KSNM60 in Clinical Nuclear Oncology.
Since the foundation of the Korean Society of Nuclear Medicine in 1961, clinical nuclear oncology has been a major part of clinical nuclear medicine in Korea. There are several important events for the development of clinical nuclear oncology in Korea. First, a scintillating type gamma camera was adopted in 1969, which enabled to perform modern oncological gamma imaging. Second, Tc-99 m generator was imported to Korea since 1979, which promoted the wide clinical use of gamma camera imaging by using various kinds of Tc-99 m labeled radiopharmaceuticals. Third, a gamma camera with single photon emission tomography (SPECT) capability was first installed in 1980, which has been used for various kinds of tumor SPECT imaging. Fourth, in 1994, clinical positron emission tomography (PET) scanner and cyclotron with a production of F-18 fluorodeoxyglucose were first installed in Korea. Fifth, Korean Board of Nuclear Medicine was established in 1995, which contributed in the education and manpower training of dedicated nuclear medicine physicians in Korea. Finally, an integrated PET/CT scanner was first installed in 2002. Since that, PET/CT imaging has been a major imaging tool in clinical nuclear oncology in Korea. In this review, a brief history of clinical nuclear oncology in Korea is described.


Utility of fever, white blood cells, and differential count in predicting bacterial infections in the elderly.
A total of 221 elderly patients between the ages of 70 to 99 years who presented to a community-based teaching hospital emergency room were prospectively evaluated by assessing for fever (greater than or equal to 37.5 degrees C), leukocytosis (greater than or equal to 14,000/mm3) and bandemia (greater than 6%) as a screening method for predicting the presence of bacterial infection. Thirty-three patients had documented bacterial infections. Although with increasing body temperature the percent of patients who were infected increased, 48% of the infected elderly patients had no fever. In patients with fever, 39% had a bacterial infection compared to only 9% in the afebrile group. In patients with fever, leukocytosis, and bandemia, all patients were infected. Conversely, in the absence of fever, leukocytosis, and bandemia, only 6% had bacterial infection. All elderly patients who present with an acute or subacute change in health status or functional capabilities associated with fever, leukocytosis, or bandemia should be carefully assessed for the high probability of a bacterial infection.


T-gamma large granular lymphocyte leukemia associated with amegakaryocytic thrombocytopenic purpura, Sjögren's syndrome, and polyglandular autoimmune syndrome type II, with subsequent development of pure red cell aplasia.
We present a female patient with T-gamma LGL leukemia, who was followed for the last 20 years. Over these years she developed several autoimmune disorders, including Sjögren's syndrome, Hashimoto's thyroiditis, premature ovarian failure (compatible with type II autoimmune polyglandular syndrome), amegakaryocytic thrombocytopenic purpura, and finally pure red cell aplasia. PCR analysis confirmed rearrangement for TCR gamma. This case emphasizes the complex association of LGL leukemia with autoimmune disorders.


[Effect of prolonged loading with lysine on distribution of free amino acids in the brain].
Prolonged loading with small amounts of lysine and a mixture of lysine and metabolism cofactors evokes considerable shifts in the distribution of the amino acid pool in the rat cerebral cortex. Under the influence of lysine the functional activity of the central nervous system improves.


Pyruvate kinase-catalyzed ATP-formation in human red blood cell membranes.
Previous studies on the linkage between enzymatically catalyzed ATP-generating reactions in the red blood cell membrane and the sodium and potassium transport in the control of overall glycolysis of human erythrocytes were controversial. In this study a significant amount of pyruvate kinase activity is shown to be localized within the membrane. Membrane fragments produce 20.5 mumol of ATP per 10(10) membranes per hour from phosphoenolpyruvate and ADP. The kinetics of the membrane-localized pyruvate kinase do not differ from those of the enzyme from hemolysates. The results clearly document the presence of the second ATP-generating enzyme of glycolysis, pyruvate kinase, in human red blood cell membranes. The main fraction of the enzyme is deeply hidden in the lipid layers of the membrane. It can be demasked by mechanical desintegration of membranes at high levels of activity. It is suggested that the amount of the membrane-localized fraction of pyruvate kinase is related to the clinical severity of the hemolytic process in pyruvate kinase deficiency.


Massive peripheral giant-cell reparative granuloma of the jaw: a pregnancy dependent tumor.
The case of a pregnant patient with giant-cell granuloma is presented. Differential diagnosis and treatment are discussed and the literature is reviewed.


Bone Mineral Density and Dickkopf-1 in Adolescents with Non-Deletional Hemoglobin H Disease.
Low bone mineral density (BMD) is prevalent in individuals with β-thalassemia and is associated with increased circulating dickkopf-1 concentration. These data are limited in α-thalassemia. Therefore, we aimed to determine the prevalence of low BMD and the association between BMD and serum dickkopf-1 in adolescents with non-deletional hemoglobin H disease, a form of α-thalassemia whose severity is comparable to β-thalassemia intermedia. The lumbar spine and total body BMD were measured and converted into height-adjusted z-scores. Low BMD was defined as BMD z-score ≤ -2. Participant blood was drawn for measurement of dickkopf-1 and bone turnover marker concentrations. Thirty-seven participants with non-deletional hemoglobin H disease (59% female, mean age 14.6 ± 3.2 years, 86% Tanner stage ≥2, 95% regularly transfused, 16% taking prednisolone) were included. Over one year prior to the study, mean average pretransfusion hemoglobin, ferritin and 25-hydroxyvitamin D concentrations were 8.8 ± 1.0 g/dL, and 958 ± 513 and 26 ± 6 ng/mL, respectively. When participants taking prednisolone were excluded, the prevalence of low BMD at the lumbar spine and total body was 42% and 17%, respectively. BMD at both sites was correlated positively with body mass index z-score, and negatively with dickkopf-1 (all p-values <0.05). There were no correlations among dickkopf-1, 25-hydroxyvitamin D, osteocalcin and C-telopeptide of type-I collagen. Multiple regression analysis showed dickkopf-1 inversely associated with total body BMD z-score adjusting for sex, bone age, body mass index, pre-transfusion hemoglobin, 25-hydroxyvitamin D, history of delayed puberty, type of iron chelator and prednisolone use (p-value = 0.009). We demonstrated a high prevalence of low BMD in adolescents with non-deletional hemoglobin H disease. Moreover, dickkopf-1 inversely associated with total body BMD suggesting it may serve as a bone biomarker in this patient population.


The Prevalence of Tuberous/Constricted Breast Deformity in Population and in Breast Augmentation and Reduction Mammaplasty Patients.
The exact prevalence of tuberous breast deformity (TBD) has not been properly investigated and still remains undetermined. We report our data about TBD prevalence with the aim of demonstrating its high prevalence. A retrospective analysis was performed on preoperative photographs of 1600 Caucasian female patients admitted to our department from January 2009 to July 2014 for augmentation or reduction mammaplasty and other breast clinical conditions. The main features of TBD included a contracted skin envelope, a reduction in breast parenchyma of the lower medial and lateral quadrants, a constricted breast base, abnormal elevation of the inframammary fold, herniation of the breast into the areola with a constricted breast base, and nipple areola complex herniation with a normal breast base. Patients were classified into three groups: breast augmentation group (AUG group), breast reduction group (RED group), and general population group (POP group). Four hundred patients were analyzed for each group (AUG and RED group); 194 patients (48.5 %) and 189 cases (47.3 %), respectively, demonstrated at least one tuberous breast deformity; in 800 patients of the POP group, we found 221 patients (27.6 %) with at least one tuberous breast deformity. Retrospective analysis reveals a high prevalence of TBD in the general population and in particular in women seeking breast augmentation or breast reduction (about 50 %). TBD is characterized by a wide range of clinical features with a spectrum of degrees. Preoperative evaluation is crucial to achieve an optimum outcome and patient satisfaction. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .


Accuracy of maxillary repositioning surgery using CAD/CAM customized surgical guides and fixation plates.
The advent of three-dimensional imaging and computer-aided surgical simulation (CASS) have brought about a paradigm shift in surgical planning. The aim of this study was to assess the accuracy of maxillary repositioning surgery using computer-aided design and manufacturing (CAD/CAM) customized titanium surgical guides and fixation plates. Thirty consecutive adult patients, 13 male and 17 female, with a mean age of 29.2 years and 25.5 years, respectively, requiring Le Fort I maxillary osteotomy, with or without simultaneous mandibular surgery, were evaluated retrospectively. All orthognathic surgeries were performed by one experienced surgeon. The pre-surgical and post-surgical volumetric imaging were superimposed to assess the linear and angular differences between the planned and actual positions of the maxilla following surgery. With the use of the CAD/CAM titanium surgical guides and fixation plates, all surgical movements were within 2mm and 4° of the planned movements, which is considered clinically insignificant. The overall root mean square error between the planned and actual surgical movements was 0.38mm in the transverse dimension, 0.64mm in the anteroposterior dimension, and 0.55mm in the vertical dimension. In regard to the centroid of the maxilla, the absolute angular difference of the maxillary centroid was 1.06° in pitch, 0.47° in roll, and 0.49° in yaw. Maxillary repositioning surgery can be performed with high accuracy using CAD/CAM titanium surgical guides and fixation plates.


Imaging of electric and magnetic fields near plasmonic nanowires.
Near-field imaging is a powerful tool to investigate the complex structure of light at the nanoscale. Recent advances in near-field imaging have indicated the possibility for the complete reconstruction of both electric and magnetic components of the evanescent field. Here we study the electro-magnetic field structure of surface plasmon polariton waves propagating along subwavelength gold nanowires by performing phase- and polarization-resolved near-field microscopy in collection mode. By applying the optical reciprocity theorem, we describe the signal collected by the probe as an overlap integral of the nanowire's evanescent field and the probe's response function. As a result, we find that the probe's sensitivity to the magnetic field is approximately equal to its sensitivity to the electric field. Through rigorous modeling of the nanowire mode as well as the aperture probe response function, we obtain a good agreement between experimentally measured signals and a numerical model. Our findings provide a better understanding of aperture-based near-field imaging of the nanoscopic plasmonic and photonic structures and are helpful for the interpretation of future near-field experiments.


