Prognosis and management of Crohn's disease in the over-55 age group.
The course, prognosis and management of 62 patients with Crohn's disease aged 55 years or over at diagnosis has been reviewed. The distal ileus was the commonest site of disease in the older patient, where the characteristic presentation was acute after initially mild symptoms. Early local resection was often required, particularly where there was diagnostic doubt or suspicion of caecal malignancy. Recurrence rates were much lower in the older patient than after resection in younger patients. Medical treatment played a minor role in the management of patients with distal ileal disease, in part because stricture formation was present at diagnosis and the acute nature of symptoms at presentation led to early surgical treatment. Colonic Crohn's disease was usually confined to the distal or left side of the colon and initially could be difficult to distinguish from diverticular disease. Extensive colonic Crohn's disease was rare. The apparently limited disease was not necessarily associated with a good prognosis, since disease at this site sometimes progressed rapidly, necessitating urgent surgical resection. Medical treatment (corticosteriod therapy, with or without azathioprine) was usually effective initially for treatment of symptomatic colonic Crohn's disease, but sustained remission was rare. Those patients with persistent symptoms were restored to good health with surgical treatment but at a price, in that nearly half eventually required a permanent stoma.


Experimental determination of blood permittivity and conductivity in simple shear flow.
The paper is concerned with the determination of blood permittivity and conductivity in Poiseuille and Couette simple shear flows. The experimental procedure, based on dielectric spectroscopy, evidences the sensitivity of blood electric properties to the applied frequency and local shear rate magnitude. The method evidences the possibility to correlate (for well-defined flow geometry) magnitude of shear rate, and consequently the shear stress level, with spectra permittivity of blood.


Interdependence of JAK-STAT and MAPK signaling pathways during EGF-mediated HTR-8/SVneo cell invasion.
Invasion of trophoblast cells is spatio-temporally regulated by various cytokines and growth factors. In pregnancy, complications like preeclampsia, shallow invasion of trophoblast cells and low amounts of epidermal growth factor (EGF) have been reported. In the present study, regulatory mechanisms associated with EGF-mediated invasion in HTR-8/SVneo trophoblastic cells have been delineated. Treatment of HTR-8/SVneo cells with EGF (10 ng/ml) led to eight fold increase (p < 0.05) in invasion. Increased invasion of HTR-8/SVneo cells by EGF was associated with an increase in phosphorylation of ERK½. In addition, significant phosphorylation of STAT1 (ser 727) and STAT3 (both tyr 705 and ser 727 residues) was also observed, accompanied by a decrease in total STAT1. Inhibition of ERK½ phosphorylation by U0126 (10 μM) led to a significant decrease in EGF-mediated invasion with simultaneous decrease in the phosphorylated forms of STAT3 and STAT1. Decrease in total STAT1 was also reversed on inhibition of ERK½. Interestingly, inhibition of STAT3 by siRNA led to a significant decrease in EGF-mediated invasion of HTR-8/SVneo cells and phosphorylation of STAT1, but it did not have any effect on the activation of ERK½. On the other hand, inhibition of STAT1 by siRNA, also led to a significant decrease in the EGF-mediated invasion of HTR-8/SVneo cells, showed concomitant decrease in ERK½ phosphorylation and STAT3 phosphorylation at ser 727 residue. These results suggest cross-communication between ERK½ and JAK-STAT pathways during EGF-mediated increase in invasion of trophoblast cells; phosphorylation at ser 727 residue of both STAT3 and STAT1 appears to be critical.


Breaking the access barrier: evaluating an asthma center's efforts to provide education to children with asthma in schools.
To evaluate an asthma education program for children with asthma that is delivered in their school by certified asthma educators from a local hospital-based asthma center. Randomized controlled trial. Twenty-six elementary schools located in a suburb of Toronto. A total of 256 children in grades 2 to 5 with asthma and their parents were randomized to control and experimental groups. Children in the experimental group received the "Roaring Adventures of Puff" asthma education program over the course of six weekly 1-h sessions. Those in the control group continued receiving usual care. Data collection involved measuring asthma quality of life, self-efficacy for managing asthma, school absenteeism, days of interrupted activity, health services use, and parental loss of time from work. Quality of life and self-efficacy data were collected from the children at baseline and 2 months. Telephone parental interviews conducted over 1 year were used to collect data on the remaining variables. Unpaired t test, analysis of variance, and chi2 test were used to determine whether differences existed between the groups. The results are reported as the mean +/- SD. The experimental group demonstrated higher scores than the control group for self-efficacy (3.6 +/- 0.7 vs 3.8 +/- 0.9, respectively; p < 0.05) and quality of life (5.0 +/- 1.4 vs 5.5 +/- 1.4, respectively; p < 0.05). At 1 year, the experimental group demonstrated fewer mean urgent health-care visits (2.5 +/- 2.5 vs 1.7 +/- 1.9 visits per year, respectively; p < 0.01), days of missed school (4.3 +/- 5.7 vs 3.0 +/- 4.4 days per year, respectively; p > 0.05), and days of interrupted activity (9.1 +/- 10.5 vs 6.2 +/- 7.3 days per year; p < 0.01) related to asthma than the control group. There were no differences between the groups for parental work absenteeism or scheduled asthma visits. Providing an asthma education program to children in their school can significantly improve quality of life and reduce the burden of childhood asthma.


Deep Patient Representation of Clinical Notes via Multi-Task Learning for Mortality Prediction.
We propose a deep learning-based multi-task learning (MTL) architecture focusing on patient mortality predictions from clinical notes. The MTL framework enables the model to learn a patient representation that generalizes to a variety of clinical prediction tasks. Moreover, we demonstrate how MTL enables small but consistent gains on a single classification task (e.g., in-hospital mortality prediction) simply by incorporating related tasks (e.g., 30-day and 1-year mortality prediction) into the MTL framework. To accomplish this, we utilize a multi-level Convolutional Neural Network (CNN) associated with a MTL loss component. The model is evaluated with 3, 5, and 20 tasks and is consistently able to produce a higher-performing model than a single-task learning (STL) classifier. We further discuss the effect of the multi-task model on other clinical outcomes of interest, including being able to produce high-quality representations that can be utilized to great effect by simpler models. Overall, this study demonstrates the efficiency and generalizability of MTL across tasks that STL fails to leverage.


[Patterns of Change--Transitions between "States of Mind" in a solution oriented brief therapy].
The concept of "states of mind" (configurational analysis by M. J. Horowitz) allows for a comprehensive phenomenological description of psychotherapy processes. The method is exemplified by a single case analysis of a 13-session solution oriented therapy. Some of the representative state-transitions and state-cycles are described. Additionally, the states-of-mind-approach is integrated into concepts of self-organization and pattern transitions in complex dynamic systems. States of mind can be defined as attractors of closely interconnected physiological, mental, and social processes. In this sense, psychotherapy would lead to changes in attractor constellations which represent important aspects of personality.


Acid alpha-naphthyl acetate esterase staining of lymphocytes in pleural effusions.
Cytocentrifuged preparations of mononuclear cells in blood and pleural fluid were stained for acid alpha-naphthyl acetate esterase (ANAE) in order to characterize the lymphocytes of pleural effusions histochemically. The cellular samples were obtained from 42 patients with pleural effusions caused by tuberculosis, pneumonia, cancer, malignant lymphoma, sarcoidosis, congestive heart failure, hepatic cirrhosis or nonspecific causes. The mean percentage of ANAE-positive lymphocytes from patients with tuberculous pleural effusion was significantly greater (P less than 0.001) in pleural fluid (85.6%) than in peripheral blood (70.0%). Tuberculous pleural fluid also contained a higher mean percentage of ANAE-positive lymphocytes than did pleural fluid from patients with cancer (75.0%), malignant lymphoma (50.0%), pneumonia, nonspecific disease (74.9%) or transudates (59.3%). The findings show that ANAE staining is useful for demonstrating T lymphocytes in pleural effusions. The pathogenetic role of these T lymphocytes and the diagnostic significance of demonstrating ANAE-positive cells in pleural effusions are discussed.


A Comprehensive Review of the Quality and Feasibility of Dementia Assessment Measures: The Dementia Outcomes Measurement Suite.
The diagnosis of dementia and the management of its associated symptoms are aided by high-quality assessment tools. However, there is disagreement on the optimal tools among abundant alternatives and lack of consistent quality standards across the different domains of dementia-related change (ie, cognition, severity, function, behavioral and psychological symptoms, delirium, quality of life). Standardization is difficult because the relevance of a measurement tool for health professionals may depend on the clinical setting and on the dementia type and severity. To address this need, we conducted a comprehensive and clinically relevant evidence-based review of dementia-related tools and present a set of recommended tools, the Dementia Outcomes Measurement Suite. The review revealed that considerable development has occurred in terms of assessment of persons with mild cognitive impairment, executive dysfunction, cognitively mediated functional change, and apathy. More research is needed to develop and validate tools to assess health-related quality of life and specific symptoms of dementia including anxiety, wandering, and repetitive vocalizations. This extensive overview of the quality of different measures may serve as a guide for health professionals clinically and for researchers developing new or improved dementia assessment tools.


Adoption of Information and Communication Technologies for Early Detection of Breast and Cervical Cancers in Low- and Middle-Income Countries.
In response to the growing burden of breast and cervical cancers, low- and middle-income countries (LMICs) are beginning to implement national cancer prevention programs. We reviewed the literature on information and communication technology (ICT) applications in the prevention of breast and cervical cancers in LMICs to examine their potential to enhance cancer prevention efforts. Ten databases of peer-reviewed and gray literature were searched using an automated strategy for English-language articles on the use of mobile health (mHealth) and telemedicine in breast and cervical cancer prevention (screening and early detection) published between 2005 and 2015. Articles that described the rationale for using these ICTs and/or implementation experiences (successes, challenges, and outcomes) were reviewed. Bibliographies of articles that matched the eligibility criteria were reviewed to identify additional relevant references. Of the initial 285 citations identified, eight met the inclusion criteria. Of these, four used primary data, two were overviews of ICT applications, and two were commentaries. Articles described the potential for mHealth and telemedicine to address both demand- and supply-side challenges to cancer prevention, such as awareness, access, and cost, in LMICs. However, there was a dearth of evidence to support these hypotheses. This review indicates that there are few publications that reflect specifically on the role of mHealth and telemedicine in cancer prevention and even fewer that describe or evaluate interventions. Although articles suggest that mHealth and telemedicine can enhance the implementation and use of cancer prevention interventions, more evidence is needed.


