Restoration of fertility after non-obstructive vasectomy in the rabbit.
This study was undertaken for the purpose of comparing reversibility following long-term sperm obstruction with that following long-term sperm diversion. The rabbit served as the animal model. Sperm obstruction was produced by transection and ligation of the vasa deferentia near the vasal ampulla; sperm diversion by transection of vasa and anastomosis of afferent limb with urinary bladder. After one year. vasal continuity was reestablished by end-to-end vasovasostomy. Restoration of fertility was more successful after sperm diversion than after sperm obstruction. It is concluded that vasocystostomy in the rabbit is a safe and effective method of male fertility control with greater probability for successful reversal than conventional vasectomy.


The integration of public health and prevention into all years of a medical school curriculum.
This is one of six short papers that describe additional innovations to help integrate public health into medical education; these were featured in the "Patients and Populations: Public Health in Medical Education" conference. They represent relatively new endeavors or curricular components that had not been explored in prior publications. Although evaluation data are lacking, it was felt that sharing a description of the public health, prevention, population health, and policy (P4) curriculum at the University of Arizona College of Medicine, Phoenix (UACOM-P), would be of value to medical educators.


Decreased immunogenicity of fetal kidneys: the role of passenger leukocytes.
Early in gestation, fetal rat kidneys are less immunogenic than in later fetal stages, and also less immunogenic than early-gestation fetal hepatic tissue. The purpose of this study was to test this observation in an allogeneic model, and to explore the basis of the decreased immunogenicity of early-gestation fetal kidneys. Kidneys were harvested from Fischer (FSH) fetal rats on the 15th, 17th, 18th, and 19th gestational day (GD), and then grafted under the kidney capsule of incompatible Wistar/Furth (W/F) adult male rats. Fetal hepatic tissue was harvested from 15th-GD FSH fetal rats, and then grafted under the kidney capsule of W/F adult male rats. Each recipient received either one kidney or a 3-mm piece of liver. Graft biopsies were obtained 10, 20, 30, and 40 days posttransplantation, and evaluated histologically. The severity of rejection was divided into three grades according to the degree of mononuclear infiltration and percentage of original fetal structures preserved. All fetal hepatic grafts were completely rejected (grade III) by the tenth posttransplantation day. In contrast, the degree of rejection of the kidneys was age-dependent. Fifteenth-GD kidneys showed a minimal or moderate degree of rejection (grade I or II) at 10, 20, and 30 days; however, 18th- and 19-GD kidneys were rejected (grade III) by the tenth post-transplantation day. To explore the basis for the decreased immunogenicity of 15th-GD kidneys, 20 adult W/F rats were divided into two groups. Each animal in the first group received one FSH 15th-GD kidney implanted under the kidney capsule.(ABSTRACT TRUNCATED AT 250 WORDS)


Stable expression of meningococcal class 1 protein in an antigenically reactive form in outer membranes of Escherichia coli.
The entire gene encoding the class 1 outer membrane protein of Neisseria meningitidis is located on a 2.2kb fragment, obtained on digestion of chromosomal DNA with Xbal. This Xbal fragment from strain MC50 (subtype P1-16), which had previously been cloned in bacteriophage M13, has been transferred to the plasmid vector pMTL20. The resulting plasmid (pPORA100) was propagated in Escherichia coli (JM109) and cell lysates were subjected to SDS-PAGE. Western blotting with anti-class 1 protein antibodies revealed constitutive expression of a protein of 41 kD, corresponding to the class 1 protein of the parent meningococcal strain, which was absent in the E. coli control. Fractionation of E. coli cells carrying the recombinant plasmid revealed that the protein was exclusively located in the outer membrane, and N-terminal amino acid analysis of the expressed protein revealed that normal processing of the signal peptide had occurred. Immuno-gold electron microscopy showed that the protective epitope recognized by a P1-16 subtype-specific monoclonal antibody was exposed in an antigenically reactive form on the surface of E. coli cells carrying plasmid pPORA100. In contrast, expression in E. coli of a second plasmid (pPORA104) lacking the coding sequence for the first 15 amino acids of the signal peptide resulted in accumulation of recombinant class 1 protein only in the cytoplasm of the cells. Thus the presence of the meningococcal signal sequence ensures expression of this meningococcal porin protein in an antigenically native conformation in outer membranes of E. coli, while its absence results in expression of a soluble protein.(ABSTRACT TRUNCATED AT 250 WORDS)


Two modes of amber codon read-through in vitro.
Read-through translation of bacteriophage R17 amB2 coat cistron carrying an amber mutation at the seventh codon was studied in vitro using the crude cell extract (S30) derived from an Escherichia coli nonsuppressor strain. Despite the presence of termination factors as well as ribosome-releasing factor (RRF) which prevent the read-through translation [M. Ryoji, J. W. Karpen, and A. Kaji (1981) J. Biol. Chem. 256, 5798-5801], synthesis of coat-like protein still persists at a low level in this system. Characterization of this protein by peptide fingerprinting and amino acid sequencing was performed to reexamine the generally accepted notion that it is produced by amino acid misinsertion to the amber mutation codon. The results indicated, however, that the major population of this coat-like protein is produced as a result of reinitiation of translation from the eighth codon. Read-through by amino acid misinsertion in this system becomes predominant only when the Mg2+ concentration is higher than 16 mM.


Outcomes of 25-gauge pars plana vitrectomy in the surgical management of proliferative diabetic retinopathy.
To report outcomes and complications of 25-gauge pars plana vitrectomy (PPV) for patients with complications of proliferative diabetic retinopathy (PDR). Retrospective, interventional, consecutive case series of 174 eyes undergoing primary 25-gauge PPV for PDR from 2006 to 2009. Primary outcomes were visual acuity changes and rates of postoperative complications. Visual acuity improved from 20/187 before to 20/69 after surgery (P < .0001). Postoperative vitreous hemorrhage occurred in 38.7% of eyes and 10.4% of all eyes required another PPV for non-clearing vitreous hemorrhage. Complications included limited choroidal effusion (5.2%), rhegmatogenous retinal detachment (4.6%), hypotony, rubeosis, and ocular hypertension (4.1%), neovascular glaucoma (2.3%), hyphema (1.2%), and phthisis bulbi (0.6%). The authors found 25-gauge PPV to be effective for vitreous removal and membrane dissection. The spectrum and frequency of complications were similar to those reported for 20-gauge PPV for PDR. In the surgical management of PDR, 25-gauge PPV is an alternative.


Insulin-like growth factor (IGF-1) as a stimulator of regeneration in the freeze-injured rat sciatic nerve.
The effect of insulin-like growth factor (IGF-1) on the ability of the rat sciatic nerve to regenerate into a freeze-injured nerve segment was investigated. The freeze-injured segment was perfused for 6 days with Ringer solution and different concentrations of IGF-1, dispensed by a subcutaneously implanted osmotic minipump. At a pump concentration of 50, 100 and 200 micrograms IGF-1/ml the regeneration length increased with 14, 25 and 26%, respectively, as measured by the pinch test and by immunocytochemical staining for neurofilaments (NF) in the growing neurites. Schwann cells invading the freeze-injured segment were visualized by immunostaining for S-100 protein. In nerves perfused with Ringer solution alone the Schwann cells were present as far as the neurites had regenerated, while neurites seemed to grow slightly ahead of the Schwann cells in the nerves perfused with IGF-1. Incorporation of [3H]thymidine increased in IGF-1-treated nerves. However, IGF-1 perfusion did not increase thymidine incorporation when outgrowth of neurites was detained by a transection proximal to the freeze-injured area. The results suggest that IGF-1 affects regeneration by local stimulation of the growing neurites and that IGF-1 stimulates the proliferation of non-neuronal cells indirectly.


Genetic autonomic disorders.
Genetic disorders affecting the autonomic nervous system can result in abnormal development of the nervous system or they can be caused by neurotransmitter imbalance, an ion-channel disturbance or by storage of deleterious material. The symptoms indicating autonomic dysfunction, however, will depend upon whether the genetic lesion has disrupted peripheral or central autonomic centers or both. Because the autonomic nervous system is pervasive and affects every organ system in the body, autonomic dysfunction will result in impaired homeostasis and symptoms will vary. The possibility of genetic confirmation by molecular testing for specific diagnosis is increasing but treatments tend to remain only supportive and directed toward particular symptoms.


Interferon treatment improves survival in chronic hepatitis C patients showing biochemical as well as virological responses by preventing liver-related death.
Interferon therapy for chronic hepatitis C reduces the risk of hepatocellular carcinoma, especially among virological and biochemical responders. However, little is known about the effect of interferon therapy on mortality. We studied the long-term effect of interferon therapy on mortality in patients with chronic hepatitis C. For this retrospective cohort study, 2954 patients with chronic hepatitis C were recruited, of whom 2698 received interferon therapy and 256 did not. The effect of interferon therapy on survival was assessed by standardized mortality ratio (SMR) based on published mortality data for the general Japanese population and by risk ratio calculated by proportional hazard regression. Over 6.0 +/- 2.2 years follow-up, death from liver-related diseases was observed in 69 (68%) of 101 deaths among interferon-treated patients and in 42 (81%) of 52 deaths among untreated patients. Compared with the general population, overall mortality was high among untreated patients (SMR: 2.7; 95% CI: 2.0-3.6) but not among interferon-treated patients (SMR: 0.9; 95% CI: 0.7-1.1). Liver-related mortality was extremely high among untreated patients (SMR: 22.2; 95% CI: 16.0-30.0) and less among interferon-treated patients (SMR: 5.5; 95% CI: 4.3-6.9). The risk of death from all causes was lower for interferon-treated than untreated patients (risk ratio: 0.47; 95% CI: 0.261-0.836; P = 0.01). The risk of death from liver-related diseases was significantly lower for sustained virological responders (risk ratio: 0.04; 95% CI: 0.005-0.301; P = 0.002) compared with untreated patients, but not for nonsustained virological responders. Sustained biochemical responders (risk ratio: 0.03; 95% CI: 0.004-0.230; P < 0.001) and transient biochemical responders (risk ratio: 0.18; 95% CI: 0.063-0.532; P = 0.002) showed a significantly reduced risk of death from liver-related death, whereas biochemical nonresponders did not. Hence interferon treatment improved survival in chronic hepatitis C patients showing a biochemical as well as a virological response by preventing liver-related deaths.


