[Neonatal effects of uterine incision-to-delivery interval during elective cesarean section under epidural anesthesia].
The relationships between uterine incision to delivery interval (U-DI) and neonatal umbilical blood acid-base status and Apgar scores at 1-minute were studied in 130 healthy parturients undergoing elective cesarean section under epidural anesthesia. U-DI was correlated with umbilical venous (UV) and umbilical arterial (UA) pH, PCO2 and PO2, and was also correlated with 1-minute Apgar scores. U-DI of more than 150 sec was associated with significantly higher UVPCO2, UAPCO2, lower UVpH, UApH, UVPO2, and UAPO2. The only two newborns with low 1-minute Apgar scores (6 and 3) in the present study both had prolonged U-DI (> 150 sec) and inhaled amniotic fluid just before the delivery. It is concluded that U-DI of more than 150 sec has considerable influence on the neonatal status.


Bottlenosed dolphins (Tursiops truncatus) comprehend the referent of both static and dynamic human gazing and pointing in an object-choice task.
The authors tested 2 bottlenosed dolphins (Tursiops truncatus) for their understanding of human-directed gazing or pointing in a 2-alternative object-choice task. A dolphin watched a human informant either gazing at or pointing toward 1 of 2 laterally placed objects and was required to perform a previously indicated action to that object. Both static and dynamic gaze, as well as static and dynamic direct points and cross-body points, yielded errorless or nearly errorless performance. Gaze with the informant's torso obscured (only the head was shown) produced no performance decrement, but gaze with eyes only resulted in chance performance. The results revealed spontaneous understanding of human gaze accomplished through head orientation, with or without the human informant's eyes obscured, and demonstrated that gaze-directed cues were as effective as point-directed cues in the object-choice task.


Daily energy intake, energy expenditure and activity patterns of selected Malaysian sportsmen.
Seventeen members of the national sepaktakraw squad undergoing centralised training participated in a comprehensive study to determine their daily food intake, activity patterns and energy requirements. Food intake was recorded as a mean of 3-days weighed food intake and the nutrient contents were calculated using a local food composition table. The energy cost of standardised activities was determined by indirect calorimetry while time and motion study was used to estimate the daily energy expenditure of each subject. The mean daily energy intake was 2784±373 kcal (11.6±1.6 MJ) while the mean daily energy expenditure was 3004±298 kcal (12.6±1.2 MJ), with a negative energy balance of 220 kcal ((0.9 MJ). Intake of other nutrients were adequate when compared with the Malaysian RDA, with the exception of niacin. The results of the activity pattern study indicated that the subjects spent about 80% of the day doing light activities while 20% of the day was devoted to their training programme comprising of moderate to heavy activities. This data set represents the first of its kind in Malaysia and should provide impetus for further research in this area which would help establish dietary guidelines for Malaysian sportsmen.


The challenges of residents teaching neurology.
Teaching is integrated into the daily practice of residents, and it is a skill necessary for practice as well as academics. The settings in which teaching and learning take place are ubiquitous but include classrooms, small groups, bedside rounds, and grand rounds. Given the learning environment of residency, neurology residents should have working knowledge of basic principles of effective teaching to make learning successful. Teaching also reinforces knowledge, and residents will likely be better practitioners if some basic skills of teaching are practiced. Neurology teaching techniques for residents are rarely addressed in the medical literature. Although information regarding teaching principles in medicine exists, there is little information regarding how residents teach. We examine and review some of the more effective methods and appreciated qualities in teachers, with a particular emphasis for the neurology resident. We also review whom neurologists need to teach and the various settings in which teaching may take place. Neurology residents encounter a variety of audiences in a variety of settings that require diverse teaching skills to effectively convey information to other providers as well as patients. The majority of these skills should be learned in residency to establish a foundation for teaching, regardless of future practice settings.


Differences in ventricular vulnerability, serum enzyme activities, and electrolyte levels between male and female broilers.
Sudden death syndrome (SDS) is one of the most serious diseases of fast-growing broilers. The incidence of SDS may result from a decrease in ventricular function. The purpose of this study was to explore the mechanism of sexual difference in the sensitivity of broilers to SDS by measuring their ventricular vulnerability, serum enzyme activities, and serum electrolyte levels. Results were as follows. 1) Ventricular fibrillation thresholds induced by injection of KCl and by electrical stimulus of male broilers were both significantly lower than those of female broilers (P < 0.05), suggesting that the ventricular vulnerability of male broilers was higher than that of female broilers. 2) Serum lactate dehydrogenase and creatine kinase activities of male broilers were significantly higher than those of female broilers (P < 0.01), but there was not a significant difference in serum aspartate aminotransferase activity between male and female broilers. 3) No significant difference was observed in serum electrolyte levels of potassium, sodium, and chloride between males and females. From these results, we concluded that there is a significant difference between males and females in their ventricular vulnerability and serum enzyme activities, which may result in a higher sensitivity of male broilers to injury of the myocardium by stress and may further result in a sexual difference in sensitivity to SDS.


Synthesis and potential anthelmintic activity of methyl-5-(4-salicyloyl-piperazin-1-yl)-benzimidazole-2-carbamates.
A series of methyl-5-(4-salicyloyl-piperazin-1-yl)-benzimidazole-2-carba mates (IX) has been prepared. 5-(4-Salicyloyl-piperazin-1-yl)-2-nitro anilines (VII) have been synthesized starting from 5-piperazino-2-nitro anilines and salicyloyl chlorides. Catalytic reduction of VII with Pd/C, followed by treatment with 1,3-dicarbomethoxy-S-methyl isothiourea, yielded the corresponding carbamates (IX), the anthelmintic activity of which was studied. Compound IXa significantly reduced the numbers of preadults, adults and encysted T. spiralis larvae in experimental mice.


Dental practice and dental insurance.
The time has come for dentists to recognize that the dental insurers, as an outside factor, must be considered when designing a practice business model. The same efficiencies that would be well-placed in any business now need to be considered carefully in a dental practice to keep income from being reduced. Fortunately, there is a great deal of opportunity to increase practice efficiency and maintain or exceed the current level of financial performance.


Schistosoma mansoni: gene structure and localization of a homologue to cysteine protease ER 60.
We have isolated and characterized a cDNA encoding the complete sequence of a homologue of the ER luminal cysteine protease ER 60 in Schistosoma mansoni. The deduced protein of 484 amino acids contains two thioredoxin domains, each with the CGHC motif, that characterize all members of the protein disulfide isomerase family. The corresponding gene exists as a single copy and consists of six exons, interrupted by five very small introns of 32 to 40 nucleotides. Immunohistology and in situ hybridization identify the sustentacular cells of the testes, the wall cells of the protonephridia, and the gastrodermis of the gut to be the major tissues of ER 60 gene expression.


A tropical Atlantic species of Melibe Rang, 1829 (Mollusca, Nudibranchia, Tethyiidae).
A new species of Melibe is described based on two specimens collected in Florida. This new species is well differentiated morphologically and genetically from other species of Melibe studied to date. The four residue deletions in the cytochrome c oxidase subunit 1 protein found in all previously sequenced tropical species of Melibe sequenced (and Melibe rosea) are also present in this new species. These deletions do not appear to affect important structural components of this protein but might have fitness implications. This paper provides the first confirmed record of Melibe in the tropical western Atlantic Ocean.


Renal cell carcinoma in a horseshoe kidney and preoperative superselective renal artery embolization: a case report.
Only rarely is renal cell carcinoma encountered in a horseshoe kidney. This is a case report on renal cell carcinoma in a horseshoe kidney, in which superselective renal artery embolization was performed preoperatively. CT and digital subtraction angiography revealed a horseshoe kidney with a 3-cm tumor in the left side. Superselective renal artery embolization of the tumor was performed as a prerequisite procedure for the organ-preserving surgery of simple enucleation. Preoperative superselective renal artery embolization can be an effective tool to facilitate organ-preserving surgery in a horseshoe kidney.


Interspecific hybridization in ants: at the intersection of ecology, evolution, and behavior.
Ants are social and are haplodiploid. This combination may allow the evolution of a variety of unusual genetic pathways to achieve reproductive success. These include hybridizing across species, differential use of sperm to create a hybrid worker population, and reproductively isolated gene pools that depend on each other for their survival. Although there are demonstrable costs for colony development and reproduction, these phenomena may nevertheless be relatively common in nature. The specific ecological advantages that favor the evolution of these reproductive modes remain to be discovered.


Superinjection of Holes in Homojunction Diodes Based on Wide-Bandgap Semiconductors.
Electrically driven light sources are essential in a wide range of applications, from indication and display technologies to high-speed data communication and quantum information processing. Wide-bandgap semiconductors promise to advance solid-state lighting by delivering novel light sources. However, electrical pumping of these devices is still a challenging problem. Many wide-bandgap semiconductor materials, such as SiC, GaN, AlN, ZnS, and Ga2O3, can be easily n-type doped, but their efficient p-type doping is extremely difficult. The lack of holes due to the high activation energy of acceptors greatly limits the performance and practical applicability of wide-bandgap semiconductor devices. Here, we study a novel effect which allows homojunction semiconductor devices, such as p-i-n diodes, to operate well above the limit imposed by doping of the p-type material. Using a rigorous numerical approach, we show that the density of injected holes can exceed the density of holes in the p-type injection layer by up to four orders of magnitude depending on the semiconductor material, dopant, and temperature, which gives the possibility to significantly overcome the doping problem. We present a clear physical explanation of this unexpected feature of wide-bandgap semiconductor p-i-n diodes and closely examine it in 4H-SiC, 3C-SiC, AlN, and ZnS structures. The predicted effect can be exploited to develop bright-light-emitting devices, especially electrically driven nonclassical light sources based on color centers in SiC, AlN, ZnO, and other wide-bandgap semiconductors.


Fabrication of single-crystal silicon nanotubes with sub-10 nm walls using cryogenic inductively coupled plasma reactive ion etching.
Single-crystal silicon nanostructures have attracted much attention in recent years due in part to their unique optical properties. In this work, we demonstrate direct fabrication of single-crystal silicon nanotubes with sub-10 nm walls which show low reflectivity. The fabrication was based on a cryogenic inductively coupled plasma reactive ion etching process using high-resolution hydrogen silsesquioxane nanostructures as the hard mask. Two main etching parameters including substrate low-frequency power and SF6/O2 flow rate ratio were investigated to determine the etching mechanism in the process. With optimized etching parameters, high-aspect-ratio silicon nanotubes with smooth and vertical sub-10 nm walls were fabricated. Compared to commonly-used antireflection silicon nanopillars with the same feature size, the densely packed silicon nanotubes possessed a lower reflectivity, implying possible potential applications of silicon nanotubes in photovoltaics.


