the manager or the physician will be the de facto "compliance officer". Therefore, it is assumed that duties and responsibilities in the sample policy will be assigned to meet the needs of the practice. This information is intended solely to provide risk management recommendations. It is not intended to constitute legal advice and should not be relied upon as a source for legal advice. If legal advice is desired or needed, an attorney should be consulted.


Medication-Related Osteonecrosis of the Jaws: A Comparison of SICMF-SIPMO and AAOMS Guidelines.
(1) Background: Medication-related osteonecrosis of the jaws (MRONJ) is an adverse drug reaction characterized by progressive bone disruption and necrosis in the mandibular and/or maxillary bones. It occurs in individuals who have received antiresorptive drugs without prior radiotherapy. Since its first reported cases in the USA in 2003, extensive literature has emerged worldwide, leading to significant advancements in understanding MRONJ's pathogenesis and management. (2) Results: This article aims to compare the current national recommendations provided by the Italian Society of Maxillofacial Surgery (SICMF)/Italian Society of Oral Pathology and Medicine (SIPMO) and the American Association of Oral and Maxillofacial Surgeons (AAOMS). (3) Conclusions: Historically, the AAOMS advocated for a more conservative approach compared to the Italian guidelines. However, in their 2022 update, the AAOMS adopted a different perspective based on reported evidence, highlighting the advantages of early surgical treatment. Despite resolving some initial controversies, differences still exist between the two sets of recommendations, particularly regarding diagnosis and staging.


Idiopathic and structural episodic nonintentional head tremor in dogs: 100 cases (2004-2022).
Although idiopathic episodic head tremor (IEHT) in dogs is well-known, little is known about structural brain lesions causing structural episodic head tremor (SEHT). Describe semiology, magnetic resonance imaging (MRI) findings and outcome of dogs with IEHT or SEHT. We hypothesized that structural lesions affecting the middle cranial fossa or mesencephalic aqueduct could lead to SEHT. One hundred dogs with IEHT (n = 71) or SEHT (n = 29). Retrospective, multicenter, study of dogs with episodic (nonintentional) head tremor and brain MRI between 2004 and 2022. Lesions on MRI in SEHT dogs were localized to the middle cranial fossa (15/29), cerebrocortex (3/29), brainstem (2/29), fourth ventricle (1/29) or multifocal (8/29) with thalamus involvement (6/8). Secondary compression of the mesencephalic aqueduct (19/29), third ventricle or interthalamic adhesion or both (14/29) was common. The most common underlying condition in dogs with SEHT was a pituitary mass. Dogs with SEHT were older, had additional neurological signs and were more likely to be euthanized after diagnosis (P < .001 for all) compared to IEHT dogs. Two SEHT dogs had only tremor. In IEHT dogs, 8/10 owners reported that the tremor decreased or abated over time (range, 106-2315 days) without treatment. Tremor remission occurred in SEHT dogs treated for underlying meningoencephalitis. Presence of additional neurological signs and older age may indicate an underlying structural cause for episodic (nonintentional) head tremor involving the mesencephalic aqueduct, third ventricle, interthalamic adhesion or some combination of these. An intracranial structural abnormality cannot be excluded in dogs with normal neurological examination.


Reports to OSHA of severe occupational injuries due to animals, 2015-2021.
Workers can be injured by animals such as mammals and insects. Previous studies found that most animal-related occupational fatalities were caused by horses and cattle. We analyzed characteristics of recent nonfatal severe animal-related injuries in US workers. The severe injury reports (SIR) database, collected by the Occupational Safety and Health Administration, contains employer self-reports of inpatient hospitalizations and amputations. We used 2015-2021 SIR data to assess properties of animal-related injuries, including the type of animal involved, the nature of the injury, and the industry of the employer. Industry-specific incidence rates were calculated. We identified 788 severe animal-related injuries during the 7-year study period. Mammals caused over half of these injuries (476; 60.4%), followed by insects, arachnids, and mites (183; 23.2%) and reptiles (127; 16.1%). Two-thirds (529; 67.1%) of animal-related injuries were traumatic, while 211 (28.0%) injuries were due to poisoning or allergic reaction. The highest observed incidence was in livestock merchant wholesalers (59.6 severe injuries per 100,000 workers per year); injuries in this industry were often due to cattle. Mail delivery and landscape architecture, two industries in which animal contact is atypical, were also among the 10 industries with the highest incidence. Workers in many industries experienced severe injuries due to animals. Among workers whose job involves animal contact, cattle workers appear to be at highest risk. Outdoor workers in some industries require protection from bites of dogs, snakes, and insects.


Alcohol consumption and the risk of colorectal cancer at low levels of micronutrient intake.
The purpose of our study was to assess the relationship between simultaneous exposure to alcohol and consumption of micronutrients that may have protective properties against colorectal cancer. This hospital-based case-control study of colorectal cancer was carried out between January 1998 and November 1999 in Cracow, Poland. A total of 180 cases of colorectal cancer confirmed by histopathology were recruited from the University Hospital in Cracow. An equal number of controls, individually matched by gender and age (+/- 5 years) were chosen from among patients from the same hospital with no history of cancer. An interviewer-administered food frequency questionnaire covering 148 food items, including the quantity consumed, was used to assess the typical dietary pattern. When the analysis was carried out on quartile intake data, a consistent inverse association was confirmed between the intake of retinol, thiamine or antioxidant micronutrients (carotene, vitamin C and E) and the occurrence of colorectal cancer. Alcohol intake appeared to be an important risk factor for this cancer site, and the risk increased with the amount of pure alcohol intake. The group with deficient intake of retinol, carotene, and vitamins C and E, but with higher consumption of alcohol, incur a noticeably high risk of colorectal cancer (OR=6.79; 95%CI: 2.08-22.18). The data support the hypothesis that higher consumption of alcohol, when combined with low micronutrient intake, may considerably increase the risk of colorectal cancer.


Pheophytin a inhibits inflammation via suppression of LPS-induced nitric oxide synthase-2, prostaglandin E2, and interleukin-1β of macrophages.
Inflammation is a serious health issue worldwide that induces many diseases such as sepsis. There has been a vast search for potentially effective drugs to decrease mortality from sepsis. Pheophytin a is a chlorophyll-related compound derived from green tea. We found that pre-treatment with pheophytin a suppressed lipopolysaccharide (LPS)-induced nitric oxide (NO), prostaglandin E2 (PGE2), and interleukin-1β in RAW 264.7 macrophages. NO synthase-2 (NOS2) and cyclooxygenase-2 (COX-2) expression levels were repressed by pre-treatment with pheophytin a at both the transcriptional and translational levels. Pheophytin a inhibited NOS2 promoter activity, but not its mRNA stability, through extracellular signal-regulated kinase (ERK1/2). This suppression was reversed by ERK1/2 inhibitor (U0126). Pheophytin a reduced signal transducers and activators of transcription 1 (STAT-1) activation, without an obvious influence on activator protein-1 (AP-1) and nuclear factor κB (NF-κB). These results suggest that pheophytin a functions by down-regulating the transcriptional levels of inflammatory mediators and blocking the ERK and STAT-1 pathways.


Emissions of air pollutants from indoor charcoal barbecue.
Ten types of commercial charcoal commonly used in Taiwan were investigated to study the potential health effects of air pollutants generated during charcoal combustion in barbecue restaurants. The charcoal samples were combusted in a tubular high-temperature furnace to simulate the high-temperature charcoal combustion in barbecue restaurants. The results indicated that traditional charcoal has higher heating value than green synthetic charcoal. The amount of PM10 and PM2.5 emitted during the smoldering stage increased when the burning temperature was raised. The EF for CO and CO2 fell within the range of 68-300 and 644-1225 g/kg, respectively. Among the charcoals, the lowest EF for PM2.5 and PM10 were found in Binchōtan (B1). Sawdust briquette charcoal (I1S) emitted the smallest amount of carbonyl compounds. Charcoal briquettes (C2S) emitted the largest amount of air pollutants during burning, with the EF for HC, PM2.5, PM10, formaldehyde, and acetaldehyde being the highest among the charcoals studied. The emission of PM2.5, PM10, formaldehyde, and acetaldehyde were 5-10 times those of the second highest charcoal. The results suggest that the adverse effects of the large amounts of air pollutants generated during indoor charcoal combustion on health and indoor air quality must not be ignored.


Tunable hydrogel viscoelasticity modulates human neural maturation.
Human-induced pluripotent stem cells (hiPSCs) have emerged as a promising in vitro model system for studying neurodevelopment. However, current models remain limited in their ability to incorporate tunable biomechanical signaling cues imparted by the extracellular matrix (ECM). The native brain ECM is viscoelastic and stress-relaxing, exhibiting a time-dependent response to an applied force. To recapitulate the remodelability of the neural ECM, we developed a family of protein-engineered hydrogels that exhibit tunable stress relaxation rates. hiPSC-derived neural progenitor cells (NPCs) encapsulated within these gels underwent relaxation rate-dependent maturation. Specifically, NPCs within hydrogels with faster stress relaxation rates extended longer, more complex neuritic projections, exhibited decreased metabolic activity, and expressed higher levels of genes associated with neural maturation. By inhibiting actin polymerization, we observed decreased neuritic projections and a concomitant decrease in neural maturation gene expression. Together, these results suggest that microenvironmental viscoelasticity is sufficient to bias human NPC maturation.


