Acute hepatotoxicity and lethality of CCl4 in chlordecone-pretreated rats.
In a subchronic dietary pretreatment protocol chlordecone (CD) is a powerful potentiator of CCl4 hepatotoxicity, as indicated by biochemical, hepatofunctional, histopathological, and lethality parameters. The purpose of this investigation is to further explore the CD + CCl4 interaction in an acute CD pretreatment protocol and to compare the two pretreatment protocols in terms of their effect upon quantitative histopathology, serum enzymes, and lethality. Groups of four male rats received one of the following four pretreatments: chlordecone (10 mg/kg; single po), mirex (10 mg/kg; single po), phenobarbital (PB) (80 mg/kg/day for 2 successive days; ip in 0.9% saline), or corn oil vehicle (1 ml/kg; single po). Twenty-four hours later, the rats were given a single ip injection of CCl4 (0.1 ml/kg). Twenty-four hours after CCl4 administration, serum enzymes (SGPT, SGOT, and ICD) were measured and the livers removed and fixed in 10% buffered formalin for histological evaluation. The LD50 were determined by the method of moving averages. CD + CCl4 was the most hepatotoxic combination, in terms of serum enzyme elevations and lethality followed by PB + CCl4. The PB + CCl4 combination caused a greater degree of hepatocyte necrosis. These findings indicate that the acute pretreatment with CD enhances hepatotoxicity and the lethality of CCl4 in a fashion qualitatively similar to the subchronic pretreatment protocol.


The use of the Lima reverse shoulder arthroplasty for the treatment of fracture sequelae of the proximal humerus.
Experience treating proximal humerus fracture sequelae with reverse total shoulder arthroplasty is limited. We report our results. Forty-four patients with sequelae of a proximal humeral fracture were treated with a reverse total shoulder prosthesis. There were 26 women and 18 men, with a mean age of 77 years (range, 74-84 years). The mean follow-up after reverse arthroplasty was 48 months (range, 40-84 months). The mean Constant score increased from 28 preoperatively to 58 postoperatively (p < 0.0001). The average anterior elevation increased from 40° to 100° (p < 0.0001), abduction from 41° to 95° (p < 0.0001), external rotation from 15° to 35° (p < 0.0001) and internal rotation from 25° to 60° (p < 0.0001). The average subjective shoulder score increased from 13% preoperatively to 56% postoperatively (p < 0.0001). All but six patients would undergo the same procedure again if faced with the same problem. Twenty-four patients were very satisfied, 14 satisfied and 6 unhappy with the operation. Six prosthetic dislocations occurred (13.6%). Two of them were successfully treated by adding an extension to the humeral neck component to increase the offset and tension. In the other four dislocations this procedure failed, and the prosthesis was revised and converted to a hemiarthroplasty. There was one case of glenoid component loosening that was converted to a hemiarthroplasty. The reverse total shoulder arthroplasty improves function and motion in patients with proximal humeral fracture sequelae. However, the dislocation rate is high.


Effect of procainamide on renal tubular transport of cimetidine in the isolated perfused rat kidney.
The effect of procainamide on renal tubular transport of cimetidine was studied in isolated perfused rat kidney based on the multiple indicator dilution (MID) technique. T-1824-labeled albumin (a vascular reference), [14C]creatine (an extracellular reference), and [3H]cimetidine were rapidly injected into the renal artery of isolated perfused rat kidney in the presence or absence of procainamide (100 microM) in the perfusate, and normalized outflow-time patterns were secured from rapidly sampled renal perfusate. A distributed two-compartmental model was fitted to the dilution data by non-linear least-squares regression, and the influx, efflux and sequestration rate constants were estimated. Net transport and influx processes of cimetidine were competitively inhibited by procainamide (PA), while the efflux and sequestration processes were increased. The increase in the values of the efflux and sequestration rate constants by addition of procainamide may be explained by the increase in the tissue binding of cimetidine. However, these three processes were not significantly affected by p-aminohippurate (PAH). These results suggest that both cimetidine and procainamide are secreted into the lumen by an organic base transport mechanism in the perfused kidney, in which the spatial organization and cell polarity of the kidney are maintained.


Efficacy of the levonorgestrel-releasing intrauterine system in uterine leiomyoma.
To evaluate the efficacy of the levonorgestrel-releasing intrauterine system (LNG-IUS) in reducing menstrual blood loss (MBL) in myoma-related menorrhagia and to assess the effect of the LNG-IUS on uterine and leiomyoma volume. A prospective comparative study investigated the effect of LNG-IUS use in women with myoma-related menorrhagia (n=54) and women with idiopathic menorrhagia (n=50). The outcome was assessed in terms of reductions in MBL and in myoma and uterine volume. Within 1 month of LNG-IUS insertion, the Pictorial Blood Loss Assessment Chart score in the myoma group fell by 86.8% (P<0.0001). At 3, 12, 24, 36, and 48 months, the MBL was reduced by 92.1%, 97.4%, 97.4%, 99.5%, and 99.5%, respectively, similar to the effect seen in the idiopathic menorrhagia group. The mean uterine volume was significantly reduced in both groups, but the reduction was greater in the group with leiomyomas (idiopathic menorrhagia, P=0.038; myoma-related menorrhagia, P=0.012). There was no statistically significant reduction in the myoma volume (P=0.409). Use of the LNG-IUS appears to lead to a significant reduction in the uterine volume of women with menorrhagia, as well as reducing the MBL in women with uterine leiomyomas.


[Bond and autonomy of the oral health practice in the Family Health Program].
To understand the establishment of bond in the construction of autonomy of the subjects who generate the practices of oral health in the Family Health Program. A critical reflexive approach was undertaken in this qualitative study carried out in Alagoinhas (Northeastern Brazil). Interviewees taken care of by the oral health team of the Program point out their problems and the treatment they want. A line of tension is established that will define the service as welcoming, binding and will contribute towards enhancing the autonomy of those seeking oral health services. However, negotiation concerning the treatment that will be implemented, between those seeking and providing it, is fundamental. Establishing a bond made it possible for negotiation to lead to a consensus concerning necessities and responsibilities, impeding the therapeutic act from being centered on the health care worker, allowing it to ensue according to the desire of the person seeking care. Bond maintains a close relationship with the capacity of the other to become an active subject in decision making with regard to his/her life. It allows subjects to strive towards their potentialities, favoring the reciprocity of experiences and the construction of therapeutic acts for which they are co-responsible. Oral health practice based on relational pillars needs to foster bond, making those that seek care autonomous and amplifying care.


Evaluation of counselling materials for hybrid cardiac rehabilitation in a low-resource setting: Perceptions of patients and providers.
This study evaluated the usefulness of a booklet as support material for counseling focused on self-efficacy and therapist interaction in the course of counseling in a hybrid CR program (i.e., supervised and unsupervised sessions) developed for low-resource settings. Counseling material was developed by a multidisciplinary team, with patient input. Using multi-methods, first input from patients from six centers in Chile was sought through a telephone survey (cross-sectional). Second, input from physiotherapists delivering the intervention at all centres was solicited qualitatively through a focus group on Zoom. Content analysis was performed using a deductive-thematic approach. Seventy-one patients were included. All (100 %) participants responded that the materials were easy to understand, contained suggestions applicable to daily life, captured their attention and was useful for future questions. The booklet overall was rated 6.7 ± 0.6/7 %, and 98.2 % were satisfied with the counselling. Overall themes from the six deliverers related to the CR intervention (e.g., well manualized protocols for counselling), the deliverer (e.g., expertise to deliver) and patients (e.g., found information useful). The usefulness of the counseling together with the supporting booklet was established by patients and delivering professionals. Thus, with some final refinement, this resource can be disseminated for use by other Spanish CR programs.


Carbapenemase-producing Enterobacteriaceae among pregnant women and newborns in Algeria: Prevalence, molecular characterization, maternal-neonatal transmission, and risk factors for carriage.
The diffusion of carbapenemase-producing Enterobacteriaceae (CPE) represents a worldwide public health problem. This study revealed that the prevalence of OXA-48-producing enterobacteria was 4.6% (19/414) and 1.6% (7/422) in mothers and newborns, respectively, from 2 maternity units in Algeria. Previous hospital admission was an independent factor associated with an increased risk of CPE carriage in the mothers (P = .021). The low birth weight was significantly associated with this carriage in the newborns (P = .008). The screening of these bacteria is essential to prevent the dissemination of CPE.


[Inhibition of the cardiochronotropic component of baroreceptor reflexes following activation of somatic afferents].
Stimulation of cutaneous or muscle nerve as well as activation of ventral roots L6--S1 led to inhibition of vagal bradycardia evoked by noradrenaline, in unanesthetized decerebrated cats. Unnociceptive stimulation of m. gastrocnemius in unrestrained cats evoked contraction of the muscle and was followed by depression of the cardiac component of baroreceptive reflex. Propranolol had no effect on this response, while methylatropin abolished it completely.


Metformin treatment in different phenotypes of polycystic ovary syndrome.
The aim of this study was to evaluate the effectiveness of Metformin on ovulation and eventual clinical pregnancy in different phenotypes of polycystic ovary syndrome (PCOS). A total of 359 subjects who had proven PCOS according to Rotterdam criteria were prospectively selected. Patients' PCOS phenotypes were determined and recorded. All patients were younger than 35 years. Clinical and biochemical assays in all patients were initially obtained. Then patients were divided into two separate groups. One group received both 1,500 mg of Metformin and 1 mg of folic acid per day and the other group received only 1 mg of folic acid for a total of 2 months. Subsequently, all patients underwent ovulation stimulation with 5 mg of Letrozole per day for 5 days followed by an intra-uterine insemination. Finally, ovulation and pregnancy rates were evaluated for all four PCOS phenotypes. Effect of Metformin therapy was evaluated for each group and each phenotype. The pregnancy rate in Metformin and non-Metformin groups were, respectively, as follows: in phenotype A (39.2 vs. 33.7 %, p = 0.270), phenotype B (43.8 vs. 20 %, p = 0.210), phenotype C (44 vs. 20 %, p = 0.064), and phenotype D (36.5 vs. 28.6 %, p = 0.279). Although there was a little improvement in ovulation and pregnancy rates among patients with B and C phenotypes, there was not a statistically significant difference between the two groups. Based on our study, Metformin therapy does not change the ovulation and pregnancy rate.