Survival of mammalian B104 cells following neurite transection at different locations depends on somal Ca2+ concentration.
We report that cell survival after neurite transection in a mammalian neuronal model (cultured B104 cells) critically depends on somal [Ca2+]i, a novel result that reconciles separate long-standing observations that somal survival decreases with more-proximal axonal transections and that increased somal Ca2+ is cytotoxic. Using fluorescence microscopy, we demonstrate that extracellular Ca2+ at the site of plasmalemmal transection is necessary to form a plasmalemmal barrier, and that other divalent ions (Ba2+, Mg2+) do not play a major role. We also show that extracellular Ca2+, rather than injury per se, initiates the formation of a plasmalemmal barrier and that a transient increase in somal [Ca2+]i significantly decreases the percentage of cells that survive neurite transection. Furthermore, we show that the increased somal [Ca2+]i and decreased cell survival following proximal transections are not due to less frequent or slower plasmalemmal sealing or Ca2+ entry through plasmalemmal Na+ and Ca2+ channels. Rather, the increased somal [Ca2+]i and lethality of proximal neurite injuries may be due to the decreased path length/increased diameter for Ca2+ entering the transection site to reach the soma. A ryanodine block of Ca2+ release from internal stores before transection has no effect on cell survival; however, a ryanodine- or thapsigargin-induced buildup of somal [Ca2+]i before transection markedly reduces cell survival, suggesting a minor involvement of Ca2+-induced release from internal stores. Finally, we show that cell survival following proximal injuries can be enhanced by increasing intracellular Ca2+ buffering capacity with BAPTA to prevent the increase in somal [Ca2+]i.


Posterior hemivertebral resection for upper thoracic congenital scoliosis: be aware of high risk of complications.
The treatment of congenital hemivertebrae in the upper thoracic region is challenging. The objective of this study was to investigate the outcomes of posterior hemivertebral resection for the upper thoracic region. Twenty-one patients diagnosed with upper thoracic congenital scoliosis were included. All of them received hemivertebral resection surgery via the posterior-only approach with at least 2 years of follow-up. The radiographic parameters and Scoliosis Research Society-22 score were analyzed. All the intraoperative and postoperative complications were recorded retrospectively. The segmental main curve was 35.9° before surgery and 7.0° at the last follow-up, with an average correction rate of 80.2%. The total main curve was 44.1° before surgery and 11.6° at the last follow-up, with an average correction rate of 73.9%. The caudal compensatory curve was corrected from 20.2° to 7.1°, with an average correction rate of 64.9%. The segmental kyphosis was corrected from 30.9° to 8.9°, with an average correction rate of 65.5%. The total Scoliosis Research Society-22 score significantly improved in all patients at the last follow-up, mainly resulting from the improvement of the self-image, mental health, and satisfaction domains. The following complications were found: one pedicle fracture, two malpositioned screws, one transient neurologic deficit, one implant failure, and four postoperative curve progressions. Although good radiographic deformity correction and clinical results were achieved after surgery, the incidence rate of complications was high at 42.9%; great care should be taken to prevent them, especially for postoperative curve progression (19.0%).


Population genetic structure in farm and feral American mink (Neovison vison) inferred from RAD sequencing-generated single nucleotide polymorphisms.
Feral American mink populations (), derived from mink farms, are widespread in Europe. In this study we investigated genetic diversity and genetic differentiation between feral and farm mink using a panel of genetic markers (194 SNP) generated from RAD sequencing data. Sampling included a total of 211 individuals from 14 populations, 4 feral and 10 from farms, the latter including a total of 7 color types (Brown, Black, Mahogany, Sapphire, White, Pearl, and Silver). Our study revealed similar low levels of genetic diversity in both farm and feral mink. Results are consistent with small effective population size as a consequence of line selection in the farms and founder effects of a few escapees from the farms in feral populations. Moderately high genetic differentiation was found between farm and feral animals, suggesting a scenario in which wild populations were founded from farm escapes a few decades ago. Currently, escapes and gene flow are probably limited. Genetic differentiation was higher among farm color types than among farms, consistent with line selection using few individuals to create the lines. Finally, no indications of inbreeding were found in either farm or feral samples, with significant negative values found in most farm samples, showing farms are successful in avoiding inbreeding.


A Case Report of NMO Transverse Myelitis.
Transverse myelitis is considered one of the cardinal features of neuromyelitis optica spectrum disorder (NMOSD), an immune-mediated inflammatory condition of the CNS characterized by severe, immune-mediated demyelination and axonal damage predominantly targeting optic nerves and spinal cord. We describe a case in which a diagnosis of NMOSD was established, associated with West Nile Virus (WNV) infection. A healthy 18-year-old female presented with intractable hiccups and rapidly progressing paraparesis. MRI demonstrated T2 edema extending from the medulla to the conus, consistent with longitudinally extensive transverse myelitis. Serum and CSF Aquaporin-4 IgG (AQP4) were both positive with high titers. In conjunction with antiviral therapy, immunomodulatory treatment was initiated using pulse methylprednisolone, plasmapheresis and Rituximab. A month and a half after admission, the patient was fully ambulatory with no residual symptoms. On her rheumatology follow-up visit, West Nile Virus-specific IgM in CSF was found to be positive from the patient's initial presentation. We propose that West Nile Virus may have been the autoimmune trigger to the patient's development of NMOSD, highlighting the importance of evaluating viral triggers in autoimmune diseases.


A Lexicon for Descriptive Sensory Evaluation of Blended Tea.
A lexicon provides standardized vocabulary that facilitates communication among various objects. We developed a lexicon to describe the sensory flavor and aroma characteristics of fermented tea and blended tea. The 37 sensory attributes of blended tea were identified, defined, and referenced by six highly trained panelists. The lexicon included 24 flavor attributes and 13 aroma attributes. Ingredients in the blended tea included fermented tea, rose petal, lavender, hibiscus, chamomile, peppermint, lemongrass, rosemary, pandanus, and osmanthus. Most of the lexicon attributes were derived from the constituents found in the tea: brown, spicy, cooling, earthy, nutty, sweet, and bitter. Also, attributes derived from the characteristics of the ingredients were included. The lexicon developed in this study can help more accurately describe the flavors and aromas of tea containing fermented tea and herbs.


Biomechanics of aortic rupture at classical location in traffic accidents.
Twenty-six aortic ruptures were found in 107 autopsies of vehicular trauma victims. There were 21 ruptures discovered at the classical location. In 14 accidents aortic rupture occurred in car passengers, in 4 cases in pedestrians and in 2 cases in cyclists. The aortic rupture was always caused by a severe accident, marked by high speed collision, considerable degree of automobile destruction and severe associated injuries. Aortic rupture could be correlated to a severe compression trauma in all cases. In 14 victims the impact force ran from right ventro-caudal to left dorso-cranial. In 2 victims the impact ran from left ventro-cranial to right dorso-caudal and in one pedestrian from right ventro-cranial to left dorso-caudal. The theories proposed for explaining aortic rupture at the classical location are examined on the basis of the material presented. The importance of forces acting in a right ventro-caudal to left ventro-cranial direction in causing rupture is stressed.


The costs of surgery for limb-threatening ischemia.
The clinical courses of 106 patients with limb-threatening ischemia were traced for as long as 5 years to determine the cost of their care. Seventy-eight patients initially treated with vascular reconstruction accrued an average of $40,769 +/- $3726 in costs over a mean follow-up period of 805 +/- 57 days, during which they had an average of 2.4 +/- 0.2 hospitalizations or 67 +/- 6 inpatient days. Twenty-eight high-risk patients treated with primary amputation accrued $40,563 +/- $4729 in costs over a mean follow-up period of 663 +/- 97 days, during which they had an average of 2.2 +/- 0.3 hospitalizations or 85 +/- 10 inpatient days. Successful revascularization resulted in lower costs ($28,374) than did primary amputation ($40,563) or failed reconstruction ($56,809). Patients with ischemic tissue loss accrued costs more rapidly than did patients with rest pain only. The high cost of providing care for these patients and the advent of diagnosis related group reimbursement mandate that proposed treatment protocols be evaluated not only for their effectiveness but also for their cost-effectiveness.


Racial differences in dietary antioxidant intake and cardiac event-free survival in patients with heart failure.
Heart failure is a chronic, burdensome condition with higher re-hospitalization rates in African Americans than Whites. Higher dietary antioxidant intake is associated with lower oxidative stress and improved endothelial function. Lower dietary antioxidant intake in African Americans may play a role in the re-hospitalization disparity between African American and White patients with heart failure. The objective of this study was to examine the associations among race, dietary antioxidant intake, and cardiac event-free survival in patients with heart failure. In a secondary analysis of 247 patients with heart failure who completed a four-day food diary, intake of alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein, zeaxanthin, lycopene, vitamins C and E, zinc, and selenium were assessed. Antioxidant deficiency was defined as intake below the estimated average requirement for antioxidants with an established estimated average requirement, or lower than the sample median for antioxidants without an established estimated average requirement. Patients were followed for a median of one year to determine time to first cardiac event (hospitalization or death). Survival analysis was used for data analysis. African American patients had more dietary antioxidant deficiencies and a shorter cardiac event-free survival compared with Whites ( p = .007 and p = .028, respectively). In Cox regression, race and antioxidant deficiency were associated with cardiac event-free survival before and after adjusting for covariates. African Americans with heart failure had more dietary antioxidant deficiencies and shorter cardiac event-free survival than Whites. This suggests that encouraging African American patients with heart failure to consume an antioxidant-rich diet may be beneficial in lengthening cardiac event-free survival.


