The Influence of High and Low Negative Pressure Liposuction and Various Harvesting Techniques on the Viability and Function of Harvested Cells-a Systematic Review of Animal and Human Studies.
An understanding of fat grafting methodology, techniques and patient-related factors is crucial when considering fat grafting. Multiple factors can influence the success of a fat graft and consequently the outcome of the procedure. The aim of this systematic review is to elucidate the influence of negative pressure and various techniques of fat harvesting on the viability and function of cells, particularly adipocytes and adipose-derived stem cells. We conducted a literature search from 1975 to 2020 using the PubMed bibliography, ScienceDirect, SCOPUS and the Google Scholar databases which produced 168,628 articles on the first pass. After applying all the exclusion criteria by two independent reviewers, we were left with 21 articles (level IV of Oxford Centre for Evidence-Based Studies and Grade C of Grade Practice Recommendation from the American Society of Plastic Surgeons) on which this review is based. From 11 studies focused on different negative pressures, no one found using high negative pressure advantageous. Summarising 13 studies focused on various harvesting techniques (excision, syringe, and pump-machine), most often equal results were reported, followed by excision being better than either syringe or liposuction. From our systematic review, we can conclude that the low negative pressure seems to yield better results and that the excision seems to be the most sparing method for fat graft harvesting. However, we have to point out that this conclusion is based on a very limited number of statistically challengeable articles and we recommend well-conducted further research. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .


[Investigation of triazavirin antiviral activity against influenza A virus (H5N1) in cell culture].
Analysis of triazavirin efficacy with respect to influenza A virus (H5N1) in sensitive cell culture MDSK vs. effective antigrippe drugs, such as tamiflu, remantadin and arbidol showed that triazavirin in a wide range of the concentrations was efficient in inhibition of the virus cytopathic activity and formation of the specific hemagglutinin.


A Prospective, 3-year Longitudinal Study of Modic Changes of the Lumbar Spine in a Population-based Cohort: The Wakayama Spine Study.
Large-scale, prospective, population-based, longitudinal observational study. The aim of this study was to investigate the rate of incidence, transformation, and reverse transformation of Modic changes (MCs) using T1-weighted (T1W) and T2-weighted (T2W) lumbar magnetic resonance images (MRI) over a 3-year period. Although MCs in populational study are considered significant, existing epidemiological evidence is based on cross-sectional studies only. Overall, 678 subjects (208 men, 470 women, mean age 62.1 ± 12.8 years in 2013) in both 2013 and 2016 surveys were included. The rate of change in Modic Type I (T1W: low-intensity, T2W: high-intensity), Type II (T1W: high, T2W: high), and Type III (T1W: low, T2W: low) at five endplates was analyzed over a 3-year period. An incidence of MC at each level and in the lumbar region was defined as no MC at baseline with signal changes at follow-up. Transformation was defined as Type I or II MC at baseline with conversion at follow-up Type II from Type I or Type III MC from Type I and II. Furthermore, reverse transformation was defined as Type I, II, or III MC at baseline, with at least one endplate showing a reversion in Modic type (no MC for baseline Type I; no MC and Type I for baseline Type II; no MC, Type I or Type II for baseline Type III) at follow-up. Overall, 3390 endplates were included. For 3 years, the incidence, transformation, and reverse transformation of MCs were seen in 395 (11.7%), 84 (2.5%), and 11 (0.3%) endplates, respectively. The highest levels of incidence, transformation, and reverse transformation were at L2/3 (96 [14.2%] endplates), L5/S1 (32 [4.7%] endplates), and L2/3 (5 [0.7%] endplates), respectively. This study revealed a high incidence of MCs at the upper lumbar levels and transformation at the lower lumbar levels. Reverse transformation of MCs occurs but are rare.Level of Evidence: 2.


Efficacy of Vitamin D Supplements in Prevention of Acute Respiratory Infection: A Meta-Analysis for Randomized Controlled Trials.
Previous systematic reviews and meta-analyses of randomized controlled trials (RCTs) have reported inconsistent results regarding the efficacy of vitamin D supplements in the prevention of acute respiratory infections (ARIs). We investigated these efficacy results by using a meta-analysis of RCTs. We searched PubMed, EMBASE, and the Cochrane Library in June 2021. Out of 390 trials searched from the database, a total of 30 RCTs involving 30,263 participants were included in the final analysis. In the meta-analysis of all the trials, vitamin D supplementation showed no significant effect in the prevention of ARIs (relative risk (RR) 0.96, 95% confidence interval (CI) 0.91-1.01, I2 = 59.0%, n = 30). In the subgroup meta-analysis, vitamin D supplementation was effective in daily supplementation (RR 0.83, 95% CI, 0.73-0.95, I2 = 69.1%, n = 15) and short-term supplementation (RR 0.83, 95% CI, 0.71-0.97, I2 = 66.8%, n = 13). However, such beneficial effects disappeared in the subgroup meta-analysis of high-quality studies (RR 0.89, 95% CI, 0.78-1.02, I2 = 67.0%, n = 10 assessed by the Jadad scale; RR 0.87, 95% CI, 0.66-1.15, I2 = 51.0%, n = 4 assessed by the Cochrane's risk of bias tool). Additionally, publication bias was observed. The current meta-analysis found that vitamin D supplementation has no clinical effect in the prevention of ARIs.


Recurrent abdominal pain visits to the emergency department: A case report using the Central Sensitization Inventory.
Chronic pain conditions are among the most common complaints seen in the emergency department (ED). Exacerbations of these conditions are often approached as one would an acute painful condition, with liberal use of imaging, labs, and analgesics. This patient population is often prescribed short courses of opioids without a definite explanation for their painful episodes and often leave the ED dissatisfied with their experience. We describe a patient with a history of chronic abdominal pain who presented to the ED with an exacerbation of his pain. Upon further review of his previous records, we noted that this patient experienced many similar events, resulting in 46 imaging studies over the past year. At this point, the patient was given the Central Sensitization Inventory, and his score demonstrated severe underlying central sensitization. The patient was counseled about his condition and provided with appropriate follow-up care.


Theoretical and in vivo investigations of morphology and concentration of gold nanoparticles for laser surgery.
Precise control of the thermal damage is critical during thermal therapy with the assistance of gold nanoparticles, which depends on the laser parameters and characteristics of gold nanoparticles. However, the current understanding of the relationship between the gold nanoparticles/incident laser light and the efficiency of photothermal therapy is limited, which should be studied systematically. In this study, theoretical simulations were conducted to investigate the influence of laser wavelength, the size and shape of gold nanoparticles, and the distance of the particle in complex nanostructures on the optical properties and temperature distribution after laser irradiation, aiming to achieve maximum photothermal conversion efficiency and therapeutic effect during the laser treatment of port wine stains. Thereafter, gold nanoparticles were prepared and in vivo experiments were conducted to evaluate the effect on thermal damage of blood vessels. For the laser wavelength at 532 nm, gold nanospheres with diameters of 20 nm are ideal in terms of temperature rise. The optimized particle distance is 5 nm and the corresponding concentration is 0.26 mg/ml. For Nd:YAG laser at 1064 nm, gold nanorods with an aspect ratio of 6.3 and an effective radius of 12.7 nm are the most effective photothermal agents. The optimized particle distance is 4 nm, yielding the optimal concentration of 0.017 mg/ml. In vivo results demonstrated that using gold nanoparticles following our simulations as photothermal agents can greatly enhance the thermal damage of diseased blood vessels, reducing the laser energy and laser pulses required for the obvious thermal response of blood vessels. For different laser wavelengths used in clinics in the near future, theoretical models presented in this study can be employed to obtain the morphology of single gold nanoparticle and the concentration of nanoparticles solutions, thereby obtaining the optimal photothermal conversion and enhanced thermal damage assisted by gold nanoparticles.


The mediation effect of perceived weight stigma in association between weight status and eating disturbances among university students: is there any gender difference?
The study aimed to examine the association between perceived weight stigma (PWS), weight status, and eating disturbances. We hypothesized that PWS would partially mediate the association between weight status and eating disturbances among university students. The study involved 705 undergraduate students (379 females and 326 males) recruited from Hong Kong and Taiwan Universities (399 Hong Kong; 306 Taiwan participants). Our sample was from one Hong Kong university (located in Kowloon) and five Taiwan universities (three located in Southern Taiwan, one located in Central Taiwan, and one located in North Taiwan). Participants' mean age was 20.27 years (SD = 1.79). All participants completed a demographic information sheet, the Three-Factor Eating Questionnaire-18 (TFEQ-R18), and the PWS questionnaire. PROCESS macro models were used to analyze potential mediations. We found a significantly higher PWS scores in a high weight group for females and males. There was a significant difference between weight status and eating disturbances. Moreover, PWS partially mediated the association between weight status and eating disturbances for both genders. PWS is associated with weight status and eating disturbances, making it an important target for health improvement among young adults. Further studies are needed to corroborate such associations in participants from other societies and cultures.


Female breast cancer incidence and mortality in China, 2013.
Breast cancer is the most common cancer among women. Population-based cancer registration data from the National Central Cancer Registry were used to analyze and evaluate the incidence and mortality rates in China in 2013, providing scientific information for cancer prevention and control. Pooled data were stratified by area (urban/rural), gender, and age group. National new cases and deaths were estimated using age-specific rates and the corresponding population in 2013. The Chinese population in 2000 and Segi's world population were used to calculate age-standardized rates. The estimated number of new breast cancer cases was about 278 800 in China in 2013. The crude incidence, age-standardized rate of incidence by Chinese standard population, and age-standardized rate of incidence by world standard population were 42.02/100 000, 30.41/100 000, and 28.42/100 000, respectively. The estimated number of breast cancer deaths was about 64 600 in China in 2013. The crude mortality, age-standardized rate of mortality by Chinese standard population, and age-standardized rate of mortality by world standard population were 9.74/100 000, 6.54/100 000, and 6.34/100 000, respectively. Both incidence and mortality were higher in urban than in rural areas. Age-specific breast cancer incidence significantly increased with age, particularly after age 20, and peaked at 50-55 years, while age-specific mortality increased rapidly after 25 years, peaking at 85+ years. Breast cancer is the most common cancer in Chinese women, especially women in urban areas. Comprehensive measures are needed to reduce the heavy burden of breast cancer.


Clinical assessment of optic nerve disorders.
Optic nerve disorders range from the manifestations of life-threatening intracranial or systemic disease, to minor congenital anomalies. Careful clinical assessment, which relies upon a thorough evaluation of symptoms as well as signs, is essential for effective and timely investigation and treatment. Examination methods and pitfalls to be avoided are discussed.


