Management of hypertensive emergencies in acute brain disease: evaluation of the treatment effects of intravenous nicardipine on cerebral oxygenation.
Inappropriate sudden blood pressure (BP) reductions may adversely affect cerebral perfusion. This study explores the effect of nicardipine on regional brain tissue O(2) (PbtO(2)) during treatment of acute hypertensive emergencies. A prospective case-control study was performed in 30 patients with neurological conditions and clinically elevated BP. All patients had a parenchymal PbtO(2) and intracranial pressure bolt inserted following resuscitation. Using a critical care guide, PbtO(2) was optimized. Intravenous nicardipine (5-15 mg/hour) was titrated to systolic BP < 160 mm Hg, diastolic BP < 90 mm Hg, mean arterial BP (MABP) 90-110 mm Hg, and PbtO(2) > 20 mm Hg. Physiological parameters-intracranial pressure, PbtO(2), central venous pressure, systolic BP, diastolic BP, MABP, fraction of inspired O(2), and cerebral perfusion pressure (CPP)-were compared before infusion, at 4 hours, and at 8 hours using a t-test. Sixty episodes of hypertension were reported in 30 patients (traumatic brain injury in 13 patients; aneurysmal subarachnoid hemorrhage in 11; intracerebral and intraventricular hemorrhage in 3 and 1, respectively; arteriovenous malformation in 1; and hypoxic brain injury in 1). Nicardipine was effective in 87% of the patients (with intravenous beta blockers in 4 patients), with a 19.7% reduction in mean 4-hour MABP (115.3 +/- 13.1 mm Hg preinfusion vs 92.9 +/- 11.40 mm Hg after 4 hours of therapy, p < 0.001). No deleterious effect on mean PbtO(2) was recorded (26.74 +/- 15.42 mm Hg preinfusion vs 27.68 +/- 12.51 mm Hg after 4 hours of therapy, p = 0.883) despite significant reduction in CPP. Less dependence on normobaric hyperoxia was achieved at 8 hours (0.72 +/- 0.289 mm Hg preinfusion vs 0.626 +/- 0.286 mm Hg after 8 hours of therapy, p < 0.01). Subgroup analysis revealed that 12 patients had low pretreatment PbtO(2) (10.30 +/- 6.49 mm Hg), with higher CPP (p < 0.001) requiring hyperoxia (p = 0.02). In this group, intravenous nicardipine resulted in an 83% improvement in 4- and 8-hour PbtO(2) levels (18.1 +/- 11.33 and 19.59 +/- 23.68 mm Hg, respectively; p < 0.01) despite significant reductions in both mean MABP (120.6 +/- 16.65 vs 95.8 +/- 8.3 mm Hg, p < 0.001) and CPP (105.00 +/- 20.7 vs 81.2 +/- 15.4 mm Hg, p < 0.001). Intravenous nicardipine is effective for the treatment of hypertensive neurological emergencies and has no adverse effect on PbtO(2).


6-thioguanine in the treatment of psoriasis: a case report and literature review.
6-Thioguanine is a purine analog primarily indicated for acute myelogenous leukemia. Its use in psoriasis was first investigated in the 1950s and current interest in serious treatments for psoriasis, such as cyclosporine, has renewed interest in this medication. Newer therapies, such as PUVA and retinoids, have side effects as do some older treatments, such as methotrexate, which fell into favor at the same time 6-thioguanine was being investigated. Reexamining older treatments can open up new therapeutic options in difficult cases. The goal of this article is to provide a comprehensive review of the literature regarding the use of 6-thioguanine in the treatment of psoriasis as well as an illustrative case report demonstrating the use and side effects of 6-thioguanine in a patient with pustular psoriasis. Topics reviewed include efficacy, side effects, laboratory monitoring, different dosing regimens, and proposed mechanisms of action. 6-Thioguanine has been highly effective in treating and maintaining improvement in patients with psoriasis. A study comparing efficacies with methotrexate would be extremely useful. Because of the possibility of severe bone marrow depression, 6-thioguanine is not a first-line treatment. However, with new dosing regimens, proper laboratory monitoring, and further studies, use of 6-Thioguanine could expand in the future.


Trans-sialidase and sialidase activities discriminate between morphologically indistinguishable trypanosomatids.
The expression of trans-sialidase and sialidase activities in the kinetoplastid protozoa was explored as a potential marker to discriminate between the morphologically indistinguishable flagellates isolated from human, insects and vertebrate reservoir hosts. By virtue of the differences observed in the ratios of these enzyme activities, a collection of 52 species and strains comprising the major taxa of these parasites could be separated into four expression types. Type-I parasites express comparable levels of both trans-sialidase and sialidase activities (Endotrypanum species and Trypanosoma lewisi). Type-II parasites express predominantly trans-sialidase activity (Trypanosoma cruzi and Trypanosoma conorhini). Type-III parasites express sialidase activity exclusively (Trypanosoma rangeli and Trypanosoma leeuwenhoeki). Type-IV parasites do not express either activity (Leishmania species and Trypanoplasma borreli). The measurement of trans-sialidase and sialidase activities thus permits the differentiation of parasites frequently found in the same insect vectors that are difficult to distinguish, such as T. cruzi and T. rangeli, or in the same sylvatic vertebrate and invertebrate hosts, such as Leishmania and Endotrypanum.


Differential activation of a C/EBP beta isoform by a novel redox switch may confer the lipopolysaccharide-inducible expression of interleukin-6 gene.
C/EBP beta, a member of the CCAAT/enhancer binding protein (C/EBP) family, is one of the key transcription factors responsible for the induction of a wide array of genes, some of which play important roles in innate immunity, inflammatory response, adipocyte and myeloid cell differentiation, and the acute phase response. Three C/EBP beta isoforms (i.e. LAP*, LAP, and LIP) were known to arise from differential translation initiation and display different functions in gene regulation. C/EBP beta is known to induce interleukin (IL)-6 gene when P388D1 cells are treated with lipopolysaccharide (LPS). Exactly how the transcriptional activities of C/EBP beta isoforms are involved in the regulation of the IL-6 gene remains unclear. Here we report that LPS-induced expression of IL-6 gene in P388D1 cells is mediated by a redox switch-activated LAP*. The intramolecular disulfide bonds of LAP* and LAP have been determined. Among the cysteine residues, amino acid 11 (Cys11) of LAP* plays key roles for determining the overall intramolecular disulfide bonds that form the basis for redox switch regulation. The DNA binding activity and transcriptional activity of LAP* are enhanced under reducing condition. LAP and LIP, lacking 21 and 151 amino acids, respectively, in the N-terminal region, are not regulated in a similar redox-responsive manner. Our results indicate that LAP* is the primary isoform of C/EBP beta that regulates, through a redox switch, the LPS-induced expression of the IL-6 gene.


Risk associated with transportation and lairage on hide contamination with Salmonella enterica in finished beef cattle at slaughter.
Transportation of cattle to the slaughter plant could influence hide contamination with Salmonella enterica. Fecal and hide samples were obtained from 40 lots of cattle at the feedlot and again at the slaughter plant. Potential risk factors for hide contamination were evaluated. A multilevel Poisson regression model was used to determine whether transportation and lairage were associated with hide contamination by Salmonella. Cattle with hide samples positive for Salmonella at the feedlot had twice the risk of having positive slaughter hide samples compared with cattle without positive feedlot hide samples (relative risk [RR], 1.9). Cattle transported in trailers from which samples positive for Salmonella were collected had twice the risk of having positive slaughter hide samples compared with cattle transported in culture-negative trailers (RR, 2.3). Cattle transported for long distances had twice the risk of having positive hide samples at slaughter compared with cattle transported shorter distances (RR, 2.3). Cattle held in lairage pens contaminated with feces had twice the risk of having positive slaughter hide samples compared with cattle held in clean pens (RR, 1.8). Cattle held off feed longer than 18 h before loading had twice the risk of having positive slaughter hide samples compared with cattle held off feed for shorter times (RR, 1.7). Cattle that were agitated during loading had twice the risk of having positive slaughter hide samples compared with cattle that were calm (RR, 2.2). These findings suggest that variables associated with transportation and lairage can impact the presence of Salmonella on the hides of cattle at slaughter.


Potential energy surfaces for all-trans P5H6(+) and P5Me6(+) may be less complicated than anticipated.
Burford and co-workers recently (2007) investigated the synthesis, structure, and pseudorotation of a family of cyclotetraphosphinophosphonium ions comprehensively. We now report theoretical computations through the CCSD(T) level to study the conformations of the parent model rings, P5H6(+) and P5Me6(+). The all-trans conformations on the full pseudorotational cycle for the cyclotetraphosphinophosphonium cation (P5H6(+)) and for its methyl-substituted derivative (P5Me6(+)) were located systematically on their potential energy surfaces. The potential energy for the pseudorotational circuit of P5H6(+) is smooth and monotonic with only one minimum ((3)T4) and one maximum ((4)T3), but the analogous P5Me6(+) circuit has two minima. The P5H6(+) and P5Me6(+) potential surfaces appear to be qualitatively very different from that for the well investigated tetrahydrofuran. Since the (3)T4 form of P5H6(+)avoids unfavorable eclipsing PH-PH and lone pair-lone pair interactions, it is the global minimum among all possible P5H6(+) configurations and conformations.


Relevance Between Programmed Death Ligand 1 and Radiologic Invasiveness in Pathologic Stage I Lung Adenocarcinoma.
Programmed death ligand 1 (PD-L1) was reported to predict the response of immunotherapy; however, the association between PD-L1 expression and radiologic and pathologic features has yet to be elucidated. In all, 292 patients with resected pathologic stage I adenocarcinoma were analyzed for PD-L1 expression by immunohistochemistry and evaluated to determine the association between PD-L1 expression and the radiologic/pathologic invasiveness. Specifically, the radiologic invasiveness and noninvasiveness were determined based on the consolidation/tumor ratio, with a cutoff value of 0.25 by thin-section computed tomography. Among 292 patients, 47 (16.1%) were positive for PD-L1 expression; the remaining 245 patients (83.9%) were negative for PD-L1 expression. Fisher's exact test demonstrated that PD-L1 expression was significantly associated with a higher consolidation/tumor ratio (p = 0.029) and higher maximum standardized uptake value (p = 0.004). The mean values of consolidation/tumor ratio and maximum standardized uptake in patients with and without PD-L1 expression were 0.845 ± 0.052 and 7.241 ± 0.795, and 0.607 ± 0.023 and 3.60 ± 0.364, respectively (p < 0.001 and p < 0.001, respectively). Among 47 adenocarcinomas harboring PD-L1 expression, the frequencies of PD-L1 expression for consolidation/tumor ratios of 0, 0.1 to 0.25, 0.26 to 0.5, and 0.51 or more were 6.4%, 2.1%, 4.3%, and 87.2%, respectively (p = 0.007). Pathologically, PD-L1 was identified exclusively only in more invasive subtypes, not in less invasive ones, such as atypical adenomatous hyperplasia, adenocarcinoma in situ, minimally invasive adenocarcinoma, and lepidic predominant ones (p < 0.001). Expression of PD-L1 was significantly associated with radiologic/pathologic invasive adenocarcinomas. This study provides the first evidence of the radiologic and pathologic invasiveness in resected pathologic stage I adenocarcinoma with PD-L1 expression.


