Lactate dehydrogenase activity staining demonstrates time-dependent immune cell infiltration in human ex-vivo burn-injured skin.
Burn injuries constitute one of the most serious accidental injuries. Increased metabolic rate is a hallmark feature of burn injury. Visualising lactate dehydrogenase (LDH) activity has been previously used to identify metabolic activity differences, hence cell viability and burn depth in burn skin. LDH activity was visualised in injured and uninjured skin from 38 sub-acute burn patients. LDH activity aided the identification of spatially correlating immunocompetent cells in a sub-group of six patients. Desorption Electrospray Ionisation Mass Spectrometry Imaging (DESI MSI) was used to describe relative lactate and pyruvate abundance in burned and uninjured tissue. LDH activity was significantly increased in the middle and deep regions of burnt skin compared with superficial areas in burnt skin and uninjured tissue and positively correlated with post-burn time. Regions of increased LDH activity showed high pyruvate and low lactate abundance when examined with DESI-MSI. Areas of increased LDH activity exhibited cellular infiltration, including CD3 + and CD4 + T-lymphocytes and CD68 + macrophages. Our data demonstrate a steady increase in functional LDH activity in sub-acute burn wounds linked to cellular infiltration. The cell types associated are related to tissue restructuring and inflammation. This region in burn wounds is likely the focus of dysregulated inflammation and hypermetabolism.


Radiochemotherapy in combination with regional hyperthermia in preirradiated patients with recurrent rectal cancer.
Encouraging results of phase II studies combining chemotherapy with radiotherapy have been published. In this study, the results of a multimodal salvage therapy including radiochemotherapy (RCT) and regional hyperthermia (RHT) in preirradiated patients with recurrent rectal cancer are reported. All patients enrolled had received previous pelvic irradiation (median dose 50.4 Gy). The median time interval between prior radiotherapy and the onset of local recurrence was 34 months. The combined treatment consisted of reirradiation with a median dose of 39.6 Gy (30.0-45.0 Gy), delivered in fractions of 1.8 Gy/day. 5-fluorouracil was given as continuous infusion 350 mg/m(2)/day five times weekly, and RHT (BSD-2000 system) was applied twice a week within 1 h after radiotherapy. The primary endpoint was local progression-free survival (LPFS); secondary endpoints were overall survival, symptom control, and toxicity. 24 patients (median age 59 years) with a previously irradiated locally recurrent adenocarcinoma of the rectum were enrolled. The median LPFS was 15 months (95% confidence interval 12-18 months] with a median follow-up of 27 months (16-37 months). The overall 1-year and 3-year survival rates were 87% and 30%, respectively. Pain was the main symptom in 17 patients. Release of pain was achieved in 12/17 patients (70%). No grade 3 or 4 hematologic or skin toxicity occurred. Grade 3 gastrointestinal acute toxicity was observed in 12.5% of the patients. Paratumoral thermometry revealed a homogeneous distribution of temperatures. RCT combined with RHT is an efficient salvage therapy showing high efficacy with acceptable toxicity and can be recommended as treatment option for this unfavorable group of preirradiated patients with local recurrence of rectal cancer.


Multi-Cellular Functions of MG53 in Muscle Calcium Signaling and Regeneration.
Since its identification in 2009, multiple studies have indicated the importance of MG53 in muscle physiology. The protein is produced in striated muscles but has physiologic implications reaching beyond the confines of striated muscles. Roles in muscle regeneration, calcium homeostasis, excitation-contraction coupling, myogenesis, and the mitochondria highlight the protein's wide-reaching impact. Numerous therapeutic applications could potentially emerge from these physiologic roles. This review summarizes the current literature regarding the role of MG53 in the skeletal muscle. Therapeutic applications are discussed.


Neuropeptides as synaptic transmitters.
Neuropeptides are small protein molecules (composed of 3-100 amino-acid residues) that have been localized to discrete cell populations of central and peripheral neurons. In most instances, they coexist with low-molecular-weight neurotransmitters within the same neurons. At the subcellular level, neuropeptides are selectively stored, singularly or more frequently in combinations, within large granular vesicles. Release occurs through mechanisms different from classical calcium-dependent exocytosis at the synaptic cleft, and thus they account for slow synaptic and/or non-synaptic communication in neurons. Neuropeptide co-storage and coexistence can be observed throughout the central nervous system and are responsible for a series of functional interactions that occur at both pre- and post-synaptic levels. Thus, the subcellular site(s) of storage and sorting mechanisms into different neuronal compartments are crucial to the mode of release and the function of neuropeptides as neuronal messengers.


Treatment of cold urticaria.
In a single patient with severe essential acquired cold urticaria, the following drug regimes were assessed: diphenhydramine, cyproheptadine, hydroxyzine, terbutaline, cimetidine, hydroxyzine plus cimetidine, and hydroxyzine plus terbutaline. Each regime showed favourable results, but a significance level of P = 0.01 was reached only for (a) hydroxyzine plus cimetidine in the suppression of erythema, and (b) the histamine H1 antagonists in the suppression of wealing.


PGMD: a comprehensive manually curated pharmacogenomic database.
The PharmacoGenomic Mutation Database (PGMD) is a comprehensive manually curated pharmacogenomics database. Two major sources of PGMD data are peer-reviewed literature and Food and Drug Administration (FDA) and European Medicines Agency (EMA) drug labels. PGMD curators capture information on exact genomic location and sequence changes, on resulting phenotype, drugs administered, patient population, study design, disease context, statistical significance and other properties of reported pharmacogenomic variants. Variants are annotated into functional categories on the basis of their influence on pharmacokinetics, pharmacodynamics, efficacy or clinical outcome. The current release of PGMD includes over 117 000 unique pharmacogenomic observations, covering all 24 disease superclasses and nearly 1400 drugs. Over 2800 genes have associated pharmacogenomic variants, including genes in proximity to intergenic variants. PGMD is optimized for use in annotating next-generation sequencing data by providing genomic coordinates for all covered variants, including Single Nucleotide Polymorphisms (SNPs), insertions, deletions, haplotypes, diplotypes, Variable Number Tandem Repeats (VNTR), copy number variations and structural variations.


High Overweight and Obesity in Fontan Patients: A 20-Year History.
The prevalence of obesity in long-term survivors with complex congenital heart disease may be increasing, and little is known about the timing and onset of weight gain and growth patterns in these high-risk patients. Prevalence rates of overweight/obesity and longitudinal changes in body mass index (BMI) with age were determined in 606 patients with Fontan circulation seen at a tertiary care cardiology center from 1992 to 2012. The number of clinic encounters (n) was stratified by age group (n = 401, 2-5 years; n = 333, 6-11 years; n = 217, 12-19 years; and n = 129, >20 years). Among adults, 39% were overweight/obese at last clinic visit; 22% overweight, and 17% obese. Childhood anthropometric data were available for 82 adults, of which 15% (n = 12/82) were overweight/obese in childhood. The likelihood of being overweight/obese as an adult was three times higher if there was a BMI ≥ 85th percentile in childhood (CI 2.1-4.5, P < 0.01). Overweight/obesity in adulthood was associated with lower heart failure rates (4 vs. 19%, P = 0.03). Pediatric rates of overweight/obesity were comparable to national data (NHANES 2011-2012) in every age group: at 2-5 years, (25 vs. 23%), 6-11 years (26 vs. 34%), and 12-19 years (15 vs. 35%). Systolic blood pressure was higher in overweight/obese children as young as 2-5 years of age. Childhood and adult survivors with Fontan circulation have high rates of overweight/obesity. Childhood obesity is a strong predictor of future adiposity and is linked to changes in systolic blood pressure at a very young age.


Evaluation of Version 2.0 of the PROMIS Upper Extremity Computer Adaptive Test in Nonshoulder Upper Extremity Patients.
The Patient-Reported Outcomes Measurement Information System (PROMIS) Upper Extremity Computer Adaptive Test (UE CAT) was recently updated to version 2.0 (v2.0). We hypothesized that the PROMIS UE CAT v2.0 would exhibit improved performance characteristics compared with the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) when administered to a nonshoulder upper extremity patient population. The UE CAT v2.0, Physical Function (PF) CAT v2.0, and the QuickDASH were each prospectively administered via tablet computer to all patients presenting to a tertiary hand and upper extremity clinic between April 2017 and October 2017. Patient responses were analyzed, and the mean, range, floor and ceiling effect, and correlations between instruments were calculated. Among 825 patients, the mean UE CAT v2.0 score was 38.3 (SD 10.7) with a range of 15 to 61 and interquartile range of 15.4. The UE CAT v2.0 had a strong correlation with the QuickDASH (r = -0.749) and the PF CAT v2.0 (r = 0.719). No patient scored between 56 and 60, indicating a gap in scoring in that range. The UE CAT v2.0 demonstrated a floor effect of 1%, a ceiling effect of 6.9%, and a high internal consistency with a Cronbach alpha of 0.99. The PROMIS UE CAT v2.0 demonstrated improved ceiling effects, range, and a decreased gap in scoring compared with prior versions. Limitations of the PROMIS UE CAT v2.0 are still present, but updates have led to an incremental improvement over prior versions, demonstrating the ability to influence PROMIS instrument performance through upgrades. The updated PROMIS UE CAT v2.0 still demonstrates a ceiling effect and gap in scores at the upper end of the instrument, both of which may limit discrimination between different levels of upper extremity function for high-functioning patients.


Prepregnancy smoking and the risk of gestational diabetes requiring insulin therapy.
The relationship between maternal smoking and gestational diabetes mellitus (GDM) is inconclusive. We investigated whether prepregnancy smoking is a risk factor for insulin-requiring GDM in Korean women. Using the National Health Insurance Service database, 325,297 women who delivered between 2011 and 2015 and who received a health examination within 52 weeks before pregnancy were included. Insulin-requiring GDM was defined as no claims for diabetes mellitus and a fasting blood glucose level of < 126 mg/dL before pregnancy, and initiation of insulin treatment during pregnancy. Smoking status was identified in a self-reported questionnaire completed during the health examination. There were 2,114 women (0.65%) with GDM who required insulin therapy. Compared with nonsmokers, the fully adjusted odd ratios (ORs) of former smokers and current smokers for insulin-requiring GDM were 1.55 (95% confidence interval [CI] 1.27-1.90) and 1.73 (1.42-2.09), respectively. The ORs (95% CIs) of insulin-requiring GDM among women who reported ≤ 2, 2-≤ 4, 4-≤ 6, 6-≤ 8, 8-≤ 10, and > 10 pack-years of smoking were 1.50 (1.22-1.84), 1.71 (1.31-2.22), 1.60 (1.13-2.26), 1.97 (1.14-3.40), 2.34 (1.22-4.51), and 2.29 (1.25-4.22), respectively, compared with nonsmokers (P for trend < 0.001). This association was similar in women with or without obesity and abdominal obesity. In conclusions, women who smoke have a significantly higher risk of GDM requiring insulin therapy, which may be proportional to the cumulative exposure to smoking. Cessation of smoking should be emphasized in women of childbearing age for the prevention of GDM.