Public access defibrillation.
To review the current status of the use of automated external defibrillators by lay persons, a concept known as public access defibrillation. Public access defibrillation is a relatively new strategy in the management of out-of-hospital cardiac arrest. The rationale is clear- to enable defibrillation with the minimum of delay, before the arrival of the emergency medical services. Impressive results have been reported when automated external defibrillators are installed in high-risk locations. Only few arrests occur in such busy public places, however, and strategies to use public access defibrillation to treat a majority of arrests that occur at home are not so well defined. At present, no clear evidence is available to guide the comprehensive implementation of public access defibrillation in communities. Public access defibrillation can save lives but further studies are required to define the optimal placement and use of automated external defibrillators in communities and the training of the personnel who use them.


Geographical distribution of contaminants and productivity measures of herring gulls in the Great Lakes: Lake Erie and connecting channels 1978/79.
The distribution and size of colonies, residue levels of DDE, DDT, HCB, dieldrin, mirex and PCBs in eggs, productivity and eggshell thickness were determined for herring gulls at 14 sites in Lake Erie and connecting channels. The centre of distribution for breeding herring gulls was the Western Basin where approximately 90% of the 6200 nests in the study area were located. Seven of 22 colonies showed an average annual population increase of 48.3%. Most of the increase in breeding herring gulls on Lake Erie is directly associated with sites that have undergone habitat modification by man. Levels of PCBs and DDE ranged from 35 to 140 ppm (wet weight) and from 2.8 to 9.4 ppm, respectively; all other residues were less than 0.49 ppm. Most organochlorine residue levels were highest in eggs from colonies in or near the Niagara or Detroit Rivers. Mirex residues were greatest in the Niagara River and decreased significantly to the west. PCB residues were greatest in the Detroit River and decreased significantly to the east. The lowest levels generally came from colonies in the Sandusky Basin and near Pelee Island in western Lake Erie. Discriminant function analysis of six organochlorine contaminants correctly classified 90% or more of the eggs from up to four colonies in one or more years. Levels of PCBs and HCB appeared to have the greatest discriminating power. Herring gull productivity at all colonies (1-1.7 young gulls/pair) was normal and showed no significant geographical variation. Eggshell thickness was greatest in colonies in the Sandusky Basin and least in colonies in the Detroit River and extreme west end of the lake; mean eggshell thickness was 0.350 +/- 0.02 mm (6.7% thinning), which was weakly, but significantly correlated to DDE concentration. The variation in contaminants in herring gull eggs on a Basin basis (i.e., Western, Eastern, Sandusky, etc.) paralleled those known for sediments, water and fish. Thus, we suggest that in addition to its role as an indicator of lake-wide contamination of the Great Lakes, the herring gull, under some circumstances, may function as an indicator of "regional" contamination. This is an important distinction as it improves the geographical specificity of the herring gull as an indicator species on the Great Lakes, where it is a non-migratory species.


Peptide immunoreactivity of the ciliary ganglion and its accessory cells in the rat.
By means of immunohistochemistry, calcitonin gene-related peptide, Leu-enkephalin and neuropeptide Y localize to rat ciliary and accessory ganglion cells. The proportion of ciliary and accessory neurons immunoreactive to each peptide is provided and compared to previous data for vasoactive intestinal peptide. These findings indicate considerable neurochemical complexity for a parasympathetic ganglion with a small cell population.


Observations with Depo-Provera (medroxyprogesterone) in the management of renal tumours.
A total of 30 patients with renal tumours were started on Depo-Provera (medroxyprogesterone) in December 1981 and followed up for 17 to 44 months. The survivors were checked in July 1985. In 2 of the 13 metastasis-free patients deposits of lethal outcome had formed, survival time averaging 27 months. One of the 8 patients with local metastases had died of renal tumour, average survival time being 26 months. Among the 9 patients with distant metastases there are 2 with survival times of 42 and 44 months, respectively. The liver metastases confirmed by ultrasonography in the first, and in the vena cava in the second case at the time of surgery are no longer demonstrable. Survival time in the last-named group averages 14.5 months.


Influence of selective, reversible inhibitors of monoamine oxidase on the prolonged depletion of striatal dopamine by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine in mice.
1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) hydrochloride injected s.c. at 20 mg/kg once daily for four days resulted in marked depletion of dopamine, 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) in mouse striatum one week after the last dose. Pretreatment with MD 240928, (R)-[4-((3-chlorophenyl)-methoxy)phenyl]-5-[(methylamino)methyl]-2- oxazolidinone methanesulfonate, prevented the depletion of striatal dopamine, DOPAC and HVA, whereas pretreatment with harmaline did not. MD 240928 selectively inhibited type B not type A monoamine oxidase (MAO), whereas harmaline selectively inhibited type A MAO in mouse striatum. Acutely after injection of harmaline, DOPAC and HVA concentrations were decreased in mouse striatum; these changes were not produced by MD 240928. The acute changes in dopamine metabolites reveal that MAO-A not MAO-B is responsible for the oxidation of dopamine in mouse striatum. Protection against the neurotoxic effects of MPTP by MD 240928 but not by harmaline indicates that prevention of dopamine oxidation is not the mechanism of the protective effect; instead the protection probably is due to prevention of MPTP metabolism by MAO-B, this metabolism having been shown to occur by other workers. The results with these reversible, competitive inhibitors of the two types of MAO are in agreement with previously reported results from studies using irreversible inhibitors of MAO.


Coagulation Disorders and Bleedings in Critically Ill Patients With Hemophagocytic Lymphohistiocytosis.
Reactive hemophagocytic lymphohistiocytosis (HLH) is a life-threatening condition related to a cytokine storm leading to multiorgan dysfunction. A better understanding of coagulation disorders, frequently reported in HLH patients, may improve outcomes. Critically ill HLH patients managed in a multidisciplinary national reference center were retrospectively included. Relationships between coagulation disorders, severe bleedings, and outcomes were assessed. One hundred and seventeen patients fulfilled the HLH 2004 criteria. The most common HLH etiology was hematologic conditions (73%), followed by infectious diseases (20%), systemic rheumatic diseases (5%), and undetermined HLH etiology (3%). All patients exerted thrombocytopenia. Coagulation disorders were diagnosed in 79 (68%) patients (61 had hypofibrinogenemia < 1.5 g/L, 51 had prothrombin time [PT] < 0%). The worst median value throughout ICU stay was 52% (38-65) for PT with a factor V level of 35% (27-43), 1.59 (1.30-2.09) for the activated partial thromboplastin time (APTT) ratio, and 2.33 g/L (1.13-3.86) for the fibrinogen level. Disseminated intravascular coagulation (DIC) was found in 50% of patients. Coagulation disorders were more frequent in immunocompromised patients, those with histological/cytological feature of hemophagocytosis, those with the highest ferritin concentrations, and in patients with HLH not related to infection. These patients were more prone to receive mechanical ventilation, vasopressors, or renal replacement therapy. Twenty-six (22%) patients presented severe bleeding complications, including 5 patients dying from hemorrhagic shock. Strikingly, the only coagulation parameter significantly associated with severe bleeding was low fibrinogen with a cutoff value of 2 g/L (P = 0.03). Overall, 33 (28%) patients died in the ICU and hospital mortality was 44%. Coagulation disorders were associated with higher mortality, especially fibrinogen < 2 g/L (P = 0.04) and PT value (P = 0.03). The occurrence of bleeding complications was not associated with higher risk of hospital death. Risk factors associated with mortality by multivariate analysis were fibrinogen level < 2 g/L (OR 2.42 [1.08-5.41]), SOFA score > 6 (OR 3.04 [1.32-6.98]), and age > 46 years (OR 2.26 [1.02-5.04]). Up to two-third of critically ill HLH patients present with coagulation disorders. Hypofibrinogenemia or DIC was found in half of the patients and low PT in 40%. These patients require more life support and have a higher mortality rate. Fibrinogen < 2 g/L is associated with the occurrence of severe bleeding and mortality.


A qualitative study of medical-surgical intensive care unit nurses' experiences in caring for critical patients.
To describe the meaning attributed to nurses' clinical experience in a medical-surgical intensive care unit in Northern Cyprus. The qualitative study was conducted in two medical-surgical intensive care units at a university hospital. Data were collected through in-depth interviews with 17 nurses. Giorgi's descriptive phenomenological approach was used to analyze nurses' experiences. The consolidated criteria for reporting a qualitative research checklist were followed in this study. The data analysis led to the extraction of the 5 themes and 19 subthemes. The themes identified for the study were competence, the emotional universe, stress resources, the meaning of nursing care, and profoundly affecting events. The study results show that the nurses expressed that having gained much experience in intensive care units and working there has contributed significantly to their professional development. It was indicated that the nurses had meaningful, caring experiences in intensive care units, which were perceived, however, as stressful experiences as well. The study has important implications for nurses, faculty members, and administrators to gain positive care experiences in terms of intensive care units.


Seven-Tesla magnetic resonance images of the substantia nigra in Parkinson disease.
To investigate anatomical changes in the substantia nigra (SN) of Parkinson disease (PD) patients with age-matched controls by using ultra-high field magnetic resonance imaging (MRI). We performed 7T MRI in 10 PD and 10 age-matched control subjects. Magnetic resonance images of the SN were obtained from a 3-dimensional (3D) T(2)*-weighted gradient echo sequence. Region of interest-based 3D shape analysis was performed to quantitatively compare images from the 2 groups. The boundary between the SN and crus cerebri was not smooth in PD subjects. Undulation in the lateral surface of the SN appeared more intense in the side contralateral to that with the more severe symptoms, and more prominent at the rostral level of the SN than at the intermediate or caudal levels. In addition to the lateral surface, there was a striking difference in the dorsomedial aspects of the SN between PD and control subjects. In control subjects, a brighter signal region was observed along the dorsomedial surface of the lateral portion of SN, whereas in PD subjects, this region was observed as a dark region containing a hypointense signal in T(2)*-weighted images. The measurement of SN volumes, normalized to the intracranial volumes, showed higher values in PD subjects than in control subjects. This study demonstrates that 3D 7T MRI can definitively visualize anatomical alterations occurring in the SN of PD subjects. Further pathological studies are required to elucidate the nature of these anatomical alterations.