Structure and Dynamics in the ATG8 Family From Experimental to Computational Techniques.
Autophagy is a conserved and essential intracellular mechanism for the removal of damaged components. Since autophagy deregulation is linked to different kinds of pathologies, it is fundamental to gain knowledge on the fine molecular and structural details related to the core proteins of the autophagy machinery. Among these, the family of human ATG8 proteins plays a central role in recruiting other proteins to the different membrane structures involved in the autophagic pathway. Several experimental structures are available for the members of the ATG8 family alone or in complex with their different biological partners, including disordered regions of proteins containing a short linear motif called LC3 interacting motif. Recently, the first structural details of the interaction of ATG8 proteins with biological membranes came into light. The availability of structural data for human ATG8 proteins has been paving the way for studies on their structure-function-dynamic relationship using biomolecular simulations. Experimental and computational structural biology can help to address several outstanding questions on the mechanism of human ATG8 proteins, including their specificity toward different interactors, their association with membranes, the heterogeneity of their conformational ensemble, and their regulation by post-translational modifications. We here summarize the main results collected so far and discuss the future perspectives within the field and the knowledge gaps. Our review can serve as a roadmap for future structural and dynamics studies of the ATG8 family members in health and disease.


GENE FLOW AND INEFFECTIVE ANTIPREDATOR BEHAVIOR IN A STREAM-BREEDING SALAMANDER.
Predators often feed on prey that show ineffective antipredator behavior. Gene flow among populations may constrain evolution of effective antipredator ability in larvae of the streamside salamander, Ambystoma barbouri, a species that occupies distinctly different habitats with conflicting selection pressures. Some streams are ephemeral, where larvae should be active to feed and reach metamorphosis before stream drying. In contrast, other streams are more permanent and contain pools with predatory fish, where larvae should remain inactive to avoid fish predation. Feeding rates and predator escape behavior were assayed for laboratory-reared larvae from 15 populations. Larval survival was also compared among populations in artificial streams with natural predators. Five populations represented streams subjected to fish predation along a gradient of genetic and geographic isolation from populations without fish; the remaining 10 populations were ephemeral and without fish. Individuals from populations with fish had significantly stronger behavioral responses to fish (i.e., decreased feeding rate associated with the presence of fish and increased escape response) than individuals from fishless populations. Larvae from populations containing fish that were more isolated from fishless populations showed stronger antipredator responses than less isolated populations. Further, larvae from more isolated populations survived longer in the predation experiment, indicating that the behaviors measured were related with survival. These results suggest that gene flow between populations with conflicting selection pressures limits local adaptation in some salamander populations with fish. While previous studies have typically focused on the role of gene flow in pairs of populations, the results of this study suggest that gene flow is acting to swamp local adaptation across several populations.


An enigmatic new species of Panorpa Linneaus from the Bashan Mountains (Mecoptera, Panorpidae).
A new species of Panorpidae, Panorpabashanicolasp. n., is described and illustrated from the Bashan Mountains in central China. The new species is characterized by the following characters: vertex black, with two pale longitudinal stripes and four pale rounded spots; vein 1A ending before the origin of Rs; meso- and metanotum pale, and the pale color extending to tergum III in V-shape; male epandrium emarginate distally in deep U-shape; hypovalves without basal stalk, completely represented by a pair of short hypovalves, extending to distal third of gonocoxite, with five black stout setae in distal portion; paramere simple, S-shaped; a bundle of long hairs between dorsal and ventral valves of aedeagus; dorsal valves of aedeagus much longer than ventral valves and curved ventrally, with distal portion foot-shaped; female medigynium twice as long as wide, with stout axis extending over one-third its length beyond main plate.


[Roles of Platelet Toll-like Receptors in Thrombosis].
Platelets are non-nuclear blood cells that are widely involved in physiological and pathological processes.Their main role is to participate in hemostasis and thrombosis.Toll-like receptors(TLRs)are innate immune receptors.Platelets express multiple TLRs and can promote thrombosis by recognizing ligand-induced platelet activation and aggregation.This article reviews the relationship between platelets/TLR and thrombosis and the roles of TLRs in the development of thrombotic diseases.


Effect of lactobacilli on E. coli adhesion to Caco-2 cells in vitro.
Inhibitory effect of various lactobacilli against pathogenic strains of E. coli in model system Caco2 cells was determined by enumerating the number of adhering E. coli after pre-incubation (exclusion), post-incubation (displacement) or co-incubation (competition) with lactobacilli. Porcine E. coli strain F107 (F18ab, Stx2v) in the competition assay with porcine lactobacillus strain P10 gave bacterial counts 7.25 (log CFU per well); in the exclusion test it was only 7.05 while in displacement test it reached 7.29. The lowest E. coli counts adhering to Caco-2 cells were in exclusion assay (pre-incubation, Lactobacillus inoculated as the first). Pre-treatment of E. coli with our lactobacilli strains reduced the cultivable E. coli numbers.


Feasibility of short message service to document bleeding episodes in children with haemophilia.
The increasing emphasis on home-based treatment for the management of children with haemophilia has meant that many of these children no longer regularly report to a medical facility. Consequently, it is difficult to monitor incidence of bleeding episodes. The aim of this study was to assess the feasibility of using a short message service (SMS) to monitor incidence of bleeding episodes in children with haemophilia. One hundred and four children with moderate and severe haemophilia A or B took part in a 1-year prospective study between 2008 and 2010. Children or their parents were asked to maintain a bleeds diary. They received a weekly SMS asking whether there had been a bleeding episode in the preceding week. Response rates were calculated. Children were followed for a total of 4839 person-weeks. SMS replies were received for 4201 weeks. Thus, the rate of follow-up was 86.8%. Median responses rates were 94.2% (IQR: 86.1-100%). Weekly SMS is a feasible reporting tool for documenting bleeding episodes in children with haemophilia. It is associated with high response rates and minimal expense and intrusion. The use of SMS could be extended to encourage compliance to prophylactic treatment, particularly in adolescents with haemophilia.


Nesting Monte Carlo EM for high-dimensional item factor analysis.
The item factor analysis model for investigating multidimensional latent spaces has proved to be useful. Parameter estimation in this model requires computationally demanding high-dimensional integrations. While several approaches to approximate such integrations have been proposed, they suffer various computational difficulties. This paper proposes a Nesting Monte Carlo Expectation-Maximization (MCEM) algorithm for item factor analysis with binary data. Simulation studies and a real data example suggest that the Nesting MCEM approach can significantly improve computational efficiency while also enjoying the good properties of stable convergence and easy implementation.


Facial and jaw-elevator EMG activity in relation to changes in performance level during a sustained information processing task.
This study was undertaken as a further evaluation of spontaneous facial EMG activity as an index of mental effort. We investigated whether concordant alterations in task performance level and EMG amplitude existed during a sustained information processing task. The EMG of six different facial and jaw-elevator muscles was recorded in 21 subjects performing a 20 min externally paced visual two-choice serial reaction task and in 24 other subjects performing a self-paced version of this task. In both conditions, a post-hoc division was made between subjects with stable task performance parameters and subjects with a decline in performance throughout the task period. In all subject groups, there was a gradual increase in EMG activity of frontalis, corrugator, and orbicularis oris inferior muscles following task onset. As in earlier studies, this increase was interpreted as a sign of growing compensatory mental effort. In the subject groups with declining performance, however, the initial EMG increase passed into a decreasing trend towards the end of the task period whereas in the groups with stable performance, EMG increased uninterruptedly. These results were interpreted as further support for the hypothesis that EMG activity in particular facial muscles is related to the mobilization of aspecific energetic resources.


Validation of orthopaedic bench models for trauma surgery.
The aim of this study was to validate the use of three models of fracture fixation in the assessment of technical skills. We recruited 21 subjects (six experts, seven intermediates, and eight novices) to perform three procedures: application of a dynamic compression plate on a cadaver porcine model, insertion of an unreamed tibial intramedullary nail, and application of a forearm external fixator, both on synthetic bone models. The primary outcome measures were the Objective Structural Assessment of technical skills global rating scale on video recordings of the procedures which were scored by two independent expert observers, and the hand movements of the surgeons which were analysed using the Imperial College Surgical Assessment Device. The video scores were significantly different for the three groups in all three procedures (p < 0.05), with excellent inter-rater reliability (alpha = 0.88). The novice and intermediate groups specifically were significantly different in their performance with dynamic compression plate and intramedullary nails (p < 0.05). Movement analysis distinguished between the three groups in the dynamic compression plate model, but a ceiling effect was demonstrated in the intramedullary nail and external fixator procedures, where intermediates and experts performed to comparable standards (p > 0.6). A total of 85% (18 of 21) of the subjects found the dynamic compression model and 57% (12 of 21) found all the models acceptable tools of assessment. This study has validated a low-cost, high-fidelity porcine dynamic compression plate model using video rating scores for skills assessment and movement analysis. It has also demonstrated that Synbone models for the application of and intramedullary nail and an external fixator are less sensitive and should be improved for further assessment of surgical skills in trauma. The availability of valid objective tools of assessment of surgical skills allows further studies into improving methods of training.


