Seed priming with rutin enhances tomato resistance against the whitefly Bemisia tabaci.
Flavonoids are ubiquitously distributed in plants, showing pleiotropic effects in defense against abiotic and biotic stresses. Although it has been shown that seed priming with flavonoids can enhance plant resistance to abiotic stress, little is known about its potential to enhance plant tolerance to biotic stresses, especially for herbivorous insects. Here, we investigated whether treatment of tomato (Solanum lycopersicum) seeds with rutin improves plant resistance against the whitefly (Bemisia tabaci). Specifically, we measured the effect of rutin seed treatment on tomato seedling vigour, plant growth, feeding behavior and performance of B. tabaci on plants grown from control and rutin-treated seeds, and plant defense responses to B. tabaci attack. We found that seed treatment with different concentrations of rutin (viz 1, 2, 5, 10, and 20 mM) had minimal impact on shoot growth. Furthermore, seed treatment of rutin reduced the developmental rate of nymphs, the fecundity and feeding efficiency of adult females on plants grown from these seeds. The enhanced resistance of tomato against B. tabaci is closely associated with increased flavonoids accumulation, callose deposition and the expression of jasmonic acid (JA)-dependent defense genes. Additionally, callose deposition and expression of JA-dependent genes in tomato plants grown from rutin-treated seeds significantly increased upon B. tabaci infestation. These results suggest that seed treatment with rutin primes tomato resistance against B. tabaci, and are not accompanied by reductions in shoot growth. Defense priming by seed treatments may therefore be suitable for commercial exploitation.


Which adolescents develop persistent substance dependence in adulthood? Using population-representative longitudinal data to inform universal risk assessment.
To our knowledge, there are no universal screening tools for substance dependence that (1) were developed using a population-based sample, (2) estimate total risk briefly and inexpensively by incorporating a relatively small number of well-established risk factors, and (3) aggregate risk factors using a simple algorithm. We created a universal screening tool that incorporates these features to identify adolescents at risk for persistent substance dependence in adulthood. Participants were members of a representative cohort of 1037 individuals born in Dunedin, New Zealand in 1972-1973 and followed prospectively to age 38 years, with 95% retention. We assessed a small set of childhood and adolescent risk factors: family history of substance dependence, childhood psychopathology (conduct disorder, depression), early exposure to substances, frequent substance use in adolescence, sex, and childhood socioeconomic status. We defined the outcome (persistent substance dependence in adulthood) as dependence on one or more of alcohol, tobacco, cannabis, or hard drugs at ⩾3 assessment ages: 21, 26, 32, and 38 years. A cumulative risk index, a simple sum of nine childhood and adolescent risk factors, predicted persistent substance dependence in adulthood with considerable accuracy (AUC = 0.80). A cumulative risk score can accurately predict which adolescents in the general population will develop persistent substance dependence in adulthood.


Open Reduction and Internal Fixation Plus Total Hip Arthroplasty for the Acute Treatment of Older Patients with Acetabular Fracture: Surgical Techniques.
Open reduction and internal fixation of displaced acetabular fractures has been the gold standard for treatment of these complex injuries. The subset of older patients with dome impaction, femoral head impaction, or a posterior wall component are considered for treatment with concomitant open reduction and internal fixation and total hip arthroplasty. Little has been written on the surgical techniques to perform concomitant open reduction and internal fixation plus total hip arthroplasty safely. This article describes the important intrinsic factors for acetabular component stability, choice of surgical approach for management of these injuries, and surgical technique for anterior and posterior approaches.


Association between occurrence of multiple white and flat elevated gastric lesions and oral proton pump inhibitor intake.
Multiple white and flat elevated lesions (MWFL) that develop from the gastric corpus to the fornix may be strongly associated with oral antacid intake. Therefore, this study aimed to determine the association between the occurrence of MWFL and oral proton pump inhibitor (PPI) intake and clarify the endoscopic and clinicopathological characteristics of MWFL. The study included 163 patients. The history of oral drug intake was collected, and serum gastrin levels and anti-Helicobacter pylori immunoglobulin G antibody titers were measured. Upper gastrointestinal endoscopy was performed. The primary study endpoint was the association between MWFL and oral PPI intake. In the univariate analyses, MWFL were observed in 35 (49.3%) of 71 patients who received oral PPIs and 10 (10.9%) of 92 patients who did not receive oral PPIs. The occurrence of MWFL was significantly higher among patients who received PPIs than in those who did not (p<0.001). Moreover, the occurrence of MWFL was significantly higher in patients with hypergastrinemia (p=0.005). In the multivariate analyses, oral PPI intake was the only significant independent factor associated with the presence of MWFL (p=0.001; odds ratio, 5.78; 95% confidence interval, 2.06-16.2). Our findings suggest that oral PPI intake is associated with the presence of MWFL (UMINCTR 000030144).


Pessary treatment of pelvic relaxation: factors affecting successful fitting and continued use.
The aims of this study were to determine predictors of successful pessary fitting and continued pessary use in patients with pelvic relaxation. Retrospective observational study. The medical records of 130 consecutive patients evaluated for pessary treatment of pelvic relaxation by a single specially trained nurse practitioner (CRJ) at Kaiser Foundation Hospital, Harbor City, Calif, between May 1, 1997, and June 30, 2002, were retrospectively reviewed. Voiding diaries, data collection sheet, and questionnaires. The medical records of the 130 patients were retrospectively reviewed, and data were recorded on data collection sheets. Patients using pessaries completed a questionnaire to assess treatment effectiveness. Coexisting stress urinary incontinence and previous prolapse and cystocele/rectocele repairs were each found to be independent predictors of unsuccessful pessary fitting. Fifty percent of successfully fitted patients had discontinued pessary use by 24 months. Current pessary users were more likely to have undergone prior pelvic reconstructive surgery (37% vs 13%, P = .02), less likely to require a space-filling pessary (13% vs 37%, P = .03), and more likely to recommend pessary to their friends or family (87% vs 50%, P = .007) compared to patients who discontinued pessary use. Prior pelvic reconstructive surgery is associated with an increased risk of unsuccessful pessary fitting; however, those patients who are successfully fitted tend to continue pessary use.


Investigating the Effect of Tones and Frequency Sweeps on the Collective Behavior of Penned Herring (Clupea harengus).
We experimentally played back tones and sweeps to captive herring (Clupea harengus) in a net pen and measured the collective response of a large and a small group of fish using a camera, echo sounder, and multibeam sonar. The playbacks ranged in frequency from 160 to 500 Hz and 131 to 147 dB re 1 μPa in received sound pressure level. Herring behavior was scored by a team that blindly evaluated the observations. Overall, the responses were modest. Stronger reactions were observed at higher source levels, lower frequencies, and smaller school sizes, but there was no effect on signal rise time.


The Impact of the Number of Injections per Visit on the Likelihood of Human Papillomavirus Immunization.
To test whether adolescents, who are injection limited, that is, receiving only a limited number of immunization injections per visit, are less likely to complete the human papillomavirus (HPV) immunization series. For Oregon adolescents age 13-17 years, HPV series completion rates were assessed based on never receiving >1 injection per visit from age ≥9 years. Among a study subset born and resident in Oregon through adolescence, HPV series rates were assessed based on never receiving >1 or 2 injections per visit from age ≥4 years. Cox proportional hazards regression was used to assess delays owing to limiting injections, controlling for sex and rural location. Among 241 453 study adolescents, 16.3% had only single-injection visits from age ≥9 years. Their HPV completion rate was 7.7% as compared with 61.7% for those with no limitations of number of injections. Among study adolescents born in Oregon, 10.2% never received >1 or 2 injections per visit from age ≥4 and were less than half as likely to complete the HPV series (28.4% vs 59.1%). Limiting the number of injections per visit is associated with decreased completion of HPV immunization. As larger cohorts of young children with early injection-limiting characteristics age into adolescence, progress on HPV immunization rates may be challenged.


Classical group theory adapted to the mechanism of Pt3Ni nanoparticle growth: the role of W(CO)6 as the "shape-controlling" agent.
Classical group theory was applied to prove the Pt3Ni crystallographic transformation from Platonic cubic to Archimedean cuboctahedral structures and the formation of Pt3Ni polypods. The role of W(CO)6 as a shape-controlling agent is discussed with respect to the crystallographic features of the clusters and superstructures generated as control samples.


Embryonic lens induction: more than meets the optic vesicle.
The classic model of lens induction stipulated that the optic vesicle is both a necessary and sufficient inductor of the lens in amphibian development. Although this view has subsequently been modified to encompass the contributions of earlier inductors, such as the involuting endo-mesoderm, it is still widely reported that the optic vesicle alone is able to elicit lens formation from ectoderm. Recent work, which has employed a host- and donor-marking scheme, has shown the optic vesicle to be a weak inductor of the lens, involved only in the final rather than the initial phases of determination. In addition, a review of the literature substantiates this conclusion since many of the transplantation experiments arguing for the sufficiency of the optic vesicle are characterized by the lack of adequate criteria for judging the authenticity of the resulting lens responses, particularly the absence of a host- and donor-marking strategy. This analysis of the literature, together with our own results, lead us to propose a new model of lens determination in which tissue interactions during gastrulation are required to confer a lens-forming bias upon a large area of head ectoderm allowing the optic vesicle to induce lens formation in a defined area of this primed ectoderm. Data from studies on mesoderm and neural induction are also beginning to suggest a multistep model involving the initial establishment of bias and subsequent interactions resulting in determination, and we propose that this framework will serve as a general paradigm for embryonic induction.


Layered membranes: a diffusion barrier to gases in teleostean swimbladders.
Flattened cells are dispersed in an overlapping fashion within the submucosa of closed (physoclistous) swimbladders. Within the cells are located round platelets best seen by phase or interference type microscopy. At the electron microscope level the platelets are revealed as repeated, numerous layers of membranous discs. Each disc is a bilayer with an enlarged rim. The bilayer is strongly and preferentially reactive to osmium tetroxide. Swimbladder walls are known to be highly resistant to passage of gases. The randomly disposed platelets with the highly ordered layering of membranes may provide that physical resistance to gas movement.