Telemedical technologies in urological cancer care: past, present and future applications.
Since the initial development of telegraphy by Sir Charles Wheatstone in 1837 and the telephone by Alexander Graham Bell in 1875, doctors have been able to convey medical information across great distances. The exchange and sharing of medical information has evolved and adapted to suit the vast array of today's medicine. Early adopters of telemedicine within clinical practice have gained significant health economic benefits. The arrival of wireless connections has further enhanced the possibilities for all clinical work with focus on diagnosis, treatment and management of urological cancers, as highlighted in this article.


Analysis of high-throughput biological data using their rank values.
High-throughput biological technologies are routinely used to generate gene expression profiling or cytogenetics data. To achieve high performance, methods available in the literature become more specialized and often require high computational resources. Here, we propose a new versatile method based on the data-ordering rank values. We use linear algebra, the Perron-Frobenius theorem and also extend a method presented earlier for searching differentially expressed genes for the detection of recurrent copy number aberration. A result derived from the proposed method is a one-sample Student's t-test based on rank values. The proposed method is to our knowledge the only that applies to gene expression profiling and to cytogenetics data sets. This new method is fast, deterministic, and requires a low computational load. Probabilities are associated with genes to allow a statistically significant subset selection in the data set. Stability scores are also introduced as quality parameters. The performance and comparative analyses were carried out using real data sets. The proposed method can be accessed through an R package available from the CRAN (Comprehensive R Archive Network) website: https://cran.r-project.org/web/packages/fcros .


Doppler effect of nonlinear waves and superspirals in oscillatory media.
Nonlinear waves emitted from a moving source are studied. A meandering spiral in a reaction-diffusion medium provides an example in which waves originate from a source exhibiting a back-and-forth movement in a radial direction. The periodic motion of the source induces a Doppler effect that causes a modulation in wavelength and amplitude of the waves ("superspiral"). Using direct simulations as well as numerical nonlinear analysis within the complex Ginzburg-Landau equation, we show that waves subject to a convective Eckhaus instability can exhibit monotonic growth or decay as well as saturation of these modulations depending on the perturbation frequency. Our findings elucidate recent experimental observations concerning superspirals and their decay to spatiotemporal chaos.


Association between diabetic retinopathy and serum lipoproteins level.
diabetic retinopathy is the leading cause of blindness of working-age patients in the urban areas. to find out the association between diabetic retinopathy and serum lipoproteins in patients with diabetes mellitus a community-based cross-sectional study involving 100 subjects with type II diabetes living in the cities of Kathmandu, Bhaktapur and Lalitpur of Nepal was carried out using a purposive sampling method. The retinopathy was classified according to the modified Airlie House classification of diabetic retinopathy. The patients with systolic hypertension were excluded. The blood sugar level was assessed by using glycosylated hemoglobin. The fasting serum lipoproteins were assessed by photometric enzymatic methods. the SPSS version 10.0 software was used. The p value of <0.05 was considered significant. the majority (n=91) of the patients were in the age group 31-60 years with the mean of 48.2 +/- 9.5. The mean duration of diabetes mellitus in the patients with no-diabetic-retinopathy was 4 +/- 3.4 years and that in those with the retinopathy was 6.4 +/- 4years, (p =0.006). The mean glycosylated hemoglobin level for no-diabetic-retinopathy group was 6.9 1.1%, whereas for the diabetic retinopathy group, it was 7.7 +/- 1.5% (p = 0.004). The mean values of serum lipoproteins when taken together were slightly higher in the diabetic retinopathy group than in the group with no-diabetic-retinopathy. The serum triglyceride value was higher in the group with diabetic retinopathy than in the group with no retinopathy. Serum triglyceride had a low degree of positive correlation with HbA lc value. there is no significant association between the serum lipoprotein levels and diabetic retinopathy in patients with type II diabetes mellitus. Serum triglyceride level has a low degree of positive correlation with HbA lc value.


Remote blended treatment for individuals with suicidal ideation: A single-arm proof-of-concept trial.
New digital treatment formats may reduce barriers to treatment for individuals with suicidal ideation. This study aimed to investigate the feasibility of a remote blended care programme for this population, defined as acceptability, demand, practicality, adaptation, indications of efficacy and safety. We conducted a mixed-methods single-arm trial for proof-of-concept. Participants were eligible if they were at least 18 years old, had sufficient German proficiency, a Beck Scale for Suicidal Ideation score ≥2, internet access and lived near the outpatient clinic. The treatment consisted of 12 sessions of cognitive-behavioural videotherapy combined with online modules over 6 weeks. We included 10 participants. All patients were satisfied with the treatment; most patients (80%) reported unpleasant memories resurfacing. All patients completed all therapy sessions and a mean of 13.7 modules (SD = 5.7); three patients switched to face-to-face treatment, in one case due to safety concerns. All patients and most therapists (83.3%) found the treatment overall practicable. Most patients (66.7%) and therapists (66.7%) considered remote treatment equivalent to face-to-face therapy. There were no serious adverse events. While promising, the results suggest changes to the programme might be needed, particularly for patients' safety. A controlled feasibility trial should investigate temporary deteriorations.


C-reactive protein in nipple aspirate fluid associated with Gail model factors.
The majority of breast cancers originate in the epithelial lining of the breast ductal system. Premalignant cell damage in this lining may produce biochemical signals that deliver inflammatory proteins to the site. The presence of C-reactive protein (CRP) in nipple aspirate fluid (NAF) may reflect an inflammatory state indicative of a premalignant breast microenvironment. This study ascertained CRP's presence in NAF and evaluated if risk factors, as identified by the Gail model, were associated with NAF CRP levels among healthy women. NAF CRP levels were assayed in 59 women. CRP was present in NAF and significantly (p = .04) and positively related to breast cancer risk as predicted by the Gail model. CRP is differentially present in NAF and varies by Gail model risk factors. CRP in NAF holds promise as a noninvasive biomarker that detects a precarcinogenic breast ductal microenvironment and may contribute to the diagnosis of breast cancer early in the course of the disease when prognosis is most favorable.


Regurgitant volume informs rate of progressive cardiac dysfunction in asymptomatic patients with chronic aortic or mitral regurgitation.
This study hypothesized that regurgitation severity, as determined by using the regurgitant volume index, would better delineate differential cardiac dysfunction in asymptomatic patients with moderate to severe aortic regurgitation (AR) and mitral regurgitation (MR). Frequent surveillance echocardiography is considered appropriate in asymptomatic patients with moderate to severe AR and MR. However, the evidence to support this practice and to define the appropriate frequency is limited. This was an observational cohort study of consecutive patients with moderate to severe asymptomatic AR or MR who underwent exercise echocardiography. Our cohort included 130 patients with moderate to severe asymptomatic MR and 130 patients with moderate to severe asymptomatic AR who were matched according to age and regurgitant volume index. All patients underwent yearly echocardiographic follow-up studies. Regurgitation severity was determined according to regurgitant volume index, with a level ≥30 ml/m(2) considered a marker of severe regurgitation. During follow-up, regardless of etiology, patients with severe regurgitation demonstrated increasing left ventricular volume indexes (4.2 ± 1.5 ml/m(2) per year; p = 0.01) and decreasing left ventricular ejection fractions (1.3 ± 0.4% per year; p = 0.002). In patients with moderate regurgitation, left ventricular volumes and ejection fractions did not significantly change. In addition, patients with severe regurgitation experienced a similar drop in contractility (end-systolic pressure/end-systolic volume ratio and single-beat pre-load recruitable stroke work) during follow-up independent of regurgitation etiology. Contractility parameters did not change in patients with moderate regurgitation. These asymptomatic patients with moderate AR or MR had stable cardiac function during 3 years of follow-up; thus, frequent echocardiography without a change in clinical status may not be necessary. In the setting of severe regurgitation, further cardiac deterioration occurred at a similar rate and manner irrespective of whether the dysfunction was related to AR or MR.


Depletion of myo-inositol and amino acids in galactosemic neuropathy.
A depletion of not only myo-inositol (MI) but also taurine and other amino acids was observed in the sciatic nerve of a galactosemic rat. Treatment of the galactosemic rats with sorbinil, an aldose reductase (AR) inhibitor, was found to block galactitol formation and protect against the loss of MI, taurine, and other amino acids. Incubation studies of sciatic nerve have revealed that [3H]MI and [3H]taurine were actively taken up and concentrated. Incubation of the nerve in a high-galactose medium showed a decrease in the accumulation of [3H]MI and [3H]taurine whereas the galactitol level increased. Time-course studies have shown that the galactitol level reached a plateau before a substantial decrease in the accumulation of [3H]MI and [3H]taurine occurred. The addition of AR inhibitors in the galactose medium significantly protected against the loss in the capacity of the nerve to accumulate [3H]MI and [3H]taurine. Hypertonicity of the galactose medium also seemed to have a protective effect similar to that of AR inhibitors.


[Detection and clinical significance of myeloid-derived suppressor cells in peripheral blood of patients with rectal carcinoma].
To study the expression of myeloid-derived suppressor cells (MDSC) in peripheral blood of patients with rectal carcinoma and to preliminarily explore its clinical significance. Blood samples from 76 rectal carcinoma patients who underwent surgery in Department of General Surgery, The Affiliated Cancer Hospital, Zhengzhou University between June and October 2013 were collected before operation, postoperative day 10 and 2 years after operation respectively. Flow cytometry was used to detect MDSC percentage in peripheral blood of 76 rectal carcinoma patients and 40 healthy people. The change of MDSC percentage in peripheral blood of rectal carcinoma patients after treatment was investigated. Furthermore, the relationship of peripheral blood MDSC percentage with clinicopathological characteristics was examined. Preoperative MDSC percentage in peripheral blood of 76 rectal carcinoma patients [(3.52±0.68)%] was higher than that of 40 healthy people[(0.92±0.21)%], with significant difference (t=3.026, P=0.005). Preoperative MDSC percentage in peripheral blood of rectal carcinoma patients was significantly related with histological classification (t=2.453, P=0.018), depth of tumor invasion (t=2.051, P=0.035), lymph node metastasis (t=2.328, P=0.022), TNM stage (t=2.529, P=0.016). Univariate analysis showed that TNM stage, histological classification, lymph node metastasis, preoperative MDSC percentage in peripheral blood were the prognostic factors in rectal carcinoma. Multivariate analysis showed that TNM stage (HR=2.535, 95%CI: 0.851 to 4.160, P=0.038) and preoperative MDSC percentage in peripheral blood (HR=3.651, 95%CI: 0.877 to 14.263, P=0.031) were independent prognostic factors of rectal carcinoma. MDSC percentage in peripheral blood of rectal carcinoma patients decreased significantly on the postoperative 10-day [(2.41±0.46)%] compared to that before operation [(3.52±0.68)%], whose difference was statistically significant (t=1.778, P=0.043). During follow-up, tumor recurrence or metastasis was found in 23 patients. MDSC percentage in peripheral blood of rectal carcinoma patients with recurrence or metastasis [(4.37±1.23)%] was higher than that of rectal carcinoma patients without recurrence or metastasis [(2.36±0.35)%] two years after operation, with statistically significant difference (t=1.982, P=0.039). MDSC percentage in peripheral blood of rectal carcinoma patients is significantly elevated compared to that of healthy people. Increased MDSC percentage indicates poor prognosis and tumor progression in rectal carcinoma patients. Measurement of peripheral blood MDSC percentage may have a potential clinical value in prognosis prediction of rectal carcinoma.