Synthesis and fungicidal activity of novel 2-(2-alkylthio-6-phenylpyrimidin-4-yl)-1H-benzimidazoles.
With the aim of exploring new benzimidazole derivative with high fungicidal activity, a series of novel 2-(2-(alkylthio)-6-phenylpyrimidin-4-yl)-1H-benzimidazoles were designed and synthesized, and their in vitro fungicidal activities were evaluated. Compounds 5a, 5f, 5g, 5h, 5i and 5l exhibited excellent fungicidal activities against Botrytis cinerea, and 5c, 5f, 5h, 5i and 5l displayed notable fungicidal activities against Sclerotinia sclerotiorum. Among them, compound 5i (R1 = fluorine, R2 = benzyl) displayed the best activity towards the two tested fungi. Docking study of 5i with β-tubulin protein revealed that the NH moiety of benzimidazole ring generated a hydrogen bond with Gln-11 residue, and the fluorine atom of benzene ring formed a hydrogen bond with Tyr-208 residue, respectively; the benzene ring of Tyr-222 and the pyrimidine ring of 5i yielded a π-π interaction. The molecular electrostatic potential analysis elucidated the nitrogen atom of benzimidazole ring, fluorine atom of benzene ring and sulfur atom of thioether moiety were located in the negative potential regions, whereas some hydrogen atoms of benzene, benzimidazole and pyrimidine rings were located in the positive potential regions. This analysis demonstrated the reason why 5i can form hydrogen bonds with amino acid residues of target protein.


Genes involved in the epithelial-mesenchymal transition in oral cancer: A systematic review.
Epithelial-mesenchymal transition (EMT) is considered the initial step in the invasion-metastasis cascade. The aim of this systematic review was to study the signature of genes involved in the EMT process in oral cancer (OC) confirmed by protein expression and its possible relationship with oral squamous cell carcinoma (OSCC) prognostic variables. A search of the scientific literature was carried out with no start date restriction until 17 September 2020 in the electronic databases Pubmed/MEDLINE, Web of Science, Cochrane Library and Scopus, following specific eligibility criteria. The methodological quality of the included studies was assessed using the Newcastle-Ottawa tool. A total of 8 retrospective cohort studies were included, all of them performed in China and with low risk of bias. Overexpression of the genes HNRNPC, ITGA5, HMGA2 and SRSF3, and low expression of ALDH3A1 and ARID2 promote EMT in OC. The more advanced clinical stages of the TNM classification were significantly associated with overexpression of HNRNPC, ITGA5, HMGA2 and SRSF3, and low expression of ARID2. HNRNPC, ITGA5, HMGA2, SRSF3, ALDH3A1 and ARID2 genes were associated with EMT process. Over- or under-expression of these genes is associated with worse stages of OSCC and/or worse prognosis of the tumor. Further studies on this topic are needed in different countries to be able to confirm these results, since the detection of these genes can help to know which tumors have a worse prognosis.


Cronkhite-Canada syndrome: An investigation in clinical features and pathogenesis.
This study aimed to investigate the clinical features and potential pathogenesis of a rare nonhereditary polyposis syndrome, Cronkhite-Canada syndrome (CCS). Medical records of eight patients with CCS who were admitted to our hospital from January 2005 to November 2019 were reviewed. Transcriptome profiling was performed in one patient to investigate its difference between gastric polyp tissue and normal mucosa. Differentially expressed genes (DEGs) were determined for functional analysis. The expression of inhibin beta A (INHBA) was further assessed by using immunohistochemistry. All patients presented with gastrointestinal polyposis, accompanied by diarrhea, skin hyperpigmentation, hair loss and nail dystrophy. Hyperplastic polyps were observed in seven patients, tubular adenoma in two, inflammatory polyps in one and hamartomatous polyps in one, respectively. All patients underwent comprehensive treatment and five achieved clinical remission. A total of 2107 DEGs, including 1265 upregulated and 842 downregulated, were found in the gastric polyp. Gene ontology analysis showed that upregulated genes were significantly enriched in the positive regulation of cell proliferation, epithelium development and angiogenesis. A protein-protein interaction analysis suggested that INHBA was at the center of the interaction network and might play an important role in CCS. Immunohistochemistry confirmed that INHBA expression was upregulated in CCS gastric polyps. CCS is a rare disease and its diagnosis mainly depends on typical clinical manifestations, endoscopic findings and histological features. INHBA upregulation may contribute to its pathogenesis.


Urolithiasis from stapler anastomosis.
The simplicity of operation and versatility and speed of automatic stapling devices in the creation of ileal loops have been amply documented. Three cases of stone formation in the ileal loop, secondary to encrustation about the staples, are reported herein, and the modification to the surgical technic which would obviate this problem is presented.


Neural representations of hunger and satiety in Prader-Willi syndrome.
To investigate the neural basis of the abnormal eating behaviour in Prader-Willi syndrome (PWS), using brain imaging. We predicted that the satiety response in those with PWS would be delayed and insensitive to food intake. The design of this study was based on a previous investigation of the neural activation associated with conditions of fasting and food intake in a nonobese, non-PWS group. The findings were used to generate specific hypotheses regarding brain regions of interest for the current study, in which 13 adults with PWS took part (mean +/- s.d. age = 29 +/- 6; BMI = 31.5 +/- 5.1; IQ = 71 +/- 8, six were female). Regional cerebral blood flow was measured using positron emission tomography in three sessions: one following an overnight fast and two following disguised energy controlled meals of similar volume and appearance--one of 1674 kJ (400 kcal) and another of 5021 kJ (1200 kcal). Subjective ratings of hunger, fullness and desire to eat, and blood plasma levels of glucose, insulin, leptin, ghrelin and PYY were measured before and after each imaging session. The neural representation of hunger, after an overnight fast, was similar to that found in nonobese individuals in the control study. In contrast, after food intake, the patterns of neural activation previously associated with satiety were not found, even after the higher-energy load. Lateral and medial orbitofrontal cortical activation was associated with consumption of the 400- and 1200-kcal meals, respectively. The medial orbitofrontal activation, however, was only found in those who had shown a large percentage change in fullness ratings following the higher-energy meal. We conclude that there is a dysfunction in the satiety system in those with PWS. These findings suggest that brain regions associated with satiety are insensitive even to high-energy food intake in those with the syndrome. This may be the neural basis of the hyperphagia seen in PWS.


Potassium uptake in the mouse submandibular gland is dependent on chloride and sodium and abolished by piretanide.
Nervous or hormonal stimulation of salivary secretion in vivo is associated with a pronounced efflux of K+ from the secretory, acinar cells into the blood. This K+ efflux is followed in the post-stimulus period by a reuptake of K+ into the glandular tissue. In the present study we monitor the changes in [K+] of physiological solutions perfusing a flow chamber containing isolated segments of mouse submandibular glands. Nervous stimulation or the application of exogenous acetylcholine (ACh, 10(-5) M) to the isolated glandular tissue results in characteristic changes in the [K+] of the superfusate, indicating net K+ release followed by K+ reuptake. The post-stimulus reuptake of K+ is shown to be susceptible to blockade by either ouabain (10(-3) M) or piretanide (10(-4) M). The reuptake was markedly attenuated if Cl- in the superfusate was replaced by either NO3- or SO4(2-). The K+ uptake was, however, unaffected when Br- replaced Cl- in the superfusate. Similar effects were observed in the unstimulated glandular tissues. The introduction of Cl-(-)free media containing either NO3- or SO4(2-) resulted in a loss of K+ from the tissue which was followed, upon reintroduction of Cl-, by a pronounced uptake of K+. When Br- was substituted for Cl- there was very little change in [K+] upon removal or reintroduction of Cl-. The uptake of K+ induced by reintroduction of Cl- after a period of NO3- or SO4(2-) superfusion was blocked by both ouabain and piretanide. This uptake of K+ was also dependent on the presence of extracellular Na+. Both Cl- and Na+ had to be present in the superfusing medium for K+ uptake to be fully manifest. These findings indicate that the K+ uptake observed in both the resting and stimulated submandibular gland cannot be explained as solely due to the activity of the Na+-K+-adenosine triphosphatase (Na+-K+-ATPase). The demonstrated anionic selectivity, dependence on extracellular Na+ and susceptibility to blockade by the diuretic piretanide would strongly suggest that a coupled Na+-K+-Cl- co-transport system operates in submandibular glands as it does in other transporting epithelia to achieve K+ uptake.


Recent advances in physiological and molecular mechanisms of heavy metal accumulation in plants.
Among abiotic stress, the toxicity of metals impacts negatively on plants' growth and productivity. This toxicity promotes various perturbations in plants at different levels. To withstand stress, plants involve efficient mechanisms through the implication of various signaling pathways. These pathways enhance the expression of many target genes among them gene coding for metal transporters. Various metal transporters which are localized at the plasma membrane and/or at the tonoplast are crucial in metal stress response. Furthermore, metal detoxification is provided by metal-binding proteins like phytochelatins and metallothioneins. The understanding of the molecular basis of metal toxicities signaling pathways and tolerance mechanisms is crucial for genetic engineering to produce transgenic plants that enhance phytoremediation. This review presents an overview of the recent advances in our understanding of metal stress response. Firstly, we described the effect of metal stress on plants. Then, we highlight the mechanisms involved in metal detoxification and the importance of the regulation in the response to heavy metal stress. Finally, we mentioned the importance of genetic engineering for enhancing the phytoremediation technique. In the end, the response to heavy metal stress is complex and implicates various components. Thus, further studies are needed to better understand the mechanisms involved in response to this abiotic stress.


Theoretical analysis of the binding of salicylate by human serum albumin: the relationship between free and bound drug and therapeutic levels.
The binding of salicylates by human serum albumin was analyzed by use of a computer program using previously published association constants and binding capacities for the two sets of binding sites on the protein. The analysis consisted of computing free and bound salicylates for a range of therapeutic and toxic concentration from 181 to 7246 mumole/L (25 to 1000 mg/L). At low and therapeutic levels the total amount of bound drug would exceed the amount of free drug. At higher levels, which included therapeutic and toxic ranges, the amount of free drug plasma, up to 2000 mumole/L the high affinity sites (Site 1), would bind most of the drug, but as the concentration of drug increased this site would approach saturation and the low affinity Site 2 would bind increasing amounts of salicylate. At high salicylate levels the amount of drug bound by the low affinity sites. Computation also showed that when the total amount of protein in the analysis was reduced, from 5, 4, 3, to 2 gm%, as in hypoalbuminemia, the total amount of drug bound by the protein would decrease and the quantity of free drug would increase. The amount of drug bound by each of the two sets of sites also fell as the concentration of protein decreased. Some of the possible clinical implications of these findings are discussed.