Baicalin; a promising chemopreventive agent, enhances the antitumor effect of 5-FU against breast cancer and inhibits tumor growth and angiogenesis in Ehrlich solid tumor.
Despite considerable advances in cancer treatment, chemotherapy remains a cornerstone in breast cancer therapy. Therefore, reducing chemoresistance and adverse effects of chemotherapy is a priority. In this regard, Baicalin (BA) is the dominant natural flavonoid extracted from the roots of Scutellaria baicalensis showed fascinating antitumor activity in many types of cancers, including breast cancer. The present study aimed to explore the chemopreventive and antitumor action of baicalin alone and in combination with 5-FU in addition to its ability to enhance the antitumor effect of 5-FU on breast cancer using the Ehrlich solid tumor-mice model. A total of 70 female mice were divided into seven groups (1st group, saline group; 2nd group, DMSO group; 3rd group, BA+EST group; 4th group, EST group; 5th group, EST+5-FU; 6th group, EST+BA group; 7th group, EST+5-FU+BA).tumors were assessed by weight and histopathological examination. Inflammation, angiogenesis, and apoptosis were examined by ELISA, qRT-PCR, and immunohistochemical examinations. showed that pre-treatment with baicalin and treatment with baicalin and/or 5-FU significantly reduced inflammation and angiogenesis indicated by suppression of NF-kB/ IL-1β and VEGF amplification loop with marked elevation in apoptosis indicated by up-regulation of apoptotic caspase-3, pro-apoptotic p53, Bax and downregulation of anti-apoptotic Bcl-2. BA is a promising preventive or adjuvant therapy in breast cancer treatment with 5-FU mainly via cooperative inhibition of inflammation, angiogenesis, and triggering apoptotic cell death.


Effects of vitamins, coenzymes and amino acids on reactions of homolytic cleavage of the O-glycoside bond in carbohydrates.
It has been established that vitamins B1, K3 and C, coenzyme Q0 and amino acids cysteine and histidine effectively inhibit reactions of homolytic cleavage of the O-glycoside bond, which are responsible for the destruction of di- and polysaccharides on gamma-irradiation or the action of other reactive radical initiators. This effect was shown to originate from either oxidation or reduction of the radicals of carbohydrates undergoing destruction.


Induction immunosuppression with basiliximab in heart transplantation.
After clinical heart transplantation (HT), it is crucial to use appropriate immunosuppressive agents to prevent rejection. The use of basiliximab or rabbit anti-thymocyte globulin (RATG) for induction therapy has significantly reduced the incidence of acute rejection episodes after kidney transplantation. In this study we sought to examine the effects of basiliximab after HT. From June 2006 to July 2007, we performed 43 HT including patients 18-65 years old undergoing primary HT who were included in this study of basiliximab induction (20 mg intravenous [iv] on days 0 and 4). Cyclosporine and everolimus were given with basiliximab induction. All others received RATG induction (1.5-2.5 mg/kg iv infusion on days 0, 1, and 2) followed by cyclosporine or tacrolimus combined with mycophenolate mofetil. All patients underwent the same operative procedure, steroid-tapering protocol, and postoperative care with protocol endomyocardial biopsy. Basiliximab was well-tolerated and easy to use. There was only 1 operative mortality; the patient died of sepsis due to Enterobacter cloacae. All others survived the operation and are alive and in good health with a 2-year survival rate of 92.86%. No severe adverse events were noted during the first postoperative month. No acute rejection > or = grade 2R or rejection associated with hemodynamic compromise was noted during the whole course. Basiliximab as induction immunosuppressant was simple, safe, and effective after HT.


Management of neurovascular complications in extended skull base surgery.
Combined oncologic approaches to the skull base now permit resection of extensive basicranial neoplasms. Despite advances in microsurgical techniques, disabling or life-threatening complications are still encountered in such surgery. Successful management of these sequelae is dependent upon meticulous intraoperative care and compulsive postoperative clinical assessment. Perioperative neurovascular complications were recorded in 154 consecutive skull base procedures. The most frequent severe complication was cerebral edema, which occasionally required surgical intervention. Dysphagia was the most common complication noted in the late postoperative period. Based upon this review, the management and methods found to minimize the incidence of various perioperative neurovascular complications related to extended skull base surgery are described.


Gas-phase hydrolysis of proteins and peptides.
A simplified gas-phase hydrolysis procedure for proteins and peptides is described. The apparatus consists of a glass vacuum desiccator, a ceramic plate, and a Teflon ring. The method was shown to give reproducible compositions for hydrolysis of human serum albumin and microanalysis of alpha-melanocyte stimulating hormone including the quantitation of as little as one residue of tryptophan. It minimizes sample handling and allows for the simultaneous hydrolysis of a large number of samples.


A 12-month clinical study comparing four glass ionomer cements for the cementation of orthodontic molar bands.
Four different glass ionomer cements were evaluated in vivo as luting agents for orthodontic molar bands. A sample of 199 patients with full fixed appliances (Begg Light Wire) were monitored over a period of 12 months during active treatment for loose molar bands. Failures for each cement were: Fuji I, 2.5 percent, Fuji II, 4.5 percent, Ketac-Cem, 4.0 percent and Hy-Bond Luting, 3.0 percent. Chi squared tests showed no statistical difference in failure rates for each cement.


A solid-phase extraction and size-exclusion liquid chromatographic method for polyethylene glycol 25 p-aminobenzoic acid determination in urine: validation for urinary excretion studies of users of sunscreens.
No previous publications about percutaneous absorption of polyethylene glycol 25 p-aminobenzoic acid (PEG-25 PABA) have been found in the literature and the expected levels to be found in human urine after sunscreens use are unknown. The method proposed here is suitable to determine PEG-25 PABA in the urine of sunscreens users in order to carry out studies on body accumulation/excretion. It is based on solid-phase extraction (SPE) with size-exclusion liquid chromatography determination. Solid-phase extraction allows the analyte to be retained and subsequently eluted for a clean-up, using a silica-based cartridge. The size-exclusion liquid chromatography of the eluted allows the rest of matrix interferences to be avoided. Fluorescence intensity was measured at lambda(em)=350 nm (lambda(exc)=300 nm). The sensitivity of the proposed method is in the order of 450+/-5 mLng(-1) and the detection limit (3S(y/x)/b) in the measured solutions is in the order of 13 ngmL(-1), that is 2.6 ngmL(-1) in urine samples. The method enables PEG-25 PABA to be determined in both, spiked and unspiked human urine samples. Results obtained for spiked human urine samples (11-100 ngmL(-1)) demonstrated the accuracy of the method. The mean relative standard deviation of the results was in the order of 3-10%. Three volunteers applied a sunscreen lotion containing a 8% PEG-25 PABA sunscreen cream and their urinary excretion was controlled from the moment of application until the excreted amounts were no longer detectable.


Recent progress and prospects of alkaline phosphatase biosensor based on fluorescence strategy.
Alkaline phosphatase (ALP) is a membrane-bound enzyme widely present in biological tissues and is extensively used as a biomarker in clinical diagnosis because abnormal ALP levels in organisms are often closely related to many diseases. In order to meet the urgent needs of human health and the development of precision medicine, the classic method of detecting ALP seems to be unable to meet a "tailor-made" treatment plan for patients. In order to get the best therapeutic effect and the lowest side effects, the researchers have made considerable efforts and established numerous strategies for detecting ALP. In this review, we focus on the current development and basic principles of fluorescence strategy to detect ALP, and compare the advantages and disadvantages of detecting ALP based on different fluorescent detection modes. In addition, to more intuitively understand the performance of different materials for detecting ALP, a table is presented. Finally, the future trends and prospective in this field will be discussed, it could be speculated that invent and design the detection mechanism based on the relationship between the new material and ALP is the key to effective detection of ALP, and process data with a computer analog digital platform will be a welcome and obsessive technology. It is hoped that some insights and inspiration for future research work will be provided.


A Multidisciplinary Orbit-Sparing Treatment Approach That Includes Proton Therapy for Epithelial Tumors of the Orbit and Ocular Adnexa.
Postoperative radiation is often indicated in the treatment of malignant epithelial tumors of the orbit and ocular adnexa. We present details of radiation technique and toxicity data after orbit-sparing surgery followed by adjuvant proton radiation therapy. Twenty patients underwent orbit-sparing surgery followed by proton therapy for newly diagnosed malignant epithelial tumors of the lacrimal gland (n=7), lacrimal sac/nasolacrimal duct (n=10), or eyelid (n=3). Tumor characteristics, treatment details, and visual outcomes were obtained from medical records. Acute and chronic toxicity were prospectively scored using Common Terminology Criteria for Adverse Events version 4.0. The median radiation dose was 60 Gy(RBE) (relative biological effectiveness; [range 50-70 Gy]); 11 patients received concurrent chemotherapy. Dose to ipsilateral anterior optic structures was reduced in 13 patients by having them gaze away from the target during treatment. At a median follow-up time of 27.1 months (range 2.6-77.2 months), no patient had experienced local recurrence; 1 had regional and 1 had distant recurrence. Three patients developed chronic grade 3 epiphora, and 3 developed grade 3 exposure keratopathy. Four patients experienced a decrease in visual acuity from baseline but maintained vision sufficient to perform all activities of daily living without difficulty. Patients with grade ≥3 chronic ocular toxicity had higher maximum dose to the ipsilateral cornea (median 46.3 Gy[RBE], range 36.6-52.7 Gy[RBE] vs median 37.4 Gy[RBE], range 9.0-47.3 Gy(RBE); P=.017). Orbit-sparing surgery for epithelial tumors of the orbit and ocular adnexa followed by proton therapy successfully achieved disease control and was well tolerated. No patient required orbital exenteration or enucleation. Chronic grade 3 toxicity was associated with high maximum dose to the cornea. An eye-deviation technique can be used to limit the maximum corneal dose to <35 Gy(RBE).


Transdermal estrogen replacement therapy and plasma lipids in 693 French women.
The cardiovascular effects of transdermal estrogen are not so well established than those induced by oral estrogen. In a representative sample of French postmenopausal women, we assessed plasma lipid changes induced by transdermal 17 beta-estradiol. This cross-sectional study was carried out among the population sample of the third MONICA survey on cardiovascular risk factors. We selected 693 postmenopausal women according to the followed criteria; women with intact uterus and no menstruation for more than 12 months, women with bilateral oophorectomy, hysterectomized women older than 55 years and hysterectomized women who had followed hormone replacement therapy. We used multivariate linear regression models, taking into account confounding variables, to assess lipid changes induced by estrogen. We compared 192 women currently taking transdermal 17 beta-estradiol (27 unopposed estrogen and 165 estrogen plus progestin) with 501 women without any hormonal treatment. After adjustment for living area, education level, income tax, smoking, alcohol consumption, physical activity, age and body mass index, transdermal estrogen replacement therapy (ERT) was significantly associated with lower levels of serum total cholesterol [6.10 (S.E., 0.11) vs 6.35 (0.09) mmol/l, P < 0.01], triglycerides [1.06 (0.06) vs 1.23 (0.05) mmol/l, P < 0.001], LDL-cholesterol [3.93 (0.11) vs 4.13 (0.09) mmol/l, P < 0.05], VLDL-cholesterol [0.48 (0.03) vs 0.56 (0.02) mmol/l, P < 0.001] and apolipoprotein B [1.20 (0.03) vs 1.26 (0.02) g/l, P < 0.01]. Levels did not differ significantly for HDL-cholesterol [1.68 (0.05) vs 1.66 (0.04) mmol/l] and apolipoprotein A1 [1.79 (0.03) vs 1.81 (0.02) g/l]. Transdermal ERT may confer a cardiovascular protection by lowering atherogenic lipoproteins.