Exchange of macromolecules between plasma and skin interstitium in extensive skin disease.
The concentrations of albumin, transferrin, IgG and alpha 2-macroglobulin were measured in serum (C8) and in blister fluid (Cb) from lesional skin obtained by suction in 11 patients with extensive skin disease. The results were compared with those of 10 matched control subjects. In the patients the Cb/C8 ratios and the distribution ratios (i.e., intravascular to total masses) of the 4 proteins and that of inulin were correlated to the corresponding molecular weights. The distribution ratios of the proteins were calculated from plasma volume (PV), C8, Cb and extracellular fluid volume (ECV) determined with inulin, and that of inulin as PV/ECV. The distribution ratio of albumin was similar to that obtained from a long-term metabolic turnover study. It is concluded that the sieving properties of the dermal vascular endothelium is maintained during suction also in patients with extensive skin disease and that the blister fluid equals "average" interstitial fluid. The transcapillary escape rate (TER) of albumin and IgG (i.e., fractions of intravascular masses of albumin and IgG passing to the extravascular space per unit time) and the accumulation rate of i.v. injected 131I human serum albumin and 125I-IgG in the blister fluid was significantly increased in the patients. The latter was increased 2 to 3-fold. It is shown, that the increased extravasation of plasma proteins from the skin microvasculature accounts fully for the increased escape rates as measured in whole man, of albumin as well as IgG.


Genetic differences in hypothalamic-pituitary-adrenal axis activity and food restriction-induced hyperactivity in three inbred strains of rats.
We used three inbred rat strains known for significant differences in the activity and reactivity of their hypothalamic-pituitary-adrenal (HPA) axis to stress [Fischer 344 (F344), Brown Norway (BN) and Lewis (Lew) rats] to search for a strain difference in the paradoxical increase in running activity induced by food restriction and to explore the role of the HPA axis in this behaviour. Rats were randomly assigned to either an ad lib sedentary group (AL), a control wheel activity group (ACT), a food restriction-induced hyperactivity group (FR-ACT) group (1.5 h/day ad lib food, 22.5 h/day ad lib wheel access) or a pair-fed group (FR). The BN and Lew rats reached the 25% body weight-loss criterion of FR-ACT (strain effect: F(2,132) = 45.58, P < 10-6) faster than the F344 strain due to higher food restriction-induced running activity (strain effect: F(2,65) = 17.43, P = 0.00001). FR and FR-ACT decreased thymus weight (marker of integrated HPA axis activation) in all strains. In Lew and BN strains, FR-ACT induced a further decrement on thymus weight compared to their FR group. Prefeeding corticosterone levels (15.00 h) increased during the study in BN and Lew FR-ACT rats, but not in F344. Total wheel turns were correlated to both final adipose weight (r = -0.49, P = 0.002) and thymus weight decrement (r = 0.59, P = 0.0001), emphasizing the relationship between fat mass and HPA axis activation in excessive running activity. Increased running in conditions of food restriction and HPA axis activation may be linked at the level of the central nervous system. However, the involvement of corticotrophin-releasing hormone, agouti-related peptide or cocaine- and amphetamine-regulated transcript in behavioural disturbances of FR-ACT rats was excluded (in situ hybridization). We propose that corticosterone may be the link between initial low levels of fat mass and/or rate of fat mass loss (peripheral energy stores) and increased wheel activity, favouring fueling through lipolysis and proteolysis and reinforcing the self starvation via reward mechanisms, thus establishing a deleterious vicious cycle.


Clinical testing of antiretroviral drugs as future prevention against vaginal and rectal transmission of HIV infection - a review of currently available results.
The original purpose of vaginally applied microbicides was to slow down the HIV epidemic among the population until an effective vaccination was developed. Nowadays, antiretrovirals applied in the form of gels or vaginal rings are considered most prominent in this field and are tested via vaginal or, rarely, rectal applications in numerous clinical studies (9 different antiretroviral drugs in 33 clinical studies, especially in Africa). Only tenofovir (1 % gel) and dapivirine (25 mg in vaginal ring) progressed into the phase III clinical testing. Their efficiency depended on the user´s strict adherence to the application regimen (for tenofovir 54 %, for dapivirine 61 % in participants over 25 years of age). Despite this, they are expected to be important and effective tools of preventive medicine in the near future. This review summarizes the results obtained during long-term clinical testing (2005-2018) of antiretroviral drugs against vaginal and rectal transmission of HIV infection.


[Research and development of the surface EMG detection and analysis system].
To meet the requirement of developing myoelectric controller for a man-machine systems, a surface electromyography (EMG) detection and analysis system is discussed in this paper. This system consists of two parts--data acquisition hardware and signal processing software. In the surface EMG acquisition system both wire and wireless TELEMG are available. In the surface EMG processing system various methods are integrated such as the methods in time domain, the methods for frequency analysis, and also including some newly developed methods, e.g., wavelet transform and fractal analysis. This system provides a useful platform for research and development of the myoelectric controller that is widely used in rehabilitation engineering products.


5-Azacytidine and BDNF enhance the maturation of neurons derived from EGF-generated neural stem cells.
EGF-generated neural stem cells can form astrocytes, neurons, and oligodendrocytes upon differentiation; however, the proportion of cells that actually form neurons is very small. In the present study, we have studied the effect that 5-azacytidine (5AzaC), a demethylation agent, and brain-derived growth factor (BDNF) have on the differentiation and maturation of neurons originating from EGF-generated neural stem cells. Stem cells were maintained under a variety of culture conditions using combinations of 5AzaC and BDNF either alone or together. More neurons, as determined by the number of beta-tubulin III-immunoreactive somata, were present in cultures maintained in BDNF medium (a nearly fourfold increase compared to control cultures). 5AzaC did not significantly affect neuronal number, regardless of the presence of BDNF. In addition to neuronal number, the effect of 5AzaC and BDNF on the distribution of the microtubule proteins MAP2 and Tau was analyzed. In most cultures, MAP2 and Tau were colocalized throughout the neuron. In contrast, neurons cotreated with 5AzaC and BDNF contained neurons that began to exhibit cytoskeletal segregation of MAP2 into the somatodendritic compartments. Tau remained dispersed within the somata and the axon. This effect was not produced when 5AzaC or BDNF was used individually. These results demonstrate that 5AzaC and BDNF cooperate to produce more mature neurons from EGF-generated neural stem cells then either molecule can alone.


Pharmacotherapeutic approaches for treating psoriasis in difficult-to-treat areas.
Despite great therapeutic advancements in psoriasis, four notable difficult-to-treat areas including the scalp, nails, intertriginous (including genitals), and palmoplantar regions, pose a challenge to both physicians and patients. Localized disease of these specific body regions inflicts a significant burden on patients' quality of life and requires an adequate selection of treatments. This manuscript discusses appropriate therapies and important treatment considerations for these difficult-to-treat areas based on the available clinical data from the literature. Clinical trials assessing therapies for the difficult-to-treat areas have been inadequate. With the first biological clinical trial for genital psoriasis pending publication, it is with hope that other biological agents will be evaluated for region-specific psoriasis. A greater understanding of the genetic and immunologic aspects of regional psoriasis, as well as identification of unique biomarkers, will further guide management decisions. For example, the recent discovery of the IL-36 receptor gene for generalized pustular psoriasis may prove valuable for other forms of psoriasis. Ultimately, identification of the most beneficial treatments for each psoriasis subtype and difficult-to-treat area will provide patients with maximal quality of life.


[Distress of cancer patients: prevalence and associated factors in the opinion of family].
The study aimed to verify the opinion of family members about distress on cancer patients and the factors associated with it. Interviews with 140 family members of cancer patients were conducted. The Distress Thermometer was adapted to be used with family members. Approximately 72.9% of patients were considered in distress, related to concern (80.4%), nervousness (78.4%), sadness (74.5%), pain (67.6%), fatigue (67.6%) and problems with eating (57.8%). The hierarchical logistic regression models showed that while male (OR=0.025) and older ages (OR=0.006 to 0.059) had lower risk of perceiving the distress, individuals Protestants, compared to Catholics, were 12.77 times more likely to perceive it. About the associated factors, nervousness (OR=10.8) contributed significantly more to the perception of distress for family members when compared to fatigue (OR=3.38) or have private health insurance (OR=2.55). Family can be great allies in the evaluation and monitoring of distress in patients with cancer.


Revival of oscillation and symmetry breaking in coupled quantum oscillators.
Restoration of oscillations from an oscillation suppressed state in coupled oscillators is an important topic of research and has been studied widely in recent years. However, the same in the quantum regime has not been explored yet. Recent works established that under certain coupling conditions, coupled quantum oscillators are susceptible to suppression of oscillations, such as amplitude death and oscillation death. In this paper, for the first time, we demonstrate that quantum oscillation suppression states can be revoked and rhythmogenesis can be established in coupled quantum oscillators by controlling a feedback parameter in the coupling path. However, in sharp contrast to the classical system, we show that in the deep quantum regime, the feedback parameter fails to revive oscillations, and rather results in a transition from a quantum amplitude death state to the recently discovered quantum oscillation death state. We use the formalism of an open quantum system and a phase space representation of quantum mechanics to establish our results. Therefore, our study establishes that the revival scheme proposed for classical systems does not always result in restoration of oscillations in quantum systems, but in the deep quantum regime, it may give counterintuitive behaviors that are of a pure quantum mechanical origin.