A case study of pyoderma gangrenosum.
Pyoderma gangrenosum is a rare neutrophilic dermatosis seen initially as painful pustules or bullae on the skin that rapidly ulcerate and have a characteristic raised, purplish areola surrounding them. It is often associated with inflammatory bowel disease and less commonly with other systemic diseases, such as myelofibrosis, rheumatoid arthritis, and chronic active hepatitis. Pyoderma gangrenosum involving the hand is a rare entity, with only two previous cases reported in the literature. This article describes a patient with myelofibrosis in whom pyoderma gangrenosum of the hand developed after she underwent splenectomy.


The consequences of neurodegenerative disease on neuron-astrocyte metabolic and redox interactions.
Brain metabolic pathways relating to bioenergetic and redox homeostasis are closely linked, and deficits in these pathways are thought to occur in many neurodegenerative diseases. Astrocytes play important roles in both processes, and growing evidence suggests that neuron-astrocyte intercellular signalling ensures brain bioenergetic and redox homeostasis in health. Moreover, alterations to this crosstalk have been observed in the context of neurodegenerative pathology. In this review, we summarise the current understanding of how neuron-astrocyte interactions influence brain metabolism and antioxidant functions in health as well as during neurodegeneration. It is apparent that deleterious and adaptive protective responses alter brain metabolism in disease, and that knowledge of both may illuminate targets for future therapeutic interventions.


Focal ectasia of the terminal bowel accompanying low anal deformities.
Three patients were treated at birth for low anal deformities and developed intractable constipation, not imputable to usual causes of rectal inertia. Barium enema, done the first time at ten days of age in one case, revealed focal ectasia of the terminal bowel, with a peculiar "balloon-like" aspect of the rectum. Optimal treatment includes resection of the terminal bowel down to the dentate line. Incidence of this anomaly in association with low anal deformities has been 5% in our series.


Ophthalmic herpes zoster with contralateral hemiparesis: a case report.
Herpes zoster of the ophthalmic division of the left fifth cranial nerve with contralateral hemiparesis was observed in a 30-year-old man. Left carotid angiography showed segmental constrictions consistent with cerebral arteritis, possibly provoked by direct viral infection along the intracranial part of the ophthalmic nerve. An ischaemic lesion revealed by computed tomographic scan was considered secondary to arteritis and responsible for the hemiparesis. The presence of an immune response within the blood-CSF barrier was suggested by an increase of oligoclonal CSF IgG and IgA.


Analysis of serotonin and derivatives by reversed-phase ion-pair partition chromatography with fluorometric and electrochemical detection.
A flexible and efficient system is described for reversed-phase ion-pair partition-chromatographic analysis of serotonin, its precursors tryptophan and 5-hydroxytryptophan, its main metabolite 5-hydroxyindoleacetic acid, and tryptamine. The chromatographic system consists of tri-n-butylphosphate as stationary phase and buffered water-methanol mixtures, containing perchlorate, as mobile phases. Retention can be selectively influenced by means of the pH, the perchlorate concentration, and the methanol content of the mobile phase, as well as the temperature of the phase system. The compounds of interest can be separated within 10 min and no interference from catecholamines and derivatives was observed. Compared with electrochemical detection, fluorometric detection yielded more favourable detection limits and was more selective when supernatants of brain tissue homogenates were directly injected. Both detection systems showed inadequate selectivity if urine samples were directly injected, but 5-hydroxyindoleacetic acid could readily be assayed.


Apnea associated with Chiari malformation: medullary hemorrhage revealed by MRI.
Medullary hemorrhage in the medulla oblongata of an infant with Chiari malformation, hydrocephalus, meningomyelocele and hypogenesis of the corpus callosum is reported. Four days after placement of a ventriculoperitoneal shunt, spontaneous respiration diminished. Magnetic resonance imaging (MRI) successfully revealed a small medullary hemorrhage.


Sunlight concurrently reduces Prymnesium parvum elicited acute toxicity to fish and prymnesins.
Prymnesium parvum continues to spread globally, producing harmful algal blooms that release toxins known to cause fish kills. While previous work has identified possible P. parvum toxin(s) (e.g., prymnesins, fatty acids, fatty acid amides) and investigated treatment strategies targeted at minimizing cell abundance, studies examining efficacy of treatment approaches to remove toxins are lacking. To understand influences of sunlight on toxins stability and toxicity to fish, acutely toxic P. parvum cultures were exposed to three light scenarios (lab dark control, field dark, and field light) and then evaluated for acute toxicity to fish and prymnesins abundance. Previous work showed acute toxicity to fathead minnow larvae was ameliorated after 2 h of sunlight exposure, and results observed herein found an identical trend. Acute toxicity disappeared in light exposed filtrate, but filtrate exposed to 35 °C without sunlight remained acutely toxic to fish. Additionally, six prymnesins were identified through high-resolution mass spectrometry and abundance corresponded to acute toxicity levels. Prymnesins were present at the highest level in filtrate that was acutely toxic but diminished in filtrate that was exposed to light and correspondingly ameliorated acute toxicity to fish. These findings suggest prymnesins are responsible for measured acute toxicity and are photo-labile, which represents an important implication for treatment strategies.


One injection of cocaine produces a long-lasting increase in [3H]-dopamine release.
A single cocaine exposure has been reported to sensitize animals to the behavioral effect of subsequent cocaine administration for up to one week. We now report that a single injection of cocaine results in an augmentation in amphetamine-induced release of tritium from rat striatal slices preloaded with [3H]-dopamine. The augmentation appears within 24 hr and persists for at least 2 weeks after injection. This increase in release may result in increased synaptic concentrations of dopamine possibly caused by a change in the membrane transporter for dopamine. Increased dopaminergic synaptic transmission could explain behavioral sensitization.


Atypical axon-Schwann cell relationships in the common peroneal nerve of the dystrophic mouse: an ultrastructural study.
Several atypical features of myelination of the peripheral nervous system are reported in common peroneal nerve of dystrophic mice (129 Re J dy/dy): (i) central nervous system-like contact between myelin sheaths of adjacent nerve fibres; (ii) nodes and internodes of myelinated fibres enwrapped with cytoplasmic processes of Schwann cells from adjacent nerve fibres; (iii) Schwann cells of adjacent nerve fibres co-operating in formation of a single myelin sheath; and (iv) a single Schwann cell myelinating two separate axons. In view of the presence of similar features of myelination in the central nervous system, where the myelin producing cells lack basement membrane, we suggest that in the dystrophic peripheral nerves the development of these features can be attributed to the partial deficiency of the Schwann cell basement membrane. Two types of widened nodes of Ranvier are also identified: (i) nodes with paranodal damage; and (ii) nodes without paranodal damage. In addition, abnormal features of myelination are described which are likely to represent altered Schwann cell/axon relationships during demyelination and remyelination and/or decreased myelinating ability of Schwann cells. We interpret these findings as indicating a metabolic disorder of Schwann cells. They provide an experimental model for the investigation of factors involved in the origin and maintenance of the structural organization of peripheral nerve.


Acetabular UHMWPE survival and wear changes with different manufacturing techniques.
Polyethylene wear may be affected by the type of polyethylene resin, manufacturing technique, degree of thermal stabilization, and sterilization technique. We therefore compared femoral head penetration into the PE and cup survival using the same cup system with different PE resins, manufacturing, and sterilization techniques. Our study group consisted of 1912 THAs performed using the same uncemented cup and identical 28-mm cobalt-chrome heads. The polyethylene varied as follows: Group 1 (94 cups), GUR 4150 resin, ram-extruded, sterilized in air, no barrier packaging; Group 2 (74 cups), same as Group 1 but sterilized in argon; Group 3 (75 cups), Himont 1900 resin, compression-molded bar stock, sterilized in argon, no barrier packaging; Group 4 (620 cups), same as Group 3 except with barrier packing; Group 5 (711 cups), GUR 1050 resin, compression-molded bar stock, sterilized in argon gas with barrier packaging; and Group 6 (338 cups), GUR 1050 resin, compression-molded bar stock, sterilized in argon with barrier packaging, irradiated with 50 kGy, heated below melting temperature, machined, and finally placed in nonbarrier packaging with gas plasma sterilization. Minimum followup was 2 years (average, 7 years; range, 2-17 years). Femoral head penetration averaged 0.05 mm per year for Groups 5 and 6 and was substantially lower than for Groups 1 to 4. Cup survival was higher at seven years in Groups 3, 4, and 5, and at 10 years in group 4 when compared to groups 1, 2, and 3. We observed lower FHP rates and higher cup survival with polyethylene machined from direct compression-molded bar stock, sterilized in argon gas, with barrier packaging. Level III Therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.


Sulfur-oleyl amine platelet derivatives with liquid crystalline behavior.
A novel sulfur-based platelet derivative was synthesized by reacting elemental sulfur with oleyl amine. The sulfur-oleyl amine (S-OA) derivative has an ionic salt form, layered morphology and forms a highly lamellar structure. Polarized optical microscopy (POM) clearly shows the birefringent lyotropic liquid crystalline behavior of the S-OA platelets dispersions.


Effects of various coryneforms on mononuclear phagocyte system function and on production of tumour necrosis factor in mice.
Vaccines of 6 strains of the genera Corynebacterium and Propionibacterium were tested for induction of hepatosplenomegaly and stimulation of clearance of injected colloidal carbon and viable Listeria monocytogenes. These effects were compared with the ability of these strains to support the endotoxin-induced liberation of tumour necrosis factor, interferon and heat-stable cytostatic factors in mouse circulation. Five strains caused good stimulation of macrophage functions and induced high levels of all factors. One strain was nearly lacking in macrophage stimulatory capacity and also failed to support factor production. These data are discussed in relation to the production mechanisms of the factors.