O6-methylguanine in blood leucocyte DNA: an association with the geographic prevalence of gastric cancer and with low levels of serum pepsinogen A, a marker of severe chronic atrophic gastritis. The EUROGAST Study Group.
Using a competitive repair assay, 407 samples of peripheral blood leucocyte DNA from randomly selected subjects in 17 populations were tested for the presence of the adduct O6-methylguanine. With a limit of assay sensitivity of 0.05 fmol/micrograms DNA, the adduct was detected in 21 samples (5%). Sixteen positive samples came from 102 tested (16%) from two populations, in Japan and Portugal, with extremely high gastric cancer rates. This was significantly higher (P < 0.001) than the three positive samples out of 216 tested (1%) from populations with low or intermediate rates of gastric cancer. There was also an association between presence of the adduct and having a low (< 25 ng/ml) level of serum pepsinogen A, a marker of severe chronic atrophic gastritis. These results are consistent with the general involvement of methylating agents in the pathogenesis of gastric cancer and with the model proposing formation of such compounds by endogenous nitrosation in the hypochlorhydric stomach.


Neural basis of abnormal response to negative feedback in unmedicated mood disorders.
Depressed individuals show hypersensitivity to negative feedback during cognitive testing, which can precipitate subsequent errors and thereby impair a broad range of cognitive abilities. We studied the neural mechanisms underlying this feedback hypersensitivity using functional magnetic resonance imaging (fMRI) with a reversal learning task that required subjects to ignore misleading negative feedback on some trials. Thirteen depressed subjects with major depressive disorder (MDD), 12 depressed subjects with bipolar disorder (BD) and 15 healthy controls participated. The MDD group, but not the BD group, demonstrated enhanced sensitivity to negative feedback compared to controls, as indicated by the rates of rule reversal following misleading negative feedback. In the control and BD groups, hemodynamic activity was significantly higher in the dorsomedial and ventrolateral prefrontal cortices during reversal shifting, and significantly lower in the right amygdala in response to negative feedback. The extent to which the amygdala showed less activity during negative feedback correlated inversely with the behavioral tendency to reverse after misleading feedback. This effect was not present in the MDD group, who also failed to recruit the prefrontal cortex during behavioral reversal. Hypersensitivity to negative feedback is present in unmedicated depressed patients with MDD. Disrupted top-down control by the prefrontal cortex of the amygdala may underlie this abnormal response to negative feedback in unipolar depression.


Comparative study of static, dynamic, and proprioceptive neuromuscular facilitation stretching techniques on flexibility.
63 college women served as subjects in this 7-wk. study examining the effects of static, dynamic, and proprioceptive neuromuscular facilitating stretching techniques on the flexibility of the hamstring-gastrocnemius muscles. Subjects were assigned to one of the 3 treatment groups and received treatment 3 days a week. A pretest, a midtest (after 11 treatment days), and a posttest (after 21 treatment days) were administered. Analysis of group and test effects was accomplished by using a 3 X 3 factorial design with the group factor nested and the test factor crossed. Post hoc analysis indicated that all scores significantly improved from pretest to posttest. The findings indicated all 3 methods of flexibility training produced significant improvements when pretest and posttest mean scores were compared.


De Novo Intrahepatic Cholangiocarcinoma After Deceased Donor Liver Transplant in an Adult Patient.
Survival after liver transplant has progressively improved over recent decades. Recurrent or de novo malignancy, however, remains a major cause of patient death after transplant. Here, we have described a patient who developed de novo intrahepatic cholangiocarcinoma in the graft liver after orthotopic liver transplant. The 48-year-old male patient had end-stage liver disease from hepatitis B-related liver cirrhosis and a Model for End-Stage Liver Disease score of 26 and was listed for liver transplant. Recurrent esophageal variceal hemorrhage, severe ascites, and splenomegaly had complicated the liver disease. He underwent emergent whole organ, deceased donor liver transplant for liver cirrhosis. The donor liver was procured through the standard donation after brain death process from a 72-year-old man who died of intracranial hemorrhage. The graft weighted 1500 g and had normal color, and cold ischemia time was 5 hours upon arrival at our hospital. The patient's early postoperative course was uneventful. Two months posttransplant, the patient presented to the emergency department with fever, abdominal pain, and skin rash. Computed tomography revealed a focal biliary stricture in the right hepatic duct. Magnetic resonance cholangiopancreatography identified intrahepatic duct dilatations. Subsequent endoscopic retrograde cholangiography demonstrated marked intra- and extrahepatic biliary dilatation. We considered it to be a benign stricture and inserted plastic stents. He recovered from biliary stricture-related cholangitis. Approximately 10 months posttransplant, the patient was admitted with fever and skin rash. Marked dilatation of the intrahepatic bile duct was shown with a poorly enhancing tumor in the right lobe of the graft. Percutaneous transhepatic biliary drainage and tumor biopsy confirmed intrahepatic cholangiocarcinoma. We believe this to be the first case of de novo intrahepatic cholangiocarcinoma in a patient with hepatitis B-related end-stage liver disease after liver transplant without primary sclerosing cholangitis.


Sperm competition enhances functional capacity of mammalian spermatozoa.
When females mate promiscuously, sperm from rival males compete within the female reproductive tract to fertilize ova. Sperm competition is a powerful selective force that has shaped sexual behavior, sperm production, and sperm morphology. However, nothing is known about the influence of sperm competition on fertilization-related processes, because it has been assumed that sperm competition only involves a race to reach the site of fertilization. We compared four closely related rodent species with different levels of sperm competition to examine whether there are differences in the proportion of spermatozoa that become ready to interact with the ovum ("capacitated") and in the proportion of spermatozoa that experience the acrosome reaction in response to a natural stimulant. Our results show that differences between species in levels of sperm competition were associated with the proportion of spermatozoa that undergo capacitation and with the proportion of spermatozoa that respond to progesterone, an ovum-associated signal. Sperm competition thus favors a larger population of spermatozoa that are competent to fertilize, and spermatozoa that are more sensitive to the signals emitted by the ovum and that may penetrate the ova vestments more rapidly. These results suggest that, contrary to previous assumptions, competition between spermatozoa from rival males continues at the site of fertilization. These findings may have further evolutionary implications because the enhanced competitiveness of spermatozoa during fertilization may increase the risk of polyspermy to females. This could lead to antagonistic coevolution between the sexes and may contribute to the explanation of the rapid divergence observed in fertilization-related traits.


RamB is an activator of the pyruvate dehydrogenase complex subunit E1p gene in Corynebacterium glutamicum.
In Corynebacterium glutamicum, the transcriptional regulator RamB negatively controls the expression of genes involved in acetate metabolism. Here we show that during growth in media containing glucose and in complex medium without glucose RamB activates expression of the aceE gene, encoding the E1p subunit of the pyruvate dehydrogenase complex. Thus, RamB functions both as repressor and as activator in C. glutamicum.


Effects of lactulose and silymarin on liver enzymes in cirrhotic rats.
Silymarin, a mixture of antihepatotoxic flavonolignans used in the treatment of liver diseases, and lactulose, a nonabsorbable synthetic disaccharide, were investigated to analyze their probable synergic and healing effects in a hepatic cirrhotic rat model. Liver damage was induced by the administration and subsequent withdrawal of thioacetamide. The significant decrease in liver enzymes and malondialdehyde levels confirmed the curative effects of silymarin and lactulose. In the silymarin + lactulose group, liver enzyme and malondialdehyde levels were significantly reduced compared with those in the thioacetamide group. All treatments led to liver regeneration and triggered enhanced regeneration. Silymarin and lactulose alone or in combination have potent curative effects and reduce thioacetamide-induced liver damage.


Our experience in the treatment of fractures of the astragalus.
The authors evaluate the results of a series of cases treated by surgery for fractures of the astragalus at the IInd Orthopaedic Division of the University of Pisa between 1978 and 1998. Treatment consisted in reduction and stabilization of the fractures by percutaneous route or by anterolateral approach. Prognosis for fractures of the neck worsens as the Hawkins radiographic classification of degrees increases. Based on the Hawkins clinical evaluation form, excellent and good results were obtained in 56% of cases. Radiographic evaluation confirmed the effectiveness of the Hawkins sign for the prediction of necrosis of the body; this necrosis occurred in 37.5% of cases; arthrosis of the astragalus developed in about half of the patients, which was, however, not always associated with stiffness of this joint. A stiff astragalus was the most fastidious complication, after necrosis of the astragalar body.