In situ time-resolved DXAFS for the determination of kinetics of structural changes of H-ZSM-5-supported active Re-cluster catalyst in the direct phenol synthesis from benzene and O2.
Dynamic structural changes and their kinetics of a Re(10)-cluster catalyst in the direct phenol synthesis from benzene and O(2) were investigated by in situ time-resolved Re L(III)-edge energy-dispersive XAFS (DXAFS). We have successfully monitored the structural transformation of active Re(10) clusters to inactive Re monomers in the course of the selective oxidation of benzene with O(2) on the catalyst by the DXAFS technique in a real time. The results obtained suggested that the Re(10) cluster transformed directly to the Re monomers, which showed first order kinetics with respect to the quantity of Re(10) clusters. The absence of undesirable intermediate structures with low phenol selectivity during the structural transformation may be an advantageous issue for the high phenol selectivity of 93.9% at 9.9% conversion in a pulse reaction and 87.7% at 5.8% conversion in a steady-state reaction on the Re(10)-cluster catalyst. The reactant benzene inhibited the unfavorable structural transformation of the Re(10) cluster to the Re monomers during the selective benzene oxidation to phenol.


Endocrine Disruptors and Obesity: An Overview.
Obesity is a growing pandemic. Endocrine-disrupting chemicals are widespread in the environment. In this perspective, the authors examine the issue related to the exposure to several chemicals with endocrine-disrupting properties as promoting factors to obesity. Data show that Phthalates, Bisphenol compounds, Persistent Organic Pollutants (POPs), solvents, and personal care products can modify metabolic properties in a dose-response and sex-specific manner. Phthalates and bisphenol compounds increase body mass index, waist circumference, waist to height ratio, and the sum of skinfold thicknesses in women and not in men. Low-dose exposure to Persistent Organic Pollutants is strongly associated with increased body mass index in men and decreased this parameter in women. The mechanism through which these compounds act on anthropometric parameters is not entirely understood. Several studies suggest a possible interference in gonadotropin secretion and the thyroid axis. These inspire a decrease in both total and free testosterone levels in men and FT3 and FT4 levels in women, particularly after a pregnancy. The impact of endocrine disruptor chemicals on adipose tissue inflammation and future cardio-metabolic disorders remains to be elucidated. Therefore, studies involving both healthy and obese individuals are needed to unambiguously confirm results from in vitro and animal models.


Echinacoside Protects Against Dysfunction of Spermatogenesis Through the MAPK Signaling Pathway.
Dysfunction at various levels of spermatogenesis (SD) is one of the important causes of infertility in men of reproductive age and requires advanced treatment strategies. Increasing evidence suggests that the therapeutic effects of echinacoside (ECH) mainly depend on their capacity to inhibit cell death. This study aimed to explore the therapeutic potential of ECH in SD rat models. Treatment with ECH reverted the morphological changes observed in testes with spermatogenesis dysfunction. It improved total sperm number, decreased the sperm deformity rate, and increased the sperm forward motility rate. The level of glutathione (GSH) was significantly higher in ECH-treated mice, whereas the lactate dehydrogenase (LDH) and SOD activities were improved compared with those in the spermatogenesis dysfunction model. Moreover, the increased expression of p38 and JNK was partially reversed by ECH. The number of normal TM3 cells increased gradually in an Echinacea dosage-dependent manner, suggesting that ECH promoted the proliferation of TM3 cells. In addition, treatment with ECH partially reversed the increased expression of p38 and JNK in TM3 cells. ECH protects against oxidative stress damage by activating antioxidant enzymes and MAPK signaling-related factors (p38 and JNK). It suggested that treatment with ECH alleviated spermatogenetic dysfunction of testes in male mice and it could be a promising strategy for patients suffering severe SD.


The Haven Clinic: The Planning and Implementation of a Medical Home for Child Trafficking Survivors.
The authors describe the planning and implementation of a survivor-informed medical home for child trafficking survivors. Key partnerships necessary for establishing clinical infrastructure are highlighted. The trauma-informed clinical practices are described in detail. An overview of next steps for evaluation of this clinical program is provided.


Screening for the metabolic syndrome in community psychiatric patients prescribed antipsychotics: a quality improvement programme.
The aim was to evaluate a quality improvement programme designed to increase screening for the metabolic syndrome in community psychiatric patients prescribed antipsychotics. Baseline audit against evidence-based standards, followed by provision of benchmarked data and a range of change interventions, with re-audit 1 year later. At baseline, 48 assertive outreach teams across the UK submitted data on screening over the previous year for 1966 patients. At re-audit, 35 of the teams submitted data for 1516 patients. Screening for all four aspects of the metabolic syndrome (measuring blood pressure, obesity, blood glucose and plasma lipids) had increased significantly by re-audit. Clinical variables increasing the likelihood of full screening were clozapine treatment and a known diagnosis of diabetes or dyslipidaemia. The programme's success may be partly attributed to the use of a widely-accepted audit standard, and bespoke change interventions that directly addressed barriers to screening identified by the participating clinical teams.


Bilateral Knee Osteoarthritis Treated With Medial Open-Wedge High Tibial Osteotomy Using Two Types of β-Tricalcium Phosphate With Differing Placements in Each Knee: A Report of Two Cases.
In medial open-wedge high tibial osteotomy (MOWHTO) for knee osteoarthritis, synthetic bone is commonly used as a replacement material for the opening gap. Unidirectional porous β-tricalcium phosphate (UDPTCP) and spherical porous β-tricalcium phosphate (SPTCP) have been widely used in this regard. In general, the two prostheses are placed parallel to the osteotomy opening gap. In this report, we discuss two cases involving a 63-year-old woman and a 51-year-old man who underwent MOWHTO for bilateral knee osteoarthritis. Both patients had experienced bilateral knee pain. In both patients, UDPTCP was placed anteriorly and SPTCP was placed posteriorly in one knee, with the placement reversed in the other knee. The remodeling of each type of β-TCP was evaluated using CT immediately after the surgery and one year postoperatively. The postoperative corrective loss and clinical outcomes were also evaluated. Remodeling with β-TCP was found to be faster with UDPTCP than with SPTCP, even though the anteroposterior placement differed laterally in each patient. Furthermore, there was no correction loss, and the clinical outcomes were comparable, regardless of the placement of β-TCP.


Erythrocyte vesiculation. 2. Membrane molecular transformation.
A population of vesicles 150 +/- 30 nm in diameter was isolated from banked human blood and the perturbation of their membrane studied. SDS polyacrylamide gel electrophoresis revealed the complete loss of spectrins from the vesicle membrane which was also depleted of various intrinsic proteins. In particular, severe reduction of protein 3 and glycophorin is consistent with the over 80% decline of intramembrane particles in either fracture face of the vesicle membrane. The stimulation of vesicle acetylcholinesterase is considered indicative of an initial disintegration associated with the segregation and rearrangement of membrane constituents. The findings are discussed with regard to the subcellular mechanisms of erythrocyte vesiculation.


Ehrlichiosis infection mimicking thrombotic microangiopathy syndrome early after kidney transplantation.
Fever of unknown origin and the clinical picture of thrombotic microangiopathy (TMA) are diagnostic challenges in the early period after kidney transplantation. Here, we report a case of human monocytic ehrlichiosis in a renal allograft recipient who presented with fever and clinical picture of TMA in the first month post-kidney transplant. Despite broad coverage with multiple antimicrobial agents, fever and hematological abnormalities persisted for several days. A history of contact exposure and living in an endemic area raised clinical suspicion for human monocytic ehrlichiosis (HME), and empiric treatment with doxycycline was initiated. Definitive diagnosis of HME was confirmed by polymerase chain reaction (PCR) for Ehrlichia chaffeensis. Human ehrlichiosis should be considered within the differential diagnosis in kidney transplant recipients with the clinical picture of TMA and fever of unknown origin. Furthermore, early treatment with doxycycline enhances rapid resolution of clinical and laboratory recovery.


Methicillin Resistant Staphylococcus Aureus Sacroiliac Joint Septic Arthritis in an Adult Patient Treated with Daptomycin.
Sacroiliac joint septic arthritis is a rare disease entity representing 1-2% of all cases of septic arthritis. Establishment of the diagnosis is often challenging given the non-specific presenting features and the potential cross-over with other pathologies. We report the case of a 50 year old gentleman who suffers with psoriasis and presented with sacroiliac joint septic arthritis complicated by Methicillin Resistant Staphylococcus Aureus (MRSA) bacteraemia and an iliopsoas abscess. This was successfully treated conservatively with a course of the novel antibiotic Daptomycin.


Retinal ganglion cell survival and axon regeneration in WldS transgenic rats after optic nerve crush and lens injury.
We have previously shown that the slow Wallerian degeneration mutation, whilst delaying axonal degeneration after optic nerve crush, does not protect retinal ganglion cell (RGC) bodies in adult rats. To test the effects of a combination approach protecting both axons and cell bodies we performed combined optic nerve crush and lens injury, which results in both enhanced RGC survival as well as axon regeneration past the lesion site in wildtype animals. As previously reported we found that the Wld(S) mutation does not protect RGC bodies after optic nerve crush alone. Surprisingly, we found that Wld(S) transgenic rats did not exhibit the enhanced RGC survival response after combined optic nerve crush and lens injury that was observed in wildtype rats. RGC axon regeneration past the optic nerve lesion site was, however, similar in Wld(S) and wildtypes. Furthermore, activation of retinal glia, previously shown to be associated with enhanced RGC survival and axon regeneration after optic nerve crush and lens injury, was unaffected in Wld(S) transgenic rats. RGC axon regeneration is similar between Wld(S) transgenic and wildtype rats, but Wld(S) transgenic rats do not exhibit enhanced RGC survival after combined optic nerve crush and lens injury suggesting that the neuroprotective effects of lens injury on RGC survival may be limited by the Wld(S) protein.


Osmotaxis in Escherichia coli.
The escape of motile organisms from high concentrations of chemicals was studied in Escherichia coli. We have found all chemicals tested to be osmorepellents. It was shown in both a spatial assay and a temporal assay that the known sensory receptors for chemotaxis are not used for osmotaxis, so a different sensory mechanism appears to be employed. According to the temporal assay, the mechanism between sensory receptors and flagella is also not used for tumbling response (at least in solutions above 0.4 osmolar).