Effects of extremely low frequency electromagnetic fields on hematologic and immunologic parameters in welders.
Electric arc welding is known to cause considerable exposure to extremely low frequency magnetic fields. Although some studies of exposure to magnetic fields and epidemiologic studies have included groups of welders, typically little information is available concerning the hematologic and immunologic effects of ELF electromagnetic fields on welders. Therefore, the aim of the present study is to investigate whether or not extremely low frequency electromagnetic fields (ELF EMF) emitted from electric arc welding affect some hematologic and immunologic parameters of welders. The study was carried out on 16 male welders and 14 healthy males between 20 and 40 years of age from the same geographic area and with similar life styles. The following hematologic and immunologic parameters were measured in both groups: red blood cells (RBC); hemoglobin (Hgb); hematocrit (Hct); platelets (Plt); total white blood cells (WBC); neutrophils; lymphocytes; eosinophils; and CD3, CD4, CD8, and CD4/CD8. Some of the hematologic and immunologic parameters under investigation were similar in both groups. Although T lymphocyte surface antigens, such as levels of CD4 and CD8(,) were found to be lower in the welders than in the control subjects (p <0.001, p <0.05), the hematocrit levels of the welders were found to be higher than those of the control subjects (p <0.05). However, the differences observed were not clinically significant. ELF electromagnetic field intensities in the welding areas varied between 0.10 and 0.25 mT. These results suggest that ELF electromagnetic fields do not affect the hematologic and immunologic parameters of welders.


Electrocardiographic criteria of left ventricular hypertrophy in general population.
The question on whether the electrocardiographic criteria are reliable for detection of left ventricular hypertrophy (LVH) and play a role in predicting outcome is open. Answer can only proceed from population-based studies over unselected people followed up for years. In this study, 1,699 subjects from general population underwent echocardiogram and standard electrocardiogram (ECG) codified for LVH with Minnesota code and with other five methods. Other items were also recorded and used as covariables. Left ventricular mass index (LVMI) was 127.6 +/- 44.9 g m(-2) in men and 120.8 +/- 41.2 g m(-2 )in women, and correlated directly with age in both genders. Prevalence of echocardiographic LVH was 36.6% in men and 53.4% in women. LVMI correlated directly with the Sokolow-Lyon score in both genders at any age, with the Romhilt-Estes, Cornell and R(aVL) scores in all subjects but elderly men, and with the Lewis score in men and women aged < or =69 years. Sensitivity and the predictive value of electrocardiographic tests, as well as the prevalence of LVH diagnosed with electrocardiographic criteria, were always low. Specificity was high for all the tests, and in particular for the Cornell index. Only when diagnosed with echocardiogram or with the Sokolow-Lyon criterion, LVH was an independent predictor of mortality. We conclude that electrocardiographic tests cannot be used as a surrogate of echocardiogram in detecting LVH in the general population because their positive predictive value (PPV) is unacceptably low. On the contrary, they could replace echocardiography in the follow up and for prediction of outcome, when LVH has previously been correctly diagnosed with other methods.


Post removal prior to retreatment.
Removing posts from root canals prior to endodontic retreatment is often a challenge. The Gonon post removing system (Thomas Extracteur De Pivots; FFDM-Pneumat, Bourges, France) is safe and efficient and can be used for anterior, bicuspid, and even molar teeth. The Gonon system is illustrated with one clinical case.


Safety of early antiplatelet administration in patients with acute ischemic stroke treated with alteplase (SEAPT-24).
Alteplase, a tissue-type plasminogen activator, is recommended for ischemic stroke patients presenting within 4.5 h. Due to bleeding risks, current guidelines advise delaying antiplatelet therapy for 24 h after alteplase. However, specific scenarios may require antiplatelet therapy to be given within the 24 h window. This study aimed to examine the safety of early antiplatelet therapy administration within the first 24 h after alteplase. This study is a retrospective, observational study of adult patients with acute ischemic stroke who received alteplase across a multi-hospital system. Patients were grouped based on early antiplatelet therapy (within 24 h window) or as recommended per guidelines. The occurrence of bleeding events, including symptomatic intracranial hemorrhage and/or gastrointestinal bleeding, in-hospital mortality, unfavorable outcomes (modified Rankin score 3-6), and hospital length of stay, were compared between groups. Patients were predominantly African American (72%) and female (53%) with a median age of 62 years. Median baseline NIHSS scores were higher in the early group (5 vs. 7; p = 0.04), and patients in the early group were more likely to undergo endovascular therapy (26% vs. 8%, p < 0.0001). In patients treated with alteplase only and who did not undergo endovascular therapy, there was no difference in symptomatic intracranial hemorrhage (1.4% vs. 0%, p = 0.1), gastrointestinal bleeding, in-hospital mortality, unfavorable outcomes, or length of stay. In our retrospective analysis, early administration of antiplatelet therapy (< 24 h post-alteplase) did not increase the risk of symptomatic intracranial hemorrhage, gastrointestinal bleeding, or unfavorable outcomes in patients who received alteplase alone for management of acute ischemic stroke. Prospective studies are needed to validate these findings.


Metabotropic glutamate receptor activation produces extrapyramidal motor system activation that is mediated by striatal dopamine.
Little is known about the in vivo function of the GTP-binding protein-coupled "metabotropic" excitatory amino acid (EAA) receptor. In vitro studies on agonist-induced brain phosphoinositide hydrolysis have shown that (1S,3R)-1-aminocyclopentane-1,3-dicarboxylic acid is a highly selective and efficacious metabotropic EAA agonist. We have recently reported that in vivo unilateral intrastriatal injection of (1S,3R)-1-aminocyclopentane-1,3-dicarboxylic acid induces transient extrapyramidal motor activation that manifests itself as contralateral turning. In this study, we fully characterized the onset of turning behavior following intrastriatal (1S,3R)-1-aminocyclopentane-1,3-dicarboxylic acid injection and the possible involvement of striatal dopamine neurons in the mediation of this effect. Rats were anesthetized with the short-acting agent halothane to allow for rapid surgical recovery and thus early behavioral measurements. Intrastriatal (1S,3R)-1-aminocyclopentane-1,3-dicarboxylic acid (1 mumol/2 microliters) produced an incremental increase in contralateral turning starting at 1 h and plateauing 3-6 h after injection (peak effect, 39.1 +/- 6.7 rotations per 5 min). Dopamine depletion with alpha-methyl-DL-p-tyrosine (250 mg/kg i.p., 80% depletion) resulted in greater than 85% inhibition of (1S,3R)-1-aminocyclopentane-1,3-dicarboxylic acid-induced contralateral turning. The dopamine antagonist haloperidol (0.3 mg/kg i.p.) produced 48% inhibition of the (1S,3R)-1-aminocyclopentane-1,3-dicarboxylic acid response. In time course studies, turning behavior correlated with increases in levels of the dopamine metabolites 3,4-dihydroxyphenylacetic acid and homovanillic acid. These results suggest a functional interaction between the metabotropic EAA receptor and the dopaminergic system in the striatum.


Polyol accumulation in human placenta and umbilical cord.
Ultrafiltrable metabolites in human term placenta and umbilical cord were analysed by means of 13C-NMR spectroscopy and gas-liquid chromatography. In these tissues, existing in a very reduced redox state, lactate and polyols (sorbitol, myoinositol and xylitol) were found to be the major accumulated intermediates of the glycolytic pathways. The cord tissue preferentially took up myoinositol.


Induction of profound hypothermia modulates the immune/inflammatory response in a swine model of lethal hemorrhage.
Profound hypothermic arrest ("suspended animation") is a new strategy to improve outcome following uncontrolled lethal hemorrhage (ULH). However, the impact of this approach on the immune/inflammatory response is unknown. This experiment was conducted to test the influence of profound hypothermia on markers of immune/inflammatory system. ULH was induced in 32 female swine (80-120 lb) by creating an iliac artery and vein injury, followed 30 min later by laceration of the descending thoracic aorta. Through a left thoracotomy approach, total body hypothermic hyperkalemic metabolic arrest was induced by infusing organ preservation fluids into the aorta using a cardiopulmonary bypass machine (CPB). Experimental groups were (1) normothermic controls (no cooling, NC), or hypothermia induced at the following rates: (2) 0.5 degrees C/min (slow, SC), (3) 1 degrees C/min (medium, MC) and (4) 2 degrees C/min (fast, FC). Vascular injuries were repaired during 60 min of profound (10 degrees C) hypothermic arrest. Hyperkalemia was reversed by hypokalemic fluid exchange, and blood was infused for resuscitation during re-warming (0.5 degrees C/min). The surviving animals were monitored for 6 weeks. Levels of IL-1, TNFalpha, IL-6, IL-10, TGF-1 beta and heat shock protein (HSP-70) were measured by ELISA in serum samples collected serially during the experiment and post-operatively. Some of the immune markers were influenced by the use of CPB, independent of hypothermia (decrease in TGF-1 beta and increase in IL-1 beta). Hypothermia caused a significant decrease in IL-6, and an increase in HSP-70 expression compared to normothermic controls, independent of the cooling rate. An increase in IL-10 levels was noted which was influenced by the rate of cooling (p<0.05, MC versus NC). Profound hypothermia modulates the post-shock immune/inflammatory system by attenuating the pro-inflammatory IL-6, increasing anti-inflammatory IL-10 and augmenting the protective heat shock responses.


A new prostatic stent for the treatment of benign prostatic hyperplasia in high-risk patients.
The objective of this study was to evaluate the efficacy and safety of a new prostatic stent (Trestle((R)), Boston Scientific Microvasive) for the treatment of BPH in patients with complete urinary retention and considered to be inoperable. The efficacy of the stent was evaluated in terms of return of micturition, level of patient satisfaction, uroflowmetry and residual urine. Any stents removed were examined by infrared spectrophotometry for the presence of crystalline encrustations. From December 1997 to April 1999, 20 stents were inserted under local anaesthesia in 17 patients aged 54-90 years. Stents remained in place for an average of 3.5 months. Two migrations were reported. The mean maximum flow rate was 13.7 ml/s and the mean residual urine was 110 ml. The infrared spectrophotometry study revealed a glycoprotein film on stents in place for 1-6 months, accompanied by uric acid crystals on stents in place for 9 months. The Trestle prostatic stent is effective and constitutes a good alternative to surgical treatment in patients with a high operative risk.


