[Prognostic significance of the elevation of the indices of myocardial damage after percutaneous coronary revascularization interventions].
In the last 10 years a large number of studies have clearly shown that mild to moderate elevation of biochemical markers of myocardial damage is quite common following otherwise successful percutaneous coronary revascularization. The true significance of these findings is not fully understood and the question if they carry sufficient adverse clinical impact to be categorized as a "complication" of the procedure is still debatable. The majority of experience published so far has reported an association between post-procedure enzyme release and long-term mortality, with a direct link between the level of elevation of the creatine kinase myocardial band (CK-MB) and the risk of death. Side branch occlusion and microembolization are the most frequent factors responsible for myocardial damage after stent implantation. Potential mechanisms of adverse prognosis include increased susceptibility to ventricular arrhythmias via microreentrant circuits, compromised coronary collaterals, or dysfunction of microvascular circulation. A cause and effect relationship between post-procedure enzyme elevation and a worse outcome has not been clearly demonstrated; patients in whom CK-MB elevation develops are older and have more extensive coronary artery disease than patients without enzymatic infarct; it is difficult therefore to determine whether the elevations are causative or whether they are associated with mortality due to their association with higher risk at baseline. Consequently it is not clear if prevention of procedural mild myocardial damage is associated with long-term benefit. Numerous other questions remain unanswered, regarding: 1) the biochemical marker most suitable in identifying patients at increased risk of late adverse events; 2) the threshold at which this elevation is clinically significant; 3) the relevance of the type of percutaneous device used. Ongoing large-scale, prospective studies, with extended follow-up, could provide further insights into prognostic significance of elevation of markers of myocardial necrosis following percutaneous coronary interventions.


Development, Trait Evolution, and the Evolution of Development in Trilobites.
Trilobites offer one of the best fossil records of any arthropod group. This is due to a number of factors, most notably the combination of (1) having inhabited areas where organisms are more likely to be buried and ultimately fossilized; and (2) having had a highly biomineralized exoskeleton more likely to survive the stresses of fossilization. This biomineralized exoskeleton was also morphologically complex, bearing traits that had ecological significance, and was present throughout postembryonic development, from larval to adult stages. Because the morphology of the exoskeleton changed gradually across molts during development, it is possible to reconstruct ontogenetic series for many species. Over the last decade, studies have documented both variation in modularity among closely related species and conserved developmental patterns among modules. In the latter case, trait evolution could still occur through modification of rates of morphological change along otherwise conserved ontogenetic trajectories. At the clade level, the pattern of expression and release of new exoskeletal segments during post-embryonic development was generally conserved across most species, but the relative timing of different segmentation events could vary, and developmental traits appear to have been relatively labile across the clade's evolutionary history. Most recently, comparative analyses indicate that the association between segmentation events and the timing of shifts in the rate of ontogenetic shape change varies across species. Despite these advances, we still know relatively little about how development constrained or contributed to trait evolution in trilobites, and almost nothing about the origin of novel traits in trilobites. A major (but removable) obstacle is the current lack of well-supported trilobite phylogenies that span higher taxonomic levels.


Environmental emission, fate and transformation of microplastics in biotic and abiotic compartments: Global status, recent advances and future perspectives.
The intensive use and wide-ranging application of plastic- and plastic-derived products have resulted in alarming levels of plastic pollution in different environmental compartments worldwide. As a result of various biogeochemical mechanisms, this plastic litter is converted into small, ubiquitous and persistent fragments called microplastics (<5 mm), which are of significant and increasing concern to the scientific community. Microplastics have spread across the globe and now exist in virtually all environmental compartments (the soil, atmosphere, and water). Although these compartments are often considered to be independent environments, in reality, they are very closely linked. Ample research has been done on microplastics, but there are still questions and knowledge gaps regarding the emission, occurrence, distribution, detection, environmental fate and transport of MPs in different environmental compartments. The current article is intended to provide a systematic overview of MP emissions, pollution conditions, sampling and analytical approaches, transport, fates and transformation mechanisms in different environmental compartments. It also identifies research gaps and future research directions and perspectives.


Alterations of the position of the marginal soft tissue following periodontal surgery.
The present study was performed to examine the alterations of the position of the marginal soft tissue ("gingival margin") on the buccal surface of teeth in patients who following periodontal surgery were enrolled in a supervised maintenance care program for 10--11 years. The material consisted of 43 patients with severe destruction of the periodontal tissues. Following initial treatment comprising scaling, root planing and instructions in plaque control measures, deepened periodontal pockets were eliminated by the use of an apically repositioned flap procedure including osseous surgery to eliminate bony defects. After treatment, the patients were recalled once every 3--6 months for maintenance care. In all patients, the distance between the cemento-enamel junction and the gingival margin on the buccal surfaces of all treated teeth was assessed (1) prior to surgery, (2) after initial healing, and (3) at a reexamination 10--11 years after treatment. In addition, the presence or absence of keratinized gingiva was determined. The results showed that (1) during active periodontal treatment the position of the gingival margin was shifted in an apical direction, (2) this displacement was to some extent compensated for by a coronal regrowth during the postoperative maintenance care period, (3) the alterations of the position of the gingival margin followed a similar pattern in areas with and without a zone of keratinized gingiva, (4) the number of gingival units devoid of keratinized gingiva decreased during the maintenance care period.


Hard and soft acids and bases: structure and process.
Under investigation is the structure and process that gives rise to hard-soft behavior in simple anionic atomic bases. That for simple atomic bases the chemical hardness is expected to be the only extrinsic component of acid-base strength, has been substantiated in the current study. A thermochemically based operational scale of chemical hardness was used to identify the structure within anionic atomic bases that is responsible for chemical hardness. The base's responding electrons have been identified as the structure, and the relaxation that occurs during charge transfer has been identified as the process giving rise to hard-soft behavior. This is in contrast the commonly accepted explanations that attribute hard-soft behavior to varying degrees of electrostatic and covalent contributions to the acid-base interaction. The ability of the atomic ion's responding electrons to cause hard-soft behavior has been assessed by examining the correlation of the estimated relaxation energies of the responding electrons with the operational chemical hardness. It has been demonstrated that the responding electrons are able to give rise to hard-soft behavior in simple anionic bases.


Open posterior dislocation of hip in a 6-year-old boy: a rare case report.
Open hip dislocation in pediatric patients is a rare injury. Open posterior dislocation because of soft tissue damage is unstable after reduction. There is no treatment protocol in the literature for this injury in pediatric patients. We treated a 6-year-old boy presented with open posterior hip dislocation. Thorough debridement was performed and antibiotics were administered to prevent infection, and fixation of reduction with Kirschner-wires (K-wires) was performed. Nonthreaded K-wires were used under an image intensifier to minimize the risk of physeal injury. A hip spica cast was used to prevent the breakage of K-wires into the joint because of movements at the hip.


Genomic analysis of Hepatitis B virus and its association with disease manifestations in Bangladesh.
The direct cytopathic effects of the hepatitis B virus (HBV) on subsequent liver damage are not fully understood in HBV-infected patients. However, associations between the prevalence of various HBV genotypes and the extent of liver damage have been reported from different parts of the world. The purpose of this study was to determine the distribution of HBV genotypes in patients with chronic HBV infection in Bangladesh, a country of 160 million people, of which approximately 3-6 million are chronically infected HBV patients. In addition, whole and partial genome sequencing of HBV was performed to evaluate the relationship between HBV mutations and genotypes. We found that 42% of the patients with low HBV DNA and normal levels of alanine aminotransferase (ALT) had HBV genotype D. In contrast, the HBV genotype C was dominant among patients with high HBV DNA levels (>2000 IU/ml) and elevated ALT and in patients with liver cirrhosis (LC) and hepatocellular carcinomas (HCC). Whole and partial genome sequences of HBV revealed that most patients with LC and HCC had HBV genotype C with mutations at the T1762/A1764 positions. It seems that Bangladesh represents a borderline country, situated within East Asia, which mainly consists of individuals with HBV genotypes B and C, whereas in the western parts of Asia, HBV genotypes A and D are prevalent. Bangladesh is, therefore, an excellent model for the comparison of the pathophysiology of three major HBV genotypes in a single population. The findings of this study suggest a possible association between HBV viral factors and the extent of liver damage in chronic HBV-infected patients.


[Clinical Study on Cerebellar Contusion:A Report on 9 Cases and Literature Review].
We report 9 cases of cerebellar contusion from April 2011 to September 2014 at our department. Frequency, clinicoradiological findings, mechanism of injury, treatments, and outcomes were retrospectively analyzed. Of 239 head injury cases admitted to our department during the same period, 9(3.8%)were diagnosed as cerebellar contusion. Among these 9 cases, 7 were men, and 2 were women. The patient age ranged from 12 to 83 years with a mean age of 64.7 years. The mechanism of injury was traffic accident in one patient, and fall in 8. All cases were associated with direct head trauma to the occiput, and radiographic studies showed occipital bone fracture in 8 cases. Six cases were managed conservatively. Three cases underwent suboccipital craniectomies and clot evacuations. Glasgow Outcome Scale(GOS)score at discharge were Good Recovery(GR)in 2, Moderate Disability(MD)in 2, Severe Disability(SD)in 3, Vegetative State(VS)in 1, and Dead(D)in 1. GOS scores in surgically treated cases were GR in 1, SD in 1, and VS in 1. Supratentorial severe traumatic lesions were concomitant with poor prognosis. Coup injury was a significant cause of cerebellar contusion. External decompression and clot evacuation were useful in patients who suffered severe cerebellar contusion;however, concomitant supratentorial lesions influenced the prognosis.


Anomeric reactivity-based one-pot synthesis of heparin-like oligosaccharides.
A highly efficient one-pot methodology is described for the synthesis of heparin and heparan sulfate oligosaccharides utilizing thioglycosides with well-defined reactivity as building blocks. L-Idopyranosyl and D-glucopyranosyl thioglycosides 5 and 10 were used as donors due to low reactivity of uronic acids as the glycosyl donors in the one-pot synthesis. The formation of uronic acids by a selective oxidation at C-6 was performed after assembly of the oligosaccharides. The efficiency of this programmable strategy with the flexibility for sulfate incorporation was demonstrated in the representative synthesis of disaccharides 17, 18, tetrasaccharide 23, and pentasaccharide 26.