What is the rationale for hydrocortisone treatment in children with infection-related adrenal insufficiency and septic shock?
Recent studies show that children who die from fulminant meningococcaemia have very low cortisol:adrenocorticotrophic hormone (ACTH) ratios within the first 8 h of presentation to emergency facilities compared with survivors. This observation supports the possibility that adrenal insufficiency may contribute to rapid cardiovascular collapse in these children. In recent years, the use of hydrocortisone treatment has become increasingly popular in the care of adult and paediatric patients with septic shock. In this review, the classical adrenal insufficiency literature is presented and the existing rationale for using titrated hydrocortisone treatment (2-50 mg/kg/day) to reverse catecholamine-resistant shock in children who have absolute adrenal insufficiency (defined by peak cortisol level <18 microg/dl after ACTH challenge) or pituitary, hypothalamic or adrenal axis insufficiency is provided. In addition, the concept of relative adrenal insufficiency (basal cortisol >18 microg/dl but a peak response to ACTH <9 microg/dl) is reviewed. Although there is a good rationale supporting the use of 7 days of low-dose hydrocortisone treatment (about 5 mg/kg/day) in adults with this condition and catecholamine resistant septic shock, the paediatric literature suggests that it is prudent to conduct more studies before recommending this approach in children.


Air-Stable, Self-Bleaching Electrochromic Device Based on Viologen- and Ferrocene-Containing Triflimide Redox Ionic Liquids.
We demonstrate an electrochromic device with self-bleaching ability that uses ethyl viologen- ([EV]2+) and ferrocene-based redox ionic liquids ([FcNTf]-) as the electroactive species. These electroactive compounds are insensitive to atmospheric O2 and H2O in both their oxidized and reduced states once dissolved in a typical ionic liquid electrolyte ([BMIm][NTf2]), allowing for the device to be assembled outside a glovebox without any encapsulation. This device could generate a deep blue color by the application of a 2.0 V potential between two fluorine-doped tin oxide (FTO) substrates to oxidize the ferrocenyl centers to [FcNTf]0 while reducing viologen to [EV]+•. Self-bleaching occurs at OCP as [EV]+• and [FcNTf]0 undergo homogeneous electron transfer in the electrolyte. The mass transport of ethyl viologen and ferrocenylsulfonyl(trifluoromethylsulfonyl)imide ([FcNTf]-) anion was evaluated by double potential step chronoamperometry to study the impact of the diffusion coefficient on the self-bleaching mechanism. The electrochromic device demonstrated here shows a contrast ΔT (610 nm) around 40% at 2.0 V as colored cell voltage, a switching time in the order of few seconds for coloration and bleaching, coloration efficiency of 105.4 to 146.2 cm2 C1- at 610 nm, and very high stability (94.8% ΔT after 1000 cycles) despite the presence of O2 and H2O in the electrolyte.


Facilitating research participation and improving quality of life for African American prostate cancer survivors and their intimate partners. A pilot study of telephone-based coping skills training.
African American men experience worse prostate cancer outcomes compared with those of Caucasian men, not only in incidence and mortality rates, but also in coping with the side effects of treatment. Unfortunately, African American men have been significantly under-represented in research evaluating the efficacy of psychosocial interventions for improving coping in prostate cancer survivors. This pilot study explored the feasibility and efficacy of coping skills training (CST), an intervention developed to enhance coping with treatment side effects in a sample of African American prostate cancer survivors and their intimate partners. The intervention was delivered in a telephone-based format designed to facilitate research participation. A total of 40 couples were randomized to either 6 sessions of CST or usual care. Survivors completed measures of disease-specific quality of life (QOL) related to urinary, sexual, bowel, and hormonal symptom domains, as well as measures of global QOL (i.e., physical functioning and mental health). Partners completed measures of caregiver strain, mood, and vigor. Analysis of data from 30 couples (12 couples in CST, 18 couples in usual care) indicated that CST produced moderate to large treatment effects for QOL related to bowel, urinary, sexual, and hormonal symptoms. Partners who underwent CST reported less caregiver strain, depression, and fatigue, and more vigor, with moderate effect sizes observed that approached conventional levels of statistical significance. These preliminary findings suggest that telephone-based CST is a feasible approach that can successfully enhance coping inAfrican American prostate cancer survivors and their intimate partners. Cancer 2007. (c) 2006 American Cancer Society.


Young stroke, cardiac myxoma, and multiple emboli: a case report and literature review.
Cardiac myxoma is a source of emboli to the vascular tree, especially to the central nervous system. Although it is rare, its early recognition is particularly important because of its unique clinical features of subsequently leading to intracerebral or subarachnoid hemorrhage, even brain metastases, and its potential for surgical cure. Missing the diagnosis may lead to devastating results, including stroke, even sudden death. A 40-year-old male with no other conventional vascular risk factors such as hypertension, diabetes or hyperlipidemia presented with right hemiplegia, global aphasia, vomiting, and fever. Infarction over the left middle cerebral artery was disclosed on magnetic resonance imaging study, and echocardiogram showed a huge mass, about 5cm in size, on the mitral valve which was histopathologically proved to be a cardiac myxoma. He also presented with multiple emboli to the kidneys and the left eye. There is uncertainty about the role of anticoagulation. The treatment of choice remains surgical excision of the cardiac myxoma which may lead to normalization of serum interleukin-6 levels and resolution of constitutional symptoms, and the intracranial aneurysms may regress and resolve.


Isolation and Functional Characterization of Fusobacterium nucleatum Bacteriophage.
Bacteriophages are viruses that specifically lyse bacteria. They have demonstrated potential in applications as antibacterial agents in medicine, agriculture, and environmental remediation. Due to the complex and dynamic nature of the oral microbiome, antibiotic treatment of chronic, polymicrobial oral diseases may lead to dysbiosis. In these diseases, bacteriophages may provide targeted activity against oral bacteria without such disruption to the broader microbial community. In this chapter, we describe the methods for screening samples that may contain bacteriophages against oral pathogenic bacteria, and using the example of FNU1, the bacteriophage we isolated against Fusobacterium nucleatum, describe the process of bacteriophage purification and characterization.


[Expression and role of sugar chains on airway mucus during the exacerbation of airway inflammation].
Human bronchial mucins, such as MUC5AC, have traditionally been defined as a family of high-molecular weight glycoproteins. Changes in the contents of sugar chains on MUC5AC are among the fundamental features in inflammatory respiratory disease. The changes have been shown to lead to unfavorable alterations in the viscosity of mucus, resulting in impairment of mucociliary transport, vulnerability to viral/bacterial infection as sugar chains play an important role in adhesion of some viruses and bacteria to the epithelium, and finally inflammatory cell infiltration in the airway. Recently, we found that expression of some glycosyltransferases associated with the contents and structure of sugar chains is regulated by phosphatidylinositol-phospholipase (PI-PL) C signaling in cells. L-Carbocisteine, a mucoregulatory drug, normalized or balanced fucosylated and sialylated sugar chains, such as sialyl Lewis x through inhibition of PI-PL C signaling. We prepared MUC5AC fusion protein with tandem repeats associated with MUC5AC, and confirmed that L-carbocisteine inhibited the increases in viscosity associated with sialyl Lewis x expression levels. In addition, the clinical study (2008) noted that L-carbocisteine reduced the frequency of common colds and exacerbation of symptoms in patients with COPD. These favorable effects in patients may be due to normalization of sugar chain contents on mucins. We suggest that the inhibitory effect on infection of airway epithelial cells by rhinoviruses, respiratory syncytial virus, and influenza viruses by treatment with L-carbocisteine may also be based on the regulation of sugar chain contents or structures on mucins.


Recurrent post-tympanostomy tube otorrhea secondary to aerobic endospore-forming bacilli: a case report and brief literature review.
We report a unique case in which a 57-year-old man with an 8-year history of late recurrent post-tympanostomy tube otorrhea (PTTO) was found to harbor Bacillus subtilis, an aerobic endospore-forming bacillus that is typically resistant to chemical and physical agents because of its unique life cycle. Removal of the patient's tympanostomy tube resulted in complete resolution of his long-standing otorrhea. We also review the etiologies of and treatment strategies for early, late, chronic, and recurrent PTTO. We conclude that regardless of the etiology, a patient with persistent or recurrent PTTO should consider undergoing removal of the ventilation tube.


The treatment and research for posttraumatic stress disorder with Chinese medicine.
There is no disease called posttraumatic stress disorder (PTSD) in traditional Chinese medicine (TCM). However, Huangdi's Canon of Medicine written in about 200 BC, one of the most famous TCM classics, recorded diseases with similar etiology, pathogenesis, and clinical symptoms. Moreover, contemporary TCM also attaches great importance to diseases caused by trauma. Especially after 2008, there is a mini-rush of study on PTSD as a result of Sichuan earthquake. Referring to ancient and modern literature, we summarize the TCM treatment of PTSD and wish to contribute to the further study on TCM remedy for PTSD.