The quality of mental disorder information websites: a review.
This paper reviews studies assessing the quality of websites providing information about mental disorders. The review included 31 articles identified by searching research databases in March 2010. Topics covered included affective disorders, anxiety disorders, eating disorders, substance use disorders and schizophrenia/psychosis. The largest number of articles (13) reported studies assessing affective disorder information quality. Methodologies varied in site selection and rating methods, with some of limited validity. Most concluded that quality was poor, although quality of affective disorder sites may be improving. There is currently very little understanding of the influence of website quality on user behaviour. Future quality assessments might use the criteria informed by key behaviour change theories. A possible approach to research on websites and user behaviour might be to develop an evaluation framework incorporating strategies from behaviour change models, key mental health literacy elements and health outcomes relevant to mental health promotion.


Clinical effectiveness of hemipelvic reconstruction using computer-aided custom-made prostheses after resection of malignant pelvic tumors.
This is a retrospective analysis of 16 patients with primary malignant pelvic tumors who underwent wide resection of the hemipelvis and consequent reconstruction between 2003 and 2007. Mean patient age was 27 years, whereas median follow-up was 36 months (range, 23-62 months). Hemipelvic prostheses were individually designed for each patient based on preoperative computed tomographic scans and consequent surgical modeling. The 3-year prosthesis survival rate was 69%. There were 3 cases of local recurrence (19%), and 4 patients died because of pulmonary metastases. The mean follow-up Musculoskeletal Tumor Society functional score was 72%. In conclusion, computer-aided custom-made hemipelvic prosthesis can be applied to quickly and effectively restore the bone defect after internal hemipelvectomy for treatment of pelvic tumors.


Modification of the Marmarou model in developing countries.
Head injury is an injury or wound of the brain tissue due to external forces; it can cause a decrease or change in the status of consciousness. Many head injury models have used mice as experimental animals; the Marmarou model is the most famous and the most widely-used diffuse brain injury model. In this study, we slightly modified the Marmarou model. The purpose of this study is to help researchers examining head injuries in mice, especially those in developing countries who have limited facilities and infrastructure. This experimental research uses animals models (Rattus novergicus, strain Sprague Dawley) that fit several criteria, including male, aged 10-12 weeks, and body weight of 200-300 g. This study involves a slight modification on the tube used, with a 20 cm-long weight of 20 g. The blood samples for the following assays of ELISA and brain tissue samples were collected at 24 h and 4, 5, 6, and 7 days post-trauma. A significant effect on the brain was seen with the Marmarou model modification, at a mass weight of 20 g and height of 20 cm, with 0.04 J energy produced. Changes were also seen in the histological features of brain tissue and the serum levels of AQP-4, F2 IsoPs, MPO, and VEGF from 24 h until 7 days after trauma. This report describes the development of an experimental head injury approach modifying the Marmarou model that is able to produce a diffuse brain injury model in mice.


Peroxisome proliferator activated receptors in Atlantic salmon (Salmo salar): effects on PPAR transcription and acyl-CoA oxidase activity in hepatocytes by peroxisome proliferators and fatty acids.
A cDNA fragment which encodes salmon peroxisome proliferator activated receptor y (sPPARgamma) was amplified by PCR from the liver of Atlantic salmon (Salmo salar L.). The fragment was 627 bp long. The sequence of the amplified PCR product was similar to the PPARgamma of mouse and hamster. 59% of the bases were identical. Northern blot analysis of salmon liver mRNA showed that the amplified sPPARgamma fragment hybridised to three specific transcripts of lengths 1.6, 2.4 and 3.3 kb. Clofibric acid and bezafibrate, administered to salmon hepatocytes in culture, resulted in a 1.7-fold increase of the 1.6 kb sPPARgamma transcript. The activity of acyl-CoA oxidase also increased approx. 1.7-fold after administration of fibrates. These results indicate that PPAR is an important factor in mediating enzymatic response to fibrates in fish.


Study of cerebral aneurysms in a modified rat model: from real-time imaging to histological analysis.
Cerebral aneurysm (CA) is a life-threatening condition with a pathogenesis that remains unclear. Previous hypotheses have primarily been based on in vitro examinations of animal models. Therefore, we attempted to observe CA in living rats and to establish a multi-level evaluation system. The rat model was produced by deoxycorticosterone-acetate (DOCA; Sigma Aldrich, St. Louis, MO, USA) induced hypertension and a single injection of elastase into the basal cistern. The animals were assessed 35 days later. At the endpoint, we induced well-developed CA in 41.7% of the surviving rats. Using synchrotron radiation angiography (SRA), we observed the experimental aneurysms and their surrounding arteries dynamically in the living model. Further anatomical and histological analyses demonstrated the typical degenerative changes of the mural structure and a major infiltration of macrophages into the aneurysmal wall. In conclusion, we visualised well-developed experimental CA in living rats using SRA and demonstrated the associated degenerative histological changes and macrophage involvement; thus, we have provided an effective model for the study of dynamic multi-level changes associated with CA in a rat model.


[Establishment of an experimental model with a high frequency of liver metastasis and recurrence from gastric VX2 cancer: histological analysis of the developmental process of primary and metastatic cancer lesions].
An experimental model with a high frequency of liver metastases and recurrence was established by the non-resection and resection of gastric cancer lesions induced with implanting VX2 cancer cells into the stomach of 35 rabbits. The frequency of liver metastases was 0% on Days 7 and 14, 40% on Day 21 and 60% on Day 28 in the non-resection group. In the resection group, primary lesions were resected on Days 7, 10 and 14, and the metastases were found in all the animals 14 days after the resection on Day 14, though they did not occur in every animal 18 and 21 days after the resection on Days 10 and 7. The metastatic lesions were found in the peri-lobular area, accompanied by cancer emboli in the interlobular veins. Vascular invasion was found in almost all (90%) the primary lesions of animals with liver metastases or recurrence. These results suggest that hepatic micrometastases occur between 10 and 14 days after implantation, and that vascular invasion plays an important role in the formation and extension of liver metastases or recurrence. They also suggest that this model is utilized as a useful tool for studying many aspects of liver metastases or recurrence in gastric cancer.


Clinical features and surgical outcomes of major urological interventions during cytoreductive surgery and hyperthermic intraperitoneal chemotheraphy.
Urinary system resections and reconstructions are needed in peritoneal carcinomatosis due to abdominal malignancies. The effect of hyperthermic intraperitoneal chemotherapy on these urological procedures after reconstruction remains uncertain. The aim of the study is to evaluate major urological interventions during cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in complex abdominal malignancies with peritoneal carcinomatosis. Forty-four cases underwent surgical intervention related to the urinary system among 208 cases who underwent cytoreductive surgery and hyperthermic intraperitoneal chemotherapy because of peritoneal carcinomatosis. Urinary system procedures performed in these patients (radical-partial cystectomy, partial ureter resection ureteroneocystostomy, ureteroureterostomy, nephrectomy) were evaluated in terms of postoperative morbidity-mortality and survival. Urinary system resections were performed during cytoreductive surgery in a total of 44 cases. The mean age was 54 years (20-73). Patients were diagnosed with peritoneal carcinomatosis due to colorectal cancer in 21 (47.8%), ovarian cancer in nine (20.4%), sarcomatosis in five (11.4%), cervical cancer in four (9%) and other cancers (mesothelioma, uterus, breast, gastric) in five (11.4%) cases. Total nephrectomy was performed in three cases and partial nephrectomy in one case. Cystectomy was performed in 21 cases; 16 of these were partial and five were total cystectomies. Ureteroureterocystostomy with double J was performed in four cases and ureteroneocystostomy in 12 cases. While Clavian-Dindo grade 3-4 complications were seen in nine cases (20.4%), three cases (6.8%) became exitus during the first 30-day follow-up. Although urinary system involvements have been regarded as inoperable in the past, we think that with adequate experience radical urinary interventions performed in suitable patients can be carried out with acceptable morbidity and mortality as seen in our series.


Impact of low molecular weight organic acids and dissolved organic matter on sorption and mobility of isoproturon in two soils.
Isoproturon is a selective herbicide belonging to the phenylurea family and widely used for pre- and post-emergence control of annual weeds. Soil amendments (e.g. organic compounds or dissolved organic matter) may affect environmental behavior and bioavailability of pesticides. However, whether the physiochemical process of isoproturon in soils is affected by organic amendments and how it is affected in different soil types are unknown. To evaluate the impact of low molecular weight organic acids (LMWOA) and dissolved organic matter (DOM) on sorption/desorption and mobility of isoproturon in soils, comprehensive analyses were performed using two distinct soil types (Eutric gleysols and Hap udic cambisols). Our analysis revealed that adsorption of isoproturon in Eutric gleysols was depressed, and desorption and mobility of isoproturon were promoted in the presence of DOM and LMWOA. However, the opposite result was observed with Hap udic cambisols, suggesting that the soil type affected predominantly the physiochemical process. We also characterized differential components of the soils using three-dimensional excitation-emission matrix (EEM) fluorescence spectroscopy and Fourier transform infrared (FT-IR) spectroscopy and show that the two soils displayed different intensity of absorption bands for several functional groups.


Persistent truncus arteriosus: twenty years experience in a tertiary care center in Taiwan.
Persistent truncus arteriosus (PTA) is a rare congenital heart disease. The disease spectrum and outcome in the Oriental are still unclear. A total of 35 patients with PTA were identified from the Pediatric Cardiology Database of this institution, giving an incidence of 0.47%. According to the Van Praagh classification, we found type A1 in 16, A2 in 10, A3 in 4 and A4 in 5 patients. The most common truncal valves were still tricuspid (57.1%) and quadricuspid (28.5%), with the latter being associated with moderate to severe truncal regurgutation. Eleven patients had not received surgery and all died. We classified the era of operation as early (between 1980 and 1995) or late (1996-2001), and further classified the type of PTA as simple (type A1 or A2) or complex (interrupted aortic arch-A4, absent orifice of one PA from truncal root-A3 or moderate truncal valve insufficiency). The overall surgical mortality was 67%. Statistical analysis revealed that age at operation (older than 6 months), early operation era and complex PTA were risk factors for survival. PTA is a rare form of congenital heart disease in Taiwan and probably also in the Oriental. The surgical reparation seems to improve with experience. Early operation may prevent pulmonary vasculopathy. However, the results in complex PTA remain poor.