Longitudinal measurement of airway inflammation over one year in children and adults with intermittent asthma.
Asthma is an inflammatory disease of the airways, but in clinical practice inflammation is rarely monitored. The aim of this study was to assess the level of airway inflammation in steroid naïve adult and pediatric patients with intermittent asthma over one year. 54 children and 50 adults with intermittent asthma (GINA step 1) were included. On up to 6 visits lung function, airway hyperresponsiveness to methacholine (PC20FEV1), sputum eosinophils and exhaled nitric oxide (FeNO) were assessed. 36 pediatric and 34 adult patients were able to produce at least three adequate sputum samples over the study period and were included into the analysis.In 8 children (22%) the percentage of sputum eosinophils was always below 2.5%. A higher level of eosinophils (>2.5%) was found on at least one visit in 16 (44%) and always >2.5% in 12 children (33%). In the adult group the respective numbers were 14 patients (41%) with always low (<2.5%), 17 (50%) with at least once over 2.5% and three patients (9%) were always above the threshold of 2.5% sputum eosinophils. These results demonstrate that a substantial number of children and adults with intermittent asthma under ß-agonist treatment only, have variable or persistently high levels of eosinophilic airway inflammation. Long-term studies are needed to observe the progression of asthma severity in such patient populations.


The contribution of ego psychology to understanding the process of termination in psychoanalysis and psychotherapy.
Ego psychology is presented as an integrated psychoanalytic developmental theory, including a theory of object relations. The process of termination is employed as one of the many possible illustrations of the usefulness of this theory. Termination is regarded as a process that pervades the treatment from the outset, rather than as the final phase of treatment only, because the treatment process, whether psychoanalysis or psychotherapy, includes continuous promotion of ever-increasing autonomy. Ideally, by the time termination proper takes place, maximum autonomy has been attained. To the definition of autonomy as intersystemic, involving relative independence of the ego from the drives (and from the super-ego), an object-relations dimension is added which extends that definition to include an intrasystemic consideration--namely, relative independence of the self-representation from the object representations. Especially in the treatment of the borderline conditions is the intrasystemic factor cogent because borderline states are characterized by varying degrees of incompletely differentiated self- and object representations. The objective, in the psychoanalysis of neurosis, where self- and object constancy already exist to a large degree, is ego autonomy in the intersystemic sense. In the psychotherapy of the borderline conditions, the objective is greater differentiation of the self-representation from the object representations.


A new class of PANI-Ag core-shell nanorods with sensing dimensions.
A single-step, cost-effective and eco-safe synthesis of a new class of homogeneous silver-polyaniline (PANI-Ag) core-shell nanorods is carried out via mild photolysis by ultraviolet radiation from sunlight (SUN UV-radiation). X-ray diffraction (XRD) of these core-shell nanorods gives two additional peaks from PANI centered at 2θ = 20.5° and 24. 9°. A validation of the core-shell structural information is given by transmission electron spectroscopy (TEM) whereas the tubular shape morphology is determined by scanning electron microscopy (SEM). UV-Vis. absorption shows a strong blue-shift along with photoluminescence emission. Fourier transform-infrared spectroscopy (FT-IR) and energy dispersive X-ray spectroscopy (EDX) also support the core-shell formation. Thermogravimetric analysis (TGA) shows good thermal stability and allows excellent detection of hydrogen peroxide and hydrazine. The cyclic voltammetry (CV) results show excellent electro-activation, indicating its promising potential in sensing of clinical and environmental analytes.


[Treatment indication with endothoracic drainage tube in parapneumonic effusions by partial pressure of carbon dioxide measurement in pleural fluid].
Parapneumonic effusions with pH < 7.20 or glucose < 0.40 g/l or lactate dehydrogenase (LDH) > 1000 U/l have indication of treatment with endothoracic drainage tube (EDT). The aim of the present study was to determine the accuracy of partial pressure of carbon dioxide (pCO2) measurement in pleural fluid for the subsequent treatment indication with EDT in parapneumonic effusions, by analyzing the area under curve ROC (AUC) and determining the optimal cut off value. 207 pleural fluids were studied. Glucose, LDH, pCO2, and pH were measured, and data concerning the etiology of pleural effusion and whether EDT treatment was needed were collected after patients were discharged from hospital. Forty-six out of 207 pleural fluids studied were parapneumonic effusions. Thirty-two were treated with EDT. AUC values were 0.888 (p < 0.0001), 0.890 (p < 0.0001), 0.816 (p < 0.0001), and 0.801 (p < 0.0001) for pCO2, pH, glucose, and LDH, respectively. No significant differences were found among them. Optimal cut off value for pCO2 was 48.6 mmHg, exhibiting 90.6% sensitivity and 78.6% specificity. All parapneumonic effusions showing pCO2 > 60.9 mmHg were treated with EDT. Remarkably, 3 out of 46 parapneumonic effusions (6.5%) that had been improperly treated following pH, glucose or LDH values, were correctly treated following pCO2. pCO2 determination in pleural fluid appears to be the best way to decide the indication of EDT in parapneumonic effusions.


Rumen-protected l-carnitine supplementation during mating period altered metabolic status and reproductive performance of ewes.
Current study hypothesized that dietary l-carnitine (LC) inclusion during the mating period ameliorates both metabolic status and reproductive performance of ewes. Seventy Baluchi ewes (52 ± 4.2 kg of bodyweight and 18 ± 6 months old of age) were enrolled in this study. Animals were randomly allocated into two dietary treatments, control (only basal diet) or basal diet plus supplementation with a rumen-protected LC (Carneon 20 Rumin-pro; 20% LC; Kaesler Nutrition GmbH) at the rate of 10 g/head/day from 21 days before until 35 days after introducing rams to the ewes (MP). Feed intake was monitored by subtracting the ort from feed offered. Blood sample collection was conducted on Days -10, +10 and +20 relative to MP. Pregnancy was confirmed on Day 30 post-MP. Feed intake of the ewes in the LC group was higher than the control (p < 0.05). LC supplementation increased the cholesterol concentration in the ewes (p < 0.05). Blood urea concentration of animals in the LC group was significantly lower than the control (p < 0.05). The mRNA expression of toll-like receptor 4 was evidently lower in animals supplemented with LC than the control (p < 0.05). Both lambing and fecundity rates in the LC group tended to be higher compared with the control. LC supplementation showed potential to alter certain metabolites in the ewes. A tendency for higher lambing rate may partly be driven by dams efficient energy partitioning to support foetal growth and maintaining pregnancy.


Sialic acid-binding motif of Maackia amurensis lectins.
Maackia amurensis hemagglutinin (MAH) and leukoagglutinin (MAL) are leguminous lectins which recognize carbohydrate chains containing sialic acid residues linked alpha2,3 to penultimate galactose residues. In the present investigation, cDNA clones encoding MAL were isolated from a cDNA library constructed from germinated Maackia amurensis seeds and sequenced. From the reading frame of the cloned cDNAs, MAL was predicted to be composed of 287 amino acid residues, and showed strong similarity to MAH (86.2% identity). In leguminous lectins, most amino acid residues involved in sugar-binding were previously shown to be conserved. However, in both MAL and MAH lectins, the conserved glycine and asparagine were shown to be substituted by lysine and aspartic acid, respectively. Substitutions were made at position 105 and/or 135 of MAH to examine the roles of amino acid residues postulated to be important in binding to sialic acids. Recombinant MAH bound to the sialic acid-containing CB-II glycopeptide of human glycophorin A. By contrast, mutant lectins with lysine-105 substituted with glycine and/or aspartic acid-135 with asparagine did not bind to sialic acid residues. This indicates that these characteristic substitutions are important in sialic acid binding.


Case Report: Hemophagocytic Lymphohistiocytosis Caused by Disseminated Histoplasmosis in a Venezuelan Patient with HIV and Epstein-Barr Virus Reactivation Who Traveled to Japan.
We describe a Venezuelan visitor to Japan who was diagnosed with hemophagocytic lymphohistiocytosis (HLH). The patient was also diagnosed with human immunodeficiency virus (HIV) and Epstein-Barr virus infection by the Western blot and polymerase chain reaction (PCR) tests, respectively. The cause of HLH was considered to be these two infections at first; however, the patient did not recover with antiretroviral/anti-herpes virus therapy. Thereafter, diagnosis of disseminated histoplasmosis was confirmed with an antigen detection test, culture, and PCR test of blood, urine, and bone marrow, and the patient improved gradually after the initiation of liposomal amphotericin B. This case highlights the importance of ruling out endemic mycosis as a cause of HLH even if other probable causes exist in patients from endemic areas.


Prediction of the Lethal Outcome of Acute Recurrent Cerebral Ischemic Hemispheric Stroke.
Background and objectives. Stroke-induced mortality is the third most common cause of death in developed countries. Intense interest has focused on the recurrent ischemic stroke, which rate makes up 30% during first 5 years after first-ever stroke. This work aims to develop criteria for the prediction of acute recurrent cerebral ischemic hemispheric stroke (RCIHS) outcome on the basis of comprehensive baseline clinical, laboratory, and neuroimaging examinations. Materials and Methods. One hundred thirty-six patients (71 males and 65 females, median age 74 (65; 78)) with acute RCIHS were enrolled in the study. All patients underwent a detailed clinical and neurological examination using National Institutes of Health Stroke Scale (NIHSS), computed tomography of the brain, hematological, and biochemical investigations. In order to detect the dependent and independent risk factors of the lethal outcome of the acute period of RCIHS, univariable and multivariable regression analysis were conducted. A receiver operating characteristic (ROC) analysis with the calculation of sensitivity and specificity was performed to determine the prediction variables. Results. Twenty-five patients died. The independent predictors of the lethal outcome of acute RCIHS were: Baseline NIHSS score (OR 95% CІ 1.33 (1.08-1.64), p = 0.0003), septum pellucidum displacement (OR 95% CI 1.53 (1.17-2.00), p = 0.0021), glucose serum level (OR 95% CI 1.28 (1.09-1.50), p = 0.0022), neutrophil-to-lymphocyte ratio (OR 95% CI 1.11 (1.00-1.21), p = 0.0303). The mathematical model, which included these variables was developed and it could determine the prognosis of lethal outcome of the acute RCIHS with an accuracy of 86.8% (AUC = 0.88 ± 0.04 (0.88-0.93), p < 0.0001).