Determination of basic criteria that influence the functionality of gluten protein fractions and gluten complex on roll bread characteristics.
Determinations of basic criteria that influence the functionality of gluten protein fractions on roll bread characteristics were investigated. SE-HPLC and RP-HPLC methods were used to quantification of protein/gluten composition of six different wheat flour samples with unique quality characteristics. Consequently, following new findings were reached: The ratio of HMW-GS/LMW-GS is more important than the amounts of HMW-GS and LMW-GS in flour. And as this rate increases, bread characteristics improve. In determining dough resistance, bread elasticity and height; the ratio of insoluble to soluble glutenin is influential factor and this ratio should be at the level of 1.3-1.4. When the pointer changes towards to insoluble glutenin; the dough is more resistant, the bread is more elastic and heighten, but the viscosity is weaker. Best bread flour had balance not only between gliadin and glutenin; but also, soluble glutenin and insoluble glutenin (1:1). Strong flours had 25-30%, whereas weak flours had 16% insoluble glutenin, as a percentage of flour protein.


[RESEARCH AND PROSPECT OF MESENCHYMAL STEM CELLS IN FEMALE FERTILITY PRESERVATION].
Fertility preservation (FP) technology has gradually been concerned by scholars all over the world due to the increasing survival rate of cancer patients. To review the recent progress of mesenchymal stem cells (MSCs) in female FP. The recent original literature about MSCs in female FP was extensively reviewed. MSCs have the advantages of rich source, easy isolation and amplification, and capacities for multipotential differentiation and migration so that they can be used to avoid the ethical and legal controversy which have great potential of FP for the damage of ovarian tissue and reproductive endocrine disorders. In addition, MSCs can be induced to differentiate into a specific condition, which is expected to be the resource in oocyte-like cells that can be used as a steady cell source for the future experiments and clinical application. MSCs have great potential to provide new research ideas for future FP technology.


Flow field characterization between vertical plate electrodes in a bench-scale cell of electrochemical water softening.
To analyze the effect of flow characteristics on electrochemical water softening, characteristics of flow fields in the vicinity of vertical plate electrodes in a bench-scale electrolysis cell for electrochemical water softening were visualized using particle image velocimetry technology, and the hardness drop values under different process conditions were measured. Properly increasing the current density or reducing the electrode spacing can increase the average flow velocity in the electrode gap. Excessive current density will cause bubble accumulation, form a bubble vortex, interfere with the orderly flow of surrounding liquid and reduce mass transfer efficiency. When the electrode spacing is 120 mm, the highest water softening efficiency measured at the current density of 60 A/m2 is 16.56%. When the current density is 50 A/m2, the highest average speed measured at the electrode spacing of 60 mm is 0.00169 m/s, but the highest water softening efficiency measured at the electrode spacing of 90 mm is 23.3%.The circulation efficiency in the electrode gap of a semi-closed structure is lower than that of a free convection structure. The behavior of bubbles is the key to flow and mass transfer. It is important to consider its influence on bubble behavior when optimizing electrochemical parameters.


A Review of Methods to Quantify the Genomic Similarity of Topological Associating Domains.
Topologically associating domains (TADs) are the most fundamental elements and significant structures of the eukaryotic genome. Currently, algorithms have been developed to find the TADs. But few algorithms are reported to compare the similarity of TADs between genomes. In this study, mice Hi-C sequencing data of four contrasts were enrolled. Seventeen algorithms, including BPscore, Jaccard index (JI) distance, VI distance, image hash, image subtraction, image variance, and so on, were used to quantify the genomic similarity of TADs. Image subtraction, Euclidean distance, and Manhattan distance were significantly better for TAD difference detection than the others. Deferent Hash (dHash) with the best zoom size ranked the second, followed by improved Hamming distance algorithm and JI distance. Advantages and disadvantages of various algorithms for quantifying the similarity of TADs were compared. Our work could provide the fundament for TADs comparison.


Neuroanatomy of the normal prostate.
The prostate is a richly innervated organ, but its neuroanatomy has not been thoroughly mapped and analyzed quantitatively. We selected prostates from autopsy cases of cancer-free patients aging from their 40's to 70's, and histologic sections were immunostained with S-100. Nerve density hotspots were mapped, photographed, and analyzed for nerve area. Innervation of the peripheral zone was found to be significantly greater than the transition zone (P < 0.0006), which is in turn significantly more innervated than BPH (P < 0.007). The posterior capsule has significantly more nerve area than the anterior capsule (P < 0.0001). Highest innervation was seen in the neurovascular bundles and seminal vesicles, with the lowest in transition zone and BPH. When compared to increasing patient age, both peripheral zone and overall innervation tended to decrease. These results are quantitative in nature, performed in cancer-free patients ranging over four different decades of age. We plan to soon compare this profile with our developing profile of cancerous prostates, hoping to learn more about interactions between nerves and prostate cancer.


Mitochondrial double membrane fission: A mystery solved?
It has long been an unresolved question whether the division machineries that assemble on the mitochondrial surface cooperate with factors inside the organelle. Now, two studies by Connor et al. (2023. J. Cell Biol.https://doi.org/10.1083/jcb.202303147) and Fukuda et al. (2023. Mol. Cell.https://doi.org/10.1016/j.molcel.2023.04.022) have identified an intermembrane space protein that is crucial for mitochondrial double membrane division.


Update on lasers in facial plastic surgery.
Since the theory of selective photothermolysis was described, the field of facial plastic surgery has advanced the science behind laser: tissue interactions. Particular advances in skin cooling, hair removal, intense pulsed light, and uses for aesthetic and nonaesthetic skin problems are described in this review. Continued basic science research in lasers has led to improvements in current technology available to the facial plastic surgeon. Advances in skin cooling have allowed for wider use in all Fitzpatrick skin types without concomitant adverse reaction. Our understanding of laser science continues to expand our knowledge in basic laser: tissue interaction. An improvement in various laser mediums and adjunctive devices provides the facial plastic surgeon with instruments to treat a wider patient population. The benefit is a successful clinical and aesthetic result with improved safety.


Lysophosphatidic acid plasma concentrations in healthy subjects: circadian rhythm and associations with demographic, anthropometric and biochemical parameters.
Lysophosphatidic acid (LPA) is a bioactive lipid with a wide biological activity. Previous studies have shown its potential usefulness as a diagnostic marker for ovarian cancer. The aim of the study was to investigate which factors may influence plasma LPA concentrations in healthy subjects and to propose reference values. The study group consisted of 100 healthy subjects. From all of them the blood samples were taken at 7 a.m. (fasting state). From 40 volunteers additional blood samples were taken at 2 p.m., at 8 p.m. and at 2 a.m. next morning. Concentrations of LPA were measured in plasma samples using enzyme-linked immunosorbent assay. Analysis of samples from 100 healthy volunteers showed significant influence of sex and age on plasma LPA. The reference range for the plasma LPA concentration corrected for age and sex, determined at 2.5-97.5 percentile interval is 0.14-1.64 μM. LPA correlates positively with BMI, serum total cholesterol, triacylglycerols, uric acid and negatively with estimated glomerular filtration rate and serum albumin. Concentration of LPA at 2 a.m. was lower than at 2 p.m. There were not any significant differences between plasma LPA at 7 a.m. and any other time of the day. Plasma LPA is associated with demographic, anthropometric and biochemical parameters. It seems that LPA concentrations have no specific circadian rhythm and the time of donation and fasting state have marginal effect on plasma LPA. These findings may be helpful in future incorporation of LPA as a diagnostic marker.


Serologic and molecular detection of granulocytic ehrlichiosis in Rhode Island.
A new indirect fluorescent-antibody (IFA) assay with antigen produced in vitro in the human promyelocytic leukemia cell line HL60 was used to identify the first recognized case of human granulocytic ehrlichiosis in Rhode Island. This IFA assay was used to detect granulocytic ehrlichiae in white-footed mice and in a dog inhabiting the area surrounding the patient's residence. Host-seeking Ixodes scapularis ticks found in the same habitat also were infected. I. scapularis ticks collected from other locations were fed on dogs and New Zealand White rabbits to assess the competency of these species as hosts of granulocytotropic Ehrlichia. Tick-induced infections of dogs were confirmed by serologic testing, tissue culture isolation, and PCR amplification, whereas several rabbits seroconverted but were PCR and culture negative. PCR amplification of the 16S rRNA gene and DNA sequencing of the PCR products or culture isolation was used to confirm granulocytic Ehrlichia infections in humans, dogs, white-footed mice, and ticks.


Absolute Stereochemical Determination of Asymmetric Sulfoxides via Central to Axial Induction of Chirality.
The absolute configuration of chiral sulfoxides is determined by means of host-guest complexation that leads to the induction of axial chirality in an achiral host. The central to axial induction of helicity is rationalized by a simple recognition of the relative length and size of the substituents attached to the S-center. This technique is used to determine the absolute configuration of chiral sulfoxides, requiring micrograms of sample, without the need for prefunctionalization.


[The development of diagnostic of acute endometritis on the basis of modeling and cluster analysis of parameters of local immunity.]
The acute endometritis provoking expressed disorders of local immunity is considered as one of the prevalent complications of postnatal period and abortions. The purpose of study is to develop diagnostic of acute endometritis on the basis of applied correlation modeling and cluster analysis techniques diagnostically priority-driven immunological indices of vaginal cervical mucus. The sample included main group (154 patients with acute endometritis) and control group (103 patients with uncomplicated post-natal period). Both groups were subjected to enzyme-linked immunosorbent assay to analyze content of immunoglobulins, components of complement and lysozyme in vaginal cervical mucus. The sampling of diagnostically significant indices was implemented using correlation and cluster analysis techniques. It is established that chief diagnostic indices of local immunity in case of acute endometritis are IG M, sIg A, С4 components of complement and lysozyme. The established diagnostically significant parameters of local immunity provide development of detection of acute endometritis according less number of indices.


High-frequency EPR and ENDOR spectroscopy on semiconductor nanocrystals.
EPR and ENDOR experiments at 95 GHz on ZnO nanoparticles reveal the presence of shallow donors related to interstitial Li and Na atoms. The experiments allowed, for the first time, to probe the effect of confinement on the shape of the electronic wave function. In addition, it is observed that the 67Zn nuclear spins become polarized upon saturation of the EPR transition. This Overhauser effect is induced by the zero-point vibrations of the phonon system in the nanoparticles.


[Treatment of rheumatoid spondylarthritis with salazosulfapyridine].
Salazosulfapyridine (salazopyrin) (SASP) is effective basic treatment for rheumatoid arthritis (RA) after failure or intolerance of antimalarials or gold salts. Sulfapyridine is the active part of the molecule. Its mechanism of action probably involves anti-inflammatory activity as well as effects on cells participating in immune reactions. Adverse reactions occur in approximately one third of cases, in the majority of instances during the first three months of treatments. Simple digestive upsets are the commonest, but SASP may be responsible for sometimes severe cutaneous, hematological and hepatic reactions. The sometimes delayed onset of intolerance reactions justifies continuous monitoring of laboratory parameters. Results obtained with SASP are sometimes prolonged and therapeutic maintenance rates are similar to those seen with other basic treatment for RA. The use of SASP in RA should be tried before methotrexate in relatively early forms of the disease.