Occult hepatosplenic T-gamma delta lymphoma. Value of genotypic analysis in the differential diagnosis.
We report on a patient with a rare hepatosplenic gamma delta T-cell lymphoma (gamma delta TCL) presenting clinically with B-symptoms, hepatosplenomegaly and pancytopenia. During the initial stage of the disease the sparse malignant cells could not be detected histologically. Furthermore, their identification was obscured by massive macrophage proliferation with haemophagocytosis in the spleen. Diagnosis was established by detection of a clonal T-cell receptor (TcR) rearrangement and, retrospectively, by demonstration of rare cells expressing and aberrant T-cell phenotype. The findings in this patient emphasize that minimal neoplastic T-cell infiltrates can lead to severe clinical symptoms. Initial biopsy findings may be misinterpreted as benign. Gamma delta TCL may elaborate lymphokines that suppress haematopoiesis, leading to pancytopenia and macrophage proliferation.


Clinician assessment of guidelines that support common dental procedures.
Many common clinical dental procedures do not have high-quality clinical guidelines available. Clinical guidelines are considered an important tool for applying the evidence-based concept to dental practice. The main objective of this study was to assess if current clinical guidelines that are easily available to dental practitioners in electronic databases support common dental procedures. In addition, a useful model for the assessment of the quality of the guidelines is presented. The results of a literature search demonstrated a lack in both the number and quality of clinical dental guidelines that support common dental procedures. Nine selected guidelines were assessed using the Appraisal of Guidelines, Research, and Evaluation instrument (AGREE). Following the AGREE recommendation, only one guideline could be considered for use in dental practice. Four guidelines were also considered for use in practice, but they would need some alteration in their contents. The last four guidelines did not achieve a good score and therefore could not be considered for use in dental practice. In conclusion, more high-quality dental guidelines should be developed to support common dental procedures using standardized quality criteria in order to appropriately implement the evidence-based process into dental practice. Furthermore, the AGREE instrument may help dental practitioners objectively assess the quality of clinical guidelines.


Photoplethysmographic Signal to Screen Sleep-Disordered Breathing in Hospitalized Heart Failure Patients: Feasibility of a Prospective Clinical Pathway.
The purpose of this study was to evaluate the plethysmographic signal-derived oxygen desaturation index (ODI) as an inpatient screening strategy to identify sleep-disordered breathing (SDB) in patients with congestive heart failure (CHF). SDB is highly prevalent among patients hospitalized with CHF but is widely underdiagnosed. We evaluated overnight photoplethysmography as a possible screening strategy for hospitalized patients with CHF. Consecutively admitted heart failure patients with high clinical suspicion of SDB and ODI ≥5 were offered outpatient polysomnography (PSG), which was completed within 4 weeks of discharge. PSG was considered positive if the apnea hypoxia index (AHI) was ≥5. A Bland-Altman plot was used to assess agreement between ODI and AHI. Receiver-operator characteristics were determined for ODI ≥5 and AHI ≥5. A screening questionnaire identified 246 of 282 consecutive patients with positive symptoms for SDB. Of these patients, 105 patients were offered further evaluation and 86 had ODI ≥5 (mean ODI 17 ± 17). Among these 86 patients, 68 underwent outpatient PSG within 4 weeks of discharge. PSG showed that 64 (94%) had SDB, with a mean AHI of 28. Inpatient ODI correlated well with PSG-derived AHI. The area under the curve was 0.82 for AHI ≥5. The Bland-Altman plot revealed no major bias. Matthew's correlation coefficient revealed that the optimal cut-off for ODI is 5. Screening hospitalized patients with heart failure using targeted inpatient ODI identifies a cohort of patients with a high prevalence of SDB. Our screening strategy provides a potentially cost-effective method for early detection and treatment of SDB.


Fear-potentiated startle using an auditory conditioned stimulus: effect of lesions of the amygdala.
The effect of lesions of the amygdala on fear-potentiated startle using an auditory conditioned stimulus (CS) was evaluated, after replicating and extending previous findings that a tone is an effective CS for fear-potentiated startle. Rats received 10 tone-shock pairings on 2 successive days. At 24-48 hr following training, they received bilateral electrolytic lesions of the central nucleus of the amygdala or sham operations, and then were tested for fear-potentiated startle 4-5 days later. Lesions of the amygdala impaired fear-potentiated startle using an auditory CS, consistent with the previous findings using a visual CS. These data indicate that the effect of lesions of the amygdala on fear-potentiated startle is not specific to one sensory modality, consistent with the hypotheses that the amygdala is involved in processing multimodal information related to conditioned fear, or is part of an output pathway for motor and autonomic expressions of conditioned fear.


Genetic damage in Rhinella marina populations in habitats affected by agriculture in the middle region of the Sinú River, Colombia.
Contamination with pesticide residues affects the environmental health of agroecosystems, especially the amphibian fauna that lives in these environments. The objective of the present study was to determine pesticides concentrations in sediments of agroecosystems and to evaluate genetic damage in Rhinella marina populations living in these zones. A total of 91 individuals were collected, 51 in the group exposed in different areas of the middle region of the Sinú River (Irrigation District of Mocari 16, Irrigation District of Aguas Negras 21, Irrigation District of Cerete 14) and 40 in a control group; at the same time, 36 subsamples of sediments were taken at each sampled station to determine pesticides organochlorine by means of chromatography coupled with ISQ Thermo Scientific mass spectrometer. The micronucleus test was applied in erythrocytes of the individuals collected. Results showed the presence of persistent organochlorine pesticides (POPs) in the sediment samples (p,p'-DDT, p,p'-DDE, and p,p'-DDD) of agricultural soils. Two individuals were registered with abnormalities in their limbs at the Mocari station, representing 12.5% of the morphological malformations to this sector. Micronucleus analysis revealed statistically significant genetic damage in exposed individuals (Mocari 9.87 ± 5.1, Cerete 7.7 ± 1.7, Aguas Negras 5.6 ± 3.6) with respect to the control group (2.4 ± 1.9) (p < 0.05). Spearman correlation analysis revealed a positive association between genetic damage and POP concentrations (p < 0.05). In addition, cellular alterations such as nuclear buds, and pyknosis (cell death), were statistically significant in the exposed group compared to the control group (p < 0.05). This study suggests that there is evidence for morphological and genotoxic effects in R. marina populations inhabiting areas influenced by agriculture, possibly associated with the presence of p,p'-DDT, p,p'-DDD, and p,p'-DDE.


Paramedian forehead flap pedicle division after 7 days using laser-assisted indocyanine green angiography.
The paramedian forehead flap is a major workhorse for reconstruction of medium- to large-sized nasal defects. The tissue bridge that results from the vascular pedicle results in significant cosmetic deformity, with associated social and occupational costs to the patient. This prospective cross-sectional study sought to assess efficacy and safety of takedown of the flap pedicle at 1 week using indocyanine green (ICG) angiography to assist in determining neovascularization of the flap. This study was performed at a tertiary care center from April 13, 2018 to March 22, 2019. Patients eligible for enrollment included those with defects appropriate for reconstruction with a paramedian forehead flap, partial-thickness defect, vascularized tissue in more than 50% of the recipient bed, and lack of nicotine use. Ten patients were included, and all underwent reconstructive surgery by a single surgeon. Laser-assisted ICG angiography was used during the first stage as well as at the second stage both immediately before and after flap division. Perfusion was in both time-independent and time-dependent analyses relative to a cheek reference point. Herein, we found successful 7-day flap takedown with no flap-related complications in all patients. There was an average of approximately 44% flap-to-cheek vascularity across all patients, and pre-division flap perfusion correlated well with post-division perfusion. In conclusion, in carefully selected patients with amenable defects, division of the pedicle at 1 week after initial flap transfer is safe and has the potential to limit the morbidity associated with the procedure.


Malignant glioma grade 3 and 4: how relevant is timing of radiotherapy?
The aim of this study is to determine prognostic factors that influence further outcome in patients with glioma. Between 01/2002 and 08/2008, 153 patients with malignant gliomas of WHO-grade 3 or 4 who were treated with external beam radiotherapy with or without chemotherapy. In univariate analysis, following factors were ascertained as statistically significant prognostic parameters: grade (p = 0.000), time between operation and radiotherapy >24 days (p = 0.044) for progression-free survival; grade (p = 0.000), age<58 years (p = 0.001), extent of surgery (p = 0.011), time between operation and radiotherapy >24 days (p = 0.009), overall treatment time >68 days (p = 0.003), use of chemotherapy (p = 0.015) for overall survival. A longer time period between resection and start of radiotherapy showed to be associated with improved outcome. After multivariate analysis, only grade (p = 0.000) remained a statistically significant factor for progression-free and grade (p = 0.000) and use of chemotherapy (p = 0.031) for overall survival. We were able to recognize grade and use of chemotherapy as statistically significant prognostic determinants, but not time intervals or overall treatment time.


Hydration of casein micelles: kinetics and isotherms of water sorption of micellar casein isolated from fresh and heat-treated milk.
Water vapour sorption isotherms of casein micelles prepared from raw milk and various heat-treated milks were determined. The equilibrium water contents of the heated preparations were markedly lower than that of the raw-milk casein over the whole range of vapour pressures studied. An analysis of the sorption isotherms in the relative vapour pressure range 0.1--0.45, according to the Brunauer, Emmett & Teller (1938) equation, showed that there were significant differences between preparations in the computed monolayer contents. Differences in the rates of water sorption were also observed between the different preparations. As judged from the amount of absorbed water, the influence of the heating methods could be ranked in the order: HTST (92 degrees C) approximately UHT (direct) less than UHT (indirect) less than HTST (72 degrees C).


When should a urine specimen be examined after removal of a urinary catheter?
Catheter urine specimens (CSUs) were taken from 72 patients with short term urinary catheters just before the catheter was removed. The patients were assessed to see whether this specimen influenced their management. Their subsequent urinary symptoms were followed, and daily mid stream urines (MSUs) compared with the initial CSU to see if the initial CSU gave an accurate indication of the likelihood of infection when the catheter was removed. Only one patient was given antimicrobial therapy as a consequence of the initial CSU, and 18 patients (25 per cent) showed significant growth on the CSU but no growth or a non-significant growth on subsequent MSUs. It would appear that CSUs taken prior to the removal of urinary catheters are of limited value.