Determination of total viable count (TVC) in chicken breast fillets by near-infrared hyperspectral imaging and spectroscopic transforms.
Near infrared (NIR) hyperspectral imaging (HSI) and different spectroscopic transforms were investigated for their potential in detecting total viable counts in raw chicken fillets. A laboratory-based pushbroom hyperspectral imaging system was utilized to acquire images of raw chicken breast fillets and the resulting reflectance images were corrected and transformed into hypercubes in absorbance and Kubelka-Munck (K-M) units. Full wavelength partial least regression models were established to correlate the three spectral profiles with measured bacterial counts, and the best calibration model was based on absorbance spectra, where the correlation coefficients (R) were 0.97 and 0.93, and the root mean squared errors (RMSEs) were 0.37 and 0.57 log10 colony forming units (CFU) per gram for calibration and cross validation, respectively. To simplify the models, several wavelengths were selected by stepwise regression. More robustness was found in the resulting simplified models and the model based on K-M spectra was found to be excellent with an indicative high ratio of performance to deviation (RPD) value of 3.02. The correlation coefficients and RMSEs for this model were 0.96 and 0.40 log10 CFU per gram as well as 0.94 and 0.50 log10 CFU per gram for calibration and cross validation, respectively. Visualization maps produced by applying the developed models to the images could be an alternative to test the adaptability of a calibration model. Moreover, multi-spectral imaging systems were suggested to be developed for online applications.


Turnover of phosphatidyl choline and changes in enzymatic activity in cell membranes of the CNS during early myelination.
Subfractions of fraction A, which floats on top on 0.8 M sucrose in the classical density gradient used for the isolation of brain subcellular fractions (A1 corresponding in adult rats to myelin and A2 which corresponds to the myelin-like fraction), were studied in comparison to other brain subcellular fractions in 5 day old rats and at different stages of development, up to 60 days of age. Variations in the enzymatic activity of acetylcholinesterase, non-specific cholinesterase and 2',3'-Cyclic nucleotide phosphohydrolase, changes in lipid and protein composition and turnover of phosphatidyl choline were investigated. Results indicate that fractions A1 and A2 obtained prior to the beginning of myelination could be composed of fragments of the oligodendroglial cell plasma membranes, and that both fractions undergo substantial changes in chemical composition, enzymatic activity and in turnover of phosphatidyl choline during maturation. In vivo experiments at short times, using radioactive choline as a precursor of phosphatidylcholine suggest that membrane fragments isolated in fraction A2 are precursors of those isolated in fraction A1 at all ages.


Law, professional ethics and the problem of conflict with personal values.
There are, on occasions, instances in which a nurse may not agree with a given medical order of prescribed treatment. This is particularly likely in cases involving the use of extraordinary means of life-saving treatments on chronically or terminally ill patients. In such instances, the nurse may either (1) refuse to carry out the given medical order(s) or (2) refuse/decline to care for the patient in question (e.g. the nurse may instead request to be assigned a different patient in an attempt to avoid a personal dilemma). In cases where medical orders stand to violate the law, a nurse's refusal to carry out the medical order(s) in question might be seen to be fully justified; where medical orders violate nothing more than a philosophical or personal sense of right and wrong, however, justification for refusing to carry out such orders may not seem so defensible. This paper will critically examine the questions of when, if ever, a nurse might be justified on other than legal grounds (given the sometimes inappropriate and inadequate nature of law) to either (1) refuse to carry out a doctor's orders or (2) refuse/decline to care for a given patient. These questions will be discussed in relation to a real life scenario.


Functional and histological effects of intravaginal electrical stimulation on the pelvic muscles: a study in the rat.
We studied functional and histological effects of electrical stimulation (ES) on pelvic muscles of the rat. With intravaginal electrodes, the musculus pubococcygeus and musculus iliococcygeus in the awake animal were stimulated three times 6 min per day with 5 min of rest in between, 5 days per week, 7 consecutive weeks with a biphasic rectangular symmetrical current of 25 Hz, 400-mus pulse duration, on/off time of 5/10 and with an amplitude of 2-4 mA. A "sham group" received the same handling but no stimulation. Contraction measured with intra-rectal pressure during stimulation increased more in the stimulated than in the sham group, but did not reach statistical significance probably due to low power. The 2A fast fibres increased with 14% in the musculus iliococcygeus and with 6% in the musculus pubococcygeus. Type 1 slow fibres did not change. Increased capillary density was found after stimulation. Repeated intravaginal ES has mainly an influence on the fast fibres in the pelvic muscles. To influence slow fibres, another stimulation program or current parameters would seem necessary.


The cyclo-oxygenase 2 promoter is induced in nontarget cells following adenovirus infection, but an AU-rich 3'-untranslated region destabilization element can increase specificity.
Cyclo-oxygenase 2 (Cox-2) is expressed in many types of tumors, but typically undetectable in normal tissues. However, Cox-2 is known to be induced following infection by many microbial agents, which might threaten the tumor selectivity of the Cox-2 promoter in the context of virotherapy or viral gene delivery. Cox-2 expression is regulated in part post-transcriptionally by stimulation or inhibition of mRNA degradation by 3'-untranslated region (3'-UTR) AU-rich elements. In the present study, we investigated the induction of the Cox-2 promoter both in normal and tumor cells after adenovirus infection and explored the utility of AU-rich elements for regaining promoter selectivity. Nontumor and tumor cells were transfected in vitro and in vivo with plasmids containing the Cox-2 or cytomegalovirus immediate early promoter driving luciferase (with or without 3'-UTR elements) followed by adenoviral infection. Selectivity and activity of the promoters and 3'-UTR elements were analysed by luciferase assay and in-vivo imaging. The Cox-2 promoter was induced in both normal and tumor cells following infection with E1 containing replicative adenoviruses but not in the absence of E1. Utilization of AU-rich elements counteracted promoter induction in vitro and in vivo in nonmalignant cells but not in cancer cells, thus increasing the selectivity of the approach ten-fold without loss of potency. Adenoviral infection induces the Cox-2 promoter in normal and tumor cells, which might compromise specificity of the promoter. Utilization of AU-rich destabilization elements can rescue the tumor selectivity of the promoter.


A Systematic Evaluation of Field-Based Screening Methods for the Assessment of Anterior Cruciate Ligament (ACL) Injury Risk.
Laboratory-based measures provide an accurate method to identify risk factors for anterior cruciate ligament (ACL) injury; however, these methods are generally prohibitive to the wider community. Screening methods that can be completed in a field or clinical setting may be more applicable for wider community use. Examination of field-based screening methods for ACL injury risk can aid in identifying the most applicable method(s) for use in these settings. The objective of this systematic review was to evaluate and compare field-based screening methods for ACL injury risk to determine their efficacy of use in wider community settings. An electronic database search was conducted on the SPORTDiscus™, MEDLINE, AMED and CINAHL databases (January 1990-July 2015) using a combination of relevant keywords. A secondary search of the same databases, using relevant keywords from identified screening methods, was also undertaken. Studies identified as potentially relevant were independently examined by two reviewers for inclusion. Where consensus could not be reached, a third reviewer was consulted. Original research articles that examined screening methods for ACL injury risk that could be undertaken outside of a laboratory setting were included for review. Two reviewers independently assessed the quality of included studies. Included studies were categorized according to the screening method they examined. A description of each screening method, and data pertaining to the ability to prospectively identify ACL injuries, validity and reliability, recommendations for identifying 'at-risk' athletes, equipment and training required to complete screening, time taken to screen athletes, and applicability of the screening method across sports and athletes were extracted from relevant studies. Of 1077 citations from the initial search, a total of 25 articles were identified as potentially relevant, with 12 meeting all inclusion/exclusion criteria. From the secondary search, eight further studies met all criteria, resulting in 20 studies being included for review. Five ACL-screening methods-the Landing Error Scoring System (LESS), Clinic-Based Algorithm, Observational Screening of Dynamic Knee Valgus (OSDKV), 2D-Cam Method, and Tuck Jump Assessment-were identified. There was limited evidence supporting the use of field-based screening methods in predicting ACL injuries across a range of populations. Differences relating to the equipment and time required to complete screening methods were identified. Only screening methods for ACL injury risk were included for review. Field-based screening methods developed for lower-limb injury risk in general may also incorporate, and be useful in, screening for ACL injury risk. Limited studies were available relating to the OSDKV and 2D-Cam Method. The LESS showed predictive validity in identifying ACL injuries, however only in a youth athlete population. The LESS also appears practical for community-wide use due to the minimal equipment and set-up/analysis time required. The Clinic-Based Algorithm may have predictive value for ACL injury risk as it identifies athletes who exhibit high frontal plane knee loads during a landing task, but requires extensive additional equipment and time, which may limit its application to wider community settings.


Aggressive digital papillary adenocarcinoma presenting as a paronychia of the finger.
Aggressive digital papillary adenocarcinoma is a rare skin adnexal tumour, which has a predilection for the digits. We report a case of this tumour presenting as a simple nail bed infection.


The optimum regime for the administration of misonidazole and the establishment of multi-centre clinical trials.
The amount of misonidazole which may be given to one patient is limited because of the risk of neurotoxicity. The drug may be given with every treatment of a multi-fraction course of radiotherapy or only with some of the treatments. The number of radiotherapy treatments can be reduced or multiple treatments given after each dose of the drug. Experience in 19 patients given daily doses of misonidazole is reported. This is practical regime to be considered for clinical trials of this hypoxic cell sensitizer.


Maternal smoking during pregnancy and child emotional problems: the relevance of maternal and child 5-HTTLPR genotype.
Serotonin is involved in the development of neural circuits modulating emotional behavior. The short allele (s) of a polymorphism (5-HTTLPR) of the serotonin transporter gene is a risk factor for psychopathology in the presence of environmental stressors. Maternal smoking is associated with growth restriction of the human fetal brain and adverse effects of nicotine on the developing serotonin system have been documented. We hypothesized that maternal smoking interacts with both child and mother 5-HTTLPR genotype as a risk factor for later child emotional problems. In a sample of n = 1,529 mother-child dyads, smoking habits were assessed by questionnaires during pregnancy. Child emotional problems were measured by the Child Behavior Checklist at the child's age of 3 years. Maternal smoking during pregnancy significantly increased the risk for emotional problems in children carrying the s-allele; β = 0.24, P = 0.03 (mother-report), and β = 0.46, P = 0.001 (father-report). In children heterozygous at 5-HTTLPR and exposed to maternal prenatal smoking (n = 79) risk of emotional problems increased with each additional s-allele the mother carried. The associations between 5-HTTLPR and child emotional problems were not moderated by paternal prenatal smoking. These findings imply that the vulnerability for emotional problems in s-allele carriers may already originate in fetal life.