Direction of temperature gradient for normal-phase temperature gradient interaction chromatography in polystyrene fractionation.
Temperature gradient interaction chromatography (TGIC) is a powerful technique for molecular weight fractionation of polymers, in which the interaction strength is controlled by varying the column temperature. In the present paper, the effects of the sign of the temperature dependence of the retention and the direction of the temperature gradient (raising or lowering) on TGIC in the normal-phase mode were studied for the molecular weight fractionation of polystyrene samples in organic mobile phases. It was found that a positive temperature gradient was effective in the system consisting of amino-modified silica (NH(2)) column and the eluent mixture of tetrahydrofuran and n-hexane where retention decreased with increasing temperature. A negative temperature gradient was effective for the systems consisting of a bare-silica column//chloroform/n-hexane and NH(2)-column//chloroform/n-hexane, where retention increased with increasing temperature. Increasing retention with increasing temperature has been found, so far, only for a water-soluble polymer (PEO) in an aqueous mobile phase in RP-TGIC.


Retracted: A Prediction Model of Health Development Based on Linear Sequential Extreme Learning Machine Algorithm Matrix.
[This retracts the article DOI: 10.1155/2022/7632841.].


Visual performance after posterior chamber phakic intraocular lens implantation and wavefront-guided laser in situ keratomileusis for low to moderate myopia.
To compare postoperative visual function after implantable collamer lens (ICL) implantation and after wavefront-guided laser in situ keratomileusis (LASIK) in eyes with low to moderate myopia. Retrospective observational case study. We investigated 30 eyes of 20 patients undergoing ICL implantation and 64 eyes of 38 patients undergoing wavefront-guided LASIK for the correction of low to moderate myopia (manifest spherical equivalent: -3.00 to -5.88 diopters [D]). Ocular higher-order aberrations (HOAs) and contrast sensitivity (CS) function were measured by Hartmann-Shack aberrometry and a contrast sensitivity unit before and 3 months after surgery, respectively. From the contrast sensitivity, the area under the log contrast sensitivity function was calculated. For 4-mm and 6-mm pupils, the changes in ocular third-order aberrations, fourth-order aberrations, and total HOAs after ICL implantation were significantly less than those after wavefront-guided LASIK (P < .05, Mann-Whitney U test). The postoperative area under the log contrast sensitivity function was significantly increased after ICL implantation (P < .001), whereas, after wavefront-guided LASIK, it was not significantly changed (P = .11). ICL implantation induces significantly fewer ocular HOAs than wavefront-guided LASIK. Moreover, CS was significantly improved after ICL implantation but unchanged after wavefront-guided LASIK in eyes with low to moderate myopia. Thus, even in the correction of low to moderate myopia, ICL implantation appears to be superior in visual performance to wavefront-guided LASIK, suggesting that it may be a viable surgical option for the treatment of such eyes.


Brain damage in fatal non-missile head injury in relation to age and type of injury.
Brain damage in a series of 635 fatal non-missile head injuries has been analysed with particular reference to the age of the patient and the type of injury. The differences in the type of brain damage in relation to age were less than we had anticipated, lending further support to the contention that the aged brain has a reduced potential for recovery. The analysis confirms the relationship between road traffic accidents, diffuse axonal injury, gliding contusions and 'basal ganglia' haematomas, and the importance of diffuse brain swelling resulting from a head injury in children.


Occurrence of Rotavirus A Genotypes and Other Enteric Pathogens in Diarrheic Suckling Piglets from Spanish Swine Farms.
Species A rotavirus (RVA) is a major viral pathogen causing diarrhea in suckling piglets. Studies on its genetic heterogeneity have implications for vaccine efficacy in the field. In this study, fecal samples (n = 866) from diarrheic piglets younger than 28 days were analyzed over a two-year period (2018-2019). Samples were submitted from 426 farms located in 36 provinces throughout Spain and were tested using real-time PCR (qPCR) and reverse transcription real-time PCR (RT-qPCR) for five enteric pathogens. The individual prevalence was 89.4%, 64.4%, 44.9%, 33.7% and 4.4% for Clostridiumperfringens, Clostridioides (formerly Clostridium) difficile, species A rotavirus, species C rotavirus and porcine epidemic diarrhea virus, respectively. Most specimens (96.9%) were positive for at least one of the target pathogens, and more than 80% of samples harbored mixed infections. Nucleotide sequencing of 70 specimens positive for RVA revealed the presence of the VP7 genotypes G4, G9, G3, G5, G11 and the VP4 genotypes P7, P23, P6 and P13, with the combinations G4P7 and G9P23 being the most prevalent, and especially in the areas with the highest pig population. The study shows the extensive genetic diversity of RVA strains as well as discrepancies with the genotypes contained in the vaccine available in Spain, and multiple amino acid differences in antigenic epitopes of different G- and P- genotypes with the vaccine strains. Further investigations are needed to determine the efficacy of the vaccine to confer clinical protection against heterologous strains.


Smoking in a small city: an ethnographic study to serve as a base for the creation of a public health program.
To outline the prevalence of smoking in the city of Parazinho, Brazil, with the objective of generating data on which to base a plan of action for smoking control programs in the city. A questionnaire was applied to 150 people (25.6% of whom were smokers) by community health agents during home visits. The questionnaire comprised 30 objective and subjective questions to collect social and biological information on smokers in urban and rural areas. The data were analyzed using descriptive statistics, and the principal findings were as follows: the prevalence of smoking was higher among males (57.8%); most of the interviewees started smoking at an early age (45% before the age of 12); economic conditions constituted a contributing factor (66% of the smokers interviewed earned less than the minimum wage); most of the interviewees reported difficulty in kicking the habit (44.6% reported living with a smoker, and 80% had a friend who smoked); there was a high prevalence of tobacco-related diseases (56.6% had respiratory problems); and there was concomitant alcohol use in 52% of the smokers. This outline can be used in the generation of a local program of smoking prevention and control. Such a program is, in fact, under development. A team of professionals has received training in a 'minimal, intensive approach to the smoker', and a municipal outpatient clinic for the treatment of nicotine dependence has been inaugurated.


Molecular Design Strategy of Thermally Activated Delayed Fluorescent Emitters Using CN-Substituted Imidazopyrazine as a New Electron-Accepting Unit.
Thermally activated delayed fluorescence (TADF)-based organic light-emitting diodes (OLEDs) have attracted enormous attention recently due to their capability to replace conventional phosphorescent organic light-emitting diodes for practical applications. In this work, a newly designed CN-substituted imidazopyrazine moiety was utilized as an electron-accepting unit in a TADF emitter. Two TADF emitters, 8-(3-cyano-4-(9,9-dimethylacridin-10(9H)-yl)phenyl)-2-phenylimidazo[1,2-a]pyrazine-3-carbonitrile (Ac-CNImPyr) and 8-(3-cyano-4-(10H-phenoxazin-10-yl)phenyl)-2-phenylimidazo[1,2-a]pyrazine-3-carbonitrile (PXZ-CNImPyr), were developed based on the CN-substituted imidazopyrazine acceptor combined with acridine and phenoxazine donor, respectively. A CN-substituted phenyl spacer was introduced between the donor and acceptor for a sufficiently small singlet-triplet energy gap (ΔEST ) and molecular orbital management. Small ΔEST of 0.07 eV was achieved for the phenoxazine donor-based PXZ-CNImPyr emitter. As a result, an organic light-emitting diode based on the PXZ-CNImPyr emitter exhibited a high external quantum efficiency of up to 12.7 %, which surpassed the EQE limit of common fluorescent emitters. Hence, the CN-modified imidazopyrazine unit can be introduced as a new acceptor for further modifications to develop efficient TADF-based OLEDs.


Operative treatment of interdigital Morton's neuroma.
The Authors present their experience in the surgical treatment of Morton's neuroma via a dorsal approach. The assessed results have been very good in terms of a clear clinical improvement and no recurrences in all the treated cases. The histological examination carried out on all the removed samples have shown that the thickening of the nerve first occurs due to perineural fibrosis and successively associated with sclerohyalinosis of the tissue, which is in line with the already existing literature reports. The Authors of the article reckon the adopted surgical technique to be simple, safe and highly effective.


Current understanding and distinct features of multifocal and multicentric breast cancers.
Multifocal (MF) and multicentric (MC) breast cancers are referred to as synchronous, multiple ipsilateral breast cancers; however, the definitions vary among the literature, which has made understanding and analyzing these diseases challenging. The incidence ranges from 1% to 60%, with a higher prevalence in pre-menopausal women. MF and MC breast cancers, compared with unifocal breast cancers, tend to be more aggressive and are associated with lower survival rates, higher recurrence, and lymph node metastasis. Typically, patients with MF/MC breast cancers are treated with radical surgery, while breast conservation therapy may also be considered. Investigations have focused on elucidating the distinct biological features of MF/MC breast cancers, including the clonality of the cancers, the genetic alterations, and the impact of these features on disease aggressiveness and patient prognosis. These findings will broaden the understanding of these breast cancer subtypes and aid in the development of more tailored treatment plans for patients.


Relationships between mortality, morbidity, and physical function in adults who survived a period of prolonged mechanical ventilation.
This study aimed to report mortality, morbidity, and the relationship between these outcomes with physical function in patients who survived prolonged mechanical ventilation during an intensive care unit (ICU) admission. Records were reviewed for Western Australian residents admitted to an ICU in 2007 or 2008 who were ventilated for 7 days or longer and survived their acute care stay. Records were linked with data maintained by the Department of Health. A total of 181 patients (aged 52 ± 19 years) were included in this study. In the 12 months after discharge, 159 (88%) survived and 148 (82%) had been hospitalized. Compared with those who were ambulating independently when discharged from acute care, those who were not had more admissions (incident rate ratio, 1.81; 95% confidence interval, 1.28-2.57) and a greater cumulative length of hospital stay (10 [37] vs 57 [115] days, P < .001) over the first 12 months after discharge. Time between admission to ICU and when the patient first stood correlated with the number of admissions (Rs = 0.320, P < .001) and cumulative length of stay (Rs = 0.426, P < .001) in the 12 months after discharge. For survivors of prolonged mechanical ventilation, physical function during acute care was associated with hospitalization over the following 12 months.


Robotic nerve-sparing radical parametrectomy: feasibility and technique.
The objective of this research was to evaluate the feasibility of robotic nerve-sparing radical parametrectomy for cervical cancer after simple hysterectomy. A 41 year-old patient was diagnosed with invasive cervical adenocarcinoma after simple hysterectomy. Hysterectomy margins were negative. A robotic nerve-sparing radical parametrectomy was offered and performed 5 weeks later. Total operating time was 330 min, blood loss was 145 ml and length of hospitalization 2 days. Pathology revealed no residual tumour. Normal bladder function resumed on postoperative day 9. At a follow-up of 16 months, the patient remains with no evidence of disease and with normal bladder and bowel function. Robotic nerve-sparing radical parametrectomy is safe and feasible and can be offered to patients with indications for radical parametrectomy.