Hole-doped semiconductor nanowire on top of an s-wave superconductor: a new and experimentally accessible system for Majorana fermions.
Majorana fermions were envisioned by Majorana in 1935 to describe neutrinos. Recently, it has been shown that they can be realized even in a class of electron-doped semiconductors, on which ordinary s-wave superconductivity is proximity induced, provided the time reversal symmetry is broken by an external Zeeman field above a threshold. Here we show that in a hole-doped semiconductor nanowire the threshold Zeeman field for Majorana fermions can be very small for some magic values of the hole density. In contrast to the electron-doped systems, smaller Zeeman fields and much stronger spin-orbit coupling and effective mass of holes allow the hole-doped systems to support Majorana fermions in a parameter regime which is routinely realized in current experiments.


Serum sialic acid and prostate-specific antigen in differential diagnosis of benign prostate hyperplasia and prostate cancer.
In order to improve the diagnostic accuracy of the serum total and free prostate-specific antigen (PSA) in differential diagnosis between benign prostate hyperplasia (BPH) and prostate cancer, the serum total sialic acid (TSA) was measured and logistic regression (LR) models were built. Significantly higher serum PSA (p<0.001) concentrations were observed in patients with prostate cancer compared to control subjects, but no statistically significant differences were found in serum TSA concentrations between these groups. Serum PSA reliably discriminated patients with prostate cancer from control subjects, the area under the ROC curve (AUC) being 0.991 (0.010). When serum PSA was in the gray zone, from 4 to 10 microg/l, the diagnostic accuracy of PSA in discriminating patients with prostate cancer from BPH patients was very poor, AUC being 0.563 (0.132). However, using the same set of patients the LR model combining serum PSA, free to total PSA ratio and TSA values, as well as digital rectal examination results, had good diagnostic accuracy in discriminating the prostate cancer patients from patients with BPH, the area under the ROC curve being 0.895 (0.054). The present data suggest that the logistic regression model combining laboratory measurements and results of the clinical examination may be a useful adjunct in the differential diagnosis of benign and malignant prostate disease.


Migration of plasticiser from haemodialysis blood tubing.
Di-2-ethylhexyl phthalate (DEHP) was found to migrate from polyvinyl chloride (PVC) blood tubing into human blood during both in vivo and in vitro haemodialysis. DEHP blood level increased during in vivo dialysis but decreased again toward the end of a six hour dialysis period. During in vitro haemodialysis of outdated human blood DEHP accumulated up to 5580 ppb. Although toxic effects have not yet been observed, we believe plastic tubing that does not contain extractable materials should be developed.


Quantitative coupled-mode model for a metal-dielectric-metal waveguide with a side-coupled cavity.
The Fabry-Perot model is proposed to analyze the wavelength-selective transmission behaviors of the metal-dielectric-metal waveguide with a rectangular side-coupled cavity. The guided modes propagating in the waveguide and the cavity are extracted by the aperiodic Fourier modal method (a-FMM). The scattering coefficients that appeared in the model are calculated by the a-FMM and the normal-mode theory. The applications of such structure in the wavelength-selective filter and the refractive index sensor are also discussed. Our model is shown to accurately predict the fully vectorial data and thus can provide reliable and quantitative analysis of this kind of device.


Too Important for the Bureaucrats: Rethinking Risk and Regulatory Presumptions in Times of Crisis.
The posture of American regulation of medicine is negative-we assume that a new drug is unsafe and ineffective until it is proven safe and effective.1 This regulatory posture is a heuristic normative principle, a specific instance of the so-called precautionary principle in public health law.2 It is defensible, if debatable, in many ordinary circumstances.3 But like many normative heuristics, this negative posture may compel suboptimal decision-making in emergencies, where context-specific decisions must be made and a range of unique values may apply.


Auxotypes of Neisseria gonorrhoeae isolated from heterosexual men, homosexual men, and heterosexual women.
During 1979-1984 we auxotyped 1822 strains of Neisseria gonorrhoeae and recorded the site of isolation and sexual orientation of the patients. Auxotypes were determined by the growth requirements of strains for proline (Pro-), uracil (Ura-), hypoxanthine (Hyx-), citrulline (Cit-), or citrulline replaceable by ornithine (Orn-). Of all isolates from homosexual men, 96% belonged to three auxotypes: nonrequiring (NR), Pro-, or Orn-, and only 1.5% belonged to the Pro-, Cit-, Ura- and Orn-, Ura-, Hyx- auxotypes. Of the isolates from women, 49.9% belonged to these latter two auxotypes. Of the strains isolated from male homosexuals, 19.5% were resistant to 1.0 microgram of erythromycin/ml, whereas only 9.6% of strains from other men and 2.6% of strains from women were resistant to this concentration. We suggest that strains of N. gonorrhoeae infecting homosexual men tend to be less demanding in their nutritional requirements and more resistant to erythromycin than strains infecting heterosexual men and women.


Effects of attention control training on drug abusers' attentional bias and treatment outcome.
Attentional bias for drug-related stimuli (Drug-AB) has been shown to play an important role in drug abuse, drug treatment, and relapse. This study sought to retrain Drug-AB using the Drug Attention Control Training Program (Drug-ACTP) on a sample of Iranian drug abusers. The experimental group (n = 24) received 3 sessions of training with the Drug-ACTP in addition to treatment as usual; the control group (n = 24) received only treatment as usual. All participants completed a demographic questionnaire, the drug-Stroop test, measures of physiological cue reactivity, the Personal Concerns Inventory (a measure of motivational structure), Persian Temptation Scale, Perceived Stress Scale (PSS), Positive Affect and Negative Affect Schedule (PANAS), Situational Confidence Questionnaire (SCQ), and Readiness to Change Questionnaire (RTCQ). All participants were tested at baseline, posttraining, and a 2-month follow-up. A brief, 6-month telephone follow-up was also conducted to monitor their temptation, SCQ, RTCQ, PANAS, and PSS scores; doses of medicine taken; and number of lapses. The results showed that, compared to the control group, the experimental group showed (a) reductions in Drug-AB, temptations to use, doses of medicine, and number of lapses; and (b) increases on the RTCQ and 2 subscales of the SCQ. Regardless of group membership, adaptive motivation was positively correlated with success in achieving therapeutic goals, and negatively associated with doses of methadone taken and number of relapses. It seems that attentional training can be an important addition to methadone maintenance therapy. (PsycINFO Database Record


Predictors of treatment response in pediatric obsessive-compulsive disorder.
To examine predictors of treatment response in pediatric obsessive-compulsive disorder (OCD). A literature review of psychotherapy (i.e., cognitive-behavioral therapy) and medication studies for pediatric OCD published from 1985 to 2007 was conducted using several databases. The literature search produced a total of 21 studies (6 cognitive-behavioral therapy, 13 medication, and 2 combination studies) that met specific methodological criteria. Across studies, the following nine predictors were examined: child sex, child age, duration of illness/age at onset, baseline severity of obsessive-compulsive symptoms, type of obsessive-compulsive symptoms, comorbid disorders/symptoms, psychophysiological factors, neuropsychological factors, and family factors. Among all of the studies, there was little evidence that sex, age, or duration of illness (age at onset) was associated with treatment response. Baseline severity of obsessive-compulsive symptoms and family dysfunction were associated with poorer response to cognitive-behavioral therapy, whereas comorbid tics and externalizing disorders were associated with poorer response in medication-only studies. Overall, there are limited data on predictors of treatment response for pediatric OCD. The majority of studies are plagued with methodological limitations and post hoc approaches. Additional research is needed to better delineate the predictors of treatment response in pediatric OCD with the goal of developing individualized treatment approaches.


Fermentation of high-salt liquid-state soy sauce without any additives by inoculation of lactic acid bacteria and yeast.
Food additives are artificial or natural substances that are added to food to improve the color, aroma, taste, and other qualities, and to meet processing requirements. For the concern of food health and safety, brewed soy sauce without additives has attracted consumers' attention. Here, only four necessary raw materials including soybean, wheat, salt, and water were added. High-salt soy sauce fermentation was conducted for six months by sequential inoculation of lactic acid bacteria and yeast under different brine content (18%, 20%, and 22%). By analyzing the physicochemical indicators during moromi, three soy sauces (No. 1: 18% salt, inoculated with Tetragenococcus halophilus and Zygosaccharomyces rouxii, No. 5: 20% salt, inoculated with T. halophilus and Z. rouxii, No. 11: 22% salt, inoculated with T. halophilus and Candida versatilis) were selected and sterilized to produce finished products for further comparative investigation. Results showed that the flavor components of these three soy sauces were richer in variety than the commercial soy sauces and No. 11 soy sauce was detected to have the largest total amount of organic acids. Plate count agar analysis revealed that the free amino acid differences of soy sauces were distinct, among which the No. 11 soy sauce had the highest glutamate content of 19.64 g L-1. Besides, it was found that the shelf life of these three soy sauces could reach two years at 4 ℃. This study suggests that the high-salt soy sauce made by rational application of lactic acid bacteria, yeast, and effective sterilization can have high quality and long shelf life without adding any additives.


Preparation and functional characterization of thylakoids from Arabidopsis thaliana.
A protocol for the isolation of functional thylakoids from Arabidopsis thaliana leaves was developed. The critical factor in obtaining active, coupled and stable preparation is the inclusion of EDTA and EGTA in the grinding buffer. Preparations were characterized with respect to the whole or partial electron transport chain, ATP/NADPH, ATP/O(2) and PS II/chlorophyll ratios. Sensitivity to a light-chill photoinhibitory treatment was also determined by evaluating the decrease in both maximal photochemical efficiency (Fv/Fm) and in electron transport rate.


Anorexia nervosa, obsessional behavior, and serotonin.
Although many women diet, relatively few develop the extreme weight loss and the clinical symptoms of anorexia nervosa. An underlying biological diathesis and temperament may place someone at risk for developing anorexia nervosa. Certain traits, such as negative affect, behavioral inhibition, compliance, high harm avoidance, and an obsessive concern with symmetry, exactness, and perfectionism, persist after recovery from anorexia nervosa. These persistent symptoms raise the possibility that such traits exist premorbidly and contribute to the pathogenesis of this disorder. Such traits could be associated with increased brain serotonin activity. After recovery, anorexics have increased levels of 5-HIAA, the major metabolite of serotonin, in the cerebrospinal fluid (CSF). Low CSF 5-HIAA levels have been associated with impulsive and aggressive behaviors, which are opposite to those typically found in anorexia nervosa. Increased serotonin activity could contribute to many behavioral symptoms, such as increased satiety. Moreover, recent data suggest that selective serotonin reuptake inhibitor (SSRI)-type medication improves outcome and prevents relapse in people with anorexia nervosa. These theoretical issues have important clinical implications in this era of diminished support for treatment of eating disorders. Anorexia nervosa, like other major psychiatric disorders, has contributory pathophysiology and can benefit from and deserves appropriate treatment resources.