The effect of adenosine triphosphate on the functional status of the ductus arteriosus.
We investigated whether a low-dose infusion of ATP-MgCl2 could affect the functional status of the ductus arteriosus during hypoxia-induced pulmonary vasoconstriction. Three-day-old piglets were made hypoxic by ventilation with a mixture containing 10% oxygen, 4% CO2, and balance nitrogen. Serial infusions of ATP-MgCl2 at 0.1, 0.5, and 1.0 mg/kg/min were compared with preinfusion hypoxia baselines. The functional status of the ductus arteriosus was determined by change in transit time of a bolus of iced saline between thermistor probes in the pulmonary artery and aorta. The method was validated using a Blalock-Taussing shunt (subclavian to pulmonary artery) in 3-week-old piglets instrumented in a similar manner. In these three-day-old piglets, hypoxia alone produced a significant elevation in pulmonary artery pressure and reduction in PO2. All dose rates of ATP-MgCl2 produced a significant decrease in mean pulmonary artery pressure. Systemic pressure was significantly decreased only during the 1.0-mg/kg/min infusion. Transit times of a bolus of iced saline during the validation were definitive for characterizing a situation of "shunt open" or "shunt closed." Infusion of ATP-MgCl2 produced no change in the status of the ductus arteriosus in 45 (94%) of the determinations. In only three cases was the effect of ATP-MgCl2 sufficient to result in a functional change in the status of the ductus arteriosus. Pre- and postductal pulmonary artery PO2 were not altered during ATP-MgCl2 infusion, thus corroborating the transit time determinations. From these results, we conclude that an infusion of ATP-MgCl2 does not alter the functional status of the ductus arteriosus.


Whole-genome sequencing and gene mapping of a newly isolated lytic enterococcal bacteriophage EFRM31.
Bacteriophages contribute greatly to bacterial evolution. There has been limited investigation of enterococcal bacteriophages, and only two enterococcal bacteriophages have been sequenced completely. In this study, a novel enterococcal bacteriophage, EFRM31, was isolated from a piggery effluent sample and then characterized. The complete bacteriophage genome was determined by shotgun sequencing. EFRM31 belongs to the family Siphoviridae (order Caudovirales) and has a circular double-stranded DNA genome. The putative EFRM31 genome consists of 16945 nucleotides with a low GC content (34.5%) and does not contain CpG islands. The EFRM31 genome contains 82 putative open reading frames, including 17 with identities to genes required for the assembly of a head-tail bacteriophage and 6 hypothetical proteins of unknown function. In general, the sequencing results from EFRM31 revealed considerable similarity to another enterococcal bacteriophage, EFAP-1. This identity and the order of shared genes suggest a close relationship or a common ancestor for these two bacteriophages.


Spleen-preserving distal pancreatectomy from multi-port to reduced-port surgery approach.
Minimally invasive pancreatic surgery via the multi-port approach has become a primary surgical method for distal pancreatectomy (DP) due to its advantages of lower wound pain and superior cosmetic results. Some studies have applied reduced-port techniques for DP in an attempt to enhance cosmetic outcomes due to the minimally invasive effects. Numerous recent review studies have compared multi-port laparoscopic DP (LDP) and multi-port robotic DP (RDP); most of these studies concluded multi-port RDP is more beneficial than multi-port LDP for spleen preservation. However, there have been no comprehensive reviews of the value of reduced-port LDP and reduced-port RDP. To search for and review the studies on spleen preservation and the clinical outcomes of minimally invasive DP that compared reduced-port DP surgery with multi-port DP surgery. The PubMed medical database was searched for articles published between 2013 and 2022. The search terms were implemented using the following Boolean search algorithm: ("distal pancreatectomy" OR "left pancreatectomy" OR "peripheral pancreatic resection") AND ("reduced-port" OR "single-site" OR "single-port" OR "dual-incision" OR "single-incision") AND ("spleen-preserving" OR "spleen preservation" OR "splenic preservation"). A literature review was conducted to identify studies that compared the perioperative outcomes of reduced-port LDP and reduced-port RDP. Fifteen articles published in the period from 2013 to 2022 were retrieved using three groups of search terms. Two studies were added after manually searching the related papers. Finally, 10 papers were selected after removing case reports (n = 3), non-English language papers (n = 1), technique papers (n = 1), reviews (n = 1), and animal studies (n = 1). The common items were defined as items reported in more than five papers, and data on these common items were extracted from all papers. The ten studies included a total of 337 patients (females/males: 231/106) who underwent DP. In total, 166 patients (females/males, 106/60) received multi-port LDP, 126 (females/males, 90/36) received reduced-port LDP, and 45 (females/males, 35/10) received reduced-port RDP. Reduced-port RDP leads to a lower intraoperative blood loss, a lower postoperative pancreatic fistula rate, and shorter hospital stay and follow-up duration, but has a lower spleen preservation rate.


Molecular characterization and phylogenetic analysis of Fasciola gigantica from western Java, Indonesia.
Fasciola gigantica and aspermic (hybrid) Fasciola flukes are thought to be distributed in Southeast Asian countries. The objectives of this study were to investigate the distribution of these flukes from unidentified ruminants in western Java, Indonesia, and to determine their distribution history into the area. Sixty Fasciola flukes from western Java were identified as F. gigantica based on the nucleotide sequences of the nuclear phosphoenolpyruvate carboxykinase (pepck) and DNA polymerase delta (pold) genes. The flukes were then analyzed phylogenetically based on the nucleotide sequence of the mitochondrial NADH dehydrogenase subunit 1 (nad1) gene, together with Fasciola flukes from other Asian countries. All but one F. gigantica fluke were classified in F. gigantica haplogroup C, which mainly contains nad1 haplotypes detected in flukes from Thailand, Vietnam, and China. A population genetic analysis suggested that haplogroup C spread from Thailand to the neighboring countries including Indonesia together with domestic ruminants, such as the swamp buffalo, Bubalus bubalis. The swamp buffalo is one of the important definitive hosts of Fasciola flukes in Indonesia, and is considered to have been domesticated in the north of Thailand. The remaining one fluke displayed a novel nad1 haplotype that has never been detected in the reference countries. Therefore, the origin of the fluke could not be established. No hybrid Fasciola flukes were detected in this study, in contrast to neighboring Asian countries.


Multivariate tools to investigate the spatial contaminant distribution in a highly anthropized area (Gulf of Naples, Italy).
The Gulf of Naples located in a high anthropized coastal area is subjected to an infrastructural intervention for the installation of a submarine power pipeline. In order to evaluate the distribution of contaminants in the seafloor sediments, a preliminary study has been conducted in the area using multivariate techniques. The statistic approach was performed to gain insights on the occurrence of organic and inorganic contaminants within the area, aiming to identify the relevant hot spots. Three geographical sub-areas influenced by different contaminant association were recognized: Torre Annunziata (TA), Capri (CA), and middle offshore (MO). TA and CA resulted marked by a severe contamination pattern due to anthropogenic pressures. In addition, the influence of the depositional basin in governing the contamination trend has been pointed out. The supervised technique PLS_DA resulted to be a powerful tool in addressing the complexity of the huge dataset acquired during the marine survey, highlighting the main trends in the variability of quality indicators, orienting thus the deeper investigations during follow-up monitoring activities.


Prediction of a rare chromosomal aberration simultaneously with next generation sequencing-based comprehensive chromosome screening in human preimplantation embryos for recurrent pregnancy loss.
Preimplantation genetic testing has been used widely in recent years as a part of assisted reproductive technology (ART) owing to the breakthrough development of deoxyribonucleic acid (DNA) sequencing. With the advancement of technology and increased resolution of next generation sequencing (NGS), extensive comprehensive chromosome screening along with small clinically significant deletions and duplications can possibly be performed simultaneously. Here, we present a case of rare chromosomal aberrations: 46,XY,dup(15)(q11.2q13),t(16;18)(q23;p11.2), which resulted in a normally developed adult but abnormal gametes leading to recurrent pregnancy loss (RPL). To our best knowledge, this is the first report of t(16;18) translocation with such a small exchanged segment detected by NGS platform of MiSeq system in simultaneous 24-chromosome aneuploidy screening.


Presentation, diagnoses, mechanisms of injury, and treatment of soldiers injured in Operation Iraqi Freedom: an epidemiological study conducted at two military pain management centers.
In recent military conflicts the major source of soldier attrition has not been battle injuries but more mundane causes similar to those encountered in civilian life. In an effort to determine the pain conditions affecting soldiers during wartime, we conducted an observational study among 162 soldiers medically evacuated from Operation Iraqi Freedom who were referred to 2 large pain treatment centers located outside the theaters of combat. Fifty-three percent of soldiers presented with either radicular (n = 49) or axial (n = 37) low back pain, with lumbar herniated disk being the most frequently diagnosed condition (24%). The two most implicated etiologies were exacerbation of a previous pain condition treated with surgery (15%) and motor vehicle accidents(12%). Only 17% of patients were injured during battle. Seventy-two percent of soldiers received at least one nerve block/injection, the most common of which was lumbar epidural steroid administration (22%). Nonsteroidal antiinflammatory drugs were prescribed to 56% of patients, opioids to 49%, and some form of alternative therapy to 17%. Among the 49 patients in whom data were available, only 2% returned to combat duty in Iraq. With the exception of battle-related injuries, the pain conditions suffered during modern warfare seem to be similar to those encountered in civilian pain clinics. To improve the return-to-duty rate, better preventive measures and more aggressive treatment conducted in forward-deployed medical units are recommended. We conducted an observational study at two large military pain treatment centers among soldiers injured in Operation Iraqi Freedom. Fifty-three percent of soldiers presented with low back pain, with lumbar herniated disk being the most common diagnosis. Only 2% of patients returned to combat duty in Iraq. To improve the return-to-duty rate, better preventive measures and more aggressive treatment in forward-deployed medical units are recommended.