Sources of protein-induced endogenous acid production and excretion by human adults.
The origin of the increase in endogenous acid production and excretion associated with the calciuretic action of high protein intakes was investigated in human adults. Eight subjects, 4 males and 4 females, aged 25-36 years, were fed a low protein diet (50 g/day) and a high protein diet (120 g/day in males and 106 g/day in females) for 7 days each. The high protein diet was formulated by supplementing the low protein diet with a mixture of four purified proteins. Increased protein intake was associated with increases in urinary Ca, sulfate, titratable acidity (acid phosphates) and ammonium, and decreases in urinary pH and bicarbonate. There was no increase in organic anion excretion. The increases in endogenous acid production (EAP) and net acid excretion (NAE) were entirely attributable to the oxidation of excess sulfur amino acids (SAA), which yields 2 moles of hydrogen ions per mole of amino acid catabolized. The results differ in this respect from those reported for studies on the effect of SAA loading, which indicate that non-SAA make a major contribution to the increase in EAP seen under these conditions.


[Continuous measurement of cardiac output with pulse contour analysis].
Pulse contour cardiac output (PCCO) is an easily applicable method for continuous measurement of cardiac output in critically ill patients. Calculation of stroke volume is possible by analysing the area under the systolic part of the arterial pulse pressure waveform together with an individual calibration factor (Zao) to account for the individually variable vascular impedance. Since vascular impedance is potentially affected by altered vascular tone, it was the aim of the present study to examine the validity of PCCO in ICU patients receiving various dosages of a variety of vasoactive drugs. PATIENTS AND METHODS. Continuous cardiac output was measured in 20 ICU patients for a total of 110 h using the pulse contour method. The precision of PCCO was determined in comparison with its calibration reference, the thermodilution method (TDCO): (1) during administration of vasoactive drugs at a constant rate and (2) during conditions with altered vascular tone and haemodynamics elicited by changes in vasoactive drug dosage. For this purpose, the patients received varying dosages of vasoactive drugs (dopamine, dobutamine, epinephrine, norepinephrine, nitroglycerin, prostacyclin and urapidil). RESULTS. A total of 165 data sets was obtained, each consisting of the average of four capnometrically triggered TDCO measurements and the corresponding PCCO values. The relative difference between methods (+/- 2 SD) was +/- 23.9% (SD 0.85 l.min-1; r = 0.93) if a single calibration at the beginning of measurement series was performed (Fig. 2). The bias of the mean cardiac output values of both methods was -0.09 l.min-1. The precision of PCCO improved to +/- 15.7% by additional calibrations (SD 0.56.min-1; r = 0.96; bias 0.003 l.min-1). Data of two patients showed that recalibration may be necessary after extreme haemodynamic changes due to septic shock or cooling. Alteration of vascular tone by clinically used dosage of vasoactive drugs, however, had no destabilizing effect on the pulse contour method. CONCLUSIONS. It could be demonstrated that PCCO provides a valuable method for continuous cardiac output measurement in the intensive care setting with a precision comparable to that of thermodilution.


Salivirus type 1 and type 2 in patients with acute gastroenteritis, Germany.
Salivirus (SaV-A) is a novel member of the family Picornaviridae and has been associated with acute gastroenteritis. Recently, a second type of SaV-A, SaV-A2, was identified in a sewage sample from Bangkok, Thailand. No information is available on the prevalence of SaV-A in Western Europe. Stool samples from patients with symptoms of acute viral gastroenteritis were analyzed for SaV-A and the clinical course of SaV-A-positive individuals was evaluated. A total of 3019 fecal samples collected during 2012-2013 from 1941 hospitalized patients with acute gastroenteritis were screened for SaV-A by a newly designed real-time reverse transcription polymerase chain reaction targeting a conserved sequence in the 5'-untranslated region. Positive results were verified by sequencing the viral capsid protein 1 gene also allowing typing of the virus. Medical records of SaV-A-infected patients were reviewed for clinical features and laboratory data. SaV-A was detected in five patients. Viral RNA concentrations ranged from 7.1×10(6) to 7.2×10(8)copies/g feces. The viruses from four patients were classified as SaV-A1 while SaV-A2 was present in one patient. After reviewing the medical records, SaV-A could not be considered as the sole possible cause of gastroenteritis symptoms given the presence of other plausible causes in all five patients. SaV-A infection can be detected in Germany, Western Europe, albeit at low levels. The detection of SaV-A2 in Europe suggests wider spread of SaV-A2. Presence of SaV-A, even at high concentrations, in a stool sample provides no conclusive evidence that SaV is the major cause of the patient's gastroenteritis symptoms.


C1q--how many functions? How many receptors?
C1, the first component of the classical pathway of complement activation is a complex of three proteins called C1q, C1r and C1s. Normally, C1q binding to aggregated IgG molecules results in activation of the classical pathway of complement. However, C1q has a number of other observed functions, not directly related to complement, that could be mediated by recently identified binding proteins acting as cell-surface receptors or soluble modulators of C1q-mediated functions. This article discusses the various activities of C1q and the evidence that these functions might be influenced by both membrane-bound and soluble C1q-binding proteins.


Arrangement of the tunica muscularis of the ileum, cecum and colon at the transition between the small and the large intestines of swine.
The arrangement of the bundles of muscular fibers in the transition between the small and the large intestines was studied in 12 male adult crossbred swine by dissection, after immersion in 50% nitric acid solution. The connection between the small and the large intestines was formed by the association of the muscular tissue, the connective tissue and the fat tissue. The tunica muscularis of these organs was organized in thin thread-like bundles and wide ribbon-like bundles of variable width and thickness. The superficial bundles of the longitudinal stratum of the tunica muscularis of the ileum established the continuity with the large intestine; the deep bundles penetrated into the ileal papilla. The limit between the cecum and the ascending colon was externally marked by the sulcus cecocolicus dorsalis and ventralis. The connection between the cecum and the ascending colon was formed by bundles of muscular fibers coming from the ileum, and the taeniae ventralis, lateralis and medialis of the cecum. Some bundles of muscular fibers from the ascending colon and the cecum headed toward the sulcus cecocolicus. The median bundles of muscular fibers of the taenia ventralis of the cecum, near the termination of the ileum, were arranged to form a loop around the termination of the ileum, mixing with the musculature of the ascending colon at the level of this junction.


Ontogeny of galanin-immunoreactive elements in the intrinsic nervous system of the chicken gut.
Galanin is a brain-gut peptide that is present in the central and peripheral nervous systems. In the gut, it is contained exclusively in intrinsic and extrinsic nerve supplies, and it is involved overall in the regulation of gut motility. To obtain information about the ontogeny of galanin, we undertook an immunohistochemical study of chicken embryos. The time of first appearance and the distribution patterns of galanin were investigated with fluorescence and streptavidin-biotin-peroxidase (ABC) immunohistochemical protocols by using a galanin polyclonal antiserum. The various regions of the gut and the pancreas were obtained from chicken embryos aged from 3 days of incubation to hatching. All specimens were fixed in buffered picric acid-paraformaldehyde, frozen, and cut with a cryostat. Galanin-immunoreactive neuroblasts were first detected at 4 days in the mesenchyme of the proventriculus/gizzard primordium and within the Remak ganglion. They then extended cranially and caudally, reaching all of the other gut regions at 6.5 days. Galanin-immunoreactive nerve elements mainly occupied the sites of myenteric and submucous plexuses. From day 15, galanin-immunoreactive nerve fibers tended to invade the circular muscular layer and part of the lamina propria of the mucosa. In the pancreas, weak galanin-immunoreactive nerve elements were detected at 5.5 days. They tended to be distributed among the glandular lobules according to the organ differentiation. The widespread distribution during the earlier embryonic stages represents evidence indicating that the neuropeptide galanin may have a role as a differentiating or growth factor. From late embryonic life, its predominant presence in sympathetic nerves and in muscular layers fits with the functions demonstrated previously in adults of other vertebrates for galanin as a modulator of intestinal motility.


Left-primary & right-auxiliary operation mode in mediastinoscope-assisted radical esophagectomy.
Mediastinoscope-assisted transhiatal esophagectomy (MATHE) is the most minimally invasive esophagectomy procedure. It is a more challenging procedure and more difficult to be popularized than thoracoscopic surgery. We developed a new MATHE operation mode that provides a clearer visual field and makes the procedures simpler. A total of 80 patients with esophageal cancer were divided into a control group (n = 29) and a study group (n = 51). The control group underwent classic MATHE, while the study group received modified MATHE. We compared the two groups on operation time; intraoperative blood loss; blood transfusion amount; incidence rate of lung infection, recurrent laryngeal nerves (RLNs) injury, chylothorax, and anastomotic leakage; and upper mediastinal lymph node dissection. The study group was significantly better than the control group in operation time (271.78 min vs. 322.90 min, p < 0.05), intraoperative blood loss (48.63 mL vs. 68.97 mL, p < 0.05), and left paratracheal lymph node (No. 4L) dissection rate (88.24% vs. 24.14%, p < 0.01). No significant differences were identified in the incidence rate of anastomotic leakage, lung complications, or RLNs injury between the two groups. The modified MATHE is easier to perform. Modified MATHE is significantly superior to classic MATHE in operation time, intraoperative blood loss, and upper mediastinal lymph node dissection rate.


Effects of organotin alternative antifoulants on oyster embryo.
In September 2008, organotin (Ot) compounds were prohibited from being used worldwide. From 1997 onward in Japan, the production of paints containing TBT (tributylin) compounds was prohibited, and thus alternatives to Ot antifoulants have been used since then. It has been said that the decomposition characteristics of these materials are better than those of Ot compounds. The toxicity of alternative Ot antifoulants (e.g., diuron, irgarol 1051®, and Sea-Nine 211®) and Ot compounds (TBT and TPT (triphenyltin)), using oysters that inhabit a large area of Hiroshima Bay, were evaluated. The results showed that the toxicity of diuron and irgarol 1051 is very low, and the toxicity of Sea-Nine 211 is almost the same as that of TPT. Sea-Nine 211's effect was stronger on oysters than other shellfish, causing concern about the extent of Sea-Nine 211's impact on oyster development.


Measles, Mumps, And Communion: A Vision For Vaccine Policy.
A pediatrician offers a vision for vaccine policy that promotes public health while respecting religious beliefs.


The bright and shadow images of an atom in the transmission electron microscope.
Scherzer discussed in his paper of 1949 the phase contrast of an atom image which was given in the form i(psi-psi). The second order term psi psi, which gave the bright image of the atom, was neglected. Under the first Born approximation as adopted by him, the phase contrast disappears at the exact focus of the ideal electron microscope. Under the second Born approximation, the phase contrast does appear under the same condition. It can be interpreted as the shadow image because it compensates the bright image.