Immunoelectron microscopic localization of galectin-3, an IgE binding protein, in human mast cells and basophils.
Galectin-3 is an endogenous soluble lectin within the family called galectins that bind beta-galactosides. Homologs of the protein isolated from different sources were previously designated as IgE-binding protein (epsilon BP), CBP35, CPB30, Mac-2, RL-29, RLL, L-29, and HL-29. All are now renamed galectin-3. This lectin is widely distributed in cells and tissues of mice, rats, dogs, hamsters, and humans. Light microscopic immunohistochemistry and ultrastructural immunogold labeling methods were used to determine the distribution of galectin-3 in human mast cells of several organs, in mast cells developed in vitro from human fetal liver cells, and in human peripheral blood basophils. Immunolabeling for the protein was observed in mast cells from all sources and in basophils. The lectin was detected in the nucleus and/or the cytoplasm. The nuclear labeling was over heterochromatin whereas euchromatin was unlabeled. Cytoplasmic labeling was concentrated over secretory granules. The intensity of staining generally was greater in mast cells of skin when compared with that of mast cells in other locations and with that of basophils. Studies have indicated that in mast cells galectin-3 may be involved in promoting their adhesion to basal laminae. In this study the localization of galectin-3 in the secretory granules of human mast cells and basophils suggests that these cells may release this lectin when activated to degranulate.


Genes differentially regulated by NKX2-3 in B cells between ulcerative colitis and Crohn's disease patients and possible involvement of EGR1.
Ulcerative colitis (UC) and Crohn's disease (CD) are two related yet different forms of chronic intestinal inflammation. We investigated the genes regulated by NKX2-3 in B cells from a UC patient by cDNA microarray and compared the results to those genes regulated by NKX2-3 in B cells from a CD patient. Genes regulated by NKX2-3 in B cells from UC were mainly involved in cell growth, inflammation, and immune response. Among the genes regulated by NKX2-3 in both UC and CD, expression of 145 genes was similarly altered and 34 genes was differentially affected by NKX2-3 knockdown. EGR1 was up-regulated in NKX2-3 knockdown B cells from UC while down-regulated in NKX2-3 knockdown B cells from CD. mRNA expressions of NKX2-3 and EGR1 were increased in diseased intestinal tissues from 19 CD patients. NKX2-3 may play different roles in UC and CD pathogenesis by differential regulation of EGR1.


PEAK CORTISOL RESPONSE TO EXHAUSTING EXERCISE: EFFECT OF BLOOD SAMPLING SCHEDULE.
Strenuous exercise provokes increases in circulating cortisol levels. When the peak cortisol response to exercise occurs is a point of contention, as some research suggests the peak response coincides with the end of exercise while other indicate it is delayed and occurs during recovery. This study examined when peak cortisol levels occur in response to intensive, exhausting exercise of a prolonged nature. Thirty-four healthy male subjects ran on a treadmill until volitional exhaustion. Blood specimens were analyzed for cortisol levels immediately at the end of exercise and at 30, 60, and 90 minutes into recovery. A significantly greater number (25/34; i.e., 73.5%) of the peak cortisol responses occurred during the recovery period (at 30 - 90 minutes) after the subjects reached volitional exhaustion and had stopped exercising. The findings suggest that if researchers are interested in assessing the peak cortisol response to exhausting exercise they should continue blood sampling for approximately 1 hour into the recovery period.


Trends in menstrual cycle symptoms, physical activity avoidance, and hormonal contraceptive use in a general population of adult women.
Research examining symptoms and side effects of the menstrual cycle on physical activity performance and participation has almost exclusively focussed on elite and athletic populations. The current study aimed to i) identify any differences in symptomatic experiences of the menstrual cycle between hormonal contraceptive users and non-users, ii) gain insight into hormonal contraceptive use, iii) describe perceived symptomatic influences on physical activity engagement, and iv) identify perceived levels of knowledge and understanding around the menstrual cycle. An online questionnaire was completed by 881 adult females aged between 18 and 55 years. Questionnaire items related to hormonal contraceptive use, habitual physical activity levels, experiences and symptoms of the menstrual cycle, and sources of information resulting in knowledge and understanding of the menstrual cycle. More than half of all participants (52%) identified themselves as being recreationally active, and the most commonly reported menstrual symptoms were abdominal cramps, lethargy, abdominal bloating, lower back pain, and heavy bleeding. Of all respondents, 48.1% were using some form of hormonal contraception, 66% of which were using a version of a combined oral contraceptive pill. Consistent with previous studies, 90% of respondents regularly experienced adverse menstrual symptoms, including abdominal cramps, lethargy, abdominal bloating, lower back pain, and heavy bleeding. Menstrual symptoms were frequently identified as influential factors in the avoidance of, and reduced performance in, physical activity. Almost half of all participants were using some form of hormonal contraception, a noticeably larger proportion than has been previously documented in studies examining non-athletic populations.


An unusual case of combined classic and reverse twiddler's syndrome.
In recent years the phenomenon of reverse twiddler's syndrome has been described, characterized by pulse generator manipulation resulting in lead advancement rather than retraction. We describe what we believe to be the first reported case of both classic and reverse twiddler's syndrome occurring simultaneously in a patient with a biventricular implantable cardioverter-defibrillator.


Cowden syndrome: report of a large family with macrocephaly and increased severity of signs in subsequent generations.
We report Cowden syndrome in a large four-generation family, paying special attention to the apparently greater severity and earlier onset of signs and symptoms in subsequent generations. Macrocephaly was present in all affected individuals and was markedly progressive in three of six affected children of the fourth generation, and associated with slight to moderate delay in psychomotor development.


A theory of expert leadership (TEL) in psychiatry.
Leaders' technical competence - 'expert knowledge' - has been shown in many settings to be associated with better organizational performance. In universities, for example, there is longitudinal evidence that research-focused scholars make the best leaders; results from a hospital study show that doctors instead of professional managers are most closely associated with the best performing institutions. To explain these patterns, and raise hypotheses, a theory of expert leadership (TEL) has been developed that might explain these patterns. In this paper the framework for expert leadership is applied to psychiatry. The TEL proposes that psychiatric leaders, as opposed to non-expert managers, improve organizational performance through several channels. First, experts' knowledge influences organizational strategy. Second, having been 'one of them', a psychiatrist understands how to create the optimal work environment for psychiatric teams, through appropriate goal-setting, evaluation and support. These factors are positively associated with workers' wellbeing and performance. Third, exceptional psychiatrist-leaders are likely to set high standards for hiring. Fourth, leaders' credibility extends their influence among core workers, and also signals organizational priorities to stakeholders. Finally, a necessary prerequisite of TEL is that expert leaders have direct executive power inclusive of budgetary and strategic oversight.


Motor evoked responses from the thigh muscles to the stimulation of the upper limb nerves in patients with late poliomyelitis.
To demonstrate a clear-cut M response recorded from the severely affected thigh muscles to the stimulation of the upper limb nerves in a serial of patients with late poliomyelitis. Fifteen patients with late poliomyelitis, 7 patients with spinal cord disorders and 11 control subjects were included. Evoked muscle responses were investigated in quadriceps femoris and/or thigh adductor muscles to the stimulation of the brachial plexus, median and ulnar nerves. Evoked muscle responses were obtained from the thigh muscles in all 12 late polio patients with proximal lower extremity involvement. The response could not be recorded from the thigh muscles neither in the 3 polio patients with upper extremity involvement nor in the healthy control subjects and in patients with other spinal cord disorders of anterior horn cell. It is proposed that the electrical stimulation of the arm nerves produce interlimb descending muscle responses in the severely affected atrophic thigh muscles of the patients with late polio. This finding suggests that there might be a focal and/or specific loss of inhibitory interneurons between injured and normal motor neurons and increased facilitatory synaptic action at the end of long propriospinal descending fibers in the case of late poliomyelitis.


Effect of dibutyryl cAMP on cell cycle progression of rat brain tumor cells in vitro.
Autoradiographic and flow microfluorometry analyses have been applied to a study of perturbed cell kinetics in 9L rat brain tumor cells treated with dibutyryl cyclic AMP and theophylline alone and in combination in vitro. At a concentration of 1 mM each, cell growth ceased shortly after the administration of these drugs. The results indicate that cells in S and G2 phase at the time of drug administration can undergo mitosis even though a considerable prolongation of G2 phase was apparent. However, cells in G1 at the time of drug administration was arrested in that phase, whereas those cells in S or G2 were able to complete one mitosis before becoming arrested in the G1 phase. This blocking effect was reversible, and cells resumed proliferation at a normal rate shortly after the removal of these drugs.


Stapedotomy in osteogenesis imperfecta: a prospective study of 23 consecutive cases.
To prospectively evaluate the hearing results in surgically treated cases of stapes fixation in patients with osteogenesis imperfecta. A prospective study of osteogenesis imperfecta patients with stapes fixation. One tertiary referral center. Eighteen patients (23 ears) who underwent stapes surgery from 1994 to 2004 were prospectively included. Stapedotomy with vein graft interposition and reconstruction with a Teflon piston or a bucket handle (cup) prosthesis. Preoperative and postoperative audiometric evaluation using conventional audiometry. Air-bone gap, bone-conduction thresholds, and air-conduction thresholds were measured. Postoperative audiometry was performed at 6, 9, 12, 18, and 24 months after surgery and at a yearly interval thereafter. Overall, a postoperative air-bone gap closure to within 10 dB was achieved in 85.7% of cases. Postoperative improvement of air-conduction thresholds superior to 20 dB was found in 57% of cases. The postoperative bone-conduction thresholds were unchanged. This study shows that safe and successful stapedotomy is possible in cases of stapes fixation in patients with osteogenesis imperfecta.


Intracranial bleeding following soccer-related head trauma in a young student with occult factor VII deficiency.
It is important to obtain coagulation tests to assess bleeding risk in trauma patients undergoing emergency surgery when a bleeding disorder may be obscured. Identifying specific clotting factor defects is critical in successful patient management.