Effects of mismatches and insertions on discrimination accuracy of nucleic acid probes.
Effective discrimination of non-complementary nucleotides is an important factor to ensure the accuracy of hybridization-based nucleic acid analyses. The current study investigates the effects of the chemical nature, the positions, the numbers, and the cooperative behavior of mismatches as well as insertions on 20-mer and 30-mer duplexes. We observed the hybridization stability trend affected by mismatches: G:T approximately G:G > G:A > A:A approximately T:T > A:C approximately T:C > C:C. The experimental data show that mismatches at the center of the oligonucleotide probes have a more profound destabilizing effect on the hybridization stability than those at either ends. Insertions also demonstrate a similar destabilizing effect as mismatches. These results provide useful information for designing DNA microarray nucleotide probes and for improving the discrimination accuracy of hybridization-based detections.


A Social-Ecological View of Barriers and Facilitators for HIV Treatment Adherence: Interviews with Puerto Rican HIV Patients.
To identify perceived barriers and facilitators for HAART adherence among people living with HIV/AIDS in Southern Puerto Rico using a Social Ecological framework. Individual in-depths interviews were conducted with 12 HIV patients with a history of HAART non-adherence. Interviews were audio-taped and transcribed. Content analysis was performed for each transcribed interview by three independent coders using a codebook. Using Atlas TI, super-codes and families were generated to facilitate the categorization tree as well as grounded analyses and density estimates. Most participants reported a monthly income of $500 or less (n = 7), a high school education level (n = 7), being unemployed (n = 9) and being recipients of government health insurance (n = 11). Three out of six women reported living alone with their children and most men informed living with their parents or other relatives (n = 4). For the grounded analyses, the top four sub-categories linked to high number of quotations were mental health barriers (G = 32) followed by treatment regimen (G = 28), health system (G = 24) and interpersonal relations (G = 16). The top four sub-categories linked to high number of codes are treatment regimen (D = 4), health status perception (D = 3), interpersonal relations (D = 3) and health system (D = 3). The results of this study suggest the interconnection of HIV treatment adherence barriers at various system levels. Future studies on HIV treatment barriers should explore these interactions and investigate the possible synergistic effect on non-adherent behavior.


Excitability governs neural development in a hippocampal region-specific manner.
Neuronal activity, including intrinsic neuronal excitability and synaptic transmission, is an essential regulator of brain development. However, how the intrinsic neuronal excitability of distinct neurons affects their integration into developing circuits remains poorly understood. To investigate this problem, we created several transgenic mouse lines in which intrinsic excitability is suppressed, and the neurons are effectively silenced, in different excitatory neuronal populations of the hippocampus. Here we show that CA1, CA3 and dentate gyrus neurons each have unique responses to suppressed intrinsic excitability during circuit development. Silenced CA1 pyramidal neurons show altered spine development and synaptic transmission after postnatal day 15. By contrast, silenced CA3 pyramidal neurons seem to develop normally. Silenced dentate granule cells develop with input-specific decreases in spine density starting at postnatal day 11; however, a compensatory enhancement of neurotransmitter release onto these neurons maintains normal levels of synaptic activity. The synaptic changes in CA1 and dentate granule neurons are not observed when synaptic transmission, rather than intrinsic excitability, is blocked in these neurons. Thus, our results demonstrate a crucial role for intrinsic neuronal excitability in establishing hippocampal connectivity and reveal that neuronal development in each hippocampal region is distinctly regulated by excitability.


Gender differences in the dimensions of quality of life.
To explore gender differences and similarities in the dimensions of quality of life (QOL). Secondary analysis of the Multidimensional Quality of Life Scale--Cancer Version (MQOLS--CA) data from two different research studies. Multiple outpatient oncology sites. The typical female participant (n = 254) was 58 years old (SD +/- 11.3) with 14 years of education, married/partnered (64%), Caucasian (88%), and diagnosed with breast (47%) or colorectal (16%) cancer. The typical male participant (n = 222) was 60 years old (SD +/- 14) with 14.3 years of education, married/partnered (69%), Caucasian (85%), and diagnosed with colorectal (31%) or prostate (13%) cancer. Factor analytic procedures and reliability testing. QOL as measured by the MQOLS-CA, gender. For women, two factors emerged from the analysis procedures-psychosocial well-being (7 items) and physical competence (6 items). For the men, two different factors emerged--vitality (8 items) and personal resources (4 items). None of the cancer-specific items from the MQOLS-CA loaded on any of the factors for either gender. Measurement of QOL requires gender-specific questions to accurately address the dimensions of the concept of QOL in females and males. Additional research is warranted to replicate these findings. Gender-specific interventions could then be developed and tested to maximize the QOL of all patients.


Dispersion of sneeze droplets in a meat facility indoor environment - Without partitions.
Spreading patterns of the coronavirus disease (COVID-19) showed that infected and asymptotic carriers both played critical role in escalating transmission of virus leading to global pandemic. Indoor environments of restaurants, classrooms, hospitals, offices, large assemblies, and industrial installations are susceptible to virus outbreak. Industrial facilities such as fabrication rooms of meat processing plants, which are laden with moisture and fat in indoor air are the most sensitive spaces. Fabrication room workers standing next to each other are exposed to the risk of long-range viral droplets transmission within the facility. An asymptomatic carrier may transmit the virus unintentionally to fellow workers through sporadic sneezing leading to community spread. A novel Computational Fluid Dynamics (CFD) model of a fabrication room with typical interior (stationary objects) was prepared and investigated. Study was conducted to identify indoor airflow patterns, droplets spreading patterns, leading droplets removal mechanism, locations causing maximum spread of droplets, and infection index for workers along with stationary objects in reference to seven sneeze locations covering the entire room. The role of condensers, exhaust fans and leakage of indoor air through large and small openings to other rooms was investigated. This comprehensive study presents flow scenarios in the facility and helps identify locations that are potentially at lower or higher risk for exposure to COVID-19. The results presented in this study are suitable for future engineering analyses aimed at redesigning public spaces and common areas to minimize the spread of aerosols and droplets that may contain pathogens.


Effects of bazedoxifene/conjugated estrogens on reproductive endocrinology and reproductive tract ultrasonographic appearance in premenopausal women: a preliminary study.
Bazedoxifene (BZA) paired with conjugated estrogens (CE) is the first tissue selective estrogen receptor complex (TSEC) approved by the United States Food and Drug Administration for the treatment of menopausal symptoms. Clinical trials in menopausal women and in premenopausal murine models of endometriosis have demonstrated safety and efficacy, however, the impact of BZA/CE on premenopausal women is not known. Here we report a case series study in premenopausal women assessing effects of BZA/CE on reproductive hormones, and uterine/ovarian ultrasonographic appearance. After one monitoring cycle, five subjects underwent daily administration of BZA/CE (20 mg/0.45 mg) for 12 weeks, and were followed for 4 weeks after treatment. Uterine/ovarian morphology was assessed with ultrasound, and endocrinologic function with ovulation prediction kits and serum assessment of reproductive hormones throughout the menstrual cycle. All subjects demonstrated an LH surge on the medication; interestingly there was a significant decrease in luteinizing hormone level during treatment compared to posttreatment values. BZA/CE was well-tolerated in premenopausal women and did not induce clinically relevant reproductive hormone changes, endometrial alterations, or abnormal ovarian folliculogenesis.


[Quality management according to the new SN EN ISO-Norm 9001:2000--experiences from initial certification of a hospital department].
Those who want to implement a quality-management system at a hospital these days cannot fall back on a broad-based system proven over the years. Though quality management as defined by ISO norm 9001 has been established as the central standard in many industrial areas, applicability of this ISO norm in the hospital sector has stirred up much controversy during recent years. Introduction of the new ISO norm 9001:2000 has changed the situation. The 2000 version of the new standard seeks to meet the demand for service operations--especially by establishing a clear procedural orientation. This report describes the new standard and its introduction in the Department of Surgery at the Cantonal Hospital in Olten, Canton Solothurn, Switzerland. It indicates the steps taken, for instance in the spheres of top management, quality management, procedural guidance, as well as customer and staff counselling. It also discusses the project's cost/benefit ratio for the organization.


Possible mechanism for cold denaturation of proteins at high pressure.
We study cold denaturation of proteins at high pressures. Using multicanonical Monte Carlo simulations of a model protein in a water bath, we investigate the effect of water density fluctuations on protein stability. We find that above the pressure where water freezes to the dense ice phase (approximately 2 kbars) the mechanism for cold denaturation with decreasing temperature is the loss of local low-density water structure. We find our results in agreement with data of bovine pancreatic ribonuclease A.


Optimism, mental health, and quality of life: a study among breast cancer patients.
Fifty one breast cancer patients participated in a cross-sectional study developed to assess the relation between their level of optimism, positive and negative mental health, and their quality of life. Patients were measured with the Life Orientation Test (LOT), the Center for Epidemiological Studies Depression Scale (CES-D), and the Functional Living Index-Cancer (FLIC). T-tests revealed that these breast cancer patients reported more optimism than pessimism, more positive than negative mental health, and the majority of the sample reported doing well on each qualify life domain of the FLIC. As expected, individuals who reported more depressive symptoms also reported less qualify of life. Breast cancer patients who scored lower on pessimism showed more positive mental health, but they showed no relation to negative mental health. Women who scored higher on optimism reported better social and mental functioning on the FLIC than women who scored low on optimism.


Survival of women with gestational trophoblastic neoplasia and liver metastases: is it improving?
To determine whether survival outcomes of women with liver metastases from gestational trophoblastic neoplasia (GTN) have improved from the previous finding of 27% at 5 years. The Charing Cross GTN database was searched for patients with liver metastases treated between 1975 and 2007. Prognostic variables were recorded and analyzed for effect on survival. Thirty-eight (1.8%) of 2,100 GTN patients had liver metastases. One patient with placental site trophoblastic tumor was excluded. In the remaining 37 cases the overall survival was 48% at 5 years. Seven patients with very advanced disease died <4 weeks after admission, and 12 late deaths occurred, 5 due to non-GTN causes (1 stroke and 4 second cancers). After exclusion of the early deaths and censoring for the non-GTN related deaths, the cause-specific survival was 68%. No prognostic variable was significant on univariate analysis. However, patients presenting >2.8 years and <2.8 years from the antecedent pregnancy had a 32% and 75% (p = 0.08) chance of long-term survival, respectively. The prognosis of patients with liver metastases from GTN has improved. Outcome may be best in those patients presenting within 2.8 years of the causative pregnancy and without very large volumes of disease.