Variation of inflammatory indexes after electrical cardioversion of persistent atrial fibrillation. Is there an association with early recurrence rates?
Inflammation has been recently implicated in the pathophysiology of atrial fibrillation (AF). The aim of this study was to examine the variation of inflammatory indexes during the first week after successful electrical cardioversion of persistent AF. Successive measurements of white blood cell (WBC) count, C-reactive protein (CRP) and fibrinogen levels were performed in 30 cardioverted patients. At the end of the 7-day follow-up period, AF had recurred in 30% of patients. A significant variance was found in serial measurements of fibrinogen levels in the two groups (non-relapse and relapse, p = 0.005). Fibrinogen levels increased significantly in patients who relapsed into AF, but remained stable in patients who remained in sinus rhythm. In the latter patients, CRP values tended to decrease post-cardioversion, but WBC count was significantly lower (p < 0.001) on the 7th day (6083 +/- 1335), compared with baseline values (6648 +/- 1395). The variation of inflammatory indices post-cardioversion might have prognostic implications with regard to sinus rhythm maintenance.


Internet usage and potential impact for acute care hospitals: survey in the United States.
These survey results are from a national survey of acute care hospitals. A random sample of 813 hospitals was selected with 115 responding and 33 incorrect addresses resulting in a 15% response rate. The purpose of the study was to measure the extent of information systems integration in the financial, medical, and administrative systems of the hospitals. Internet usage including homepages and advertising was measured. Other selected telecommunication applications are analyzed. As demonstration projects from the literature are compared to the survey results, the potential for hospitals is tremendous. Resulting cost savings could be equally impressive. This information will provide a benchmark for hospitals to determine their position relative to Internet technology and to set goals.


Functional diversity within the suppressor phenotype as defined by monoclonal antibody in T-cell prolymphocytic leukemia.
A patient with T-cell prolymphocytic leukemia (T-PLL) is described. The malignant T-cells from the patient were predominantly Leu-2-positive, indicating a suppressor phenotype. The cells were then tested to determine their functional capabilities. The patient's Leu-2-positive cells initially suppressed B-cell proliferation, as predicted by their phenotype but later functioned as T helper cells in the pokeweed mitogen system without a change in phenotype. The cells also responded inadequately to alloantigen and mitogen despite addition of exogenous T-cell growth factor (TCGF). Leu-2-positive prolymphocytes from the spleen of the patient were constitutive producers of TCGF. Surface phenotype using monoclonal antibody was inadequate to predict T-cell function of the cells from this patient with T-PLL. In addition, these data suggest there may be functional subpopulations within the OKT8+ phenotype. Constitutive TCGF production by malignant post-thymic T-cells may represent a mechanism by which these cells sustain their own growth.


Vessel density ratio: A novel approach to identify "culprit" coronary lesion by spiral computed tomography.
We hypothesized that a "culprit" lesion in acute coronary syndrome (ACS) should have low overall vessel lumen and plaque density on multidetector computed tomography-assisted coronary angiography (MDCTA) because of lower calcification and the presence of occlusive thrombus. However, thrombi and calcification both can themselves blur the demarcation between vessel wall and lumen. If we calculated a "vessel density ratio" (VDR) obtained by measuring the mean density of contrast-enhancement within a region of interest (ROI), which includes the vessel wall, lumen, plaque, and thrombus, and comparing that with the aortic root mean density acting as a reference point, this ratio may be more convenient, standardized, and reproducible to test the feasibility of VDR in identifying "culprit" lesions in ACS. Sixty-four patients-21 exertional angina; 17 unstable angina/non-ST elevation myocardial infarction (NSTEMI); 26 ST elevation myocardial infarction (STEMI)-provided 188 diseased segments on conventional angiography. All underwent MDCTA within a week of angiography. ROI was mapped out from maximum intensity projections of diseased segments in planar view. One hundred seventy-four segments were evaluated. Patients who presented with ACS (STEMI and unstable angina/non-ST elevation myocardial infarction) had lower mean VDR compared to patients with exertional angina (0.58 vs. 0.66 vs. 0.81; P < 0.001). Culprit lesions in ACS patients also had the lowest mean VDR when compared to nonculprit lesions and lesions in patients without ACS (0.51 vs. 0.68 vs. 0.81; P < 0.001). VDR is a new, convenient, and standardized approach in identifying "culprit" lesions by MDCTA.


BOLD data representing activation and connectivity for rare no-go versus frequent go cues.
The neural circuitry underlying response control is often studied using go/no-go tasks, in which participants are required to respond as fast as possible to go cues and withhold from responding to no-go stimuli. In the current task, response control was studied using a fully counterbalanced design in which blocks with a low frequency of no-go cues (75% go, 25% no-go) were alternated with blocks with a low frequency of go cues (25% go, 75% no-go); see also "Segregating attention from response control when performing a motor inhibition task: Segregating attention from response control" [1]. We applied a whole brain corrected, paired t-test to the data assessing for regions differentially activated by low frequency no-go cues relative to high frequency go cues. In addition, we conducted a generalized psychophysiological interaction analysis on the data using a right inferior frontal gyrus seed region. This region was identified through the BOLD response t-test and was chosen because right inferior gyrus is highly implicated in response inhibition.


Identification and isolation of vinculin from platelets.
A vinculin-like protein was identified in chicken as well as in bovine platelets by ELISA competitive binding assay using antibodies against vinculin from chicken gizzard. By a modified procedure (J. Biol. Chem. (1980) 255, 1194-1199) we succeeded in isolating bovine platelet vinculin to apparent homogeneity. The structural identity of platelet and chicken gizzard vinculin was demonstrated by circular dichroism analysis. It was also shown that platelet vinculin induces a significant decrease in the low shear viscosity of F-actin. Vinculin, in all probability, plays an important role in the organization of actin filaments in platelets, especially in the linkages of microfilaments to the membrane.


PSA-NCAM expression in the piriform cortex of the adult rat. Modulation by NMDA receptor antagonist administration.
Administration of NMDA receptor antagonists upregulates the expression of the polysialylated form of the neural cell adhesion molecule (PSA-NCAM) in the adult hippocampus. Since the piriform cortex is also populated by PSA-NCAM immunoreactive neurons during adulthood, we sought to characterize them in detail and to test whether NMDA receptor antagonists also modulate PSA-NCAM in this cortical region. PSA-NCAM immunoreactivity is located mainly in layer II, where many neurogliaform and some pyramidal-semilunar transitional neurons are labeled. Many large neurons in layer III and endopiriform nucleus also express PSA-NCAM. Interestingly, some small labeled cells resembling migratory neuroblasts appear in these layers and in the ventral end of the corpus callosum subjacent to the piriform cortex. These putative migratory cells and some neurogliaform neurons in layer II do not express NeuN, a marker of differentiated neurons. Many of these PSA-NCAM immunoreactive cells also express doublecortin, a molecule involved in neuronal migration. The number of PSA-NCAM immunoreactive neurogliaform neurons increases significantly 7 days after the administration of an NMDA receptor antagonist. Moreover, 21 days after the treatment we observe a significant increase in the number of doublecortin expressing cells in the deep layers of the piriform cortex. These results expand the current knowledge of the neuronal populations expressing PSA-NCAM in the piriform cortex, suggesting that some of these cells could be involved in structural plastic events such as axonal outgrowth, synaptogenesis or even neuronal migration. Similar to the hippocampus, NMDA receptors appear to play a critical role in these processes in the adult piriform cortex.


Microbial load of heritage dermatological moulages of the historic university department in Wroclaw, Poland.
Many historic dermatology departments keep and preserve valuable collections of dermatological moulages. The aim of the present research was to find out whether the specimens collected in the Museum of the Department of Dermatology, Venereology, and Allergology of Wroclaw Medical University are colonized by microorganisms, and whether these organisms can pose a risk of damage to this heritage or a health risk to visitors. In the study 32 historic moulages and their environment (museum) were subjected to microbiological evaluation. Swabs from moulages turned to be positive in 28% of cases. Micrococcus luteus was mainly isolated. The flora isolated from the air and the external surfaces of the museum display cases was much richer. Environmental bacteria and fungi were determined, as well as organisms probably associated with the hospital flora: Pseudosomonas spp., Paebacillus sp., Acinetobacter sp. The close proximity of clinical wards probably influences the composition of the museum environment. The surprisingly low contamination of the moulages may be due to the antiseptic properties of the bee wax from which they were made. Conservation work on the moulages as well as people visiting the museum do not pose significant health risks. However, the small number of studies devoted to this topic limits the conclusions. Further research on medical collections is needed to provide 'evidence-based care' for this heritage.


Antioxidant and antimicrobial activities of fruit extracts from different fresh chili peppers.
The aim of the current study was to assess the antimicrobial and antioxidant potential of ethanol extracts obtained from the fruit of five species of fresh chili pepper, Capsicum (C.) baccatum L. (Aji Amarillo), C. chinense (Fidalgo Roxa), C. annuum (Cherry Chocolate), C. pubescens (Rocoto Orange) and C. frutescens (Peruvian Purple). To obtain the ethanol extracts, accelerated solvent extraction (ASE) was applied. DPPH assay was used to determine the antioxidant activity of the extract samples. The disc diffusion method was used to measure antimicrobial activity against nine investigated microorganism species. The tested extract samples exhibited DPPH radical scavenging activities ranging from 0.24 ±0.01 (Peruvian Purple) to 0.72 ±0.02 (Aji Amarillo) mg TEAC∙g–1 dw. The differences between all the varieties were statistically significant (P < 0.05; except for the Cherry Chocolate and Rocoto Orange), and the potential of antioxidant capacity increased in the following manner: Peruvian Purple < Fidalgo Roxa < Rocoto Orange < Cherry Chocolate < Aji Amarillo. The results from the antimicrobial evaluation showed that the Capsicum extracts had no uniform inhibition activity against tested gram-negative, gram-positive bacteria, and yeast. Specifically, Aji Amarillo fruit extract revealed the strongest antimicrobial activity against S. pneumoniae (6.33 ±0.58 mm), followed by Cherry Chocolate against S. pneumoniae (5.33 ±0.58 mm), Rocoto Orange against S. enterica (5.27 ±0.58 mm), Fidalgo Roxa against C. albicans (4.67 ±0.58 mm), and Peruvian Purple against S. pneumoniae (4.57 ±0.58 mm). Considering these results, Capsicum spp. can be used as a source of novel antioxidant and antimicrobial compounds.