Construction and verification of atopic dermatitis diagnostic model based on pyroptosis related biological markers using machine learning methods.
The aim of this study was to construct a model used for the accurate diagnosis of Atopic dermatitis (AD) using pyroptosis related biological markers (PRBMs) through the methods of machine learning. The pyroptosis related genes (PRGs) were acquired from molecular signatures database (MSigDB). The chip data of GSE120721, GSE6012, GSE32924, and GSE153007 were downloaded from gene expression omnibus (GEO) database. The data of GSE120721 and GSE6012 were combined as the training group, while the others were served as the testing groups. Subsequently, the expression of PRGs was extracted from the training group and differentially expressed analysis was conducted. CIBERSORT algorithm calculated the immune cells infiltration and differentially expressed analysis was conducted. Consistent cluster analysis divided AD patients into different modules according to the expression levels of PRGs. Then, weighted correlation network analysis (WGCNA) screened the key module. For the key module, we used Random forest (RF), support vector machines (SVM), Extreme Gradient Boosting (XGB), and generalized linear model (GLM) to construct diagnostic models. For the five PRBMs with the highest model importance, we built a nomogram. Finally, the results of the model were validated using GSE32924, and GSE153007 datasets. Nine PRGs were significant differences in normal humans and AD patients. Immune cells infiltration showed that the activated CD4+ memory T cells and Dendritic cells (DCs) were significantly higher in AD patients than normal humans, while the activated natural killer (NK) cells and the resting mast cells were significantly lower in AD patients than normal humans. Consistent cluster analysis divided the expressing matrix into 2 modules. Subsequently, WGCNA analysis showed that the turquoise module had a significant difference and high correlation coefficient. Then, the machine model was constructed and the results showed that the XGB model was the optimal model. The nomogram was constructed by using HDAC1, GPALPP1, LGALS3, SLC29A1, and RWDD3 five PRBMs. Finally, the datasets GSE32924 and GSE153007 verified the reliability of this result. The XGB model based on five PRBMs can be used for the accurate diagnosis of AD patients.


Blood-brain barrier structure and function and the challenges for CNS drug delivery.
The neurons of the central nervous system (CNS) require precise control of their bathing microenvironment for optimal function, and an important element in this control is the blood-brain barrier (BBB). The BBB is formed by the endothelial cells lining the brain microvessels, under the inductive influence of neighbouring cell types within the 'neurovascular unit' (NVU) including astrocytes and pericytes. The endothelium forms the major interface between the blood and the CNS, and by a combination of low passive permeability and presence of specific transport systems, enzymes and receptors regulates molecular and cellular traffic across the barrier layer. A number of methods and models are available for examining BBB permeation in vivo and in vitro, and can give valuable information on the mechanisms by which therapeutic agents and constructs permeate, ways to optimize permeation, and implications for drug discovery, delivery and toxicity. For treating lysosomal storage diseases (LSDs), models can be included that mimic aspects of the disease, including genetically-modified animals, and in vitro models can be used to examine the effects of cells of the NVU on the BBB under pathological conditions. For testing CNS drug delivery, several in vitro models now provide reliable prediction of penetration of drugs including large molecules and artificial constructs with promising potential in treating LSDs. For many of these diseases it is still not clear how best to deliver appropriate drugs to the CNS, and a concerted approach using a variety of models and methods can give critical insights and indicate practical solutions.


Comparison of antiplatelet efficacy and tolerability of clopidogrel napadisilate with clopidogrel bisulfate in coronary artery disease patients after percutaneous coronary intervention: a prospective, multicenter, randomized, open-label, phase IV, noninferiority trial.
Clopidogrel bisulfate, a potent antiplatelet agent, has a pivotal role in the prevention and treatment of atherothrombotic disease. Clopidogrel napadisilate, a different salt preparation of clopidogrel, has been developed and approved in Korea and several European countries. Recent studies have suggested that clopidogrel napadisilate might have improved stability and comparable bioequivalence to clopidogrel bisulfate. However, these 2 clopidogrel preparations have not been compared in terms of efficacy and tolerability in patients with coronary artery disease (CAD) who underwent percutaneous coronary intervention (PCI). We sought to investigate the antiplatelet efficacy and safety profile of clopidogrel napadisilate compared with clopidogrel bisulfate in CAD patients after PCI. This was a randomized, multicenter, open-label, Phase IV, noninferiority clinical trial. We prospectively recruited CAD patient in 6 institutions in Korea between October 2010 and November 2011. Patients who underwent PCI were randomly assigned to the test group (clopidogrel napadisilate plus aspirin) or control group (clopidogrel bisulfate plus aspirin). Antiplatelet efficacy and safety profile were assessed after 4 weeks of maintenance treatment. The primary end point was noninferiority of the percentage of P2Y(12) inhibition, measured by point-of-care assay. The rate of major adverse cardiovascular events (MACE), as a secondary end point, was compared between the 2 clopidogrel preparations. To assess tolerability, we evaluated the incidence, severity, and causal relation of adverse events (AEs) of 2 groups. A total of 169 patients were screened, and 127 patients completed the study (64 in the test group and 63 in the control group; P = 0.296). The baseline characteristics of patients did not differ significantly between the treatment groups. The between-group difference in percentage of P2Y(12) inhibition did not exceed the prespecified limit for noninferiority (P for noninferiority = 0.032; 95% CI, -8.33 to 5.53). With respect to the risk of MACE, no significant difference was found in the incidence of myocardial infarction or stroke between the groups (1 in the test group and 2 in the control group; P > 0.99); no mortality was reported in either group. The tolerability of clopidogrel napadisilate was comparable with that of clopidogrel bisulfate in terms of all AEs, drug-related AEs, and serious AEs (all AEs: test group, 33.3%; control group, 32.9% [P > 0.99]; drug-related AEs: test group, 4.17%; control group, 0% [P = 0.113]; serious AEs: test group, 1.39%; control group, 5.26% [P=0.367]). In this study of CAD Korean patients who have undergone PCI, the antiplatelet efficacy of clopidogrel napadisilate was noninferior to that of clopidogrel bisulfate after 4 weeks of maintenance treatment. No statistically significant difference was found in tolerability between the 2 treatment groups.


A simple fast micromethod for measuring enzyme activities which release tritium as tritium water.
The entire procedure is carried out in a counting vial by mixing the reagents as a 20- to 30-microliters drop in the cap of a counting vial, incubating, quenching the reaction, and then distilling the tritium water produced into the chilled vial, in which it is assayed after the addition of scintillation solvent and a clean cap. The application of this technique to the analysis of serum transaminases is described.


In vitro culture and labeling of neural cell aggregates followed by transplantation.
Septal, cortical, or whole brain fetal (E15-17) cells were dissociated and cultured in serum-supplemented Dulbecco minimum essential medium under rotating culture conditions. Preincubation and exposure to cytosine arabinoside was utilized to produce "neuron-rich" cultures. Fluorescent latex microbeads were added to cultures at seeding time or early after aggregate formation. All cell types were found to incorporate the fluorescent beads, although apparently not to the same extent. Two- to five-day-old aggregates tended to attach and grow neurites after their transfer to poly-l-lysine- or Matrigel-coated dishes under stationary conditions. Early aggregates transplanted to the hippocampus of adult rats developed into identifiable grafts, with fluorescent-labeled cells. We conclude that "young" neural cell aggregates maintain their ability to undergo two basic phenomena for cellular interaction, i.e., attachment and neuritic growth. Floating aggregates may provide a convenient cellular condition whenever culturing of neural cells is to be used before grafting them into a host animal.


Mould deterioration of agricultural commodities during transit: problems faced by developing countries.
Huge quantities of agricultural commodities are being either imported or exported by the developing countries. The commodities have to be transported from the fields of cultivation to the centres of consumption, considerable time being taken for the movement not only because of long distances but also because of various socio-economic, environmental and biological reasons. These commodities are likely to be damaged by mould growth and subsequent aflatoxin accumulation. If the contamination occurs during transit, often no insurance cover for the risk is available. Because of different methods of sampling followed in the exporting and importing countries it is often difficult to define the exact responsibility of the development of aflatoxin as having taken place during transit. The statistics of the export of aflatoxin high-risk commodities like red pepper (chillies), cotton seed and groundnut extractions clearly, for the last decade, demonstrate the extent of loss suffered by the exporting countries because of aflatoxins. The problem of mould damage and mycotoxin contamination can be minimised by improving facilities for storage at ports and transit points as well as on ships.


Purification of the pancreatic cholecystokinin receptor.
We have previously shown that the pancreatic cholecystokinin (CCK) receptor can be solubilized in 1% digitonin. In this study, digitonin-solubilized CCK receptors from rat pancreas were purified using sequential affinity chromatography on ricin-II agarose and on AffiGel-CCK. Electrophoresis of the radioiodinated purified receptors on SDS-polyacrylamide gels followed by autoradiography revealed two proteins: a major band of Mr = 80,000-90,000, and a minor band of Mr = 55,000. Through the purification procedure, the receptors preserved their agonist specificity (CCK-8 less than CCK-33 less than desulfated CCK-8 less than CCK-4) and binding affinity. Scatchard transformations of binding data for the purified receptor preparation were best fit by linear plots compatible with a single class of binding sites with Kd = 9.4 nM. The estimated purification was about 80,000 fold and consistent with the expected Bmax for a pure Mr = 80,000 protein binding one CCK molecule. This two-step purification procedure opens the possibility for molecular studies of the CCK receptor.


Difficult lives: A descriptive and relational study on the coping with stress and care burden of caregivers of patients with epilepsy.
This study was conducted to examine the relationship between coping with stress status and the burden of care of the caregivers of patients with epilepsy. This descriptive correlational study was carried out with a total of 230 voluntary caregivers of patients with epilepsy who visited the neurology clinics and outpatient clinics of a training and research hospital in the southeastern part of Turkiye between March 2022 and February 2023. Study data were collected through the Personal Information Form, the Zarit Caregiver Burden Assessment and the Ways of Coping Scale. Descriptive statistics and multiple regression analysis were used for the evaluation of the data. While the mean score of the caregivers from the Zarit Caregiver Burden Assessment was 41.20 ± 12.44, they had mean scores of 12.12 ± 3.25, 8.93 ± 1.93, 12.24 ± 3.61, 8.77 ± 3.17, and 7.89 ± 1.95, respectively, from the self-confident approach, optimistic approach, helpless approach, submissive approach, and social support-seeking approach sub-dimensions. In the study, a moderate positive statistically significant relationship was found between the caregivers' burden of care and the mean scores of the helpless and submissive approach sub-dimensions(p < 0.05). The caregivers' burden of care and coping with stress were at moderate levels. The helpless approach, which is one of the ineffective methods of coping with stress, was found to be higher. The helpless and submissive approaches were found to increase in this study as the caregivers' burden of care increased. The use of effective coping skills to reduce the level of personal burden of care would improve the caregiver's physical health and psychological well-being.