How important is thermal expansion for predicting molecular crystal structures and thermochemistry at finite temperatures?
Molecular crystals expand appreciably upon heating due to both zero-point and thermal vibrational motion, yet this expansion is often neglected in molecular crystal modeling studies. Here, a quasi-harmonic approximation is coupled with fragment-based hybrid many-body interaction calculations to predict thermal expansion and finite-temperature thermochemical properties in crystalline carbon dioxide, ice Ih, acetic acid and imidazole. Fragment-based second-order Möller-Plesset perturbation theory (MP2) and coupled cluster theory with singles, doubles and perturbative triples [CCSD(T)] predict the thermal expansion and the temperature dependence of the enthalpies, entropies and Gibbs free energies of sublimation in good agreement with experiment. The errors introduced by neglecting thermal expansion in the enthalpy and entropy cancel somewhat in the Gibbs free energy. The resulting ∼ 1-2 kJ mol(-1) errors in the free energy near room temperature are comparable to or smaller than the errors expected from the electronic structure treatment, but they may be sufficiently large to affect free-energy rankings among energetically close polymorphs.


Whole-exome sequencing to identify somatic mutations in peritoneal metastatic gastric adenocarcinoma: A preliminary study.
Peritoneal metastasis occurs in more than half of patients with unresectable or recurrent gastric cancer and is associated with the worst prognosis. The associated genomic events and pathogenesis remain ambiguous. The aim of the present study was to characterize the mutation spectrum of gastric cancer with peritoneal metastasis and provide a basis for the identification of new biomarkers and treatment targets. Matched pairs of normal gastric mucosa and peritoneal tissue and matched pairs of primary tumor and peritoneal metastasis were collected from one patient for whole-exome sequencing (WES); Sanger sequencing was employed to confirm the somatic mutations. G>A and C>T mutations were the two most frequent transversions among the somatic mutations. We confirmed 48somatic mutations in the primary site and 49 in the peritoneal site. Additionally, 25 non-synonymous somatic variations (single-nucleotide variants, SNVs) and 2 somatic insertions/deletions (INDELs) were confirmed in the primary tumor, and 30 SNVs and 5 INDELs were verified in the peritoneal metastasis. Approximately 59% of the somatic mutations were shared between the primary and metastatic site. Five genes (TP53, BAI1, THSD1, ARID2, and KIAA2022) verified in our study were also mutated at a frequency greater than 5%in the COSMIC database. We also identified 9genes (ERBB4, ZNF721, NT5E, PDE10A, CA1, NUMB, NBN, ZFYVE16, and NCAM1) that were only mutated in metastasis and are expected to become treatment targets. In conclusion, we observed that the majority of the somatic mutations in the primary site persisted in metastasis, whereas several single-nucleotide polymorphisms occurred de novo at the second site.


Effects of contaminants on reproductive success of aquatic birds nesting at Edwards Air Force Base, California.
Contamination by organochlorine pesticides (OCs), polychlorinated biphenyls, metals, and trace elements at Edwards Air Force Base (EAFB), located in the Mojave Desert, could adversely affect nesting aquatic birds, especially at the sewage lagoons that comprise Piute Ponds. Estimates of avian reproduction, in conjunction with analyses of eggs and avian foods for contaminant residues, may indicate the potential for negative effects on avian populations. From 1996 to 1999, we conducted studies at the Piute Ponds area of EAFB to evaluate the impacts of contaminants on nesting birds. Avian reproduction was evaluated in 1999. Eggs were collected for chemical analyses in 1996 and 1999, and African clawed frogs (Xenopus laevis), a likely food source, were collected for chemical analyses in 1998. Avian species occupying the higher trophic levels--black-crowned night-heron (Nycticorax nycticorax), white-faced ibis (Plegadis chihi), and American avocet (Recurvirostra americana)--generally bioaccumulated higher concentrations of contaminants in their eggs. Reproductive success and egg hatchability of night-herons and white-faced ibises in the Piute Ponds were similar to results observed at other western colonies. Deformities were observed in only one embryo in this study, but concentrations of contaminants evaluated in this ibis embryo were considered insufficient to have caused the deformities. Because clawed frogs, a primary prey item for night-herons at Piute Ponds, had no detectable levels of any OCs, it is likely that OCs found in night-heron eggs were acquired from the wintering grounds rather than from EAFB. The presence of isomers of dichlorodiphenyltrichloroethane (DDT) in ibis eggs indicated recent exposure, but invertebrates used for food by ibises were not sampled at Piute Ponds, and conclusions about the source of OCs in ibis eggs could not be made. Concentrations of contaminants in random and failed eggs of individual species were not different, and we concluded that contaminants did not cause the observed egg failures.


Renal hypouricemia: incomplete combined defect.
A 20-year-old man with hypouricemia with markedly increased renal uric acid clearance is described. He also exhibited idiopathic hypercalciuria and lipoid nephrosis on hospital admission. Urate excretion was minimally suppressed by pyrazinamide and minimally increased after administration of probenecid, whereas it decreased after administration of benzbromarone. These results suggest that not only presecretory reabsorption, but also postsecretory reabsorption of urate was incompletely defective and indicate that the latter is more defective than the former. The relationship between hypouricemia and hypercalciuria or lipoid nephrosis in this case is not clear. However, since the hypouricemia persisted despite the remission of minimal change nephrotic syndrome, it appears that at least his nephrosis was incidental.


Impact of pre-treatment prostate tissue androgen content on the prediction of castration-resistant prostate cancer development in patients treated with primary androgen deprivation therapy.
Great advances in tissue androgen analysis using liquid chromatography-tandem mass spectrometry (LC-MS/MS) have made it possible to evaluate the tissue androgen content from a single needle prostate biopsy specimen. In this study, we investigated if pre-treatment androgen content in prostate biopsy specimens could predict their response to primary androgen deprivation therapy (ADT) and future castration-resistant prostate cancer (CRPC). One-hundred and sixty-five prostate cancer patients who received primary ADT were enrolled. They had received multiple core prostate needle biopsy at diagnosis, and an additional one needle biopsy specimen was obtained for tissue androgen determination using LC-MS/MS. The patients' prostate specific antigen (PSA) values were periodically followed during the treatment and patients were determined to have CRPC when their PSA value increased continuously to 25% above the nadir and a 2.0 ng/mL increase. A significant correlation was found between PSA value decline velocity (PSA half-time) after ADT and pre-ADT tissue androgen content. Twenty-three patients were determined to have CRPC. These CRPC patients had a significantly high concentration of tissue T (p < 0.01) and low concentration of tissue 5α-dihydrotestosterone (DHT) (p < 0.01), resulting in a higher tissue T/DHT ratio (p < 0.001). A multivariate Cox proportional hazard model revealed the pre-ADT tissue T/DHT ratio and Gleason score as independent predictors for CRPC development. By using the two statistically significant variables, the relative risk of CRPC development could be calculated. The results of this study suggest that the evaluation of prostate androgen content in a single needle biopsy specimen may be useful to predict future CRPC development after primary ADT. Further studies are required for the clinical application of T/DHT ratio evaluation.


Effect of oleic acid on induction of steatosis and cytotoxicity in BRL 3A cells.
Recent studies have shown that monounsaturated oleic acid induces steatosis in cultured hepatocyte steatosis in the form of nonalcoholic fatty liver disease models in vitro. However, the underlying mechanism of steatosis development is not completely understood. Therefore, we investigated the molecular mechanism of steatosis and the role of mitogen-activated protein kinase (MAPK)/toll-like receptor 4-related protein (TLR4) expression in this study. Rat hepatocyte cells were subjected to oleic acid in different concentrations (1.2-2.4 mM) for 24 hours. The cell morphological injury index and the changes in the MAPK/TLR4 signaling pathway-related proteins were evaluated. We found that the microstructure of the cells in the oleic acid treatment group was damaged, and higher phosphorylation levels of the MAPK pathway-related proteins were detected than those in the control group. In addition, the protein expression of TLR4, sterol regulatory element-binding protein-1, and fatty acid synthase were increased in the oleic acid treatment group. Our findings demonstrate that oleic acid causes toxic damage to rat hepatocyte cells, and the MAPK/TLR4 signaling pathway plays a significant role in lipid storage.


Parasite-reactive serum IgE antibodies in African populations. Relation to intestinal parasite load.
Serum IgE levels and IgE antibodies against four intestinal parasites, and the presence and abundance of parasites in stool samples were investigated in 161 Rwanda natives. Most of the IgE turn out to be helminth-reacting antibodies. The stimulation and production of these antibodies are much different from those of anti-amoeba antibodies in their relation to the specific intestinal parasite load; helminth infestations seem to play a major role in the development of anti-amoeba antibodies as well.


Knowledge and attitudes regarding cardiovascular disease risk and prevention in patients with coronary or peripheral arterial disease.
We compared perceptions regarding risk of cardiovascular events and benefits of cardiovascular disease (CVD) risk factor reduction between patients with peripheral arterial disease (PAD), patients with coronary artery disease (CAD), and patients without atherosclerosis (no disease). Participants with no disease (n = 142) had a normal ankle-brachial index and no clinically evident atherosclerosis (group 1). The PAD participants (n = 136) had an ankle-brachial index less than 0.90 and no other clinically evident atherosclerosis (group 2). Participants with CAD (n = 70) had a normal ankle-brachial index and a history of heart disease (group 3). Participants were interviewed regarding risk of mortality, CVD, and the importance of CVD risk factor reduction for hypothetical patients with PAD and CAD. All groups reported that risks of myocardial infarction, stroke, and death were higher for a patient with CAD than for a patient with PAD. Group 2 was less likely than group 3 to believe that PAD is associated with an extremely high risk of stroke (13.3% vs 28.7%; P =.005) or mortality (10.9% vs 26.6%; P =.003). Group 2 was less likely than group 1 to believe that a patient with PAD has a very high risk of myocardial infarction (13.1% vs 23.8%; P =.02), stroke (13.3% vs 27.5%; P =.003), or mortality (10.9% vs 24.3%; P =.004). Compared with group 3, a smaller percentage of patients in group 2 reported that cholesterol lowering was very important in PAD (57.5% vs 75.8%; P =.005). Compared with other patients, those with PAD underestimated the high risk of cardiovascular events associated with PAD and the benefits of cholesterol-lowering therapy. These findings may help explain the low rates of CVD risk factor control previously reported in patients with PAD.