The effect of persistence of cocaine use on 12-month outcomes for the treatment of heroin dependence.
To determine the effects of cocaine use across the study period on outcomes of treatment for heroin dependence 12 months post-treatment entry. Longitudinal cohort (12 months). Interviews were conducted at baseline, 3 and 12 months. Sydney, Australia. Four hundred ninety-five heroin users recruited for the Australian Treatment Outcome Study and re-interviewed at 12-month follow-up. Cocaine was widely used among treatment entrants in NSW, with almost all having a lifetime history of cocaine use and almost half having used in the month preceding baseline. While there was an overall decline in cocaine use across the study period, individual use patterns varied widely. Approximately half of the cohort did not report cocaine use at any data point, with the remainder reporting having used at one (29%), two (12%), or at all three (5%) points. Cocaine use across the study period was an independent predictor of most major treatment outcomes, with more cocaine use points predicting poorer outcome. Persistent cocaine use predicted a higher prevalence of homelessness, heroin use, daily injecting, needle sharing and injection-related health problems at 12 months as well as more extensive recent polydrug use. Cocaine use was common among individuals seeking treatment for primary heroin dependence in NSW. Any cocaine use over the study period was associated with poorer outcomes in virtually all areas. Persistent cocaine use over the study period, however, appeared particularly detrimental. Cocaine use among clients should evidently be a cause for concern amongst treatment providers and may warrant being specifically targeted during treatment.


4-Chloro-2-[1-(4-ethyl-phen-yl)-4,5-diphenyl-1H-imidazol-2-yl]phenol.
In the title compound, C29H23ClN2O, the 5-chloro-phenol ring and the imidazole ring are nearly coplanar, with a dihedral angle of 15.76 (9)° between them. The ethyl-phenyl ring and the two phenyl rings subtend angles of 71.09 (7), 43.95 (5) and 36.53 (9)°, respectively, with the imidazole plane. An intra-molecular O-H⋯N hydrogen bond supports the mol-ecular conformation, and an inter-molecular C-H⋯O inter-action, originating from an ortho-phenyl H atom, stabilizes the packing arrangement. In addition, a weak C-H⋯π inter-action, also involving an ortho-phenyl H atom, is observed.


Influence of airway management strategy on "no-flow-time" in a standardized single rescuer manikin scenario (a comparison between LTS-D and I-gel).
In 2005 the European Resuscitation Council (ERC) published a revised version of the guidelines for Advanced Life Support (ALS). One of the aims was to reduce the time without chest compression in the first period of cardiac arrest (no-flow-time; NFT). We evaluated in a manikin study the influence on NFT using the single use laryngeal tube with suction option (LTS-D) compared to single use I-gel for emergency airway management. A randomised prospective study with 200 paramedics who performed standardised simulated cardiac arrest management in a manikin. The use of the LTS-D did not significantly reduce NFT compared with the I-gel (104.7s vs. 105.1s; p>0.05). The LTS-D was inserted as fast as the I-gel (10.4s vs. 9.3s; p>0.05). The LTS-D was correctly positioned by 98% of the participants on the first attempt compared to 96% with the I-gel. During the cardiac arrest simulation, establishing and performing first ventilation took an average of 40.5s with the LTS-D compared to 40.9s with the I-gel. In our manikin study, NFT was comparable using the LTS-D and the I-gel. Therefore, for personnel not experienced in tracheal intubation, the LTS-D and the I-gel seem to be equal alternatives in establishing the airway during cardiac arrest. However, relevant clinical studies are appropriate because any change in guidelines in this area must be based on clinical evidence.


Control of bursting behavior in neurons by autaptic modulation.
Firing properties of biological neurons have long been recognized to be determined by extrinsic synaptic afferents that neurons receive and intrinsic ionic mechanisms that neurons possess, however, previous researches have also demonstrated that firing behavior of single neurons can be modulated by the neurons themselves, realized by the autapses. Thus in this investigation, we argued that how autaptic modulations shape the bursting behavior of biological neurons. We considered the issue from the following two aspects: autaptic-excitation and -inhibition. Our results suggested that for autaptic-excitation, under the condition of relatively weak stimulus, regular bursting was more incline to occur when the autaptic strength was weak, while regular spiking was more likely to appear when the autaptic strength was strong. However, larger stimulus would diminish the portion of bursting, but increase the portion of spiking. For autaptic-inhibition, under relatively weak stimulus, a wide range of regular bursting emerges when the autaptic strength was small, but when stronger stimulus were applied, the range of regular bursting shrinked into a small region. Meanwhile, we observed that synaptic delays have no obvious effects in the case of autaptic-excitation, while a subtle effect of synaptic delays was observed in the case of autaptic-inhibition. These results showed that bursting behavior of neurons could be controlled and modulated by the autaptic mechanisms that biological neurons intrinsically possess, and the final results may further promote the understanding in the generation of various neuronal firing patterns.


The proteasomal system and HNE-modified proteins.
Metabolic processes and environmental conditions cause the constant formation of oxidizing species over the lifetime of cells and organisms. This leads to a continuous oxidation of intracellular components, including lipids, DNA and proteins. During the extensively studied process of lipid peroxidation, several reactive low-molecular weight products are formed, including reactive aldehydes as 4-hydroxynonenal (HNE). These aldehydic lipid peroxidation products in turn are able to modify proteins. The degradation of oxidized and oxidatively modified proteins is an essential part of the oxidant defenses of cells. The major proteolytic system responsible for the removal of oxidized cytosolic and nuclear proteins is the proteasomal system. The proteasomal system by itself is a multicomponent system responsible for the degradation of the majority of intracellular proteins. It has been shown that some, mildly cross-linked, HNE-modified proteins are preferentially degraded by the proteasome, but extensive modification with this cross-linking aldehyde leads to the formation of protein aggregates, that can actually inhibit the proteasome. This review summarizes our knowledge of the interactions between lipid peroxidation products, proteins, and the proteasomal system.


Exploring the mycobiota of bromeliads phytotelmata in Brazilian Campos Rupestres.
The phytotelmata is a water-filled tank on a terrestrial plant, and it plays an important role in bromeliad growth and ecosystem functioning. Even though previous studies have contributed to elucidate the composition of the prokaryotic component of this aquatic ecosystem, its mycobiota (fungal community) is still poorly known. In the present work, ITS2 amplicon deep sequencing was used to examine the fungal communities inhabiting the phytotelmata of two bromeliads species that coexist in a sun-exposed rupestrian field of Southeastern Brazil, namely Aechmea nudicaulis (AN) and Vriesea minarum (VM). Ascomycota was the most abundant phylum in both bromeliads (57.1 and 89.1% in AN and VM respectively, on average), while the others were present in low abundance (< 2%). Mortierellomycota and Glomeromycota were exclusively observed in AN. Beta-diversity analysis showed that samples from each bromeliad significantly clustered together. In conclusion, despite the considerable within-group variation, the results suggested that each bromeliad harbor a distinct fungi community, what could be associated with the physicochemical characteristics of the phytotelmata (mainly total nitrogen, total organic carbon, and total carbon) and plant morphological features.


[New aspects of pharmacological nephroprotection].
Current estimates forecast that chronic kidney diseases will be the fifth most common cause of death worldwide by 2040. The prevalence of chronic renal diseases increases with age and, in many countries, affects patients with overweight, diabetes and hypertension. The primary objective of the treatment of chronic renal diseases is the delay of disease progression. Established markers for the deterioration of renal function include glomerular filtration rate and albuminuria. Pharmacological blockade of the renin-angiotensin-aldosterone system (RAAS) by angiotensin-converting enzyme inhibitors (ACE) or angiotensin receptor blockers (ARB) represents the cornerstone of drug-related nephroprotection. Current Kidney Disease: Improving Global Outcomes (KDIGO) guidelines recommend the use of ACEI or ARB for diabetic and non-diabetic patients with moderate and heavy albuminuria. In recent years, sodium-glucose linked transporter 2 inhibitors (SGLT-2 ) have been established in the field of cardio- and nephroprotection. Their protective effects occur regardless of blood sugar reduction. Current data suggest that the use of SGLT‑2 inhibitors will soon be part of therapy in non-diabetic kidney disease. One of the first drugs in this substance class, dapagliflozin, is already approved in Germany for the treatment of chronic renal diseases in adults with and without type 2 diabetes.


Modification and evaluation of the Carba NP test by use of paper strip for simple and rapid detection of carbapenemase-producing Enterobacteriaceae.
Carbapenemase-producing Enterobacteriaceae (CPE) isolates have now emerged worldwide. We therefore modified the phenotypic Carba NP test by use of a filter paper strip for easily and rapidly identifying CPE in routine laboratory. A collection of 56 CPE and carbapenemase-producing Pseudomonas spp. isolates (including 28 NDM-1, 11 IMP-14a, 1 IMP-1, 1 IMP-4, 1 IMP-9, 1 IMP-15, 4 VIM-2, 1 VIM-1, 1 IMP-14a with VIM-2, 3 OXA-48, 3 OXA-181 and 1 KPC-2 producers) and 41 non-CPE isolates (including 19 ESBL, 7 pAmpC, 3 AmpC, 9 ESBL with pAmpC and 3 non-ESBL & non-AmpC producers) as confirmed by the PCR methods were tested by the paper strip method using pharmaceutical imipenem/cilastatin as a substrate. Bacterial colonies of each isolate were applied directly on filter paper strips dropped with either imipenem-phenol red (test strip) or phenol red solution alone (control strip). The reaction was read within 5 min. This test failed to detect 3 OXA-181, 2 OXA-48 and 3 IMP-14a producers (85.7 % sensitivity), whereas no false positives were seen (100 % specificity). Further evaluation of the paper strip test in 267 CPE screening-positive isolates from three hospitals by their medical technologists showed 92.0 % sensitivity (100 % for NDM producers) and 100 % specificity compared with the PCR methods. Because of its ease, rapidness and cost effective, the paper strip test has a potential for routine CPE testing in low-resource laboratories particularly in areas with high prevalence of NDM enzymes, leading to appropriate antimicrobial therapy and infection control strategy.


Superior oblique muscle paresis after sub-Tenon's anesthesia for cataract surgery.
A 68-year-old man developed strabismus after having sub-Tenon's anesthesia for cataract extraction and intraocular lens implantation. An ipsilateral hypertropia with superior oblique muscle paresis developed in the operated eye. The hypertropia appeared 1 day after surgery and resolved 1 month later. Although sub-Tenon's anesthesia is considered safer than other methods of local anesthesia, strabismus may occur.