Insulin degradation in vivo: a high-performance liquid chromatographic analysis.
The metabolism of insulin in vivo was investigated using an isocratic reversed-phase high-performance liquid chromatographic (RP-HPLC) method. After intravenous injection of A14-[125I]insulin into normals, eight labelled insulin derivatives were found in plasma (peaks 1-8). Two of them (peaks 1 and 7) showed an elution pattern identical with those of reference [125I]monoiodotyrosine and intact A14-[125I]insulin, respectively. Of the other six peaks, five (2-6) eluted before and one (peak 8) after insulin. This pattern was highly reproducible in terms of capacity factors and peak heights. Radioactivity separated by RP-HPLC was further characterized for its trichloroacetic acid precipitability and immunoprecipitability. Fractions corresponding to peaks 4-6 and 8, which showed an immunoprecipitability higher than 50%, were pooled in order to obtain sufficient radioactivity and were found to be insulin separated by Sephadex G-50 chromatography, containing in its structure, after sulphitolysis, intact A-chain and to be partially rebindable to monocyte insulin receptors. These data demonstrate that in blood, products of insulin metabolism circulate which retain a part of the immunological and biological properties of the hormone. These products are clearly separated from one another and from intact insulin by RP-HPLC, suggesting that the appropriate use of this technique may allow a further and more accurate qualitative and quantitative characterization of in vivo insulin metabolism in physiological and pathological conditions.


A study of the effects of LCD glass sand on the properties of concrete.
In order to study the recycling of discarded liquid crystal display (LCD) glass into concrete (LCDGC), a portion of the usual river sand was replaced by sand prepared from discarded LCD glass. Three different mix designs were regulated by the ACI method (fc(28)=21, 28, and 35MPa) with 0%, 20%, 40%, 60%, and 80% LCD glass sand replacements investigated; their engineering properties were determined. Test results revealed that, when compared to the design slump of 15cm, the 20% glass sand concrete for the three different mix designs kept good slump and slump flow. Furthermore, a slump loss ranging from 7 to 11cm was observed for specimens with 60% and 80% glass sand replacement for the design strengths of 28 and 35MPa. The compressive strengths of the concrete with glass sand replacement were higher than the design strengths. Moreover, the durability of the concrete with 20% glass sand replacement was better than that of the control group. Surface resistivity for specimens with different amounts of LCD glass sand replacement was also higher than that in the control group for mid to long curing ages. The sulfate attack in concrete with different amounts of glass sand replacement caused less weight loss than in the control group. Moderate chloride ion penetration was observed for glass sand concrete. Furthermore, the measured ultrasonic pulse velocities for LCD glass sand concrete specimens were higher than 4100m/s, which qualified these specimens as good concrete. OM and SEM indicate that the dense C-S-H gel hydrate was produced at the interface between the glass sand and cement paste. The test results indicate that the addition of 20% LCD glass sand to concrete satisfies the slump requirements and improves the strength and durability of concrete. This suggests that LCD glass sand can potentially be used as a recycled material in concrete applications.


Silica sol assisted chromatographic NMR spectroscopy for resolution of trans- and cis-isomers.
Chromatographic NMR spectroscopy can separate the mixtures of species with significantly different molecular size, but generally fails for isomeric species. Herein, we reported the resolution of trans- and cis-isomers and their structural analogue, which are different in molecular shapes, but similar in mass, were greatly enhanced in the presence of silica sol. The mixtures of maleic acid, fumaric acid and succinic acid, and the mixtures of trans- and cis-1,2-cyclohexanedicarboxylic acids, were distinguished by virtue of their different degrees of interaction with silica sol. Moreover, we found mixed solvents could improve the spectral resolution of DOSY spectra of mixtures.


Treatment of infantile haemangioma with captopril.
Infantile haemangioma (IH) has recently been reported as an aberrant proliferation and differentiation of a primitive mesoderm-derived haemogenic endothelium regulated by the renin-angiotensin system (RAS), leading us to propose angiotensin converting enzyme (ACE) as a potential therapeutic target. To present initial results of our open-labelled observational clinical trial using captopril, an ACE inhibitor (ACEi), in the treatment of problematic proliferating IH. After initial screening investigations, infants with problematic IH were admitted for initiation of captopril with a 0·1 mg kg(-1) test dose orally, followed by 0·15 8-hourly over 24 h. This was then followed by dose escalation to 0·3 mg kg(-1) 8-hourly for another 24 hours. The dosage was increased to 0·5 mg kg(-1) 8-hourly 1 week later, if a noticeable involution had not already occurred. The response of IH to captopril was documented clinically and photographically before and after treatment and any side-effect was recorded. Two boys and six girls aged 5-22 weeks (mean 12·9) with problematic IH were recruited with the lesions located in nasal tip (n = 1), cervicofacial (n = 3), periorbital (n = 1) and perineal (n = 2) areas, and shoulder (n = 1). Transient mild renal impairment occurred in one subject but resolved spontaneously. No other complication was observed. The IHs in all patients responded to captopril at a dosage of 1·5 mg kg(-1) daily which led to a dramatic response in three, moderate response in two, and slow response in three patients. Continued involution of IHs was observed during the follow-up period of 8-19 months (mean 15·8) in all subjects. Treatment was ceased at 14 months of age in seven patients with no rebound growth. In the remaining patient, rapid healing occurred with ongoing gradual reduction in the size and colour of a large ulcerated retroauricular lesion following 5·5 months of treatment. The lesion was excised to address its persistent distortion of the ear. The response of IH to an ACEi supports a critical role for the RAS in IH and represents a paradigm shift in the understanding and treatment of this enigmatic condition.


Comparison of quality, birth outcomes, and service utilization between health facilities with and without maternity waiting homes in Liberia.
1) To assess the quality of health facilities associated with functional Maternity Waiting Homes and health facilities without functional maternity waiting homes in Liberia. 2) To examine birth outcomes and care utilization amongst health facilities with and without functional maternity waiting homes in Liberia. Secondary analysis design using data from a facility capacity checklist and Liberia's Health Management Information System. 71 health facilities associated with functional maternity waiting homes and 14 health facilities without functional maternity waiting homes across 14 counties of Liberia. No human participants were used in this study. Independent t-test, Pearson chi-square test, and logistic regression were performed to assess quality, birth outcomes, and service utilization between health facilities with and without functional maternity waiting homes. The overall health facility quality was not significantly different between health facilities associated with functional maternity waiting homes and those without. However, health facilities with functional maternity waiting homes had better infection control with the presence of soap and sharps boxes. Health facilities with functional maternity waiting homes were also more likely to have parenteral oxytocic drugs and were better able to perform assisted vaginal deliveries. The presence of functional maternity waiting homes were not significantly associated with health facility quality, birth outcomes, or care utilization. Health facilities with functional MWHs were better prepared to prevent infection and manage complicated deliveries. This study further highlights specific areas for quality improvement amongst these health facilities, including labor complications management.


Ebf Activates Expression of a Cholinergic Locus in a Multipolar Motor Ganglion Interneuron Subtype in Ciona.
Conserved transcription factors termed "terminal selectors" regulate neuronal sub-type specification and differentiation through combinatorial transcriptional regulation of terminal differentiation genes. The unique combinations of terminal differentiation gene products in turn contribute to the functional identities of each neuron. One well-characterized terminal selector is COE (Collier/Olf/Ebf), which has been shown to activate cholinergic gene batteries in C. elegans motor neurons. However, its functions in other metazoans, particularly chordates, is less clear. Here we show that the sole COE ortholog in the non-vertebrate chordate Ciona robusta, Ebf, controls the expression of the cholinergic locus VAChT/ChAT in a single dorsal interneuron of the larval Motor Ganglion, which is presumed to be homologous to the vertebrate spinal cord. We propose that, while the function of Ebf as a regulator of cholinergic neuron identity conserved across bilaterians, its exact role may have diverged in different cholinergic neuron subtypes (e.g., interneurons vs. motor neurons) in chordate-specific motor circuits.


Kidney transplantation in older patients: benefits and risks.
The proportion of older patients accepted for dialysis is increasing every year both in the US and abroad. Of the two treatment modalities for end-stage renal disease, i.e. dialysis and transplantation, the latter offers more freedom and is associated with better clinical outcome. Most elderly patients seem to have excellent functional rehabilitation after a kidney transplant. However, in view of the wide gap between the availability of cadaver organs and the people in need, giving the precious organ to the elderly who have a shorter expected lifespan may present an ethical problem. Therefore, it has become increasingly important to offer the kidney to only those who have no significant comorbid conditions or other high risk factors, so as to improve the odds of success after renal transplantation.


Human biomonitoring for metals in Italian urban adolescents: data from Latium Region.
As a part of the activities of the first Italian human biomonitoring survey (PROBE - PROgramme for Biomonitoring general population Exposure), a reference population of adolescents, aged 13-15 years, was examined for their exposure to metals. The study included 252 adolescents living in urban areas, representative of Latium Region (Italy) and blood specimens were analyzed for metals (As, Be, Cd, Co, Cr, Hg, Ir, Mn, Mo, Ni, Pb, Pd, Pt, Rh, Sb, Sn, Tl, U, V and W) by sector field inductively coupled plasma mass spectrometry. The results obtained will improve the knowledge about the body burden in adolescents and are tentative reference values for Italian young people as a basis for risk evaluation deriving from urban/environmental exposure to metals.


Neoadjuvant chemotherapy followed by extended-field concurrent chemoradiotherapy in squamous cell carcinoma of the cervix with positive paraaortic lymph nodes: two cases.
To report the feasibility of neoadjuvant chemotherapy (NAC) followed by extended-field concurrent chemoradiotherapy (EF-CCRT) for squamous cell carcinoma of the cervix (CC) with paraaortic lymph node (PAN) metastasis. Two patients were diagnosed with CC with positive PAN, and received two courses of cisplatin (120 mg/m2) in a neoadjuvant setting. They then received extended-field, external-beam radiotherapy (50.4 Gy) followed by intracavitary brachytherapy concurrently with cisplatin (20 mg/m2 x 5 days) at 21-day intervals. EF-CCRT was interrupted in one patient for five days because of grade 4 neutropenia. No severe late toxicities were observed. The two patients are alive with no evidence of recurrence at present. NAC followed by EF-CCRT is feasible and may improve the survival outcome of patients with CC with positive PAN.


Reproducibility of automated calculation technique for diffusion tensor image analysis along the perivascular space.
The method of diffusion tensor image analysis along the perivascular space (DTI-ALPS) was gathering attention to evaluate the brain's glymphatic function or interstitial fluid dynamics. However, to the best knowledge, no study was conducted on the reproducibility of these automated methods for ALPS index values. Therefore, the current study evaluated the ALPS index reproducibility based on DTI-ALPS using two major automated calculation techniques in scan and rescan of the same subject on the same day. This study included 23 participants, including 2 with Alzheimer's disease, 15 with mild cognitive impairment, and 6 with cognitive normals. Scan and rescan data of diffusion magnetic resonance images were obtained, as well as automatically index for ALPS (ALPS index) and ALPS index maintaining tensor vector orientation information (vALPS index) with region of interest on the template fractional anisotropy map calculated by FSL software.These ALPS indices were compared in terms of scan and rescan reproducibility. The absolute difference in ALPS-index values between scan and rescan was larger in the ALPS index than in the vALPS index by approximately 0.6% as the relative difference. Cohen's d for the left and right ALPS indices between methods were 0.121 and 0.159, respectively. The vALPS index based on DTI-ALPS maintaining tensor vector orientation information has higher reproducibility than the ALPS index. This result encourages a multisite study on the ALPS index with a large sample size and helps detect a subtle pathological change in the ALPS index.