Complications of regional anaesthesia.
Regional anaesthesia can marvellously dull the pain (and limit some other complications) of trauma, surgery and childbirth. But like all powerful techniques, it may have complications. Here the complications of regional anaesthesia are reviewed. The risks, presentation and the management of these complications are discussed in turn.


Radiation dose reduction without degradation of low-contrast detectability at abdominal multisection CT with a low-tube voltage technique: phantom study.
To reduce radiation dose from abdominal computed tomography (CT) without degradation of low-contrast detectability by using a technique with low tube voltage (90 kV). The institutional review board approved the participation of the radiologists in the observer performance test, and informed consent was obtained from all participating radiologists. A phantom for measurement of the radiation dose and a phantom containing low-contrast objects were scanned with a 16-detector row CT scanner at 120 kV and 90 kV. For determination of the radiation dose at both 90 kV and 120 kV, the tube current-time product settings were 100-560 mAs, and the doses at the center and periphery of the phantom were measured. To assess low-contrast detectability, we used a 300-mAs setting at 120 kV and 250-560-mAs settings at 90 kV. Five observers participated in the receiver operating characteristic analysis. Area under the receiver operating characteristic curve (A(z)) values were calculated in each observer. A(z) values obtained with each of the scanning techniques were recorded, and differences were examined for significance by using the Dunnet method. The mean A(z) value was 0.951 at 120 kV and 300 mAs. A(z) values were 0.927-0.973 at 90 kV and 450-560 mAs, and the differences between those values and values obtained at 120 kV and 300 mAs were not significant (P = .937-.952). A value of 100% was assigned to the radiation dose delivered to the center of the phantom at 120 kV and 300 mAs. The relative dose delivered at 90 kV ranged from 65% at 450 mAs to 79% at 560 mAs. A reduction from 120 kV to 90 kV led to as much as a 35% reduction in the radiation dose, without sacrifice of low-contrast detectability, at CT.


Improved survival and reduction in local failure rates after preoperative radiotherapy: evidence for the generalizability of the results of Swedish Rectal Cancer Trial.
The Swedish Rectal Cancer Trial (SRCT) demonstrated that a short-term regimen of high-dose preoperative radiotherapy (5 x 5 Gy) not only reduced the local recurrence rates but also improved the overall survival rate. This compelling evidence will have a significant impact on the primary treatment of rectal cancer. The authors' aim was to explore the representativeness of the study. Until the SRCT was presented in 1997, no major trial had established that radiotherapy has a positive effect on the overall survival rate. A review of all rectal cancer cases reported to the Swedish Cancer Registry during the same period that the SRCT accrued patients (1987 to 1990) was performed at 57 of 68 participating hospitals. At these 57 hospitals, there were 2366 patients with invasive rectal cancer, with 1664 of these patients fulfilling the criteria for inclusion in the SRCT. Fifty-two percent (866/1664) of eligible patients were included in the SRCT. The patients not included, of whom 8% (67/798) received adjuvant radiotherapy, had an overall 5-year survival rate of 48%, which was identical to the overall survival rate in the SRCT surgery-alone group (48%) but was inferior to the SRCT radiotherapy group (58%). The cancer-specific 5-year survival rates were 65% and 66% among the patients not included and the surgery-alone group, respectively. The local recurrence rates reached 27% in both groups. The results were still comparable when stratifying for curative surgery, tumor stage, and surgical procedure. The achieved inclusion level of 52% in a randomized multicenter trial is comparatively high. Because the population in the SRCT was representative, it was concluded that the study results are reliable.


Species recognition in the truffle genus Tuber -- the synonyms Tuber aestivum and Tuber uncinatum.
The two morphologically similar truffles Tuber aestivum and T. uncinatum have caused confusion because T. uncinatum is regarded by different authors, as either a distinct species, variety, subspecies, or synonym of T. aestivum. A clarification of the relationship between the two truffles would help both conservation biology and cultivation. We aimed both to test the reliability of the only quantitative morphological character used to distinguish the two taxa, i.e. the height of the spore reticulum, and to compare sequences of the ribosomal DNA (rDNA) internal transcribed spacer (ITS) region. Our study included 117 fruit bodies of T. aestivum and T. uncinatum, originating from eight European countries. The results showed that the spore reticulum height is not diagnostic. The phylogenetic analysis of ITS sequences from 81 fruit bodies and an additional 32 sequences from GenBank showed that T. aestivum and T. uncinatum were intermingled in one highly supported (100% bootstrap) monophyletic clade, separate from its sister species Tuber mesentericum. We conclude that T. aestivum and T. uncinatum are synonyms and the species should be named T. aestivum, as the oldest name has priority. For traders, T. aestivum syn. T. uncinatum should be used until conformity has been reached.


In Vivo Comparison of Three Human Acellular Dermal Matrices for Breast Reconstruction.
Acellular dermal matrices (ADMs) have become popular in implant-based breast reconstruction. The aim of this study was to compare three commonly used ADM products in vivo in an animal model. The nucleic acid content (residual double-stranded DNA) and the levels of the remaining growth factors after decellularization were measured for each ADM. Cytocompatibility with ADMs was documented using NIH 3T3 mouse fibroblast cells. In vivo, the implanted ADMs were histologically evaluated at 1, 2, 3, and 6 months (n=5) using male 8-week-old Sprague-Dawley rats. Fibroblasts grew in the SureDerm HD and DermACELL with no cytotoxicity. In a rat model, SureDerm HD and DermACELL incorporated more readily into the surrounding host tissue, as measured by rapid cell influx and collagen deposition, and showed more delayed tissue remodeling with decreased matrix metalloproteinases levels compared to AlloDerm. SureDerm HD and DermACELL can be used as biological materials for breast reconstruction.


The New Tics study: A Novel Approach to Pathophysiology and Cause of Tic Disorders.
We report on the ongoing project "The New Tics Study: A Novel Approach to Pathophysiology and Cause of Tic Disorders," describing the work completed to date, ongoing studies and long-term goals. The overall goals of this research are to study the pathophysiology of Provisional Tic Disorder, and to study tic remission (or improvement) in a prospective fashion. Preliminary data collection for the project began almost 10 years ago. The current study is nearing completion of its third year, and has already reported several novel and important results. First, surprisingly, at least 90% of children who had experienced tics for only a mean of 3 months still had tics at the 12-month anniversary of their first tic, though in some cases tics were seen only with remote video observation of the child sitting alone. Thus almost all of them now had a DSM-5 diagnosis of Tourette's Disorder or Persistent (Chronic) Tic Disorder. Baseline clinical features that predicted 12-month outcome included tic severity, subsyndromal autism spectrum symptoms, an anxiety disorder, and a history of 3 or more phonic tics. Second, we found that poorer tic suppression ability when immediately rewarded for suppression predicted greater tic severity at follow-up. Third, striatal volumes did not predict outcome as hypothesized, but a larger hippocampus at baseline predicted worse severity at follow-up. Enrollment and data collection continue, including functional connectivity MRI (fcMRI) imaging, and additional analyses are planned once the full sample is enrolled.


Interleukin-17A Aggravates Middle Ear Injury Induced by Streptococcus pneumoniae through the p38 Mitogen-Activated Protein Kinase Signaling Pathway.
Acute otitis media (AOM) is one of the most common bacterial infectious diseases in children aged 2 to 7 years worldwide. We previously demonstrated that interleukin-17A (IL-17A) promotes an acute inflammatory response characterized by the influx of neutrophils into the middle ear cavity during Streptococcus pneumoniae-induced AOM. In general, the inflammatory response is viewed as an effector that frequently causes local tissue damage. However, little is known about the pathogenic effects of IL-17A in AOM. Here, we investigated the pathogenic effects of IL-17A by using wild-type (WT) and IL-17A knockout (KO) mouse models. The results showed that the pathogenic effects of AOM, including weight loss, histopathological changes, and proinflammatory cytokine production, were more severe in WT mice than in IL-17A KO mice, suggesting that IL-17A aggravates tissue damage in AOM. Furthermore, these pathogenic effects were found to be dependent on p38 mitogen-activated protein kinase (MAPK) and could be reversed in the presence of a p38 MAPK-specific inhibitor. It was also demonstrated that IL-17A promoted the production of neutrophil myeloperoxidase (MPO) through the p38 MAPK signaling pathway, which was responsible for the middle ear tissue injury. These data support the conclusion that IL-17A contributes to middle ear injury through the p38 MAPK signaling pathway.


[Determination of the activity of semicarbazide-sensitive amine oxidase in the differentiated 3T3-F442A cells by enzyme-linked spectrophotometric assay].
In order to probe into the patho-physiology semicarbazide-sensitive amine oxidase (SSAO), we determined the variation of its activity in the days of 3T3-F442A cells' differentiation into adipocytes in vitro. The differentiated 3T3-F442A cells were collected in various days and disrupted by ultrasonication. Then we studied the SSAO activity of the collected cells by oxidase-linked spectrophotometric assay. In the course of 3T3-F442A cells' differentiation, SSAO expression was shown by a curve graph. There was no SSAO detected in 3T3-F442A preadipocyte, and only a little of SSAO was detected in the cells on the 3rd day of differentiation. Since then, SSAO significantly increased and reached to a maximum level six or seven days after the cells' differentiation.


Characterization of a temporoparietal junction subtype of Alzheimer's disease.
Alzheimer's disease (AD) subtypes have been described according to genetics, neuropsychology, neuropathology, and neuroimaging. Thirty-one patients with clinically probable AD were selected based on perisylvian metabolic decrease on FDG-PET. They were compared to 25 patients with a typical pattern of decreased posterior metabolism. Tree-based machine learning was used on those 56 images to create a classifier that was subsequently applied to 207 Alzheimer's Disease Neuroimaging Initiative (ADNI) patients with AD. Machine learning was also used to discriminate between the two ADNI groups based on neuropsychological scores. Compared to AD patients with a typical precuneus metabolic decrease, the new subtype showed stronger hypometabolism in the temporoparietal junction. The classifier was able to distinguish the two groups in the ADNI population. Both groups could only be distinguished cognitively by Trail Making Test-A scores. This study further confirms that there is more than a typical metabolic pattern in probable AD with amnestic presentation.