SUC1 and SUC2: two sucrose transporters from Arabidopsis thaliana; expression and characterization in baker's yeast and identification of the histidine-tagged protein.
An important, most likely essential step for the long distance transport of sucrose in higher plants is the energy-dependent, uncoupler-sensitive loading into phloem cells via a sucrose-H+ symporter. This paper describes functional expression in Saccharomyces cerevisiae of two cDNAs encoding energy-dependent sucrose transporters from the plasma membrane of Arabidopsis thaliana, SUC1 and SUC2. Yeast cells transformed with vectors allowing expression of either SUC1 or SUC2 under the control of the promoter of the yeast plasma membrane ATPase gene (PMA1) transport sucrose, and to a lesser extent also maltose, across their plasma membranes in an energy-dependent manner. The KM-values for sucrose transport are 0.50 mM and 0.77 mM, respectively, and transport by both proteins is strongly inhibited by uncouplers such as carbonyl cyanide m-chlorophenylhydrazone (CCCP) and dinitrophenol (DNP), or SH-group inhibitors. The VMAX but not the KM-values of sucrose transport depend on the energy status of transgenic yeast cells. The two proteins exhibit different patterns of pH dependence with SUC1 being much more active at neutral and slightly acidic pH values than SUC2. The proteins share 78% identical amino acids, their apparent molecular weights are 54.9 kDa and 54.5 kDA, respectively, and both proteins contain 12 putative transmembrane helices. A modified SUC1-His6 cDNA encoding a histidine tag at the SUC1 C-terminus was also expressed in S. cerevisiae. The tagged protein is fully active and is shown to migrate at an apparent molecular weight of 45 kDa on 10% SDS-polyacrylamide gels.


Postoperative Diabetes Insipidus Mimicking Radiological Findings and Symptoms of Intracranial Hypotension: A Case Report.
Endocrine disturbances such as diabetes insipidus (DI) and syndrome of inappropriate antidiuretic hormone secretion (SIADH) are recognized complications of craniopharyngioma surgery, which occur due to damage to structures that produce or store antidiuretic hormone (ADH). Intracranial hypotension is a clinical syndrome that presents with headache and typical radiological features and can occur due to a leak of cerebral spinal fluid (CSF) in operations that involve the opening of the arachnoid (e.g., craniopharyngioma surgery). We describe a patient presenting with headache, radiological evidence of intracranial hypotension, and chronic DI after craniopharyngioma surgery. This occurred in the absence of evidence of a CSF leak. The headache and radiological findings resolved after the identification and treatment of DI. Intracranial hypotension may have occurred secondary to dehydration in chronic DI. A 48-year-old woman presented with progressive visual field loss due to cystic recurrence of a craniopharyngioma. She underwent redo (second) extended endoscopic transsphenoidal surgery, having previously undergone an uncomplicated debulking procedure two years prior. Her redo operation was uneventful, and her vision improved postoperatively. A lumbar drain was placed preoperatively to protect the skull base repair and was removed after 48 hours. In the initial postoperative period, she developed a clinical (polyuria) and biochemical picture consistent with DI, subsequently reverting to a SIADH, after which fluid and sodium homeostasis appeared to normalize, and she was discharged. Two months after discharge, she re-presented with new headaches eased by lying flat. Magnetic resonance imaging (MRI) brain showed bilateral convexity subdural effusions and diffuse pachymeningeal enhancement, suggesting intracranial hypotension and raising concern for postoperative CSF leak. MRI spine did not show a CSF fistula at the site of the previous lumbar drain. Transsphenoidal examination under anesthesia showed a well-healed skull base repair and no evidence of CSF leak. She concurrently reported polyuria and polydipsia. A formal water deprivation test confirmed central DI. Treatment with desmopressin improved her headache, and a follow-up MRI brain showed resolution of the previous stigmata of intracranial hypotension. This case report reminds physicians and neurosurgeons that systemic disorders (such as dehydration) can cause intracranial hypotension.


Eighteen-year experience with echinococcosus of the heart: clinical and echocardiographic features in 14 patients.
We present a retrospective analysis of clinical symptoms and echocardiographic features in 14 patients having cardiac hydatic cysts and screened during the 18 last years, with surgical correlations in 13. The heart was the sole location of the cyst in six patients. The revealing symptoms were precordial pain (six patients), dyspnea (two patients). A systolic murmur of false pulmonic stenosis was present in three patients. In 13 patients, two-dimensional echocardiographic images of hydatic cysts were those of masses of liquid content with a well-contrasted capsule, which was single in eight patients and multiple in five, one of which had a honeycomb appearance. The mass was solid and calcified in one patient. The outlines of the cysts were particularly sharp on transesophageal echocardiograms (six patients). The cyst size ranged from 1.8 to 11 cm in diameter. Cysts were located in the intramyocardium in 10 patients (left ventricle in four patients, interventricular septum in four patients, right ventricle in two patients), the pericardium in three and the mediatinum in one. There were a Doppler pulmonary valve gradient in three patients. Computed tomography (eight patients) and coronary arteriography (seven patients) have no additional diagnosis value than echocardiography. Nuclear magnetic resonance imaging (three patients) was helpful in determining extracardiac extension of the cysts. Transthoracic and transesophageal two-dimensional echocardiography have a central role in diagnosing cardiac hydatic cysts.


Idiopathic thrombocytopenia with iron deficiency anemia.
We report a rare case of anemia and thrombocytopenia as a result of uterine fibroid and adenomyosis, complicated by immune thrombocytopenic purpura (ITP). Symptoms were presented as menorrhagia and metrorrhagia in a 34-year-old African American woman, who was later treated with blood and platelet transfusion and iron therapy with steroids. Uterine fibroids are commonly found to cause hematologic disturbances such as anemia and reactive thrombocytosis and, less commonly, thrombocytopenia. Moreover, such hematologic disturbances are secondary to heavy and irregular uterine bleeding, which is typically presented. A previous uterine fibroid diagnosis was made and reconfirmed by pelvic and transvaginal ultrasound to exclude other locoregional pathologies. ITP was suggested by Coombs test and several other serologies, leading to confirmation via bone marrow biopsy. In a previous case study, we reported positive responses in hemotecrit and platelet count after the introduction of iron therapy to an iron-depleted middle-aged female presenting severe anemia and thrombocytopenia.1.


Comparison of small RNA profiles in Nicotiana benthamiana and Solanum lycopersicum infected by polygonum ringspot tospovirus reveals host-specific responses to viral infection.
Viral small RNAs (vsRNAs) are one of the key elements involved in RNA silencing-based defense against viruses in plants. We analyzed the vsRNA profiles in Nicotiana benthamiana and Solanum lycopersicum infected by polygonum ringspot virus (PolRSV) (Tospovirus, Bunyaviridae). VsRNAs were abundant in both hosts, but a different size profile was observed, with an abundance peak at 21 in N. benthamiana and at 22 nt in tomato. VsRNAs mapping to the PolRSV L genomic segment were under-represented in both hosts, while S and M segments were differentially and highly targeted in N. benthamiana and tomato, respectively. Differences in preferential targeting of single ORFs were observed, with over-representation of NSs ORF-derived reads in N. benthamiana. Intergenic regions (IGRs)-mapping vsRNAs were under-represented, while enrichment of vsRNAs reads mapping to the NSs positive sense strand was observed in both hosts. Comparison with a previous study on tomato spotted wilt virus (TSWV) under the same experimental conditions, showed that the relative accumulation of PolRSV-specific and endogenous sRNAs was similar to the one observed for silencing suppressor-deficient TSWV strains, suggesting possible different properties of PolRSV NSs silencing suppressor compared to that of TSWV.


[Value of transduodenoscopic wirsungography in the diagnosis of pancreatic pseudocysts].
The radiographic pictures obtained by endoscopic wirsungraphy in a group of 24 patients suffering from pancreatic pseudocysts and subsequently examined intraoperatively by wirsungraphy and cystography are analysed and commented. Pre-operative endoscopic visualisation of the lesion was obtained in 70% of the cases. In 55% of the cases there were co-existing alterations of calibre and trend of the main pancreatic duct, chiefly attributable to chronic basic pancreatitis and to a very small extent to the pseudocystic lesion. The following are discussed: a) the diagnostic value of the endoscopic procedure, which reaches absolute values in the direct visualisation of the sac, with a power of resolution that is difficult to reach with other methods; b) the probable prognostic significance with reference to the not absolutely precluded possibilities of spontaneous regression; c) the notable usefulness of the procedure, combined with intra-operative wirsungraphy and cystography, for anatomo-topographical definition of the lesion and its relations with the ductal system, indispensable for a correct formulation of the surgical tactic.


Successful Management of Recurrent Subacute Thyroiditis by Adding Colchicine to Glucocorticoid Treatment: A Case Series Study.
Although subacute thyroiditis (SAT) is thought to be a self-limited inflammatory thyroid disease, the recurrence rate of SAT is approximately 10-20%. It is difficult for these patients to stop glucocorticoid treatment, and they are usually bothered with recurrent pain and the side effects of glucocorticoids for more than several months. We describe three cases who were diagnosed with recurrent subacute thyroiditis after a reduction in prednisolone (PSL) dose, either immediately upon the cessation of PSL or shortly thereafter. Their symptoms, including the adverse effects of PSL, severely impacted their quality of life. After a complete assessment, we administered colchicine at 1 mg per day for 1-2 months to control the recurrence of SAT and monitored their routine blood parameters every two weeks. All 3 patients were successfully tapered off of PSL treatment and were free of frequently recurrent SAT. Colchicine may be therapeutic in patients with prednisolone-refractory, recurrent SAT. However, a large-scale, double-blind, controlled, prospective multicenter study is required to provide a solid body of evidence.


Pituitary stalk metastasis from breast cancer treated with systemic chemotherapy.
We describe a 61-year-old woman with diabetes insipidus caused by a pituitary stalk metastasis from breast cancer. She had a medical history of breast conservation therapy for early breast cancer 5 years previously. Pituitary, lung, liver, bone and neck lymphnode metastases was revealed at the same time. She received systemic chemotherapy consisting of docetaxel and cisplatin. After chemotherapy MRI finding in pituitary gland was improved, lung and liver metastases also improved, however, symptoms of diabetes insipidus did not improve. She is alive, receiving endocrine treatment for 2 years, since onset of diabetes insipidus.


Heparan sulfate composition of alternatively spliced CD44 fusion proteins.
Prior analyses of recombinant CD44 fusion proteins have indicated that combinatorial splicing of variant exons exerts distal effects on chondroitin sulfate content and structure, which may regulate the biological properties of the respective CD44 isoforms. The consequences of splicing of variant exons V4-7 on the heparan sulfate moieties were therefore examined, utilizing recombinant chimeras containing exons V3 and V8-10, engineered with or without exons V4-7 and expressed as Ig fusion proteins in COS cells. Splicing of exons V4-7, though they contain no consensus motifs for glycosaminoglycan assembly, resulted in markedly increased polymer sulfation levels of the heparan sulfates. The sulfate groups of both the CD44 V3-10 and V3,8-10 isoforms occurred as di- and tri-sulfated dissacharide units and were restricted to one N-sulfated block domain within the polymers. Compared to native human keratinocyte CD44, the recombinant heparan sulfates were relatively low in sulfate content. Our data indicate that variant exon V4-7 splicing exerts distal effects on the composition of this glycosaminoglycan. These effects may regulate those functions that are mediated through the heparan sulfate moieties, such as the binding of growth factors.