Gynecologic issues in the HIV-infected woman.
In this article, gynecologic conditions of increased importance in the HIV-infected woman are discussed. Women living with HIV may have an increase in menstrual disorders, lower genital tract neoplasias, gynecologic surgery, and sexually transmitted infections. The literature relevant to choosing a method of contraception for HIV-positive women is also discussed. With the advent of HAART, seropositive women are now facing issues around longevity, such as menopause and disorders of bone mineral density, as well as those associated with fertility.


A novel scoring method based on RNA-Seq immunograms describing individual cancer-immunity interactions.
Because of the complexity of cancer-immune system interactions, combinations of biomarkers will be required for predicting individual patient responses to treatment and for monitoring combination strategies to overcome treatment resistance. To this end, the "immunogram" has been proposed as a comprehensive framework to capture all relevant immunological variables. Here, we developed a method to convert transcriptomic data into immunogram scores (IGS). This immunogram includes 10 molecular profiles, consisting of innate immunity, priming and activation, T cell response, interferon γ (IFNG) response, inhibitory molecules, regulatory T cells, myeloid-derived suppressor cells (MDSCs), recognition of tumor cells, proliferation, and glycolysis. Using genes related to these 10 parameters, we applied single-sample gene set enrichment analysis (ssGSEA) to 9417 bulk RNA-Seq data from 9362 cancer patients with 29 different solid cancers in The Cancer Genome Atlas (TCGA). Enrichment scores were z-score normalized (Z) for each cancer type or the entire TCGA cohort. The IGS was defined by the formula IGS = 3 + 1.5 × Z so that patients would be well distributed over a range of scores from 1 to 5. The immunograms constructed in this way for all individual patients in the entire TCGA cohort can be accessed at "The RNA-Seq based Cancer Immunogram Web" (https://yamashige33.shinyapps.io/immunogram/).


A Randomized Comparison of the Pharmacokinetics and Bioavailability of Fluticasone Propionate Delivered via Xhance Exhalation Delivery System Versus Flonase Nasal Spray and Flovent HFA Inhalational Aerosol.
The exhalation delivery system with fluticasone propionate (Xhance®) has been shown to deliver drug substantially more broadly in the nasal cavity (particularly into superior/posterior regions), with less off-target loss of drug to drip-out and swallowing, than conventional nasal sprays. This open-label study evaluated the systemic bioavailability of Xhance® by comparing the pharmacokinetic (PK) properties of a single dose of fluticasone from 3 products administering the drug using 3 different devices: Xhance®, Flonase® (fluticasone propionate inhalational nasal spray), and Flovent® HFA (fluticasone propionate inhalational aerosol). This open-label study was conducted in 2 parts. Study part 1 compared systemic exposure with a single dose of Xhance® 186 or 372 μg versus Flonase® 400 μg (3-way, 3-treatment, 3-sequence, randomized crossover in healthy subjects; n = 90). A separate study, part 2, under the same umbrella protocol, compared systemic exposure with Xhance® 372 μg versus Flovent® HFA 440 μg (2-way, 2-treatment, 2-sequence, randomized crossover in patients with mild to moderate asthma; n = 30). With Xhance® 186 μg, the geometric least squares mean (LSM) Cmax was higher than with Flonase® 400 μg (16.02 vs 11.66 pg/mL, respectively; geometric mean ratio [GMR], 137.42%) and the geometric LSM AUC0-∞ values were similar (97.30 vs 99.61 pg · h/mL; GMR, 97.78%). With Xhance® 372 μg, the geometric LSM Cmax and AUC0-∞ were higher than with Flonase® 400 μg (Cmax, 23.50 vs 11.66 pg/mL [GMR, 201.53%]; AUC0-∞, 146.61 vs 99.61 pg · h/mL [GMR, 147.19%]). In part 2, the geometric LSM Cmax and AUC0-∞ values were lower with Xhance® 372 μg than with Flovent® HFA 440 μg (Cmax, 25.28 vs 40.02 pg/mL [GMR, 63.18%]; AUC0-∞, 205.78 vs 415.16 pg · h/mL [GMR, 49.57%]). Similar intranasal doses of Xhance® (372 μg) and Flonase® (400 μg) are clearly not bioequivalent. Systemic exposure is very low with all products. Systemic exposure is higher with Xhance® than with Flonase® and substantially lower than with Flovent® HFA 440 μg and, based on dose normalization, Flovent® HFA 220 μg. ClincalTrials.gov identifier: NCT02266927.


Life Events Predicting the First Onset of Adolescent Direct Self-Injurious Behavior-A Prospective Multicenter Study.
Self-injurious behavior is a frequent phenomenon in adolescence. The present study prospectively examined life events as risk factors for the first onset of direct self-injurious behavior (D-SIB) in the Saving and Empowering Young Lives in Europe school-based multicenter sample. Longitudinal assessments with an interval of 1 year were performed within a sample of 1,933 adolescents (51.47% females; mean age 14.84 ± .9 years) from 10 European countries and Israel. The number of life events during the past 6 months predicted the first onset of D-SIB in the following year. Gender neither predicted the onset of D-SIB nor moderated the association with life events. Moreover, analyses of individual events identified a range of mainly interpersonal events within both family and peer group as proximal risk factors for first episode D-SIB. The results support the critical role of interpersonal life events in the development of D-SIB for both genders and refine the conceptualization of proximal risk factors in terms of accumulated stressors and interpersonal events.


Outcomes following transarterial radioembolization with 90Y and nanoparticles loaded resin microspheres.
90Y bremsstrahlung Single-Photon Emission Tomography (SPECT) imaging is employed to check the possibility of extrahepatic uptake and the quantification of delivered dose in Transarterial Radioembolization (TARE). 90Y bremsstrahlung SPECT imaging is challenging due to the nature of bremsstrahlung photons. We reported a Monte Carlo study using the resin microspheres loaded with 90Y and Nanoparticles (NPs) in the TARE. By injection of Bismuth (Bi) and Europium (Eu) NPs into the resin microspheres, the sensitivity and the contrast to noise ratio increased for the bremsstrahlung planar images. The highest signal to background ratio was observed in the characteristic X-ray planar images taken with the energy window at the Kα1 ± 10 keV when Eu NPs were incorporated into the microsphere. The dose enhancement ratio decreased dramatically at NP concentrations >2.4 M. Incorporating NPs into the resin microspheres improves the quality of post-treatment images and establishes a standardized imaging protocol for post-treatment imaging by characteristic X-rays.


Perimyocarditis: An Unusual Manifestation of Dengue Virus Infection.
Dengue is a febrile viral illness transmitted by Aedes Aegypti mosquito, presenting with a range of clinical features including a mild febrile illness to a life-threatening hemorrhagic fever or shock syndrome. Additionally, dengue fever can present with atypical features with the involvement of multiple organ systems including the heart. Here, we report a case of a 35-year-old female with dengue fever who presented with chest pain and dyspnea and was diagnosed with perimyocarditis.


Response of acoustic transmission to positive airway pressure therapy in experimental lung injury.
To evaluate the effect of positive end-expiratory pressure on the sound filtering characteristics of injured lungs. Prospective experimental study in the animal laboratory in an academic medical center. Six 35- to 45-kg anesthetized, intubated pigs. Acute lung injury with intravenous oleic acid. We injected a multifrequency broad-band sound signal into the airway while recording transmitted sound at three locations bilaterally on the chest wall. Oleic acid injections effected a severe pulmonary edema predominantly in the dependent lung regions, with an average increase in venous admixture from 16+/-14% to 57+/-13% and a reduction in static respiratory system compliance from 31+/-6 to 16+/-3 ml/cm H(2)O. A significant concomitant increase in sound transfer function amplitude was seen in the dependent and lateral lung regions; little change occurred in the nondependent areas. The application of PEEP resulted in a decrease in venous admixture, increase in respiratory system compliance, and return of the sound transmission to preinjury levels. Acute lung injury causes regional acoustic transmission abnormalities that are reversed during alveolar recruitment with PEEP.


Reader variability in reporting breast imaging according to BI-RADS assessment categories (the Florence experience).
The inter- and intraobserver agreement (K statistic) in reporting according to BI-RADS assessment categories was tested on 12 dedicated breast radiologists, with little prior working knowledge of BI-RADS, reading a set of 50 lesions (29 malignant, 21 benign). Intraobserver agreement (four categories: R2, R3, R4, R5) was fair (0.21-0.40), moderate (0.41-0.60), substantial (0.61-0.80) or almost perfect (>0.80) for one, two, five or four radiologists, or (six categories: R2, R3, R4a, R4b, R4c, R5) fair, moderate, substantial or almost perfect for three, three, three or three radiologists, respectively. Interobserver agreement (four categories) was fair, moderate or substantial for three, six, or three radiologists, or (six categories) slight, fair or moderate for one, six, or five radiologists. Major disagreement occurred for intermediate categories (R3=0.12, R4=0.25, R4a=0.08, R4b=0.07, R4c=0.10). We found insufficient intra- and interobserver consistency of breast radiologists in reporting BI-RADS assessment categories. Although training may improve these results, simpler alternative reporting methods (systems), focused on clinical decision-making, should be explored.