Characterization and mapping to human chromosome 8q24.3 of Ly-6-related gene 9804 encoding an apparent homologue of mouse TSA-1.
The 9804 gene, which encodes a human Ly-6 protein most similar to mouse differentiation Ag TSA-1/Sca-2, has also been called RIG-E. Like mouse TSA-1, it has a broad tissue distribution with varied expression levels in normal human tissues and tumor cell lines. Like some members of the murine Ly-6 family, the 9804 gene is responsive to IFNs, particularly IFN-alpha. Overlapping genomic fragments spanning the 9804 gene (5543 bp) have been isolated and characterized. The gene organization is analogous to that of known mouse Ly-6 genes. The first exon, 2296 bp upstream from exon II, is entirely untranslated. The three coding exons (II, III, and IV) are separated by short introns of 321 and 131 bp, respectively. Primers were developed for specific amplification of 9804 gene fragments. Screening of human-hamster somatic cell hybrids and yeast artificial chromosomes (YACs) indicated that the gene is distal to c-Myc, located in the q arm of human chromosome 8. No positives were detected from the Centre d'Etude du Polymorphisme Humain mega-YAC A or B panels, nor from bacterial artificial chromosome libraries; two positive cosmids (c101F1 and c157F6) were isolated from a human chromosome 8 cosmid library (LA08NC01). Fluorescence in situ hybridization of metaphase spreads of chromosome 8, containing hybrid cell line 706-B6 clone 17 (CL-17) with cosmid c101F1, placed the 9804 gene close to the telomere at 8q24.3. This mapping is significant, since the region shares a homology with a portion of mouse chromosome 15, which extends into band E where Ly-6 genes reside. Moreover, the gene encoding E48, the homologue of mouse Ly-6 molecule ThB, has also been mapped to 8q24.


Evaluation of a citrate-based anticoagulant with platelet inhibitory activity for feline blood cell Counts.
Aggregation of feline platelets in vitro results in difficulty assessing platelet number. A citrate-based anticoagulant containing the platelet inhibitors theophylline, adenosine, and dipyridamole (CTAD; Diatube-H, Becton Dickinson, Oxford, UK) has been developed for use in human platelet studies and heparin assays. To evaluate the efficacy of CTAD in reducing platelet aggregation in feline blood samples, aliquots of blood from 51 cats were anticoagulated with EDTA, CTAD, and for 12 samples, citrate solution. Samples preserved in CTAD had significantly higher (P</=.001) platelet counts, as determined by an impedance counter, hemacytometer, and smear estimation, than samples preserved in EDTA. In addition, subjective assessment of blood smears showed significantly fewer platelet aggregates (P<.001) in CTAD-treated samples compared with EDTA samples. Although values were similar, automated platelet counts and smear estimates of platelet number were significantly higher (P<.05) and platelet aggregation was significantly less (P<.05) in CTAD samples than in citrate samples. These results suggest that the platelet inhibitory activity of CTAD reduced feline platelet aggregation. Automated total WBC counts in CTAD samples were significantly lower (P<.001) than automated counts in EDTAsamples but were similar to manual WBC counts in EDTAsamples. Differences in both platelet and WBC counts between CTAD and EDTA or citrate samples were clinically relevant. Mean platelet volume and MCV were significantly lower (P<.05) in CTAD samples than in EDTA samples. No effect was seen on cell morphology or staining characteristics. The anticoagulant CTAD offers an advantage over both EDTA and cit-rate for feline hematologic analysis, by decreasing pseudothrombocytopenia and pseudoleukocytosis.


Green rapid biogenic synthesis of bioactive silver nanoparticles (AgNPs) using Pseudomonas aeruginosa.
The present work was focused on isolating a bacterial strain of Pseudomonas sp. with the ability to synthesise AgNPs rapidly. A strain of Pseudomonas aeruginosa designated JO was found to be a potential candidate for rapid synthesis of AgNPs with a synthesis time of 4h in light, at room temperature which is a shorter time period noticed for the synthesis when compared to the previous reports Biosynthesis of AgNPs was achieved by addition of culture supernatant with aqueous silver nitrate solution (1 mM). The reaction mixture exhibits change in colour from green to brown with a peak at 420 nm corresponding to the plasmon absorbance of AgNPs by UV-vis spectroscopy. The nanoparticles were characterised by X-ray diffraction (XRD), energy-dispersive X-ray analysis, Fourier-transform infrared spectroscopy, scanning electron microscopy (SEM), Zetasizer and transmission electron microscopy (TEM). The XRD spectrum exhibited 2θ values corresponding to the silver nanocrystals. TEM and SEM micrographs revealed the extracellular formation of polydispersed elongated nanoparticles with an average size of 27.5 nm. Synthesised nanoparticles showed antibacterial property against both gram-positive and gram-negative microorganisms, but more effective towards gram-negative.


Phytotoxicity and phytoaccumulation of trivalent and hexavalent chromium in brake fern.
A recently recognized hyperaccumulator plant, Chinese brake fern (Pteris vittata), has been found to extract very high concentration of arsenic from arsenic-contaminated soil. Chromium usually is a coexisting contaminant with arsenic in most contaminated soils. The potential application of ferns for phytoremediation of chromium(III)- and chromium(VI)-contaminated soils and their phytotoxicity to ferns has not been studied before. In this study, chromium distribution and phytotoxicity at the plant and cellular levels of brake ferns were studied using chemical analyses and scanning electron microscopy. The results show a higher phytotoxicity of Cr from Cr(VI)-contaminated soil to Chinese brake fern than from Cr(III)-contaminated soil. Phytotoxicity symptoms included significant decreases both in fresh biomass weight and relative water content (RWC), and also in leaf chlorosis during the late stage of growing. At higher concentrations (500 mg/kg Cr[VI] and 1,000 mg/kg Cr[III] addition), plants showed reduction in the number of palisade and spongy parenchyma cells in leaves. Compared with other plant species reported for phytoremediation of Cr(VI)-contaminated soil, brake fern took up and accumulated significant amounts of Cr (up to 1,145 mg/kg in shoots and 5,717 mg/kg in roots) and did not die immediately from phytotoxicity. Our study suggests that Chinese brake fern is a potential candidate for phytoremediation of Cr(VI)-contaminated soils, even though plants showed severe phytotoxic symptoms at higher soil Cr concentrations.


Public opinions and attitudes toward a state monopoly: a study of the finnish gambling system.
Gambling regulated through a state monopoly is often justified for reasons of public health, that is, that monopolies are a more effective means of reducing potential harm. This focus on harm prevention has increased in recent years, particularly as a result of pressures arising from the growth of online gambling and of legislation designed to promote competition. While prior works have examined the role of stakeholders in influencing policy decisions and in public discussions of the monopoly systems, attention has been focused on those with direct financial interests; the opinions of the public have largely been absent from these discussions. In 2017 Finland restructured its monopoly order to improve efficacy of addressing gambling related harms; this restructuring offers a valuable insight into public perceptions of and attitudes toward the suitability of the Finnish system to address gambling-related harm. This work uses Structural Equation Modelling and compares attitudes toward the Finnish system between 2015 (pre-restructuring) and 2019 (post-restructuring). Overall public opinion of the Finnish system as being suitable for addressing gambling harms declined between 2015 and 2019, despite the restructuring. Several predictors of attitudes were identified, however, the majority had small effect sizes, while the model explained little variance. This work concludes that existing approaches to examining public opinions of gambling regulation should be amended to include additional predictors. Furthermore, it is likely that context-specific predictors should be included in models, in order to reflect the socio-cultural history of the population being investigated. Such predictors should be determined in respect to the population of interest but, for example, could include items measuring trust in authority, political orientation, cultural acceptance of gambling, or religious affiliation.


Radial artery occlusion, a rare presentation of Behçet's disease.
Behçet's disease (BD) is a multi-system inflammatory disorder which presents with recurrent orogenital ulceration, uveitis, and erythema nodosum. Medium vessel vasculitis of upper limb is extremely rare and it is only reported in patients with Behçet's disease on long follow up. Mean duration from diagnosis of disease to development of vasculitis is 5.8 years. We present a patient who presented with gangrene of fingers with absent radial pulse and during course of his illness he developed features of Behçet's disease. Diagnosis was established by clinical features and histopathology and patient was treated with steroids and colchicine.


Differential physiological responses of the German cockroach to social interactions during the ovarian cycle.
In many animal species, social interactions can influence the morphology, physiology and behavior of individuals, including their rate of development and reproduction. Reproduction in cockroaches is regulated by juvenile hormone III (JH), and social interactions have been shown to accelerate female reproduction in the German cockroach, Blattella germanica (L.), by stimulating JH production. However, it is not clear in this or any other insect species whether social facilitation of the reproductive rate occurs throughout the ovarian cycle or only at certain stages. We compared the effects of social interactions during the pre-oviposition period (when JH production is high) and during gestation (when little JH is produced), as well as during the first ovarian cycle (when females are virgin) and the second ovarian cycle (after females had mated). Social interaction with one conspecific female was sufficient to accelerate JH production and oocyte maturation, but this effect was reversed by crowding. Social interactions also accelerated the onset of sexual receptivity in virgin females. However, social interactions failed to shorten gestation, suggesting that social cues stimulate JH production only when the corpora allata (CA) are active and not when CA activity is suppressed by the central nervous system. Females were most responsive to transient social isolation and transient social interactions when 2-3 days old, suggesting that they are particularly sensitive to social interactions when their CA become active. Overall, these results show that all JH-dependent events in the reproductive cycle of B. germanica females are under the strong influence of social interactions.


Does imaginal exposure exacerbate PTSD symptoms?
Symptom exacerbation (i.e., treatment side effects) has often been neglected in the psychotherapy literature. Although prolonged exposure has gained empirical support for the treatment of chronic posttraumatic stress disorder (PTSD), some have expressed concem that imaginal exposure, a component of this therapy, may cause symptom exacerbation, leading to inferior outcome or dropout. In the present study, symptom exacerbation was examined in 76 women with chronic PTSD. To define a "reliable" exacerbation, we used a method incorporating the standard deviation and test-retest reliability of each outcome measure. Only a minority of participants exhibited reliable symptom exacerbation. Individuals who reported symptom exacerbation benefited comparably from treatment. Further, symptom exacerbation was unrelated to dropout. Thus, although a minority of individuals experienced a temporary symptom exacerbation, this exacerbation was unrelated to outcome.