[Free light chains reduction on acute kidney injury in multiple myeloma: critical role of high cut-off membranes].
We report our experience with five patients, with dialysis dependent AKI and multiple myeloma (MM). Two of them were already suffering from a mild degree of renal insufficiency, one was on follow-up for smouldering MM and two had a relapse of symptomatic MM. Median concentration of the involved FLC (iFLC) was 15104 mg/L (range 1196-24384). All patients underwent three times per week HCO-HD for 6 hour sessions using Theralite 2100 (median 10, range 6-13 sessions) with one having further twelve sessions of 4 hours using SUPRA device (Bellco). In addition, they followed a bortezomib and dexamethasone regimen according to a bi-weekly schedule (3-5 cycles) plus Thalidomide. iFLC concentrations were measured by immunonephelometry in blood at the beginning of each dialysis session. All patients but one, showed a very good partial hematological response. The only exception demonstrated a partial response. iFLCs decreased between 72,8% and 99,7% in a median period of three weeks. After 6 months three patients underwent autologous stem-cell transplantation (ASCT), one of whom repeated the procedure 6 months later. In conclusion, three patients became dialysis independent at the end of the HCO-HD period, one patient became dialysis independent three months later and one remained dialysis dependent. Recovery of renal function in 4 out of 5 patients with a very good hematological response is a consequence of an early and fast removal of the iFLC joined to an efficient therapeutic regimen.


Emotional closeness with perpetrators and amnesia for child sexual abuse.
Over the past decade, a contentious debate regarding delayed memories of childhood sexual abuse (CSA) has existed. In order to address this debate, 240 female participants completed questions about CSA, the Dissociative Experience Scale (Bernstein & Putnam, 1986), Perceived Emotional Closeness with Perpetrator Scale (Schultz, Passmore, & Yoder, 2000), and the Gudjonsson Suggestibility Scale 2 (GSS 2) (Gudjonsson, 1987). Eighty-two (36%) reported CSA and 37% of these indicated memory disturbances for the CSA. Participants reporting memory disturbances also reported significantly higher numbers of perpetrators, chemical abuse in their families, and closer relationships with the perpetrator(s) than participants reporting no memory disturbances. Implications for clinicians working with clients reporting CSA are discussed.


[Work-related musculoskeletal disorders: appropriateness of the requests of clinical consultation in occupational medicine departments].
The authors analyze the results of the clinical assessment of patients suffering from suspected work-related muscular-skeletal disorders (WMSDs), observed during the course of 2008 in the Department of Occupational Medicine of the Ospedali Riuniti hospital in Bergamo. The aim was to analyse the appropriateness of the requests of clinical consultation, comparing the cases sent by general practitioners and by occupational physicians. We assessed 149 patients (mean age 47 years, DS 9.4; mean work seniority 29.5 years, DS 10.2), investigating 218 disorders in different muscular-skeletal segments. The majority of patients (63.7%) for whom a clinical consultation was requested were sent by general practitioners, 32.9% by occupational physicians, 3.4% by the National Insurance Institute for Occupational Accidents and Diseases (INAIL). The assessment was made in two steps: first a clinical and instrumental definition of the disorders, prescribing the necessary medical investigations were the diagnosis was not already clear; secondly a definition of the aetiology, requesting documentation about working conditions when this was not clear from the medical history, experience and literature, or making an inspection. A majority of the patients (40.2%) were employed in the construction industry. Regarding symptoms, 54.4% of the subjects reported low back pain, 74.5% upper limb disorders (some of the patients reported several problems in different segments). The clinical diagnosis was already clear at the first consultation for 62.8% of all cases; for the other 37.2% it was necessary to prescribe some instrumental examinations or specialistic (neurologic, physiatric, orthopaedic) medical examinations. We concluded for a diagnosis of WMSDs in 99 (45.4%) of the 218 cases (50% of the assessments requested by occupational physicians, 45.3% of the assessments requested by general practitioners). The most frequent reason for rejecting an occupational aetiology was the lack of correlation between type of disease and occupational exposure, both for patients referred by occupational physicians (58.1%) and by general practitioners (51.8%). The results demonstrated that the appropriateness requests for clinical consultation was identical for general practitioners and occupational physicians. All physicians showed a high degree of attention for the upper limb disorders, which is a topical subject of great epidemiological interest. General practitioners and occupational physicians need to take more advantage of the diagnostic support and clinical evaluations offered by Occupational Medicine Departments and Universities for WMSDs.


Squamous cell carcinoma in the small intestine.
Primary carcinomas of small intestine are rare, and most are adenocarcinomas. Duodenum is the commonest site. Primary squamous cell carcinomas are exceptional. Small intestine, however, is the commonest site for metastatic spread in the gastrointestinal tract. Both adeno and squamous cell carcinoma from a wide variety of sites can metastasise to the small intestine. The authors report a case of a squamous cell carcinoma arising in the ileum of a 65-year-old woman.


Investigating the effects of Hydroalcoholic extract of jujube fruit (Zizyphus vulgaris L.) on second degree burn wound healing in Balb/c mice.
Background and Objective: Two thirds of all accidents and injuries leading to death all around the world occur in developing countries like Iran. One of these accidents is burn that can have unpleasant effects on the individual's body and soul. Skin wound healing is a process that happens as a result of coordination between tissues, cells, and different factors. The remaining inflammation and insufficient amount of vessel construction are among the most important causes of delayed wound healing. In recent years, jujube fruit (Zizyphus vulgaris L.) has been reported to have anti-inflammatory effects as a traditional therapeutic agent. Therefore, the present study was conducted in order to investigate the effects of jujube fruit extract on second-degree burn wound among Balb/c mice. Materials and Methods: The present empirical-interventional study included 48 Balb/c mice weighing approximately 30 +/- 3 gr. After burn wounds of 1.5 cm2 were created and second-degree burns was affirmed by a pathologist, the mice were divided into four control groups; one treated with Vaseline, one treated with silver sulfadiazine ointment, one treated with jujube fruit extract 1%, and a control group. Results: In treatment groups, 1 gr ointment containing hydroalcoholic extract of jujube fruit was utilized twice a day until complete recovery. Afterwards, the four groups were compared with regard to the wound area and histopathology. The collected data were analyzed through one-way ANOVA and Tukey tests by using SPSS software. Conclusion: There was a significant difference between the intervention group and the Vaseline and control groups with regard to the percentage of wound recovery (P smaller than 0.05). The results of the study indicated that the jujube fruit extract could accelerate burn wound healing among Balb/c mice. It is recommended that further research is conducted on the effects of different doses of this medicine on laboratory animals and then on humans.


Interferon induced in human leukocytes by mitogens: production, partial purification and characterization.
Interferon was induced in leukocyte suspensions from human buffy coats by exposure to phytohemagglutinin P, concanavalin A (Con A) and staphylococcal enterotoxin A, under a variety of cell culture conditions. Con A was found to rapidly (within 12 h) induce high yields of antiviral activity (1.5 units/1000 cells). Lesser yields were obtained with the other two mitogens studied. The interferon was partially purified to a spec. act. around 10(5.3) units/mg protein, by batch adsorption on controlled-pore glass (CPG) beads and desorption by ethylene glycol. This material was characterized as containing mainly gamma-type interferon. Specifically on gel filtration, a fraction of 45000 daltons was obtained which could account for virtually all antiviral activity present in the starting material. Furthermore, the ethylene glycol-eluted antiviral activity was acid-labile, serologically distinct from alpha and beta-type interferon and strictly species-specific (no activity detectable on any of the available cell species sensitive to alpha and beta-type interferon). The crude culture supernatant also contained some antiviral activity which resembled beta-type interferon in that it adsorbed to CPG, could be desorbed by pH 2 buffer, was acid-resistant and could be neutralized by a specific anti-fibroblast interferon antiserum. The CPG/ethylene glycol-purified gamma-type interefron preparation was found to inhibit the growth of certain lymphoblastoid cells (Daudi and Molt-4). It also potentiated natural killer activity of fresh donor lymphocytes. In both respects, the gamma-type interferon preparation was not significantly more active than preparations of alpha and beta-interferon of similar antiviral potency.


[Organization of the quality control service for the forensic medical expert activity at the Saint-Petersburg state budgetary healthcare facility 'Bureau of Forensic Medical Expertise'].
The Saint-Petersburg Bureau of Forensic Medical Expertise has created the universal system of the internal quality control oriented toward the more rational exploitation of the available resources, material and technical facilities, and systemic management of the quality of forensic medical activities. The system serves as a basis for the timely identification of undesirable problematic situations, efficiently predict and/or prevent them and the resulting deterioration of the quality of expert work leading to the inadequate provision of finance and resources. Moreover, the system makes it possible to optimize and correct the operational management of the Bureau activities and develop programs for successful carrying them out in the future. The results of the evaluation of all forms of control are used to work out the modern technologies for the management of forensic medical expertise activities together with the final concluding reports and analytical reviews of the positive experience and of the typical imperfections in forensic medical expertise operations are distributed among the structural departments of the Bureau. These materials are used as a basis for the development of the measures and recommendations for the improvement of forensic medical expert activities of the Bureau, compilation of analytical reviews, specification of the criteria for the effectiveness of the forensic medical expertise, improvement of the procedures for the specialist screening studies (in conformity with the internal standards adopted by the Bureau), the subject matter and the schedule of advanced expert training, contents and procedures of instructions, the systems of delegation of authorities and empowerment with responsibilities, provision of economic incentives for the staff members, etc.