Correlation between Microstructure and Potassium Storage Behavior in Reduced Graphene Oxide Materials.
Potassium-ion batteries (PIBs) are considered to be potential alternatives to the conventional lithium-ion batteries (LIBs) due to the similar working mechanism and abundant potassium (K) resource. However, it still remains challenging to directly apply commercial graphite anodes for PIBs owing to the large K ions, which may impede the electrochemical intercalation of K ions into the graphite interlayer and result in a poor cyclic stability and rate capability. Reduced graphene oxide (rGO) has shown remarkable electrochemical performance as an anode material for PIBs due to the fact that rGO possesses more active sites with an enlarged interlayer distance. Understanding the microstructure of rGO is crucial for optimizing its K-ion storage capabilities. Herein, it is revealed that the K-ion storage behavior of rGO is strongly dependent on the thermal treatment temperature on account of the difference in microstructure. rGO graphitized at 2500 °C exhibits a superior long-term cyclic stability for 2500 cycles due to the expanded interlayer distance and the unique graphite-like structure in a long range, enabling it to endure the huge volume change during uninterrupted K-ion intercalation/deintercalation processes.


[Childhood stress and neurosis--results of a control group study].
Biographical stress-risk was compared between a group of 68 neurotic-psychosomatic patients and a parallel control group matched in terms of age and sex. This risk rate was established using a so-called risk-index in which 8 known and variably weighted risk factors were taken into consideration. The following hypotheses were confirmed in the study: Neurotically ill persons show a higher stress-risk (risk-index) in their childhood and pre-adolescence than is found in healthy persons. A person's stress-index is related to the degree of neurosis (r = .42).


[Is radiotherapy indicated in cases of metastatic brain tumors? A retrospective analysis of 35 cases].
The results of 35 patients who got whole brain irradiation for metastatic disease are analysed in terms of relief of symptoms, quality of remission and survival time. Patients are distinguished in a group with known and in a group with unknown primary tumor. The results of the first group are indicated in brackets. The mean survival time for patients with unknown primary tumor is 7,5(4,2) and the median survival time is 3(2,2) months. 12 months after radiotherapy, 25% (9%) of the patients are still alive. More than 75% (55%) show considerable relief of symptoms. The proportion of failures is approximately 20% for both groups. These results indicate that radiotherapy of brain metastases gives good palliation even for patients with unknown primary tumor.


Volar intercalary carpal instability following a seemingly innocent wrist fracture.
A case of volar of intercalary carpal instability following a radial fracture is described and the mechanics of injury examined. Such an injury is rare and the type of radial fracture which produced it unusual. Continued instability of the carpus produces late degenerative changes. In contrast to the many reports of early and persistent pain and functional limitation this patient's wrist settled rapidly.


Development of an Automatic Measurement Method for CD8 and PD-1 Positive T Cells Using Image Analysis Software.
With the progress in cancer immunotherapy using immune checkpoint blockade (ICB) therapy, histological observations of tumor-infiltrating lymphocyte (TIL) status are needed to evaluate the antitumor effect of ICB using imaging analysis software. Formalin-fixed paraffin-embedded sections obtained from colorectal cancer and gastric cancer patients with more than 500 single nucleotide variants were stained with anti-CD8 and anti-PD-1 antibodies. Based on our own algorithm and imaging analysis software, an automatic TIL measurement method was established and compared to the manual counting methods. In the CD8+ T cell number measurement, there was a good correlation (r=0.738 by Pearson test) between the manual and automated counting methods. However, in the PD-1+ T cell measurement, there was a large difference in TIL numbers in both groups. After adjustment of the parameter settings, the correlation between the manual and automated methods in the PD-1+ T cell measurements improved (r=0.668 by Pearson test). An imaging software-based automatic measurement could be a simple and useful tool for evaluating the therapeutic effect of cancer immunotherapies in terms of TIL status.


The Effect of the Application of the Team-STEPPS-Based Preceptorship Guidance Model on the Competence of Nursing Students.
Student competence is an important topic of discussion during the implementation of counseling in the clinic. The purpose of this study was to analyze the effect of the Team-STEPPS-based preceptorship guidance model on student competency. A comparative study was used to analyze the quantitative data. Participants were clinical practice students at "Ngudi Waluyo" Public Hospital with a total of 92 registered students divided into treatment and control groups. The Wilcoxon Signed Rank Test and the Mann-Whitney U-Test were used to assess differences between the intervention and control groups. There were post-test differences between the intervention group and the control group, namely clinical competence p-value (0.003), nursing management p (0.000), technical competence p (0.008), self-management p (0.000), and care-oriented patients p (0.000). The Team-STEPPS-based preceptorship guidance model is very important in increasing student competency, not only in mastering clinical competence, but also in mastering technical skill competencies, nursing management, self-management, and patient-oriented care skills, and therefore, can increase student independence.


The prognostic value of clinical characteristics and parameters of cerebrospinal fluid hydrodynamics in shunting for idiopathic normal pressure hydrocephalus.
It is difficult to predict which patients with symptoms and radiological signs of normal pressure hydrocephalus (NPH) will benefit from a shunting procedure and which patients will not. Risk of this procedure is also higher in patients with NPH than in the overall population of hydrocephalic patients. The aim of this study is to investigate which clinical characteristics, CT parameters and parameters of cerebrospinal fluid dynamics could predict improvement after shunting. Eighty-three consecutive patients with symptoms and radiological signs of NPH were included in a prospective study. Parameters of the cerebrospinal fluid dynamics were measured by calculation of computerised data obtained by a constant-flow lumbar infusion test. Sixty-six patients considered candidates for surgery were treated with a medium-pressure Spitz-Holter valve; in seventeen patients a shunting procedure was not considered indicated. Clinical and radiological follow-up was performed for at least one year postoperatively. The odds ratio, the sensitivity and specificity as well as the positive and negative predictive value of individual and combinations of measured parameters did not show a statistically significant relation to clinical improvement after shunting. We conclude that neither individual parameters nor combinations of measured parameters show any statistically significant relation to clinical improvement following shunting procedures in patients suspected of NPH. We suggest restricting the term normal pressure hydrocephalus to cases that improve after shunting and using the term normal pressure hydrocephalus syndrome for patients suspected of NPH and for patients not improving after implantation of a proven well-functioning shunt.


Management decisions in extremely premature infants.
Survival rates in excess of 25% at 23 weeks' gestation and in excess of 50% at 24 weeks' gestation have been reported among live births in the 1990s within tertiary perinatal care centres in the USA and Australia. Decisions about medical management at these gestational ages can no longer be based merely on whether survival is possible. Relevant moral considerations include the primacy of the newborn's best interests, parental autonomy, physicians' duties of beneficence and non-maleficence, and distributive justice. There is significant variability between developed nations in the survival of extremely premature infants among cohorts born within perinatal tertiary care centres. This is, at least to some degree, the result of differences in the aggressiveness of obstetrical and neonatal management at these gestational ages. There is also great variability in the prevalence of major neurodevelopmental disability among survivors. Moreover, the prevalence of major disabilities does not inform quality-of-life considerations adequately. Despite similar gestational age ranges over which the benefit:burden ratio of aggressive obstetric and neonatal care is questioned in developed countries, there is marked variation in the frequency with which it is provided within these ranges. This is understandable given the relevant moral values and the different ways in which competing values will be balanced by different individuals, cultures and societies; the increasing survival of extremely premature infants, but the persistence of high (but widely variable) prevalences of major disabilities reported among survivors and even higher prevalences of mild-to-moderate neurodevelopmental sequelae; our imperfect ability to estimate an individual extremely premature infant's prognosis; and the complexities of estimating the quality of life from the individual's own perspective.


Vitamin A active metabolite, all-trans retinoic acid, induces spinal cord sensitization. I. Effects after oral administration.
Retinoic acid is an active metabolite of vitamin A involved in the modulation of the inflammatory and nociceptive responses. The aim of the present study was to analyze the properties of spinal cord neuronal responses of male Wistar rats treated with all-trans retinoic acid (ATRA) p.o. in the normal situation and under carrageenan-induced inflammation. We also studied the expression and distribution of cyclooxygenases (COX) in the spinal cord. Properties of spinal cord neurons were studied by means of the single motor unit technique. The expression of COX enzymes in the spinal cord was assessed by Western blot analysis and immunohistochemistry. Intensity thresholds for mechanical and electrical stimulation (C-fibers) were significantly lower in animals treated with ATRA than vehicle, either in normal rats or in rats with inflammation. The size of cutaneous receptive fields was also larger in animals treated with ATRA in the normal and inflammatory conditions. The expression of COX-2 enzyme, but not COX-1, was significantly higher in animals treated with ATRA. COX-2 labeling was observed in dorsal horn cells and in ventral horn motoneurons. In conclusion, the oral treatment with ATRA in rats induces a sensitization-like effect on spinal cord neuronal responses similar to that observed in animals with inflammation and might explain the enhancement of allodynia and hyperalgesia observed in previously published behavioral experiments. The mechanism of action involves an over-expression of COX-2, but not COX-1, in dorsal and ventral horn areas of the lumbar spinal cord.


Adolescents discuss themselves and drugs through music.
This paper discusses a technique which uses rock music lyrics to enable adolescents to gain an understanding of dependency upon mood-altering substances. While the pervasiveness of alcohol and other drugs in society is well-known, it is surprising and instructive for adolescents to explore the close inter-relationship between drugs, rock lyrics, and their own behavior. Drug-related songs were chosen, recorded and the lyrics were transcribed. A chart, illustrating the progression of addiction, was used to demonstrate how themes in drug-related songs parallel the stages of addiction. Adolescents hear, read, and discuss the lyrics in relationship to the stages, and in the process, increase their personal understanding of drug issues such as the search for relief, increased dependence, loss of control, and physical deterioration, all stages on the addiction chart. Through guided discussion of the lyrics and issues, adolescents begin to consider alternative ways of coping with daily pressures other than withdrawal from society or aggression toward it, two types of behavior seen with increasing frequency among today's youth.