Glutathione S-transferase P1, gene-gene interaction, and lung cancer susceptibility in the Chinese population: An updated meta-analysis and review.
To assess the impact of glutathione S-transferase P1 (GSTP1) Ile105Val polymorphism on the risk of lung cancer in the Chinese population, an updated meta-analysis and review was performed. Relevant studies were identified from PubMed, Springer Link, Ovid, Chinese Wanfang Data Knowledge Service Platform, Chinese National Knowledge Infrastructure, and Chinese Biology Medicine published through January 22, 2015. The odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to estimate the strength of the associations. A total of 13 case-control studies, including 2026 lung cancer cases and 2451 controls, were included in this meta-analysis. Overall, significantly increased lung cancer risk was associated with the variant genotypes of GSTP1 polymorphism in the Chinese population (GG vs. AA: OR=1.36, 95% CI=1.01-1.84). In subgroup analyses stratified by geographic area and source of controls, the significant results were found in population-based studies (GG vs. AA: OR=1.62, 95% CI: 1.13-2.31; GG vs. AG: OR=1.49, 95% CI: 1.03-2.16; GG vs. AA+AG: OR=1.55, 95% CI: 1.12-2.26). A gene-gene interaction analysis showed that there was an interaction for individuals with combination of GSTM1 (or GSTT1) null genotype and GSTP1 (AG+GG) mutant genotype for lung cancer risk in Chinese. This meta-analysis suggests that GSTP1 Ile105Val polymorphism may increase the risk of lung cancer in the Chinese population.


Huge primary retroperitoneal mature cystic teratoma mimicking adrenal incidentaloma: A case report and literature review.
Teratomas originating from extra-gonadal account for 15 % of all teratomas, while retroperitoneal site being the least site for teratoma 1-11 %, extremely rare adrenal teratoma is less than 4 % of the retroperitoneal teratomas. Usually, patients are asymptomatic and the tumours are detected incidentally during imaging. A case of a 29 years old female, presented with intractable pain for four weeks. Computed tomography scan study of the abdomen showed an avascular septate cystic lesion measuring 11.6 × 11.4 14.5 cm (cranial-caudal x transverse x anterior-posterior) with central fat density and large punctate calcification in the right suprarenal region displacing the inferior vena-cava laterally, abutting the gall bladder, pancreas and duodenum. Impressions of right adrenal teratoma and less likely adrenal myelipoma were suggested. She remarkably improved one day post operation. During clinic visit a month later, she was completely recovered and resumed her daily activities. In adults primary retroperitoneal mature cystic teratoma are uncommon, mostly are secondary tumours and very rare will occur in adrenal gland. Adrenal incidentaloma have been seldom reported mimicking primary mature cystic teratoma. Biochemical and Imaging studies are of great importance in diagnosing and showing relationship of the tumour and other organs. This work has been reported in line with the SCARE criteria (Agha et al., 2018 [1]). Primary retroperitoneal tumours are rare and surgery is the main stay of treatment whether it be open or laparoscopic, the latter being best for small lesion for it offers early recovery and complete excision gives excellent prognosis of 100 %.


No association of DAPK1 and ABCA2 SNPs on chromosome 9 with Alzheimer's disease.
Recently genetic variation in the DAPK1 and ABCA2 genes has been reported to be associated with late- and early-onset Alzheimer's disease (AD), respectively. We examined the most significant two single-nucleotide polymorphisms (SNPs) in DAPK1 in a large case-control cohort of late-onset subjects and matched controls and one of the most significant SNPs in ABCA2 in a small set of early-onset subjects as well. We did not detect associations with AD for any variation.


Impact of engineered zinc oxide nanoparticles on the individual performance of Mytilus galloprovincialis.
The increased use of engineered nanoparticles (ENPs) in consumer products raises the concern of environmental release and subsequent impacts in natural communities. We tested for physiological and demographic impacts of ZnO, a prevalent metal oxide ENP, on the mussel Mytilus galloprovincialis. We exposed mussels of two size classes, <4.5 and ≥ 4.5 cm shell length, to 0.1-2 mg l(-1) ZnO ENPs in seawater for 12 wk, and measured the effect on mussel respiration, accumulation of Zn, growth, and survival. After 12 wk of exposure to ZnO ENPs, respiration rates of mussels increased with ZnO concentration. Mussels had up to three fold more Zn in tissues than control groups after 12 wk of exposure, but patterns of Zn accumulation varied with mussel size and Zn concentrations. Small mussels accumulated Zn 10 times faster than large mussels at 0.5 mg l(-1), while large mussels accumulated Zn four times faster than small mussels at 2 mg l(-1). Mussels exposed to 2 mg l(-1) ZnO grew 40% less than mussels in our control group for both size classes. Survival significantly decreased only in groups exposed to the highest ZnO concentration (2 mg l(-1)) and was lower for small mussels than large. Our results indicate that ZnO ENPs are toxic to mussels but at levels unlikely to be reached in natural marine waters.


The effects of ovarian biopsy and blood sampling methods on salivary cortisol and behaviour in sows.
In reproductive physiology research, experimental animals are often subjected to stressful procedures, including blood sampling and biopsy. In this present study, presence of pain or distress induced by four different procedures was examined using a measurement of salivary cortisol levels and activity observations in sows. The treatments were: 1) PAL: The ovary was palpated through the rectum without snaring, 2) TUB: transvaginal ultrasound-guided biopsy of the ovary was conducted without snaring, 3) SNA: a soft rope snare was placed around the maxilla, 4) CAT: A soft rope snare was placed around the maxilla, and an intravenous catheter was inserted through the ear vein of the sows. Activities, social cohesion and other pain-related behaviour, and salivary cortisol concentrations were recorded. Salivary cortisol concentrations in CAT sows increased in response to the procedure (P<0.05), whereas the other treatments did not trigger a significant response. The CAT sows had higher cortisol concentrations than the other groups for 10min after initiation of the procedures (P<0.01), and they maintained higher cortisol levels than the PAL and TUB groups 15min post-treatment (P<0.05). Furthermore, the CAT sows showed the highest frequency of head shaking (P<0.001) and trembling behaviour (P<0.05) during the 1h post-treatment. Summarizing, the catheterization procedure might induce a short-term pain or stress response during and after the procedure in terms of pain-related behaviour and salivary cortisol status. We suggest that TUB might not cause appreciable pain or distress.


Caspr2 antibody limbic encephalitis is associated with Hashimoto thyroiditis and thymoma.
Contactin-associated protein 2 (Caspr2) antibody is a neuronal surface antibody (NSAb) capable of causing disorders involving central and peripheral nervous systems (PNS). Thymoma can be found in patients with Caspr2 antibodies and is most frequently associated with PNS symptoms. Myasthenia gravis can be found in these patients, but Hashimoto thyroiditis (HT) has not been reported. A 76-year-old woman presented with sub-acute-onset changes in mental status. Further investigations revealed thymoma and HT. The presence of NSAb was tested by immunofluorescence on human embryonic kidney-293 cells. Treatment included corticosteroids, azathioprine, thyroxine, plasmapheresis, and thymectomy. Caspr2 antibody was positive in serum but absent in CSF. Brain magnetic resonance imaging (MRI) showed diffuse cortical atrophy, but did not change significantly after treatments. Brain positron emission tomography (PET) revealed diffuse hypometabolism over the cerebral cortex. The patient's mental status only partially improved. In Caspr2 antibody-associated syndromes, thymoma can occur in patients presenting only with LE, and HT can be an accompanying disease. Brain MRI and PET may not show specific lesions in limbic area. Patients with Caspr2 antibodies and thymoma may not have good prognosis.


Myocardial technetium 99m-labeled teboroxime clearance derived from canine scans differentiates severity of stenosis after dipyridamole.
The purposes of this study were to determine (1) whether perfusion defects and differential teboroxime clearance observed on serial postdipyridamole planar gamma camera images have utility in differentiating severity of coronary stenosis in canine myocardium and (2) whether single-zone (99mTc activity in one zone over time) or dual-zone (99mTc activity ratio in two zones over time) quantitative analysis provides the most useful characterization of teboroxime clearance kinetics. Accordingly, eight dogs received a mild coronary stenosis (microsphere-determined, post-dipyridamole flow > or = 0.4 ml/min/gm) and 10 dogs received a severe coronary stenosis (flow < or = 0.3 ml/min/gm). In three control dogs there was no coronary stenosis. Teboroxime (5 mCi) was injected after dipyridamole (0.8 mg/kg/min), and gamma camera imaging was begun immediately and continued for 60 minutes. Quantitative analysis of single-zone clearance curves indicated that teboroxime retention for both zones of stenosis (mild = 66.3% +/- 2.8%, SEM; severe = 69.5% +/- 3.7%) was significantly greater than control zone retention (54.5% +/- 3.0%; p < 0.05) at 10 minutes. Retention in mild (37.2% +/- 1.9%, SEM) and severe (42.3% +/- 1.5%) zones of stenosis was significantly different from each other at 60 minutes (p < 0.05). There was a significant direct, linear correlation of flow with teboroxime clearance at 20 minutes (r = +0.74, normal and ischemic zones). Quantitative analysis with dual-zone count ratios (stenosed/normal) demonstrated significant differences among control (0.93 +/- 0.04, SEM), mild stenoses (0.54 +/- 0.04), and severe stenoses (0.39 +/- 0.03) as early as 2 minutes after administration of 99mTc-labeled teboroxime. The correlation coefficient for flow ratio versus dual-zone counts/pixel ratio at 20 minutes was r = +0.74. Thus in this canine stenosis model with dipyridamole, gamma camera imaging could distinguish mild from severe coronary stenoses by either single- or dual-zone analysis.


How to minimize morbidity in radiotherapy of pharyngolaryngeal tumors?
Radiotherapy is one of the most effective treatment modalities for head and neck cancer. However, because of the intricacy between tumors and normal tissues, it can induce morbidity, such as mucositis, dermatitis, xerostomia, dysphagia, hearing loss, vision impairment, skin fibrosis, and osteoradionecrosis of the jaw, and it can dramatically impact on patient quality of life. Throughout the last decade, significant improvements have been made in head and neck cancer radiotherapy, especially with the introduction on a routine basis of intensity-modulated radiotherapy. In this context, this review manuscript will focus on how the implementation of intensity-modulated radiotherapy influences treatment morbidity. Specifically, the issues of target volume and organ-at-risk delineation, sparing of organs at risk, tailored treatment intensity, adaptive treatment, and the use of proton therapy will be discussed.


How to measure the local Dzyaloshinskii-Moriya Interaction in Skyrmion Thin-Film Multilayers.
The current-driven motion of skyrmions in MnSi and FeGe thinned single crystals could be initiated at current densities of the order of 106 A/m2, five orders of magnitude smaller than for magnetic domain walls. The technologically crucial step of replicating these results in thin films has not been successful to-date, but the reasons are not clear. Elucidating them requires analyzing system characteristics at scales of few nm where the key Dzyaloshinskii-Moriya (DM) interactions vary, and doing so in near-application conditions, i.e. in systems at room temperature, capped with additional layers for oxidation protection. In this work's magnetic force microscopy (MFM) studies of magnetron-sputtered Ir/Co/Pt-multilayers we show skyrmions that are smaller than previously observed, are not circularly symmetric, and are pinned to 50-nm wide areas where the DM interaction is higher than average. This finding matches our measurement of inhomogeneity of the magnetic moment areal density, which amounts to a standard deviation of the Co layer thickness of 0.3 monolayers in our 0.6 nm thick Co layers. This likely originates in small Co layer thickness variation and alloying. These film characteristics must be controlled with greater precision to preclude skyrmion pinning.