Professional nurse caring as perceived by critically ill patients: a phenomenologic study.
Critically ill patients have received little attention in the caring literature and yet are a population for whom caring behaviors are particularly important. To describe patients' perceptions of caring exhibited by professional nurses in a critical care unit and to describe the meaning to the patients of these demonstrations of caring. We used a phenomenologic approach for this descriptive study, which was conducted on 13 patients hospitalized in a critical care unit for at least 48 hours within 48 hours of their transfer from the unit. We asked them to respond to two open-ended questions and recorded all interviews on audio tapes that were transcribed verbatim. Caring in a critical care unit is attentive, vigilant behavior on the part of the nurse. This vigilance embodies nurturance and incorporates highly skilled, technical practices, as well as basic nursing care and beyond. Caring is a healing process of which lifesaving actions by the nurse are a part. Identifying the characteristics of the individuals involved in this healing process was one way of describing caring. Personal attributes of nurses, family members, and patients themselves are important in the descriptions of the caring process. These attributes are incorporated into the concept of mutuality. Caring is descriptive of a mutual process in which intentions are joined to form a shared experience. In this mutual process, healing is an outcome that might otherwise be elusive.


Effect on anxiety and depression of a multifactorial risk factor intervention program after stroke and TIA: a randomized controlled trial.
Depression and anxiety related to stroke are caused by vascular lesions and psychological reactions. Treatment of vascular and modifiable behavioral risk factors reduces the risk of stroke and may also reduce the risk of emotional changes after stroke. We aimed to investigate whether a multifactorial risk factor intervention program in patients with first-ever stroke or transient ischemic attack (TIA) can influence post-stroke anxiety and depressive symptoms in patients one year post-stroke. The study population consisted of first-ever stroke and TIA patients allocated in a randomized, evaluator-blinded, controlled trial to care as usual or a structured and multidisciplinary follow-up including intensive treatment of vascular risk. The primary endpoint (cognition) has previously been reported. The secondary endpoint, reported here, was changes in the Hospital Anxiety and Depression Scale (HADS) from baseline to 12-month follow-up. One hundred and ninety-five patients were randomized. The estimated difference between treatment groups, in changes in HADS, from baseline to 12 months was -1.32 (95% confidence interval: -2.61, -0.04; P = 0.044) in favor of the intervention group. One year post-stroke, 4/85 (4.7%) patients in the intervention group and 12/89 (13.5%) in the control group suffered from depression (P = 0.045), while 7/85 (8.2%) patients in the intervention group and 13/89 (14.6%) patients in the control group suffered from anxiety (P = 0.19). A structured, multidisciplinary, multifactorial risk factor program including vascular risk factor management may be associated with reduced HADS scores and a lower prevalence of depressive symptoms one year after stroke.


Isolation of four xylanases capable of hydrolyzing corn fiber xylan from Paenibacillus sp. H2C.
Corn fibre xylan (CX) shows high resistance to enzymatic hydrolysis due to its densely decorated side chains. To find enzymes capable of hydrolyzing CX, we isolated a bacterial strain (named H2C) from soil, by enrichment culture using non-starch polysaccharides of corn as the sole carbon source. Analysis based on the 16S rRNA sequence placed strain H2C within genus Paenibacillus. Enzymes were purified from supernatant of culture broth of strain H2C based on solubilizing activities toward CX. Four enzymes, Xyn5A, Xyn10B, Xyn11A, and Xyn30A, were successfully identified, which belong to glycoside hydrolase (GH) families, 5, 10, 11, and 30, respectively. Phylogenetic analysis classified Xyn5A in subfamily 35 of GH family 5, a subfamily of unknown function. Their activities toward beechwood xylan and/or wheat arabinoxylan indicated that these enzymes are β-1,4-xylanases. They showed high solubilizing activities toward a feed material, corn dried distiller's grains with solubles, compared to five previously characterized xylanases.Abbreviations : CX: corn fibre xylan; DDGS: corn dried distiller's grains with solubles.


Determination of radiation equivalence of the chemical furylfuramide (AF-2) for the induction of gene conversion in diploid yeast and estimation of genetic risk to the Japanese population.
Dose--effect relationships for the induction of gene conversion by AF-2 in diploid yeast have been established. On the basis of these, the rec value for AF-2 for induction of gene conversion has been calculated to be 0.085 microgram/ml.h. This compares well with the rec values obtained with other test systems and other genetic end-points. The genetic burden to the Japanese population due to consumption of AF-2 is estimated to be equivalent to 55 millirec. However, uncertainties in the consumption of AF-2 per person and its metabolic detoxication tend to lower this value to, probably, a small fraction of that due to natural background ionizing radiation.


Fine-needle aspiration cytology of pheochromocytoma-ganglioneuroma of the organ of Zuckerkandl.
Fine-needle aspiration (FNA) cytologic and immunocytochemical findings of a rare combined pheochromocytoma-ganglioneuroma developing in a 48-yr-old Japanese man in the organ of Zuckerkandl are described. This is the first report of a combined pheochromocytoma-ganglioneuroma of the organ of Zuckerkandl. FNA cytology showed typical cytologic findings of these two components similar to those described individually in fine-needle aspirates of these neoplasms. The neoplastic cells showed positive reactions for vasoactive intestinal polypeptide, neuron-specific enolase, and S-100.


The Influence of Pleasure and Attentional Focus on Performance and Pacing Strategies in Elite Individual Time Trials.
Recent psychophysiological models of endurance performance explained that pacing strategies and exercise-intensity regulation influence cyclists' ability to produce high mean power output (PO) during time trials (TTs). However, the relationships between these pacing strategies and psychological parameters of the athletes remain unknown. To determine the impact of pacing strategies on cyclists' mean PO during an elite TT championship and to identify the relationships between these pacing strategies and psychological parameters. Mean PO, projected frontal area, attentional focus, and pleasure were recorded for 9 male cyclists during an official individual TT national championship. Pacing regulations were quantified from PO using the new exposure variation analysis, which determines times spent at adapted PO for optimal constant-pacing strategy (APO) and inaccurate PO for optimal constant-pacing strategy (IPO). Relationships between mean PO, times spent at APO and IPO, and psychological variables were analyzed. Significant relationships were found between mean PO and exposure variation analysis pacing parameters (r2 .56-.86, P > .05). Time spent at IPO was negatively related to pleasure during the individual TT (r = -.746, P = .016). Conversely, time spent at APO was significantly related to cyclists' attentional focus (r = .827, P = .006). Mean PO during elite individual TTs is directly related to athletes' ability to optimally regulate pace throughout the event. This pacing regulation is influenced by attentional focus and pleasure, underlining that coaches and athletes should devote greater attention to these psychological parameters to improve their performances.


Retracted: Analyzing the Treatment of Patients with Acute Exacerbation of COPD with the Aid of Intelligent Diagnosis Method.
[This retracts the article DOI: 10.1155/2022/3962074.].


Lithium and ECT--concurrent use still demands attention: three case reports.
Bipolar disorders as well as recurrent major depressive episodes can be most effectively treated with electroconvulsive therapy (ECT). Since continuation/maintenance ECT is not well established, prophylactic therapy in recurrent illnesses is more commonly carried out using antidepressive medication alone or more often in combination with lithium. In case of relapse the clinically important question of discontinuation of lithium versus the concurrent use of ECT and lithium may arise. The safety of concurrent use has also to be balanced when lithium treatment is started within an ECT course. Since recent studies have reported no negative interactions with concurrent use, we here report three cases (one case of a prolonged seizure, a serotonin syndrome and a focal seizure) of severe lithium-induced side effects while patients underwent ECT without complications and lithium serum levels were still subtherapeutic. Clinical consequences are discussed and disturbances of the blood brain barrier system as a speculative cause are hypothesized taking previous studies, animal studies and an additional reported clinical case into account.


Sleep and blood pressure: further observations.
Twenty-seven healthy people with a wide range of casual blood pressure readings (120/70 to 230/120 mm. Hg) had their blood pressure recorded continuously over a 24-hour period. Arterial pressure fell during sleep and only rose appreciably after the patients had awakened and a further rise was associated with physical activity, once they were out of bed. This pattern was observed in 18 untreated patients and in nine currently receiving hypotensive treatment. This study suggests that arterial pressure is not specifically related to time and is chiefly governed by physical activity and sleep.


Sensory effects on judgments of short time-intervals.
Two experiments were conducted to test the effect of nontemporal factors on duration discrimination. In Exp. 1, a forced-choice adaptive procedure with a standard duration of 400 or 800 ms was employed. It was shown that, for both auditory and visual modes, the discrimination is better with empty intervals (a silent period between two brief signals) than with filled intervals (a continuous signal), but only with shorter durations. In a second experiment, where intervals of the same duration range were employed but were presented with a single-stimulus method, discrimination was better with empty than with filled intervals, and this effect applied to both ranges of duration and both sensory modes. In both experiments, discrimination was better in the auditory than in the visual mode. These data are discussed in the context of current models of timing mechanisms.


Total removal of a parasagittal meningioma of the posterior third of the sagittal sinus and its repair by autogenous vein graft. Case report.
Total removal is reported of a parasaggital meningioma that invaded the lateral wall and lateral recess of the posterior third of the superior sagittal sinus. The operation was performed by using a silicone rubber non-collapsible tube with an inflatable balloon cuff at each end for the bypass of the sinus blood, and entailed repair of the defect in the sinus wall by a saphenous vein graft. The clinical results and angiographic findings are presented.


[The resistance to infection of digestive sutures. Experimental study (author's transl)].
The authors study the effects of severe sepsis due to pathogenic gems in large quantity an healing of the suture of the ileum in the rabbit. Contamination of the suture did not lead to any breakdown of the suture whatever the germ. These experimental facts, compared with the data in the literature suggest that the peritoneal serosa ensures efficacious anti-infectious defence, permitting healing of intra-peritoneal digestive sutures in spite of the septic nature of the intestinal contents.


The genetics of pheromonally mediated intermale aggression in mice: current status and prospects of the model.
A genetic model of pheromonally mediated aggression in laboratory male mice, which has been developed over the past decade, is reviewed and integrated with recent developments in the neurobiology of olfaction and the chemistry of pheromones in Mus musculus. Experimental data strongly support the possibility of enzymatic activation of aggression promoting and inhibiting pheromones by beta-glucuronidase (EC 188.8.131.52). These findings introduce important questions as to the involvement of beta-GLU genes (Gus and Eg on chromosomes 5 and 8, respectively) in the determination of urine odor profiling. The discovery of two neuroanatomically, and functionally distinct, olfactory structures in 1975 led the way for direct selection of olfactory bulb relay neurons, medial amygdala nucleus neurons and TIDA-neurons for analysis of the genetic mechanisms involved in pheromonal action on aggressive and other olfactory mediated social behaviors in rodents.