Enhancement of long-term angiogenic efficacy of adipose stem cells by delivery of FGF2.
Stem cell transplantation can induce neovascularization. Regenerated blood vessels should remain stable for a long-term period in order to function as new blood vessels in ischemic tissues. Here we show that local delivery of FGF2 enhances the long-term (12weeks) angiogenic efficacy of human adipose-derived stem cells (hADSCs) implanted into mouse ischemic hindlimbs. Following transplantation of hADSCs into ischemic hindlimbs of mice, hADSC viability was significantly higher in the hADSC+FGF2 group at 4 and 12weeks post-transplantation than in the hADSC only group. Furthermore, hADSCs produced higher levels of angiogenic growth factors (i.e., fibroblast growth factor 2, vascular endothelial growth factor, hepatocyte growth factor, and platelet-derived growth factor) at both time points. As a result, the density of arterioles in the ischemic hindlimb muscle was significantly higher in the hADSC+FGF2 group than in either hADSC or FGF2 only group at both time points. The number of arterioles with larger diameters was significantly greater in the hADSC+FGF2 group than in the other groups at 12weeks, and increased in the hADSC+FGF2 group as the time period increased from 4weeks to 12weeks post-transplantation. This suggests that FGF2 delivery to hADSC transplantation sites enhances long-term angiogenic efficacy of hADSCs transplanted into ischemic tissues.


The pH dependence of red cell membrane transport of titratable anions studied by NMR spectroscopy.
The effects of varying extracellular pH on the rates of uptake of titratable anions by human erythrocytes under conditions of constant intracellular pH have been determined for a series of highly related anions, the phosphate "analogs." These compounds are simply substituted phosphorus oxyacids, differing in the number and acidity of titratable protons: phosphate (HPO4(2-), pKa 6.8); phosphite (HPO3(2-), pKa 6.4); hypophosphite (H2PO2-); methylphosphonate ((CH3)PO3(2-), pKa 7.4); dimethylphosphinate ((CH3)2PO2-); fluorophosphate [PO3F2-, pKa 4.7); and thiophosphate (HSPO3(2-), pKa 5.5). Suspensions of intact, Cl(-)-loaded erythrocytes (intracellular pH, 7.2) were incubated at 37 degrees C in isotonic buffers (pH 4-8) containing 60 mM phosphate analog for specified time intervals, whereupon influx was halted by the addition of 1 mM 4-acetamido-4'-isothiocyanatostilbene-2,2'-disulfonic acid (SITS), an inhibitor of anion exchange. The intracellular anion concentrations were determined from 31P or 19F nuclear magnetic resonance spectra from the erythrocyte suspensions. The influx rates for the titratable phosphate analogs exhibited bimodal pH dependence, reaching maximal levels at pH values that increased with increasing anion pK. This pH-dependent behavior is consistent with a transport channel that contains a titratable regulatory site which interacts with the translocated anion. Based upon the Henderson-Hasselbalch equation, the probability that a titratable anion will have an electric charge of equal magnitude to that of the titratable carrier is highest at a pH value exactly midway between the pK of the regulatory site and that of the anion. The pH maxima observed for the phosphate analogs indicate a pK for this site of 5.5 at 37 degrees C. Intracellular pH changes associated with influx indicated that transport of the "fast" anion phosphite is largely in monoionized form. Intracellular pH changes associated with transport of slow anions were predominantly determined by partial ionic equilibrium effects and did not indicate the ionization state of the transported anion.


Cloning, characterization and expression analysis of metallothioneins from Ipomoea aquatica and their cultivar-dependent roles in Cd accumulation and detoxification.
To explore the possible roles of metallothioneins (MTs) played in cadmium (Cd) accumulation of water spinach, three IaMT genes, IaMT1, IaMT2 and IaMT3 in a high-shoot-Cd (T308) and a low-shoot-Cd accumulation cultivar (QLQ) were cloned, characterized, and quantitated. Gene expression analysis suggested that the expression of the IaMTs was differentially regulated by Cd stress in different cultivars, and T308 showed higher MTs expression overall. Furthermore, only shoot IaMT3 expression was cultivar dependent among the three IaMTs. Antioxidant analysis showed that the high production of IaMTs in T308 should be associated with its high oxidation resistance. The role of IaMTs in protecting against Cd toxicity was demonstrated in vitro via recombinant E. coli strains. The results showed that IaMT1 correlated with neither Cd tolerance nor Cd accumulation of E. coli, while IaMT2 conferred Cd tolerance in E. coli, IaMT2 and IaMT3 increased Cd accumulation in E. coli. These findings help to clarify the roles of IaMTs in Cd accumulation, and increase our understanding of the cultivar-dependent Cd accumulation in water spinach.


Cardiac regeneration and remodelling of the cardiomyocyte cytoarchitecture.
Adult mammals are unable to regenerate their hearts after cardiac injury, largely due to the incapacity of cardiomyocytes (CMs) to undergo cell division. However, mammalian embryonic and fetal CMs, similar to CMs from fish and amphibians during their entire life, exhibit robust replicative activity, which stops abruptly after birth and never significantly resumes. Converging evidence indicates that formation of the highly ordered and stable cytoarchitecture of mammalian mature CMs is coupled with loss of their proliferative potential. Here, we review the available information on the role of the cardiac cytoskeleton and sarcomere in the regulation of CM proliferation. The actin cytoskeleton, the intercalated disc, the microtubular network and the dystrophin-glycoprotein complex each sense mechanical cues from the surrounding environment. Furthermore, they participate in the regulation of CM proliferation by impinging on the yes-associated protein/transcriptional co-activator with PDZ-binding motif, β-catenin and myocardin-related transcription factor transcriptional co-activators. Mastering the molecular mechanisms regulating CM proliferation would permit the development of innovative strategies to stimulate cardiac regeneration in adult individuals, a hitherto unachieved yet fundamental therapeutic goal.


Increased inflammation in rheumatoid arthritis patients living where farm soils contain high levels of copper.
Heavy metal pollution in farm soils is a problem in some parts of Taiwan. Copper can be a factor associated with increased disease activities of rheumatoid arthritis (RA). Thus, the aim of this study was to investigate whether copper pollution in farm soils is associated with worsened RA. Clinical parameters from 122 RA patients were collected from a medical center in central Taiwan. Levels of heavy metals in the blood were measured using inductively coupled plasma mass spectrometry. Levels of copper in farm soils were retrieved from a national survey. These data were analyzed to find the factors related to RA disease activities. RA patients living where farm soils contained high levels of copper had increased white blood cell counts, erythrocyte sedimentation rate, and disease activity score 28, compared with patients living where copper levels were low. Among the nine types of heavy metal measured in the study, blood levels of copper and nickel correlated with erythrocyte sedimentation rate. Our cross-sectional data suggest a correlation between RA disease activity and the level of copper at township farm soils samples. Further longitudinal studies using more rigorous methodologies are warranted to examine whether this correlation is causal.


Therapy of periprosthetical leakage with tissue augmentation using Bioplastique around the implanted voice prosthesis.
Having a voice prosthesis provides a good possibility for speech rehabilitation after total laryngectomy has been performed, especially if common complications such as leakage around the valve can be reduced effectively. The early applications of a voice prosthesis-which was originally invented and applied by Mozolewski in 1972, was further developed by Blom and Singer and became an internationally available implantable instrument by 1980- already made clear not only the typical benefits, but also the complications, such as possible leakage around the implanted valve. Remacle proposed the injection of collagen into the surrounding tissues in order to stop leakage. Knowing that collagen is usually resorbed as time goes by, new substances that can be tolerated by human tissues must be found. This article reports the experiences of the authors in the search for such an injectable material that cannot be resorbed and does not migrate. In order to solve the above-mentioned problem, Lichtenberger introduced the injection of Bioplastique into the perivalvular tissues. This delivered the best results ever achieved in this field at our department. During the past 2 years, Bioplastique augmentation was performed for seven laryngectomized and speech-rehabilitated patients in order to reduce periprosthetical leakage. All procedures were successful in terms of either eliminating or reducing the leakage, and also the non-resorbable property of Bioplastique has been proven.


FT-IR, FT-Raman spectra and other molecular properties of 3,5-dichlorobenzonitrile: a DFT study.
The IR and Raman spectra of 3,5-dichlorobenzonitrile (3,5-DCBN) molecule were recorded at room temperature and then the assignment of the observed fundamental bands were achieved by the aid of the theoretical vibrational spectral data obtained from a quantum chemical study carried out for the free molecule case. In the calculations performed to determine the molecular geometry, vibrational spectral data and thermodynamic parameters, Møller-Plesset second order perturbation theory (MP2) and hybrid Density Functional Theory (DFT) types of electronic structure methods, B3LYP and B3PW91, were used. The overestimations of the calculated harmonic wavenumbers were efficiently corrected by the aid of a specific scaling procedure. This empirical scaling process significantly increased the reliability of our assignments and analyses on the observed bands due to different vibrational normal modes of the molecule. For the majority of the normal modes, the deviations between the corresponding experimental and scaled theoretical wavenumbers have located in the expected range. A correct characterization of the normal modes is of vital importance in the assignment of the observed bands, and this was successfully done by the aid of the Potential Energy Distributions (PEDs) separately calculated for each normal mode of 3,5-DCBN.


Unusual presentation of maxillary plasma cell gingivitis mistakenly treated as aggressive periodontitis. (A case report).
A rare benign inflammatory condition of gingiva of unknown etiology, characterized by diffuse and massive infiltration of plasma cells into the sub-epithelial gingival tissue. Plasma Cell Gingivitis (PCG) is characterized by macular lesions that are bright red, velvety, sharply circumscribed, and flat to slightly elevated. Female patient 38 years old, complain of mobility of upper right 7 with dull pain and swelling related to it. She also mentioned that the upper wisdom molar at the same side was extracted a year before due to the same reason. Extraction of upper right 7 and excisional biopsy of surrounding soft tissue swelling and by laboratory investigation and analysis to the biopsy we found that the lesion is gingival plasmacytosis. Microscopic examination revealed marked squamous hyperplasia with focal ulceration and diffuse dense subepithelial plasmacytic infiltrate consistent with PCG. At higher magnification, plasma cells were seen without cellular atypia. The individual plasma cells had eccentric round nuclei with cartwheel chromatin patterns and abundant cytoplasm. In the current report, the surgical team performed complete scaling and root planning to remove the associated plaque to decrease any chance of recurrence or plaque induced exacerbation. The patient was instructed to change her habits to avoid the possibility of exacerbation by unknown allergen. The lesion was excised by enblock removal to decrease recurrence possibility. Plasma cell gingivitis needs radical management and a thorough diagnosis should be done to rule out and differentiate it from the malignant type of plasma cell tumors like multiple myeloma.