Male rats with the testicular feminization mutation of the androgen receptor display elevated anxiety-related behavior and corticosterone response to mild stress.
Testosterone influences the hypothalamic-pituitary-adrenal axis, anxiety-related behavior, and sensorimotor gating in rodents, but little is known about the role of the androgen receptor (AR) in mediating these influences. We compared levels of the stress hormone corticosterone at baseline and following exposure to a novel object in an open field in wild type (wt) male and female rats, and male rats with the testicular feminization mutation (Tfm) of the AR, which disables its function. Basal corticosterone was equivalent in all groups, but exposure to a novel object in an open field elicited a greater increase in corticosterone in Tfm males and wt females than in wt males. Tfm males also showed increased behavioral indices of anxiety compared to wt males and females in the test. Analysis of the immediate early gene c-Fos expression after exposure to a novel object revealed greater activation in Tfm males than wt males in some regions (medial preoptic area) and lesser activation in others (dentate gyrus, posterodorsal medial amygdala). No differences were found in a measure of sensorimotor gating (prepulse inhibition of the acoustic startle response), although Tfm males had an increased acoustic startle response compared to wt males and females. These findings demonstrate that ARs play a role in regulating anxiety-related behaviors, as well as corticosterone responses and neural activation following exposure to a mild stressor in rats.


Cytokine profile in autosomal dominant polycystic kidney disease.
To elucidate the pathogenetic mechanism of renal parenchymal injury in autosomal dominant polycystic kidney disease (ADPKD) patients, typically characterized by renal cystic changes paralleled by interstitial inflammation and gradual fibrotic changes, the role of selected inflammatory mediators was evaluated in a group of ADPKD patients with normal glomerular filtration rate. The plasma concentrations of IL-6, IL-8, ICAM-1 and VCAM-1 (which may reflect systemic response to inflammation/infection) were increased in the ADPKD patient group. Coupled with decreased urinary excretion of the IL-1 receptor antagonist (which exerts an anti-inflammatory role), these results suggest that even in overt infection free status, the proinflammatory system is more activated and anti-inflammatory defence system weakened in ADPKD subjects. Our data support the current view that cytokines are candidate contributors to pathogenesis of ADPKD.


Responses of conduct-disordered versus psychotic adolescents to PPVT-R items of human versus nonhuman content.
24 conduct-disordered youth were compared with 22 psychotic youth on differential responsivity to human versus nonhuman content plates on the PPVT-R. Conduct-disordered youth performed worse on items featuring human stimuli, implying antisocial patterns which might correlate with more active avoidance of social relating.


Retroversion of the humeral head in the normal shoulder and its relationship to the normal range of motion.
Retroversion of the humeral head and the range of motion of the shoulder joint in both the frontal and the scapular plane have been studied in 100 shoulder joints in 50 healthy subjects, 25 men and 25 women. The average angle for humeral head retroversion was 33 degrees on the dominant side and 29 degrees for the nondominant side. There was no difference between genders. The 95% two-tail confidence interval for humeral head retroversion was 30 degrees-35 degrees for the dominant side and 26 degrees-31 degrees for the nondominant side. A larger retroversion angle was consistent with an increased range of external rotation. Mean external rotation in 90 degrees abduction was 105 degrees in the frontal plane and 120 degrees in the scapular plane. External rotation in 90 degrees abduction was greater in women than in men, but there was no difference between dominant and nondominant shoulder joints. The range of motion of rotation was found to be greater than the accepted normal values.


Regulator of the mucoid phenotype A gene increases the virulent ability of extended-spectrum beta-lactamase-producing serotype non-K1/K2 Klebsiella pneumonia.
To determine whether the presence of a capsule regulator gene [i.e., regulator of mucoid phenotype A (rmpA) gene] contributes to virulence on extended-spectrum β-lactamase-producing Klebsiella pneumoniae (ESBL-KP) with serotype non-K1/K2 strains. Twenty-eight ESBL-KP and non-ESBL-KP isolates were collected from the Tri-Service General Hospital (Taipei, Taiwan). The impact of the virulent rmpA gene in different capsular polysaccharide serotypes on ESBL-KP and non-ESBL-KP isolates was studied by a neutrophil phagocytosis reaction, a serum bactericidal assay, and an animal survival model. Resistance to broad spectrum antibiotics was more prevalent in ESBL-KP strains than in non-ESBL-KP strains (p < 0.01). The ESBL-KP strains had different molecular patterns from non-ESBL-KP strains, based on pulsed-field gel electrophoresis. The frequency of serum-resistant isolates was the highest among ESBL-KP strains with rmpA (i.e., rmpA(+)) [71.4% (5/7)] than among of non-ESBL-KP rmpA(+) strains [42.8% (6/14)], ESBL-KP strains without rmpA (rmpA(-)) [33.3% (7/21)], and non-ESBL-KP rmpA(-) strains [14.2% (2/14)]. The most significant increase in neutrophil resistance occurred in the ESBL-KP rmpA(+) strains in comparison to the non-ESBL-KP rmpA(+), ESBL-KP rmpA(-), and non-ESBL-KP rmpA(-) strains (p < 0.01). The results of the animal survival model were compatible with the neutrophil phagocytosis reaction and serum bactericidal assay. We conclude that the pathogenic potential is greater in rmpA(+) ESBL-KP strains than in rmpA(-) ESBL-KP and non-ESBL-KP strains.


Detection of left ventricular systolic and diastolic abnormalities in patients with coronary artery disease by color kinesis.
Color kinesis (CK) is a recently developed echocardiographic technique based on acoustic quantification that automatically tracks and displays endocardial motion in real time and has been used in initial studies to improve the evaluation of global and regional wall motion. For further validation of the use of CK for analysis of segmental ventricular dysfunction, we assessed its sensitivity and specificity for detection of regional systolic and diastolic wall motion abnormalities in patients with coronary artery disease (CAD). Two-dimensional (2-D) echocardiography and CK were used to study 15 normal subjects and 63 patients with technically good quality echocardiographic tracings, who underwent coronary arteriography within 1 month of echocardiography. Significant (> 70% luminal diameter stenosis) CAD was present in 50 patients (79%). Color kinesis tracked endocardial motion accurately in 93% of left ventricular segments. Wall motion score, systolic segmental endocardial motion (SEM), and the time of systolic SEM (tSEM) and diastolic (tDEM) segmental endocardial motion were calculated. Intra- and interobserver variability were within narrow limits. SEM and tSEM were significantly lower and tDEM was significantly higher in the patient population than in the control group (p < 0.001). Comparison between CK and 2-D echocardiography showed a correlation coefficient of 0.81 between the two techniques. The score was identically graded in 74% of segments, with concordance of 82% in diagnosing segments as abnormal. Interobserver concordance was 86% for CK (r = 0.85) and 81% for 2-D echocardiography (r = 0.80). The sensitivity and specificity of systolic and diastolic CK parameters for the detection of CAD were 88 and 92% and 77 and 85%, respectively. The positive predictive values were 93 and 96%, respectively, the negative predictive values were 63 and 73%, respectively, and the overall accuracy was 86 and 91%, respectively. Our data suggest that CK is a feasible and sensitive technique for identifying regional systolic as well as diastolic wall motion abnormalities in patients with CAD.


Effects of postoperative adjuvant radiotherapy on recurrence and survival in stage III rectal cancer.
The aim of this study is to evaluate whether the addition of radiotherapy to chemotherapy would enhance the benefits obtained with chemotherapy alone, in stage III rectal cancer in the era of preoperative chemoradiotherapy and total mesorectal excision (TME). From January 1999 to January 2008, 300 stage III rectal cancer patients who underwent TME were prospectively identified; a total of 46 patients who received preoperative chemoradiotherapy or did not receive adjuvant therapy were excluded. Patients who received postoperative chemotherapy alone (n=190) and those who received postoperative chemoradiotherapy (n=64) were compared. The median follow-up period was 52 (range, 4-129) months. Patients receiving radiotherapy were younger and had a higher percentage of advanced pT category or perineural invasion than patients who did not. The estimated 5-year local recurrence-free survival rate was radiotherapy 92% with radiotherapy and 86% without. The disease-free survival rate was 55% with radiotherapy compared to 57% without and the overall survival rates were similar (63% vs. 68%, all P>0.05). In patients with a positive circumferential resection margin or insufficient distal resection margin, the local recurrence-free, disease-free, and overall survival rates were unaffected by radiotherapy. The addition of postoperative radiotherapy to chemotherapy did not reduce the recurrence or mortality in node-positive rectal cancer when compared with chemotherapy alone. Moreover, this approach may not compensate for a positive circumferential resection margin or insufficient distal resection margin following rectal cancer surgery.


Noradrenergic regulation of period1 expression in spinal astrocytes is involved in protein kinase A, c-Jun N-terminal kinase and extracellular signal-regulated kinase activation mediated by α1- and β2-adrenoceptors.
Our recent data suggest that noradrenaline (NA) regulates expression of Per1 mRNA in rat C6 cells, as a model of brain astrocytes, by two distinct NA-mediating pathways. Although C6 cells possess potential astrocyte-type characteristics, we hypothesize that astrocytes located in a distinct tissue or organ play specific roles consistent with their own unique functions in response to the surrounding environment. We have herein found in primary rat spinal astrocytes using real-time RT-PCR that NA induced robust transient increases in Per1, Cry1, Cry2 and Bmal1 mRNA expression. Cry1, Cry2 and Bmal1 expressions induced by NA were attenuated by transfection of Per1 small interference RNA (siRNA). The effect of NA on Per1 expression was partially blocked by either prazosin (a selective antagonist of α1-adrenoceptor) or ICI118551 (a selective antagonist of β2-adrenoceptor), and completely blocked by the combination of both antagonists. Treatment with H89 (a protein kinase A [PKA] inhibitor), SP600125 (a c-Jun N-terminal kinase [JNK] inhibitor), or PD98059 (an extracellular signal-regulated kinase [ERK] inhibitor), partially inhibited NA-induced Per1 mRNA expression, and the combination of these three inhibitors inhibited expression to nearly a non-stimulated level. Furthermore, NA phosphorylated not only ERK but also JNK1, an effect that was detected by western blotting. These actions were inhibited only by prazosin, and not by ICI118551. In addition, we found that NA induced phosphorylation of transcription-related proteins such as cAMP response element binding protein (CREB) and c-Jun. These phosphorylation processes were regulated through distinct pathways: CREB phosphorylation was dependent on the PKA and JNK pathways but c-Jun phosphorylation was mediated by the ERK and JNK pathways. These results suggest that Per1 plays a key role in noradrenergic regulation on clock gene expression in spinal astrocytes and activation of α1 and β2 adrenoceptors are of importance in regulation of Per1 mRNA expression via PKA/JNK-CREB and ERK/JNK-c-Jun cascades.