Power and vested interests--tacit influences on the construction of nursing curricula?
Educational reform and the introduction of Project 2000 has presented an opportunity to construct broader curricula with the intention of educating adaptive, critical practitioners who are able to deliver holistic patient care. Evidence within nursing literature, and from a small-scale descriptive research study (N = 38), suggests that there is a lack of consensus about how knowledge from various cognate disciplines should be emphasised and structured within nursing curricula. Findings from the research study suggest that the emphasis placed on different cognate disciplines within nursing curricula may reflect individuals' vested interests and power. A conceptual framework based upon the sociology of knowledge, and conflicts and tensions between groups within a profession, is presented as a construct which lends support to this suggestion. It is hoped that this paper will stimulate reflection and critical debate about how knowledge from a variety of cognate disciplines is selected and emphasised in the construction of nursing curricula.


Innominate Vein Turn-down Procedure for Failing Fontan Circulation.
After the Fontan, systemic venous hypertension induces pathophysiologic changes in the lymphatic system that can result in complications of pleural effusion, ascites, plastic bronchitis, and protein losing enteropathy. Advances in medical therapy and novel interventional approaches have not substantially improved the poor prognosis of these complications. A more physiological approach has been developed by decompression of the thoracic duct to the lower pressure common atrium with a concomitant increase of preload. Diverting the innominate vein to the common atrium increases the transport capacity of the thoracic duct, which in most patients enters the circulation at the left subclavian-jugular vein junction. Contrary to the fenestrated Fontan circulation, in which the thoracic duct is drained into the high pressure Fontan circulation, turn down of the innominate vein to the common atrium effectively decompresses the thoracic duct to the lower pressure system with "diastolic suctioning" of lymph. Innominate vein turn-down may be considered for medical-refractory post-Fontan lymphatic complications of persistent chylothorax, plastic bronchitis, and protein losing enteropathy. Prophylactic innominate vein turn-down may also be considered at time of the Fontan operation for patients that are higher risk for lymphatic complications.


Laying open (deroofing) and curettage under local anesthesia for pilonidal disease: An outpatient procedure.
To test the efficacy of lay open (deroofing, not excision) with curettage under local anesthesia (LOCULA) for pilonidal sinus as an outpatient procedure. LOCULA procedure was done for all types of pilonidal disease. The primary outcome measure was cure rate. The secondary outcome measures were hospital stay, operating time, return to work, healing time and complication rate. Thirty-three (M/F-30/3, mean age-23.4 ± 5.8 years) consecutive patients were operated and followed for 24 mo (6-46 mo). Eleven were pilonidal abscess and 22 were chronic pilonidal disease. Six had recurrent disease. Operating time and the hospital stay was 22.3 ± 5.6 min and 63.8 ± 22.3 min respectively. The patients could resume normal work in 4.3 ± 3.2 d and the healing time was 42.9 ± 8.1 d. Thirty (93.8%) patients had complete resolution of the disease and two (6.2%) had a recurrence. Both the recurrences happened in patients who had complete healing but ignored the prescribed recommendations. One out of these got cured after getting operated again with the same procedure. Thus the overall success rate of this procedure was 96.9%. Lay open (deroofing) with curettage procedure under local anesthesia is an effective procedure to treat both simple and complicated pilonidal sinus and abscess. It is a simple procedure, has a high cure rate (up to 97%), doesn't require admission and is associated with minimal morbidity and scarring. Considering the distinct advantages, this procedure has the potential to become the first line procedure for treating pilonidal disease.


[Prostate-specific antigen. A new biological serum marker for prostatic adenocarcinoma].
Prostate-specific antigen (PSA) was measured by polyclonal radioimmunoassay in 45 untreated patients with prostatic cancer and 14 patients with benign prostatic hyperplasia. Prostatic acid phosphatase (PAP) was determined in 35 patients with prostatic cancer and 14 patients with benign hyperplasia. Serum PSA was raised in 42 patients with cancer of the prostate, but only 14 of 35 patients showed increased serum levels of PAP. Half the patients with benign prostate hyperplasia had PSA greater than 4 micrograms/l and one third had PSA greater than 10 micrograms/l. PAP was slightly elevated in two patients with benign prostatic hyperplasia. Serum PSA increased with the clinical stage of prostatic cancer. However, preoperative levels of PSA were not sufficiently reliable to predict the final pathological stage for each individual patient. After radical prostatectomy for cancer confined to the prostate, serum PSA fell to an undetectable level.


Integrating social and cognitive aspects of belief dynamics: towards a unifying framework.
Belief change and spread have been studied in many disciplines-from psychology, sociology, economics and philosophy, to biology, computer science and statistical physics-but we still do not have a firm grasp on why some beliefs change more easily and spread faster than others. To fully capture the complex social-cognitive system that gives rise to belief dynamics, we first review insights about structural components and processes of belief dynamics studied within different disciplines. We then outline a unifying quantitative framework that enables theoretical and empirical comparisons of different belief dynamic models. This framework uses a statistical physics formalism, grounded in cognitive and social theory, as well as empirical observations. We show how this framework can be used to integrate extant knowledge and develop a more comprehensive understanding of belief dynamics.


Synergistic enhancement of glucagon-like peptide-1 release by γ-aminobutyric acid and L-phenylalanine in enteroendocrine cells-searching active ingredients in a water extract of corn zein protein.
This study investigated the glucagon-like peptide-1 (GLP-1)-releasing activity of an aqueous extract (ZeinS) from corn zein protein and aimed to identify the active compounds responsible for this activity. Glucagon-like peptide-1-releasing activity was evaluated using a murine enteroendocrine cell line (GLUTag). Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was performed on purified fractions of ZeinS to identify active molecules. ZeinS stimulated more GLP-1 secretion from GLUTag cells compared to zein hydrolysate. Fractions displaying biological activity were determined by solid-phase extraction and high-performance liquid chromatography (HPLC) fractionation. Subsequent LC-MS/MS analysis identified several amino acids in the active fractions of ZeinS. In particular, γ-aminobutyric acid (GABA) exhibited significant GLP-1-releasing activity both alone and synergistically with L-phenylalanine (Phe). Moreover, ZeinS-induced GLP-1 secretion was attenuated by antagonists for the GABA receptor and calcium sensing receptor. These results demonstrate that GABA and Phe identified in ZeinS synergistically stimulate GLP-1 secretion in enteroendocrine cells.


Lateralized exanthem mimicking figurate inflammatory dermatosis of infancy after methimazole therapy.
We reported a case of an 11-year-old girl admitted to our hospital for goiter, tachycardia, sweating, and visible and palpable thyroid. Thyroid function tests revealed a low thyrotropin level (<0.004 mIU/L) and elevated free thyroxine level (3.4 ng/ dL) diagnosed with Graves' disease and treated with methimazole. This anti-thyroid drug is recommended as first-line treatment in children with Graves' disease because it produces minor adverse effects with respect to propylthiouracil. She developed a lateralized exanthem mimicking figurate inflammatory dermatosis of infancy after methimazole therapy. The symptoms resolved after discontinuation of methimazole and treatment with an antihistamine and a corticosteroid. Furthermore, the treatment was changed to propylthiouracil without any adverse effects. According to current literature this is the first case of cutaneous figurate erythema related to methimazole, different from other well-known reactions such as skin eruption or urticaria.


Quantum nature of the proton in water-hydroxyl overlayers on metal surfaces.
Using ab initio path-integral molecular dynamics, we show that water-hydroxyl overlayers on transition metal surfaces exhibit surprisingly pronounced quantum nuclear effects. The metal substrates serve to reduce the classical proton transfer barriers within the overlayers and, in analogy to ice under high pressure, to shorten the corresponding intermolecular hydrogen bonds. Depending on the substrate and the intermolecular separations it imposes, the traditional distinction between covalent and hydrogen bonds is lost partially [e.g., on Pt(111) and Ru(0001)] or almost entirely [e.g., on Ni(111)]. We suggest that these systems provide an excellent platform on which to systematically explore the magnitude of quantum nuclear effects in hydrogen bonds.


In two minds: executive functioning versus theory of mind in behavioural variant frontotemporal dementia.
The relationship of executive function (EF) and theory of mind (ToM) deficits in neurodegeneration is still debated. There is contradicting evidence as to whether these cognitive processes are overlapping or distinct, which has clear clinical relevance for the evaluation of their associated clinical symptoms. To investigate the relationship of EF and ToM deficits via a data-driven approach in a large sample of patients with behavioural variant frontotemporal dementia (bvFTD). Data of 46 patients with bvFTD were employed in a hierarchical cluster analysis to determine the similarity of variance between different EF measures (verbal abstraction, verbal initiation, motor programming, sensitivity to interference, inhibitory control, visual abstraction, flexibility, working memory/attention) and ToM (faux pas). Overall results showed that EF measures were clustered separately from the ToM measure. A post hoc analysis revealed a more complex picture where selected ToM subcomponents (empathy; intention) showed a relationship to specific EF measures (verbal abstraction; working memory/attention), whereas the remaining EF and ToM subcomponents were separate. Taken together, these findings suggest that EF and ToM are distinct components; however, ToM empathy and intention subcomponents might share some functions with specific EF processes. This has important implications for guiding diagnostic assessment of these deficits in clinical conditions.