[Clinical, biochemical and socio-medical problems in cystic fibrosis].
The major thrust of the worldwide effort on the disease entity cystic fibrosis is concerned with genetic, diagnostic and therapeutical questions and detection of the primary defect. The authors summarize new aspects presented at the VIIIth International Congress on Cystic Fibrosis in Toronto, Canada, 1980. Their aim is to inform about present knowledge on prenatal diagnosis and neonatal screening, to review clinical problems in the management of children with cystic fibrosis and, finally, discuss the future problems of adolescent and adult cystic fibrosis patients.


IgG Glycosylation Profile and the Glycan Score Are Associated with Type 2 Diabetes in Independent Chinese Populations: A Case-Control Study.
The relationship between the IgG glycan panel and type 2 diabetes remains unclear in Chinese population. We aimed to investigate the association of the IgG glycan profile and glycan score with type 2 diabetes. In the discovery population, 162 individuals diagnosed with type 2 diabetes and 162 matched controls from Beijing health management cohort were included. We analyzed the IgG glycan profile and composed a glycan score for type 2 diabetes. Findings were validated in the replication population from Beijing Xuanwu community cohort (280 cases and 508 controls). Area under curve (AUC) using 10-fold and bootstrap validation, net reclassification index (NRI), and integrated discrimination index (IDI) were calculated for the glycan score. In the discovery population, 5 initial IgG glycans and 7 derived traits were significantly associated with type 2 diabetes after Bonferroni correction and Lasso selection, which were validated in the replication population subsequently. The glycan score composed of these IgG glycans and traits showed a strong association with type 2 diabetes (combined odds ratio (OR): 3.78) and its risk factors. In the replication population, AUC of the model involving clinical traits improved from 0.74 to above 0.90, and the values of NRI and IDI were 0.35 and 0.42, respectively, with the glycan score added. IgG glycosylation profiles were associated with type 2 diabetes and the glycan score may be a novel indicator for diabetes which reflected a proinflammatory status.


Bioformulation of Silk-Based Coating to Preserve and Deliver Rhizobium tropici to Phaseolus vulgaris Under Saline Environments.
Seed priming has been for a long time an efficient application method of biofertilizers and biocontrol agents. Due to the quick degradation of the priming agents, this technique has been limited to specific immediate uses. With the increase of awareness of the importance of sustainable use of biofertilizers, seed coating has presented a competitive advantage regarding its ability to adhere easily to the seed, preserve the inoculant, and decompose in the soil. This study compared primed Phaseolus vulgaris seeds with Rhizobium tropici and trehalose with coated seeds using a silk solution mixed with R. tropici and trehalose. We represented the effect of priming and seed coating on seed germination and the development of seedlings by evaluating physiological and morphological parameters under different salinity levels (0, 20, 50, and 75 mM). Results showed that germination and morphological parameters have been significantly enhanced by applying R. tropici and trehalose. Seedlings of coated seeds show higher root density than the freshly primed seeds and the control. The physiological response has been evaluated through the stomatal conductance, the chlorophyll content, and the total phenolic compounds. The stability of these physiological traits indicated the role of trehalose in the protection of the photosystems of the plant under low and medium salinity levels. R. tropici and trehalose helped the plant mitigate the negative impact of salt stress on all traits. These findings represent an essential contribution to our understanding of stress responses in coated and primed seeds. This knowledge is essential to the design of coating materials optimized for stressed environments. However, further progress in this area of research must anticipate the development of coatings adapted to different stresses using micro and macro elements, bacteria, and fungi with a significant focus on biopolymers for sustainable agriculture and soil microbiome preservation.


[Blood stock management by computers in a transfusion center].
In large blood Transfusion Centers, blood stock management is quite difficult because of the numerous daily movements, the short storage time of blood products, the multiplicity of sample types, and, indeed, of blood antigens, etc. A data processing system has been established in the Blood Transfusion Center ofLille (170 000 bottles a year). From information codified in collection and in distribution departments, the computer is able to give to the authorities essential daily decision elements such as the knowledge of :--the exact profile of each collection (1 119 in 1974),--statistics of blood distributions,--available stock, classified by storage time, volume, blood group, etc. The computer contribution from the security point of view, as well as its utilization in phenotyped blood research is described here.


Electronic changes due to thermal disorder of hydrogen bonds in liquids: pyridine in an aqueous environment.
Combined Metropolis Monte Carlo computer simulation and first-principles quantum mechanical calculations of pyridine in water are performed to analyze the role of thermal disorder in the electronic properties of hydrogen bonds in an aqueous environment. The simulation uses the NVT ensemble and includes one pyridine and 400 water molecules. Using a very efficient geometric-energetic criterion, the hydrogen bonds between pyridine and water C5H5N---H2O are identified and separated for subsequent quantum mechanical calculations of the electronic and spectroscopic properties. Statistically uncorrelated configurations composed of one pyridine and one water molecule are used to represent the configuration space of the hydrogen bonds in the liquid. The quantum mechanical calculations on these structures are performed at the correlated second-order perturbation theory level and all results are corrected for basis-set superposition error. The results are compared with the equivalent electronic properties of the hydrogen bond in the minimum-energy configuration. Charge transfer, dipole moment, and dipole polarizabilities are calculated for the thermally disordered and minimum-energy structures. In addition, using the mean and anisotropic polarizabilities, the Rayleigh depolarizations are obtained. All properties obtained for the thermally disordered structures are represented by a statistical distribution and a convergence of the average values is obtained. The results indicate that the charge transfer, dipole moment, and average depolarization ratios are systematically decreased in the liquid compared to the optimized cluster. This study quantifies, using ab initio quantum mechanics and statistical analysis, the important aspect of the thermal disorder of the hydrogen bond in a liquid system.


Histamine release induced by human leukocyte lysates. Reabsorption of previously released histamine after exposure to cyclic amp-active agents.
The role of cyclic AMP in histamine release induced by human leukocyte lysates was investigated. Leukocytes were incubated with leukocyte lysates prepared by ultrasonic disruption, and histamine was determined fluorimetrically. Several cyclic AMP-active agents had a marked inhibitory effect on histamine release. Theophylline and isoproterenol produced 50% inhibition at concentrations of less than 10(-5) M. Prostaglandin E(1) and dibutyryl cyclic AMP inhibited release by 50% at 7 x 10(-8) M and 6 x 10(-5) M concentrations, respectively. Histamine, which has recently been shown to increase leukocyte cyclic AMP, had a pronounced inhibitory effect on lysate-induced histamine release, producing 50% inhibition at a concentration of only 2.5 x 10(-12) M.Leukocytes, incubated with leukocyte lysates, were sampled at various times and assayed for free histamine released into the incubation mixture supernates, and for bound histamine associated with the leukocyte buttons after centrifugation. Theophylline, prostaglandin E(1) and dibutyryl cyclic AMP not only blocked histamine release, but also caused a progressive decrease in free histamine when added at any time up to 30 min after initiation of the release reaction. As the free histamine decreased after addition of the inhibitors, there was a corresponding increase in the bound histamine, suggesting that previously released histamine was reabsorbed by the leukocytes after exposure to cyclic AMP-active agents. Continued incubation of leukocytes in their own histamine after completion of the release reaction also resulted in reabsorption of the previously released histamine. Previous studies have indicated that cyclic AMP inhibits leukocyte histamine release. The results of the present studies suggest that cyclic AMP modulates histamine release induced by human leukocyte lysates by stimulating reabsorption of histamine from the extracellular environment. These studies also suggest that previously released extracellular histamine may stimulate its own reabsorption by increasing the intracellular level of cyclic AMP.


Total synthesis of (-)-dactylolide and formal synthesis of (-)-zampanolide via target oriented beta-C-glycoside formation.
The total synthesis of (-)-dactylolide and formal synthesis of (-)-zampanolide via target oriented beta-C-glycoside formation is described. The two key reactions involved a stereoselective reduction of the appropriate oxocarbenium cation and a highly chemo- and diastereoselective ring-closing metathesis protocol for the formation of the macrocyclic core. In addition to the described chemistry, in vitro screening of the antipode of natural dactylolide against the NCI's 60 cancer cell line helped to illuminate the critical importance of the N-acyl hemiaminal side chain of natural zampanolide for its reported potent nanomolar cytotoxicities. Furthermore, by means of the in vitro screen of (-)-dactylolide, a promising cancer therapeutic lead has now emerged for a variety of carcinomas. More specifically, (-)-dactylolide exhibited GI50 values in the nanomolar (25-99 ng/mL) range against the four cell lines HL-60, K-562, HCC-2998, and SF-539, while displaying modest LC50 values.


Terbium Functionalized Micelle Nanoprobe for Ratiometric Fluorescence Detection of Anthrax Spore Biomarker.
Rapid, sensitive, and selective quantitative detection of pyridine dicarboxylic acid (DPA) as biomarker of anthrax spores is in great demand since anthrax spores are highly lethal to human beings and animals and also potential biological warfare agents. Herein, we prepared a ratiometric fluorescence lanthanide functionalized micelle nanoprobe by "one-pot" self-assembly, with an amphiphilic ligand containing β-diketone derivative which can "immobilize" terbium ions through the coordination interaction and a fluorophore as fluorescence reference (FR). The detection strategy was ascribed to Tb3+ ions in lanthanide functionalized micelle, which can be sensitized to emit the intrinsic luminescence upon addition of DPA due to the presence of energy transfer when DPA chromophore coordinated with Tb3+ ion. The fluorescence intensity of FR remained essentially constant, leading to ratiometric fluorescence response toward DPA. The results demonstrate that the terbium functionalized micelle was able to sensitively detect DPA with a linear relation in the range of 0 μM to 7.0 μM in aqueous solution, which also showed remarkable selectivity to DPA over other aromatic ligands. Our work paves a new way in the design of ratiometric fluorescence lanthanide functionalized micelle nanoprobes which can be promising for selective and sensitive detection of bacterial spores or biomolecules.