Analysis of the humoral and cellular immune response after a full course of BNT162b2 anti-SARS-CoV-2 vaccine in cancer patients treated with PD-1/PD-L1 inhibitors with or without chemotherapy: an update after 6 months of follow-up.
The durability of immunogenicity of SARS-CoV-2 vaccination in cancer patients remains to be elucidated. We prospectively evaluated the immunogenicity of the vaccine in triggering both the humoral and the cell-mediated immune response in cancer patients treated with anti-programmed cell death protein 1/programmed death-ligand 1 with or without chemotherapy 6 months after BNT162b2 vaccine. In the previous study, 88 patients were enrolled, whereas the analyses below refer to the 60 patients still on immunotherapy at the time of the follow-up. According to previous SARS-CoV-2 exposure, patients were classified as SARS-CoV-2-naive (without previous SARS-CoV-2 exposure) and SARS-CoV-2-experienced (with previous SARS-CoV-2 infection). Neutralizing antibody (NT Ab) titer against the B.1.1 strain and total anti-spike immunoglobulin G concentration were quantified in serum samples. The enzyme-linked immunosorbent spot assay was used for quantification of anti-spike interferon-γ (IFN-γ)-producing cells/106 peripheral blood mononuclear cells. Fifty patients (83.0%) were on immunotherapy alone, whereas 10 patients (7%) were on chemo-immunotherapy. We analyzed separately patients on immunotherapy and patients on chemo-immunotherapy. The median T-cell response at 6 months was significantly lower than that measured at 3 weeks after vaccination [50 interquartile range (IQR) 20-118.8 versus 175 IQR 67.5-371.3 IFN-γ-producing cells/106 peripheral blood mononuclear cells; P < 0.0001]. The median reduction of immunoglobulin G concentration was 88% in SARS-CoV-2-naive subjects and 2.1% in SARS-CoV-2-experienced subjects. SARS-CoV-2 NT Ab titer was maintained in SARS-CoV-2-experienced subjects, whereas a significant decrease was observed in SARS-CoV-2-naive subjects (from median 1 : 160, IQR 1 : 40-1 : 640 to median 1 : 20, IQR 1 : 10-1 : 40; P < 0.0001). A weak correlation was observed between SARS-CoV-2 NT Ab titer and spike-specific IFN-γ-producing cells at both 6 months and 3 weeks after vaccination (r = 0.467; P = 0.0002 and r = 0.428; P = 0.0006, respectively). Our work highlights a reduction in the immune response in cancer patients, particularly in SARS-CoV-2-naive subjects. Our data support administering a third dose of COVID-19 vaccine to cancer patients treated with programmed cell death protein 1/programmed death-ligand 1 inhibitors.


RNA aptamers and spiegelmers: synthesis, purification, and post-synthetic PEG conjugation.
This unit describes the solid-phase synthesis and downstream processing for RNA oligonucleotides with a length of up to 40 to 50 nucleotides on a 1- to 4-mmol scale with subsequent conjugation to PEG using the L-RNA spiegelmer NOX-E36 as an example. Following synthesis and two-step deprotection, the crude oligonucleotide is purified by preparative reversed-phase HPLC and desalted by tangential flow ultrafiltration. The resulting intermediate amino-modified oligonucleotide is reacted with NHS-ester-activated PEG, and the oligonucleotide-PEG conjugate is obtained after preparative AX-HPLC purification, followed by ultrafiltration and lyophilization. Critical process parameters are described, as well as time considerations and examples for analytical methods used as in-process and quality controls.


Cross-National Differences in the Association Between Parental Work Hours and Time with Children in Europe: A Multilevel Analysis.
This study investigates cross-national differences in the association between parental work hours and parent-child interaction time and explains differences in this individual-level association on the basis of country characteristics. It extends prior research by testing the moderating effects of country characteristics through multilevel analyses and by considering the possibility of selection effects. The presumption was that parents employ strategies to protect family life from work encroachments and that these strategies are enhanced by reconciliation policies, stronger parenthood ideologies, access to part-time work and higher income levels. Multilevel analyses were based on a subset of 5.183 parents in 23 countries from the 2005 European Working Conditions Survey that was complemented with country-level data. The negative association between parental work hours and parent-child time indeed varied significantly across countries and was weaker in countries where formal child care coverage was higher, part-time work was less prevalent, and earnings were lower. The effects of part-time work and earnings mainly applied to mothers. These findings suggest that child care coverage limits the availability of children and that differences in parent-child time between parents who work short and long hours are more pronounced when part-time work is more accessible and affordable.


Evaluating the Performance of ChatGPT in Ophthalmology: An Analysis of Its Successes and Shortcomings.
Foundation models are a novel type of artificial intelligence algorithms, in which models are pretrained at scale on unannotated data and fine-tuned for a myriad of downstream tasks, such as generating text. This study assessed the accuracy of ChatGPT, a large language model (LLM), in the ophthalmology question-answering space. Evaluation of diagnostic test or technology. ChatGPT is a publicly available LLM. We tested 2 versions of ChatGPT (January 9 "legacy" and ChatGPT Plus) on 2 popular multiple choice question banks commonly used to prepare for the high-stakes Ophthalmic Knowledge Assessment Program (OKAP) examination. We generated two 260-question simulated exams from the Basic and Clinical Science Course (BCSC) Self-Assessment Program and the OphthoQuestions online question bank. We carried out logistic regression to determine the effect of the examination section, cognitive level, and difficulty index on answer accuracy. We also performed a post hoc analysis using Tukey's test to decide if there were meaningful differences between the tested subspecialties. We reported the accuracy of ChatGPT for each examination section in percentage correct by comparing ChatGPT's outputs with the answer key provided by the question banks. We presented logistic regression results with a likelihood ratio (LR) chi-square. We considered differences between examination sections statistically significant at a P value of < 0.05. The legacy model achieved 55.8% accuracy on the BCSC set and 42.7% on the OphthoQuestions set. With ChatGPT Plus, accuracy increased to 59.4% ± 0.6% and 49.2% ± 1.0%, respectively. Accuracy improved with easier questions when controlling for the examination section and cognitive level. Logistic regression analysis of the legacy model showed that the examination section (LR, 27.57; P = 0.006) followed by question difficulty (LR, 24.05; P < 0.001) were most predictive of ChatGPT's answer accuracy. Although the legacy model performed best in general medicine and worst in neuro-ophthalmology (P < 0.001) and ocular pathology (P = 0.029), similar post hoc findings were not seen with ChatGPT Plus, suggesting more consistent results across examination sections. ChatGPT has encouraging performance on a simulated OKAP examination. Specializing LLMs through domain-specific pretraining may be necessary to improve their performance in ophthalmic subspecialties. Proprietary or commercial disclosure may be found after the references.


Analysis of the pumpkin phloem proteome provides insights into angiosperm sieve tube function.
Increasing evidence suggests that proteins present in the angiosperm sieve tube system play an important role in the long distance signaling system of plants. To identify the nature of these putatively non-cell-autonomous proteins, we adopted a large scale proteomics approach to analyze pumpkin phloem exudates. Phloem proteins were fractionated by fast protein liquid chromatography using both anion and cation exchange columns and then either in-solution or in-gel digested following further separation by SDS-PAGE. A total of 345 LC-MS/MS data sets were analyzed using a combination of Mascot and X!Tandem against the NCBI non-redundant green plant database and an extensive Cucurbit maxima expressed sequence tag database. In this analysis, 1,209 different consensi were obtained of which 1,121 could be annotated from GenBank and BLAST search analyses against three plant species, Arabidopsis thaliana, rice (Oryza sativa), and poplar (Populus trichocarpa). Gene ontology (GO) enrichment analyses identified sets of phloem proteins that function in RNA binding, mRNA translation, ubiquitin-mediated proteolysis, and macromolecular and vesicle trafficking. Our findings indicate that protein synthesis and turnover, processes that were thought to be absent in enucleate sieve elements, likely occur within the angiosperm phloem translocation stream. In addition, our GO analysis identified a set of phloem proteins that are associated with the GO term "embryonic development ending in seed dormancy"; this finding raises the intriguing question as to whether the phloem may exert some level of control over seed development. The universal significance of the phloem proteome was highlighted by conservation of the phloem proteome in species as diverse as monocots (rice), eudicots (Arabidopsis and pumpkin), and trees (poplar). These results are discussed from the perspective of the role played by the phloem proteome as an integral component of the whole plant communication system.


Thermometry of interstitial hyperthermia given as an adjuvant to brachytherapy for the treatment of carcinoma of the prostate.
Recurrence in the prostatic gland remains a significant problem in the management of locally advanced prostatic cancer. Transperineal thermobrachytherapy has been utilized in an attempt to improve local tumor control. The purpose of this study was to quantitate the temperature distributions obtained in carcinoma of the prostate treated with interstitial radiofrequency-induced hyperthermia given in conjunction with 192Ir brachytherapy in a Phase I study. From 1987 until 1992, 36 patients (5 with locally recurrent, 15 with Stage B, and 16 Stage C prostate cancers) were treated with interstitial brachytherapy implants supplemented with radiofrequency-induced hyperthermia. An array of 7-32 stainless steel trocar electrodes (outer diameter = 1.5 mm, interelectrode spacing = 8 mm) were implanted into the prostate gland through a perineal approach utilizing a specially designed template. Each trocar was electrically insulated along the length which traversed surrounding normal tissues. One to three additional plastic catheters were implanted for automated temperature mapping. Thirty-four of these procedures were performed following lymph node sampling. However, the last two removable interstitial hyperthermic prostate implants were done by the transperineal route under ultrasound guidance. A hyperthermia treatment (goal of 43 degrees C for 45 minutes) was given immediately prior to the insertion and immediately following the removal of the 192Ir. A computer-controlled radiofrequency-based generator (freq. 0.5 MHz) implementing electrode multiplexing was used to induce and maintain elevated temperatures. Transient local pain was the most common treatment limiting factor. The average values of the measured minimum, mean, and maximum temperatures were 38.9 degrees C, 41.9 degrees C, and 45.7 degrees C in tumor, and 37.7 degrees C, 39.8 degrees C, and 42.9 degrees C in surrounding normal tissue, respectively. The percentages of mapped temperatures exceeding 41 degrees C, 42 degrees C, and 43 degrees C were 67%, 46%, and 27% in tumor, and 26%, 11%, and 4% in normal surrounding tissue, respectively. From this study we conclude that heterogeneous temperature distributions were induced in the prostate; significant normal tissue protection was realized in part through the selective insulation of sections of each electrode; and interstitial radiofrequency-induced hyperthermia of the prostate is feasible and well tolerated, with further technical developments warranted.