In vivo visualization of aromatase in animals and humans.
Aromatase catalyzes the last and obligatory step in the biosynthesis of estrogens across species. In vivo visualization of aromatase can be performed using positron emission tomography (PET) with radiolabeled aromatase inhibitors such as [(11)C]vorozole. PET studies in rats, monkeys and healthy human subjects demonstrate widespread but heterogeneous aromatase availability in brain and body, which appears to be regulated in a species, sex and region-specific manner. Thus, aromatase availability is high in brain amygdala and in ovaries of all species examined to date, with males demonstrating higher levels than females in all comparable organs. However, the highest concentrations of aromatase in the human brain are found in specific nuclei of the thalamus while the highest levels in rats and monkeys are found in the amygdala. Regional brain aromatase availability is increased by androgens and inhibited by nicotine. Future studies may improve diagnosis and treatment in brain disorders and cancers overexpressing aromatase.


Spatio-temporal evolution characteristics of eco-efficiency in the Yellow River Basin of China based on the super-efficient SBM model.
It is of great significance to study the trends and internal differences of eco-efficiency in the Yellow River Basin for ecological protection and high-quality development of the Yellow River Basin. According to the characteristics of the Yellow River Basin in China, the eco-efficiency evaluation system was constructed, and the super-efficiency slack-based measure (SBM) model and the super-efficiency SBM model of undesired output were used to calculate the eco-efficiency levels of provinces in the Yellow River Basin from 2005 to 2020, and the variation trend and internal differences were analyzed. The results show that when only the expected output was considered, the eco-efficiency of the Yellow River Basin as a whole and each province showed a fluctuating upward trend, but there were obvious differences. Qinghai Province, Sichuan Province, and Ningxia Autonomous Region had high eco-efficiency, while Shaanxi Province, Shanxi Province, and Inner Mongolia Autonomous Region had low eco-efficiency. Compared with only considering the expected outputs, eco-efficiency of Qinghai Province had improved significantly when considering non-expected outputs. The eco-efficiency of Shandong Province and Henan Province had improved significantly after 2016, while the eco-efficiency of the two provinces had decreased significantly before 2016. The eco-efficiency of Shaanxi, Shanxi, Inner Mongolia, Ningxia, and Gansu had declined to varying degrees. Finally, the reasons for the differences in eco-efficiency in various provinces in the Yellow River Basin were analyzed, and suggestions for improving the eco-efficiency of the Yellow River Basin were put forward.


Adaptation to simulated microgravity in Streptococcus mutans.
Long-term space missions have shown an increased incidence of oral disease in astronauts' and as a result, are one of the top conditions predicted to impact future missions. Here we set out to evaluate the adaptive response of Streptococcus mutans (etiological agent of dental caries) to simulated microgravity. This organism has been well studied on earth and treatment strategies are more predictable. Despite this, we are unsure how the bacterium will respond to the environmental stressors in space. We used experimental evolution for 100-days in high aspect ratio vessels followed by whole genome resequencing to evaluate this adaptive response. Our data shows that planktonic S. mutans did evolve variants in three genes (pknB, SMU_399 and SMU_1307c) that can be uniquely attributed to simulated microgravity populations. In addition, collection of data at multiple time points showed mutations in three additional genes (SMU_399, ptsH and rex) that were detected earlier in simulated microgravity populations than in the normal gravity controls, many of which are consistent with other studies. Comparison of virulence-related phenotypes between biological replicates from simulated microgravity and control orientation cultures generally showed few changes in antibiotic susceptibility, while acid tolerance and adhesion varied significantly between biological replicates and decreased as compared to the ancestral populations. Most importantly, our data shows the importance of a parallel normal gravity control, sequencing at multiple time points and the use of biological replicates for appropriate analysis of adaptation in simulated microgravity.


Immunoregulation of lysozyme-specific suppression. I. Induction and suppression of delayed-type hypersensitivity to hen egg-white lysozyme.
Subcutaneous immunization with hen egg-white lysozyme (HEL) in complete Freund's adjuvant induces, both in antibody responder and nonresponder mice, a classical delayed-type hypersensitivity (DTH) reaction evaluated as footpad swelling. This response can be specifically transferred to naive recipients by Lyt-1+2- T cells and passive transfer is restricted by genes mapping in or to the left of the I-A region of the H-2 complex. Fine antigenic specificity analysis shows that HEL-primed T cells mediating DTH recognize ring-necked pheasant egg-white lysozyme, a lysozyme closely related to HEL, but fail to respond to human lysozyme, differing from HEL at 40% amino acid residues. Complete cross-reactivity between native and denaturated (reduced and carboxymethylated) HEL is exhibited by T cells involved in the DTH response. Subcutaneous injection of HEL coupled to spleen cells is also able to induce antigen-specific and genetically restricted DTH responses whereas the same cells administered by i.v. or i.p. route induce predominantly suppressor T cell activation. These suppressor T cells specifically inhibit the induction phase of DTH reactivity to HEL.


Ultrastructural changes in the rat neurohypophysis following castration and testosterone replacement.
Ultrastructural changes in male rat neurohypophyses were studied 8 or 30 days after castration, with or without testosterone (T) replacement via capsule implants. Morphometric analyses determined the: (a) amount of neural contact at the basal lamina (BL) of the neurovascular contact zone, (b) average length of individual terminal contacts with the BL, (c) number of neurosecretory terminals per 100 micrograms of BL, and (d) mean number of enclosed axonal processes per pituicyte. Eight days after castration there was decreased neural/BL contact and increased pituicyte enclosure of neurosecretory processes, conditions associated with decreased hormone release. In contrast, T replacement resulted in increased individual nerve terminal length, a measure associated with increased hormone demand. This observation may indicate a stimulatory effect of continuous high-normal circulating levels of testosterone from the capsule implants. There were no differences from control in 30-day castrate rats, but the 30-day rats with T replacement showed morphological indications of increased hormone release. These consisted of increased neural contact with the BL apparently through a significant increase in the number of neurosecretory terminals per unit length of BL. These findings support studies showing a complex feedback interaction between circulating levels of testosterone and vasopressin release.


Expression of natural cytotoxicity receptors NKp30, NKp44, and NKp46 mRNAs and proteins by human hematopoietic and non-hematopoietic cells.
T-cells and NK cells arise from common pluripotent stem cells, with shared early developmental pathway and surface markers. Distinguishing between them is becoming difficult, but critical for study. A large family of NK cells, including classical NK, NK-T, and NK-CTL exists. Natural cytotoxicity receptors (NKp46, NKp44, NKp30) have been proposed as specific for classical NK cells, but were expressed at protein and mRNA level by CD8+NK/T cell line SRIK-NKL, suggesting more widespread expression. We investigated and found expression of these markers at the protein and mRNA level in multiple human cell lines.


Improving dental implant stability by optimizing thread design: Simultaneous application of finite element method and data mining approach.
Lack of knowledge regarding the optimal design of thread configuration in dental implants, which can offer a satisfactory level of stability in the implant-bone construct, is a significant challenge in the field of dental biomechanics. The purpose of this finite element analysis study was to identify the optimal thread design by investigating the effects of thread parameters such as thread depth (TD), thread width (TW), and thread pitch (TP), as well as upper (α) and lower (β) thread angles, on the maximum principal stress in cancellous and cortical bone, maximum von Mises stress in the dental implant, and maximum shear stress at the implant-bone interface. A finite element model of an alveolar bone segment with a dental implant was developed. The Latin hypercube sampling method was used to generate a dataset of virtual experiments, which were analyzed by using the decision tree method to identify suitable thread designs that minimize mechanical stimuli. Additionally, the effectiveness of thread parameters on stress levels in the bone, implant, and their interface were assessed. The results of this study, verified by comparison with previous literature, indicated that TD, TW, and upper thread angle were the most effective parameters in promoting implant stability. By analyzing the decision trees, optimum ranges for all the thread parameters were determined as follows: 0.25<TD<0.34, 0.25≤TW≤0.28, 0.8≤TP≤0.88, 66.2≤α≤80, and β≤65.4, which led to the V-shape thread design.


Trash-to-fuel: Converting municipal waste into transportation fuels by pyrolysis.
In daily life humankind is producing a significant amount of garbage, creating a great environmental concern. However, garbage consists of high amounts of carbon based materials, making it a very useful resource. An easy way to use it is to produce transport fuels obtained through pyrolysis. Multiple plastic waste materials were investigated here. Thermogravimetric analysis (TGA) of individual polymers shows that almost complete conversion could be achieved. More than 70% liquid fuels were derived from pyrolysis of polypropylene, polystyrene at 450°C, and low-/high-density polyethylene at 500°C. Using gas chromatography/high-resolution mass spectrometry (GC/HR-MS) allows studying the thermal transformation and proposing a mechanism. An examination of carbon number distribution reveals the potential of plastic liquid fuels, which can be used as an alternative to partial substitution of fossil-fuel-derived gasoline and diesel fuel and also provides a final use of polymer materials, which otherwise would be deposited on waste dumps.


Protocol Design for Surveillance of Risk Factors of Non-communicable Diseases During the COVID-19 Pandemic: An Experience from Iran STEPS Survey 2021.
Regarding the growing burden of non-communicable diseases (NCDs) and exposure to their risk factors, and the continuous need for nationwide data, we aimed to develop the latest round of the STEPwise Approach to NCD Risk Factor Surveillance (STEPS) survey in 2021 in Iran, while the COVID-19 pandemic was still present. In addition to the three main steps of this survey, including questionnaires, physical measurements, and laboratory assessments, we adapted the survey with the situation caused by the COVID-19 pandemic, by adding to various aspects of study phases and changing some scientific and executive procedures in this round of STEPS survey in Iran. These changes were beyond the initial novelties embedded within the survey before the pandemic, by refining the study protocol benefiting from the previous experiences of the STEPS survey. By amending the required changes, we could include a total of 27874 individuals in the first step of the survey. This number was 27745 and 18119 for the second and third steps. Comparing the preliminary results with the previous nationwide surveys, this study was highly representative on both national and provincial levels. Also, implementing the COVID-19 prevention and control strategies in all stages of survey led to the least infection transmission between the study investigators and participants. The novel initiatives and developed strategies in this round of Iran STEPS survey provide a state-of-the-art protocol for national surveys in the presence of an overwhelming catastrophe like the COVID-19 pandemic and the triggered limitations and shortages of resources.