Natural history and prognostic factors of diabetic nephropathy in type 2 diabetes.
The causes and mechanisms of increased mortality of patients with diabetic nephropathy are unclear, and its natural history is poorly understood. To evaluate risk factors for mortality in type 2 diabetic patients with nephropathy. Retrospective study of clinical and biochemical parameters in diabetic nephropathic patients and controls sampled from a secondary care register. We studied 170 type 2 diabetic patients (from 1987 to 1995) with nephropathy (proteinuria >0.5 g/24 h) and 170 non-nephropathic patients. Follow-up was until death or December 1997. Details of demographics, clinical and treatment history were obtained from medical records. Mean follow-up was 5.3 years. Of the patients with nephropathy at baseline, 63 (37%) died compared with 14 (8%) non-nephropathic patients (chi(2)=53.8, p<0.0001). Age- and sex-adjusted all-cause mortality rates were 8.1 (6.4, 9.8) and 1.4 (0.5, 2.2) deaths per 100 person-years, respectively (rate ratio 5.8). Forty-four patients (57%) died from cardiovascular causes (rate ratio 5.4). Mortality was directly proportional to degree of proteinuria: 0.5-2 g/24 h, 4.6 (2.9-7.1); >2 g/24 h, 9.9 (7.3-13.5) per 100 patient-years. A 36% (5-78%) excess risk of mortality was observed for each log unit increase in proteinuria. Multivariate Cox regression analyses confirmed a five-fold excess risk for all-cause and cardiovascular mortality in patients with nephropathy compared with those without. This was independent of other risk factors including baseline age [5% (1-8%)/year], creatinine [2.5 (1.12-5.6)/10 micromol/l] and glycaemic control (HbA(1c)) [15% (1-31%) per 1% rise]. Proteinuria is a potentially preventable and reversible risk factor associated with high mortality in type 2 diabetic patients. Prevention of the development of overt nephropathy and improvement in diabetes control may reduce mortality in these patients.


An Analysis of Laryngomalacia and Its Interplay With Obesity and Obstructive Sleep Apnea in Pediatric Inpatients.
Objective This study aimed to investigate the potential relationship between laryngomalacia and obesity as well as explore the interplay between laryngomalacia and obstructive sleep apnea using the Kids' Inpatient Database (KID) for the year 2016. Methods The Healthcare Cost and Utilization Project (HCUP) KID for 2016 provided a dataset for analysis. Patient demographics, diagnoses, and hospital characteristics were considered. Patients less than three years old were included due to the high prevalence of laryngomalacia in this age group. Results Among 4,512,196 neonatal admissions, 1,341 obesity cases and 11,642 laryngomalacia cases were analyzed. The frequency of laryngomalacia in patients with obesity was 578.1% higher than in the general population. Patients with obstructive sleep apnea (OSA) exhibited a 5,243.2% increase in laryngomalacia frequency compared to the overall population. Combining obesity and laryngomalacia resulted in a 6,738.5% increase in OSA frequency. Conclusions This study identified a significant correlation between obesity and increased laryngomalacia risk. The findings have important clinical implications for pediatric care, emphasizing the need to prevent childhood obesity to reduce laryngomalacia risk. Additionally, understanding these risk factors enables better risk stratification for laryngomalacia and potential OSA development.


Arytenoid dislocation and computed tomography.
The insertion of endotracheal tubes is surprisingly free of laryngeal complications. Although the exact incidence of endotracheal tube-induced laryngeal trauma is unknown, recent reports of arytenoid dislocations have led to an increased awareness of the possibility for this type of laryngeal injury. Since indirect examination of the larynx in a postoperative patient is not always an easy procedure, the use of a computed tomographic (CT) scan may provide help in making the diagnosis of arytenoid dislocation and in confirming the return of the arytenoid to its usual position following endoscopic manipulation. A 27-year-old man had a weak voice following an atraumatic intubation. A scan done on a body scanner without contrast revealed a right arytenoid dislocation. Following laryngoscopic manipulation, an improved position of the arytenoid was confirmed by a subsequent CT scan done in the same manner. The use of this noninvasive technique may be an additional aid in the diagnosis of laryngeal disorders following intubation.


Astrocytic glutamate release-induced transient depolarization and epileptiform discharges in hippocampal CA1 pyramidal neurons.
A paroxysmal depolarization shift (PDS) has been suggested to be a hallmark for epileptic activity in partial-onset seizures. By monitoring membrane potentials and currents in pairs of pyramidal neurons and astrocytes with dual patch-clamp recording and exocytosis of vesicles from astrocytes with two-photon laser scanning microscopy in hippocampal slices, we found that infusion of inositol 1,4,5-trisphosphate (IP(3)) into astrocytes by patch pipettes induced astrocytic glutamate release that triggered a transient depolarization (TD) and epileptiform discharges in CA1 pyramidal neurons. The TD is due to a tetrodotoxin (TTX)-insensitive slowly decaying transient inward current (STC). Astrocytic glutamate release simultaneously triggers both the STC in pyramidal neurons and a transport current (TC) in astrocytes. The neuronal STC is mediated by ionotropic glutamate receptors leading to the TD and epileptiform discharges; while the astrocytic TC is a glutamate reuptake current resulting from transporting released glutamate into the patched astrocyte. Fusion of a large vesicle in astrocytes was immediately followed by an astrocytic TC, suggesting that the fused vesicle contains glutamate. Both fusion of large vesicles and astrocytic TCs were blocked by tetanus toxin (TeNT), suggesting that astrocytic glutamate release is via SNARE-dependent exocytosis of glutamate-containing vesicles. In the presence of TTX, the epileptogenic reagent, 4-AP, also induced similar neuronal STCs and astrocytic TCs, suggesting that astrocytic glutamate release may play an epileptogenic role in initiation of epileptic seizures under pathological conditions. Our study provides a novel mechanism, astrocytic release of glutamate, for seizure initiation.


[Addisonian Crisis - Risk Assessment and Appropriate Treatment].
An adrenal crisis (Addisonian crisis) is an acute life-threatening complication of adrenal insufficiency. It occurs when hydrocortisone demand is not met by supplementation in the context of an infection - often gastrointestinal, fever, trauma, acute psychological or physical stress. Symptoms of weakness, nausea, muscle/joint pain and drowsiness may develop out of robust health within few hours. If overlooked, treated too late, with insufficient dose or route of application, there exists a considerable risk of mortality. Treatment consists of immediate parenteral hydrocortisone (100 mg bolus) and subsequent continuous infusion until the underlying precipitating cause is cured and/or when regular supplementation can be continued. Physicians and nurses must not underestimate the condition, since diagnosis and treatment must not be delayed. Patients, relatives and spouses need to be trained in prevention and early recognition through educational programs and emergency cards.


Cardiac Implantable Electronic Device Implantation: Intraoperative, Acute, and Remote Complications.
Implantation of cardiac implantable electronic devices (CIEDs), including pacemakers, implantable cardioverter-defibrillators, and biventricular pacemakers/cardioverter-defibrillators, is becoming increasingly common with new implants now exceeding 1.5 million per year globally. As a result, health care providers in all disciplines are caring for an increasing number of patients with CIEDs. Although the risk of complications associated with implantation of CIEDs is relatively low, the sequela can be catastrophic. Management requires an understanding of an individual patient's indication for CIED implant, the steps of implant procedures, device function, and natural history of each complication.


Hepatitis B virus DNA negativity acts as a favorable prognostic factor in hepatocellular carcinoma patients.
This retrospective study was aimed to investigate the efficacy of prophylactic agents in hepatocellular carcinoma (HCC) patients receiving TACE and compare the difference between lamivudine and entecavir. A consecutive series of 203 HBV-related HCC patients receiving TACE were analyzed including 91 patients given prophylactic agents. Virologic events, defined as an increase in serum HBV DNA level to more than 1 log10 IU/ml higher than the nadir level, hepatitis flares due to HBV reactivation and progression free survival (PFS) were the main endpoints. Some 48 (69.6%) reached virologic response. Prophylaxis significantly reduced virologic events (8.8% vs 58.0%, p=0.000) and hepatitis flares (1.1% vs 13.4%, p=0.001). Patients presenting undetectable HBV DNA levels displayed a significantly improved PFS as compared to those who never achieved undetectable HBV DNA. Prophylaxis and e-antigen positivity were the only significant variables associated with virologic events. In addition, prophylaxis was the only independent protective factor for hepatitis flares. Liver cirrhosis, more cycles of TACE, HBV DNA negativity, a lower Cancer of the Liver Italian Program score, non-metastasis and no hepatitis flares were protective factors for PFS. Prophylactic lamivudine demonstrated similar efficacy as entecavir. Prophylactic agents are efficacious for prevention of HBV reactivation in HCC patients receiving TACE. Achievement of undetectable HBV DNA levels displayed a significant capability in improving PFS. Moreover, persistent tumor residual lesions, positive HBV DNA and hepatitis B flares might be causes of tumor progression in these patients.


A comparison of purging and nonpurging eating-disordered outpatients: mediating effects of weight and general psychopathology.
The present study compared purging and nonpurging eating-disordered outpatients on key behavioral and psychological features of their disorder. It also investigated the possible mediating effects of current level of depression, anxiety or general psychopathology, and current weight on differences between purgers and nonpurgers. Seventy-seven patients from an outpatient eating disorder clinic who purged were compared to 48 clinic patients who did not purge on measures of eating behavior disturbances and specific psychopathology while controlling for weight, level of depression, anxiety, and general distress. Purgers reported significantly more eating behavior disturbance and higher scores on measures of specific psychopathology than the nonpurgers. These differences were unrelated to current weight, level of anxiety, or general distress. However, severity of depression did moderate some of the difference between the groups. These data provide further support for the proposition that purging is a distinctive clinical marker in all types of eating-disordered patients.