[Food hypersensibility: inhalation reactions are different from ingestion reactions].
Eight children, aged from 3 to 9 years, presented to inhaled peanut an immediate allergic reaction. All were sensitized to peanut but none had already ingested it overtly. A strict avoidance diet was prescribed concerning this food allergen. An oral provocation challenge was realized to determine the eliciting dose (ED) to ingestion. The ED was high enough to allow all the children a less restrictive diet. Inhaled allergic reaction to peanut does not always justify a strict avoidance diet.


Impact of zinc supplementation on the improvement of ethanol tolerance and yield of self-flocculating yeast in continuous ethanol fermentation.
The effects of zinc supplementation were investigated in the continuous ethanol fermentation using self-flocculating yeast. Zinc sulfate was added at the concentrations of 0.01, 0.05 and 0.1 g l(-1), respectively. Reduced average floc sizes were observed in all the zinc-supplemented cultures. Both the ethanol tolerance and thermal tolerance were significantly improved by zinc supplements, which correlated well with the increased ergosterol and trehalose contents in the yeast flocs. The highest ethanol concentration by 0.05 g l(-1) zinc sulfate supplementation attained 114.5 g l(-1), in contrast to 104.1 g l(-1) in the control culture. Glycerol production was decreased by zinc supplementations, with the lowest level 3.21 g l(-1), about 58% of the control. Zinc content in yeast cells was about 1.4 microMol g(-1) dry cell weight, about sixfold higher than that of control in all the zinc-supplemented cultures, and close correlation of zinc content in yeast cells with the cell viability against ethanol and heat shock treatment was observed. These studies suggest that exogenous zinc addition led to a reprogramming of cellular metabolic network, resulting in enhanced ethanol tolerance and ethanol production.


First confirmed human case of Diphyllobothrium stemmacephalum infection and molecular verification of the synonymy of Diphyllobothrium yonagoense with D. stemmacephalum (Cestoda: Diphyllobothriidea).
Several tapeworm species in the genus Diphyllobothrium Cobbold, 1858 have uncertain taxonomic positions, leading to taxonomic confusion as well as misdiagnosis of infections. Taxonomic revision based on DNA sequence analysis is considered necessary to resolve the taxonomy of several cases, including that between Diphyllobothrium stemmacephalum, the type species of the genus, and Diphyllobothrium yonagoense. Diphyllobothrium yonagoense was synonymized with D. stemmacephalum based on morphological observations by Andersen (1987), however no molecular studies have been undertaken to verify the validity of this synonymization. In the present study, the first human case confirmed molecularly as D. stemmacephalum infection is reported, and the validity of the synonymization of D. yonagoense with D. stemmacephalum was assessed based on molecular phylogenetics. Diphyllobothrium stemmacephalum and D. yonagoense grouped into the same clades with high bootstrap confidence values for both cox1 and nad3. Genetic distances between the two taxa were very small (0.000-0.012 and 0.000-0.017 for cox1 and nad3, respectively) and were considered to fall within the range of intraspecific variation. Using these molecular analyses, this study verified molecularly that D. yonagoense is a junior synonym of D. stemmacephalum. Further, the closer phylogenetic relationship between D. stemmacephalum and Diplogonoporus species rather than other diphyllobothriids, including Diphyllobothrium nihonkaiense and Diphyllobothrium latum, was corroborated. The genus name for D. nihonkaiense and D. latum is also discussed.


Water swallows versus food ingestion as manometric tests for esophageal dysfunction.
Data from 100 consecutive patients with chest pain or dysphagia, or both, who underwent esophageal testing with standard water swallows and upright food ingestion were retrospectively evaluated. In addition to having manometric patterns monitored, patients were asked to relate symptoms during testing. Of 77 patients with a history of dysphagia, significantly more had abnormal manometry during the test meal than with water swallows (79 vs. 43%, p less than 0.005). Additionally, dysphagia, although reported in only 8% of these patients during standard testing, occurred in 47% during the test meal (p less than 0.001). Of 60 patients with chest pain, symptoms were rarely reported (5%) with water or with food ingestion. We conclude that manometry with food ingestion should be used as a provocative test in anatomically normal patients with dysphagia.


Metallophilic macrophages are lacking in the thymus of lymphotoxin-beta receptor-deficient mice.
Lymphotoxin-beta receptor (LTbetaR) axis plays a crucial role in development and compartmentalization of peripheral lymphatic organs. But, it is also required for the appropriate function and maintenance of structural integrity of the thymus: in LTbetaR-deficient animals the clonal deletion of autoreactive lymphocytes is impaired and differentiation of thymic medullary epithelial cells is disturbed. In this study, using several markers, we showed that thymic metallophilic macrophages were lacking in LTbetaR-deficient mice. In tumor necrosis factor receptor-I (p55)-deficient mice (which we used as positive control) thymic metallophilic cells were located, similarly as in normal mice, in the thymic cortico-medullary zone at the junction of cortex and medulla. These findings show that LTbetaR is necessary for maintenance of metallophilic macrophages in the thymus and provide further evidence that these cells may represent a factor involved in thymic negative selection.


Discriminatory ability of simple OGTT-based beta cell function indices for prediction of prediabetes and type 2 diabetes: the CODAM study.
The hyperglycaemic clamp technique and the frequently sampled IVGTT are unsuitable techniques to assess beta cell function (BCF) in large cohorts. Therefore, the aim of this study was to evaluate the discriminatory ability of simple OGTT-based BCF indices for prediction of prediabetes (meaning impaired fasting glucose and/or impaired glucose tolerance) and type 2 diabetes. Glucose metabolism status was assessed by 2 h 75 g OGTT at baseline (n = 476, mean age 59.2 years, 38.7% women) and after 7 years of follow-up (n = 416) in the Cohort on Diabetes and Atherosclerosis Maastricht (CODAM) study (1999-2009). Baseline plasma glucose, insulin and C-peptide values during OGTTs were used to calculate 21 simple indices of BCF. Disposition indices (BCF index × Matsuda index), to compensate for the prevailing level of insulin resistance, were calculated for the BCF indices with the best discriminatory abilities. The discriminatory ability of the BCF indices was estimated by the area under the receiver operating characteristics curve (ROC AUC) with an outcome of incident prediabetes (n = 73) or type 2 diabetes (n = 60 and n = 18 cases, respectively, in individuals who were non-diabetic or had normal glucose metabolism at baseline). For incident prediabetes (n = 73), all ROC AUCs were less than 70%, whereas for incident type 2 diabetes, I30/I0, CP30/CP0, ΔI30/ΔG30, ΔCP30/ΔG30 (where I, CP and G are the plasma concentrations of insulin, C-peptide and glucose, respectively, at the times indicated), and corrected insulin response at 30 min had ROC AUCs over 70%. In at-baseline non-diabetic individuals, disposition indices ΔI30/ΔG30, ΔCP30/ΔG30 and corrected insulin response at 30 min had ROC AUCs of over 80% for incident type 2 diabetes. Moreover, these BCF disposition indices had significantly better discriminatory abilities for incident type 2 diabetes than the Matsuda index alone. BCF indices reflecting early-phase insulin secretion have the best ability to discriminate individuals who will develop prediabetes and type 2 diabetes. Of these, ΔCP30/ΔG30, often referred to as the C-peptidogenic index, performed consistently well.


Isolation of ribonuclease-free intact polyribosomes from rat kidney.
High levels of RNAase present in rat kidney have prevented isolation of intact polyribosomes from this tissue. This problem has been circumvented by a thorough in situ arterial perfusion of rat kidney, coupled with homogenization of the perfused rat kidney in heparin and detergents-fortified high-speed supernatant prepared from rat liver. This procedure reduced RNAase activity in the homogenate by as much as 70%. Sedimentation of the polyribosomes from this homogenate through a layer of 2.0 M sucrose resulted in a 78--80% yield of polyribosomes from the rat kidney. The resulting polyribosomal pellet contained less than 8% of the RNAase activity present in polyribosomes from non-perfused rat kidney. The remaining RNAase activity was separated from the larger polyribomes by sucrose density gradient centrifugation. The majority of the polyribosomes were larger than tetramers. This procedure also incrased both the yield and size of polyribosomes from rat and mouse liver.


An amperometric enzyme-linked immunosensor for Nitrobacter.
A new amperometric enzyme-linked immunoassay for specific enumeration of Nitrobacter has been developed. This assay uses an electrode made of glassy carbon, on which the immunological reaction is carried out. The method is based on a competitive immunoassay principle, utilising monoclonal primary antibody and alkaline-phosphatase-labelled secondary antibody. The enzyme substrate 5-bromo-4-chloro-3-indolyl phosphate generates an electroactive product which is amperometrically detected. The effects of different parameters on the performance of the sensor have been studied. Quantitative detection of Nitrobacter using the immunosensor has been compared to a previously developed enzyme-linked immunosorbent assay showing compatible results. In addition, the overall assay time can be shortened with this new sensor. A detection limit of approximately 3 x 10(6) Nitrobacter cells/ml was obtained.


Comparison of metabolic effects of pioglitazone, metformin, and glimepiride over 1 year in Japanese patients with newly diagnosed Type 2 diabetes.
To compare the metabolic effects of pioglitazone, metformin, and glimepiride in the treatment of Japanese patients with newly diagnosed Type 2 diabetes. A total of 114 patients with Type 2 diabetes who had never used oral hypoglycaemic drugs were studied for 12 months. Patients were randomly assigned to pioglitazone (30-45 mg/day, n = 38), metformin (750 mg/day, n = 39), or glimepiride (1.0-2.0 mg/day, n = 37). The effect of treatment on fasting plasma glucose (FPG), glycated haemoglobin (HbA(1c)), 1,5-anhydroglucitol (1,5AG), total cholesterol, high-density lipoprotein (HDL)-cholesterol, triglycerides, free fatty acids (FFA), and fasting plasma insulin levels was monitored monthly. Body weight and safety data were also collected. Eight patients withdrew from the study (three in the pioglitazone group, two in the metformin group, and three in the glimepiride group). The rate of reduction of HbA(1c) was fastest in patients receiving glimepiride and slowest in patients receiving pioglitazone. Although there were no significant differences among the three groups in HbA(1c) levels at the end of the study, patients taking pioglitazone had relatively lower FPG and 1,5AG levels than patients taking the other two drugs. These results suggest that pioglitazone acts predominantly on nocturnal metabolism rather than at mealtimes. FFA were reduced significantly in those taking pioglitazone (542.2 microEq/l vs. 237.3 microEq/l; P < 0.01) before a decrease in HbA(1c) was apparent. The change in FFA levels correlated with the change in HbA(1c) (r = 0.409, P < 0.01). There were no significant differences in other lipid parameters among the groups. Pioglitazone, metformin, and glimepiride are equally effective in reducing blood glucose in patients with newly diagnosed Type 2 diabetes. However, their specific characteristics, such as the rapid action on blood glucose levels of glimepiride and the favourable action on FPG and FFA of pioglitazone, should be considered when choosing an appropriate agent.