Biofortification of Wheat Cultivars to Combat Zinc Deficiency.
Zinc (Zn) deficiency caused by inadequate dietary intake is a global nutritional problem, particularly in developing countries. Therefore, zinc biofortification of wheat and other cereal crops is being urgently addressed and highly prioritized as a research topic. A field study was planned to evaluate the influence of zinc application on grain yield, grain zinc content, and grain phytic acid concentrations of wheat cultivars, and the relationships between these parameters. Three wheat cultivars, C1 = Faisalabad-2008, C2 = Punjab-2011, and C3 = Millet-2011 were tested with five different methods of zinc application: T1 = control, T2 = seed priming, T3 = soil application, T4 = foliar application, and T5 = soil + foliar application. It was found that grain yield and grain zinc were positively correlated, whereas, grain phytic acid and grain zinc were significantly negatively correlated. Results also revealed that T5, T3, and T4 considerably increased grain yield; however, T2 only slightly enhanced grain yield. Grain zinc concentration increased from 33.1 and 33.7 mg kg-1 in T1 to 62.3 and 63.1 mg kg-1 in T5 in 2013-2014 and 2014-2015, respectively. In particular, T5 markedly decreased grain phytic acid content; however, maximum concentration was recorded in T1. Moreover, all the tested cultivars exhibited considerable variation in grain yield, grain zinc, and grain phytic acid content. In conclusion, T5 was found to be most suitable for both optimum grain yield and grain biofortification of wheat.


Therapy of chronic lymphocytic leukemia patients. Results from the French cooperative trials. French Cooperative Group on Chronic Lymphocytic Leukemia.
This paper summarizes results from clinical trials in Chronic Lymphocytic Leukemia with a special emphasis on our protocols, CLL 80 and CLL 85, both based on the (A, B, C) staging. The third interim analysis of the CLL 80 protocol (973 patients, 287 deaths) confirmed, in stage C patients, the effectiveness of the CHOP regimen when compared to the COP regimen; failed to show a benefit from the COP regimen when compared to chlorambucil in stage B patients; and pointed out a toxic effect on survival from a daily indefinite course of chlorambucil when compared to no treatment in stage A patients. The major question of the CLL 85 protocol was the potential benefit of the CHOP regimen in stage B patients. The first interim analysis estimated the percentage of stage B patients who reached clinical remission or stage A at 77% with the CHOP regimen versus 53% in the control group (intermittent chlorambucil-prednisone).


Precision Medicine in Breast Cancer.
Breast cancer care has improved markedly in recent decades, but new advancements in diagnosis and treatment depend on translating genomics and precision medicine into clinical care. This article discusses the basics of genomics, breast cancer biomarkers and subtypes, and the effects of genomic advancements on future breast cancer diagnosis, treatment, and survival. The article also presents challenges related to introducing precision medicine into cancer care and the role of imaging in breast cancer diagnosis and treatment in precision medicine.


Venous thrombosis: the clinical problem.
Although the exact cause of DVT is not known, venous thrombosis and its sequelae remain important clinical problems. Pulmonary embolism is a significant cause of morbidity and mortality in the hospitalized population, and the postthrombotic syndrome affects a large portion of the general population. While specific screening tests are not readily available to detect those patients who are likely to develop DVT, certain clinical risk factors have been identified that predispose to thrombosis. These groups include patients undergoing a wide variety of surgical procedures, patients with cardiac disease or cancer, pregnant or postpartum women, and individuals with previous history of DVT. The diagnosis of thrombosis is based on clinical findings and must be confirmed with appropriate laboratory tests. While contrast venography remains the gold standard, noninvasive tests have become increasingly more accurate. The recent use of real-time B-mode ultrasonic imaging and duplex sonography for the diagnoses of DVT has been shown to be efficacious. The postthrombotic syndrome with its associated chronic pain and ulcerations remains a significant clinical problem. The general diagnosis of this condition is readily made on clinical grounds in the advanced state. However, exact knowledge of the location and cause of the venous pathology can only be obtained using objective diagnostic tests. Older noninvasive and invasive tests may diagnose the presence of venous obstruction, valvular incompetence, and also may document venous hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)


An equivalent circuit based electro-vibro-acoustic model of a cylindrical transducer array.
Cylindrical transducer arrays are used in many applications such as SONAR, depth sounding, ultrasound imaging, etc. This study developed the equivalent circuit (EC)-based-model of a cylindrical array with theoretical acoustic coupling. The electro-mechanical-acoustic coupling impedance matrix was first constructed to determine the response of the array. The electrical and mechanical impedances of the individual transducers were obtained by the EC model. The acoustic radiation impedances were obtained by the theoretical model. The cylindrical array is modeled by coupling the EC model and acoustic radiation impedances. The acoustic transfer matrix was then constructed using the theoretical method to determine both the far-field and near-field acoustic responses. The characteristics of the transducer array were represented with the electrical admittance, velocity response as a function of the voltage, transmit voltage response, beam pattern, and normalized pressure curve. To verify the proposed model, the analysis results were successfully compared to those of the fully coupled finite element model. Due to its high accuracy and computational efficiency, the proposed EC-based-model is expected to be useful for the conceptual design stage, which requires frequent design changes.


Imaging features of alveolar soft-part sarcoma: a report from Children's Oncology Group Study ARST0332.
There are few studies in the literature regarding the imaging features of alveolar soft-part sarcoma (ASPS). We performed a comprehensive assessment of the imaging characteristics of this rare tumor to determine whether there are features that suggest the diagnosis. Twenty-two subjects with ASPS underwent pretherapy imaging as part of enrollment in Children's Oncology Group protocol ARST0332 for the treatment of nonrhabdomyosarcoma soft-tissue sarcomas: 16 patients underwent MRI; three, CT; and three, both MRI and CT. Two radiologists retrospectively reviewed the imaging studies by consensus and recorded tumor location, size, contour, internal architecture, signal characteristics, presence of flow voids, and enhancement patterns. The 12 females and 10 males in the study group ranged in age from 8 to 23 years 7 months (mean, 15 years 8 months). The most common anatomic site was the lower extremity (12/22, 55%) followed by the upper extremity (4/22, 18%). The maximal tumor diameter ranged from 2.3 to 20.0 cm (median, 5.9 cm). All tumors imaged with MRI had flow voids (19/19, 100%), and 19 (19/22, 86%) had large peripheral vessels, lobulated margins, and nodular internal architecture. Unenhanced T1-weighted MRI was available for 18 tumors: 14 (14/18, 78%) appeared slightly hyperintense to muscle. Of the 16 tumors imaged with contrast material, 11 (11/16, 69%) showed intense enhancement and five (5/16, 31%), moderate enhancement. Six tumors (6/16, 38%) had a thick enhancing peripheral rim with a nonenhancing center consistent with necrosis. The imaging features of ASPS include flow voids, large peripheral vessels, internal nodularity, and lobulated margins. Contrast administration produces intense to moderate enhancement, sometimes with a thick enhancing peripheral rim around central necrosis. Extremity tumors with these imaging features in a child or young adult should suggest the diagnosis of ASPS.


Changes in skin microcirculation during radiation therapy for breast cancer.
The majority of breast cancer patients who receive radiation treatment are affected by acute radiation-induced skin changes. The assessment of these changes is usually done by subjective methods, which complicates the comparison between different treatments or patient groups. This study investigates the feasibility of new robust methods for monitoring skin microcirculation to objectively assess and quantify acute skin reactions during radiation treatment. Laser Doppler flowmetry, laser speckle contrast imaging, and polarized light spectroscopy imaging were used to measure radiation-induced changes in microvascular perfusion and red blood cell concentration (RBC) in the skin of 15 patients undergoing adjuvant radiation therapy for breast cancer. Measurements were made before treatment, once a week during treatment, and directly after the last fraction. In the treated breast, perfusion and RBC concentration were increased after 1-5 fractions (2.66-13.3 Gy) compared to baseline. The largest effects were seen in the areola and the medial area. No changes in perfusion and RBC concentration were seen in the untreated breast. In contrast, Radiation Therapy Oncology Group (RTOG) scores were increased only after 2 weeks of treatment, which demonstrates the potential of the proposed methods for early assessment of skin changes. Also, there was a moderate to good correlation between the perfusion (r = 0.52) and RBC concentration (r = 0.59) and the RTOG score given a week later. We conclude that radiation-induced microvascular changes in the skin can be objectively measured using novel camera-based techniques before visual changes in the skin are apparent. Objective measurement of microvascular changes in the skin may be valuable in the comparison of skin reactions between different radiation treatments and possibly in predicting acute skin effects at an earlier stage.


Correlation between Troponin-I and B-Type Natriuretic Peptide Level in Acute Myocardial Infarction Patients with Heart Failure.
Troponins are regarded as markers of choice for the diagnosis of acute myocardial infarction (AMI). But B-type natriuretic peptide (BNP) level is also elevated in AMI and is a quantitative biochemical marker related to the extent of infarction and the left ventricle systolic dysfunction. Thus, BNP has prognostic value. In this study, we investigate the correlation of Troponin-I with BNP levels in patients presenting with AMI with or without Acute Heart Failure. Rationale of this study is to see, whether quantitative Troponin alone can serve for both diagnosis and prognosis of AMI Patients with heart failure or not. This cross-sectional analytical study was conducted in the Department of Cardiology in Mymensingh Medical College Hospital from January 2014 to December 2014. Total 100 patients were studied and divided into two groups - 50 patients in each group. Group I: Patients with first attack of acute myocardial infarction (without heart failure) & Group II: Patients with first attack of acute myocardial infarction with acute heart failure. Mean Troponin-I of Group I and Group II were 3.10±2.68 and 62.93±32.75ng/ml respectively & mean BNP value of Group I and Group II were 20.96±14.18 and 615.65±249.27pg/ml respectively. In this study, it was shown that the levels of BNP had positive correlation with Troponin-I levels, with medium strength of association (r=0.734, p<0.05). Echocardiography shows that patients with high BNP level has low ejection fraction (LVEF) and patients with low BNP level has preserved ejection fraction (LVEF). Thus, the present study shows that the higher the Troponin-I levels, the higher the BNP levels in first attack of AMI patients and the more severe the heart failure (more severe left ventricle dysfunction). There is positive correlation between Troponin-I and BNP levels in first attack of AMI patients with acute heart failure.