Influence of anaesthetics on tumour-cell kill and repopulation in B16 melanoma treated with melphalan.
The influence of anaesthetics on the in vivo response of B16 melanoma to melphalan was studied using an in vitro cell-survival assay. Three anaesthetics were used, Saffan (Althesin) Sagatal (Nembutal) and Hypnorm. When Saffan was administered to tumour-bearing animals before melphalan there was a significant increase in tumour-cell kill. This effect was not observed with Sagatal or Hypnorm. Maximum increase in tumour-cell kill was achieved when Saffan was administered about 1 h before melphalan, and was dependent on Saffan dose. Clonogenic tumour-cell repopulation after melphalan was rapid (TD - 1 day) and the rate was similar from 2 levels of cell kill. When Saffan was combined with melphalan the repopulation rate was the same as with melphalan alone, and the increased cell kill was reflected in increased growth delay. The in vitro response of B16 melanoma cells to melphalan was unaltered by pretreatment with, or simultaneous exposure to Saffan. The results suggest that the mechanism of the enhanced cell kill in vivo is probably due to an indirect systemic effect, rather than a direct effect on the tumour cells.


Perioperative cataract OP management by means of teleconsultation.
Teleconsultation services have the potential to improve the communication among different medical care providers and between them and the patient. Increasing effectiveness in the shape of a savings in time or cost is often the result of better communication. A study was performed in order to demonstrate the feasibility of teleconsultation services, using the perioperative management of cataract patients as an example, and to provide data on the quality, acceptance and effectiveness of these services in comparison with a control group experiencing normal treatment. Over a period of 3 months 42 patients of the teleconsultation group and 20 controls were studied. There were two referring ophthalmologists and three surgeons. The teleconsultation group had one consultation fewer with the ophthalmic surgeon because of the teleconsultation service. Patient satisfaction was slightly higher using the new technology. Patients would like to see this technique used again should surgery on the second eye become necessary. Teleconsultation services are ready to support and improve perioperative cataract management. Patients' confidence in their medical treatment was increased by using teleconsultation services. Physicians will expand the use of teleconsultation.


Discussion: 'A new method for assessing uterine activity' by Haran et al.
In the roundtable that follows, clinicians discuss a study published in this issue of the Journal in light of its methodology, relevance to practice, and implications for future research. Article discussed: Haran G, Elbaz M, Fejgin MD, et al. A comparison of surface acquired uterine electromyography and intrauterine pressure catheter to assess uterine activity. Am J Obstet Gynecol 2012;206:412.e1-5.


Progressive Platelet Rich Fibrin tissue regeneration matrix: Description of a novel, low cost and effective method for the treatment of chronic diabetic ulcers-Pilot study.
Chronic lower limb ulcers (CLLU) are those injuries that persist for more than six weeks despite adequate care. They are relatively common; it is estimated that 10/1,000 people will develop CLLU in their lifetime. Diabetic ulcer, because of its unique pathophysiology (association between neuropathy, microangiopathy, and immune deficiency), is considered one of the most complex and difficult etiologies of CLLU for treatment. This treatment is complex, costly, and sometimes frustrating, as it is often ineffective, which worsens the quality of life of patients and makes its treatment a challenge. To describe a new method for treating diabetic CLLU and the initial results of using a new autologous tissue regeneration matrix. This is a pilot, prospective, an interventional study that used a novel protocol of autologous tissue regeneration matrix for the treatment of diabetic CLLU. Three male cases with a mean age of 54 years were included. A total of six Giant Pro PRF Membrane (GMPro) were used varying their application between one to three sessions during treatment. A total of 11 liquid phase infiltrations were performed varying their application between three and four sessions. The patients were evaluated weekly and a reduction in the wound area and scar retraction was observed during the period studied. The new tissue regeneration matrix described is an effective and low-cost method for the treatment of chronic diabetic ulcers.


Vital for Viruses: Intrinsically Disordered Proteins.
Viruses infect all kingdoms of life; their genomes vary from DNA to RNA and in size from 2kB to 1 MB or more. Viruses frequently employ disordered proteins, that is, protein products of virus genes that do not themselves fold into independent three-dimensional structures, but rather, constitute a versatile molecular toolkit to accomplish a range of functions necessary for viral infection, assembly, and proliferation. Interestingly, disordered proteins have been discovered in almost all viruses so far studied, whether the viral genome consists of DNA or RNA, and whatever the configuration of the viral capsid or other outer covering. In this review, I present a wide-ranging set of stories illustrating the range of functions of IDPs in viruses. The field is rapidly expanding, and I have not tried to include everything. What is included is meant to be a survey of the variety of tasks that viruses accomplish using disordered proteins.


Progesterone modulates diabetes/hyperglycemia-induced changes in the central nervous system and sciatic nerve.
We investigated the effect of progesterone (P4) treatment on diabetes/hyperglycemia-induced pathological changes in brain, spinal cord and sciatic nerve tissue in male rats. Animals were rendered hyperglycemic by a single dose of streptozotocin (STZ). P4 treatment was started after hyperglycemia was confirmed and body weight and blood glucose levels were monitored once/week for 5weeks. Rats underwent behavioral testing at week 5 and were then euthanized for histology. We assessed the expression of markers of angiogenesis (vascular endothelial growth factor (VEGF)), inflammation (interleukin-6 (IL-6)) and tissue injury (CD11b, NG2, COX2 and matrix metalloproteinase-2 (MMP-2)) in the brain, spinal cord and sciatic nerve. We also examined the regenerative effect of P4 on pathological changes in intra-epidermal nerve fibers (IENF) of the footpads. Diabetes/hyperglycemia led to body weight loss over 5weeks and P4 treatment reduced this loss. At week 5, blood-glucose levels were significantly lower in the P4-treated diabetic group compared to vehicle. Compared to sham or P4-treated groups, the diabetic vehicle group showed hyperactivity on the spontaneous locomotor activity test. Western blot data revealed upregulation of VEGF, IL-6, CD11b, NG2, COX2 and MMP-2 levels in the vehicle group and P4 treatment normalized these expression levels. IENF densities were reduced in the vehicle group and normalized after P4 treatment. We conclude that P4 can reduce some of the chronic pathological responses to STZ-induced diabetes.


Clinical experience with carinal resection.
Pathologic processes that involve the carina pose a tremendous challenge to thoracic surgeons. Although techniques have been developed to allow primary resection and reconstruction, few institutions have accumulated sufficient experience to allow meaningful conclusions about the indications and the morbidity and mortality rates for this type of surgery. Since 1962, 135 patients have undergone 143 carinal resections (134 primary resection, 9 re-resection) at our institution. Indications for carinal resection included bronchogenic cancer (58 patients), other airway neoplasms (60 patients), and benign or inflammatory strictures (16 patients). Thirty-seven patients (28%) had a history of prior lung or airway surgery not involving the carina. Carinal resection without pulmonary resection was accomplished in 52 patients; 57 patients had carinal pneumonectomy (44 right, 13 left); 14 patients had carinal plus lobar resection, and 11 patients had carinal resection after pneumonectomy (9 left, 2 right). There were 15 different modes of reconstruction, based on the type and extent of resection. Techniques were used to reduce anastomotic tension. The operative mortality rate in the 134 patients after primary carinal resection was 12.7%. Adult respiratory distress syndrome was responsible for 9 early deaths. Predominant predictors of operative death included postoperative mechanical ventilation (P =.001), length of resected airway (P =.03), and development of anastomotic complications (P =.04). Mortality rates varied by the type of procedure and the indication for resection. Left carinal pneumonectomy was associated with a high operative mortality rate (31%). Complications were noted in 52 patients (39%), including atrial arrhythmias (20 patients) and pneumonia (11 patients). Anastomotic complications, both early and late, were seen in a total of 23 patients (17%) and resulted in death or surgical reintervention in 21 patients (91%). The operative mortality rate for carinal re-resection was 11.1%. Carinal resection with primary reconstruction may be accomplished with acceptable mortality rates, but the underlying pathologic process and chance for long-term survival must be carefully considered before the operation is recommended, especially in the case of left carinal pneumonectomy. Anastomotic complications exact a heavy toll on involved patients. Careful patient selection and meticulous anesthetic and surgical technique remain the key to minimizing morbidity and mortality rates.


The effect of small doses of antidiuretic hormone on renal excretion of sodium and water in saline loaded acutely hypophysectomized rats.
Small doses of vasopressin (200 micronU min-1 kg-1) did not influence the loss of ability of acutely hypophysectomized rats to react by natriuresis to the extracellular fluid volume expansion with saline, inspite of restoring their arterial blood pressure to normal. It is concluded that the level of antidiuretic hormone efficient enough to concentrate urine is not a decisive factor in the homeostatic mechanism promoting the 'volume' natriuresis.


Plant growth-promoting bacteria as affected by N availability as a suitable strategy to enhance the nutritional composition of lamb's lettuce affected by global warming.
Heat and nutritional stresses have a significantly effect on the accumulation of bioactive and other compounds harmful to human health, like nitrates, in green leafy vegetables like lamb's lettuce. Plant growth-promoting bacteria (PGPB) have shown to confer beneficial biochemical changes to various crops under different stresses. The hypothesis proposed here is that the combination of optimal N level (2.5 Mm, 12 mM or 20 mM of N) with the inoculation of PGPB in plants exposed to heat shock (43 °C) may be a good strategy to obtain healthier lamb's lettuce with a higher yield. Results showed that a dose of 20 mM N can be considered as overfertilization. Moreover, the inoculation of plants fed with fertilizers with reduced N and under heat stress, resulted in higher productivity and content of sugars (60 %), amino acids (94 %), nitrogen (21 %), and total phenolic compounds (30 %), and a reduced content of nitrates (27 %).


Gaining control of bacterial cellulose colonization by polyhydroxyalkanoate-producing microorganisms to develop bioplasticized ultrathin films.
Synergistic methodological strategies based on the fields of microbial biotechnology and materials science open up an enormous range of possibilities for the sustainable production of advanced materials with predictable properties. This study shows how naturally produced polyhydroxyalkanoate (PHA) particles are introduced into bacterial cellulose (BC) driven by their bacterial producers. Thanks to an extensive knowledge of the internal structure of BC, it was possible to control the colonization process, i.e. loading and localization of PHA. A subsequent acid treatment favored the PHA-BC bonding at the position reached by the bacteria. These biodegradable films showed improved mechanical and barrier properties even with respect to reference plastic films 8 times thicker, reaching a Young's modulus 4.25 times higher and an oxygen permeability 3 times lower than those of polyethylene terephthalate (PET) films. Owing to the versatility of the method, a wide variety of materials can be developed for very diverse fields of application.


Dopamine hydrochloride (Intropin) and open-heart surgery: results of a clinical trial.
Dopamine hydrochloride (Intropin) has been used in the postoperative management of open-heart surgical patients, both children and adults. It has been associated with a very low incidence of undesirable responses and a high frequency of circulatory improvement associated with diuresis. Its administration requires careful control of infusion rate and measurement of response. In the dosages employed, it has been free of most of the undesirable side effects of other commonly used catecholamines.