Successful preemptive renal retransplantation in a patient with previous acute graft loss secondary to HIT type II: a case report and review of literature.
Type II heparin-induced thrombocytopenia (HIT II) is an immune-mediated reaction to heparin administration associated with thrombocytopenia and thrombotic complication with potentially serious outcome. We report a case of a 50-year-old man with history of autosomal dominant polycystic kidney disease (ADPKD), homocystinemia, and history of deep vein thrombosis (DVT), who was switched to intravenous heparin from oral coumadin preoperatively in preparation for preemptive living related renal transplant. Following the operation heparin-induced thrombocytopenia type II lead to graft renal artery thrombosis and subsequent graft loss. One year after first transplant patient underwent successful second living unrelated kidney transplantation with no complications with continued anticoagulation with coumadin and with no reexposure to heparin. Two years after the second transplant and 1 year after stopping anticoagulation, patient was readmitted with bilateral lower extremity DVT and high probability of pulmonary embolism. He was given argatroban on admission as a bridge to anticoagulation with lifelong coumadin therapy and is doing well with excellent graft function. To our knowledge, this is the third reported case of HIT in renal transplantation, second reported case associated with graft loss secondary to HIT and the first reported case of successful retransplantation after initial HIT with graft loss. Heparin-induced thrombocytopenia in transplantation can lead to catastrophic consequences in organ recipients. Successful management of this condition emphasizes promptness of diagnosis and treatment and complete cessation of heparin exposure.


The King's Cross fire. Part 2: The psychological injuries.
This paper describes the experiences of six people who received severe burns in the King's Cross Underground Station fire of 1987. They all developed post-traumatic stress disorder to varying levels of intensity and the problems of psychological intervention as they related to the patients' different mental defence mechanisms are outlined.


Clinical and pathologic features of invasive micropapillary carcinoma.
Invasive micropapillary carcinoma(IMC)of the breast is a rare subtype of breast carcinoma that has an extremely high incidence of lymph node metastases and poor clinical outcome. This histological subtype of breast carcinoma has remained unclear due to the rarity of cases. Many questions exist on the clinicopathological significance of this subtype, especially regarding prognosis. We reviewed all 671 cases of primary breast carcinoma that were surgically resected at our institute between 1990 and 2004. Of these, 27 cases of invasive ductal carcinoma of the breast with a pure or partial micropapillary component were reported. The cases were analyzed using various parameters, including age at presentation, tumor size, tumor grade, presence of lymphatic invasion, and axially lymph node status. The patients' age at presentation ranged from 31 to 74 years (mean 52.4 years). Tumor size ranged from 0.7 to 10 cm (mean 4 cm). 88.9% (24 of 27) of the cases had lymphatic invasion. Of cases who underwent with axillary dissection, 66.6% (18 of 27) had positive lymph nodes. Clinical follow up data were available for 17 cases with IMC for 1 to 72 months. Among these, 10 patients died from breast carcinoma within 5 years. While our series is too small to make conclusions about the behavior of IMC, the difference in 6-year survival rate between the patients with IMC and those with breast carcinoma in general was statistically significant. Recognition of this distinctive and aggressive variant of infiltrating carcinoma is important because of its poor prognosis and high incidence of lymph node metastases.


Repression of mitochondrial metabolism for cytosolic pyruvate-derived chemical production in Saccharomyces cerevisiae.
Saccharomyces cerevisiae is a suitable host for the industrial production of pyruvate-derived chemicals such as ethanol and 2,3-butanediol (23BD). For the improvement of the productivity of these chemicals, it is essential to suppress the unnecessary pyruvate consumption in S. cerevisiae to redirect the metabolic flux toward the target chemical production. In this study, mitochondrial pyruvate transporter gene (MPC1) or the essential gene for mitophagy (ATG32) was knocked-out to repress the mitochondrial metabolism and improve the production of pyruvate-derived chemical in S. cerevisiae. The growth rates of both aforementioned strains were 1.6-fold higher than that of the control strain. 13C-metabolic flux analysis revealed that both strains presented similar flux distributions and successfully decreased the tricarboxylic acid cycle fluxes by 50% compared to the control strain. Nevertheless, the intracellular metabolite pool sizes were completely different, suggesting distinct metabolic effects of gene knockouts in both strains. This difference was also observed in the test-tube culture for 23BD production. Knockout of ATG32 revealed a 23.6-fold increase in 23BD titer (557.0 ± 20.6 mg/L) compared to the control strain (23.5 ± 12.8 mg/L), whereas the knockout of MPC1 revealed only 14.3-fold increase (336.4 ± 113.5 mg/L). Further investigation using the anaerobic high-density fermentation test revealed that the MPC1 knockout was more effective for ethanol production than the 23BD production. These results suggest that the engineering of the mitochondrial transporters and membrane dynamics were effective in controlling the mitochondrial metabolism to improve the productivities of chemicals in yeast cytosol.


Influence of retinoids on phosphatidylethanolamine lipid polymorphism.
The interaction of all-trans-retinoic acid and all-trans-retinol with dielaidoylphosphatidylethanolamine has been studied by differential scanning calorimetry and 31P-NMR spectroscopy. Increasing concentrations of all-trans-retinoic acid up to a mol fraction of 0.09 were found to induce shifts to lower temperatures of both the L beta to L alpha and L alpha to hexagonal-HII phase transitions, with a slight decrease in the enthalpy change of the transitions. At higher concentrations no further effects on the transitions were observed, and this is interpreted as indicative of a limited miscibility of retinoic acid with the phospholipid. 31P-NMR spectroscopy confirmed that the L alpha to hexagonal-HII phase transition was shifted to lower temperatures in the presence of retinoic acid. On the other hand increasing concentrations of all-trans-retinol up to a mol fraction of 0.166, induced a progressive shift of the L beta to L alpha and the L alpha to hexagonal-HII phase transitions to lower temperatures. At higher concentrations the main gel to liquid-crystalline phase transition was further displaced to lower temperatures and the lamellar to hexagonal-HII phase transition was not observed in the thermograms. 31P-NMR spectroscopy indicated that retinol was able of inducing the phospholipid to adopt the hexagonal-HII phase at temperatures even below the main gel to liquid-crystalline phase transition temperature of the pure phospholipid.


Exploring nature's plasticity with a flexible probing tool, and finding new ways for its electronic distribution.
Concepts and results are described for the use of a single, but extremely flexible, probing tool to address a wide variety of genomic questions. This is achieved by transforming genomic questions into a software file that is used as the design scheme for potentially any genomic assay in a microarray format. Microarray fabrication takes place in three-dimensional microchannel reaction carriers by in situ synthesis based on spatial light modulation. This set-up allows for maximum flexibility in design and realization of genomic assays. Flexibility is achieved at the molecular, genomic and assay levels. We have applied this technology to expression profiling and genotyping experiments.


Phototherapeutic keratectomy for BIGH3-linked corneal dystrophy recurring after penetrating keratoplasty.
To determine visual results and report side effects and complications after phototherapeutic keratectomy (PTK) for BIGH3-linked corneal dystrophy recurring after penetrating keratoplasty. Retrospective noncomparative case series. Forty-two excimer laser PTK procedures were performed in 42 eyes of 29 patients with BIGH3-linked corneal dystrophies. Genetic status of all patients was determined and allowed us to assess an unambiguous diagnosis. Preoperative diagnoses included LCDIIIA/A546T (1 eye), R124 l+DT125-DE126 (4 eyes), GICD/R555W (14 eyes), LCDI/R124C (6 eyes), SGD/R124 l (16 eyes), and CDBII/R555Q (1 eye). Two excimer lasers (Summit Excimed UV 200, Summit Technology, Waltham, MA and Nidek EC 5000, Nidek, Inc., Gamagori, Japan) were used to perform all PTKs. Indications for performing PTK after a graft were severe decrease of the best-corrected visual acuity (BCVA) related to recurrent corneal deposits and/or painful recurrent epithelial erosions. Preoperative and postoperative BCVA were analyzed, significant recurrences after treatment were noted, and postoperative complications were recorded. Mean preoperative BCVA was 0.2 +/- 0.12 in the decimal chart, mean postoperative BCVA was 0.52 +/- 0.16 with a mean follow-up of 3.13 +/- 1.77 years (range, 0.3-6.65 years). Visual acuity was significantly improved after surgery (P < 0.05). The magnitude of the change in visual acuity was dependent on the mutation (P < 0.001). Seven symptomatic recurrences were observed. One regressive graft rejection and 4 cases of severe postoperative haze were observed. No other complications were noted. PTK is a simple, safe, and efficient technique for the treatment of recurrent corneal dystrophies; in many cases it prevents or delays the major incumbent problems of repeated grafting.


[Tenosynovitis in chronic inflammatory joint diseases and its sequelae in the area of the hand].
The synovial lining of tendons may participate early in chronic rheumatic diseases. As a result of the inflammatory activity degenerative changes of tendons may occur. Increasing damage to tendons ends in their rupture. At 775 tenosynovectomies, 395 of them in chronic rheumatic diseases, in 68 patients (78 hands) 173 ruptures of tendons (14 flexors, 159 extensors) were found. The value of early tenosynovectomy as a preventive measure is emphasized.


An outbreak of carbapenem-resistant Acinetobacter baumannii infection in a neonatal intensive care unit: investigation and control.
To investigate the mode of transmission of and assess control measures for an outbreak of carbapenem-resistant (multidrug-resistant) Acinetobacter baumannii infection involving 6 premature infants. An outbreak investigation based on medical record review was performed for each neonate during the outbreak (from November 2008 through January 2009) in conjunction with an infection control investigation. A 36-bed, level 3 neonatal intensive care unit in a university-affiliated teaching hospital in Detroit, Michigan. Specimens were obtained for surveillance cultures from all infants in the unit. In addition, geographic cohorting of affected infants and their nursing staff, contact isolation, re-emphasis of adherence to infection control practices, environmental cleaning, and use of educational modules were implemented to control the outbreak. Six infants (age, 10-197 days) with multidrug-resistant A. baumannii infection were identified. All 6 infants were premature (gestational age, 23-30 weeks) and had extremely low birth weights (birth weight, 1000 g or less). Conditions included conjunctivitis (2 infants), pneumonia (4 infants), and bacteremia (1 infant). One infant died of causes not attributed to infection with the organism; the remaining 5 infants were discharged home. All surveillance cultures of unaffected infants yielded negative results. The spread of multidrug-resistant A. baumannii infection was suspected to be due to staff members who spread the pathogen through close contact with infants. Clinical staff recognition of the importance of multidrug-resistant A. baumannii recovery from neonatal intensive care unit patients, geographic cohorting of infected patients, enhanced infection control practices, and staff education resulted in control of the spread of the organism.