Breastfeeding and overweight: longitudinal analysis in an Australian birth cohort.
To examine adiposity in relation to breastfeeding using longitudinal analysis in an Australian birth cohort. Repeated surveys from 16 weeks gestation to 8 years in a cohort (N = 2087) recruited through antenatal clinics. Overweight was defined by National Center for Health Statistics 95th percentiles for weight-for-length at 1 year and body mass index (BMI) at 3, 6, and 8 years. Overweight was examined using Generalized Estimating Equations with results summarized as OR. BMI Z scores were analyzed in mixed models. At 1 year, infants breastfed >12 months were the leanest group (mean Z score -0.16, 95% CL -0.28, -0.04; not breastfed 0.16, 95% CL 0.02, 0.29; breastfed < or = 4 months 0.31, 95% CL 0.22, 0.40; 5-8 months 0.17, 95% CL 0.06, 0.27; 9-12 months 0.11, 95% CL 0.01, 0.22). From 1 to 8 years, children breastfed < or = 4 months had the greatest risk of overweight (OR 1.29, 95% CL 0.89, 1.97) and the highest prevalence of maternal obesity, smoking, and lower education. Infants breastfed >12 months were leaner at 1 year but not at 8 years. Breastfeeding < or = 4 months was associated with greatest risk of overweight and adverse maternal lifestyle. Familial factors may modify associations between breastfeeding and adiposity beyond infancy.


Refined genome-wide comparative map of the domestic horse, donkey and human based on cross-species chromosome painting: insight into the occasional fertility of mules.
We have made a complete set of painting probes for the domestic horse by degenerate oligonucleotide-primed PCR amplification of flow-sorted horse chromosomes. The horse probes, together with a full set of those available for human, were hybridized onto metaphase chromosomes of human, horse and mule. Based on the hybridization results, we have generated genome-wide comparative chromosome maps involving the domestic horse, donkey and human. These maps define the overall distribution and boundaries of evolutionarily conserved chromosomal segments in the three genomes. Our results shed further light on the karyotypic relationships among these species and, in particular, the chromosomal rearrangements that underlie hybrid sterility and the occasional fertility of mules.


Patterns of physician and patient rated quality of life during antipsychotic treatment in outpatients with schizophrenia.
Quality of life (QoL) in patients with schizophrenia has been assessed both from physician and patient perspectives, but little is known about agreement between these perspectives and predictors of agreement. The aim of this study was to analyze a large sample of patients with schizophrenia to discover patterns of physician and patient-rated QoL in patients with schizophrenia and identify predictors for these patterns. This study (EASE) was designed to investigate the QoL and subjective well-being in out-patients with schizophrenia during antipsychotic treatment in a naturalistic setting. Assessments were carried out at baseline and at 3, 6, 9 and 12 months, using the quality of life scale (QLS) and the subjective well-being on neuroleptics scale (SWN-K). A hierarchical cluster analysis was used to define groups of patients based on the SWN-K and QLS total scores at all visits. 1174 patients were included in the cluster analyses that were based on SWN-K and QLS total scores over time. Four distinct clusters were identified: patients with: (1) continuously high QoL (23.2%), (2) continuously moderate QoL (45.8%), (3) continuously low QoL (11.2%), and (4) improving QoL (19.9%). Clusters 1-3 were stable in terms of QoL, whilst cluster 4 changed towards improvement. Various predictors for the four clusters were identified. In the cluster with improving QoL, the absence of treatment with an oral conventional antipsychotic pre-study and no medication change due to lack of efficacy at baseline were predictors for improvement. In the cluster with continuously high QoL, no medication change due to lack of efficacy and lowest CGI-S scores at baseline were predictors. Oral conventional antipsychotic treatment pre-study was predictive for the cluster with continuously moderate QoL. In the cluster with continuously low QoL, medication change due to lack of efficacy and highest CGI-S scores were predictors. These findings suggest that various factors may predict whether a patient with schizophrenia experiences a continuously high QoL, a continuously moderate QoL, a continuously low QoL, or improving QoL whilst on antipsychotic treatment.


Bridging the environment and neurodevelopment for children's health: Associations between real-time air pollutant exposures and cognitive outcomes.
Research suggests that children's exposure to pollutants may impact their neurocognitive development. While researchers have found associations between air pollutants and cognitive development, these associations remain underspecified. Further, these exposures occur in the context of the built environment and may be exacerbated by local social vulnerability; in this context, individuals may experience a suite of socioenvironmental stressors that lead to increased cumulative risk exposure. In this pilot study, we tested whether real-time-measured personal exposure to PM2.5 relates to children's executive function and mathematical skills, outcomes that may predict later mathematical performance, general academic performance and even employment outcomes. We recruited 30 families to participate in two rounds in Winter 2020 and Summer 2021. We collected children's demographic data, as well as data about their living environment. In each round, children carried a small device that collected real-time ambient air pollution data for 3 days; parents logged their children's activities each day. On the last day, children completed cognitive assessments indexing their working memory (n-back), inhibitory control (Go/No-Go), nonsymbolic math skills (dot comparison), and arithmetic skills (equation verification). Overall, 29 participants had pollutant readings from both rounds, and 21 had a full dataset. Nonparametric statistical analysis revealed no significant differences in ambient air pollution and cognitive performance over time, Spearman's rho correlation assessment found that PM2.5 was not significantly correlated with cognitive outcomes in R1 and R2. However, the correlations suggested that an increase in PM2.5 was associated with worse working memory, inhibitory control, nonsymbolic skills, and arithmetic skills, at least in R1. We used each participant's zip code-aggregated Social Vulnerability Index, which range from 0 to 1, with higher numbers indicating more social vulnerability. Wilcoxon Rank-Sum tests indicated that participants living in higher SVI zip codes (≥0.70; n = 15) were not significantly different from those living in lower SVI zip codes (<0.70; n = 14), in terms of their PM2.5 exposures and cognitive performance in each round. We also found that socioeconomic characteristics mattered, such that children whose parent (s) had at least a Master's degree or earned more than $100,000 a year had lower PM2.5 exposures than children in the other end.


Pediatric drug reaction with eosinophilia and systemic symptoms: A systematic review of the literature.
Drug reaction with eosinophilia and systemic symptoms (DRESS) is a severe adverse drug reaction including integumentary and internal organs. An extensive literature review of DRESS in the pediatric population has not been performed. A literature search was performed to find reports of pediatric DRESS published between 1997 and March 2019. If not already included, each case was scored based on RegiSCAR criteria. Only "probable" or "definite" cases of DRESS were included in the analysis, totaling 130 cases. In the pediatric population, the average age of diagnosis for DRESS was 8.7 years old. The most common causative drugs include antiepileptics (50%) and antibiotics (30.8%). Time from drug exposure to DRESS presentation averaged 23.8 days. Common clinical symptoms include rash (99.2%) (typically morbilliform (89.2%)), fever (96.2%), eosinophilia (90%), and lymphadenopathy (74.6%). Human herpesvirus-6 reactivation was observed in 16.1% of cases. The most commonly affected internal organ was the liver (80%), followed by the spleen (21.5%) and kidney (15.4%). Management strategies involved, either alone or in combination, included corticosteroids (intravenous 60.8% and oral 41.5%), intravenous immunoglobulins (12.3%), plasmapheresis (2.3%), and ganciclovir (1.5%). Long-term sequelae occurred in 10.8% of patients, most commonly hypothyroidism (3.8%), liver failure (3.1%), and diabetes (2.3%). The mortality rate was 5.4%. This literature review highlights the presentation and course of pediatric DRESS. Morbilliform eruption, fever, and eosinophilia appear to be clinical hallmarks of pediatric DRESS. Common causative agents, specifically carbamazepine, are comparable to the adult population. Furthermore, the mortality rate from DRESS is significant and is similar between pediatric and adult patients.


Adenocarcinoma of gallbladder producing unilateral ureteral obstruction.
Ureteral obstruction is a common problem facing the urologist. Tumors, either primary in the urinary tract or metastases from other organs, may be the causal agent. Herein we present the first case reported of ureteral obstruction caused by metastases from adenocarcinoma of the gallbladder.


Cross-linking studies of the self-association properties of apo-A-I and apo-A-II from human high density lipoprotein.
The state of self-association of the apoprotein components of human high density lipoprotein have been studied by use of the cross-linking reagent dimethyl-suberimidate. Analusis of the cross-linked products was carried out by soduim dodecyl sulfate-gel electrophoresis and by agarose column chromatography in 6 M guanidine hydrochloride. Apo-A-I was found to exist as a monomer at low concentration, but associates to tetrameric and pentameric forms at concentrations of 0.5 mg/ml or higher. The self-association was found to be ionic strength-dependent, with association promoted by the presence of salt. Apo-A-II was also found to associate, but the major oligomeric form observed was dimeric (Mr = 34,000), and the association was less dependent on ionic strength than for apo-A-I. Cross-linking in the presence of various concentrations of guanidine hydrochloride showed that apo-A-II self-association persisted at higher concentrations of the denaturant than for apo-A-I. Studies of the effect of temperature demonstrated that the self-association of both proteins was diminished at temperatures above 30 degrees C. Recombination of apo-A-II with phospholipid resulted in the formation of particles which yielded primarily trimers upon cross-linking. This suggests that phospholipid binding causes major reorganization of the self-associated forms of apo-A-II.


Structure and properties of the 5a,6-anhydrotetracycline-platinum(II) dichloride complex: a theoretical ab initio study.
Ab initio structural parameters, relative energies and spectroscopic properties are reported for the 5a,6-anhydrotetracycline-platinum(II) dichloride complex. Distinct coordination modes were analyzed in gas phase and aqueous medium indicating the tricarbonylmethane moiety (O3-Oam-O1) as the most probable Pt(II) complexation sites, supporting experimental proposals. The theoretical (1)H NMR analysis in conjunction with the observed data suggests that the Pt(II) might be bound to the O3-Oam preferentially, even though this site was found slightly unfavorable, based on energetic grounds, relative to O1-Oam. The aquation reaction, which is an important activation step in the action mechanism of cisplatin like molecules, was also investigated showing rate constants (0.5-1 x 10(-5) M(-1) s(-1)) of the same order of magnitude as those for the parent cisplatin compound. This is an important result stressing the importance of tetracyclines-Pt(II) complexes as lead compounds for the development of new platinum based antitumor drugs.