Ultrafast haplotyping of putative microRNA-binding sites in the WFS1 gene by multiplex polymerase chain reaction and capillary gel electrophoresis.
The transmembrane protein wolframin (WSF1) plays a crucial role in cell integrity in pancreatic beta cells and maintaining ER homeostasis. Genetic variations in the WFS1 gene have been described to be associated with Wolfram syndrome or type 2 diabetes mellitus. In this paper we report on an efficient double-tube allele-specific amplification method in conjunction with ultrafast capillary gel electrophoresis for direct haplotyping analysis of the SNPs in two important miRNA-binding sites (rs1046322 and rs9457) in the WFS1 gene. An automated single-channel capillary gel electrophoresis system was utilized in the method that provided dsDNA fragment analysis in less than 240 s. The light-emitting diode induced fluorescence (LEDIF) detection system enabled excellent sensitivity for automated haplotyping of a large number of clinical samples. The detection limit was 0.002 ng/μL using field amplified injection from water diluted samples. The dynamic quantitation range was 0.08-10.00 ng/μL (R(2)=0.9997) in buffer diluted samples.


Curricula interventions for identity change: substantive and ethical considerations.
The rationale for school-based curricula interventions to promote identity formation is based on the advantages of psychological functioning associated with use of the more sophisticated identity statuses and the opportunities available in school settings to create the conditions facilitating developmental movement in that direction. A variety of education strategies pertaining to identity development are described, along with their probable impacts upon various aspects of the processes involved in forming a sense of identity. Ethical considerations for both supporting and opposing identity-related interventions are presented. Suggestions are offered as to how best to proceed when implementing identity-related education curricula.


The effect of alendronate on the expression of osteopontin and osteoprotegerin in calcified aortic tissue of the rat.
Vascular calcification is a pathobiological process which leads to high morbidity and mortality in cardiovascular disease. The association between vascular calcification and osteoporosis has been reported widely, and there are close relationships among vascular calcification, related cardiovascular disease and osteoporosis, but the biochemical mechanism of vascular calcification is presently unclear. For exploring the possible mechanism of artery calcification we established aorta calcification in an animal model with vitamin D(3) and warfarin and tested the effect of alendronate on the expression of osteopontin and osteoprotegerin in calcified aorta tissue of the rat through measuring gene and protein expression of osteopontin and osteoprotegerin respectively. The results indicated compared with control group, the aortic calcium content of calcification group was obviously increased, osteopontin mRNA and osteoprotegerin mRNA were significantly reduced, and osteoprotegerin and osteopontin protein expressions were reduced. Compared with calcification group, the aortic calcium content of alendronate group was obviously reduced, osteopontin mRNA and osteoprotegerin mRNA were significantly increased, and osteopontin and osteoprotegerin protein expression were increased. We conclude that artery calcification may reduce the expression of osteopontin and osteoprotegerin. Alendronate may inhibit rat aorta calcification by up-regulating osteopontin and osteoprotegerin expression.


Development and initial validation of a measure of metacognitive beliefs in health anxiety: The MCQ-HA.
Metacognitive beliefs have been shown to correlate with emotional disorders and more recently have been implicated in health anxiety. Research exploring these beliefs have tended to use the Metacognition Questionnaire (MCQ), which is a general measure. To facilitate research on the metacognitive model applied to health anxiety the present study reports on the development and initial evaluation of a new specific metacognitive measure of health anxiety, the Metacognitions Questionnaire-Health Anxiety (MCQ-HA). Principal components analysis identified 14 suitable items to be explored. Subsequent exploratory factor analysis of the MCQ-HA identified three factors: "Beliefs that Thoughts can cause Illness", "Beliefs about Biased thinking", and "Beliefs that Thoughts are Uncontrollable". Confirmatory factor analysis supported the three factor model with all selected goodness-of-fit statistics equivalent to or better than recommended values. Preliminary evidence suggests good internal-consistency, incremental, convergent and discriminant validity in relation to associated measures. The MCQ-HA appears to be a potentially useful predictor of health anxiety.


Impact of STN-DBS on mood, drive, anhedonia and risk of psychiatric side-effects in the population of PD patients.
DBS is a surgical method of choice for various movement disorders, especially for Parkinson's disease (PD). Many publications showing improvement in motor symptoms and quality of life have been presented while there is little comprehensive research evaluation of the impact of DBS on mental state and psychiatric side-effects. The purpose of this study was to assess the impact of DBS on mood, drive, anhedonia and psychotic symptoms in the group of PD patients. 60 patients with PD were treated with STN-DBS. Mental state and psychiatric side effects were assessed with the use of MADRS, HADRS, BDI, BPRS, YMS, SHAPS, CGI and PGI rating scales. Evaluation was performed five times in the period from the day before surgery to six months after implantation of the DBS. This study showed an improvement of mood, which has followed within a month after the start of stimulation and manifested in MADRS, HADRS, BDI scores reduction. The trend towards improvement was maintained over the following 6months. No manic episodes appeared, 2 cases of mild hypomania were observed. Psychotic symptoms occurred in 1 patient. Anhedonia reduction observed during the first 30days after initiating the stimulation persisted in the assessment six months after implantation of the DBS. The survey results confirm the effect of stimulation on mood, drive, ability to feel pleasure. Psychiatric side effects such as phase change were rare and mild, while psychotic symptoms that occurred in one patient ware manageable through medication. Further intensive research in this topic are required.


Renal angiomyolipomatosis and bleeding aneurysms in a tuberous sclerosis context: selective artery embolization in a girl with end-stage renal failure.
Recent developments in endovascular radiological techniques and devices have rendered embolization a major therapeutic option prior to surgery in many renal vascular or neoplastic diseases. A 19-yearold female patient, with a diagnosis of tuberous sclerosis complex (TSC) in childhood, was admitted with severe anemia. Polycystic kidney disease in end-stage renal failure appeared four years before and the patient has been undergoing peritoneal dialysis. The patient's medical history also included bilateral renal angiomyolipomas (AMLs). One year earlier, a unilateral endovascular embolization was performed to repair a bleeding aneurysm at the right renal upper pole. A second bilateral ruptured renal aneurysm was diagnosed at admission. To continue with peritoneal dialysis and prevent intrarenal hemorrhage and intraperitonal bleeding, an urgent bilateral renal AE was performed. Two months later she underwent a bilateral retroperitoneal nephrectomy. The posterior surgical approach, preserved the peritoneal surface area and adequate conditions to continue dialysis. At histology, bilateral AMLs were confirmed and a renal cell carcinoma of the right kidney was concurrently discovered. She undergoes continuous peritoneal dialysis. Urgent selective renal AE represents a feasible treatment for bilateral AML bleeding. It is safe and feasible before performing nephrectomy in patients with end-stage renal failure.


Idiopathic chronic sleep onset insomnia in attention-deficit/hyperactivity disorder: a circadian rhythm sleep disorder.
To investigate whether ADHD-related sleep-onset insomnia (SOI) is a circadian rhythm disorder, we compared actigraphic sleep estimates, the circadian rest-activity rhythm, and dim light melatonin onset (DLMO) in ADHD children having chronic idiopathic SOI with that in ADHD children without sleep problems. Participants were 87 psychotropic-medication-naïve children, aged 6 to 12 yrs, with rigorously diagnosed ADHD and SOI (ADHD-SOI) and 33 children with ADHD without SOI (ADHD-noSOI) referred from community mental health institutions and pediatric departments of non-academic hospitals in The Netherlands. Measurements were 1 wk, 24 h actigraphy recordings and salivary DLMO. The mean (+/-SD) sleep onset time was 21:38 +/- 0:54 h in ADHD-SOI, which was significantly (p < 0.001) later than that of 20:49 +/- 0:49 h in ADHD-noSOI. DLMO was significantly later in ADHD-SOI (20:32 +/- 0:55 h), compared with ADHD-noSOI (19:47 +/- 0:49 h; p < 0.001). Wake-up time in ADHD-SOI was later than in ADHD-noSOI (p = 0.002). There were no significant between-group differences in sleep maintenance, as estimated by number of wake bouts and activity level in the least active 5 h period, or inter- and intradaily rhythm variability. We conclude that children with ADHD and chronic idiopathic sleep-onset insomnia show a delayed sleep phase and delayed DLMO, compared with ADHD children without SOI.


Pharmacokinetics and Safety of Cotadutide, a GLP-1 and Glucagon Receptor Dual Agonist, in Individuals with Renal Impairment: A Single-Dose, Phase I, Bridging Study.
Cotadutide is a balanced glucagon-like peptide-1 and glucagon receptor dual agonist under development for the treatment of non-alcoholic steatohepatitis and type 2 diabetes with chronic kidney disease. We evaluated the pharmacokinetics (PK), safety and immunogenicity of a single dose of cotadutide in individuals with varying degrees of renal impairment. In this phase I bridging study, individuals 18-85 years of age, with a body mass index of 17-40 kg/m2 and varying degrees of renal function {end-stage renal disease (ESRD; creatinine clearance [CrCl] < 20 mL/min); severe renal impairment (CrCl ≥ 20 to < 30 mL/min); lower moderate renal impairment (CrCl ≥ 30 to < 44 mL/min); upper moderate renal impairment (CrCl ≥ 45 to < 60 mL/min); normal renal function (CrCl ≥ 90 mL/min)} were treated with a single dose of subcutaneous cotadutide 100 µg under fasted conditions in the lower abdomen. The co-primary endpoints were area under the plasma concentration-time curve from time zero to 48 h (AUC48) and the maximum observed plasma concentration (Cmax) for cotadutide. Safety and immunogenicity were secondary endpoints. This trial is registered with ClinicalTrials.gov (NCT03235375). A total of 37 individuals were enrolled in the study (only three enrolled in the ESRD group, therefore this group was excluded from the primary PK analysis). AUC48 and Cmax values for cotadutide were similar across all renal function groups {severe renal impairment vs. normal renal function: AUC48 geometric mean ratio (GMR) 0.99 (90% confidence interval [CI] 0.76-1.29); lower moderate renal impairment versus normal renal function: AUC48 GMR 1.01 (90% CI 0.79-1.30); upper moderate renal impairment versus normal renal function: AUC48 GMR 1.09 (90% CI 0.82-1.43)}. A sensitivity analysis that combined the ESRD and severe renal impairment groups did not show notable changes in the AUC48 and Cmax GMRs. The incidences of treatment-emergent adverse events (TEAE) ranged from 42.9 to 72.7% across all groups and were mostly mild to moderate in severity. Only one patient had a grade III or worse TEAE during the study period. No positive antidrug antibody results were observed. These results suggest that the PK and tolerability of cotadutide are unaffected by renal function and that dose adjustments may not be required in individuals with renal impairment.