A partial revision of the marine nematode genus elzalia (monhysterida: xyalidae) with new characters and descriptions of two new species from khung kraben bay, East Thailand.
Elzalia bipectinellan. sp. and E. tuberculatan. sp. from Thailand are described and the males of three species from the Gulf of Mexico, E. federiciCastillo-Fernandez and Lambshead (1990), E. kimaeCastillo-Fernandez and Lambshead (1990), and E. poliCastillo-Fernandez and Lambshead (1990) are re-described from type and topotype specimens using light and scanning electron microscopy. New morphological characters are described that include ornamentations at the distal end of the spicula and features of the gubernaculum including the manus with digits, pontis with sensory receptor and accessory process, and the condylus with either conical or foliate projections. Also, ejaculatory and rectal glands are described for the first time for Elzalia. The relevance of the new characters to the taxonomy of Elzalia is discussed. A key to identification of males is provided. A generalized description of females is given, although characters are lacking by which females of each species may be identified.


Long-term outcomes of ultrasound-guided percutaneous microwave ablation versus resection for colorectal cancer liver metastases: a propensity-score matched study.
Many previous studies comparing liver resection versus thermal ablation for colorectal cancer liver metastases (CRCLM) are subject to severe selection bias. This study aimed to compare the long-term clinical efficacy of ultrasonography-guided percutaneous microwave ablation (PMWA) with resection for CRCLM using propensity score analysis to reduce confounding by indication. This retrospective study included 184 patients with CRCLM from January 2012 to June 2017. Treatment effect was estimated after propensity score matching, Descriptive, regression and survival statistics were applied. A lower American Society of Anesthesiologists classification score and higher performance status were found positively associated with resection (p < 0.05). After propensity score matching, the 1-, 2-, and 3-year local tumor progression free survival rates were found to be 60.3%, 19.1%, and 17.6% in the PMWA group, and 72.1%, 35.3%, 26.5% in the resection group, respectively (p = 0.049). The 1-, 3-, 5-, and 7-year overall survival rates in two groups were similar (p = 0.943). In the PMWA group and resection group, the median hospital stay was 1 (0-12) days and 7 (1-27) days (p = 0.005), respectively; major complications occurred in two patients (2%) and 11 patients (12.9%) (p = 0.009), respectively. After adjusting for factors known to affect treatment choice, no significant difference in overall survival rates was shown after ultrasound-guided PMWA versus resection for CRCLM. The LTPFS rate of the resection group were better than those of the ultrasound-guided PMWA group. However, the ultrasound-guided PMWA group had fewer complications and shorter hospital stay.


Women in novel occupational roles: mental health trends in the UK Armed Forces.
There is uncertainty about whether women in the military have more psychological symptoms than men and whether psychological symptoms have increased over time. The aims of this study were to assess changes in psychological symptoms in military women over time, to compare them with men, and assess the effect of deployment. Two cross-sectional studies based on random samples of the Armed Forces were used to assess the effects of deployment to the Gulf and Iraq Wars. We selected for the analyses all the women and a 20% random sample of men who completed a questionnaire stratified by rank. We assessed psychological distress, number of symptoms, post-traumatic stress reaction (PTSR), chronic fatigue and alcohol misuse. There has been an increase in psychological symptoms, including alcohol misuse, in those not deployed to the Gulf or Iraq Wars, especially in women. The odds ratios for PTSR [5.82 (95% CI: 1.27-26.71)], multiple symptoms [8.49 (1.97-36.65)] and alcohol misuse [6.20 (2.09-18.37)] were higher in women than in men in the non-deployed samples. Psychological distress and chronic fatigue was more common in women, and alcohol misuse, was more common in men. In women, psychological symptoms were positively associated with deployment in the Gulf War, but not the Iraq War. Psychological symptoms in the Armed Forces have increased over time regardless of gender, in those not deployed. The association between gender and psychological symptoms has not changed over time. The deployment effect in women is similar to that described in men.


Severe Hyponatremia Masking Central Diabetes Insipidus in a Patient with a Lung Adenocarcinoma.
Altered natremia is a common electrolyte disorder in clinical practice and a paraneoplastic manifestation. The syndrome of inappropriate antidiuretic hormone secretion is the first diagnostic suspicion in a patient with cancer and hyponatremia, although entities such as adrenal insufficiency primary or secondary to metastatic involvement must be taken into account. Likewise, immunorelated endrocrinopathies such as hypophysitis have been reported after the introduction of checkpoint inhibitors. A 46-year-old man diagnosed with metastatic adenocarcinoma of the lung with severe hyponatremia (111 mmol/L) consulted due to altered level of consciousness. The initial cranial CT scan did not reveal pituitary brain metastatic involvement; however, an MRI could not be performed due to the patient's clinical situation and subsequent exitus. The water restriction test confirmed the diagnostic suspicion of central diabetes insipidus. Medical treatment with desmopressin was started to avoid fluid depletion with improvement of natremia figures. It represents an exceptional case of central diabetes insipidus masked by severe hyponatremia in a patient with metastatic lung adenocarcinoma without initial evidence of pituitary metastatic involvement by CT imaging in treatment with nivolumab (anti-PD-1 agent). Secondary adrenal insufficiency due to pituitary metastatic involvement and endocrinologic toxicity immunorelated to the new checkpoint inhibitors should be considered as possible etiologic agents of central diabetes insipidus, even with hyponatremia.


[Multicenter evaluation of a newly developed microdilution test, brothMIC NTM to determine minimum inhibitory concentrations of antimicrobial agents for nontuberculous mycobacteria].
We developed a new broth microdilution susceptibility test for nontuberculous mycobacteria to determine minimum inhibitory concentrations(MICs). The test method utilized air-dried microplates containing serially diluted antimicrobial agents and the modified Middlebrook 7H9 broth. The nine agents tested were rifampicin, isoniazid, ethambutol, streptomycin, kanamycin, levofloxacin, clarithromycin, ethionamide and amikacin. The test plates were reconstituted by inoculation of 0.1 ml of cell suspensions prepared in distilled water by a 1:100 dilution of the 0.5 McFarland suspension. After inoculation, the isolates resulted in incubation at 36 degrees C with clarithromycin at pH 7.4, and with the remaining agents at pH 6.6. The growth endpoints were visually read after 7-day and 10-day incubations for slowly growing nontuberculous mycobacteria, and after 3-day and 5-day incubations for rapidly growing mycobacteria, respectively. The reproducibility was evaluated with the five ATCC reference strains of nontuberculous mycobacteria. Of the 1,287 repeated tests of the four ATCC slowly growing strains(M. avium, M. intracellulare, M. kansasii and M. gordonae), 1,200(93.2%) of the MICs read after 7-day incubation fell within 3 log 2 dilutions. Also, a strain of rapidly growing mycobacteria, M. fortuitum, was repeatedly tested, and the reproducibility was estimated to be 93.3% after 3-day incubation. A total of 728 clinical isolates of nontuberculous mycobacteria comprising 14 species were tested against nine agents. The MICs against nontuberculous mycobacteria distributed in a wide range, and the activities of rifampicin, levofloxacin, clarithromycin were more potent. These results demonstrate this newly developed test method to be a practical, rapid, quantitative means to determine MICs for nontuberculous mycobacteria in clinical laboratories.


A young man with persistent dyspepsia: the unexpected virtue of proton-pump inhibitors.
A 26-year-old man was referred to our department for a 3-year history of dyspepsia responsive to oral pump-inhibitors therapy. During the last year, he underwent a gastroscopy, a colonoscopy and a computed tomography enterography that failed to reveal an underlying organic disease: a diagnosis of functional dyspepsia was made. Because of the persistence of symptoms, he came to our ambulatory where we performed an abdominal ultrasound that revealed the presence of multiple bi-lobar lesions of the liver suspected for metastases and a hypoechoic solid lesion of the pancreas body, confirmed by a contrast enhanced computed tomography. Laboratory tests showed high chromogranin A and gastrin level, and a liver biopsy was consistent with a metastatic pancreatic neuroendocrine tumor. This report aims to underlie the diffuse heterogeneous diagnostic management of some common gastrointestinal symptoms, such as dyspepsia, that are too often approached with the prescription of proton pump inhibitors.


The androgen-binding protein gene is expressed in male and female rat brain.
Extracellular androgen-binding proteins (ABP) are thought to modulate the regulatory functions of androgens and the trans-acting nuclear androgen receptor. Testicular ABP and plasma sex hormone-binding globulin (SHBG), which is produced in liver, are encoded by the same gene. We have now found that the ABP-SHBG gene is also expressed in male and female rat brain. Immunoreactive ABP was found to be present in neuronal cell bodies throughout the brain as well as in fibers of the hypothalamic median eminence. The highest concentrations of immunoreactive cell bodies were located in the supraoptic and paraventricular nuclei. Likewise, ABP mRNA was present in all brain regions examined. Analysis of cDNA clones representing brain ABP mRNAs revealed amino acid sequence differences in brain and testicular ABPs. The protein encoded by an alternatively processed RNA has sequence characteristics suggesting that the protein could act as a competitior of ABP binding to cell surface receptors. These data and gene-sequencing experiments indicate that a specific ABP gene promoter is used for transcription initiation in brain. ABP may function in brain as an androgen carrier protein; however, in view of the widespread presence of ABP and ABP mRNA in brain, the protein may have a much broader, yet unknown, function.


Prevalence and demography of transsexualism in Belgium.
The Belgian medical world has acknowledged the diagnosis of transsexualism and accepted Sex Reassignment Surgery (SRS) as one of the steps in the treatment of choice since 1985. This prevalence and demographic study analyses data on all Belgian individuals who have undergone SRS since that year. All (188) plastic surgeons as well as all gender teams (Antwerp, Bruges, Ghent, and Liège) in Belgium were sent demographic questionnaires to be completed for each of their transsexual patients. The results show an overall prevalence of 1:12,900 for male-to-female and 1:33,800 for female-to-male transsexuals in Belgium. In Wallonia (the French-speaking region of Belgium) the prevalence is significantly lower than in Flanders (the Dutch-speaking region) and in Brussels (the bilingual capital region). In the total Belgian population the male/female sex ratio is 2.43:1, again with a substantial difference between Wallonia on the one hand and Flanders on the other. While in Flanders and in Brussels the prevalence is comparable to that in other Western European countries, in Wallonia it is markedly lower. Transsexualism in Wallonia appears to be socially less acceptable: persons suffering from gender dysphoria in that part of Belgium encounter more problems accessing gender clinics and receiving treatment.