Sex hormones and age: a cross-sectional study of testosterone and estradiol and their bioavailable fractions in community-dwelling men.
The role of endogenous sex hormones in many diseases makes understanding factors that influence levels of these hormones increasingly important. This study examined age-associated variations in total and bioavailable testosterone and estradiol levels among community-dwelling Caucasian men in Rancho Bernardo, California. Plasma samples obtained from 810 men aged 24-90 years in 1984-1987 were analyzed in 1993 using radioimmunoassay. Analyses of age-hormone associations, adjusting for weight, body mass index, alcohol ingestion, smoking, physical activity, caffeine intake, specimen storage time, and disease status, were undertaken. Bioavailable testosterone and bioavailable estradiol levels decreased significantly with age independently of covariates. Total testosterone and estradiol levels decreased with age only when analyses were controlled for confounders. The importance of the age-associated decline in endogenous sex hormone levels, particularly levels of bioavailable testosterone and bioavailable estradiol, and their relation to disease and function in men deserve further research.


Regulation of oxysterol 7alpha-hydroxylase (CYP7B1) in primary cultures of rat hepatocytes.
Conversion of cholesterol into 7alpha-hydroxylated bile acids is a principal pathway of cholesterol disposal. Cholesterol 7alpha-hydroxylase (CYP7A1) is the initial and rate-determining enzyme in the "classic" pathway of bile acid synthesis. An "alternative" pathway of bile acid synthesis is initiated by sterol 27-hydroxylase (CYP27) with subsequent 7alpha-hydroxylation of 27-hydroxycholesterol by oxysterol 7alpha-hydroxylase (CYP7B1). The regulation of CYP7B1, possibly a rate-determining enzyme in the alternative pathway, has not been thoroughly studied. The aims of this study were to (1) study the regulation of liver CYP7B1 by bile acids, cholesterol, adenosine 3', 5'-cyclic monophosphate (cAMP), and phorbol myristate acetate (PMA) in primary rat hepatocytes and (2) determine the effect of CYP7B1 overexpression on rates of bile acid synthesis. The effects of different bile acids (3-150 micromol/L), cAMP (50 micromol/L), PMA (100 nmol/L; protein kinase C stimulator), cholesterol (200 micromol/L), and squalestatin (1 micromol/L; cholesterol synthesis inhibitor) on CYP7B1 expression in primary rat hepatocytes were studied. Taurocholic acid and taurodeoxycholic acid decreased CYP7B1 activity by 45% +/- 10% and 36% +/- 7%, respectively. Tauroursodeoxycholic acid and taurochenodeoxycholic acid did not alter CYP7B1 activity. Inhibition of cholesterol synthesis with squalestatin decreased CYP7B1 activity by 35%, whereas addition of cholesterol increased activity by 39%. Both PMA and cAMP decreased CYP7B1 activity by 60% and 34%, respectively, in a time-dependent fashion. Changes in CYP7B1 messenger RNA (mRNA) levels correlated with changes in specific activities. Overexpression of CYP7B1 led to a marked increase in CYP7B1 mRNA levels and specific activity but no change in rates of bile acid synthesis. In conclusion, in the rat, CYP7B1 specific activity is highly regulated but does not seem to be rate limiting for bile acid synthesis.


Host factor TIMP1 sustains long-lasting myeloid-biased hematopoiesis after severe infection.
Infection is able to promote innate immunity by enhancing a long-term myeloid output even after the inciting infectious agent has been cleared. However, the mechanisms underlying such a regulation are not fully understood. Using a mouse polymicrobial peritonitis (sepsis) model, we show that severe infection leads to increased, sustained myelopoiesis after the infection is resolved. In post-infection mice, the tissue inhibitor of metalloproteinases 1 (TIMP1) is constitutively upregulated. TIMP1 antagonizes the function of ADAM10, an essential cleavage enzyme for the activation of the Notch signaling pathway, which suppresses myelopoiesis. While TIMP1 is dispensable for myelopoiesis under the steady state, increased TIMP1 enhances myelopoiesis after infection. Thus, our data establish TIMP1 as a molecular reporter of past infection in the host, sustaining hyper myelopoiesis and serving as a potential therapeutic target for modulating HSPC cell fate.


The scientific status of the defence mechanism test: a reply to Kline.
The Defence Mechanism Test, one of the better validated techniques for studying the operation of Freudian defences, has recently been impugned on theoretical grounds. This paper reconsiders two of the most telling points made by Kline (1987) and concludes that his alternative explanations are not well supported by theory or experiment.


Inflow Venous Occlusion for Intracardiac Resection of an Occluding Right Ventricular Tumor.
Use of normothermic venous inflow occlusion enabled removal of an intracardiac tumor in a 4 yr old, 27 kg, spayed female Airedale terrier with a history of appendicular osteosarcoma and recent exertional syncope. Inflow venous occlusion via a median sternotomy thoracotomy without hypothermia was used to access the mineralized mass within the right ventricular outflow tract. Duration of circulatory arrest was 70 s for this beating heart surgery. A circumscribed intracardiac chondrosarcoma tumor was marginally resected in this dog, successfully alleviating exertional syncope and restoring a normal echogenic appearance of the right heart. Asymptomatic intracardiac chondrosarcoma recurrence and pulmonary metastasis was detected at 309 days and cardiopulmonary arrest occurred 372 days following intracardiac surgery. Use of inflow occlusion is a viable technique for select intracardiac tumors in dogs with preoperative planning.


Prevention of motion artifacts on dual isotope subtraction parathyroid scintigraphy.
A simple, effective technique is described to identify and eliminate motion artifacts which might potentially invalidate dual isotope subtraction parathyroid scintigraphy. Cobalt-57 markers, appropriately placed on the patient, allow detection of movement and permit realignment if movement occurs between imaging sequences. This technique should assure the accuracy of dual isotope parathyroid subtraction scintigraphy.


Tolerance through Education: How Tolerogenic Dendritic Cells Shape Immunity.
Dendritic cells (DCs) are central players in the initiation and control of responses, regulating the balance between tolerance and immunity. Tolerogenic DCs are essential in the maintenance of central and peripheral tolerance by induction of clonal T cell deletion and T cell anergy, inhibition of memory and effector T cell responses, and generation and activation of regulatory T cells. Therefore, tolerogenic DCs are promising candidates for specific cellular therapy of allergic and autoimmune diseases and for treatment of transplant rejection. Studies performed in rodents have demonstrated the efficacy and feasibility of tolerogenic DCs for tolerance induction in various inflammatory diseases. In the last years, numerous protocols for the generation of human monocyte-derived tolerogenic DCs have been established and some first phase I trials have been conducted in patients suffering from autoimmune disorders, demonstrating the safety and efficiency of this cell-based immunotherapy. This review gives an overview about methods and protocols for the generation of human tolerogenic DCs and their mechanisms of tolerance induction with the focus on interleukin-10-modulated DCs. In addition, we will discuss the prerequisites for optimal clinical grade tolerogenic DC subsets and results of clinical trials with tolerogenic DCs in autoimmune diseases.


[Treatment of Bacillus Calmette-Guerin refractory superficial bladder cancer: further intravesical therapy].
We here report our clinical experience with salvage therapy for patients with bacillus Calmette-Guerin (BCG)-refractory superficial bladder cancer and discuss current approaches to the disease, especially focusing on bladder preservation. First, we evaluated the efficacy of an initial 6-week course of intravesical BCG in 93 patients with carcinoma in situ (CIS) of the bladder. Of these, 91% achieved a complete response (CR) at the evaluation at 3 months. The 2- and 5-year recurrence-free rates were 71 and 67%, respectively (mean follow-up 39 months). These results support the intravesical BCG as a first-line therapy for CIS. Next, we assessed the efficacy of a second course of intravesical BCG for 16 patients who failed the initial induction course for CIS. Of these, 94% achieved CR at the evaluation at 3-month, and the 2- and 5-year recurrence-free rates were 62 and 46%, respectively (mean follow-up 28 months). None of the patients who received a second course had disease progression. Thus, a second course of BCG therapy seems to be a reasonable option for CIS patients failing the initial course. We also report our initial experience with intravesical gemcitabine therapy for 3 patients with BCG-refractory CIS of the bladder and 1 patient with recurrent multiple tumors. Gemcitabine (1500 mg in 100 ml saline) was given in the bladder for 1 hour twice weekly for a total of 12 treatments. The treatment was associated with minimal bladder irritation and systemic absorption, and was well tolerated except in a 90-year-old man who discontinued therapy because of grade 2 toxicity. Two patients achieved CR and maintained a tumor-free status beyond 14 months, suggesting that the intravesical gemcitabine is a promising salvage therapy for BCG-refractory superficial bladder cancer.


Cap Polyposis: A Case Report.
Cap polyposis is a gastrointestinal disease with multiple inflammatory polyps between the distal colon and rectum. Its symptoms overlap with inflammatory bowel disease with typical endoscopic features of multiple sessile polyps in the rectum and sigmoid colon, located at the apices of transverse folds. Microscopically, the polyps consist of elongated, tortuous, and distended crypts covered by a "cap" of inflammatory granulation tissue. In this report, we present a case of a 18-year-old male patient who underwent polypectomy for polyposis in multiple settings. He presented with one year of painless rectal bleeding and polyposis in a recto-sigmoid area on colonoscopy, with a single polyp in the sigmoid area and multiple polyps in the rectum. He was managed with immediate and interval polypectomy. Though cap polyposis is rare, it can be cured as it is laparoscopically resectable. case reports; granulation tissue; inflammatory bowel diseases; polyps.


Sense of coherence and health of community-dwelling older adults in Spain.
In light of the demographic aging trend in Europe, investigation into successful aging is a public health priority. This paper describes the sense of coherence (SOC) of a sample of community-dwelling older adults in Spain and analyzes the relationship between SOC and both health and sociodemographic variables. SOC measures the extent to which an individual conceptualizes the world as comprehensible, manageable, and meaningful. Strong SOC may promote good health. The study followed a cross-sectional design involving a nationally representative sample of 1,106 community-dwelling adults aged 60 years and older in Spain. The sample was collected by geographically based proportional stratified sampling. RESULTS are based on responses to a questionnaire requesting sociodemographic information and including the following validated scales: SOC, Barthel index (BI), functional independence scale (FIS), personal wellbeing index (PWI), EQ-5D dimensions (mobility, personal care, daily activities, pain/discomfort, anxiety/depression), and the depression subscale of the hospital anxiety and depression scale (HADS-D). A multivariate linear regression model analyzed determinants of SOC. Personal wellbeing (b = -0.32), depression (b = 0.26), and educational level (b = -0.06) were significant determinants of SOC. Lower SOC was associated with problems in all EQ-5D dimensions and moderate/severe disability as measured by the BI. SOC in older adults is related to functional status, mental health status, personal wellbeing, and educational level. Public health initiatives should work to reduce the psychological and physiological impact of aging by focusing on the conditions that facilitate the coping of older adults.