Functional foot salvage after extensive plantar excision and amputations proximal to the standard transmetatarsal level.
It is generally accepted that when necrosis extends proximal to the transmetatarsal level a viable and functional foot can no longer be preserved and a major (above- or below-knee) amputation must be performed. However, with continuing advances in operations for limb salvage we felt the need to reexamine this concept. In 1983 we initiated a prospective study to evaluate the role of extended foot amputations. All ambulatory patients with necrosis extending proximal to the transmetatarsal level (but not involving the whole foot) were included in the study. Among the 21 patients studied amputations ranged from open guillotine transmetatarsal amputation to removal of the medial or lateral three fifths of the foot. Five of these patients had adequate pedal circulation by clinical and laboratory criteria. The remaining 16 required vascular reconstruction to improve pedal flow. Eighteen (86%) of 21 patients had complete healing of the foot amputations and were ambulatory at the time of discharge from the hospital. Two patients required early above- or below-knee amputations. Three additional patients sustained limb loss in the follow-up period. The cumulative graft patency rate was 94% at 12 months. The cumulative limb salvage rate at 24 months was 84%. The operative mortality rate was 1 (5%) of 21. Our experience in a small number of patients suggests that functional foot salvage is possible even when necrosis or gangrene extends proximal to the transmetatarsal level.


The Ca, Cl, Mg, Na, and P mass fractions in human bone affected by Ewing's sarcoma.
The Ca, Cl, Mg, Na, and P contents and Ca/P, Ca/Mg, Ca/Na, Cl/Ca, and Cl/Na ratios in samples of intact bone, inflamed bone, and Ewing's sarcoma tissue were investigated by neutron activation analysis with high-resolution spectrometry of short-lived radionuclides. In Ewing's sarcoma tissue, the mass fractions of Cl and Na are higher and the mass fractions of Ca and Mg are lower than those of both normal and inflamed bone tissues. It was shown that the levels of Ca and Cl mass fractions and also levels of the Ca/Cl and Cl/Na ratios can be used as an additional test for differential diagnosis between inflamed (or normal) bone and Ewing's sarcoma.


[Effect of a recombinant lentiviral vector carrying hepatocyte nuclear factor 6 gene on migration and invasion abilities of SW620 cells].
To construct a recombinant lentiviral vector that stably express hepatocyte nuclear factor 6 (HNF6) in colorectal cancer cell line and examine its effects on the invasive ability of SW620 cells. The lentiviral vector pLeno-DCE-HA-HNF6 was constructed and transfected into 293T cells. The supernatant containing the lentivirus particles was harvested to determine the virus titer. A stable cell line was established by infecting SW620 cells with the lentivirus particles, and the transfection efficiency was examined by fluorescence microscopy and flow cytometry. The invasion ability of the transfected SW620-HNF6 cells was assessed by wound healing and transwell assays. The recombinant lentiviral vector was correctly constructed and verified by sequencing. SW620-HNF6 cell line with stable HNF6 expression was established successfully, and the transfection efficiency reached 82.3%. Western blotting and quantitative PCR demonstrated significantly upregulated HNF6 expression in SW620-HNF6 cells, which showed obviously suppressed invasive ability in wound healing and transwell assays. We have successfully established a colorectal cancer cell line SW620-HNF6 stably expressing HNF6, which shows a lowered migration activity in vitro.


The effects of altering attentional demands of gait control on the variability of temporal and kinematic parameters.
The purpose of this study was to investigate the effects of cognitive and visuomotor tasks on gait control in terms of the magnitude and temporal structure of the variability in stride time and lower-limb kinematics measured using inertial sensors. Fourteen healthy young subjects walked on a treadmill for 15min at a self-selected gait speed in the three conditions: normal walking without a concurrent task; walking while performing a cognitive task; and walking while performing a visuomotor task. The time series data of stride time and peak shank angular velocity were generated from acceleration and angular velocity data recorded from both shanks. The mean, coefficient of variation, and fractal scaling exponent α of the time series of these variables and the standard deviation of shank angular velocity over the entire stride cycle were calculated. The cognitive task had an effect on long-range correlations in stride time but not on lower-limb kinematics. The temporal structure of variability in stride time became more random in the cognitive task. The visuomotor task had an effect on lower-limb kinematics. Subjects controlled their swing limb with greater variability and had a more complex adaptive lower-limb movement pattern in the visuomotor task. The effects of the dual tasks on gait control were different for stride time and lower-limb kinematics. These findings suggest that the temporal structure of variability and lower-limb kinematics are useful parameters to detect a change in gait pattern and provide further insight into gait control.


Polymorphisms in MSH2 gene and risk of gastric cancer, and interactions with lifestyle factors in a Chinese population.
Although polymorphisms in DNA mismatch repair (MMR) gene MSH2 have been associated with risks of many cancers, little is known about their etiology role in gastric cancer (GC) and the potential interacting role with lifestyle factors known to damage DNA. A population-based study was conducted in 3 counties (Jintan, Taixing and Huaian) of Jiangsu Province, the high-risk areas of GC in China. We investigated the association of polymorphisms IVS12-6T>C and IVS10+12G>A in MSH2 gene with the risk of GC and the potential gene-lifestyle interaction. The risk of GC was found to be associated with the IVS12-6C allele (CC vs TT, OR=2.34, 95% CI: 1.17-4.71) and IVS10+12A allele (GA or AA vs GG, OR=1.55, 95% CI: 1.14-2.21; and GA vs GG, OR=1.51, 95% CI: 1.04-2.17). Stratified analysis indicated that an increased risk of GC also was observed in: suspected familial subjects carrying the IVS12-6T>C (OR=1.68, 95% CI: 1.27-2.66) or IVS10+12G>A (OR=2.57, 95% CI: 1.53-4.10); or younger subjects carrying the IVS12-6T>C (OR=2.15, 95% CI: 1.24-3.91) or IVS10+12G>A (OR=2.23, 95% CI: 1.20-4.33); or male subjects carrying the IVS10+12G>A (OR=1.64; 95% CI: 1.10-2.54). Furthermore, the combined IVS12-6CC and IVS10+12AA genotypes also significantly increased the risk of GC (OR=2.12, 95% CI: 1.22-3.66). Statistically significant interactions were observed between: IVS10+12G>A and drinking, high pickled food or fried food intake (OR=2.32; 95% CI: 1.43-3.78, OR=2.55; 95% CI: 1.48-4.21 and OR=2.88; 95% CI: 1.70-4.94, respectively); and IVS12-6T>C and high pickled food intake or fried food intake (OR=2.65; 95% CI: 1.62-4.47 and OR=2.48; 95% CI: 1.42-4.13, respectively). The IVS10+12G>A and IVS12-6T>C polymorphisms in MSH2 gene appear to be associated with risk of GC in this Chinese population. Risk for GC, stratified by related genotypes, was further modified by drinking, high pickled food or fried food intake. Larger prospective studies are needed to confirm these findings.


Regional metrology organisations and the JCRB.
In 1999, National Metrology Institutes (NMIs) from some 39 countries signed the International Committee of Weights and Measures (CIPM) Mutual Recognition Arrangement (MRA) in Paris. The MRA, drawn up by the CIPM, under the authority given to it in the Metre Convention, was in response to requirements of Governments and Regulators to provide a sound technical foundation for trade agreements. Core objectives of the MRA are to allow for the establishment of the degree of equivalence of national measurement standards and to provide for mutual recognition of calibration certificates issued by NMIs. This presentation will detail the evolution of the MRA. Globally, NMIs are affiliated to Regional Metrology Organisations (RMOs). The key role of the RMOs in the MRA process will be discussed along with the structure and objectives of the various RMOs worldwide. The Joint Committee of the RMOs and the BIPM (JCRB) plays a central part in the effective operation of the MRA. Its tasks, membership and output will also be described.


Acute phase reactant alpha 1-antichymotrypsin is increased in cerebrospinal fluid and serum of patients with probable Alzheimer disease.
Levels of alpha 1-antichymotrypsin (alpha 1-ACT) in cerebrospinal fluid (CSF) and serum from patients with probable Alzheimer disease (AD) of both early (e-AD) and late (l-AD) onset assessed by a competitive enzyme-linked immunosorbent assay were higher than those found in controls or in patients with vascular dementia (VD). A negative correlation between CSF levels of alpha 1-ACT and the stage of the disease was present in patients with both e-AD and l-AD. No difference in alpha 2-macroglobulin levels in CSF and serum from patients with e-AD, l-AD, VD, and nondemented controls was found. Serum concentrations of alpha 1-antitrypsin from l-AD subjects were within the normal range. Thus, increased levels of alpha 1-ACT in CSF and serum were specifically associated with AD, and the detection of this serpin in CSF may be useful in monitoring the progression of the disease.


Influence of task-based airborne lead exposures on blood lead levels: a case study of informal automobile repair artisans in Nakuru town, Kenya.
Lead poisoning is an emerging worldwide public health concern, especially in the developing countries. Occupational tasks such as spray painting and welding in informal automobile repair enterprises present risks of exposures to lead generally through inhalation and ingestion. The artisans therefore risk high blood lead (BPb) levels, which is critical to chronic adverse health effects of lead. The study aimed at assessing the influence of occupational tasks on personal airborne lead exposures and to evaluate the association between these exposures with blood lead (BPb) levels among the artisans. A cross-sectional study was conducted in ten informal automobile repair workshops. Task-specific personal inhalable air samples and blood samples were collected concurrently for 20 participants performing five distinct occupational tasks. Lead levels were analysed using inductively coupled plasma atomic emission spectroscopy and data analysed by analysis of variance, simple and multiple linear regressions. The results indicated significant differences in airborne lead (PbA) exposure levels in different occupational tasks (p = 0.000). Lead-acid battery repairs recorded mean PbA exposure level of [76.11 ± (10.81 SE) µg/m3] exceeding the WHO 50 µg/m3 airborne lead permissible exposure limit. The average (PbA) exposure level was 22.55 ± (5.05 SE) µg/m3, while the mean (BPb) level was 25.08 ± (3.48 SE) µg/dl. A significant positive correlation between task-based airborne lead with blood lead levels was observed (r = 0.68, p = 0.001). In conclusion, the occupational tasks influenced personal airborne lead exposure levels, which in turn was an important predictor of blood lead levels. The study recommends lead exposure assessments, medical screening and intervention measures to minimize the risk and consequences of occupational exposures to lead among the study population.