Dependence of ultrasonic attenuation of liver on pathologic fat and fibrosis: examination with experimental fatty liver and liver fibrosis models.
To clarify the effect of the pathological state of the liver on ultrasonic attenuation, we produced two experimental rabbit models. The influence of fat on ultrasonic attenuation was examined using a fatty liver model without liver fibrosis, and that of fibrosis on attenuation using a liver fibrosis model without fatty infiltration. Ultrasonic data were obtained in vivo directly from the liver, and an acoustic attenuation coefficient slope was obtained by the spectral difference method. Tissue components of the liver, namely the total lipid, hydroxyproline and water contents, were measured precisely by quantitative methods. We revealed that ultrasonic attenuation depends mainly on fatty infiltration of the liver and to a lesser extent on fibrosis, but not on the water content.


Diagnosis of innervation-related motility disorders of the gut and basic aspects of enteric nervous system development.
Motility disorders of the gut in children have become a matter of increasing concern for the pediatric surgeon. Infantile hypertrophic pyloric stenosis is the most common disease requiring surgery in early infancy. While this entity was first described as early as 1888 by Hirschsprung, its etiology and pathogenesis are still an enigma. Fortunately, its surgical treatment is simple and safe, which cannot be said of all other motility disorders of the infantile gut. Dysmotility in small bowel atresia and in gastroschisis is related to damaged smooth muscle cells caused by concomitant ischemia of the bowel wall. In contrast, the temporarily adynamic bowel of the prematurely born child, as well as Hirschsprung's disease and related disorders, is the result of anomalies of the intestinal innervation. The pathogenesis of congenital malformations of the enteric nervous system is still a mystery to surgeons and physicians alike. With his pressure studies of the colon, Swenson first recognized Hirschsprung's disease for what it was. This led to the resection of the manometrically diagnosed abnormal colon, which was found to be aganglionic. Histological investigation of the bowel wall became the decisive tool, replacing manometry, in the diagnosis of Hirschsprung's disease. Histochemical investigation of the bowel wall is not conclusive in other malformations of the enteric nervous system, since the presence or absence of enteric neurons is not the definitive factor discriminating between normally and abnormally functioning bowel. Monoclonal antibodies raised against neuron-specific markers may become important tools for differentiation within the spectrum of congenital malformations of the enteric nervous system. The immunocytochemical technique, however, does not provide sufficient information to explain the cause of innervation disorders of the gut in infancy and childhood. Primary migration disturbances or selective disappearance of enteric neurons following ischemia are highly unlikely to cause aganglionosis of the gut. With respect to the pathogenesis and etiology of Hirschsprung's disease, current research is focused on the embryonic bowel (target organ) in plexus formation. The enteric nervous system is still an enigma, although its origin is known, at least in birds. Why neural crest cells travel, along what paths, how they reach their destination, and what may go wrong during the migratory process, are questions that must be answered. There is increasing knowledge concerning the way in which neural crest cells aggregate and form plexuses in the gut. It is largely unknown why neural crest cells settle, in the bowel, at the sites of the myenteric and submucous plexus.(ABSTRACT TRUNCATED AT 400 WORDS)


The Absence of Mutations in the Exon 2 KRAS Gene in Several Ethnic Groups in North Sumatra May Not the Main Factor for Lung Cancer.
Rat Sarcoma (RAS) protein encoded Guanosine Triphosphate (GTP-ase) activity, known as a switch of cell proliferation. The mutation of this protein alters the early stage of carcinogenesis and along with the interaction with other oncogene drivers and environmental factors affect the clinical characteristics and prognosis in cancer patients, particularly lung cancer. This study aims to determine the Kristen Rat Sarcoma (KRAS) mutation in lung cancer patients in North Sumatera and evaluate factors that might contribute in the development of lung cancer in the absence of KRAS mutation. This was a retrospective cohort study enrolled 44 subjects age > 18 year with the diagnosis of lung cancer. Histopathology preparation was obtained from surgery, bronchoscopy, and percutaneus needle biopsy then formed as paraffin-block. KRAS mutation was analyzed using Polymerase Chain Reaction (PCR) method with specific primer of exon 2 for evaluating the expression of RAS protein then continued with Sanger Sequencing Method at 12th and 13th codon. The majority of subjects were male, age > 40 years old, bataknese, heavy smoker, with Adenocarcinoma. Almost all the subjects showed the expression of exon 2 of RAS protein in PCR examinations. However, Sequencing analysis using Bioedit Software, BLASTs and Finch T showed GGT GGC as protein base 219-224 which represented 12th and 13th Codon 12 and 13. The results interpreted there was no mutations of exon 2 of KRAS in North Sumatera Population. The absence of KRAS mutation in exon 2 in several ethnics in North Sumatera populations was not the main factors of lung cancer.


Plastocyanin conformation: the effect of the oxidation state on the pKa of nitrotyrosine-83.
Plastocyanin treated with tetranitromethane was nitrated at a single location, Tyr-83. Tyr-83 and its neighboring negative charges have been implicated as a binding site for positively charged redox agents (Chapman, S.K., Watson, A.D. and Sykes, A.G. (1983) J. Chem. Soc. Dalton Trans. 1983, 2543-2548). No effect was observed on either the plastocyanin midpoint redox potential or its reaction kinetics with P-700+ and cytochrome f. This makes nitration an ideal spectroscopic probe for monitoring changes in the environment of Tyr-83. The pKa of the nitrotyrosine was 8.6 and 8.3 for reduced and oxidized plastocyanin, respectively, indicating that the charge on the copper atom is 'felt' at Tyr-83. The high pKa value for both forms indicates that Tyr-83 is in a negatively charged environment, near residues Nos. 42-45 and Nos. 59-61. The extinction of the nitrotyrosine chromophore at 360 nm was not affected by a change in redox state. However, the ellipticity of this transition was greater for the oxidized form, indicating that environment of Tyr-83 is dependent upon the charge on the copper atom. This suggests an electrostatically driven conformational change at Tyr-83. A conformational change at Tyr-83 could regulate the binding of plastocyanin with its reaction partners in order to promote smooth electron transport.


Effects of lidocaine-induced inactivation of the bed nucleus of the stria terminalis, the central or the basolateral nucleus of the amygdala on the opponent-process actions of self-administered cocaine in rats.
In addition to its rewarding actions, cocaine has profound negative effects that are unmasked as the rewarding impact of the drug fades. While much is known about the neurobiology of cocaine reward, the mechanisms underlying the negative actions of the drug remain unclear. The current study investigates the role of three brain regions each implicated in the modulation of negative affective states-the bed nucleus of the stria terminalis (BNST), the central (CeA), and the basolateral (BLA) nucleus of the amygdala. The dual actions of cocaine were assessed using a runway self-administration procedure in which rats exhibit both approach to and avoidance of a goal box associated with cocaine administration (retreat behaviors). Here, rats ran a straight alley once/day for i.v. cocaine (1.0 mg/kg/injection) over 14 days during which the BNST, CeA, or BLA was inactivated via bilateral intracranial infusions of lidocaine (0 or 20 μg/0.5 μl/side) administered 15 min prior to testing. The impact of lidocaine on spontaneous locomotor activity was also assessed to rule out nonspecific actions of the treatments. Control animals running for cocaine developed the expected pattern of approach-avoidance retreat behavior. Inactivation of the BNST attenuated such behavior, BLA inactivation had no appreciable effects, and CeA inactivation produced intermediate and more variable results. Locomotor activity was unaffected by any of the treatments. These data suggest that the BNST and to a lesser extent the CeA, but not the BLA, play a role in mediating the opponent-process actions of self-administered cocaine.


S-(1,2-dichlorovinyl)-L-homocysteine-induced cytotoxicity in isolated rat kidney cells.
Incubation of isolated, rat kidney cells with S-(1,2-dichlorovinyl)-L-homocysteine (DCVHC) caused time-dependent cell death. Cytotoxicity of DCVHC was potentiated by addition of alpha-ketobutyrate, indicating the involvement of pyridoxal phosphate-dependent enzymes. A second addition of DCVHC to cells produced increased cytotoxicity, indicating that the bioactivating ability is not lost after exposure to the conjugate. DCVHC decreased cellular glutathione concentrations by 52% and substantially inhibited glutathione biosynthesis from precursors. In contrast, the cysteine analog S-(1,2-dichlorovinyl)-L-cysteine (DCVC) failed to decrease cellular glutathione concentrations and only partially inhibited glutathione biosynthesis. As with DCVC, DCVHC did not increase cellular glutathione disulfide concentrations and did not initiate lipid peroxidation, indicating that it does not produce an oxidative stress. DCVHC and DCVC produced similar alterations in mitochondrial function: Cellular ATP concentrations were decreased by 57% and cellular ADP and AMP concentrations were increased twofold, thereby decreasing the ATP/ADP ratio from 2.8 to 0.6 and the cellular energy charge from 0.80 to 0.56; DCVHC was a potent inhibitor of succinate-dependent oxygen consumption, but had little effect on respiration linked to oxidation of glutamate + malate or ascorbate + N,N,N'N'-tetramethyl-p-phenylenediamine. DCVHC was a potent inhibitor of mitochondrial Ca2+ sequestration and, in contrast to DCVC, also inhibited microsomal Ca2+ sequestration. These DCVHC-induced alterations in cellular metabolism were prevented by addition of propargylglycine or aminooxyacetic acid, and the alpha-methyl analog S-(1,2-dichlorovinyl)-DL-alpha-methylhomocysteine was not toxic. These results support a role for pyridoxal phosphate-dependent bioactivation of DCVHC and indicate that the greater nephrotoxic potency of DCVHC as compared to DCVC is partially due to the presence of both mitochondrial and extramitochondrial targets for DCVHC.


Airway reactivity response to aged carbon-graphite/epoxy composite material smoke.
Exposure of naïve guinea pigs for a total of 30 min to aged smoke from pyrolysis of 5, 10 and 100 g of carbon-graphite/epoxy-advanced composite material (cgeCM) elicited changes in the ventilation and breathing pattern reminiscent of an acute, asthmatic episode. The severity of these responses was dose related. Although breathing pattern changes were not definitive of stimulation by a single type of respiratory irritant, non-dimensional indices derived from breath structure appeared to be characteristic of bronchoconstriction possibly complicated by CO(2)-stimulated ventilation. The highest exposure concentration also elicited convulsions in the animals, which may or may not be related to the airway reactivity (AR) response. Upon treatment with fresh air, breathing returned to normal. However, this recovery was transient with some respiratory parameters returning to abnormal levels, possibly indicating a rebound or delayed component of the response. Filtration of particulate material from the smoke moderated but did not eliminate the AR response. Animals exposed to diluted smoke from the pyrolysis of 2 g of cgeCM showed no remarkable changes in breathing or ventilation, suggesting that there may be a threshold for aged cgeCM smoke-elicited AR response.