Is complete resection of high-risk stage IV neuroblastoma associated with better survival?
The role of surgery in the management of stage IV neuroblastoma is controversial. In this study, we attempted to study if complete tumor resection had any impact on event-free survival (EFS) and overall survival (OS). A retrospective analysis of patients with stage IV neuroblastoma between November 2000 and July 2014 in a tertiary referral center was performed. Demographics data, extent of surgical resection, and outcomes were analyzed. A total of 34 patients with stage IV neuroblastoma according to International Neuroblastoma Staging System (INSS) were identified. The median age at diagnosis and operation was 3.5 (±1.9) years and 3.8 (±2.0) years, respectively. Complete gross tumor resection (CTR) was achieved in twenty-four patients (70.1%), in which one of the patients had nephrectomy and another had distal pancreatectomy. Gross total resection (GTR) with removal of >95% of tumor was performed in six patients (17.6%) and subtotal tumor resection (STR) with removal of >50%, but <95% of tumor was performed in four patients (11.8%). There was no statistical significance in terms of 5-year EFS and OS among the 3 groups. There was no surgery-related mortality or morbidity. From our center's experience, as there was no substantial survival benefit in stage IV neuroblastoma patients undergoing complete tumor resection, organ preservation and minimalization of morbidity should also be taken into consideration.


Engineering thermal transport within Si thin films: The impact of nanoslot alignment and ion implantation.
In recent years, nanoporous Si films have been intensively studied for their potential applications in thermoelectrics and the thermal management of devices. To minimize the thermal conductivity, ultrafine nanoporous patterns are required but the smallest structure size is largely limited by the spatial resolution of the employed nanofabrication techniques. Along this line, an effectively smaller characteristic length of a nanoporous film can be achieved with offset nanoslot patterns. Compared with periodic circular pores, the nanoslot pattern can achieve an even lower thermal conductivity, where a much smaller porosity is required using ultra-narrow nanoslots. The obtained low thermal conductivity can be understood from the thermally dead volume revealed by phonon Monte Carlo simulations. To further minimize the contribution from short-wavelength phonons, an additional 25% thermal conductivity reduction can be achieved with Ga ions implanted using a focused ion beam.


Comparative spatially explicit approach for testing effects of soil chemicals on terrestrial wildlife bioindicator demographics.
Wildlife species are often used as bioindicators to evaluate the extent and severity of environmental contamination and the effectiveness of remediation practices. A common approach for investigating population- or community-level impacts on bioindicators compares demographic parameter estimates (e.g., population size or density) between sites that were subjected to different levels of contamination. However, the traditional analytical method used in such studies is nonspatial capture-recapture, which results in conclusions about potential relationships between demographics and contaminants being inferred indirectly. Here, we extend this comparative approach to the spatially explicit framework, allowing direct estimation of said relationships and comparisons between study areas, by applying spatial capture-recapture (SCR) models to bioindicator (deer mice [Peromyscus spp.]) detection data from two study areas that were subjected to different industrial activities and remediation practices. Bioindicator density differed by 178% between the neighboring study areas, and the area with the highest soil concentrations of polychlorinated biphenyls, chromium, and zinc had the highest bioindicator density. Under the traditional nonspatial approach, we might have concluded that soil chemical levels had negligible influences on demographics. However, by modeling density as a spatial function of select chemical concentrations using SCR models, we found strong support for a positive relationship between density and soil chromium concentrations in one study area (β = 0.82), which was not masked by or associated with habitat-related metrics. To obtain reliable inferences about potential effects of environmental contamination on bioindicator demographics, we contend that a comparative spatially explicit approach using SCR ought to become standard.


ScaPD: a database for human scaffold proteins.
Scaffold proteins play a critical role in an increasing number of biological signaling processes, including simple tethering mechanism, regulating selectivity in pathways, shaping cellular behaviors. While many databases document the signaling pathways, few databases are devoted to the scaffold proteins that medicate signal transduction. Here, we have developed a user-friendly database, ScaPD, to describe computationally predicted, experimentally validated scaffold proteins and associated signaling pathways. It currently contains 273 scaffold proteins and 1118 associated signaling pathways. The database allows users to search, navigate and download the scaffold protein-mediated signaling networks. Manually curated and predicted scaffold protein data will be a foundation for further investigation of the scaffold protein in the signal transduction. With maintained up-to-date data, ScaPD ( http://bioinfo.wilmer.jhu.edu/ScaPD ) will be a valuable resource for understanding how individual signaling pathways are regulated.


Ontario Court of Justice dismisses police negligence case: HIV infection a factor.
On 22 February 2001, the case of Chartier v Greaves was dismissed by the Ontario Superior Court of Justice.


Electrogenic hyperpolarization in canine cardiac Purkinje fibres exposed to calcium ionophores.
The Ca ionophores markedly enhance the increase of intracellular Ca occurring during Na-free perfusion and the hyperpolarization observed upon Na readmission may be due to rapid restoration of intracellular Na and resultant stimulation of both electrogenic sodium and calcium efflux.


Cardiac stress after electroconvulsive therapy and spontaneous generalized convulsive seizures: A prospective echocardiographic and blood biomarker study.
Knowledge about cardiac stress related to seizures in electroconvulsive therapy (ECT) and spontaneously occurring generalized convulsive seizures (GCS) is limited. The aim of the present study was to analyze cardiac function and circulating markers of cardiac stress in the early postictal period after ECT and GCS. Patients undergoing ECT in the Department of Psychiatry, Psychotherapy and Psychosomatics and patients undergoing diagnostic video-EEG monitoring (VEM) in the Department of Neurology were prospectively enrolled between November 2017 and November 2018. Cardiac function was examined twice using transthoracic echocardiography within 60 min and >4 h after ECT or GCS. Established blood markers (troponin T high-sensitive, N-terminal pro brain natriuretic peptide) of cardiac stress or injury were collected within 30 min, 4 to 6 h, and 24 h after ECT or GCS. In the ECT group, the troponin T values were also correlated with periprocedural heart rate and blood pressure values. Because of organizational or technical reasons, the measurement was not performed in all patients. Twenty patients undergoing ECT and 6 patients with epilepsy with a GCS during VEM were included. Postictal echocardiography showed no wall motion disorders and no change in left ventricular and right ventricular functions. Four of 17 patients displayed a transient increase in high-sensitive cardiac troponin T 4-6 h after the seizure (3 patients with ECT-induced seizure). None of these 4 patients had signs of an acute cardiac event, and periprocedural blood pressure or heart rate peaks during ECT did not significantly differ in patients with and without troponin T elevation. Signs of mild cardiac stress can occur in some patients following ECT or GCS without clinical complications, probably related to excessive catecholamine release during the seizure.


TLR-4 polymorphisms and leukocyte TLR-4 expression in febrile UTI and renal scarring.
In this study, we aimed to determine the relation of TLR-4 Asp299Gly and Thr399Ile polymorphisms and monocyte/neutrophil TLR-4 expression to febrile urinary tract infection (UTI) and renal scar development in children. The study was performed in children with a history of febrile UTI. Patients with and without renal scarring were classified as group 1 and group 2, respectively, while the control cases in our previous study were used as the control group (group 3). All three groups were compared for the rate of TLR-4 Asp299Gly and Thr399Ile polymorphisms, and for basal and lipopolysaccharide-stimulated monocyte/neutrophil TLR-4 expression levels. There were 168 patients (86 in group 1, 82 in group 2) and 120 control cases. Monocyte/neutrophil TLR-4 expression levels were similar in groups 1 and 2. However, both groups had lower TLR-4 expression than group 3. The rate of TLR-4 Asp299Gly polymorphism was not different in all groups. TLR-4 Thr399Ile polymorphism was higher in groups 1 and 2 than in group 3 (14.0, 12.2, and 2.0 %, respectively), while group 1 and group 2 were not different. Furthermore, monocyte TLR-4 expression level was lower in those having TLR-4 Thr399Ile polymorphism than in those without this polymorphism. Patients with febrile UTI had more frequent TLR-4 Thr399Ile polymorphism and lower monocyte/neutrophil TLR-4 expression. These findings indicate that children carrying TLR-4 Thr399Ile polymorphism and/or having low level of monocyte/neutrophil TLR-4 expression have a tendency to develop febrile UTI. However, we could not show the association of TLR-4 polymorphisms and of TLR-4 expression level to renal scarring.


Changes of pancreatic exocrine function after major resection of the pancreas in dogs.
Changes of an exocrine function after major resection of the canine pancreas were observed by pancreozymin-secretin test and the results were compared with an endocrine function examined by glucose tolerance test. The exocrine function of the remnant pancreas revealed characteristic changes according to the resection rate of the pancreas: 1) After removal of 50 to 70 per cent of the entire pancreas, diabetes did not develop and the exocrine function of the remnant pancreas was well maintained. 2) After 70 to 90 per cent pancreatectomy, diabetes developed six weeks or more later and the exocrine function of the remnant pancreas per body weight decreased slightly. The degree of disturbance of the exocrine function in the diabetic dogs was greater than that in the non-diabetic group, but the exocrine function per the remnant pancreas weight increased and it was greater than normal level even in the diabetic dogs. The hypersecretory state of the exocrine pancreas after surgery was verified. 3) After 90 per cent or greater resection of the pancreas, diabetes occurred immediately and disturbance of the exocrine function was remarkable. Hypersecretory state did not appear. 4) Both the endocrine and exocrine functions after major pancreatic resection were found to be related to the resection rate, but there were significant differences in the reserve capacity of the endocrine and exocrine pancreas.


[Bladder primitive lymphoma. Report of a case].
Lymphoma is an uncommon tumor of bladder. We report herein one case in a 58 year-old man aiming to show diagnosis and treatment difficulties in our practice. This patient had medical history of nephritic colic, haematuria and cystitis. Imagery revealed tissular mass with orange-like dimension in the right bladder corn. There was no kidney function alteration. Complete mass excision was performed and histological examination diagnosed low grade lymphoma with lymphoplasmocytary type. After chemotherapy, complete remission was obtained after 10 months follow-up.