Introducing LexTALE: a quick and valid Lexical Test for Advanced Learners of English.
The increasing number of experimental studies on second language (L2) processing, frequently with English as the L2, calls for a practical and valid measure of English vocabulary knowledge and proficiency. In a large-scale study with Dutch and Korean speakers of L2 English, we tested whether LexTALE, a 5-min vocabulary test, is a valid predictor of English vocabulary knowledge and, possibly, even of general English proficiency. Furthermore, the validity of LexTALE was compared with that of self-ratings of proficiency, a measure frequently used by L2 researchers. The results showed the following in both speaker groups: (1) LexTALE was a good predictor of English vocabulary knowledge; 2) it also correlated substantially with a measure of general English proficiency; and 3) LexTALE was generally superior to self-ratings in its predictions. LexTALE, but not self-ratings, also correlated highly with previous experimental data on two word recognition paradigms. The test can be carried out on or downloaded from www.lextale.com .


Promiscuous primates engage in same-sex genital interactions.
Same-sex genital interactions (SSGIs) occur across the order primates, yet explaining their maintenance in evolutionary terms appears problematic; as such interactions seem to counteract reproductive goals. We hypothesised that in more promiscuous species, where sexual motivation, mating effort, and non-conceptive heterosexual behaviour are greater, SSGIs may also occur at greater frequencies without necessarily impeding reproduction. We found that the expression of both male and female SSGIs were greater in multimale systems than in unimale ones. Both male and female SSGIs were positively correlated with the degree of promiscuity (relative testes mass). As mating system confers biases in the sex ratio that may influence the expression of SSGIs, we controlled for availability of members of the same-sex. When employing this control, results were largely congruent. For males, SSGIs were expressed more frequently in multimale systems. For both sexes, SSGIs were expressed more frequently with greater relative testes mass. We suggest SSGIs in primates may be a neutral by-product of selection for increases in promiscuous sexual activity, and that in certain instances these interactions may be co-opted to facilitate adaptive social functions.


[Albers-Schönberg's disease with ocular manifestation].
Albers-Schönberg's disease is a rare disease (one case in 100,000 inhabitants), asymptomatic in the majority of cases. It belongs to the four clearly individualized forms of human osteopetrosis and has an autosomal dominant transmission. It induces generalized osteosclerosis, and most symptoms result from complications such as fractures following mild injury, compression of cranial nerves, especially the optic nerve, by stenosis of extracranial ostia, but also osteomyelitis of the lower maxilla. The treatment of Albers-Schönberg's disease is disappointing and only symptomatic, although the responsible genetic anomaly was recently identified. We report here the case of a 54-year-old woman, whose diagnosis of the disease has been known since adolescence, who presented with unilateral loss of vision and perimetric deficit due to papilla edema resulting from stenosis of the optic canal and benign intracranial hypertension.


Olfaction: Repellents that Congest the Mosquito Nose.
How does the common insect repellent DEET modify a mosquito's ability to detect humans? New research using GCaMP-expressing mosquitoes suggests that DEET works differently for different mosquito species. For An. coluzzii, DEET and other non-volatile repellents mask the mosquitoes' ability to detect odors.


Molecular characterization, chromosomal localization, expression profile and association analysis with carcass traits of the porcine dickkopf homolog1 gene.
DKK1 (dickkopf homolog 1) is a potent inhibitor of the canonical Wnt/β-cantenin signalling pathway, which plays a pivotal role in myogenesis, adipogenesis, and many other crucial biological processes. In this study, DKK1 was assigned to porcine 14q25-26 by using the radiation hybrid (IMpRH) panel. A G1757A single nucleotide polymorphism site by Csp6I PCR-RFLP was identified. Association analysis showed that different genotypes were associated with loin muscle area (P = 0.0281). Semi-quantitative-RT-PCR analysis revealed that DKK1 was highly expressed in spleen and lymph node at two developmental stages, while in skeletal muscle, further real-time PCR quantified that DKK1 was down-regulated in Large White pigs compared to Tongcheng pigs, accompanied by the down-regulation of CTTNB1 and TCF4, the up-regulation of LRP6, suggesting that the phenotypic difference between lean and obese pigs might be correlated with the activity of Wnt/β-cantenin signalling pathway.


[Molecular mechanisms for intracellular parasitisation and exclusion in macrophage infected with Mycobacterium leprae].
It was previously demonstrated that TLR2 and CORO1A (TACO, Coronin 1, p57) localize phagosome membrane of macrophage. However, the functional relationship between TLR2 and CORO1A was not known. We show here that there is a functional counteraction between TLR2 and CORO1A.


The demonstration of cardiac pathology using perfusion-fixation.
A simple, cheap and reliable method of perfusion-fixation of hearts is described using readily available domestic water fitments and a pump specifically designed for continuous pumping of corrosive fluids. Hearts fixed in this way readily lend themselves to dissection in echocardiographic planes so that strict correlation with clinical echocardiography may be made. Furthermore it is an excellent way to demonstrate functional valve pathology on post-mortem material.


Maintenance and Development of Paramedics' Competence on Joint Emergency Medical Service and Helicopter Emergency Medical Service Missions.
In health care, learning and collaboration between professions are crucial in providing patient-centered, responsive, and high-quality care. Given that interprofessional learning can occur indirectly while working but is scarcely studied in the context of prehospital emergency care, we examined the maintenance and development of paramedic competence on joint emergency medical service (EMS) and helicopter emergency medical service (HEMS) missions. Qualitative methodology was chosen. Sixty-one Finnish paramedics and EMS field supervisors answered a single open-ended survey question. Inductive content analysis was used to analyze the data. The maintenance and development of paramedics' competence on joint EMS and HEMS missions formed 2 main categories: the transfer of professional skills and interactive competence development. The transfer of skills was formed by 3 upper categories: practicing working as part of the team, transmission of tacit knowledge, and deepening of clinical knowledge. Interactive competence development was formed by 2 upper categories: ensuring one's own competence and educational working model as built-in. All the upper categories had several subcategories. EMS and HEMS joint missions provide an additional learning opportunity for paramedics. The expertise, examples, and educational attitudes shared by the HEMS are valued. The results reveal the need for further research on this subject.


Incidental carcinoma gall bladder during laparoscopic cholecystectomy for symptomatic gall stone disease.
Carcinoma gall bladder (CaGB) is a disease with high mortality and is usually diagnosed as an incidental case among patients undergoing laparoscopic cholecystectomy (LC) for symptomatic gall stone disease. A total of 3205 LC done between January 2004 and August 2007 for symptomatic gall stone disease were retrospectively searched for incidental CaGB (detected on histopathology). None of these cases had preoperative suspicion of malignancy and their whole data was analyzed with special attention to preoperative and intraoperative findings which could raise suspicion of CaGB. In November 2007, patients were followed up telephonically about their present status of health. Nineteen patients (14 female and 5 male) with incidental CaGB (incidence 0.59%) were detected. Mean age of the patients was 56 years. Only two of these patients had clinical jaundice and both had common bile duct (CBD) stones. The majority of the patients were in early pathological stages (pT) and none was in pT3 and pT4 stage. Seventeen patients could be followed up telephonically in November 2007 and of those 14 patients were alive at a mean follow-up duration of 21.2 months, with one of them having evidence of metastatic disease. Gall bladder (GB) malignancy may be curable if diagnosed in early stages as an incidental finding and LC may not worsen the prognosis in such cases. In our series, incidental CaGB was detected in 0.59% patients undergoing LC. No association could be found between preoperative and intraoperative findings that could raise a suspicion of malignancy of gall bladder and so use of retrieval bag as a routine measure in cases with bile spillage may reduce the incidence of port-site metastasis.


Screening for gestational diabetes: different cut-offs for different ethnicities?
To examine whether screening guidelines for gestational diabetes should be modified based on ethnicity. This is a retrospective cohort study of 14,565 pregnancies screened for gestational diabetes. The primary outcome of interest was the diagnosis of gestational diabetes based on the results of the 100-g glucose tolerance test. A diagnosis was determined if any 2 of the 4 values (fasting or 1-, 2-, or 3-hour postprandial) were at or above 95, 180, 155, or 140 mg/dL, respectively. Values of the 50-g glucose-loading test were examined from 130 mg/dL to 150 mg/dL. The sensitivity, specificity, false-positive rates, and positive predictive values of various glucose-loading test cut-offs were compared among whites, African Americans, Latinas, and Asians. The sensitivities and specificities were compared using receiver-operator characteristic curves. Sensitivity and specificity of the glucose-loading test differ by ethnicity. Generally, African Americans achieved the highest sensitivities and specificities over the range examined. To achieve a false-positive rate of 10% for the glucose-loading test, the threshold value would be 133 mg/dL for African Americans, 140 mg/dL for whites, 143 mg/dL for Latinas, and 147 mg/dL for Asians. At the lower glucose-loading test values (130 and 135 mg/dL), Asians exhibited the highest positive predictive values (30.0% and 34.0%), whereas at higher values of the glucose-loading test (145 and 150 mg/dL), African Americans had the highest positive predictive values (46.0% and 51.5%). Throughout the glucose-loading test range, whites had the lowest positive predictive values (P < .001). To maximize the sensitivity and minimize the false-positive rate of the glucose-loading test, it may be reasonable to consider varying the threshold based on ethnicity. However, modification of glucose-loading test thresholds based on maternal ethnicity merit further study to determine whether improved perinatal outcomes can be achieved.


Impact of maternal diabetes on birthweight is greater in non-Hispanic blacks than in non-Hispanic whites.
To determine the impact of maternal diabetes during pregnancy on racial disparities in fetal growth. Using linked birth certificate, inpatient hospital and prenatal claims data we examined live singleton births of mothers resident in South Carolina who self-reported their race as non-Hispanic white (NHW; n = 140,128) or non-Hispanic black (NHB; n = 82,492) and delivered at 28-42 weeks' gestation between 2004 and 2008. Prepregnancy diabetes prevalence was higher in NHB (3.0%) than in NHW (1.7%), while the prevalence of gestational diabetes mellitus (GDM) was similar in NHB (6.1%) and NHW (6.3%). At a delivery BMI of 35 kg/m(2), GDM exposure was associated with an average birthweight only 17 g (95% CI 4, 30) higher in NHW, but 78 g (95% CI 61, 95) higher in NHB (controlling for gestational age, maternal age, infant sex and availability of information on prenatal care). Figures for prepregnancy diabetes were 58 g (95% CI 34, 81) in NHW and 60 g (95% CI 37, 84) in NHB. GDM had a greater impact on birthweight in NHB than in NHW (60 g racial difference [95% CI 39, 82]), while prepregnancy diabetes had a large but similar impact. Similarly, the RR for GDM of having a large- relative to a normal-weight-for-gestational-age infant was lower in NHW (RR 1.41 [95% CI 1.34, 1.49]) than in NHB (RR 2.24 [95% CI 2.05, 2.46]). These data suggest that the negative effects of GDM combined with obesity during pregnancy may be greater in NHB than in NHW individuals.