Complications in surgery of the colon and rectum.
Postoperative complications after surgery of the colon and rectum are related most often to sepsis, anastomotic disruption, hemorrhage, urinary tract injury, bowel stoma, and sexual dysfunction. Improved safety in colorectal surgery requires comprehensive preparation of the patient with attention to associated diseases, clear surgical judgement, excellence in technical skill, and aggressive postoperative management of any complications that may develop.


A comparison of oral and intravenous pimonidazole in canine tumors using intravenous CCI-103F as a control hypoxia marker.
Pimonidazole HCl is widely used in immunohistochemical analyses of hypoxia in normal and malignant tissues. The present study investigates oral administration as a means of minimizing invasiveness. Twelve dogs with confirmed malignancy received 0.5 g/m2 of pimonidazole HCl: 6 by mouth and 6 by i.v. infusion. All dogs received i.v. CCI-103F as a control. Plasma levels of pimonidazole, pimonidazole N-oxide, and CCI-103F were measured. Tumor biopsies were formalin fixed, paraffin embedded, sectioned, immunostained, and analyzed for pimonidazole and CCI-103F binding. pH dependence for pimonidazole and CCI-103F binding was studied in vitro. Pimonidazole and CCI-103F binding in carcinomas and sarcomas was strongly correlated for both oral and i.v. pimonidazole HCl (r2=0.97). On average, the extent of pimonidazole binding exceeded that for CCI-103F by a factor of approximately 1.2, with the factor ranging from 1.0 to 1.65. Binding of both markers was pH dependent, but pimonidazole binding was greater at all values of pH. Oral pimonidazole HCl is effective as a hypoxia marker in spontaneously arising canine tumors. Selective cellular uptake and concomitant higher levels of binding in regions of hypoxia at the high end of pH gradients might account for the greater extent of pimonidazole binding.


Assessment of safety and efficacy of a bipolar fractionated radiofrequency device in the treatment of photodamaged skin.
A number of devices are available for skin rejuvenation and conventional devices include both ablative and non-ablative lasers. More recently, bipolar fractionated radiofrequency (RF) devices have been introduced. To evaluate the safety and efficacy of a novel 144 pin high density tip bipolar fractionated radiofrequency (RF) device for skin rejuvenation in Fitzpatrick skin types I-IV. This single-center, prospective, study enrolled 25 female between the ages of 35-60 years, with mild to moderate wrinkling based on the Fitzpatrick Wrinkle Scale. The subjects were of Fitzpatrick skin types I-IV. Each subject underwent 3 full-face treatments with a 144 pin fractional bipolar RF device at 30-day intervals. All subjects underwent clinical evaluations during the study period to evaluate for any adverse events. Subsequently, all subjects were evaluated for improvement in rhytides, dyschromias and skin texture based on photographic evaluation by blinded investigators at 6 months following the final RF treatment. A statistically significant improvement in rhytides, dyschromias and texture was noted. Adverse events were limited to mild erythema and swelling. Post-inflammatory pigmentary changes were not observed in any subjects. The novel 144 pin high density tip bipolar fractionated RF device is both safe and effective for facial skin rejuvenation in Fitzpatrick skin types I-IV.


Visceral fat and beta cell function in non-diabetic humans.
Preferential visceral adipose tissue (VAT) accumulation has been clearly associated with insulin resistance. In contrast, the impact of visceral obesity on beta cell function is controversial. In 62 non-diabetic women and men (age 24-69 years, BMI 21-39 kg/m2), we measured VAT and subcutaneous adipose tissue (SAT) fat mass by magnetic resonance imaging. We also measured insulin secretion and beta cell function by C-peptide deconvolution and physiological modelling of data from a frequently sampled, 75-g, 3-h OGTT, respectively. VAT (range 0.1-3.1 kg) was strongly related to sex, age and BMI; SAT was related to sex and BMI. Controlling for sex, age, BMI and SAT by multivariate analysis, excess VAT was associated with a clinical phenotype comprising higher plasma glucose levels, BP, heart rate and serum transaminases. The corresponding metabolic phenotype consisted of insulin resistance (partial r=-0.38) and hyperinsulinaemia (partial r=0.29). The latter, however, was appropriate for the degree of insulin resistance regardless of obesity and abdominal fat distribution. Moreover, none of the model-derived parameters describing beta cell function (glucose sensitivity, rate sensitivity and potentiation) was independently associated with excess VAT. In non-diabetic Caucasian adults of either sex, preferential visceral fat deposition in itself is part of an insulin-resistant phenotype. The insulin secretory response to a physiological challenge is increased to fully compensate for the insulin resistance, but the dynamics of beta cell function (glucose sensitivity, rate sensitivity and potentiation) are largely preserved.


Characterization of Astrocyte Morphology and Function Using a Fast and Reliable Tissue Clearing Technique.
Astrocytic processes interact with synapses throughout the brain modulating neurotransmitter signaling and synaptic communication. During conditions such as exposure to drugs of abuse and neurological diseases, astrocytes respond by altering their morphological and functional properties. Reactive astrocyte phenotypes exhibit a bushy morphology with altered soma volume and an increased number of processes compared to resting astrocytes. The reactive astrocytic phenotype also overexpresses proteins one of which can be glial fibrillary acidic protein (GFAP). Fluorescence microscopy on thin tissue sections (<20 µm) requires reconstruction, often through multiple sections, to delineate the full astrocytic morphology. In contrast, tissue clearing methods have been developed that enable imaging of larger sections including the whole brain, providing an opportunity to see in-depth changes in single cell structure. In this article, a detailed protocol for studying astrocyte morphology using tissue clearing and subsequent imaging of whole brains as well as region-specific slices is provided. This method is ideal for understanding the effect of different physiological conditions on astrocyte morphology. A standard biochemistry laboratory has the resources to accomplish tissue clearing using this protocol and most universities have the required imaging facilities. Protocols to study brains from both genetically modified mice that contain an astrocyte-specific marker and from wild-type mice using antibody labeling steps after tissue clearing are provided. We also describe general protocols to conduct fluorescence imaging of astrocytes in cleared tissue to characterize their morphology. This protocol could be useful for researchers working in the rapidly growing field of astrocyte biology. © 2021 Wiley Periodicals LLC. Basic Protocol 1: Brain perfusion, fixation, and tissue clearing Alternate Protocol: Clearing brain tissue with passive clarity Basic Protocol 2: Antibody labeling and refractive index matching Basic Protocol 3: Fluorescence imaging and characterization of astrocyte morphology.


The pseudopapilledema of neonatal-onset multisystem inflammatory disease.
To report a rare case of neonatal-onset multisystem inflammatory disease with serial photographs to characterize the optic nerve findings. Observational case report. A 6-year-old girl with neonatal-onset multisystem inflammatory disease, who had received systemic corticosteroid therapy for 5 years, had bilateral fibrillar opacities that surrounded the optic disks and extended into the peripapillary nerve fiber layer and vessels. A magnetic resonance imaging examination and lumbar puncture revealed elevated intracranial pressure. The elevated intracranial pressure returned to normal following a corticosteroid taper. Optic disk photographs, taken 4 years earlier, were subsequently obtained. The optic disk appearance had remained unchanged over the 4-year period, consistent with a pseudopapilledema. The optic disk appearance is not consistent with papilledema from increased intracranial pressure. The optic disk findings, in conjunction with the underlying inflammatory syndrome, suggest an infiltrative etiology for the atypical optic nerve findings in neonatal-onset multisystem inflammatory disease.


Co-formulants and adjuvants affect the acute aquatic and terrestrial toxicity of a cycloxydim herbicide formulation to European common frogs (Rana temporaria).
While pesticides are generally recognized as contributing to amphibian declines, there is a lack of knowledge about effects of co-formulants that are present in pesticide formulations and adjuvants which are mixed with these formulations. Since aquatic and terrestrial stages of amphibians can be exposed to these substances, adverse effects cannot be excluded. We investigated acute aquatic and terrestrial effects of the herbicide formulation Focus® Ultra, its active substance cycloxydim, its co-formulants solvent naphtha and docusate as well as the stabilizing adjuvant Dash® E.C. on larval and juvenile Rana temporaria. Aquatic toxicity was determined as 96-h LC50 values. Cycloxydim was the least toxic and solvent naphtha the most toxic substance of the formulation. The addition of Dash® E.C. increased the formulation toxicity substantially. Terrestrial toxicity was determined as lethal effects after a 48-h exposure to contaminated soil with 100% of the recommended field rate (FR) and as sublethal effects after the exposure to 10% of the recommended FR. The exposure to solvent naphtha and docusate at 100% FR led to mortalities of 42-100% probably due to their inhalation toxicity and dermal as well as eye irritation, respectively. Cycloxydim, Focus® Ultra and Dash® E.C. did not lead to any mortality. Sublethal effects on juvenile locomotor activity (i.e. moved distance) were observed for cycloxydim and the combined exposure of Focus® Ultra and Dash® E.C. Juvenile body masses declined significantly for all substances except for cycloxydim. The present results show that aquatic sensitivity does not predict terrestrial sensitivity. It was shown that pesticide toxicity for amphibians can highly depend on the presence and amount of co-formulants and added adjuvants. Therefore, substances included in pesticide formulations which are known to be toxic by inhalation or harmful to eyes or skin should be specifically considered in the environmental risk assessment for amphibians.


Increased 18F-FDG uptake and expression of Glut1 in the EMT transformed breast cancer cells induced by TGF-beta.
As carcinomas progress, the tumors may lose epithelial morphology and acquire mesenchymal characteristics typically called epithelial-mesenchymal transition (EMT), which is commonly associated with increased cell migration, enables cells to dissociate from their original tissue and form metastasis in distant organs. In addition to molecular and morphologic changes, the EMT transformed cells also showed the change of sensitivity to chemotherapeutics. In order to detect the EMT transition in vivo clinically, we detected the change of metabolism of MCF-7 cells after being induced by TGF-beta to form EMT condition by MTT and 18F-FDG uptake.