Correlative studies of blastogenic responses and interleukin 1 production by mononuclear cells from patients with zoopathogenic fungal infections.
The production of interleukin 1 (IL 1) by adherent peripheral blood mononuclear cells (PBMC) was quantitated in 16 individuals infected with Histoplasma capsulatum or Blastomyces dermatitidis and 16 age-matched controls. In parallel, we measured blastogenic responses to phytohemagglutinin (PHA) by PBMC from patients and controls. Of the 16 patients, six had pulmonary histoplasmosis, six had disseminated histoplasmosis, two had pulmonary blastomycosis, and two had disseminated blastomycosis. At the time of study, none of the patients were receiving immunosuppressive agents or had an underlying debilitating illness. Proliferative responses by PBMC from patients to PHA were significantly (P less than 0.05) less than the mean response by PBMC from an equal number of controls. In the 16 controls, the increase in secretion of IL 1 by lipopolysaccharide (LPS)-stimulated adherent cells over unstimulated cells ranged from 18 to 40 units of IL 1 activity per 10(5) adherent cells. The increment in IL 1 levels between LPS-stimulated adherent PBMC and unstimulated cells was diminished (less than 18 units of IL 1 activity per 10(5) adherent cells) in five of the 16 patients. Diminished IL 1 secretion in response to LPS was associated with impaired PHA responses in four of 10 patients.


No specific effects of caloric stimulation on the visual-imagery processes of normal subjects.
Recent research indicates that neglect can be temporarily, but only partially, ameliorated by activating the contralateral hemisphere via caloric stimulation and other techniques. In this study, we evaluated whether caloric stimulation could be used to manipulate visual-imagery processes in normal subjects. 11 normal subjects participated in a quantitative visual-imagery task while undergoing caloric stimulation. Neither side of report nor ear of caloric stimulation affected performance. Possible reasons for this negative result are reviewed.


An aging program at the systems level?
Many genes and pathways are known to modulate lifespan in various organisms, but it remains unclear whether there exists a common aging program, and how individual variations of lifespan can occur in an isogenic population. Recent studies on aging regulation at the systems and epigenetic levels point to the possibility of regulating and potentially reversing the aging epigenome and transcriptome, resulting in differential aging status and aging rate in different individuals. Here, the author summarize some of these findings and discuss the possibility of integrating multiple layers of aging regulation at the systems level, to identify an aging program that can explain lifespan variations introduced by environmental and developmental history.


Epistemology and ethics of evidence-based medicine: putting goal-setting in the right place.
While evidence-based medicine (EBM) is often accused on relying on a paradigm of 'absolute truth', it is in fact highly consistent with Karl Popper's criterion of demarcation through falsification. Even more relevant, the first three steps of the EBM process are closely patterned on Popper's evolutionary approach of objective knowledge: (1) recognition of a problem; (2) generation of solutions; and (3) selection of the best solution. This places the step 1 of the EBM process (building an answerable question) in a pivotal position for the understanding of the whole process, and underscores a few aspects which are often overlooked in EBM courses. First in this step internal evidence (including personal expertise) must be appraised and integrated in the problem. Second, issues of applicability of the possible solution should be anticipated. Third, and possibly more important, the goal of the intervention should be set at this stage (typically by choosing the outcome in a PICO question). Depending whether or not goals depend on the goals of others, and whether they concern others' voluntary behaviour, goals may be classified as self-serving, moral, altruistic or moralistic. Thus, delicate ethical questions must be addressed at this stage, which means that patient preferences and values must be carefully sought, so that empathy, counselling and narrative medicine must be mastered to be able to formulate correctly an answerable question. The need to modify the current description of the EBM process to increase the recognition of implicit assumptions and increase the consistency of this model is discussed.


Immunoglobulin Fc receptor molecules on Xenopus laevis splenocytes.
The existence of membrane-associated Fc receptors for IgY (Fc nu R) or IgM (Fc mu R) was demonstrated on a large percentage of Xenopus splenocytes. The Fc receptors were detected by direct fluorescent staining in which the spleen cells were incubated with fluorescein isothiocyanate (FITC)-conjugated antigen-complexed IgY antibodies or with FITC-conjugated heat-aggregated IgM. Results showed that 28.9% (SD +/- 5.1) and 5.3% (SD +/- 2.2) of the cells bear Fcnu or Fc mu receptors, respectively. The specificity of the receptors was tested after incubation of the cells in the presence of the following fluorochrome-conjugated reagents: non-aggregated Xenopus Igs and human IgG, aggregated Xenopus albumin, Fc6 nu and Fab mu fragments and human IgG, and antigen-complex Fab2 nu fragments. Results indicated that the receptors are specific for Xenopus immunoglobulins, with the restriction that the latter must be presented in a complexed or aggregated form to the cells and that the precise binding site is located on the Fc portion of IgY or IgM. The identity of a large percentage (22.4 +/- 2.8%) of cells bearing Fc nu R was established by direct simultaneous double-fluorescent staining of surface membrane IgM and Fc nu R. All Xenopus splenic B lymphocytes bearing sIgM carry also Fc nu R, while 8.8% of splenocytes, of yet unknown lineage, bear Fc nu R alone on their surface. The presence of Fc receptors on Xenopus B lymphocytes (leaving aside their eventual presence in other leucocyte types) suggests, once again, a high degree of evolution of the immune system in these lower vertebrates.


Immune restoration in head and neck cancer patients via cyclooxygenase inhibition: an update.
Most carcinomas overexpress cyclooxygenase, especially COX-2, thus secreting large amounts of immunosuppressive prostaglandins. Epidemiological data and animal models have provided evidence that inhibition of cyclooxygenase and thus prostaglandin E2 synthesis via non-steroid antiinflammatory drugs (NSAIDs) inhibits tumor growth in vitro and in vivo. Moreover, it could be demonstrated that chemoprevention, i.e. the long-term use of NSAIDs, significantly reduced the risk of developing certain types of cancer. However, the molecular mechanisms underlying these antineoplastic effects are not entirely understood. This review focuses on prostaglandin-mediated immunosuppressive mechanisms in head and neck cancer and presents immunorestorative strategies via cyclooxygenase inhibition in vitro and in vivo with special emphasis on COX-2. A better understanding of the interaction of tumors with the immune system and how the process of carcinogenesis can be antagonized by selectively modulating the activity of specific enzymes such as COX-2 will provide the rationale for the use of NSAIDs for chemoprevention or immunoadjuvant cancer therapies.


Susceptibility of snail vectors to Oriental anthropophilic Schistosoma.
Laboratory experiments were carried out to study the susceptibility of snail vectors to Oriental anthropophilic Schistosoma. Oncomelania hupensis hupensis was readily infected with the local strain of Schistosoma japonicum (Chinese strain), and also infected with S. japonicum (Philippines strain). O.h. quadrasi was only susceptible to its S. japonicum (Philippines strain). The Oncomelania races were refractory to S. mekongi, S. japonicum-like species (Malaysian strain). Tricula aperta (beta race) was readily infected with S. mekongi, S. sinensium and S. japonicum-like species from Malaysia, but not S. japonicum. T. bollingi was susceptible to S. sinensium and S. mekongi. Robertsiella kaporensis was only susceptible to the local strain, S. japonicum-like species from Malaysia. Geographical isolation may be the cause of these differences in compatibility between the snail vectors and the schistosome parasites.


Relapsed hepatosplenic T-cell lymphoma heralded by a solitary skin nodule.
Hepatosplenic T-cell lymphoma (HSTL) represents a rare form of peripheral T-cell lymphoma composed of lymphocytes that typically express the γδ T-cell receptor. This form of lymphoma rarely involves the skin. We report the case of a 23-year-old man with a history of HSTL that was presumed to be in remission who presented with a solitary cutaneous nodule. Skin biopsy showed an atypical lymphocytic infiltrate arranged in a perivascular and periappendageal pattern with associated vacuolar epidermal interface change. The constituent T cells expressed CD2, CD3, CD7, CD8, β-F1, γδ T-cell receptor, Tia-1 and granzyme B. The cells lacked the expression of CD4, CD5 and CD56. Fluorescence in situ hybridization (FISH) showed a characteristic chromosomal abnormality, namely isochromosome 7q, which confirmed the diagnosis of cutaneous HSTL. On restaging his disease, widespread progression was noted. To our knowledge, this report provides the first detailed account of cutaneous involvement by HSTL. We show the novel utility of FISH to identify isochromosome 7q in the lesional skin of HSTL patients.


Development and validation of a contextual behavioral distress intolerance task in cigarette smokers.
Distress intolerance, an individual's perceived or actual inability to withstand negative emotional or physical distress, contributes to the maintenance of smoking. However, there is limited understanding of the contextual factors that impact distress intolerance in general or among smokers specifically. This study aimed to adapt and test a computerized behavioral persistence task that requires re-typing a passage while adhering to specific instructions (Contextual-Frustration Intolerance Typing Task [C-FiTT]). C-FiTT was designed to model contextual factors that influence distress intolerance, negative affect, and smoking urges. Daily smokers (n = 550) were recruited through the use of Qualtrics Panels. Using a 2 × 2 + 1 experimental design, participants were randomly assigned to one of four C-FiTT conditions that crossed task difficulty (low or high difficulty) with passage content (neutral or tobacco withdrawal text), or a neutral control group. C-FiTT produced an average persistence time of 94.1 ± 114.3 s and 64.7% of participants self-terminated the task. C-FiTT also produced small to medium sized-increases in negative affect and smoking urges. Between-condition comparisons indicated that the high-difficulty C-FiTT produced shorter behavioral persistence, greater self-termination likelihood, and larger increases in negative affect and smoking urges. The combination of high-difficulty and withdrawal content resulted in the shortest persistence time, 100% self-termination rate, and largest increases in negative affect and smoking urges, compared to other conditions CONCLUSIONS: Findings provide initial evidence for the validity of C-FiTT in smokers within the context of tobacco withdrawal at low and high levels of task difficulty. Avenues for refinement and use of C-FiTT are discussed.