Self-Assembled Three-Dimensional Bi2Te3 Nanowire-PEDOT:PSS Hybrid Nanofilm Network for Ubiquitous Thermoelectrics.
Thermoelectric generation capable of delivering reliable performance in the low-temperature range (<150 °C) for large-scale deployment has been a challenge mainly due to limited properties of thermoelectric materials. However, realizing interdependence of topological insulators and thermoelectricity, a new research dimension on tailoring and using the topological-insulator boundary states for thermoelectric enhancement has emerged. Here, we demonstrate a promising hybrid nanowire of topological bismuth telluride (Bi2Te3) within the conductive poly(3,4-ethylenedioxythiophene):polystyrenesulfonate (PEDOT:PSS) matrix using the in situ one-pot synthesis to be incorporated into a three-dimensional network of self-assembled hybrid thermoelectric nanofilms for the scalable thermoelectric application. Significantly, the nanowire-incorporated film network exhibits simultaneous increase in electrical conductivity and Seebeck coefficient as opposed to reduced thermal conductivity, improving thermoelectric performance. Based on comprehensive measurements for electronic transport of individual nanowires revealing an interfacial conduction path along the Bi2Te3 core inside the encapsulating layer and that the hybrid nanowire is n-type semiconducting, the enhanced thermoelectricity is ascribed to increased hole mobility due to electron transfer from Bi2Te3 to PEDOT:PSS and importantly charge transport via the Bi2Te3-PEDOT:PSS interface. Scaling up the nanostructured material to construct a thermoelectric generator having the generic pipeline-insulator geometry, the device exhibits a power factor and a figure of merit of 7.45 μW m-1 K-2 and 0.048, respectively, with an unprecedented output power of 130 μW and 15 day operational stability at Δ T = 60 °C. Our findings not only encourage a new approach to cost-effective thermoelectric generation, but they could also provide a route for the enhancement of other applications based on the topological nanowire.


Fetal Congenital Peripheral Bronchial Atresia Diagnosed by Magnetic Resonance Imaging: Two Case Reports.
Two types of congenital bronchial atresia (proximal and peripheral) have been classified. We report two cases of peripheral bronchial atresia diagnosed by prenatal ultrasonography (US) and magnetic resonance imaging (MRI). Evaluating an enlarged lung mass that is homogeneously hyperechoic on US and hyperintense on T2-weighted MRI can help in determining whether bronchial atresia is present. Proximal type is suggested when a dilated main bronchus is observed as a tubule structure of an involved lung hilum. In our cases, T2-weighted MRI revealed homogeneously hyperintense lung lesion with decreased signal intensity of adjacent lobe, flattening diaphragm, and mediastinal shift. Dilatation of the main bronchus was not observed and the opposite lung was normal in appearance. These findings were explained by secondary compression due to enlargement of the involved lung. The preservation of vascular structure and the retained normal shape, though enlarged, in the affected lobe were observed, which demonstrated undisrupted pulmonary architecture of the lobe. Thus, congenital cystic adenomatoid malformation was excluded because pulmonary architecture was relatively preserved. Finally, presumed diagnoses of the peripheral bronchial atresia were made and confirmed by postnatal chest computed tomography.


Multimodality Assessment of Cystic Renal Masses.
Renal cysts are a common imaging finding, often incidental. Ultrasound, CT and MRI are the main modalities responsible for renal cyst detection and characterization. These modalities often play a complementary role in modern radiological practice, each of them with strengths and limitations. In view of a recently proposed 'multimodality' update to the historical Bosniak classification, this article provides a general overview of the current imaging approach to renal cysts, and outlines some of the diverse pathologic entities responsible for renal cyst formation.


Follicle-stimulating hormone promotes renal tubulointerstitial fibrosis in aging women via the AKT/GSK-3β/β-catenin pathway.
Estrogen withdrawal in aging women contributes to the progression of chronic kidney disease (CKD). However, the effect of high circulating follicle-stimulating hormone (FSH) levels on renal dysfunction remains unknown. In this study, blood samples from 3,055 postmenopausal women were collected and tested, which showed that there was a strong negative correlation between eGFR and FSH levels (p < 0.001), independent of LH, testosterone, and estradiol. Functional FSHR was detected in renal tubular epithelial cells. In vivo, high circulating FSH levels promoted a phenotype of tubulointerstitial fibrosis, characterized by increases in 24-hr urine protein/creatinine ratio, serum Cr, serum BUN, and ECM deposition. Similar results obtained from cultured HK-2 cells showed that FSH increased the transcriptional and protein expression of profibrotic mediators (collagen IV, fibronectin, and PAI-1). This promotion of fibrosis by FSH occurred through the activation of AKT/GSK-3β/β-catenin pathway, which could be attenuated by silencing FSHR by siRNA or by LY294002 or MK2206. In addition, FSH-stimulated HK-2 cells secreted IL-8, which promoted macrophage migration to exacerbate tubulointerstitial fibrosis. These results revealed a previously unknown effect of FSH on kidney injury, which may offer a critical insight into the development of CKD in aging postmenopausal women.


Local treatment of chronic osteomyelitis with surgical debridement and tigecycline-impregnated calcium hydroxyapatite: an experimental study.
The aim of this study was to determine the efficacy of tigecycline-impregnated hydroxyapatite in the local treatment of chronic osteomyelitis experimentally induced in rat tibias with methicillin-resistant Staphylococcus aureus. Monocortical defects were established in the left tibias of 32 adult Wistar albino rats. Five rats were randomly selected and injected intramedullarly with saline solution (group 1), whereas chronic osteomyelitis was induced in other rats by intramedullary injection of S. aureus. Infected rats were then randomized and divided into 4 groups: group 2, no further treatment; group 3, debridement only; group 4, debridement followed by implantation of calcium hydroxyapatite; and group 5, debridement followed by implantation of tigecycline-impregnated calcium hydroxyapatite. On day 21 after induction, all rats in groups 2-5 showed signs of osteomyelitis. Rats in groups 1 and 2 were killed on day 21 after induction, whereas rats in groups 3, 4, and 5 underwent debridement surgery on day 21 after induction and were killed 21 days after debridement surgery. Tibias were analyzed histopathologically and cultured for S. aureus. Compared with group 2, histopathologic disease severity scores in groups 3, 4, and 5 were 37%, 44%, and 83% lower, respectively. Nontreated infected rats had the highest bacteria count (mean 5 × 10(5) colony-forming units/g bone), and bacterial count was 26%, 29%, and 79% lower in groups 3, 4, and 5, respectively, compared with group 2. Tigecycline-impregnated hydroxyapatite can have a potential in the treatment of chronic osteomyelitis of methicillin-resistant S. aureus origin, which may be considered as a therapeutic alternative by surgeons dealing with osteomyelitis.


Effects of cholestatic agents on the structure and function of bile canaliculi in neonatal rat hepatocytes in primary culture.
The effects of cytochalasin B and colchicine on the structure and function of bile canaliculi were studied in neonatal rat hepatocytes in primary culture. Cellular contacts of neonatal hepatocytes were not as tight as those of adult hepatocytes. There was no remarkable difference in the ultrastructure of bile canaliculi between neonatal and adult hepatocytes. Neonatal hepatocytes treated with cytochalasin B were round in shape and aggregated in groups of several cells. Actin filaments stained by rhodamine-phalloidin were disrupted and condensed at the cell periphery or around dilated bile canaliculi. Markedly-dilated bile canaliculi with less microvilli were observed by transmission electron microscopy while the secretory function of horseradish peroxidase, which was used as a marker for uptake, transport and secretion into bile canaliculi, were maintained. The lumen of dilated bile canaliculi was found close to the undersurfaces of hepatocytes by scanning electron microscopy after turning over the cultured cells. By colchicine treatment, the filamentous structure of microtubules in neonatal hepatocytes disappeared. The ultrastructure of the bile canaliculi was not affected by the treatment, but transport and secretion of horseradish peroxidase into bile canaliculi were inhibited. The development of strict cellular polarity in neonatal hepatocytes may be suppressed in neonatal hepatocytes; however, cholestatic agents which rearrange the cytoskeleton caused the same morphological or functional changes of bile canaliculi as in adult hepatocytes.