Lifespan Neurodegeneration Of The Human Brain In Multiple Sclerosis.
Atrophy related to Multiple Sclerosis (MS) has been found at the early stages of the disease. However, the archetype dynamic trajectories of the neurodegenerative process, even prior to clinical diagnosis, remain unknown. We modeled the volumetric trajectories of brain structures across the entire lifespan using 40944 subjects (38295 healthy controls and 2649 MS patients). Then, we estimated the chronological progression of MS by assessing the divergence of lifespan trajectories between normal brain charts and MS brain charts. Chronologically, the first affected structure was the thalamus, then the putamen and the pallidum (3 years later), followed by the ventral diencephalon (7 years after thalamus) and finally the brainstem (9 years after thalamus). To a lesser extent, the anterior cingulate gyrus, insular cortex, occipital pole, caudate and hippocampus were impacted. Finally, the precuneus and accumbens nuclei exhibited a limited atrophy pattern. Subcortical atrophy was more pronounced than cortical atrophy. The thalamus was the most impacted structure with a very early divergence in life. It paves the way toward utilization of these lifespan models for future preclinical/prodromal prognosis and monitoring of MS.


Peripheral blood stem cell harvests from G-CSF-stimulated donors contain a skewed Th2 CD4 phenotype and a predominance of type 2 dendritic cells.
To assess the numbers and function of dendritic cell (DC) subsets and T helper cells in bone marrow (BM) and peripheral blood stem cell (PBSC) harvests. DC subsets in stem cell grafts were analyzed using three-color flow cytometry. Intracellular cytokine staining and the staining of IL-12Rbeta2 were used for determining the proportion of Th1-, Th2-, and IL-12-producing DC in the grafts. The ability of DC1 and DC2 to induce T-cell proliferation and cytokine secretion were studied using thymidine incorporation and ELISA techniques. PBSC recipients received a significantly higher number of DC2 than BM recipients and a lower proportion of IL-12-producing DC. Purified DC1 from both BM and PBSC grafts were capable of inducing proliferation of allogeneic T cells and also induced a predominant Th1 response when cultured with CD4(+)/CD45RA(+) cells. In contrast, DC2 induced a predominant Th2 cytokine response. PBSC grafts contained a higher number of both Th1 and Th2 cells compared to BM grafts; however, as a consequence of the increased number of Th2 cells the ratio of Th1:Th2 cells in PBSC grafts was 1.1:1 compared to 9.8:1 in BM. Furthermore, following in vitro activation of T cells, PBSC grafts contained a lower proportion of IL-12Rbeta2(+) T cells. G-CSF does not have a direct effect on DC function but acts to increase the numbers of DC2 in the blood of PBSC donors. This is associated with a higher proportion of Th2 cells present in PBSC grafts and T cells in PBSC grafts were less likely to develop a Th1 response following in vitro activation.


Collecting data on textiles from the internet using web crawling and web scraping tools.
Fibre population surveys are a necessary part of the forensic fibres examination field. They provide valuable information as to which fibres are the most popular and help estimate the likelihood of observing similar properties in a fibre unrelated to the event. The time needed to carry these types of studies is however a major obstacle to wider use. With the advent of e-commerce and digital computation, collecting information from digital sources and structuring it in a convenient way may provide meaningful information on fibres population. It has become more affordable for researchers who can now devote most of their time to extracting meaningful information from the structured data. In this article, we have used a scrapy and kibana/elastic search interface to crawl and scrape a major online clothes retailer. In less than 24 h we have extracted 68 text-based field describing a total of 24,701 clothes to help provide precise estimations of fibres types and color frequencies. We were able to provide data that cotton, polyester, viscose and elastane are the 4 main types of fibres used in the textile industry. Elastane, while being very popular in garments, rarely accounts for more than 10% of the mass while cotton accounts for up to 80% of content. The most common colors are white, black, and blue, with important dependencies to the fibre type. Through further statistics and examples we demonstrate that web scraping techniques have the potential to provide near real-time population studies that can greatly benefit forensic practitioners.


Understanding why delirium is often missed in older emergency department patients: a qualitative descriptive study.
Unrecognized delirium is associated with significant adverse outcomes. Despite decades of effort and educational initiatives, validated screening tools have not improved delirium recognition in the emergency department (ED). There remains a fundamental knowledge gap of why it is consistently missed. The objective of this study was to explore the perceptions of ED physicians and nurses regarding factors contributing to missed delirium in older ED patients. We conducted a qualitative descriptive study at two academic tertiary care EDs in Toronto, Canada. Emergency physicians and nurses were interviewed by a trained qualitative researcher using a semi-structured interview guide. We coded transcripts with an iteratively developed codebook. Interviews were conducted until thematic saturation occurred. Thematic data analysis occurred in conjunction with data collection to continuously monitor emerging themes and areas for further exploration. We interviewed 26 ED physicians and nurses. We identified key themes at four levels: clinical practice, provider attitudes, systematic processes, and education. The four themes include: (1) there are varied approaches to delirium recognition and infrequent use of screening tools; (2) delirium assessment is perceived as overly time consuming and of lower priority than other symptoms and syndromes; (3) it is unclear whose responsibility it is to recognize delirium; and (4) there is a need for a deeper or "functional" understanding of delirium that includes its consequences. Our findings demonstrate a need for ED leadership to identify clear team roles for delirium recognition, standardize use of delirium screening tools, and prioritize delirium as a symptom of an acute medical emergency.


Initial evidence of research quality of registered reports compared with the standard publishing model.
In registered reports (RRs), initial peer review and in-principle acceptance occur before knowing the research outcomes. This combats publication bias and distinguishes planned from unplanned research. How RRs could improve the credibility of research findings is straightforward, but there is little empirical evidence. Also, there could be unintended costs such as reducing novelty. Here, 353 researchers peer reviewed a pair of papers from 29 published RRs from psychology and neuroscience and 57 non-RR comparison papers. RRs numerically outperformed comparison papers on all 19 criteria (mean difference 0.46, scale range -4 to +4) with effects ranging from RRs being statistically indistinguishable from comparison papers in novelty (0.13, 95% credible interval [-0.24, 0.49]) and creativity (0.22, [-0.14, 0.58]) to sizeable improvements in rigour of methodology (0.99, [0.62, 1.35]) and analysis (0.97, [0.60, 1.34]) and overall paper quality (0.66, [0.30, 1.02]). RRs could improve research quality while reducing publication bias and ultimately improve the credibility of the published literature.


A rare case of polyorchidism in a 40-year-old man. A case report.
and importance Polyorchidism is defined as the presence of three testes or more. Approximately, there are about 200 cases of polyorchidism in the medical literature. In the past, surgical treatment was done but now with imaging studies, less aggressive approach is recommended.Here we present a case of 40-year-old man who was diagnosed incidentally with polyorchidism in the right hemiscrotum which is quite unusual in this age. A 40-year-old man presented to the emergency department with a swelling and pain in the left hemiscrotum. In palpation, we noticed a scrotal mass in the right hemiscrotum. His parents had first noticed a scrotal mass when he was two years old and was incorrectly diagnosed as hydrocele by an unauthorized practitioner.In the left hemiscrotum, Doppler confirmed acute epididymitis diagnosis that was treated conservatively with antibiotics and NSAIDs. In the right hemiscrotum, MRI showed that the lump had separate epididymis and shared a common vas deferens with the right testis, which confirmed the diagnosis of supernumerary testis and the patient underwent a follow-up ultrasound after a month and after six months of his presentation. Triorchidism is the most common type of polyorchidism. Polyorchidism is diagnosed incidentally hence it is asymptomatic. There are many types of Polyorchidism and tow classification have been described. When the patient is asymptomatic the concentrative treatment is recommended. Polyorchidism is a rare congenital anomaly in the genitourinary tract. It is diagnosed incidentally. Ultrasound or MRI are used to diagnose polyorchidism cases.


Anesthesia for liver transplant surgery.
Liver transplantation offers patients with liver disease an optimal chance for long-term survival. Current indications, preoperative assessment, patient selection, intraoperative anesthetic management and outcomes are described. The management of special situations, including retransplantation, pediatric transplantation, and fulminant hepatic failure are also reviewed. The success of liver transplantation has led to increased demand. This demand, coupled with a nonexpanding supply of deceased donor organs, has resulted in a shortage of grafts and prolonged waiting times. Novel solutions using segmental liver grafts from living donors, and the challenges associated with this approach, are discussed.


tDNA(ser) sequences are involved in the excision of Streptomyces griseus plasmid pSG1.
Plasmid pSG1 is maintained in some derivatives of Streptomyces griseus NRRL3851 mainly in the chromosomally integrated form (pSG1int). In others, the integrated plasmid is co-maintained with free pSG1 [Cohen et al., Plasmid 13 (1985) 41-50]. The pSG1 plasmid integration site (attP) and the pSG1int-chromosome boundaries (attL and attR) were cloned and sequenced. The results indicate that pSG1int is flanked at attL by a functional tRNA(ser) gene and at attR by a 60-nt sequence of the 3' end of the same tRNA(ser) gene. A single mismatch distinguishes the 60-nt sequence at attR from its direct repeat at attL. The attP site contains a single copy of the 60-nt repeat, identical to the one at attL. This observation indicates that pSG1, like integrating plasmids of other Actinomycetes, is integrated in a tRNA gene and suggests that the exact excision of pSG1int occurs by a recombinational crossing-over event at the first 43 nt of the 60-nt repeat.


Knowledge, attitudes and practices of health care workers in a cardiology department on influenza vaccination.
Evidence has accrued that influenza vaccination may be effective in preventing myocardial infarction (MI). However, vaccination rates in both adults and health care workers (HCW) are low, and hospitalisation is often a missed opportunity for vaccination. We hypothesised that knowledge, attitude and practices of health care workers regarding vaccination impacts vaccine uptake in hospitals. The cardiac ward admits high-risk patients, many of whom are indicated for influenza vaccine, especially those caring for patients with acute MI. To understand the knowledge, attitudes, and practices of HCW in cardiology ward within a tertiary institution, on influenza vaccination. We used focus group discussions with HCW caring for AMI patients in an acute cardiology ward, to explore the knowledge, attitudes, and practices of HCW regarding influenza vaccination for patients under their care. Discussions were recorded, transcribed, and thematically analysed using NVivo software. In addition, participants completed a survey on their knowledge and attitudes towards the uptake of influenza vaccination. A lack of awareness regarding the associations between influenza, vaccination and cardiovascular health was identified amongst HCW. Participants did not routinely discuss the benefits of influenza vaccination or recommend influenza vaccinations to patients under their care; this may be due to a combination of a lack of awareness, not seeing it as part of their job and workload issues. We also highlighted difficulties in access to vaccination, and concerns of adverse reactions to the vaccine. There is limited awareness among HCW of the role of influenza on cardiovascular health and the benefits of influenza vaccine in the prevention of cardiovascular events. Improved vaccination of at-risk patients in hospital may need active engagement of HCW. Improving the health literacy of HCW regarding the benefits of vaccination as a preventative strategy may result in better health care outcomes for cardiac patients.