Optimising outcomes for complex trauma survivors: assessing the motivators, barriers and enablers for implementing trauma informed practice within a multidisciplinary health setting.
Complex trauma is a significant public health issue with detrimental health, interpersonal and psychological impacts, which can impede client recovery and result in multiple representations. 'Trauma Informed Practice' (TIP) is an evidence-based model which ensures safe and effective services for clients and staff. This study examines health professional's use of TIP, and the motivators, enablers and barriers to implementation in a multidisciplinary setting. A mixed methods study with 24 front-line clinicians and managers within a community health setting in Australia. A purpose designed, expert validated TIP checklist was completed, followed by semi-structured focus groups. Survey data was reported using descriptive statistics. Focus group data was digitally recorded, transcribed and thematically analysed. Ten key factors were identified motivating, restricting or enabling TIP implementation. Seven were organisational factors including supportive and informed management, flexibility of service models, levels of service demands, resource availability, education opportunities, good client outcomes, and reporting requirements. Philosophical approach, team orientation, and vicarious trauma/stress management were three individual professional factors. Critically, alignment in two ways was necessary for successful implementation, that is: in knowledge and understanding across organisational role levels - clinician, manager and executive; and, in professional philosophy and team orientation of individual clinicians. Providing TIP is essential for ensuring optimum client outcomes for trauma survivors and for maintaining workforce wellbeing. Although the increasing uptake to TIP is evident within the health setting, further attention is required to address the tension between service models focused on efficiently servicing whole populations and those attuned to effectively meeting the needs of high risk groups. A complex strategy to unite therapeutic and managerial goals is necessary if client, professional and organisational needs are to be effectively met.


Effect of steam activated biochar application to industrially contaminated soils on bioavailability of polycyclic aromatic hydrocarbons and ecotoxicity of soils.
The aim of this study was to determine the effect of steam activation of biochars on the immobilization of freely dissolved (Cfree) and bioaccessible fraction (Cbioacc) of PAHs in soils. Additionally, the toxicity to various organisms like Vibrio fischeri, Lepidium sativum and Folsomia candida was measured before and after the amendment of biochars to soils. Three biochars produced from willow, coconut and wheat straw were steam activated and added to three different soils with varying content and origin of PAHs (coke vs. bitumen). The soils with the addition of the biochars (activated and non-activated) were incubated for a period of 60days. Steam activation of the biochars resulted in more pronounced reduction of both Cfree and Cbioacc. The range of the increase in effectiveness was from 10 to 84% for Cfree and from 50 to 99% for Cbioacc. In contrast, the effect of activation on the toxicity of the soils studied varied greatly and was specific to a particular test and soil type. Essentially, biochar activation did not result in a change of phytotoxicity, but it increased or decreased (depending on the parameter, type of biochar, contaminant source, and soil and soil type) the toxic effect to F. candida, and decreased the toxicity of leachates to V. fischeri.


Fatal disseminated cytomegalovirus infection with necrotizing oophoritis in a patient with acquired immunodeficiency syndrome.
Disseminated human cytomegalovirus (CMV) disease occurs mainly as a congenital infection and among immunocompromised hosts. Patients with acquired immunodeficiency syndrome (AIDS) are at increased risk for CMV infection, and the most prevalent clinical manifestation is retinitis, followed by colitis, esophagitis, pneumonitis, and encephalitis. CMV oophoritis is poorly described in the literature with some cases reported in patients with hematological or solid malignancies, bone marrow or solid organ transplantation, immunosuppressive therapy, and advanced AIDS cases. We report the case of a 61-year-old woman with a recent diagnosis of AIDS, which was associated with a wasting syndrome. The patient presented with abdominal pain, headache, cutaneous vesicular lesions on the abdomen, anemia, lymphopenia, and hyponatremia; she died suddenly on the fourth day of hospitalization. The autopsy was performed and demonstrated disseminated CMV infection with hemorrhagic encephalitis as the immediate cause of death. Additionally, pneumonitis, extensive adrenalitis, ulcerated enteritis, focal hepatitis, and necrotizing oophoritis were found.


Effects of humanin on experimental colitis induced by 2,4,6-trinitrobenzene sulphonic acid in rats.
The excessive apoptosis of intestinal epithelial cells (IECs) partly accounts for the development of colonic inflammation and eventually results in ulcerative colitis (UC). Humanin, an endogenous anti-apoptotic peptide, has previously been shown to protect against Alzheimer's disease and a variety of cellular insults. The present study aimed to investigate the effects of glysin variant of humanin (HNG) on 2,4,6-trinitrobenzene sulphonic acid (TNBS)-induced colitis in rats. Rats were divided into four groups as follows: Group 1 (n = 8): control; isotonic saline solution 0.1 ml/rat rectally, Group 2 (n = 8): TNBS colitis; 0.1 ml of a 2.5% (w/v) TNBS solution in 50% ethanol rectally, Group 3 (n = 8): 10 μM HNG, and Group 4 (n = 8): 20 μM HNG intraperitoneal (ip) on day 2 and 6 after rectal TNBS administration. Rats were sacrificed 7 days after the induction of colitis. Blood and tissue samples were harvested for biochemical and histopathological analysis. HNG treatment significantly ameliorated weight loss and macroscopic and microscopic scores. TNBS-induced colitis significantly increased the colonic mRNA expression of tumor necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1β), and caspase-3 activities in group II in comparison to the group I. HNG treatment was associated with an inhibition of mRNA expression of TNF-α and IL-1β, and a decrease in caspase-3 activities in colon tissues in group III and IV when compared to group II. The results of this study indicate that HNG treatment may exert beneficial effects in UC by decreasing inflammatory reactions and apoptosis.


Resonant behavior of a fractional oscillator with fluctuating frequency.
The long-time behavior of the first moment for the output signal of a fractional oscillator with fluctuating frequency subjected to an external periodic force is considered. Colored fluctuations of the oscillator eigenfrequency are modeled as a dichotomous noise. The viscoelastic type friction kernel with memory is assumed as a power-law function of time. Using the Shapiro-Loginov formula, exact expressions for the response to an external periodic field and for the complex susceptibility are presented. On the basis of the exact formulas it is demonstrated that interplay of colored noise and memory can generate a variety of cooperation effects, such as multiresonances versus the driving frequency and the friction coefficient as well as stochastic resonance versus noise parameters. The necessary and sufficient conditions for the cooperation effects are also discussed. Particularly, two different critical memory exponents have been found, which mark dynamical transitions in the behavior of the system.


The NLRomes of Zea mays NAM founder lines and Zea luxurians display presence-absence variation, integrated domain diversity, and mobility.
Plant pathogens cause significant crop loss worldwide, and new resistance genes deployed to combat diseases can be overcome quickly. Understanding the existing resistance gene diversity within the germplasm of major crops, such as maize, is crucial for the development of new disease-resistant varieties. We analysed the nucleotide-binding leucine-rich repeat receptors (NLRs) of 26 recently sequenced diverse founder lines from the maize nested association mapping (NAM) population and compared them to the R gene complement present in a wild relative of maize, Zea luxurians. We found that NLRs in both species contain a large diversity of atypical integrated domains, including many domains that have not previously been found in the NLRs of other species. Additionally, the single Z. luxurians genome was found to have greater integrated atypical domain diversity than all 26 NAM founder lines combined, indicating that this species may represent a rich source of novel resistance genes. NLRs were also found to have very high sequence diversity and presence-absence variation among the NAM founder lines, with a large NLR cluster on Chr10 representing a diversity hotspot. Additionally, NLRs were shown to be mobile within maize genomes, with several putative interchromosomal translocations identified.


Right ventricular involvement in Takotsubo cardiomyopathy.
The aim of our study is to assess the incidence and clinical significance of right ventricular (RV) involvement in Takotsubo cardiomyopathy (TTC). Between February 2002 and December 2005, 47 patients with TTC underwent cardiovascular magnetic resonance (CMR) at our institutions. 13 patients with delayed initial CMR were excluded. In the remaining 34 patients (32 women), RV wall motion abnormalities (WMAs) were present in nine (26%). Left ventricular ejection fraction (LVEF) was significantly lower in patients with RV involvement (40 +/- 6 vs. 48 +/- 10%, P = 0.04). The most frequently affected RV segments were the apico-lateral (89%), the antero-lateral (67%), and the inferior segment (67%). All RV WMA improved or disappeared in eight of nine patients who underwent a follow-up CMR study. Pleural effusion was more common in patients with RV involvement (67 vs. 8%, P < 0.001) and was predictive of RV dysfunction (sensitivity 67% and specificity 92%). Significant or bilateral pleural effusions were seen exclusively in patients with RV involvement. RV involvement is common in TTC and seems to be associated with a more severe impairment in LV systolic function. It may be suspected by the presence of pleural effusion.


The effect of fructan-enriched diet on bone turnover parameters in ovariectomized rats under calcium restriction.
Osteoporosis, the "quiet epidemic", is one of the most serious threats to public health. It is known that estrogen plays a significant role in the regulation of bone turnover, and its loss at menopause causes osteoporosis. Added to this, insufficient calcium intake accelerates bone mass loss, increasing the risk of fractures. The study aimed to answer the question whether a fructan-enriched diet could be helpful in preventing from disturbances in bone turnover caused by calcium restriction combined with ovariectomy-induced estrogen deficiency. The differences related to the kind of fructan and 'matrix effect' of fructan action (form of addition) were also evaluated. The study was conducted using sham-operated (control groups) or ovariectomized (OVX) rats fed a calcium restricted diet. The treatment diets contained one of three fructan sources - Jerusalem artichoke, yacon and Beneo Orafti Synergy1 - added alone or as an ingredient of strawberry sorbet, all in the amount providing 8% fructans. Analyses of biological material included: serum Ca, Mg and P concentrations, alkaline phosphatase activity (ALP), osteocalcin (OC) and C-telopeptide degradation products from type I collagen (CTX). Densitometric parameters of femora were also assayed. Among markers of bone turnover, the ALP activity depended both on the kind of fructan and the form of addition. The highest value was shown in the OVX group fed a low-calcium diet, whereas administration of diet enriched with Jerusalem artichoke led to an almost 50% decrease in the value of this parameter. Dietary fructans also lowered the OC level. Feeding rats with diet containing sorbet enriched in yacon or Jerusalem artichoke resulted in a decrease of CTX, compared to the diet containing yacon alone or fructan formulation in both forms No significant differences were observed in densitometric parameters between treatment groups. The obtained findings suggest that fructan administration with a calcium-restricted diet might exert a positive effect on bone turnover parameters. Regarding the form of their addition, it is possible that other constituents of sorbets contributed to the fructan action. It remains open whether this impact would be significant over a longer period of time.