Species lifetime distribution for simple models of ecologies.
Interpretation of empirical results based on a taxa's lifetime distribution shows apparently conflicting results. Species' lifetime is reported to be exponentially distributed, whereas higher-order taxa, such as families or genera, follow a broader distribution, compatible with power-law decay. We show that both forms of evidence are consistent with a simple evolutionary model that does not require specific assumptions on species interaction. The model provides a zero-order description of the dynamics of ecological communities, and its species lifetime distribution can be computed exactly. Different behaviors are found as follows: an initial t(-3/2) power law, emerging from a random walk type of dynamics, which crosses over to a steeper t(-2) branching process-like regime and finally is cut off by an exponential decay that becomes weaker and weaker as the total population increases. Sampling effects also can be taken into account and shown to be relevant. If species in the fossil record were sampled according to the Fisher log-series distribution, lifetime should be distributed according to a t(-1) power law. Such variability of behaviors in a simple model, combined with the scarcity of data available, casts serious doubt on the possibility of validating theories of evolution on the basis of species lifetime data.


Ultrasonic Debridement of Fournier Gangrene.
Ultrasonic debridement devices are minimally invasive and effective for biofilm removal, allowing for debridement of necrotic tissue while minimizing damage to normal tissues, such as the blood vessels and nerves. The use of ultrasonic debridement has been reported for foot ulcers and pressure ulcers but not Fournier gangrene. The perineal area, which is difficult to surgically debride using electrocautery, is a suitable site for the use of an ultrasonic debridement device because of its proximity to vital organs. We report here a case of Fournier gangrene that healed with testicular sparing using an ultrasonic debridement device.


Same-day transradial outpatient stenting with a 6-hr course of glycoprotein IIb/IIIa receptor blockade: a feasibility study.
The aim of the study was to explore the feasibility of same-day outpatient stent placement using a short course of intravenous antiplatelet therapy. Patients (n = 26) had stent placement and 6 hr of eptifibatide therapy. Demographics, procedural information, CPK data, and length of stay were recorded along with postdischarge outcomes. Twenty-one men and five women with median age of 60 years (49, 69) underwent transradial stenting. Baseline characteristics included diabetes 62%, hyperlipidemia 77%, prior coronary bypass surgery 19%, and unstable angina 35%. There were no CPK elevations (> 2 x normal) or ECG changes. Discharge occurred after 6.5 hr (5.8, 7.0). Neither vascular site complications nor readmission for procedure-related problems occurred. One patient later expressed concerns about discharge education. Outpatient stent placement with 6-hr infusion of GP IIb/IIIa inhibitor appears feasible and efficient in select patients. There may be challenges to meet with regard to patient education. Further studies with larger populations are needed to evaluate and optimize this approach.


Cholelithiasis in patients with Gaucher disease.
Gaucher disease, the inherited deficiency of the lysosomal enzyme glucocerebrosidase, manifests with a continually expanding range of clinical features. Noting that a number of adult patients with type 1 Gaucher disease also had gallstones, we reviewed the clinical records of 66 adult patients evaluated at the National Institutes of Health with type 1 Gaucher disease. Twenty-one patients were identified who had either gallstones or a history of cholecystectomy. Of the 21 patients, 6 were male. The age at which stones were noted ranged from 19 to 70 years (mean 39 years). Thirteen of the patients had a cholecystectomy performed. Several different factors may contribute to the development of gallstones in these patients, including anemia, prior splenectomy, and hepatic involvement. Eleven of the patients were found to have chronic anemia. Fifteen of the patients underwent splenectomy. An increased biliary excretion of glucosylceramide could also contribute to cholelithiasis. To determine whether our findings were specific to our referral population, the medical records of a second series of 80 adult patients of Ashkenazi Jewish ancestry with type 1 Gaucher disease followed in Northern Israel were reviewed. Sixteen of these patients (5 male, 11 female) were also noted to have gallstones. Thus, the frequency of gallbladder involvement in patients with Gaucher disease appears to be greater than previously appreciated.


Diabetes, insulin resistance and vascular disease among Indian Asians and Europeans.
Indian Asians account for one-fifth of all cardiovascular deaths worldwide. Cardiovascular mortality in Indian Asians overseas is higher than in indigenous populations. Diabetes, insulin resistance, and related metabolic disturbances are more common among Indian Asians than Europeans and may account for up to 70% of major Q wave ECG abnormalities in Asians. Previous studies provide evidence that genetic and environmental factors, the latter including intrauterine growth retardation, reduced physical activity, increased weight, and dietary intake, contribute to the high prevalence of diabetes and insulin resistance in Asians. The importance of conventional coronary risk factors is emphasized by studies showing higher prevalence of cigarette smoking, hypertension, and hypercholesterolemia in migrant and urban Indians compared with rural Indians. Recent studies suggest that new risk factors, including C-reactive protein, homocysteine, and lipoprotein(a), are increased among Indian Asians compared with Europeans and may contribute to part of the excess cardiovascular risk in Asians. Further work is needed to identify the precise genetic and environmental mechanisms underlying increased vascular risk in Indian Asians. Clinical strategies must be developed that identify Indian Asians at increased risk and assess the effectiveness of treatment for insulin resistance, and other cardiovascular risk factors, in this racial group.


Mucolytic and antibiotic effect of a new compound in chronic bronchitis.
The purpose of the study was the objective evaluation of the mucolytic and antibiotic properties of Fluimucil Antibiotic, a molecular combination of acetylcysteine and thiamphenicol. The preparation was administered to 45 patients in the dose of 3 tablets daily each containing 500 mg of thiamphenical. Statistical analysis of the data obtained showed mucolytic effects on the 4th to 5th day of treatment and marked antibiotic activity. The evaluation is positive particularly if the relatively low dose of antibiotic normally used in chronic bronchitis is considered. The preparation Fluimucil Antibiotic can be recommended for the treatment of chronic bronchitis also in view of its good tolerability.


Knowledge, attitude and practice of natural family planning methods in a population with poor utilisation of modern contraceptives.
Sub-Saharan Africa has one of the highest fertility rates in the world, which is further promoted by the low utilisation of modern contraceptive methods. Yet, many communities claim to have traditional methods of family planning that pre-date the introduction of modern contraceptives, implying that contraception is a culturally acceptable norm. It was therefore postulated that the study population would have a high level of awareness and practice of natural methods of family planning. We aimed to obtain an insight into the extent and correctness of knowledge about natural family planning methods, and its practice as a guide to the general acceptance of contraception as a concept. Pre-tested structured questionnaires were administered to women of childbearing age in households properly numbered for primary healthcare activities. The level of awareness of natural family planning methods was significantly less than awareness for modern methods of contraception. The awareness rate for rhythm method, lactational amenorrhoea method and coitus interruptus was 50.7%, 42.1% and 36.1%, respectively. For all three national family planning methods, there is a steady decline between awareness, correct description of method and utilisation, a difference that was statistically significant in all cases. The sociodemographic factors of the responders had varying influence on utilisation of all three natural family planning methods studied. Rural dwellers practised the lactational amenorrhoea method significantly more often than urban dwellers. Significantly more Muslims than Christians with four children or more practised coitus interruptus or the rhythm method, while the use of lactational amenorrhoea method was significantly increased with the number of living children in both religious groups. There is a relatively low level of awareness of natural family planning methods in the study population, poor utilisation and wrong use of methods. Therefore, improving the correct level of information on natural family planning methods is likely to improve the use of both natural family planning and modern contraceptive methods.


[Night driving capacity of pseudophakic patients].
One hundred pseudophakic patients (aged 62.1 +/- 10.8 years) were examined for glare sensitivity and contrast vision, using the Mesoptometer II, 15.8 +/- 9.8 months after implantation of monofocal intraocular lenses. The patients were tested in order to determine whether they met the requirements of the German Ophthalmological Society (DOG) for the granting of a driver's license. The patients were divided into three groups: (1) pseudophakic bilaterally (n = 50), (2) pseudophakic in one eye with phakic contralateral eye (n = 25), and (3) pseudophakic in one eye with cataract in contralateral eye (n = 25). There were no differences between the groups in corrected distance acuity (ANOVA, P = 0.17). Fifty-two percent of the patients did not fulfill the requirements of the DOG (group 1 50%, group 2 24%, group 3 84%). In groups 1 and 2 the binocular results for glare sensitivity and contrast vision were significantly better than the monocular results (P < 0.001). In group 3, however, there was no difference between binocular and monocular results (P > 0.3). In 20% of patients in this group the binocular results were worse than the monocular results. Results for both contrast vision and glare sensitivity were significantly related to age. Overall, this population of pseudophakic patients were 40-50% less suited to night driving than were healthy volunteers with normal eyes.


Post-recombination effects in confined gases photoionized at megahertz repetition rates.
Recombination-driven acoustic pulses and heating in a photoionized gas transiently alter its refractive index. Slow thermal dissipation can cause substantial heat accumulation and impair the performance and stability of gas-based laser systems operating at strong-field intensities and megahertz repetition rates. Here we study this effect by probing the pulse-by-pulse buildup of refractive index changes in gases spatially confined inside a capillary. A high-power repetition-rate-tunable femtosecond laser photoionizes the gas at its free-space focus, while a transverse-propagating probe laser interferometrically monitors the resulting time-dependent changes in refractive index. The system allows convenient exploration of the nonlinear regimes used to temporally compress pulses with durations in the ∼30 to ∼300 fs range. We observe thermal gas-density depressions, milliseconds in duration, that saturate to a level that depends on the peak intensity and repetition rate of the pulses, in good agreement with numerical modelling. The dynamics are independently confirmed by measuring the mean speed-of-sound across the capillary core, allowing us to infer that the temperature in the gas can exceed 1000 K. Finally, we explore several strategies for mitigating these effects and improving the stability of gas-based high-power laser systems at high repetition rates.