Atomic force microscopy and FT-IR spectroscopy investigations of human heart valves.
Human aortic, mitral, tricuspid and pulmonary heart valves were investigated by the contact mode atomic force microscopy (AFM) in air, and using FT-IR spectroscopy in the frequency range 950-4000 cm(-1). Heart valves were collected post mortem from 65-78 years old patients who died from non-cardiac diseases. All of the examined valves showed considerable heterogeneity in the surface topography of collagen fibrils as well as in their organization on the tissue surface. The AFM images revealed areas with significantly different spatial organization of the collagen fibril bundles. We observed zones with multidirectional, stacked collagen fibrils as well as areas of thin fibrils packed regularly, densely and "in phase". The majority of the collagen fibrils reproduced the typical transverse D-banding pattern, with the band interval varying in rather wide range of 70-90 nm. Using AFM imaging, objects that correspond to some pathological states of heart valves at their early stages, i.e. some forms of mineral deposits, were observed. The FT-IR spectra allowed us to recognize main components, i.e. collagen and elastin, in di.erent layers (ventricularis, fibrosa) of the valve leaflets as well as they gave also support for the presence of mineral deposits on the valve surface. The presented results showed, that the AFM imaging and FT-IR spectroscopy can be applied as a complementary methods for structural characterization of heart valves at the molecular and supramolecular levels.


Testosterone responses to competition: The opponent's psychological state makes it challenging.
Testosterone (T) increases after competition have typically been attributed to winning, yet there is also evidence that being victorious is not in itself sufficient to provoke a T response. Instead, it has been proposed that T responses are moderated by psychological processes. Here, we investigated whether the opponent's psychological state affected hormonal changes in men competing face to face on a rigged computer task. The results show that, irrespective of outcome, the competition led to increases in heart rate and T levels. We found that the T levels of the participants increased more when their opponents had high self-efficacy and that T levels were not influenced by participants' own psychological state. Furthermore, the T levels of losers, but not winners, increased more when their opponent judged the competition to have low importance. The findings from this study are consistent with the challenge hypothesis. Both winners and losers were being challenged to compete for social status; therefore their T responses did not differ. In addition, the psychological state of the opponent makes a competition challenging and subsequently triggers T responses.


Medical professionalism education for psychiatry trainees: does it meet standards?
Developing professionalism is an important part of a doctor's training. Developing professional attributes is an expected part of postgraduate psychiatry training, as indicated by the curriculum. It is unknown whether this requirement is being met. Our aim was to explore whether psychiatry trainees are meeting current standards of professionalism education. This audit and evaluation was investigated using an online survey, inviting trainees from three National Health Service Trusts in North West England. Invitations were sent by email with a link to an online survey. The results suggest that current standards are not being met. Trainees value professionalism education and feel it is important. However, there is a lack of formal teaching and a lack of adequate educational opportunities: 25% of trainees get any formal teaching and 78% feel this teaching is not adequate. There is also a concern that 20% of supervisors are not considered good role models. Recommendations to address this educational gap are presented. Recommendations include making time in trainees' academic programmes for formal educational activities for professionalism development, and further exploration of why some supervisors are not considered good role models for professionalism.


Epigenetics and lupus.
Systemic lupus erythematosus (SLE) is among the systemic autoimmune diseases whose complex pathogenesis involves both genetic and environmental factors. Epigenetic dysregulation resulting in overexpression of certain genes in some of the key immune cells, such as T cells, has been incriminated in the pathophysiology of SLE. Epigenetics is defined as transmissible and reversible modifications in gene expression without alterations in the nucleotide sequences. Epigenetic information is carried chiefly by DNA itself, histones, and noncoding RNAs. Several epigenetic mechanisms may play a role in SLE pathogenesis. This review discusses the various epigenetic mechanisms that regulate gene expression and provides examples relevant to SLE.


Crowdsourcing the Moral Limits of Human Gene Editing?
In 2015, a flourish of "alarums and excursions" by the scientific community propelled CRISPR/Cas9 and other new gene-editing techniques into public attention. At issue were two kinds of potential gene-editing experiments in humans: those making inheritable germ-line modifications and those designed to enhance human traits beyond what is necessary for health and healing. The scientific consensus seemed to be that while research to develop safe and effective human gene editing should continue, society's moral uncertainties about these two kinds of experiments needed to be better resolved before clinical trials of either type should be attempted. In the United States, the National Academies of Science, Engineering and Medicine (NASEM) convened the Committee on Human Gene Editing: Scientific, Medical and Ethical Considerations to pursue that resolution. The committee's 2017 consensus report has been widely interpreted as "opening the door" to inheritable human genetic modification and holding a line against enhancement interventions. But on a close reading it does neither. There are two reasons for this eccentric conclusion, both of which depend upon the strength of the committee's commitment to engaging diverse public voices in the gene-editing policy-making process.


Regioselective intramolecular reactions of 2-indolylacyl radicals with pyridines: a direct synthetic entry to ellipticine quinones.
[reaction: see text] 2-Indolylacyl radicals generated from the corresponding selenoesters under hexabutylditin-hnu conditions undergo regioselective intramolecular reaction with unprotonated pyridines to give polycyclic indolylpyridyl ketones. For substrates bearing a (3-pyridyl)methyl moiety connected to the 3-position of the indole ring, the cyclization provides easy access to ellipticine quinones.


Adherens junctions in C. elegans embryonic morphogenesis.
Caenorhabditis elegans provides a simplified, in vivo model system in which to study adherens junctions (AJs) and their role in morphogenesis. The core AJ components-HMR-1/E-cadherin, HMP-2/β-catenin and HMP-1/α-catenin-were initially identified through genetic screens for mutants with body axis elongation defects. In early embryos, AJ proteins are found at sites of contact between blastomeres, and in epithelial cells AJ proteins localize to the multifaceted apical junction (CeAJ)-a single structure that combines the adhesive and barrier functions of vertebrate adherens and tight junctions. The apically localized polarity proteins PAR-3 and PAR-6 mediate formation and maturation of junctions, while the basolaterally localized regulator LET-413/Scribble ensures that junctions remain apically positioned. AJs promote robust adhesion between epithelial cells and provide mechanical resistance for the physical strains of morphogenesis. However, in contrast to vertebrates, C. elegans AJ proteins are not essential for general cell adhesion or for epithelial cell polarization. A combination of conserved and novel proteins localizes to the CeAJ and works together with AJ proteins to mediate adhesion.


Elevated levels of circulating mitochondrial DNA predict early allograft dysfunction in patients following liver transplantation.
The role of circulating mitochondrial DNA (cmtDNA) in transplantation remains to be elucidated. cmtDNA may be released into the circulation as a consequence of liver injury; yet recent work also suggests a causative role for cmtDNA leading to hepatocellular injury. We hypothesized that elevated cmtDNA would be associated with adverse events after liver transplantation (LT) and conducted an observational cohort study. Twenty-one patients were enrolled prospectively prior to LT. Postoperative complications were observed in 47.6% (n = 10). Seven patients (33.3%) had early allograft dysfunction (EAD), and six patients (28.5%) experienced acute cellular rejection within 6 months of LT. cmtDNA levels were significantly elevated in all recipients after LT compared with healthy controls and preoperative samples (1 361 937 copies/mL [IQR 586 781-3 399 687] after LT; 545 531 copies/mL [IQR 238 562-1 381 015] before LT; and 194 562 copies/mL [IQR 182 359-231 515] in healthy controls) and returned to normal levels by 5 days after transplantation. cmtDNA levels were particularly elevated in those who developed EAD in the early postoperative period (P < 0.001). In all patients, there was initially a strong overall positive correlation between cmtDNA and plasma hepatocellular enzyme levels (P < 0.05). However, the patients with EAD demonstrated a second peak in cmtDNA at postoperative day 7, which did not correlate with liver function tests. The early release of plasma cmtDNA is strongly associated with hepatocellular damage; however, the late surge in cmtDNA in patients with EAD appeared to be independent of hepatocellular injury as measured by conventional tests.


Exploring Factors That Helped Adolescents Adjust and Continue With Life After the Death of a Parent.
The aim of this study was to explore factors that helped adolescents to adjust and continue with life after the death of a parent. A qualitative research design was utilized, in which 12 participants participated in semistructured interviews. Data were analyzed according to thematic analysis. The following categories and themes emerged from the data: family support-supportive remaining parent, parent has a supportive partner and supportive extended family; social support-child has supportive friends and supportive community; religion--religion as a coping mechanism and religion as means of communicating with the deceased parent; and a strong personal sense of coherence (the ability to relate to and make sense of the world) as an intrapersonal coping mechanism. In addition, the following themes also emerged: exercising, allowing time to prepare for the death of a terminally ill parent, tangible reminders of the deceased, and journal writing. The findings can be used to design interventions for adolescents whose parent has passed away.


Studies on P-450. X. On the coordination structure of hemoprotein P-450.
The spectral properties of a P-450 preparation from adrenocortical mitochondria were compared with those of both other hemoproteins and model compounds to examine the possibility suggested by previous authors that the mercaptide anion (thiolate anion, RS-) of a cysteine residue might be one of the axial ligands of P-45O. 1. The following features were found in addition to the well known anomalous spectral characteristics of P-450. The Soret band of the ferrous form was at anomalously short wavelengths compared with those of other ferrous high-spin hemoproteins. The regularity in the shifts of the Soret maximum observed with various forms of usual hemoproteins was disrupted in the case of P-450 by the maximum of the ferrous form. 2. The complex of methemoglobin with 2-mercaptoethanol, which was the model for P-450 used by previous authors for spectral and ESR studies, was studied more precisely. The model showed an absorption spectrum very similar to that of the imidazole complex of ferric P-450, whereas the complex of methemoglobin with imidazole showed both Soret and visible absorption maxima at shorter wavelengths. The rapid rate of reduction of methemoglobin by dithionite decreased on binding to mercaptoethanol and the slow rate of reduction of P-450 increased on binding to imidazole. Thus the half-reduction times for both complexes were of the same order of magnitude. 3. An absorption spectrum which was very similar to the spectrum of ferric high-spin P-45O could be obtained by quick scanning immediately after ferric protoheme had been dissolved in a 33% solution of mercaptoethanol in water containing Tween 20 and NaOH. 4. Protoheme dissolved in an aqueous solution of Nikkol BL9EX (a non-ionic detergent) containing NaOH, dithionite, and 1 mM mercaptoethanol formed a transient intermediate complex having a Soret maximum at 470 nm. Treatment of this complex with carbon monoxide resulted in the formation of a CO adduct having a Soret maximum at 450 nm and a single band at about 555 nm in the visible region. These maxima were similar to those of the carbon monoxide complex of P-450. Many of the results could be explained readily by assuming that a mercaptide anion was one of the axial ligands, and also that heme was held in a hydrophobic crevice in the P-450 molecule. The coordination structure of P-450 seems to be more flexible than those of usual hemoproteins.