The Impact of Reproductive Issues on Preferences of Women with Relapsing Multiple Sclerosis for Disease-Modifying Treatments.
Relapsing-remitting multiple sclerosis (RRMS) is an incurable disease characterised by relapses (periods of function loss) followed by full or partial recovery, and potential permanent disability over time. Many disease-modifying treatments (DMTs) exist that help reduce relapses and slow disease progression. Most are contraindicated during conception/pregnancy and some require a discontinuation period before trying to conceive. Although around three-quarters of people with RRMS are women, there is limited knowledge about how reproductive issues impact DMT preference. The aim of this study was to measure the preferences for DMTs of women with RRMS who are considering pregnancy. An online discrete choice experiment (DCE). Participants chose between two hypothetical DMTs characterised by a set of attributes, then indicated if they preferred their choice to no treatment. Attributes were identified from interviews and focus groups with people with RRMS and MS professionals, as well as literature reviews, and included the probability of problems with pregnancy, discontinuation of DMTs, and breastfeeding safety. In each DCE task, participants were asked to imagine making decisions in three scenarios: now; when trying to conceive; and when pregnant. Two mixed logit models were estimated, one to assess the statistical significance between scenarios and one in maximum acceptable risk space to allow comparison of the magnitudes of parameters between scenarios. Women with RRMS who were considering having a child in the future, recruited from a UK MS patient register. Sixty respondents completed the survey. Participants preferred no treatment in 12.6% of choices in the 'now' scenario, rising significantly to 37.6% in the 'trying to conceive' scenario and 60.3% in the 'pregnant' scenario (Kruskal-Wallis p < 0.001). This pattern corresponds with results from models that included a no-treatment alternative-specific constant (ASC) capturing differences between taking and not taking a DMT not specified by the attributes. The ASC was lower in the trying to conceive scenario than in the now scenario, and lower still in the pregnant scenario, indicating an intrinsic preference for no treatment. Participants also placed relatively less preference on reducing relapses and avoiding disease progression in the trying to conceive and pregnant scenarios compared with a lower risk of problems with pregnancy. In the trying to conceive scenario, participants' preference for treatments with shorter washout periods increased. Women with RRMS considering having a child prefer DMTs with more favourable reproduction-related attributes, even when not trying to conceive. Reproductive issues also influenced preferences for DMT attributes not directly related to pregnancy, with preferences dependent on the life circumstances in which choices were made. The design of the DCE highlights the benefits of considering the scenario in which participants make choices, as they may change over time.


Correlation between Sorangium cellulosum subgroups and their potential for secondary metabolite production.
Phylogenetic analysis of the groEL1 and xynB1 gene sequences from Sorangium cellulosum strains isolated in Korea previously revealed the existence of at least 5 subgroups (A-E). In the present study, we used sequence analysis of polymerase chain reaction-amplified biosynthetic genes of strains from the 5 subgroups to indicate correlations between S. cellulosum subgroups and their secondary metabolic gene categories. We detected putative biosynthetic genes for disorazol, epothilone, ambruticin, and soraphen in group A, group C, group D, and group E strains, respectively. With the exception of KYC3204, culture extracts from group A, group B, and group C strains exhibited no noticeable antimicrobial inhibitory activities. By contrast, culture extracts from group D strains inhibited the growth of Candida albicans, whereas culture extracts from group E strains inhibited the growth of C. albicans and Staphylococcus aureus. High performance liquid chromatography analysis of the culture extracts from the strains of each subgroup revealed unique peak patterns. Our findings indicate the existence of at least 5 subgroups of S. cellulosum strains, each of which has the potential to produce a unique set of secondary metabolites.


Incorrect installation of free-flow clamp in B. Braun Infusomat Space infusion pump may result in gravity flow.
Gravity flow--potentially resulting in a dangerous overinfusion--may occur with the B. Braun Infusomat Space infusion pump if the infusion set's free-flow clamp is not correctly inserted in the pump. The manufacturer is currently evaluating measures to reduce the likelihood of this error. In the interim, facilities should ensure that users are familiar with proper use of the pump and are trained to recognize signs that the infusion set was loaded incorrectly.


Arthroscopic approach for treating a pigmented villonodular sinovitis of TMJ. A case report.
The present report describes the case of a 29-year-old man referred to our service for TMJ pain and progressive reduction of the mouth opening. Differential diagnostics included rheumatologic diseases, monoarthritis and intraarticular lumps. In this line, a face CT scan and a MRI of TMJ were carried out in order to ensure a proper diagnosis. These tests showed a solid lesion into the joint cavity. In view of that, we decided to perform a diagnostic and therapeutic arthroscopy of TMJ. Histopathological studies confirmed the diagnosis of pigmented villonodular synovitis. The main aim of this report is to describe this rare syndrome with the goal of proposing suitable treatments. Moreover, we highlight the benefits of using arthroscopic procedures in the cases which the tumor is still confined to the joint. As far as we are aware, scientific literature documents only a single case of pigmented villonodular synovitis of TMJ treated with arthroscopic approach. Key words:Arthroscopic approach, pigmented villonodular synovitis, TMJ, mouth opening.


The environmental burden on endocrine neoplasia: a review on the documented impact of endocrine disrupting chemicals.
Endocrine-disrupting chemicals (EDCs) have gained more importance in the past decade, mostly due to their role in the pathogenesis of disease, especially in carcinogenesis. However, there is limited literature on the environmental burden on some of the less common endocrine neoplasia. This review focuses on both observational and experimental studies linking exposure to EDCs and endocrine neoplasia specifically pituitary, thyroid, adrenal and neuroendocrine tumors. Following PRISMA guidelines, a search of English peer-reviewed literature was performed using Medline and Google Scholar, giving preference to recent publications. Exposure to EDC occurs not only in the household but also at work, whether it is in the office, factory, or farm and during transport from one location to another. Many studies have evaluated the effect of single environmental agents; however, humans are rarely exposed to only one EDC. Different EDCs and different levels of exposure may interact together to provide either a synergistic and/or an antagonistic disruption on human health, and hence a complex mechanism to elucidate. The ultimate adverse effect is difficult to predict, as it is not only influenced by the degree of exposure, but also by genetics, lifestyle, comorbidities, and other stressors.


Emergence of the concept of cardiovascular disease.
Historically, the concept of cardiovascular disease is a recent and evolving concept. Well into the eighteenth century, cardiac and vascular diseases were little known and considered a rarity. Description of the circulation by William Harvey (1578-1657) in 1628 marks the beginning of the changes that ensued. However, knowledge was slow to accrue and not until the nineteenth century was the heart taken as a specific object of study. The description of end-stage kidney disease by Richard Bright (1789-1858) in 1827 launched studies of the vasculature, which were to lead to the recognition of hypertension and subsequent identification of the lesions of arteriosclerosis (1833) and atherosclerosis (1904) as diseases of the vasculature. Only between the two world wars did the full impact of these lesions on mortality and morbidity come to be finally recognized. Their study and therapy has defined much of the profound changes that affected twentieth century medicine.


Photogeneration and reactivity of flavin anionic semiquinone in a bifurcating electron transfer flavoprotein.
Electron transfer bifurcation allows production of a strongly reducing carrier at the expense of a weaker one, by redistributing energy among a pair of electrons. Thus, two weakly-reducing electrons from NADH are consumed to produce a strongly reducing ferredoxin or flavodoxin, paid for by reduction of an oxidizing acceptor. The prevailing mechanism calls for participation of a strongly reducing flavin semiquinone which has been difficult to observe with site-certainly in multi-flavin systems. Using blue light (450 nm) to photoexcite the flavins of bifurcating electron transfer flavoprotein (ETF), we demonstrate accumulation of anionic flavin semiquinone in excess of what is observed in equilibrium titrations, and establish its ability to reduce the low-potential electron acceptor benzyl viologen. This must occur at the bifurcating flavin because the midpoint potentials of the electron transfer (ET) flavin are not sufficiently negative. We show that bis-tris propane buffer is an effective electron donor to the flavin photoreduction, but that if the system is prepared with the ET flavin chemically reduced, so that only the bifurcating flavin is oxidized and photochemically active, flavin anionic semiquinone is formed more rapidly. Thus, excited bifurcating flavin is able to draw on an electron stored at the ET flavin. Flavin semiquinone photogenerated at the bifurcation site must therefore be accompanied by additional semiquinone formation by oxidation of the ET flavin. Consistent with the expected instability of bifurcating flavin semiquinone, it subsides immediately upon cessation of illumination. However comparison with yields of semiquinone in equilibrium titrations suggest that during continuous illumination at pH 9 a steady state population of 0.3 equivalents of bifurcating flavin semiquinone accumulates, and then undergoes further photoreduction to the hydroquinone. Although transient, the population of bifurcating flavin semiquinone explains the system's ability to conduct light-driven electron transfer from bis-tris propane to benzyl viologen, in effect trapping energy from light.


Balance of non-metabolizable base in continuous peritoneal dialysis patients.
Acid generation and elimination processes compared to titratable non-metabolizable base (NaOH equivalents, NB) turnover in end-stage renal disease patients are examined in the light of the Law of electroneutrality. The application over 2 days of the whole-body NB balance technique to 18 patients undergoing continuous ambulatory peritoneal dialysis is evaluated. The results show that the mean rate of NB loss with peritoneal effluent (as bicarbonate and organic acid anions) exceeded the mean rate of NB gain with the dialysis fluid (as salts of lactic acid) by 24 (27), m (SD), mmol per 2 days. In spite of this, the bicarbonate and pH of the plasma remained stable and within normal limits. The concurrent mean rate of the intestinal NB absorption was about 61 (27) mmol per 2 days, as calculated from the whole body balances of the several electrolytes in the metabolic steady-state. This intestinal absorption was more than sufficient to restore the body base consumed in neutralizing endogenous acid generation: 37 (14), 2H2SO4 mmol per 2 days, the remaining NB being eliminated as bicarbonate and organic acid anions. The ample spectrum of plasma acid-base (A B) values appears to some extent influenced by patient-related factors, such as the rate of drinking water intake and the set point deviation for organic acid turnover.


Determining phenomenological rate coefficients from a time-dependent, multiple-well master equation: "species reduction" at high temperatures.
In this article we discuss at length the determination of phenomenological rate coefficients from the solution to a time-dependent, multiple-well master equation. Both conservative and non-conservative formulations are considered. The emphasis is placed on how to handle the situation when a CSE (chemically significant eigenvalue of the transition matrix) merges with the quasi-continuum of IEREs (internal energy relaxation eigenvalues), indicating that one or more chemical reactions begin to take place on vibrational-rotational relaxation time scales. The methodology is illustrated with four examples.