Percutaneous Transforaminal Endoscopic Decompression for Geriatric Patients with Central Spinal Stenosis and Degenerative Lumbar Spondylolisthesis: A Novel Surgical Technique and Clinical Outcomes.
Percutaneous transforaminal endoscopic decompression (PTED) is an ultra-minimally invasive surgical option for patients that does not involve the same amount of destabilizing facet joint removal as a traditional laminectomy. The objective of this study was to describe the procedure of PTED under local anesthesia for geriatric patients with central spinal stenosis and degenerative lumbar spondylolisthesis (CSS-DLS). From January 2016 to December 2018, 30 consecutive geriatric patients who underwent surgery for single-level CSS-DLS were retrospectively reviewed. All patients were followed for at least 12 months (12-24 months). The visual analog scale (VAS) scores, Oswestry disability index (ODI) scores and modified MacNab criteria were used to evaluate the clinical results. The mean age was 73.1±6.0 years. Follow-up ranged from 12 to 36 months. The mean±SD values of the preoperative VAS for leg pain and ODI were 7.4±1.0 and 67.2±8.4, respectively. The values improved to 2.2±1.1 and 19.9±8.1 at 12 months postoperatively. The outcomes of the modified MacNab criteria showed that 93.3% of patients obtained a good-to-excellent rate. The percent slippage of spondylolisthesis before surgery (13.8±2.5%) and at the end of follow-up (14.0±2.5%) was not significantly different. PTED under local anesthesia could be a useful supplement to traditional decompression in geriatric patients with CSS-DLS.


Cobalt oxide nanoparticles as a novel high-efficiency fiber coating for solid phase microextraction of benzene, toluene, ethylbenzene and xylene from aqueous solutions.
In this work cobalt oxide nanoparticles were introduced for preparation of a novel solid phase microextraction (SPME) fiber coating. Chemical bath deposition (CBD) technique was used in order for synthesis and immobilization of the Co3O4 nanomaterials on a Pt wire for fabrication of SPME fiber. The prepared cobalt oxide coating was characterized by scanning electron microscopy (SEM) and X-ray diffraction (XRD) analysis. The fiber was evaluated for the extraction of benzene, toluene, ethylbenzene and xylene (BTEX) in combination with GC-MS. A simplex optimization method was used to optimize the factors affecting the extraction efficiency. Under optimized conditions, the proposed fiber showed extraction efficiencies comparable to those of a commercial polydimethylsiloxane (PDMS) fiber toward the BTEX compounds. The repeatability of the fiber and its reproducibility, expressed as relative standard deviation (RSD), were lower than about 11%. No significant change was observed in the extraction efficiency of the new SPME fiber after over 50 extractions. The fiber was successfully applied to the determination of BTEX compounds in real samples. The proposed nanostructure cobalt oxide fiber is a promising alternative to the commercial fibers as it is robust, inexpensive and easily prepared.


Elevated plasma inflammatory mediators in post-polio syndrome: No association with long-term functional decline.
A key feature of post-polio syndrome (PPS) is progressive loss of muscle strength. In other chronic diseases systemic inflammation has been linked to muscle wasting. In this study plasma TNF-α, IL-6, IL-8, and leptin levels were significantly increased in PPS-patients compared to healthy controls. There was however no association between these raised systemic levels of inflammatory mediators and long-term decline in quadriceps strength or other clinical parameters. In conclusion, there is evidence for systemic inflammation in PPS, yet the relationship with clinical deterioration remains tenuous.


Tumor inhibition by metallocenes: ultrastructural localization of titanium and vanadium in treated tumor cells by electron energy loss spectroscopy.
The intracellular distribution patterns of the metal atoms titanium and vanadium after in vivo as well as in vitro treatment of Ehrlich ascites tumor with the antitumor agents titanocene dichloride (TDC) or vanadocene dichloride (VDC) have been investigated by use of electron energy loss spectroscopy (EELS). The metals were found mainly accumulated in the nuclear heterochromatin and, to a minor extent, in the nucleolus and in the cytoplasmic ribosomes. In connection with other experimental results it is argued that this accumulation is indicative of the molecular interaction of the metal-containing species with the nucleic acids, especially with the DNA.


Retention of gases by hexadecyltrimethylammonium-montmorillonite clays.
Intercalated montmorillonite clays with different amounts of organic hexadecyltrimethylammonium (HDTMA) cations were studied to analyse their CO, CH(4), and SO(2) gas retentions. Equilibrium adsorption was measured by using a standard volumetric apparatus at 25 degrees C and 0.1 MPa. The solids were characterised by X-ray diffraction. The levels of adsorption of SO(2) by organo-montmorillonites (0.3595-1.6403 mmol/g) were higher than those of CO (up to 0.0202 mmol/g) and CH(4) (up to 0.0273 mmol/g) gases. HDTMA montmorillonites may be effective adsorbents for removing SO(2) and for its potential separation in the presence of CO and/or CH(4) molecules, which can be present in contaminated air.


[Psychoautonomic syndrome in occlusive lesions of the basin of the internal carotid artery].
A complex psychophysiological investigation of 120 patients with occlusions in the territory of the internal carotid artery revealed regular disorders of the suprasegmental vegetative structures manifested as psychovegetative syndrome. This may be considered as one of the cases of limitation of the adaptation capacities of the of these patients.


Applications of Genetic Code Expansion in Studying Protein Post-translational Modification.
Various post-translational modifications can naturally occur on proteins, regulating the activity, subcellular localization, interaction, or stability of the proteins. However, it can be challenging to decipher the biological implication or physiological roles of site-specific modifications due to their dynamic and sub-stoichiometric nature. Genetic code expansion method, relying on an orthogonal aminoacyl-tRNA synthetase/tRNA pair, enables site-specific incorporation of non-canonical amino acids. Here we focus on the application of genetic code expansion to study site-specific protein post-translational modification in vitro and in vivo. After a brief introduction, we discuss possibilities of incorporating non-canonical amino acids containing post-translational modifications or their mimics into target proteins. This approach is applicable for Ser/Thr/Tyr phosphorylation, Tyr sulfation/nitration/hydroxylation, Lys acetylation/acylation, Lys/His mono-methylation, as well as Arg citrullination. The next section describes the use of a precursor non-canonical amino acid followed by chemical and/or enzymatic reactions to afford the desired modification, such as Cys/Lys acylation, ubiquitin and ubiquitin-like modifications, as well as Lys/Gln methylation. We also discuss means for functional regulation of enzymes involving in post-translational modifications through genetically incorporated non-canonical amino acids. Lastly, the limitations and perspectives of genetic code expansion in studying protein post-translational modification are described.


Preferences of Patients and Pharmacists with Regard to the Management of Drug-Drug Interactions: A Choice-Based Conjoint Analysis.
The management of drug-drug interactions (DDIs) is a complex process in which risk-benefit assessments should be combined with the patient's perspective. The aim of this study was to determine patients' and pharmacists' preferences regarding DDI management. We conducted a choice-based conjoint survey about a fictitious DDI concerning the combination of a cardiovascular drug and an antibiotic for pneumonia. Patients and pharmacists had to choose 12 times between two management options. The options were described by five attributes, including risk, benefit and practical consequences. Each attribute could have two different levels, which were varied over the choice tasks. Latent class analysis was used to identify potential classes of respondents with distinct patterns of similar preferences. In total, 298 patients and 178 pharmacists completed the questionnaire. The latent class model for both patients and pharmacists resulted in three classes. For patients, in one class the most importance was attached to avoiding switch of medication (class probability 20%), in a second class to fewer adverse events (41%), and in a third class to blood sampling (39%). For pharmacists, again one class attached the highest importance to avoiding switch of medication (31%). The other classes gave priority to curing pneumonia (31%) and avoiding blood sampling (38%). The results showed diverging preferences regarding DDI management among both patients and pharmacists. Different groups attached different value to risk and benefit versus practical considerations. Awareness of existing variability in preferences among and between pharmacists and patients is a step towards shared decision making in DDI management.


Evaluation of cytokine modulators for asthma.
Th2 cytokines play an important role in producing and maintaining airway inflammation in asthma. As a consequence, there is considerable interest in developing agents that modulate their effects. Therapeutic strategies include decreasing cytokine synthesis or release, blocking their effects by antibodies or soluble receptors, as well as administration of anti-inflammatory cytokines. Initial studies of three of these approaches have shown interesting results. The first is suplatast tosilate, a selective Th2-inhibitor that suppresses the synthesis of IL-4 and IL-5 in vitro. In a randomised double-blind placebo-controlled parallel study, suplatast, given orally TID, improved lung function and symptom control when added to inhaled beclomethasone for 4 weeks and prevented deterioration when the beclomethasone dose was decreased by 50% during a second 4 weeks. The second is CDP840, a second generation phosphodiesterase type 4 inhibitor, that may decrease the release of cytokines from eosinophils and Th2 lymphocytes. In a double-blind placebo-controlled crossover study, CDP840, given orally BID for 9 days, attenuated the late response to allergen by 30% when compared to placebo. The third is a recombinant human soluble IL-4 receptor (altrakincept) that neutralises endogenously produced IL-4. In inhaled steroid-dependent subjects, weekly nebulisation of altrakincept prevented lung function decline and asthma exacerbations after abrupt withdrawal of inhaled corticosteroids. In contrast, studies of anti-IL-5 monoclonal antibodies (mepolizumab and SCH55700) indicate that this strategy only partially depletes eosinophils from the bronchial mucosa and shows no benefit on clinical markers of asthma activity. Of these novel therapeutic approaches, inhibiting Th2 synthesis of IL-4 and IL-5 (suplatast) appears to offer the greatest potential and long-term studies of this approach should be undertaken.


Targeted delivery of antisense oligodeoxynucleotides to folate receptor-overexpressing tumor cells.
A major problem in exploring the full potential of antisense ODN is the lack of a safe and efficient delivery system. In this study a new method has been developed that is highly efficient in encapsulating ODN inside folate receptor (FR)-targeted lipid vesicles. ODN formulated in these vesicles were efficiently protected from degradation by nucleases compared to free ODN. Folate efficiently mediated intracellular delivery of ODN to KB tumor cells that overexpress FR. Delivery of EGFR antisense ODN via FR-targeted lipid vesicles resulted in a significant down-regulation of EGFR expression in KB cells and cell growth inhibition, far more efficient than that with free ODN or ODN encapsulated in ligand-free lipid vesicles. Intracellular delivery of EGFR antisense ODN also sensitized KB cells to doxorubicin (DOX) treatment. Thus targeted delivery of ODN via this novel lipid vector may have potential in treating tumors that overexpress FR.