Plumbagin Ameliorates Collagen-Induced Arthritis by Regulating Treg/Th17 Cell Imbalances and Suppressing Osteoclastogenesis.
Objective: Plumbago zeylanica L. (with plumbagin as its active ingredients) has been used for centuries to treat conditions such as joint swelling, fractures, and bacterial infections, suggesting that it possesses anti-inflammatory and immunosuppressive properties. In the present study, we evaluated the potential anti-arthritic activity and related mechanisms of plumbagin. Methods: Collagen-induced arthritis (CIA) was initiated in Wistar rats with collagen type II. Plumbagin (2 and 6 mg/kg) was orally administered to rats with CIA from day 12 to day 32 post immunization. The effects of plumbagin on arthritis progression were assessed by paw swelling, clinical scoring, and histologic analysis. The percentage of Treg and Th17 were defined by flow cytometry or immunofluorescence (IF) staining. Bone erosion and resorption were assessed by micro-CT and histomorphometric analysis. Osteoclast differentiation was further determined by in vitro osteoclastogenesis assay. The molecular docking assay was used to determine the potential binding site of plumbagin. Results: Treatment with plumbagin significantly inhibited arthritis development, as well as suppressed the local and systemic inflammation. Plumbagin reciprocally regulated pro-inflammatory Th17 cell and immunosuppressive Treg cell populations. In addition, plumbagin protected inflammation-induced bone loss by inhibiting osteoclast formation and activity. Plumbagin markedly suppressed RANKL-stimulated osteoclast-specific gene expression by repressing NF-κB signaling activation and MAP kinase phosphorylation. Further study via molecular docking assay demonstrated that plumbagin bound to MET169 of JNK kinase and LYS138 and SER183 of p38 kinase. Conclusion: Plumbagin not only attenuates the immune-induced arthritis by inhibiting inflammation, but also protects bone erosion by directly inhibiting osteoclast formation and activity. These data suggest plumbagin is a promising new candidate drug for treating inflammatory joint diseases.


[An assessment of the role of the Social Insurance Institution in the occupational activation of people with health problems, conducted by issuing decisions on the appropriateness of vocational retraining].
The new training allowance policy has been put in the Social Insurance Institution to bring back to employment workers with health problems unfit for their previous occupation. These people, following specific vocational training, may acquire new skills and competencies to stay on the labor market. The aim of this study was to assess the role of the Social Insurance Institution in the activation of persons with health problems, which was carried out by issuing opinions about the appropriateness of vocational retraining. The analysis included 460 cases in which decisions on the appropriateness of vocational retraining, due to the inability to work in the current profession, were issued in 2009. It was found that 40.9% of the analyzed cases were not in accordance with the principles of adjudicating on the incapacity for work and applicable law. The majority of the study group (72.4%) were people with basic vocational education. No significant changes were found as regards gender, age and the place of residence between the retrained (N = 89) and not retrained subjects (N = 252). In the retrained group including 89 persons, 13 subjects started to collect pension again within 6 months; and 1 person collected pension while working. In addition, 51 (57.3%) retrained subjects were unemployed. After 12 months, the number of unemployed subjects decreased to 31. The effectiveness of the training allowance as a tool for the activation of people with health problems, expressed as the number of retrained people who returned to the labor market, is low. More than 80% of the people fail to get retrained and some of them again submit pension applications. A large number of incorrect vocational retraining opinions, as well as the lack of cooperation between institutions conducting retraining (the Social Insurance Institution and labor offices) resulted in a limited effectiveness of the training allowance. In order to enhance the effectiveness of the training allowance, it is necessary to carry out organizational and legislative changes, with particular emphasis on expanding the knowledge of medical examiners representing the Social Insurance Institution and occupational health physicians, as well as to improve cooperation between all institutions involved in the occupational activation of people with health problems. Med Pr. 2020;71(3):309-23.


[Malignant peritoneal mesothelioma is a rare disease].
Malignant peritoneal mesothelioma is characterized by diffuse symptoms such as bloating, abdominal pain, weight loss, anorexia, fever, diarrhoea, vomiting and ascites. The findings by radiographic imaging are unspecific and the diagnosis is therefore often first achieved by biopsy from the affected area. Although treatment with chemotherapy and cytoreductive surgery has improved the survival prognosis for the patients is poor with a median survival of 38 month.


Opinion: Making Inactivated and Subunit-Based Vaccines Work.
Empirically derived vaccines have in the past relied on the isolation and growth of disease-causing microorganisms that are then inactivated or attenuated before being administered. This is often done without prior knowledge of the mechanisms involved in conferring protective immunity. Recent advances in scientific technologies and in our knowledge of how protective immune responses are induced enable us to rationally design novel and safer vaccination strategies. Such advances have accelerated the development of inactivated whole-organism- and subunit-based vaccines. In this review, we discuss ideal attributes and criteria that need to be considered for the development of vaccines and some existing vaccine platforms. We focus on inactivated vaccines against influenza virus and ways by which vaccine efficacy can be improved with the use of adjuvants and Toll-like receptor-2 signaling.


Clinical Outcomes of Image Guided Adaptive Hypofractionated Weekly Radiation Therapy for Bladder Cancer in Patients Unsuitable for Radical Treatment.
We report on the clinical outcomes of a phase 2 study assessing image guided hypofractionated weekly radiation therapy in bladder cancer patients unsuitable for radical treatment. Fifty-five patients with T2-T4aNx-2M0-1 bladder cancer not suitable for cystectomy or daily radiation therapy treatment were recruited. A "plan of the day" radiation therapy approach was used, treating the whole (empty) bladder to 36 Gy in 6 weekly fractions. Acute toxicity was assessed weekly during radiation therapy, at 6 and 12 weeks using the Common Terminology Criteria for Adverse Events version 3.0. Late toxicity was assessed at 6 months and 12 months using Radiation Therapy Oncology Group grading. Cystoscopy was used to assess local control at 3 months. Cumulative incidence function was used to determine local progression at 1 at 2 years. Death without local progression was treated as a competing risk. Overall survival was estimated using the Kaplan-Meier method. Median age was 86 years (range, 68-97 years). Eighty-seven percent of patients completed their prescribed course of radiation therapy. Genitourinary and gastrointestinal grade 3 acute toxicity was seen in 18% (10/55) and 4% (2/55) of patients, respectively. No grade 4 genitourinary or gastrointestinal toxicity was seen. Grade ≥3 late toxicity (any) at 6 and 12 months was seen in 6.5% (2/31) and 4.3% (1/23) of patients, respectively. Local control after radiation therapy was 92% of assessed patients (60% total population). Cumulative incidence of local progression at 1 year and 2 years for all patients was 7% (95% confidence interval [CI] 2%-17%) and 17% (95% CI 8%-29%), respectively. Overall survival at 1 year was 63% (95% CI 48%-74%). Hypofractionated radiation therapy delivered weekly with a plan of the day approach offers good local control with acceptable toxicity in a patient population not suitable for radical bladder treatment.


Physical validation of a Monte Carlo-based, phantom-derived approach to computed tomography organ dosimetry under tube current modulation.
To physically validate the accuracy of a Monte Carlo-based, phantom-derived methodology for computed tomography (CT) dosimetry that utilizes organ doses from precomputed axial scans and that accounts for tube current modulation (TCM). The output of a Toshiba Aquilion ONE CT scanner was modeled, based on physical measurement, in the Monte Carlo radiation transport code MCNPX (v2.70). CT examinations were taken of two anthropomorphic phantoms representing pediatric and adult patients (15-yr-old female and adult male) at various energies, in which physical organ dose measurements were made using optically stimulated luminescence dosimeters (OSLDs). These exams (chest-abdomen-pelvis) were modeled using organ dose data obtained from the computationally equivalent phantom of each anthropomorphic phantom. TCM was accounted for by weighting all organ dose contributions by both the relative attenuation of the phantom and the image-derived mA value (from the DICOM header) at the same z-extent (cranial-caudal direction) of the axial dose data. The root mean squares of percent difference in organ dose when comparing the physical organ dose measurements to the computational estimates were 21.2, 12.1, and 15.1% for the uniform (no attenuation weighting), weighted (computationally derived), and image-based methodologies, respectively. Overall, these data suggest that the Monte Carlo-based dosimetry presented in this work is viable for CT dosimetry. Additionally, for CT exams with TCM, local attenuation weighting of organ dose contributions from precomputed axial dosimetry libraries increases organ dose accuracy.