Self-perceived social integration and the use of day centers of persons with severe and persistent schizophrenia living in the community: a qualitative analysis.
The study examined how persons with severe and persistent schizophrenia perceive their social integration and how particular types of social integration are related to the use of day centers and patient clubs. Problem-focused interviews on self-perceived social integration and the use of day structuring services were done with 100 persons with an ICD-9 diagnosis of schizophrenia living in Leipzig. Transcribed interviews were subjected to computer-aided qualitative content analysis. Results of the qualitative content analysis show that the study participants can be classified in five different groups according to their self-perceived degree of social integration. The use and the subjective meaning of existing day structuring services was found to be associated with the type of self-perceived social integration. The heterogeneous ways persons with chronic schizophrenia organize their social lives lead to different kinds of needs for support. In order to meet the needs of the whole spectrum of patients this heterogeneity must be taken into account in the process of service planning.


Bronchodilator response does not associate with asthma control or symptom burden among patients with poorly controlled asthma.
The purpose of this study was to determine how four different definitions of bronchodilator response (BDR) relate to asthma control and asthma symptom burden in a large population of participants with poorly controlled asthma. We examined the baseline change in FEV1 and FVC in response to albuterol among 931 participants with poorly controlled asthma pooled from three clinical trials conducted by the American Lung Association - Airways Clinical Research Centers. We defined BDR based on four definitions and analyzed the association of each with asthma control as measured by the Asthma Control Test or Asthma Control Questionnaire, and asthma symptom burden as measured by the Asthma Symptom Utility Index. A BDR was seen in 31-42% of all participants, depending on the definition used. There was good agreement among responses (kappa coefficient 0.73 to 0.87), but only 56% of participants met all four definitions for BDR. A BDR was more common in men than women, in Blacks compared to Whites, in non-smokers compared to smokers, and in non-obese compared to obese participants. Among those with poorly controlled asthma, 35% had a BDR compared to 25% of those with well controlled asthma, and among those with a high symptom burden, 34% had a BDR compared to 28% of those with a low symptom burden. After adjusting for age, sex, height, race, obesity and baseline lung function, none of the four definitions was associated with asthma control or symptom burden. A BDR is not associated with asthma control or symptoms in people with poorly controlled asthma, regardless of the definition of BDR used. These findings question the clinical utility of a BDR in assessing asthma control and symptoms.


Somatisation in primary care: clinical judgement and standardised measurement compared.
In daily practice general practitioners (GPs) generally rely on their clinical judgement in assessing whether patients somatise distress. Nevertheless, conclusions derived from research on somatisation in primary care are largely based on standardised measurements of somatisation. We investigated the relation between GPs' clinical judgement of somatisation and a somatisation research instrument (DSM-III-R), and examined how both operationalisations of somatisation related to other important variables. In nine general practices, 407 frequently attending patients answered a questionnaire on somatisation symptoms, while the GPs gave their judgement on somatisation and communication for each patient. Other variables were extracted from the registered health status of the patients. We found a weak association (correlation: 0.27) between the GPs' judgement and the research instrument; however, relations with other variables showed that both operationalisations were very similar constructs. The research instrument incorporated more psychological problems (depression and anxiety), while the GPs' judgement of somatisation was more influenced by attendance rate and by aspects of communication with the patient. For research addressing somatisation in primary care as a practical clinical problem, the operationalisation of somatisation should include the clinical judgement of the practitioner as well, thereby widening the focus from co-morbid mental disturbances to communication aspects.


Modifiable Predictors of In-Hospital Mortality in Patients Undergoing Transcatheter Aortic Valve Replacement.
Transcatheter aortic valve replacement (TAVR) has become an acceptable therapy for patients with severe aortic valve stenosis at high or prohibitive surgical risk. Attempts are ongoing to validate risk prediction models for in-hospital mortality after TAVR. Our aim was to define modifiable risk factors predictive of in-hospital mortality after TAVR. We identified patients who underwent TAVR from the 2012 database of the National Inpatient Sample. Patients who died during the index hospitalization were compared to those that were successfully discharged. The predictors of in-hospital mortality were analyzed using multivariate logistic regression. A total of 1,360 patients (mean age 81 ± 8.8 years, whites 80.1%, blacks 3.5%) had TAVR and 68 (5%) died during hospitalization (χ2 [1, n = 1,360] = 1,101.6, P < 0.001). The average length of hospital stay was 8.33 ± 6.7 days. The positive predictors of in-hospital mortality in the unadjusted model were comorbidities such as congestive heart failure, coagulopathy, fluid and electrolyte disorder, weight loss and history of drug abuse. Hypertension was a negative predictor of in-hospital mortality. Following multivariate analysis and adjustment for possible confounders, fluid and electrolyte disorder was the only significant positive predictor of in-hospital mortality (odds ratio = 1.89, CI: 1.11-3.22, P = 0.019). The odds of in-hospital mortality were reduced in patients with hypertension (odds ratio = 0.45, CI: 0.26-0.78, P = 0.004). Fluid and electrolyte disturbance could be a modifiable predictor of in-hospital mortality following TAVR. Efforts should be geared towards reducing its occurrence in this patient population.


Age-related sex differences in tongue strength and muscle morphometry in a rat model.
To investigate potential effects of sex on voluntary tongue strength, evoked twitch and tetanic tension, speed of contraction, and muscle fiber cross-sectional area in the muscles of the rat tongue. Additionally, we aimed to determine whether estrous cycle stage impacts any of the dependent variables as a pilot investigation into the use of female rats in a model of tongue exercise and aging. Fischer 344-Brown Norway male and female rats in two age groups (16 middle-aged, 16 young-adult) were trained to use a tongue force operandum. Tongue muscle contraction, myosin heavy chain (MyHC) composition, and cross section area of the genioglossus and styloglossus muscles were examined. Vaginal lavage determined estrous cycle stage of the female rats daily. The female group had significantly lower evoked twitch and tetanic tension, longer contraction times, and a smaller proportion of MyHC type IIa and MyHC type IIx in the styloglossus muscle. There was no significant sex effect in maximal voluntary tongue force (MVTF) despite a significant weight difference between the male and female groups. There were no significant age or sex effects in the genioglossus. Estrous cycle stage did not have a significant effect on any of the dependent variables. Sex and age both have a significant effect on tongue muscle structure and physiology. While the female group showed reduced contraction speed and maximal twitch and tetanic tension relative to the male group, differences in muscle morphology appeared to vary by muscle.


Genetic epidemiology of alcohol-induced blackouts.
Alcohol-induced blackouts (ie, periods of anterograde amnesia) have received limited recent research attention. To examine the genetic epidemiology of lifetime blackouts and having had 3 or more blackouts in a year, including analyses controlling for the frequency of intoxication. Members of the young adult Australian Twin Register, a volunteer twin panel born between January 1, 1964, and December 31, 1971, were initially registered with the panel as children by their parents between 1980 and 1982. They underwent structured psychiatric telephone interviews from February 1996 through September 2000. The current sample contains 2324 monozygotic and dizygotic twin pairs (mean [SD] age 29.9 [2.5] years) for whom both twins' responses were coded for blackout questions and for frequency of intoxication. Outcome Measure Data on lifetime blackouts and having had 3 or more blackouts in a year were collected within an examination of the genetic epidemiology of alcoholism. A lifetime history of blackouts was reported by 39.3% of women and 52.4% of men; 11.4% of women and 20.9% of men reported having had 3 or more blackouts in a year. The heritability of lifetime blackouts was 52.5% and that of having had 3 or more blackouts in a year was 57.8%. Models that controlled for frequency of intoxication found evidence of substantial genetic contribution unique to risk for the blackouts and a significant component of genetic risk shared with frequency of intoxication. The finding of a substantial genetic contribution to liability for alcohol-induced blackouts including a component of genetic loading shared with frequency of intoxication may offer important additional avenues to investigate susceptibility to alcohol-related problems.


Surgical procedures of the thorax.
Thoracic disease is common in cattle and is a significant cause for economic losses in the stocker and feedlot industries. In most cases, economic constraints limit diagnostic investigation and affect treatment options. Although medical management is, by far, the most appropriate therapeutic intervention in such cases, surgical management of some respiratory diseases can allow for profitable return to productivity. Surgical procedures of the thorax most often involve thoracotomy or pericardiotomy. Tracheal reconstruction and invasion of the mediastinum are rarely indicated in cattle.


Deep learning-based motion tracking using ultrasound images.
Ultrasound (US) imaging is an established imaging modality capable of offering video-rate volumetric images without ionizing radiation. It has the potential for intra-fraction motion tracking in radiation therapy. In this study, a deep learning-based method has been developed to tackle the challenges in motion tracking using US imaging. We present a Markov-like network, which is implemented via generative adversarial networks, to extract features from sequential US frames (one tracked frame followed by untracked frames) and thereby estimate a set of deformation vector fields (DVFs) through the registration of the tracked frame and the untracked frames. The positions of the landmarks in the untracked frames are finally determined by shifting landmarks in the tracked frame according to the estimated DVFs. The performance of the proposed method was evaluated on the testing dataset by calculating the tracking error (TE) between the predicted and ground truth landmarks on each frame. The proposed method was evaluated using the MICCAI CLUST 2015 dataset which was collected using seven US scanners with eight types of transducers and the Cardiac Acquisitions for Multi-structure Ultrasound Segmentation (CAMUS) dataset which was acquired using GE Vivid E95 ultrasound scanners. The CLUST dataset contains 63 2D and 22 3D US image sequences respectively from 42 and 18 subjects, and the CAMUS dataset includes 2D US images from 450 patients. On CLUST dataset, our proposed method achieved a mean tracking error of 0.70 ± 0.38 mm for the 2D sequences and 1.71 ± 0.84 mm for the 3D sequences for those public available annotations. And on CAMUS dataset, a mean tracking error of 0.54 ± 1.24 mm for the landmarks in the left atrium was achieved. A novel motion tracking algorithm using US images based on modern deep learning techniques has been demonstrated in this study. The proposed method can offer millimeter-level tumor motion prediction in real time, which has the potential to be adopted into routine tumor motion management in radiation therapy.