Proportional Recovery From Lower Limb Motor Impairment After Stroke.
In people with preserved corticospinal tract (CST) function after stroke, upper limb impairment resolves by ≈70% within 3 months. This is known as the proportional recovery rule. Patients without CST function do not fit this rule and have worse upper limb outcomes. This study investigated resolution of motor impairment in the lower limb (LL). Patients with stroke and LL weakness were assessed 3 days and 3 months after stroke with the LL Fugl-Meyer. CST integrity was determined in a subset of patients using transcranial magnetic stimulation to test for LL motor-evoked potentials and magnetic resonance imaging to measure CST lesion load. Linear regression analyses were conducted to predict resolution of motor impairment (ΔFugl-Meyer) including factors initial impairment, motor-evoked potential status, CST lesion load, and LL therapy dose. Thirty-two patients completed 3-month follow-up and recovered 74% (95% confidence interval, 60%-88%) of initial LL motor impairment. Initial impairment was the only significant predictor of resolution of motor impairment. There was no identifiable cluster of patients who did not fit the proportional recovery rule. Measures of CST integrity did not predict proportional LL recovery. LL impairment resolves by ≈70% within 3 months after stroke. The absence of a nonfitter group may be because of differences in the neuroanatomical organization of descending motor tracts to the upper limb and LL. Proportional recovery of the LL is not influenced by therapy dose providing further evidence that it reflects a fundamental biological process.


Posture does not matter! Paw usage and grasping paw preference in a small-bodied rooting quadrupedal mammal.
Recent results in birds, marsupials, rodents and nonhuman primates suggest that phylogeny and ecological factors such as body size, diet and postural habit of a species influence limb usage and the direction and strength of limb laterality. To examine to which extent these findings can be generalised to small-bodied rooting quadrupedal mammals, we studied trees shrews (Tupaia belangeri). We established a behavioural test battery for examining paw usage comparable to small-bodied primates and tested 36 Tupaia belangeri. We studied paw usage in a natural foraging situation (simple food grasping task) and measured the influence of varying postural demands (triped, biped, cling, sit) on paw preferences by applying a forced-food grasping task similar to other small-bodied primates. Our findings suggest that rooting tree shrews prefer mouth over paw usage to catch food in a natural foraging situation. Moreover, we demonstrated that despite differences in postural demand, tree shrews show a strong and consistent individual paw preference for grasping across different tasks, but no paw preference at a population level. Tree shrews showed less paw usage than small-bodied quadrupedal and arboreal primates, but the same paw preference. Our results confirm that individual paw preferences remain constant irrespective of postural demand in some small-bodied quadrupedal non primate and primate mammals which do not require fine motoric control for manipulating food items. Our findings suggest that the lack of paw/hand preference for grasping food at a population level is a universal pattern among those species and that the influence of postural demand on manual lateralisation in quadrupeds may have evolved in large-bodied species specialised in fine manipulations of food items.


[Biopsies of the transitional zone: impact on the detection of prostatic cancer and prognostic value].
To analyse the value of biopsies of the transitional zone (TZ) in the detection of prostate cancer and their prognostic value. The authors reviewed the literature on directed biopsies of the TZ and discuss the most recent publications concerning the impact of these biopsies on prostatic cancer detection and the prognosis of cancers of the TZ. There are currently few arguments in favour of biopsies of the TZ during a first series of prostatic biopsies, as the incidence of cancers situated exclusively in the TZ is low and first-line biopsies of the TZ do not significantly increase the cancer detection rate. However, when a suspicion of cancer persists after a first series of negative biopsies, or in patients with a large prostate, biopsies of the TZ can be indicated, as some authors consider that they considerably increase the cancer detection rate. Some authors have suggested that cancers of the TZ have a better prognosis than peripheral cancers because of their more favourable histological characteristics. These results need to be confirmed on larger scale studies. There are two situations in which biopsies of the TZ have a potential value: (1) as a second-line investigation in the case of persistent suspicion of prostate cancer after a first series of negative peripheral biopsies; (2) in patients with a very large prostate. The prognosis of cancers situated exclusively in the TZ is still poorly known, and the management of this type of cancer must remain the same as that of peripheral cancer.


A computerized assessment to compare the impact of standard, stereoscopic, and high-definition laparoscopic monitor displays on surgical technique.
Surgeons performing laparoscopic surgery have strong biases regarding the quality and nature of the laparoscopic video monitor display. In a comparative study, we used a unique computerized sensing and analysis system to evaluate the various types of monitors employed in laparoscopic surgery. We compared the impact of different types of monitor displays on an individual's performance of a laparoscopic training task which required the subject to move the instrument to a set of targets. Participants (varying from no laparoscopic experience to board-certified surgeons) were asked to perform the assigned task while using all three display systems, which were randomly assigned: a conventional laparoscopic monitor system (2D), a high-definition monitor system (HD), and a stereoscopic display (3D). The effects of monitor system on various performance parameters (total time consumed to finish the task, average speed, and movement economy) were analyzed by computer. Each of the subjects filled out a subjective questionnaire at the end of their training session. A total of 27 participants completed our study. Performance with the HD monitor was significantly slower than with either the 3D or 2D monitor (p < 0.0001). Movement economy with the HD monitor was significantly reduced compared with the 3D (p < 0.0004) or 2D (p < 0.0001) monitor. In terms of average time required to complete the task, performance with the 3D monitor was significantly faster than with the HD (p < 0.0001) or 2D (p < 0.0086) monitor. However, the HD system was the overwhelming favorite according to subjective evaluation. Computerized sensing and analysis is capable of quantitatively assessing the seemingly minor effect of monitor display on surgical training performance. The study demonstrates that, while users expressed a decided preference for HD systems, actual quantitative analysis indicates that HD monitors offer no statistically significant advantage and may even worsen performance compared with standard 2D or 3D laparoscopic monitors.


Knowledge and practice of implant-retained restorations among dental students in Saudi Arabia.
The aim of the study was to assess the knowledge and practice of implant retained restorations (IRR) among senior dental students in Saudi Arabia. Four hundred questionnaires were distributed among senior dental students of five dental schools in Saudi Arabia. Student's knowledge was assessed regarding which implant restoration [cement retained restoration (CRR) or screw retained restoration (SRR)] better provides the desired clinical properties. Students' practice of IRR, perception of their knowledge and need for further education related to IRR were also assessed. Descriptive statistics and chi-square test were employed to assess collected data. Three hundred and fifty four senior dental students responded at a response rate of 88.5%. Thirty three percent respondents did not have any practical experience of IRR. Students showed a clear preference for CRR with regards to aesthetics (71.4%), passive fit (55.3%), fabrication ease (57.3%) and fracture resistance (40%). SRR were considered to provide better retention (59.6%), soft tissue health (51.1%) and ease of retrievability (72%). Nearly 40% of students agreed that they did not get sufficient information related to IRR in undergraduate courses. Clinical training of IRR is compromised in the undergraduate curriculum in dental schools of Saudi Arabia. The knowledge of dental students regarding IRR was broadly in line with current evidence.


IFN gamma and TNF alpha cause an increased release of C3 by murine macrophages.
Macrophages from mice bearing Lewis lung carcinoma release higher amounts of C3 molecules than macrophages from healthy mice. The C3 pro-releasing activity operating in vivo was suspected to be due to an immunological network. Indeed, the supernatants of splenocytes from tumor bearing mice, but not from normal mice, induced in vitro an increased release of C3 molecules by macrophages. Recombinant IFN gamma and TNF alpha were strong inducers of C3 release, while IL-2 acted poorly. The C3 pro-releasing activity of splenocyte supernatants was largely prevented by their pretreatment with specific mAb anti IFN gamma or anti TNF alpha, but not completely prevented by the simultaneous neutralization of the two cytokines. Taken together, these results show that murine macrophages increase the release of C3 molecules upon treatment with IFN gamma or TNF alpha and that these cytokines released in vivo by splenocytes from tumor bearing mice may account, together with a yet unknown factor, for a humoral network causing the increased release of C3 by peritoneal macrophages.


A mathematical model for metal affinity protein partitioning.
A mathematical model of metal affinity partitioning has been derived and used to describe protein partitioning in Cu (II)PEG/dextran systems. A working model has been extended to account for inhibition, which for metal affinity extraction is the inhibition of protein-metal binding by hydrogen ion. PEG/dextran partitioning experiments were performed on four proteins, tuna heart cytochrome c, Candida krusei cytochrome c, horse myoglobin, and sperm whale myoglobin. The partition coefficients for these proteins are increased by the addition of Cu (II)PEG-IDA, due to the affinity between the chelated copper atom and metal-coordinating histidine residues on the protein surface. The results of experiments to determine the effects of the number of binding sites on the protein, the copper concentration, and pH on partitioning are all well-described by the mathematical model. The pK(a) value of the metal binding site was determined to be 6.5, which is in the range of pK(a) values commonly observed for surface histidines. The average association constant for the binding of Cu (II)PEG-IDA to accessible histidines was found to be 4.5 x 10(3). This value is comparable to stability constants measured by conventional potentiometry techniques for analogous small complexes.


Management adaptation of invertebrate fisheries to an extreme marine heat wave event at a global warming hot spot.
An extreme marine heat wave which affected 2000 km of the midwest coast of Australia occurred in the 2010/11 austral summer, with sea-surface temperature (SST) anomalies of 2-5°C above normal climatology. The heat wave was influenced by a strong Leeuwin Current during an extreme La Niña event at a global warming hot spot in the Indian Ocean. This event had a significant effect on the marine ecosystem with changes to seagrass/algae and coral habitats, as well as fish kills and southern extension of the range of some tropical species. The effect has been exacerbated by above-average SST in the following two summers, 2011/12 and 2012/13. This study examined the major impact the event had on invertebrate fisheries and the management adaption applied. A 99% mortality of Roei abalone (Haliotis roei) and major reductions in recruitment of scallops (Amusium balloti), king (Penaeus latisulcatus) and tiger (P. esculentus) prawns, and blue swimmer crabs were detected with management adapting with effort reductions or spatial/temporal closures to protect the spawning stock and restocking being evaluated. This study illustrates that fisheries management under extreme temperature events requires an early identification of temperature hot spots, early detection of abundance changes (preferably using pre-recruit surveys), and flexible harvest strategies which allow a quick response to minimize the effect of heavy fishing on poor recruitment to enable protection of the spawning stock. This has required researchers, managers, and industry to adapt to fish stocks affected by an extreme environmental event that may become more frequent due to climate change.