Drug-Induced Anaphylaxis.
Drugs are among the main triggers of anaphylaxis, but identification of the culprit drug is frequently difficult. To confirm diagnosis of the causative agent, medical records and clinical history are fundamental. There are a few in vitro tests available in clinical practice, such as serum-specific IgE and basophil activation test. Skin tests are often useful for the diagnosis, although drug challenge is indicated in patients with inconclusive clinical history or to provide safe alternatives. Treatment of anaphylaxis is standard and intramuscular epinephrine is the main agent to prevent morbidity and mortality. Rapid desensitization may be indicated in selected cases.


Symbolic play in autistic, Down's, and normal children of equivalent mental age.
The study assessed free play and response to modeled symbolic play with animate toys and realistic and substitute accessories in 10 autistic children and 10 Down's syndrome and 10 normal preschooler controls. Groups were matched on Peabody Picture Vocabulary Test mental age (PPVT MA) range and Mdn (2.5 years). Autistic children played less than controls, imitated less well, and, on structured baseline trials, showed lower level play. Symbolic fluency differentiated all groups in structured play. Symbolic fluency for free and structured play was positively correlated with PPVT MA in autistic children; level of play was most highly correlated with PPVT MA in normal children. Findings suggested impaired imitative capacity and symbolic functioning in autism.


Time course of plant-plant interactions in experimental mixtures of annuals: density, frequency, and nutrient effects.
Stellaria media and Poa annua were grown in a greenhouse over a wide range of mixed densities, and at three nutrient levels. The relative performances and interactions between individuals of both species were assessed over four interharvest growth periods using a new approach based on response functions (Connolly 1987). Species relative performances and interactions were complex, varying through time, and with mixed density and the nutrient environment. Studying the dynamics of the individual, interharvest growth periods led to a different, more accurate mechanistic interpretation of the final yield results, than did studying only one overall period of growth. Starting from considerably smaller seeds, Stellaria averaged twice as much biomass as young Poa plants by harvest 2 (H2). Stellaria achieved this early dominance with little suppression of Poa. Interspecific interference became more significant, and species proportional growth (K) became more similar in the second interharvest period (H2-3). During the final period of growth (H3-4), species relative performances largely reversed, Poa showing greater proportional growth than Stellaria. This superior performance by Poa occured despite individual plants being, on average, one half the size of Stellaria. Lack of interference early on is attributed to complementary above ground resource use resulting from species different shoot architectures (prostrate vs. cespitose). This complementarity disappeared as plants aged and became larger. The decline in Stellaria's superior relative growth performance through time was mainly due to its earlier and more substantial diversion of resources to reproduction. Species perception of each others influence, relative to themselves, as quantified by substitution rates, varied with both mixed density and nutrient environments. Stellaria consistently perceived Poa as less influential at higher nutrient levels than at lower levels. High nutrients favored the production of biomass for Stellaria more than for Poa, particularly in H2-3. While accelerating the switch to reproduction for Stellaria, nutrients did not increase its final reproductive yield per unit biomass. After H2, proportional growth for both species was relatively independent of frequency and density, indicating that a species acted as an aggregate of similarly behaving units of biomass whether arranged on many small, or a few large plants. An example shows that the conclusions from the response function approach applied within can be qualitatively different from those derived from a substitutive approach such as replacement series.


Diquaternized curarelike myorelaxants: structure and biological activity.
This review discusses the most active natural and synthetic curarelike compounds demonstrating myorelaxants activity. The data are grouped according to chemical structures, namely, quinoline and isoquinoline myorelaxants, myorelaxants with saturated heterocyclic or alkylamine fragments, myorelaxants with a steroid framework, natural and synthetic alkaloid myorelaxants.


[Clinical related factors of portal vein tumor thrombosis in patients with hepatocellular carcinoma: a logistic regression analysis].
To investigate the related factors of portal vein tumor thrombosis (PVTT) in patients with HCC. A total number of 234 patients with hepatocellular carcinoma (HCC) were included in this retrospective study. Uni-variate and multi-variate logistic regression analysis were employed to analyze the association between PVTT and 18 routine clinical parameters. Among the 234 patients with HCC, 15% of patients (35/235) had PVTT. Univariate logistic regression analysis revealed significant association of age (P = 0.016), gamma glutamyl transferase (GGT, P = 0.003), number of segmental invasion (P = 0.007), microvascular invasion (P < 0.01), segment location of S2 (P = 0.001), S3 (P = 0.000), S4 (P = 0.004) and S6 (P = 0.016). Multivariate analysis shows potential significant predictors of PVTT in HCC were age (RR: 0.373; 95% CI: 0.146-0.954; P = 0.040), the tumor location of S3 (RR: 4.625; 95% CI: 1.916-11. 165;P = 0.001), GGT (RR: 4.091; 95% CI: 1.448-11.553; P = 0.008) and microvascular invasion (RR: 20.912; 95% CI: 4.745-92.172; P < 0.01). PVTT occurred more commonly in the younger (< 50 years old), and those with high level of GGT, segment location of S3 and microvascular invasion.


Wire-guided intraduodenal ultrasonography using a catheter probe in the differential diagnosis of enlarged ampullary lesions.
It can be difficult to identify the cause of an enlarged ampulla of Vater (AOV). This study evaluated the accuracy of wire-guided intraduodenal ultrasonography (US) for the differential diagnosis of an enlarged AOV during endoscopic retrograde cholangiopancreatography (ERCP). Thirty-four patients with enlarged AOVs of unknown cause identified on imaging studies or endoscopic observations underwent wire-guided intraduodenal US using a catheter probe. The final diagnoses were malignant or premalignant tumors in 10 patients (29.4%), stones in nine patients (26.5%), inflammation in 14 patients (41.2%), and cyst in one patient (2.9%). The overall diagnostic accuracy of intraduodenal US for enlarged AOVs was 91.2%. The diagnostic accuracies of stones, inflammation, and AOV tumors were 100.0%, 94.1%, and 91.1%, respectively. Wire-guided intraduodenal US using a catheter probe is readily applicable during ERCP and may be useful in the differential diagnosis of enlarged ampullary lesions.


Surface characterization of metal oxides-supported activated carbon fiber catalysts for simultaneous catalytic hydrolysis of carbonyl sulfide and carbon disulfide.
The sol-gel method was used to synthesize a series of metal oxides-supported activated carbon fiber (ACF) and the simultaneous catalytic hydrolysis activity of carbonyl sulfide (COS) and carbon disulfide (CS2) at relatively low temperatures of 60°C was tested. The effects of preparation conditions on the catalyst properties were investigated, including the kinds and amount of metal oxides and calcination temperatures. The activity tests indicated that catalysts with 5 wt.% Ni after calcining at 400°C (Ni(5)/ACF(400)) had the best performance for the simultaneous catalytic hydrolysis of COS and CS2. The surface and structure properties of prepared ACF were characterized by scanning electron microscope-energy disperse spectroscopy (SEM-EDS), Brunauer-Emmett-Teller (BET), X-ray diffraction (XRD), carbon dioxide-temperature programmed desorption (CO2-TPD) and diffuse reflectance Fourier transform infrared reflection (DRFTIR). And the metal cation defects were researched by electron paramagnetic resonance (EPR) method. The characterization results showed that the supporting of Ni on the ACF made the ACF catalyst show alkaline and increased the specific surface area and the number of micropores, then improved catalytic hydrolysis activity. The DRFTIR results revealed that -OH species could facilitate the hydrolysis of COS and CS2; -COO and -C-O species could facilitate the oxidation of catalytic hydrolysate H2S. And the EPR results showed that high calcination temperature conditions provide more active reaction center for the COS and CS2 adsorption.


Reciprocal transmission of herpes simplex virus type 1 (HSV-1) between corneal epithelium and trigeminal neurites in an embryonic chick organ culture.
Reciprocal transmission between epithelia and sensory neurons of the peripheral nervous system is a crucial step in the life cycle of herpes simplex virus type 1 (HSV-1) and related alphaherpesviruses. In searching for an easy-to-perform and generally applicable experimental approach that enables the direct analysis of virus transfer between primary epithelial cells and sensory neurites, we investigated the spread of HSV-1 in a dual-chamber organ model comprising chick embryonic corneal epithelia and trigeminal sensory neurons. Embryonic chick corneal and trigeminal tissues were found to be permissive for productive infection with HSV-1. Our data show that HSV-1 efficiently enters neurites re-innervating the cornea and reaches the ganglion explant by retrograde axonal transport, with the first antigen-positive cells being detectable approximately 12 h postinfection. After direct infection of trigeminal tissues, the virus is transported by anterograde axonal transport to the corneal epithelium, causing a visible cytopathic effect approximately 48 h postinfection. These results suggest that the organ model presented in this study holds particular promise for the direct observation and molecular analysis of herpes simplex virus spread between primary epithelia and sensory neurons and that it may be an attractive alternative to current experimental approaches based on laboratory animals or human fetal tissues.


Nutritional evaluation of protein hydrolysate formulas in healthy term infants: plasma amino acids, hematology, and trace elements.
Protein hydrolysate formulas are used for infants with food allergy. Most studies of such formulas focus on their effect on allergy and rarely evaluate their capacity to provide normal nutritional status. We compared plasma aminograms, serum urea nitrogen, and trace element status in breastfed infants, infants fed hydrolysate formulas, and infants fed milk formula. From 6 wk to 6 mo of age, infants were breastfed or fed regular milk formula (RF), 1 of 2 casein-hydrolysate formulas (CH-1 or CH-2), or whey-hydrolysate formula (WH). Anthropometric measures were taken monthly, and blood samples were collected at 6 wk and 6 mo. Plasma amino acids, serum urea nitrogen, hematologic indexes, plasma zinc, and plasma copper were analyzed. There were no significant differences in hemoglobin, serum transferrin receptor, copper, or zinc among groups. Serum ferritin was significantly lower in infants fed the CH formulas than in the other groups. Infants fed CH-2 had significantly higher serum urea nitrogen than did all other groups. Plasma threonine, valine, phenylalanine, methionine, and tryptophan were significantly higher in the hydrolysate formula groups than in the breastfed group. Plasma tyrosine was significantly lower in infants fed the CH formulas than in the breastfed group, whereas arginine was significantly higher in the WH group than in all other groups. Plasma proline was lower, whereas threonine and tryptophan were higher, in the WH group than in the CH groups. The iron status of infants fed CH formula was lower than that of all other groups. The amounts of amino acids provided by hydrolysate formulas appear excessive compared with regular formula, which is reflected by high serum urea nitrogen (CH-2) and high plasma amino acid concentrations. A reduced and more balanced amino acid content of hydrolysate formulas may be beneficial.