Driving forces in free visual search: An ethology.
Visual search typically involves sequences of eye movements under the constraints of a specific scene and specific goals. Visual search has been used as an experimental paradigm to study the interplay of scene salience and top-down goals, as well as various aspects of vision, attention, and memory, usually by introducing a secondary task or by controlling and manipulating the search environment. An ethology is a study of an animal in its natural environment, and here we examine the fixation patterns of the human animal searching a series of challenging illustrated scenes that are well-known in popular culture. The search was free of secondary tasks, probes, and other distractions. Our goal was to describe saccadic behavior, including patterns of fixation duration, saccade amplitude, and angular direction. In particular, we employed both new and established techniques for identifying top-down strategies, any influences of bottom-up image salience, and the midlevel attentional effects of saccadic momentum and inhibition of return. The visual search dynamics that we observed and quantified demonstrate that saccades are not independently generated and incorporate distinct influences from strategy, salience, and attention. Sequential dependencies consistent with inhibition of return also emerged from our analyses.


Continuously Electrotriggered Core Coalescence of Double-Emulsion Drops for Microreactions.
Microfluidically generated double emulsions are promising templates for microreactions, which protect the reaction from external disturbance and enable in vitro analyses with large-scale samples. Controlled combination of their inner droplets in a continuous manner is an essential requirement toward truly applications. Here, we first generate dual-cored double-emulsion drops with different inner encapsulants using a capillary microfluidic device; next, we transfer the emulsion drops into another electrode-integrated polydimethylsiloxane microfluidic device and utilize external AC electric field to continuously trigger the coalescence of inner cores inside these emulsion drops in continuous flow. Hundreds of thousands of monodisperse microreactions with nanoliter-scale reagents can be conducted using this approach. The performance of core coalescence is investigated as a function of flow rate, applied electrical signal, and core conductivity. The coalescence efficiency can reach up to 95%. We demonstrate the utility of this technology for accommodating microreactions by analyzing an enzyme catalyzed reaction and by fabricating cell-laden hydrogel particles. The presented method can be readily used for the controlled triggering of microreactions with high flexibility for a wide range of applications, especially for continuous chemical or cell assays.


Characteristics of uptake of [3-H](plus or minus)-metaraminol by human fallopian tube.
The characteristics of accumulation of 5 X 10 minus8M [3-H] (plus or minus)-metaraminol were studied in isolated human fallopian tube. In both the ampulla and isthmus, the amine was concentrated against the concentration gradient; Accumulation was inhibited by noradrenaline, cocaine, and ouabain but not by oxytetracycline or normetanephrine. It was concluded that [3-H] (plus or minus)-metaraminol was accumulated in the adrenergic nerves present in the human fallopian tube.


Pseudomonas pseudomallei and melioidosis, with special reference to the status in Thailand.
Melioidosis is a long-known disease since 1912, but only quite recently we have obtained the knowledges about its actual clinical and epidemiological features. The disease is so unique in having a wide spectrum of disease course and clinical manifestation. The causative agent, P. pseudomallei, is free-living bacterium in the natural environments (soil and surface water) of tropical and subtropical areas. Just like legionnaires' disease, melioidosis is a good example of infectious disease in which pneumonia is produced by inhalation of contaminated soil dusts or water droplets. The infection becomes dormant for years, but with a chance of recrudescence under a variety of insults to the host resistance. The disease, may it be acute or chronic, will be symptomatically confused with malaria, typhoid fever, leptospirosis, septicemia caused by other gram-negative bacteria, tuberculosis and mycotic infections. Isolation of the causative agent from clinical specimens is the only reliable method for diagnosis. Because of the increasing clinical awareness and the development of diagnostic methods, the reported cases of melioidosis have numbered almost one thousand in Thailand during the past 20 years. This country has now the most ample clinical experiences on melioidosis. We have reviewed the history of melioidosis research from bacteriological, immunological, clinical and epidemiological viewpoints, especially including the recent reports in Thailand.


[Diaplacental influence on the disseminated intravascular coagulation (DIC) in an asphyxia model. II. Influence on the vessel's content (author's transl)].
There is reported on the possibilities of diaplacental influencing on the DIC arising from the hypoxia we provoked with the help of an asphyxia model in rabbit fetuses. We could demonstrate the impossibility of influencing on the fetal vasal content by means of low molecular dextran, heparin or streptokinase. On the contrary, the possibility exists to influence on the fetal hemostasis by low molecular synthetic substances. The antifibrinolytic drug PAMBA causes in case of advanced acidosis diaplacental a definite growth of the intravascular coagulation, as well. But an inhibition of the fibrin sedimentation in the terminal vessels at the asphyctic shock can be achieved by applying the ethyl ester of the 4-amidinophenylpyruvic acid (APPA).


Opening the treasure chest: A DNA-barcoding primer set for most higher taxa of Central European birds and mammals from museum collections.
DNA-barcoding is a rapidly developing method for efficiently identifying samples to species level by means of short standard DNA sequences. However, reliable species assignment requires the availability of a comprehensive DNA barcode reference library, and hence numerous initiatives aim at generating such barcode databases for particular taxa or geographic regions. Historical museum collections represent a potentially invaluable source for the DNA-barcoding of many taxa. This is particularly true for birds and mammals, for which collecting fresh (voucher) material is often very difficult to (nearly) impossible due to the special animal welfare and conservation regulations that apply to vertebrates in general, and birds and mammals in particular. Moreover, even great efforts might not guarantee sufficiently complete sampling of fresh material in a short period of time. DNA extracted from historical samples is usually degraded, such that only short fragments can be amplified, rendering the recovery of the barcoding region as a single fragment impossible. Here, we present a new set of primers that allows the efficient amplification and sequencing of the entire barcoding region in most higher taxa of Central European birds and mammals in six overlapping fragments, thus greatly increasing the value of historical museum collections for generating DNA barcode reference libraries. Applying our new primer set in recently established NGS protocols promises to further increase the efficiency of barcoding old bird and mammal specimens.


Seipin differentially regulates lipogenesis and adipogenesis through a conserved core sequence and an evolutionarily acquired C-terminus.
Homozygous mutations in BSCL2 (Berardinelli-Seip congenital lipodystrophy)/seipin cause CGL2 (congenital generalized lipodystrophy type 2). Recent data suggest that seipin regulates LD (lipid droplet) dynamics and adipocyte differentiation, but whether these roles are mechanistically linked remains unclear. To understand how seipin regulates these processes, we investigated the evolutionary changes of seipin orthologues, and studied individual domains in regulating lipid accumulation in non-adipocytes and adipocytes. Mammalian seipins comprise at least two distinct functional domains, a conserved core sequence and an evolutionarily acquired C-terminus. Despite its requirement for adipocyte formation, seipin overexpression inhibited oleate-induced LD formation and accumulation in nonadipocytes, which was mediated by the core sequence. In contrast, seipin overexpression did not inhibit LD accumulation during adipocyte differentiation or the adipogenic process in 3T3-L1 cells. However, adipogenesis and LD accumulation were impaired in 3T3-L1 cells expressing a seipin mutant lacking the C-terminus. Furthermore, expression of the same mutant without the C-terminus failed to rescue the adipogenic defects in seipin-knockdown cells, demonstrating the importance of the C-terminus for seipin's function in adipocyte development. We propose that seipin is involved in lipid homoeostasis by restricting lipogenesis and LD accumulation in non-adipocytes, while promoting adipogenesis to accommodate excess energy storage.


Early events in the formation of a venous thrombus following local trauma and stasis.
A jugular vein was exposed in 20 cats divided into four groups of five cats each. In group 1 the vein was removed immediately after exposure. In group 2 the vein was removed after three 5-minute periods of stasis and reflow. Groups 3 and 4 had the jugular vein occluded for 24 and 72 hours, respectively. In all groups, veins were perfused under physiologic pressure by heparinized saline to remove blood and immersed in 2.5% glutaraldehyde for fixation. All vessels were prepared for scanning and transmission electron microscopy. Group 1 cats had a normal-appearing luminal surface. Group 2 cats had deposition of leukocytes with few erythrocytes or platelets. Groups 3 and 4 had deposition of leukocytes, platelets, and erythrocytes. Leukocytes were found in all areas and associated with all cell types. Platelets and erythrocytes were seldom found in the absence of leukocytes. Thrombi were found on normal-appearing and damaged endothelium. The majority of thrombi were found at side branches and valve pockets. Our results suggest that leukocytes play a primary role in the initiation of deep vein thrombosis. Platelets may have only a secondary role.


[Discovery of Novel Biologically Active Compounds of Natural Origin, with a Focus on Anti-tumor Activity].
Numerous clinically valuable medicines, including anticancer drugs, have been developed from biologically active natural compounds and their structurally related derivatives. This review discusses novel natural compounds with promising biological activities and those with novel chemical structures. Glaziovianin A, an isoflavone isolated from the leaves of Ateleia glazioviana (Legminosae), inhibited cell cycle progression at the M-phase with an abnormal spindle structure. AU-1 and YG-1, 5β-steroidal glycosides isolated from the whole plants of Agave utahensis and the underground parts of Yucca glauca (Agavaceae), induced apoptosis of HL-60 cells via caspase-3 activation. Lycolicidinol, an alkaloid isolated from the bulbs of Lycoris albiflora (Amaryllidaceae), induced transient autophagy and morphological changes in mitochondria in the early stage of the apoptotic cell death process in HSC-2 cells. Taccasterosides isolated from the rhizomes of Tacca chantrieri (Taccaceae) and stryphnosides isolated from the pericarps of Stryphnodendron fissuratum (Legminosae) are steroidal and triterpene glycosides with unique chemical structures having novel sugar sequences.


Hydrogels as Extracellular Matrix Analogs.
The extracellular matrix (ECM) is the non-cellular component of tissue that provides physical scaffolding to cells. Emerging studies have shown that beyond structural support, the ECM provides tissue-specific biochemical and biophysical cues that are required for tissue morphogenesis and homeostasis. Hydrogel-based platforms have played a key role in advancing our knowledge of the role of ECM in regulating various cellular functions. Synthetic hydrogels allow for tunable biofunctionality, as their material properties can be tailored to mimic those of native tissues. This review discusses current advances in the design of hydrogels with defined physical and chemical properties. We also highlight research findings that demonstrate the impact of matrix properties on directing stem cell fate, such as self-renewal and differentiation. Recent and future efforts towards understanding cell-material interactions will not only advance our basic understanding, but will also help design tissue-specific matrices and delivery systems to transplant stem cells and control their response in vivo.