Effect of crop development on biogenic emissions from plant populations grown in closed plant growth chambers.
The Biomass Production Chamber at John F. Kennedy Space Center is a closed plant growth chamber facility that can be used to monitor the level of biogenic emissions from large populations of plants throughout their entire growth cycle. The head space atmosphere of a 26-day-old lettuce (Lactuca sativa cv. Waldmann's Green) stand was repeatedly sampled and emissions identified and quantified using GC-mass spectrometry. Concentrations of dimethyl sulphide, carbon disulphide, alpha-pinene, furan and 2-methylfuran were not significantly different throughout the day; whereas, isoprene showed significant differences in concentration between samples collected in light and dark periods. Volatile organic compounds from the atmosphere of wheat (Triticum aestivum cv. Yecora Rojo) were analysed and quantified from planting to maturity. Volatile plant-derived compounds included 1-butanol, 2-ethyl-1-hexanol, nonanal, benzaldehyde, tetramethylurea, tetramethylthiourea, 2-methylfuran and 3-methylfuran. Concentrations of volatiles were determined during seedling establishment, vegetative growth, anthesis, grain fill and senescence and found to vary depending on the developmental stage. Atmospheric concentrations of benzaldehyde and nonanal were highest during anthesis, 2-methylfuran and 3-methylfuran concentrations were greatest during grain fill, and the concentration of the tetramethylurea peaked during senescence.


Sevoflurane suppresses the malignant progression of breast cancer via the hsa_circ_0000129/miR-578/EPSTI1 axis.
Sevoflurane (Sev) is a commonly used volatile anesthetic that might suppress the process of breast cancer. Also, circular RNAs (circRNAs) have been reported to partake in the pathogenesis of breast cancer. Accordingly, this research was designed to investigate the mechanism of hsa_circ_0005962 on Sev-mediated breast cancer development. Sev was applied to treat breast cancer cells. Cell proliferation ability, migration, invasion, and apoptosis were detected using Cell Counting Kit-8 (CCK-8), 5-ethynyl-2'-deoxyuridine (EdU), Transwell, and flow cytometry assay. Proliferating cell nuclear antigen (PCNA), Matrix metallopeptidase 9 (MMP9), B-cell lymphoma-2 (Bcl-2)-associated X protein (Bax), and Epithelial stromal interaction 1 (EPSTI1) were assessed using western blot assay. circ_0000129, microRNA-578 (miR-578), and EPSTI1 levels were determined using real-time quantitative polymerase chain reaction (RT-qPCR). Using bioinformatics software (Circinteractome and Targetscan), the binding between miR-578 and circ_0000129 or EPSTI1 were predicted, and proved using dual-luciferase reporter and RNA pull-down assay. The biological roles of circ_0000129 and Sevoflurane on tumor growth were analyzed using a xenograft tumor model in vivo. Sevoflurane blocked tumor cell proliferation, migration, invasion, and promoted apoptosis. Circ_0000129 and EPSTI1 expression were increased, and miR-578 was decreased in breast cancer cells. Also, they presented an opposite trend in Sev-treated tumor cells. Circ_0000129 upregulation might abolish Sev-mediated tumor progression in vitro. Mechanically, circ_0000129 can affect EPSTI1 expression by sponging miR-578. Sev might inhibit tumor growth by regulating circ_0000129 in vivo. Circ_0000129 relieved Sev-triggered suppression impacts on breast cancer development partly via the miR-578/EPSTI1 axis, which provides a new mechanism for studying mediated therapy of breast cancer treatment.


Single-bundle versus double-bundle reconstruction for anterior cruciate ligament rupture: a meta-analysis--does anatomy matter?
To determine whether double-bundle anterior cruciate ligament reconstruction leads to better restoration of anterior and rotational laxity and range of motion than single-bundle reconstruction. A search was performed in the Medline, Embase, CINAHL, and Cochrane databases. All randomized, quasi-randomized, and observational clinical trials that reported the outcome of double- versus single-bundle anterior cruciate ligament reconstruction were included in our meta-analysis. The primary outcomes were anterior laxity (KT arthrometer; MEDmetric, San Diego, CA), pivot shift, and range of motion. Subgroup analyses were performed for more than 2 years' follow-up, anatomic reconstruction, and nonanatomic reconstruction. The quality of the included studies was scored by use of the GRADE Checklist. Included 12 studies in this meta-analysis, 5 of which were randomized. There was a statistically significant difference in favor of double-bundle reconstruction for anterior laxity (KT arthrometer difference, -0.6 mm), Lachman test (64% risk reduction of positive Lachman), and pivot-shift test (69% risk reduction of positive shift). Similar results were found for the subgroup with more than 2 years' follow-up and anatomic reconstructions. There were no significant differences for the subgroup with nonanatomic reconstructions, except a 2.6 times risk increase of extension deficit with nonanatomic double-bundle reconstruction compared with nonanatomic single-bundle reconstruction. Most of the included studies were found to have at least one serious limitation in study design. In comparison with single-bundle reconstruction, double-bundle reconstruction showed less anterior laxity, as measured by the KT arthrometer and Lachman test, and better rotational laxity, as measured by the pivot-shift test. The majority of the included studies had at least one major limitation in study design that decreased the quality of the study. Level I, meta-analysis.


Nutrition Considerations in Patients with Functional Diarrhea.
Functional diarrhea (FD) is a functional gastrointestinal disorder that affects a great percentage of the population and has damaging nutritional and psychological effects. In this review, evidence has been assessed and analyzed to provide nutrition considerations and recommendations for patients with functional diarrhea. The traditional irritable bowel syndrome (IBS) diet, the low FODMAP diet, and general recommendations for diarrhea have been established as interventions for FD. Additionally, nutrition outcomes such as vitamin and mineral deficiencies, hydration levels, and mental health status should be at the forefront of assessment. The importance of medical management of FD and IBS-D is established, with many existing evidence-based recommendations and approved medications available. Nutrition management of FD from a registered dietitian/dietitian nutritionist, from symptom control to dietary advice, is imperative. There are no "one-size-fits-all" approaches to nutrition management of FD, but there is promising literature that can shape personalized nutrition interventions from a registered dietitian.


A lipid linked oligosaccharide which contains hexosamine, mannose and glucose.
Previous work showed that liver microsomes catalyze the transfer of glucose from dolichol monophosphate glucose to an endogenous acceptor believed to be a dolichol pyrophosphate derivative of an oligosaccharide. This oligosaccharide has now been prepared on a larger scale so as to permit the determination of its sugars. The purification procedure includes, as a last step, a thin layer chromatography on kieselguhr-silica gel to obviate glucose-containing contaminants. After complete hydrolysis mannose, glucose and a small amount of hexosamine were detected.


Improved survival but marginal allograft function in patients treated with extracorporeal membrane oxygenation after lung transplantation.
Previous reports demonstrate that 1-year survival is severely compromised in patients with severe primary graft dysfunction (PGD) after lung transplantation. We examined if advances in extracorporeal membrane oxygenation (ECMO) support, including polymethylpentene oxygenators and reliance on venovenous (VV) ECMO have improved outcomes in patients with severe PGD after lung transplantation. The analysis included data prospectively collected on all single-lung or double-lung transplants between November 2001 and December 2009. Heart-lung transplants were excluded. Comparisons were made between recipients who did and did not require ECMO for PGD after transplant. Since November 2001, when VV ECMO became the routine treatment for severe PGD after transplant at our center, 28 of 498 patients (6%) have required VV ECMO support. Successful weaning occurred in 27 of 28 (96%). Support was withdrawn for 1 patient with irreversible neurologic injury. Survival was substantially better than in previous reports: 30 days, 82%; 1 year, 64%; and 5 years, 49%. Freedom from bronchiolitis obliterans syndrome was 88% in the ECMO survivors at 3 years, but maximum allograft function was considerably worse than in transplant recipients not requiring ECMO (peak forced expiratory volume in 1 second: 58% in ECMO vs 83% in non-ECMO, p=0.001). Advances in ECMO technology, particularly VV ECMO, have greatly improved the ability to support patients with severe PGD after lung transplantation. VV ECMO is an important tool in the armamentarium of any lung transplant program to optimize patient outcomes; however, strategies to improve lung allograft function in patients experiencing severe PGD are still needed.


Clinical and prognostic features of a rapidly progressing breast cancer in Tunisia.
Clinical and radiographic examination of 581 patients with histologically verified breast cancer has permitted us to define a subgroup having a significantly poorer prognosis than other patients. Their condition, called "poussée évolutive" (rapidly progressing), is characterized by rapid tumor growth and/or inflammation adjacent to the tumor. Statistical analysis of the survival of M0 patients (412 of the 581) shows that the diagnosis of "poussée évolutive" provides prognostic information beyond that given by T and N classifications and after delay between initial symptoms and diagnosis have been considered. Six years of clinical experience with this condition are discussed.


A Golgi study of the parvocellular neurons in the paraventricular nucleus of the domestic fowl.
The present study was focussed on the typology of small and medium-sized neurons in the hypothalamic paraventricular nucleus (PVN) of the domestic fowl as revealed by means of Golgi impregnation. This region is provided with different systems of neurons that can be distinguished on the basis of their location and dendritic morphology. Intraependymal neurons and CSF-contacting nerve cells are found in the periventricular layer together with bipolar elements endowed with processes extending parallel to the surface of the third ventricle. The short axons of these neurons may contact the magnocellular elements. Numerous isodendritic neurons are scattered throughout the entire PVN; these nerve cells possessing short and branched axons may be considered as local-circuit neurons. The complex intrinsic organization of the PVN of the domestic fowl might provide the structural basis for local interactions among the neuronal elements of this hypothalamic region.


How to manage athletes with syncope.
Athletes with syncope warrant a full evaluation, as it is possible that athletics may unmask heart disease, either structural or electrical, and these athletes may be at risk for sudden cardiac death. The work-up and treatment of syncope in the athlete offers some unique challenges: to diagnose potentially life-threatening arrhythmias, to avoid pharmacological therapy, and to maximize ability to play. This article addresses the topic of syncope and possible solutions for those athletes in whom it is diagnosed.