Retrospective review of the medical records of cardiology hospital outpatient clinics with the aim of determining the therapeutic approach to patients suffering from high blood pressure and/or dyslipidemia.
"Retrospective Review of the Medical Records of Cardiology Hospital Outpatient Clinics with the Aim of Determining the Therapeutic Approach to Patients Suffering from High Blood Pressure and/or Dyslipidemia" is a pilot study conducted by the Epidemiology and Cardiovascular Prevention Working Group of the Portuguese Society of Cardiology, based on the idea that all patients suffering from high blood pressure and/or dyslipidemia should be treated according to the guidelines for the treatment of these pathologies. The main aim was to obtain data on the therapeutic approaches to patients observed in cardiology hospital outpatient clinics with high blood pressure and/or dyslipidemia as well as other concomitant diseases, in order to plan future wider-ranging studies and to analyze the main risk factors of cardiovascular conditions in this population. Patients of both sexes aged 35 years or over were included, diagnosed at least one year previously with high blood pressure and/or dyslipidemia and observed on a regular basis at outpatient clinics, with data being recorded from the consultation after the start of the survey and from consultations in the previous 12 to 18 months. The survey covered 22 centers, and included 285 patients, 58.4% male and 41.6% female. Of these patients, 87.7% had high blood pressure, 75.8% had dyslipidemia and 63.5 % had both pathologies; the prevalence of diabetes was high and that of coronary disease was very high. The mean body mass index (BMI) at the first observation was 28.7 +/- 4.4, while under 20% of the patients had normal BMI. Sixty-two patients were ex-smokers, and 24 still smoked. Mean systolic blood pressure (BP) was over 140 mmHg in all cases, and diastolic BP was around 80 mmHg. Mean LDL cholesterol remained at around 130 mg/dl and HDL cholesterol at around 50 mg/dl. Almost all patients were under combined therapy with diuretics, beta-blockers, angiotensin-converting enzyme inhibitors, calcium channel blockers and statins, with most of these drug classes being prescribed with increasing frequency. Although this was a high-risk population for cardiovascular conditions, control of blood pressure and of total and LDL cholesterol was in many cases inadequate, exceeding the values recommended in guidelines. Patients were usually polymedicated, with most drug classes, especially statins, being prescribed with increasing frequency.


Structural Evolution in Glassy Carbon Investigated Based on the Temperature Dependence of Young's Modulus.
As a non-graphitized carbon material, possessing exceptional hardness and chemical inertness, glassy carbon (GC) is often synthesized through the pyrolysis method, which includes a compression procedure of powdered precursor materials, thus increasing the costs for production of glassy carbon at an industrial scale. Direct preparation of GC via pyrolysis of bulk precursors is a low-cost approach but encounters challenges arising from an insufficient knowledge of carbon structure formation. In order to solve this problem, a new analysis of the temperature-dependent variation in Young's modulus of GC obtained by the pyrolysis of phenolic resin at 1000 °C, utilizing the impulse excitation technique (IET), was performed. Our findings demonstrate that there is a critical temperature range of 500-600 °C where pyrolysis leads to the most significant density change and GC is formed as a result. When GC samples are heated again, a significant structural reformation occurs in the same temperature range. It causes a decrease in stiffness, especially at heating rates >3 °C/min, and an interesting restorative effect-increase in stiffness when a GC sample is annealed at temperatures of 500-550 °C. These results bring important implications for the direct formation of large amounts of glassy carbon using bulk precursors.


Toll-like receptor 4-mediated growth of endometriosis by human heat-shock protein 70.
We investigated the role of human heat-shock protein 70 (Hsp70) in Toll-like receptor 4 (TLR4)-mediated growth of endometriosis. TLR4 expression was examined in macrophages (M) isolated in primary culture from the peritoneal fluid of women with and without endometriosis. The production of a number of macromolecules by non-treated M, Hsp70-treated M and after treatment with anti-TLR4 antibody was examined by enzyme linked immunosorbent assay (ELISA). The single and combined effects of Hsp70 and lipopolysaccharide (LPS) on the growth of endometrial stromal cells were analyzed by 5-bromo-2-deoxyuridine (BrdU) incorporation study. Hsp70 levels in eutopic and ectopic endometria were measured by ELISA. TLR4 was detected in isolated M at protein and gene level. Hsp70 (10 microg/ml) significantly stimulated the production of hepatocyte growth factor, vascular endothelial cell growth factor, interleukin-6 and tumor necrosis factor alpha by M derived from women with endometriosis compared with M derived from women with no endometriosis (P < 0.05 for each). This effect of Hsp70 was abrogated after pretreatment of M with anti-TLR4 antibody. BrdU incorporation indicated that Hsp70 significantly enhanced the growth of endometrial stromal cells ( approximately 50% increase) from women with endometriosis compared to non-treated cells. A synergistic effect on cell proliferation was observed between exogenous Hsp70 and LPS and this was significantly suppressed by pretreatment of cells with anti-TLR4 antibody (P < 0.05). Tissue levels of Hsp70 were significantly higher in the eutopic endometria (P < 0.05) and opaque red lesions (P < 0.01) derived from women with endometriosis than from other peritoneal lesions or from women with no endometriosis. A prominent stress reaction was observed in blood-filled opaque red peritoneal lesions. Human Hsp70 induces pelvic inflammation and may be involved in TLR4-mediated growth of endometrial cells derived from women with endometriosis.


[Gunshot wounds. Our experience].
Abdominal gunshot wounds may result in elevated morbidity and mortality. The optimal management is still controversial. The authors report on their experience with treatment of 49 patients. In all patients the PATI score was used to identify trauma and all were treated surgically. Laparoscopy was employed only in one patient. The mortality was 2% and the morbidity 6%. The authors conclude that the PATI score correlated well with morbidity and mortality. Resuscitation with immediate surgical treatment may reduce the morbidity and mortality rates.


Surgical management of pulmonary metastases.
The management of pulmonary metastases remains controversial. More information is available, however, on outcomes in larger series of patients undergoing metastasectomy as well as the indications for the procedure. The role of video-assisted thoracic surgery for the diagnosis and management of these patients is being scrutinized carefully. Isolated perfusion techniques for treating patients with unresectable pulmonary metastases have been applied in phase I and II trials at selected institutions. More data regarding clinical outcomes are necessary, however, before widespread adaptation of this experimental form of treatment is accepted as standard practice.


The external quality assessment scheme: Five years experience as a participating laboratory.
Quality assurance in blood banking includes active participation in the external quality program. Such a program offers valuable benefits to patient care, their safety, and an overall quality of laboratory practices. In the year 2002, we participated in the External Quality Assessment Scheme (EQAS) under the World Health Organization (WHO), Bureau of Laboratory Quality Standards, Thailand. In the current study we evaluated our EQAS test result of the past five years, from 2003 to 2007. Test results of all blood samples such as ABO grouping, D typing, antibody screening, antibody identification, and transfusion transmitted infection (TTI) testing were analyzed and documented. Discordant results in one or more instances were observed with antibody identification, weak D testing, and tests for anti-HIV1/2 and HBsAg. Twice we failed to detect the 'anti-Mia' antibody in the issued sample and that could be attributed to the absence of the corresponding antigen in the used cell panel. HBsAg was missed due to its critically low titer in the serum and the comparatively low sensitivity of our Enzyme-Linked Immunosorbent Assay (ELISA) test kit. All these failures in the last five years have helped us to significantly improve our transfusion service in terms of performance evaluation, patient care and safety issues, and the overall quality of laboratory practices. We therefore recommend all laboratories and hospitals to participate in the EQAS program, which will definitely help them to improve from what they learn.


Long-term mortality of patients admitted to the intensive care unit for gastrointestinal bleeding.
Long-term mortality data for gastrointestinal (GI) bleeders is scarce in the literature. The aim of this prospective study was to determine the long-term mortality of patients admitted to two intensive care units with a primary diagnosis of GI bleeding. The charts of patients admitted to the medical intensive care unit (MICU) with GI bleeding were reviewed and the data of the patients' first day in the MICU was used to calculate APACHE III and Charlson scores. A GI bleeding score was computed by combining endoscopic findings and units of blood transfused during patients' MICU stay. Mortality data was obtained from the Vital Statistics Department of Montgomery County, Dayton, OH. Survival data and predictability of mortality based on these scores were assessed. Mean age of the 66 patient cohort was 58.6 years. Twenty-six of 51 patients with upper GI bleeding, five of seven patients with lower GI bleeding, and four of eight patients with unknown site of bleeding died within 7 years. Charlson score correlated significantly with the mortality prediction, whereas the APACHE III and bleeding scores did not. All-cause and GI bleeding-related 7-year mortality for patients admitted to the MICU with GI bleeding was lower than the rates cited in the literature. The Charlson score was helpful in predicting mortality.


Overexpression of Rice Histone H1 Gene Reduces Tolerance to Cold and Heat Stress.
Temperature stresses, including low- and high-temperature stresses, are the main abiotic stresses affecting rice yield. Due to global climate change, the impact of temperature pressure on rice yield is gradually increasing, which is also a major concern for researchers. In this study, an H1 histone in Oryza sativa (OsHis1.1, LOC_Os04g18090) was cloned, and its role in rice's response to temperature stresses was functionally characterized. The GUS staining analysis of OsHis1.1 promoter-GUS transgenic rice showed that OsHis1.1 was widely expressed in various rice tissues. Transient expression demonstrated that OsHis1.1 was localized in the nucleus. The overexpression of OsHis1.1 reduces the tolerance to temperature stress in rice by inhibiting the expression of genes that are responsive to heat and cold stress. Under stress conditions, the POD activity and chlorophyll and proline contents of OsHis1.1-overexpression rice lines were significantly lower than those of the wild type, while the malondialdehyde content was higher than that of the wild type. Compared with Nip, OsHis1.1-overexpression rice suffered more serious oxidative stress and cell damage under temperature stress. Furthermore, OsHis1.1-overexpression rice showed changes in agronomic traits.