Hepatitis B virus surface antigen suppresses the activation of monocytes through interaction with a serum protein and a monocyte-specific receptor.
During hepatitis B virus (HBV) infection, high numbers of non-infectious HBV surface antigen (HBsAg) particles are present in circulation. It is shown here that recombinant HBsAg (rHBsAg) particles, which contain the S protein only, bind almost exclusively to monocytes. Attachment of rHBsAg to the THP-1 pre-monocytic cell line occurs upon 1,25-dihydroxyvitamin D3-induced differentiation. Binding to monocytes is enhanced by a heat-labile serum protein and is inhibited by Ca(2+)/Mg(2+), low pH and an HBsAg-specific monoclonal antibody. Furthermore, it is shown that rHBsAg suppresses lipopolysaccharide- and IL-2-induced production of cytokines. These results suggest the existence of a monocyte-specific receptor, the engagement of which by HBsAg suppresses the activity of these cells.


[Effect of Nivalenol and selenium on IL-1beta and TNF-alpha secretion in cultured chondrocytes].
To investigate the effect of Nivalenol(NIV) and Selenium(Se) on the levels of IL-1beta and TNF-alpha in the cultured chondrocytes. Human chondrocytes cultured in vitro were treated with or without NIV and Se. The morphology of chondrocytes was observed by optic microscope. The DNA content was determined by UV Spectrophotometry. The levels of IL-1beta and TNF-alpha in cultured medium were measured by enzyme-linked immunosorbent assay (ELISA). Hematoxylin & eosin staining indicated there was cell necrosis in the cartilage reconstructed in vitro from both NIV group and NIV+Se group. Compared with the group of NIV toxin, the damage of chondrocytes was less severe when Se was added. NIV could inhibit chondrocyte DNA synthesis. The content of DNA with NIV was lowest than that in other groups. The levels of IL-1beta and TNF-alpha with NIV were significantly higher than control group (P<0.05). After Se was added, the levels did not change significantly compared with the groups without Se. NIV toxin could superinduce IL-1beta and TNF-alpha secretion in chondrocytes, which may be the key mechanism of chondrocyte injury by NIV. Se can partially alleviate the effects of NIV on chondrocytes cultured in vitro.


Long-Lasting Activation of the Transcription Factor CREB in Sensory Neurons by Interleukin-1β During Antigen-Induced Arthritis in Rats: A Mechanism of Persistent Arthritis Pain?
In spite of successful treatment of immune-mediated arthritis, many patients still experience pain. We undertook this study to investigate whether antigen-induced arthritis (AIA) in rats triggers neuronal changes in sensory neurons that outlast the inflammatory process. We induced unilateral AIA in the knee joint and assessed in sensory neurons the expression of CREB, a transcription factor that regulates genes involved in neuronal plasticity. We tested whether neutralization of the effects of tumor necrosis factor (TNF) by etanercept or infliximab or neutralization of the effects of interleukin-1β (IL-1β) by anakinra influences the up-regulation of phospho-CREB, and we studied the up-regulation of phospho-CREB by IL-1β and TNF in cultured dorsal root ganglion (DRG) neurons. Unilateral AIA caused bilateral up-regulation of phospho-CREB in lumbar DRG neurons. While inflammation and pain subsided within 21 days, the up-regulation of phospho-CREB still persisted on day 42. At this time point mechanical hyperalgesia at the knee reappeared in the absence of swelling. TNF neutralization during AIA significantly reduced pain-related behavior but did not prevent phospho-CREB up-regulation. In contrast, anakinra, which only reduced thermal hyperalgesia, prevented phospho-CREB up-regulation, suggesting a role of IL-1β in this process. In cultured DRG neurons the application of IL-1β significantly enhanced phospho-CREB. Immune-mediated arthritis causes neuroplastic changes in sensory neurons that outlast the inflammatory phase. Such changes may facilitate the persistence or recurrence of pain after remission of arthritis. IL-1β is an important trigger in this process, although its neutralization barely reduced mechanical hyperalgesia during inflammation.


CYP2D6 in Amerindians from Southern Mexico: low variability and higher frequency of functional alleles.
Several functional and nonfunctional CYP2D6 variants have been associated with interindividual and interethnic variability in pharmacological responses. The aim of this article was to study the diversity and the interpopulation relationships of CYP2D6 variants of south Native Mexicans to define predicted phenotypes. A fully systematic review of CYP2D6 variants reported in Amerindian populations before 2015 was performed (NCBI, Google Scholar, and 1000 Genomes Project databases). Allele data were analyzed by methods such as heat map, dissimilarity matrix, dendogram, and principal component analysis using complete-linkage clustering method. Five original studies on CYP2D6 covering 13 Native Mexican populations were identified; three of these described CYP2D6 allele frequencies were in south Native Mexican populations. Overall, CYP2D6 allele variability is scarce in southern Native Mexican populations: besides the functional alleles *1 and *2 and the null variant *4, the other variants have frequencies <0.05. This implies that most of the southern Native Mexican populations may be considered CYP2D6 extended metabolizers. The statistical analyses tend to cluster the native communities by their geographical origin, but in a disperse pattern suggesting distinct subpopulation structures. CYP2D6 functional variants are prevalent in Native Mexicans, and they may be predicted as extended drug metabolizers. In addition, allele frequencies are related to the geographic distribution of the Amerindian groups and display important population stratification.


Lever arm on bracket vs. lever arm on archwire: A 3D finite element method study of mechanics of miniscrew-supported lingual en-masse retraction of maxillary anterior teeth.
To compare the deformation of the main archwire and 3D movements of maxillary anterior teeth during miniscrew-supported en-masse retraction with the lever arm on the archwire and on the brackets in lingual orthodontic treatment in finite element analysis (FEM) simulation. A 3D dental-alveolar model with bonded 0.018×0.025-inch slot lingual brackets and a 0.017×0.025-inch dimension stainless-steel archwire was created. Four FEM models were created based on a 3D dental-alveolar model: in Models A and C, the lever arms were attached to the lingual bracket, while in Models B and D, the lever arms were attached to the archwire. Meanwhile, in Models A and B, the miniscrews were placed in between the molars, while in Models C and D, the miniscrews were positioned on the palatal roof. After a 1.5N retraction force was applied from the miniscrew to the end of the lever arm, the initial movements in the sagittal, transversal, and vertical planes were recorded and analysed for maxillary anterior teeth. In Models B and D, smaller deformation of the main archwire and less prominent bowing effect were noticed in both sagittal and vertical directions compared to their counter groups. In Models C and D, the central incisors showed less torque loss in the sagittal direction and more canine intrusion vertically. For the same lever arm-miniscrew retraction configuration, the lever arm on the bracket showed less deformation of the main archwire and more body movement of the teeth than the lever arm on the archwire group. With the same level arm height, the transverse and vertical bowing effect is reduced when the lever arm was placed distal to the central incisor and the miniscrews placed next to the palatal suture.


Impact of processing on nutritional quality of marine food items.
During the last two decades it has been established that Greenland Eskimos living on their traditional diet, have a lower incidence of coronary heart disease (CHD) than when living in Denmark on a western diet. These findings have been attributed to their diet, particularly the high amounts n-3 polyunsaturated fatty acids. The Eskimo diet consists mainly of meat and blubber of seal and whale and relatively small amounts of fish. Another aspect of the Eskimo diet, still not fully explored, is that the Eskimos consume the bulk of their food raw or dried, seldom boiled or exposed to excessive heat. The main task of modern processes is to make edible and stable products. Removal of molecules that cause off-flavours or taste to improve sensory attributes may, for instance, destroy potent antioxidants. Modern meal preparing techniques may also lower the content of biologically active components. The objective of our experiments has been, by mimicking in part the traditional Eskimo diet, to explore the beneficial effects of raw food items on parameters related to development of CHD. Reduced tendency of developing arteriosclerosis has been related to the lower reactivity of platelets and less production of proinflammatory products, e.g. cytokines, prostaglandins and leukotrienes. In our study, healthy volunteers ingested raw or heat processed marine materials (smoked versus heat processed salmon muscle, cold pressed versus refined marine oils).


Pyrrolidine-based 3-deoxysphingosylphosphorylcholine analogs as possible candidates against neglected tropical diseases (NTDs): identification of hit compounds towards development of potential treatment of Leishmania donovani.
A rational-based process was adopted for repurposing pyrrolidine-based 3-deoxysphingosylphosphorylcholine analogs bearing variable acyl chains, different stereochemical configuration and/or positional relationships. Structural features were highly influential on activity. Amongst, enantiomer 1e having 1,2-vicinal relationship for the -CH2O- and the N-acyl moieties, a saturated palmitoyl chain and an opposite stereochemical configuration to natural sphingolipids was the most potent hit compound against promastigotes showing IC50 value of 28.32 µM. The corresponding enantiomer 1a was 2-fold less potent showing a eudismic ratio of 0.54 in promastigotes. Compounds 1a and 1e inhibited the growth of amastigotes more potently relative to promastigotes. Amongst, enantiomer 1a as the more selective and safer. In silico docking study using a homology model of Leishmania donovani inositol phosphoceramide synthase (IPCS) provided plausible reasoning for the molecular factors underlying the found activity. Collectively, this study suggests compounds 1a and 1e as potential hit compounds for further development of new antileishmanial agents.