[Hydrolysis of poly(L-lactic acid) fibers and formation of low crystalline apatite on their surface by a biomimetic process].
Low crystalline apatite coating was formed on the surface of biodegradable poly(L-lactic acid) (PLLA) fibers by a biomimetic process, i.e., by immersing the fibers in a modified simulated body fluid (SBF) at 37 degrees C and pH 7.3 after hydrolysis of the fibers in water. The apatite was characterized by scanning electron microscopy with energy dispersive X-ray spectroscopy, X-ray photoelectron spectroscopy, X-ray diffraction and Fourier transform infrared spectroscopy. Results showed that the fiber hydrolysis could accelerate the apatite formation but had little effect on the chemical and crystalline structure of the apatite. The structure of the apatite coating formed by the biomimetic method was similar to that of apatite in the natural bone. The bone-like low crystalline apatite coating might exhibit enhanced osteo-conductivity when the PLLA fibers are applied in bone reconstruction biomaterials.


Comparison of laparoscopic Burch and tension-free vaginal tape in treating stress urinary incontinence in obese patients.
To compare the efficacy and safety of the tension-free vaginal tape (TVT) and laparoscopic Burch procedures in treating genuine stress urinary incontinence in obese patients. This was a retrospective evaluation of 91 consecutive cases of TVT alone or TVT combined with other procedures from April 1999 through March 2000 and 51 consecutive cases of the laparoscopic Burch procedure from January 1998 through February 1999. All procedures were performed in a private practice and community hospitals in the midwest. One hundred forty-two women (ages 34 to 79) with stress urinary incontinence documented by clinical examination and preoperative cystometric and urodynamic evaluation were included in the study. They were also divided into 5 groups based on their body mass index (BMI): NL (normal-BMI < 25), OW (overweight-BMI 25 to 29), OBI (obesity I-BMI 30 to 34), OBII (obesity II-BMI 35 to 39), OBIII (obesity III-BMI > 40). In the TVT group, 66% were obese (OBI-21, OBII-17. OBIII-22) versus 36% in the laparoscopic Burch (OBI-13, OBII-5) group. All TVT patients remain cured or symptoms improved in their genuine stress urinary incontinence, which favorably compares with the laparoscopic Burch procedure after 1 year. Operating time for the TVT portion ranged from 18 to 40 minutes. The laparoscopic Burch procedure in general took over 1 hour. No bladder, bowel, or vascular injuries have occurred in the TVT group. Superficial suprapubic ecchymoses have occurred in the TVT group occasionally but required no intervention. The average length of stay was 1 day; TVT-only patients usually were released on the same day. Ninety percent of patients were voiding normally by postoperative day 7. Most of the patients with continued urinary retention had had combined procedures. This preliminary study indicates that TVT is a safer, more effective, and easier minimally invasive surgery for genuine stress urinary incontinence regardless of the patients' BMI and favorably compares with the laparoscopic Burch procedure, which requires advanced surgical skills.


Volumetric analysis of septal region in schizophrenia and affective disorder.
MRI and post-mortem studies indicate an increased prevalence of cavum septi pellucidi (CSP) in schizophrenia and affective disorder. The aim of this study was to characterize the CSP and the septal tissue among patients with schizophrenia, patients with affective disorder, and control subjects. The volumes of CSP and septal tissue were measured in post-mortem brains in 42 patients with schizophrenia, 14 patients with affective disorder, and 17 normal control cases by planimetry of serial sections. Enlargements of CSP (>100 mm(3)) were found in eight of the 42 (19%) patients with schizophrenia. There were no significant differences in CSP volumes between patients with affective disorder and controls. Enlarged CSP in schizophrenia were not associated with reduced septal tissue volumes. By contrast, a significant positive correlation between volumes of CSP and septal tissue volumes in patients with schizophrenia (P = 0.03) and in control cases (P < 0.01) was found, but not in patients with affective disorder (P = 0.53). The finding of enlarged CSP in schizophrenia strongly supports the hypothesis of an early developmental abnormality in this key structure of the limbic system.


Use of bortezomib as induction therapy prior to stem cell transplantation in frontline treatment of multiple myeloma: impact on stem cell harvesting and engraftment.
High-dose melphalan therapy with peripheral blood stem cell (PBSC) transplantation is a standard treatment for younger patients with untreated multiple myeloma that results in high overall and complete response (CR) rates, and improved event-free and overall survival compared with standard chemotherapy alone. Induction therapy serves to reduce tumor burden prior to stem cell mobilization and thus must not adversely impact stem cell mobilization and harvesting, or engraftment following high dose therapy plus autologous stem cell transplantation. Bortezomib, an approved agent for the treatment of multiple myeloma patients who have received at least one prior therapy, is also being investigated in the frontline setting. Preclinical studies have demonstrated that bortezomib has no toxic effects on stem cells, megakaryocytes or neutrophil precursors, and causes only transient and reversible thrombocytopenia and neutropenia. Clinical studies with bortezomib-based induction regimens have demonstrated no adverse impact on PBSC harvest numbers nor on their quality as defined by engraftment times. These regimens appear to be well tolerated and highly active as induction therapy, with high response rates and consistently high CR rates. Randomized phase 3 studies comparing bortezomib-based regimens with current standard induction therapies are ongoing.


Examining the DSM-5 Section III Criteria for Obsessive-Compulsive Personality Disorder in a Community Sample.
The current study examined the extent to which the trait-based operationalization of obsessive-compulsive personality disorder (OCPD) in Section III of the DSM-5 describes the same construct as the one described in Section II. A community sample of 313 adults completed a series of personality inventories indexing the DSM-5 Sections II and III diagnostic criteria for OCPD, in addition to a measure of functional impairment modelled after the criteria in Section III. Results indicated that latent constructs representing Section II and Section III OCPD overlapped substantially (r = .75, p < .001). Hierarchical latent regression models revealed that at least three of the four DSM-5 Section III facets (Rigid Perfectionism, Perseveration, and Intimacy Avoidance) uniquely accounted for a large proportion of variance (53%) in a latent Section II OCPD variable. Further, Anxiousness and (low) Impulsivity, as well as self and interpersonal impairment, augmented the prediction of latent OCPD scores.


Case-control study of lung cancer and truck driving in the Teamsters Union.
We conducted a case-control study of lung cancer deaths in the Teamsters Union to compare the risk of different occupations within the teamsters, after controlling for smoking and other confounders. Occupations with no presumed exposure to diesel fumes were used as the nonexposed group. The study population consisted of 996 cases and 1,085 controls who had died in 1982-83 after applying for pensions. Next of kin provided information on smoking, work history, and other potential confounders. Work history data were also obtained from the Teamsters Union. While no single job category had a significant excess risk compared to the non-exposed group, certain sub-groups were elevated. The odds ratio for those with long-term employment as long-haul truckers after 1959 (an approximate date for the introduction of diesel engines) was 1.55 (95% CI: 0.97, 2.47). Long-term drivers of primarily diesel trucks had an odds ratio of 1.89 (95% CI: 1.04, 3.42). Overall, our results suggest that diesel truck drivers have an excess risk of lung cancer compared to other teamsters in jobs outside the trucking industry. However, our findings were not uniformly consistent and our data have many limitations, the most important of which is the lack of data on exposure to diesel fumes.


Validity and reliability of activities coaching context questionnaire.
Learning in a clinical environment is an inseparable part of a training program in medical education. To evaluate the quality of training in a clinical environment, a comprehensive questionnaire which is adjusted for local purposes is essential. This study was conducted to determine the validity and reliability of Activities Coaching Context (ACC)-questionnaire from the perspective of residents and students in a clinical learning environment. This was a cross-sectional study conducted with 65 residents and students of Semnan University of Medical Sciences. The Content Validity of the questionnaire was confirmed by the judgment of a panel of ten experts in medical education. The construct validity of the questionnaire was determined by factor analysis. Data were collected and analyzed by SPSS16. The ratio and index of content validity calculated by experts' view were quite acceptable (0.31 and 0.7, respectively). Construct validity was examined by factor analysis which confirmed seven first order factors. Cronbach's Alfa coefficient revealed a high degree of internal consistency (0.932). The reliability of the questionnaire was measured by test - retest (0.9). The ACC questionnaire appeared to be a valid, reliable and also appropriate tool to evaluate the educational quality of a clinical learning environment.


Plasmodium falciparum parasites deploy RhopH2 into the host erythrocyte to obtain nutrients, grow and replicate.
Plasmodium falciparum parasites, the causative agents of malaria, modify their host erythrocyte to render them permeable to supplementary nutrient uptake from the plasma and for removal of toxic waste. Here we investigate the contribution of the rhoptry protein RhopH2, in the formation of new permeability pathways (NPPs) in Plasmodium-infected erythrocytes. We show RhopH2 interacts with RhopH1, RhopH3, the erythrocyte cytoskeleton and exported proteins involved in host cell remodeling. Knockdown of RhopH2 expression in cycle one leads to a depletion of essential vitamins and cofactors and decreased de novo synthesis of pyrimidines in cycle two. There is also a significant impact on parasite growth, replication and transition into cycle three. The uptake of solutes that use NPPs to enter erythrocytes is also reduced upon RhopH2 knockdown. These findings provide direct genetic support for the contribution of the RhopH complex in NPP activity and highlight the importance of NPPs to parasite survival.


Heparan Sulfate-Mimicking Glycopolymers Bind SARS-CoV-2 Spike Protein in a Length- and Sulfation Pattern-Dependent Manner.
Heparan sulfate-mimicking glycopolymers, composed of glucosamine (GlcN)-glucuronic acid (GlcA) repeating units, bind to the receptor-binding subunit (S1) and spike glycoprotein (S) domains of the SARS-CoV-2 spike protein in a length- and sulfation pattern-dependent fashion. A glycopolymer composed of 12 repeating GlcNS6S-GlcA units exhibits a much higher affinity to the S1 protein (IC50 = 13 ± 1.1 nM) compared with the receptor-binding domain (RBD). This glycopolymer does not interfere in angiotensin-converting enzyme 2 binding of the RBD. Although this compound binds strongly to the S1/membrane-fusion subunit (S2) junction (KD = 29.7 ± 4.18 nM), it does not shield the S1/S2 site from cleavage by furin-a behavior contrary to natural heparin. This glycopolymer lacks iduronic acid, which accounts for 70% of heparin. Further, this compound, unlike natural heparin, is well defined in both sulfation pattern and length, which results in fewer off-target interactions with heparin-binding proteins. The results highlight the potential of using polymeric heparan sulfate (HS) mimetics for the therapeutic agent development.