Quantification of perfusion fMRI using a numerical model of arterial spin labeling that accounts for dynamic transit time effects.
A new approach to modeling the signal observed in arterial spin labeling (ASL) experiments during changing perfusion conditions is presented in this article. The new model uses numerical methods to extend first-order kinetic principles to include the changes in arrival time of the arterial tag that occur during neuronal activation. Estimation of the perfusion function from the ASL signal using this model is also demonstrated. The estimation algorithm uses a roughness penalty as well as prior information. The approach is demonstrated in numerical simulations and human experiments. The approach presented here is particularly suitable for fast ASL acquisition schemes, such as turbo continuous ASL (Turbo-CASL), which allows subtraction pairs to be acquired in less than 3 s but is sensitive to arrival time changes. This modeling approach can also be extended to other acquisition schemes.


Objective measurement of knee extension force based on computer adaptive testing.
False impairment is encountered when tested subjects either unintentionally or deliberately put an artificial upper limit on their force, in which case their true capacity cannot be disclosed in a straight forward measurement. The aim of this study was to develop a computer adaptive testing (CAT) system for directing subjects into generating greater forces than they intended. The system was tested on eleven cooperative female subjects who volunteered to take part in this study. The CAT consisted of interactive testing cycles, each containing a series of isometric tasks of differing intensities. While fulfilling these tasks, the tested subjects were asked to take care not to exceed a self-selected upper force limit (F(ssl)) that they were previously trained to memorize (order of 40% of the maximal voluntary contraction). Visual feedback, displaying the applied force exertions, was provided to the tested subjects but was modified by re-scaling the display in an un-anticipated manner. To confirm the subject's ability to remember her F(ssl), repeatability of joint memory was tested one week after the CAT. The CAT results were successful in causing ten out of the eleven tested participants to exert a higher force than they intended to. Additionally, the CAT algorithm caused a statistically significant higher force than the repeatability test. These results demonstrate the potential of CAT methods in improving the clinical evaluation of muscle strength, particularly in those cases where the subject's cooperation is not sufficient.


Comparison of the efficacy of autologous platelet gel and medical chitosan in the prevention of recurrence of intrauterine adhesions after transcervical resection of adhesion: a prospective, randomized, controlled trial.
Intrauterine adhesion (IUAs) in women is a debatable topic and there is no clear consensus in its management and treatment strategies. Previous treatment measures have limitations which necessitates to consider effective measures for prevention of recurrence of IUAs. Hence, the aim of this study to explore the efficacy and safety of intrauterine infusion of autologous platelet gel (APG) and medical chitosan in preventing recurrence of IUAs in females after transcervical resection of adhesion (TCRA). A prospective, randomized controlled trial was conducted among 80 patients presented with moderate to severe IUAs. Patients were randomized into two groups, APG group (n = 40) and medical chitosan group (n = 40). All patients were injected with either APG or medical chitosan after TCRA. The postoperative recurrence rate of adhesions in APG group was significantly lower than those in medical chitosan group (21% vs 49%). The median AFS score during the second-look hysteroscopy was significantly lower in APG group than in medical chitosan group (P = 0.008). The median AFS score reduction after TCRA surgery was significantly higher in APG group than in medical chitosan group (median, 95% CI 7.000, 6.0 to 8.3 vs. 6.000, 5.0 to 7.0, P = 0.004). Subgroup analysis of platelet concentration (1000 as cut-off value) into high- and low-dose subgroups reported no significant correlation existed between APG and baseline characteristics, recurrence rate and postoperative AFS reduction score except for previous intrauterine operation (P < 0.05). Thus, after TCRA, intrauterine injections of APG provides better efficacy and safety compared with intrauterine injections of medical chitosan in preventing recurrence of intrauterine adhesions.


Resolving overlap in two-dimensional NMR spectra: nuclear Overhauser effects in a polysaccharide.
Overlapping resonances in the two-dimensional nuclear Overhauser (NOESY) spectrum of the O-antigenic polysaccharide from Escherichia coli O147 have been resolved by recording a tilted projection of a three-dimensional NOESY-HSQC spectrum, where the carbon-13 and proton evolutions are linked together. Through the introduction of small contributions from the appropriate carbon-13 shifts, a cluster of five unresolved proton peaks is separated into its components without the need to perform the full three-dimensional measurement, a time saving of at least an order of magnitude.


Prevention of airway allograft tolerance by polyinosinic:polycytidylic acid requires type I interferon responsiveness for mouse airway obliteration.
Respiratory RNA viruses are associated with bronchiolitis obliterans syndrome (BOS) in lung transplant recipients (LTRS); however, the immune mechanisms that regulate airway obliteration remain incompletely understood. Using the mouse heterotopic tracheal transplant model of obliterative airway disease (OAD), we studied the role of double-stranded (ds)RNA using polyinosinic:polycytidylic acid (poly[I:C]), a synthetic analog of viral dsRNA, in abrogating airway allograft tolerance established with donor-specific transfusion (DST) and anti-CD154 monoclonal antibody therapy. Wild-type (WT) B6 recipients of accepted BALB/c airway grafts demonstrated significantly reduced intragraft CD8+ T cells, with markedly impaired allospecific interferon (INF)-γ and tumor necrosis factor-α secretion, uncoupled from an activated phenotype, and evidence of proliferation. Administration of poly(I:C) to DST/anti-CD154-treated recipients restored OAD pathology and CD8+ alloeffector responses to levels observed in untreated mice. However, B6 type I IFN receptor-deficient (IFN-αβR(-/-)) recipients were resistant to the abrogation of tolerance mediated by poly(I:C) and did not develop CD8+ alloeffector responses or OAD. Further, adoptive transfers of WT CD8+ T cells or CD11c+ dendritic cells alone into B6 IFNαβR(-/-) recipients treated with poly(I:C) and DST/anti-CD154 were incapable of abrogating airway graft tolerance. Together, these data indicate abrogation of DST/anti-CD154-induced airway allograft tolerance via dsRNA requires type-I IFN responsiveness for mouse airway obliteration.


[The superior mesenteric artery syndrome. Anatomo-clinical study and therapeutic possibilities in vascular compression of the duodenum].
Four cases of superiore mesenteric artery syndrome are presented. Reference is made to the difficulties involved in the clinical diagnosis of this form. It is pointed out that radiological examination is essential, since it dispel all doubts in nearly every case. Associations between the syndrome and peptic ulcer are relatively, and the joint surgical resolution of both forms is recommended.


Equilibrium and surviving species in a large Lotka-Volterra system of differential equations.
Lotka-Volterra (LV) equations play a key role in the mathematical modeling of various ecological, biological and chemical systems. When the number of species (or, depending on the viewpoint, chemical components) becomes large, basic but fundamental questions such as computing the number of surviving species still lack theoretical answers. In this paper, we consider a large system of LV equations where the interactions between the various species are a realization of a random matrix. We provide conditions to have a unique equilibrium and present a heuristics to compute the number of surviving species. This heuristics combines arguments from Random Matrix Theory, mathematical optimization (LCP), and standard extreme value theory. Numerical simulations, together with an empirical study where the strength of interactions evolves with time, illustrate the accuracy and scope of the results.


Mastoparan interacts with the carboxyl terminus of the alpha subunit of Gi.
Mastoparan, a peptide toxin from wasp venom, stimulates guanine nucleotide binding and hydrolysis by G proteins. To elucidate the site of mastoparan-G protein interaction, we utilized a polyclonal antibody (R16,17) directed against the carboxyl terminus of the Gi alpha subunit to develop a competitive enzyme-linked immunosorbent assay. We investigated the ability of mastoparan to influence R16,17 antibody binding to G protein alpha subunits in a purified preparation of brain Gi and in neutrophil membrane extracts. Mastoparan antagonized the ability of R16,17 to detect G protein alpha subunits with an IC50 of 15 microM in the purified preparation and with an IC50 of 1 microM for the predominant G protein population in membrane extracts. This reduction was not seen when an unrelated peptide or a peptide of similar charge composition to mastoparan was used in place of mastoparan in the assay. Additionally, antibody R16,17 blocked up to 85% of mastoparan-stimulated GTPase activity. Taken together, these data indicate that the interaction of mastoparan with G protein depends in part on the carboxyl terminus of Gi alpha. Pertussis toxin-catalyzed ADP-ribosylation of Gi alpha markedly inhibited mastoparan-stimulated GTPase activity but only slightly attenuated the ability of mastoparan to recognize G protein. These data suggest that ribosylation inhibits mastoparan-induced G protein activation by a mechanism distinct from the ability of mastoparan to physically interact with G protein. Since mastoparan is thought to mimic hormone-liganded receptors, these findings may be applicable to the mechanism of receptor-Gi protein uncoupling that results from ADP-ribosylation of the G protein.


Malignant schwannoma. A case report and review of the literature.
A rare case of a malignant schwannoma presenting as a central fracture-dislocation of the acetabulum is reported. Histological examination showed a high-grade sarcoma. A pleural metastasis was present. A local reconstructive procedure consisting of local tumor excision with an acetabular prosthetic replacement and adjunctive radiation therapy was elected for the patient, who had a short-term prognosis.


Cellular IAP1 regulates TRAIL-induced apoptosis in human fetal cortical neural progenitor cells.
Neural stem/progenitor cells (NPCs) are present in the developing and adult central nervous system. NPC apoptosis is an important aspect of normal brain development. We show that tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) receptor 2 is highly expressed on human NPCs derived from fetal cortex, yet TRAIL induces only minimal levels of apoptosis in NPCs. Caspase-8 mRNA and protein, an important factor in the TRAIL-mediated death pathway, is present at low levels in human NPCs. In contrast, inhibitors of apoptosis proteins (IAP), such as c-IAP1, are highly expressed. The transcription inhibitor actinomycin D sensitized human NPCs to TRAIL-induced apoptosis. Further, inhibition of cellular inhibitors of apoptosis protein 1 (c-IAP1) expression by small interfering RNA (siRNA) increased TRAIL-mediated caspase-3 activation and apoptosis; thus, c-IAP1 protects NPCs against TRAIL-induced apoptosis and suppresses caspase-3 activation. These findings illustrate the mechanisms for NPC resistance to apoptotic agonists such as TRAIL, and demonstrate a potentially important mechanism in CNS disease states.