Novel surface tension isotherm for surfactants based on local density functional theory.
In this Letter we report a new general method for calculating of surface tension isotherms in the presence of surfactants, based on a local density functional. We illustrate this method by deriving the interfacial tension isotherm for nonionic surfactants at an air-water or oil-water interface by using the self-consistent field theory of polymer brushes. We consider a particular case of local density functional to calculate explicitly how the interfacial tension and the surfactant adsorption depend on the surfactant bulk concentration. Experimental data for the surface tension and the surfactant adsorption isotherm for nonionic surfactants were interpreted with the help of the new isotherm. Very good agreement between the adsorption of n-dodecyl pentaoxyethylene glycol ether (C12E5) at an air-water interface, calculated from the surface tension isotherm and small-angle neutron-scattering is obtained.


A 60-year-old woman with cough, dyspnea, and atelectasis 19 years after liver transplant.
A 60-year-old black woman presented with nonproductive cough of 1-month duration. She had also experienced rapidly progressive dyspnea for 1 week and one bout of vomiting a day before presentation. Her symptoms had failed to improve with a course of amoxicillin-clavulanate. Her medical history was significant for diabetes mellitus and liver transplant 19 years earlier for hepatitis C cirrhosis, for which she was receiving tacrolimus and mycophenolate. She was a current smoker with 40 pack-years of smoking history.


Elevated PIN1 expression by C/EBPalpha-p30 blocks C/EBPalpha-induced granulocytic differentiation through c-Jun in AML.
The transcription factor CCAAT enhancer-binding protein alpha (C/EBPalpha) has an important role in granulopoiesis. The tumor suppressor function of C/EBPalpha is shown by the findings that loss of expression or function of C/EBPalpha in leukemic blasts contributes to a block in myeloid cell differentiation and to leukemia. C/EBPalpha mutations are found in around 9% of acute myeloid leukemia (AML) patients. The mechanism by which the mutant form of C/EBPalpha (C/EBPalpha-p30) exerts a differentiation block is not well understood. By using a proteomic screen, we have recently reported PIN1 as a target of C/EBPalpha-p30 in AML. In the present study, we show that C/EBPalpha-p30 induces PIN1 expression. We observed elevated PIN1 expression in leukemic patient samples. Induction of C/EBPalpha-p30 results in recruitment of E2F1 in the PIN1 promoter. We show that the inhibition of PIN1 leads to myeloid differentiation in primary AML blasts with C/EBPalpha mutations. Overexpression of PIN1 in myeloid cells leads to block of granulocyte differentiation. We also show that PIN1 increases the stability of the c-Jun protein by inhibiting c-Jun ubiquitination, and c-Jun blocks granulocyte differentiation mediated by C/EBPalpha. Our data suggest that the inhibition of PIN1 could be a potential strategy of treating AML patients with C/EBPalpha mutation.


Combination of immunosensor detection with viability testing and confirmation using the polymerase chain reaction and culture.
Rapid and accurate differential determination of viable versus nonviable microbes is critical for formulation of an appropriate response after pathogen detection. Sensors for rapid bacterial identification can be used for applications ranging from environmental monitoring and homeland defense to food process monitoring, but few provide viability information. This study combines the rapid screening capability of the array biosensor using an immunoassay format with methods for determination of viability. Additionally, cells captured by the immobilized antibodies can be cultured following fluorescence imaging to further confirm viability and for cell population expansion for further characterization, e.g., strain identification or antibiotic susceptibility testing. Finally, we demonstrate analysis of captured bacteria using the polymerase chain reaction (PCR). PCR results for waveguide-captured cells were 3 orders of magnitude more sensitive than the fluorescence immunoassay and can also provide additional genetic information on the captured microbes. These approaches can be used to rapidly detect and distinguish viable versus nonviable and pathogenic versus nonpathogenic captured organisms, provide culture materials for further analysis on a shorter time scale, and assess the efficacy of decontamination or sterilization procedures.


Exploring emotional intelligence. Implications for nursing leaders.
Emotional intelligence is being touted in the popular literature as an important characteristic for successful leaders. However, caution needs to be exercised regarding the connection between emotional intelligence and workplace success. The author contrasts 2 current models of emotional intelligence, the measurements being used, and the ability of emotional intelligence to predict success. Implications for the workplace are discussed.


Clinical characteristics of mirror syndrome: a comparison of 10 cases of mirror syndrome with non-mirror syndrome fetal hydrops cases.
To investigate clinical features of mirror syndrome. We retrospectively reviewed 71 cases of fetal hydrops with or without mirror syndrome, and compared with respect to maternal age, the body mass index, the primipara rate, the gestational age at delivery, the timing of fetal hydrops onset, the severity of fetal edema, placental swelling, the laboratory data and the fetal mortality. The data are expressed as the medians. Mirror syndrome developed in 29% (10/35) of the cases with fetal hydrops. In mirror group, the onset time of fetal hydrops was significantly earlier (29 weeks versus 31 weeks, p = 0.011), and the severity of fetal hydrops (fetal edema/biparietal diameter) was significantly higher than non-mirror group (0.23 versus 0.16, p < 0.001). There was significantly higher serum human chorionic gonadotropin (hCG) (453,000 IU/L versus 80,000 IU/L, p < 0.001) and lower hemoglobin (8.9 g/dL versus 10.1 g/dL, p =0.002), hypoalbuminemia (2.3 mg/dL versus 2.7 mg/dL, p = 0.007), hyperuricemia (6.4 mg/dL versus 5.0 mg/dL, p = 0.043) in mirror group. Mirror syndrome is occurred frequently in early and severe fetal hydrops and cause hemodilution and elevation of serum hCG.


Clinical and ethical considerations of massively parallel sequencing in transplantation science.
Massively parallel sequencing (MPS), alias next-generation sequencing, is making its way from research laboratories into applied sciences and clinics. MPS is a framework of experimental procedures which offer possibilities for genome research and genetics which could only be dreamed of until around 2005 when these technologies became available. Sequencing of a transcriptome, exome, even entire genomes is now possible within a time frame and precision that we could only hope for 10 years ago. Linking other experimental procedures with MPS enables researchers to study secondary DNA modifications across the entire genome, and protein binding sites, to name a few applications. How the advancements of sequencing technologies can contribute to transplantation science is subject of this discussion: immediate applications are in graft matching via human leukocyte antigen sequencing, as part of systems biology approaches which shed light on gene expression processes during immune response, as biomarkers of graft rejection, and to explore changes of microbiomes as a result of transplantation. Of considerable importance is the socio-ethical aspect of data ownership, privacy, informed consent, and result report to the study participant. While the technology is advancing rapidly, legislation is lagging behind due to the globalisation of data requisition, banking and sharing.


Comparison of the diagnostic sensitivity of a commercially available culture kit and a diagnostic culture test using Diamond's media for diagnosing Tritrichomonas foetus in bulls.
A number of different culture media have been described for use in the diagnosis of Tritrichomonas foetus infection in bulls, and recently, a commercial culture kit has become available. The objective of this study was to compare the sensitivity of 2 culture-based diagnostic tests for T. foetus in bulls. One test used a commercial kit for transport and culture of the samples. The other test used a thioglycollate transport medium (TFTM) for transport and a modified Diamond's medium (MDM) for culture of the samples. Twenty-one bulls infected with T. foetus were sampled repeatedly. On each sampling day, samples collected from the left and right sides of the bull were tested with one of the 2 diagnostic tests being compared. The effect of the type of diagnostic test on the outcome of the test was evaluated with a chi-square test for the calculated odds ratio. Because repeated tests from the same bull cannot be considered independent measures, unadjusted chi-square tests were adjusted for the effect of clustering by bull. Samples tested using the commercial kit were 6.95 times as likely to be positive as samples tested with a diagnostic test using MDM (P < 0.001).


Campylobacter enterocolitis in a neonatal nursery.
During a five-day period, four neonates in a neonatal nursery developed Campylobacter entercolitis. Investigations suggested that cross-infection or common-source infection were unlikely and that the neonates acquired their infection during delivery from their respective mothers, three of whom were also found to harbour Campylobacter jejuni in their stools. This suggestion was confirmed with use of the Lior serotyping system in a blind fashion. Each neonate was infected with a different serotype, and each of the three culture-positive mothers had the same serotype as her neonate. Examination of multiple colonies from the stools of five individuals showed that each was likely to have been infected by only one serotype. The presenting clinical features in the four neonates provides further evidence that neonatal Campylobacter entercolitis typically manifests as a benign, self-limited, nonfebrile, diarrheal illness with bloody stools.


Removal of cetyltrimethylammonium bromide to enhance the biocompatibility of Au nanorods synthesized by a modified seed mediated growth process.
Previously, we reported the synthesis of stable gold nanorods with higher aspect ratio (approximately 15-20) and more enhanced uniformity by a modified seed mediated growth approach using a binary surfactant system consisting of CTAB and Pluronic F-127. For the in vivo application of gold nanorods, the removal of CTABs that are strongly bound on prepared Au nanorods is necessary due to their cytotoxicity. Use of heat or acid at various conditions was performed to achieve the complete removal of CTAB from the synthesized Au nanorods while maintaining their stability. Here, we report the appropriate conditions for both treatments that can remove CTAB efficiently without hampering the stability of Au nanorods. After the removal of CTAB, Pluronic F-127 was added additionally for the stabilization and further potential functionalization of Au nanorods to make useful for various applications. VIS-NIR absorption spectroscopy, SEM, TEM, and FTIR were used for characterization.


Analysis of urine sediments after kidney transplantation.
We applied multiparameter flow cytometry for the first time to the classification of cells and particles of urine sediments after kidney transplantation. After fluorescent staining with acridine orange, cells and particles were checked for their size and their peak intensity of green and red fluorescences, known to be related to the amounts of intracellular DNA and intracellular RNA, respectively. Urine sediments were tested daily during a period of up to three weeks. Occurrence and disappearance of certain classes of cells and particles were found to be similar among different patients during normal healing. The results from patients without rejection of the graft are suggested as baseline data, differences from which should be detectable with high sensitivity due to the large number of cells being examined.


Studies on the antimicrobial mechanisms of capsaicin using yeast DNA microarray.
Capsaicin is a pungent element in a variety of red peppers that are widely used as food additives and considered to be an antimicrobial factor. For our tests, we used yeast DNA micro-array methods to understand the mechanisms of inhibitory effects of capsaicin. The capsaicin treatment significantly induced 39 genes from approximately 6,000 genes. These induced genes were classified as multi-drug resistance transporter genes, membrane biosynthesis genes, genes encoding stress proteins, and uncharacterized genes. The growth abilities of the strains with the deletion of the induced genes suggest that capsaicin is pumped out of the yeast cells by the PDR5 transporter.