Excitatory effect of M1 muscarinic acetylcholine receptor on automaticity of mouse heart.
We have investigated the effects of relatively high concentration of carbachol (CCh), an agonist of muscarinic acetylcholine receptor (mAChR), on cardiac automaticity in mouse heart. Action potentials from automatically beating right atria of mice were measured with conventional microelectrodes. When atria were treated with 100 microM CCh, atrial beating was immediately arrested and diastolic membrane potential (DMP) was depolarized. After exposure of the atria to CCh for approximately 4 min, action potentials were regenerated. The regenerated action potentials had lower frequency and shorter duration when compared with the control. When atria were pre-exposed to pirenzepine (1 microM), an M1 mAChR antagonist, there was complete inhibition of CCh-induced depolarization of DMP and regeneration of action potentials. Pre-exposure to AFDX-116 (11 ({2-[(diethylamino)-methyl]-1 -piperidyl}acetyl)-5,11 -dihydro-6H-pyridol[2,3-b][1,4] benzodiazepine-6-one base, 1 microM), an M2 mAChR antagonist, failed to block CCh-induced arrest of the beating. However, prolonged exposure to CCh elicited gradual depolarization of DMP and slight acceleration in beating rate. Our data indicate that high concentration of CCh depolarizes membrane potential and recovers right atrial automaticity via M1 mAChR, providing functional evidence for the role of M1 mAChR in the atrial myocytes.


A mutation in apolipoprotein A-I in the Iowa type of familial amyloidotic polyneuropathy.
Immunoblotting of isoelectric focusing gels of plasma and direct genomic DNA sequencing have been used to characterize a mutation in apolipoprotein A-I associated with the familial amyloidotic polyneuropathy originally described by Van Allen in an Iowa kindred. An arginine for glycine substitution in apolipoprotein A-I identified in the proband's amyloid fibrils was determined to be the result of a mutation of guanine to cytosine in the apolipoprotein A-I gene at the position corresponding to the first base of codon 26. Direct sequencing of genomic DNA of three affected individuals who died in the 1960s confirmed the inheritance of the disorder. Immunoblot analysis detected the variant apolipoprotein A-I in the proband's plasma and in several at-risk members of the kindred. In addition, allele-specific amplification by the polymerase chain reaction was used to detect carriers of the variant gene.


Neural correlates of source memory retrieval in young, middle-aged and elderly adults.
Event-related potentials (ERPs) were recorded in young (21-27 years old), middle-aged (50-57 years old) and older adults (70-77 years old) to determine whether the decline in source memory that occurs with advancing age coincides with contemporaneous neurophysiological changes. Source memory for the spatial location (quadrant on the screen) of images presented during encoding was examined. The images were shown in the center of the screen during the retrieval task. Retrieval success for source information was characterized by different scalp topographies at frontal electrode sites in young adults relative to middle-aged and older adults. The right frontal effect during unsuccessful retrieval attempts showed amplitude and latency differences across age groups and was related to the ability to discriminate between old and new images only in young adults. These results suggest that the neural correlates of the retrieval success and attempt were affected by age and these effects were present by middle-age.


Prenatal detection of pulmonary hypoplasia in giant omphalocele.
Respiratory insufficiency has sometimes been reported in giant omphalocele. To determine whether ultrasonic fetal lung measurements including lung/thorax transverse area ratio (L/T) and chest/trunk length ratio (C/T) may be useful in predicting associated pulmonary hypoplasia, 28 fetuses with abdominal wall defects between 1991 and 2003 were reviewed. Nine patients with gastroschisis and 19 with omphalocele were classified into three groups. A group with neonatal death and postmortem lung/body weight ratio below 0.012, which was defined as pulmonary hypoplasia (PH group), included two ruptured giant omphaloceles and two giant omphaloceles with intact covering membrane in utero. A group with artificial ventilation more than 3 months, which was defined as prolonged ventilation (PV group), included one ruptured giant omphalocele and three giant omphaloceles with intact covering membrane. Others were defined as ordinary group. In 12 fetuses with giant omphalocele, the evisceration rate of the liver (LER) was measured in the fetal transverse abdominal dimension including the base of the liver. The L/T in PH group was significantly decreased to other groups. The C/T in PH group was significantly increased to ordinary group. There was no significant difference in the LER among three groups. A measurement of L/T may be useful in predicting associated pulmonary hypoplasia in giant omphalocele. However, antenatal detection of patients required prolonged ventilation may be difficult and require further study.


Comparable bio-evaluation of curcumin and chitosan-encapsulated curcumin nanoparticles against the reprotoxic potential of fenpropathrin pyrethroid in rats: Genomic and morphometric prospectives.
This study delves into the intricate exploration of potential toxic effects resulting from subchronic exposure to fenpropathrin (FNP) on the reproductive system of male SD rats. Adding to the novelty, our study undertakes a pioneering comparison of the effects of curcumin (CUR) and curcumin-encapsulated chitosan nanoparticles (CS.CUR.NPs) on these toxic effects. The study involved a cohort of sixty male SD rats (six groups): vehicle control, CUR, Cs.CUR.NPs, FNP, and two combination groups (FNP with CUR or Cs.CUR.NPs). The synthesized Cs.CUR.NPs nanoparticles underwent meticulous characterization using Fourier Infrared spectroscopy (FT-IR) and transmission electron microscopy (TEM). The findings revealed that FNP caused oxidative stress, sperm abnormalities, reduced motility and sperm count FNP decreased serum LH, FSH, 17-β estradiol, and testosterone levels. FNP downregulated the mRNA expression of the spermatogenesis and steroidogenesis-related genes, While, downregulated hypothalamic KISS-1 and KISS-1r expression. Histopathological alterations were assessed and scored. Surprisingly, the treatment with CUR and Cs.CUR.NPs exhibited remarkable restorative effects on semen quality, sex hormone levels, antioxidant capacity, and mRNA expression of the targeted genes. Notably, Cs.CUR.NPs displayed superior properties when compared to CUR. Nevertheless, further research is imperative to evaluate their efficacy across various bodily tissues.


Cancer stem cells and tumor angiogenesis.
Cancer stem cells (CSCs) have been identified in several human solid and hematological tumors. They are able to initiate tumor formation and metastasis and express specific cell surface markers. CSC tend to be more resistant to chemotherapeutic agents and radiation therapy than more mature cell types from the same tissue because of increased expression of antiapoptotic proteins. In this context, the development of agents that eliminate or control CSC may be an effective strategy for cancer prevention.


Anti-inflammatory properties of pro-inflammatory interferon-gamma.
Production of interferon-gamma (IFNgamma) in response to infection is a hallmark of innate and adaptive immunity. In addition to the pivotal role of IFNgamma in host defense, its excessive release has been associated with the pathogenesis of chronic inflammatory and autoimmune diseases. In fact, knockout models reveal that IFNgamma plays a key role in mediating a number of pathological processes related to chronic immune activation. On the other hand, evidence has been accumulated in recent years that supports the concept of a dual role of IFNgamma in inflammation. Here, we review anti-inflammatory aspects of IFNgamma in the regulatory network of cytokine biology. These include induction of anti-inflammatory molecules such as interleukin (IL)-1 receptor antagonist (IL-1Ra) and IL-18 binding protein (IL-18BP), modulation of pro-inflammatory cytokine production, activation of apoptosis, and interference with the signal transduction machinery by induction of suppressors of cytokine signaling (SOCS).


Fundus characteristics of high myopia in children.
To evaluate the fundus characteristics of highly myopic eyes in children. We reviewed the medical records of 46 children (1 to 8 years old; mean age, 6.8 years) (80 eyes) with high myopia (4 D or more for children younger than 5 years, 6 D or more for children aged 6-8 years) seen consecutively during a 10-year period at the high-myopia clinic in our hospital. Children of up to 8 years of age at the initial visit were included in the study. Fundus examination revealed posterior staphyloma in only one eye (1.3%) and mild chorioretinal atrophy around the optic disc in 13 eyes (16.3%). There were no patients with choroidal neovascularization or geographic atrophy in the posterior fundus. Myopic peripapillary crescent was observed in 26 eyes (33.8%), but the area of the crescent was relatively small (mean, 0.5 disc area). The results of the present study showed that myopic fundus changes are uncommon and mild in children. They suggest that aging, in addition to mechanical stretching of the eyeball, might be important for the development of myopic fundus changes.


Viability of engineered vessels as arterial substitutes.
The search for vessel substitutes to replace small-/medium-caliber vessels is an ongoing concern for vascular surgeons. Engineered vessels were designed for use as arterial equivalents and assessed in an in vivo model in dog. Three study groups were established: clinical expanded polytetrafluoroethylene (ePTFE; control, n = 24), ePTFE seeding with endothelial cells (EC graft, n = 12), and ePTFE with a fibroblast matrix seeded with EC (FM+EC graft, n = 12). Grafts were subjected to a custom-designed femoral ex vivo circuit and implanted in the carotid artery for 60 days. The viability of the prosthetic grafts was evaluated. The ex vivo circuit revealed that the presence of a fibroblast matrix induced over double the cell retention compared to EC grafts. A significant reduction in platelet adhesion in EC grafts was observed. After their in vivo implantation, the engineered vessels were more efficient at avoiding occlusion than the prosthetic grafts. The FM+EC grafts induced more endothelialization than those seeded with ECs alone. Intimal hyperplasia response was reduced in the EC substitutes. Significant differences in apoptotic cells emerged between the EC and control ePTFE grafts. In conclusion, engineered vessels showed improved initial patency over ePTFE grafts. The EC graft was best at combating restenosis, a good indicator of the long-term efficiency of the graft.


Immune tolerance induction in patients with severe hemophilia with inhibitors: expert panel views and recommendations for clinical practice.
For hemophilia patients with inhibitors, immune tolerance induction (ITI) may help to restore clinical response to factor (F) VIII or FIX concentrates. Several ITI regimens and protocols exist; however, despite 30 yr of progressive investigation, the ITI evidence base relies mainly on observational data. Expert opinion, experience, and interpretation of the available evidence are therefore valuable to support clinical decision-making. At the Sixth Zürich Haemophilia Forum, an expert panel considered recent data and consensus to distill key practice points relating to ITI. The panel supported current recommendations that, where feasible, ITI should be offered early to children and adults (ideally ≤ 5 yr of inhibitor detection) when inhibitor titers are <10 Bethesda units (BU) and should be stopped when successful tolerance is achieved. For hemophilia A inhibitor patients, ITI can be founded on recombinant FVIII at high doses. The panel considered that patients with a high bleeding frequency should be offered additional prophylaxis with a bypassing agent. For patients with hemophilia B, there may be a benefit of genetic testing to indicate the risk for inhibitors. ITI is often less effective and associated with a greater risk of side effects in these patients. For high-titer inhibitor (≥ 5 BU) hemophilia B patients, the panel advised that bypassing agents could be offered on demand in addition to ITI. Within future ITI regimens, there may be a role for additional immunosuppressant therapies. Participants agreed that research is needed to find alternatives to ITI therapy that offer durable and sustained effects and reduced rates of complications.