Noradrenaline induces rhythmic bursting in sympathetic preganglionic neurons.
In the in vitro slice preparation of upper thoracic cord of the cat, noradrenaline, at concentrations of 10-50 microM, induced rhythmic bursting in 30% of sympathetic preganglionic neurons of the intermediolateral nucleus. The bursting frequencies were between 0.2 and 1.0 Hz at membrane potentials between -45 and -65 mV. The bursting rhythm could be reset by short intracellular current pulses. In the presence of tetrodotoxin noradrenaline produced a rhythmic oscillation in membrane potential in the same frequency range as the bursting. The frequency of oscillation was voltage dependent. Neuronal input resistance decreased at the oscillation peak and the oscillation was abolished by cobalt or low calcium.


A modified n-3 fatty acid desaturase gene from Caenorhabditis briggsae produced high proportion of DHA and DPA in transgenic mice.
The functions of polyunsaturated fatty acids (PUFAs) have been widely investigated. In mammals, levels of n-3 PUFAs are relatively low compared to those of n-6 PUFAs. Either a lack of n-3 PUFAs or an excess of n-6 PUFAs could potentially cause health problems in humans. Hence, methods to increase the amount of n-3 PUFAs in diet have been intensely sought. In this study, we demonstrated that the n-3 fatty acid desaturase gene (sFat-1) synthesized from revised and optimized codons based on roundworm Caenorhabditis briggsae genomic gene for enhanced expression in mammals was successfully expressed in Chinese hamster ovary (CHO) cells and significantly elevated cellular n-3 PUFA contents. We generated sFat-1 transgenic mice by introducing mammal expression vector DNAs containing the sFat-1 gene into regular mice through the method of microinjection. Fatty acid compositions were then altered and the levels of docosahexaenoic acid (DHA, 22:6n-3) and docosapentaenoic acid (DPA, 22:5n-3) were greatly increased in these transgenic mice. Various types of tissues in the transgenic mice produced many types of n-3 PUFAs, such as alpha-linolenic acid (ALA; 18:3n-3), eicosapentaenoic acid (EPA, 20:5n-3), DPA, and DHA, for example, muscle tissues of the transgenic mice contained 12.2% DHA, 2.0% DPA, and 23.1% total n-3 PUFAs. These research results demonstrated that the synthesized sFat-1 gene with modified and optimized codons from C. briggsae possess functional activity and greater capability of producing n-3 PUFAs, especially DHA and DPA, in transgenic mice.


Pebax-Based Membrane Filled with Two-Dimensional Mxene Nanosheets for Efficient CO2 Capture.
Mixed matrix membranes (MMMs) made from inorganic fillers and polymers is a kind of promising candidate for gas separation. In this work, two-dimensional MXene nanosheets were synthesized and incorporated into a polyether-polyamide block copolymer (Pebax) matrix to fabricate MMM for CO2 capture. The physicochemical properties of MXene nanosheets and MXene/Pebax membranes were studied systematically. The introduction of MXene nanosheets provided additional molecular transport channels and meanwhile enhanced the CO2 adsorption capacity, thereby enhancing both the CO2 peremance and CO2 /N2 selectivity of Pebax membrane. The optimized MXene/Pebax membrane with a MXene loading of 0.15 wt % displayed a high separation performance with a CO2 permeance of 21.6 GPU and a CO2 /N2 selectivity of 72.5, showing potential application in CO2 capture.


Artery/vein classification of retinal vessels using classifiers fusion.
The morphological changes in retinal blood vessels indicate cardiovascular diseases and consequently those diseases lead to ocular complications such as Hypertensive Retinopathy. One of the significant clinical findings related to this ocular abnormality is alteration of width of vessel. The classification of retinal vessels into arteries and veins in eye fundus images is a relevant task for the automatic assessment of vascular changes. This paper presents an important approach to solve this problem by means of feature ranking strategies and multiple classifiers decision-combination scheme that is specifically adapted for artery/vein classification. For this, three databases are used with a local dataset of 44 images and two publically available databases, INSPIRE-AVR containing 40 images and VICAVR containing 58 images. The local database also contains images with pathologically diseased structures. The performance of the proposed system is assessed by comparing the experimental results with the gold standard estimations as well as with the results of previous methodologies, achieving promising classification performance, with an over all accuracy of 90.45%, 93.90% and 87.82%, in retinal blood vessel separation for Local, INSPIRE-AVR and VICAVR dataset, respectively.


Microencapsulation of erythrocytes in Eudragit-RL-coated calcium alginate.
Human erythrocytes have been encapsulated in calcium alginate gel beads (approx. 2 mm diameter) which were subsequently coated with a water-insoluble cationic polyacrylate, Eudragit RL. Stained histological sections as well as scanning and transmission electron micrographs clearly showed the presence of a dense capsule wall, approx. 60 micron thick after 60 min of exposure to an aqueous emulsion of Eudragit, surrounding a sponge-like alginate core. Eudragit beads could withstand greater compressive forces before mechanical failure than uncoated beads. The effect of alginate concentration, coating time and ionic strength on the compressive load at failure, indicated the likelihood that coating involved ionic interactions between the polycationic Eudragit and the polyanionic alginate. Encapsulated erythrocytes continued to consume glucose but at a rate one-third higher than normal which attributed to an under estimate in the number of immobilized cells or to an actual increase in cell metabolism due to immobilization. Alginate/Eudragit encapsulated erythrocytes also continued to reversibly bind oxygen even after 21 days storage at 4 degrees C. Although in vivo stability and biocompatibility remain at question, this system is a model of that required to encapsulate pancreatic islets for the treatment of insulin-dependent diabetes.


MR imaging of the rotator cuff.
MR imaging is the optimal method for evaluating suspected rotator cuff pathology. Current techniques of fast spin-echo imaging without and with fat suppression allow accurate identification and characterization of tendinous and myotendinous abnormalities of the rotator cuff. Impingement disorders, tendon degeneration, instability,and trauma comprise the multifactorial nature of rotator cuff disease. This article addresses the role of MR imaging in evaluating the rotator cuff and the importance of MR imaging in identifying other lesions that may mimic rotator cuff pathology. A rationale for protocol design, including MR arthrography and the use of specialized positioning, such as abduction and external rotation (ABER), are discussed.


Residential mobility impacts exposure assessment and community socioeconomic characteristics in longitudinal epidemiology studies.
Epidemiologic studies commonly use residential locations to estimate environmental exposures or community-level characteristics. The impact of residential mobility on these characteristics, however, is rarely considered. The objective of this analysis was to examine the effect of residential mobility on estimates of traffic-related air pollution (TRAP), greenspace, and community-level characteristics. All residential addresses were reported from birth through age seven for children enrolled in the Cincinnati Childhood Allergy and Air Pollution Study. Exposure to TRAP at each address was estimated using a land use model. Greenspace was estimated using satellite imagery. Indices of neighborhood deprivation and race were created based on socioeconomic-census tract measures. Exposure estimates using the birth record address, the last known address, and the annual address history were used to determine exposure estimation error and bias in the association with asthma at age seven. Overall, 54% of the cohort moved at least once prior to age seven. Each move was separated by a median of 4 miles and associated with a median decrease of 4.4% in TRAP exposure, a 5.3% increase in greenspace, an improved deprivation index, and no change in the race index. Using the birth record address or the last known address instead of the annual address history resulted in exposure misclassification leading to a bias toward the null when associating the exposures with asthma. Using a single address to estimate environmental exposures and community-level characteristics over a time period may result in differential assessment error.


Inulin alleviates neuroinflammation and oxidative stress induced by perinatal 2-ethylhexyl diphenyl phosphate (EHDPHP) exposure in female mice and offspring.
Organophosphorus flame retardants (OPFRs), including 2-ethylhexyl diphenyl phosphate (EHDPHP), are prevalent in everyday life due to their broad usage in fields such as healthcare, electronics, industry, and sports. These compounds, added to polymers through physical mixing, can leach into the environment, posing a risk to humans through direct contact or the food chain. Despite known associations with health issues like endocrine disruption, neurotoxicity, and reproductive toxicity, the implications of perinatal EHDPHP exposure on both mothers and offspring are still unclear. This study aimed to investigate the neuroinflammatory effects of EHDPHP and the potential mitigating role of inulin. Pregnant C57 mice were administered either a corn oil control or an EHDPHP solution (300 μg/kg bw/d) from gestation day 7 (GD7) to postnatal day 21 (PND21). Concurrently, mice were provided either regular drinking water or water supplemented with 1% inulin. We found that EHDPHP significantly increased the serum levels of IL-1β, IL-6, and MDA, but decreased SOD levels in both mothers and pups. These effects were reversed by inulin supplementation. RNA-sequencing revealed that EHDPHP induced inflammation and oxidative stress through the TLR4/NF-κB pathway, which was mitigated by inulin. In conclusion, inulin ameliorated EHDPHP-induced neuroinflammation and oxidative stress in both mothers and offspring, highlighting its potential therapeutic role.


In situ characterization of O-linked glycans of Muc2 in mouse colon.
The characterization of mucus O-linked glycans in the proximal and distal mouse colon was performed by conventional histochemical methods and by lectin histochemistry in combination with enzymatic treatment (PNGase, α1,2 fucosidase, sialidase digestion), with and without prior desulfation. We demonstrated the presence of sialo- and sulfomucins in both the proximal and distal colon of the mouse. In the distal colon the sulfomucins were clearly prevalent, although there were always sialomucins with sialyl residues linked α2,6 to the subterminal galactose. Sialic acid was poorly O-acetylated, especially in the distal colon. The lectin binding pattern indicates a massive presence of fucose α1,2 linked to galactose in O-glycans and smaller quantities of fucose linked α1,6 to N-acetylglucosamine in the core of N-linked glycans. Lectin histochemistry also demonstrated the presence of glycosidic residues of N-acetylglucosamine, N-acetylgalactosamine, and galactose in oligosaccharide chains of highly sulfated mucins.


Changes in foveal photoreceptor integrity after idiopathic epiretinal membrane surgery and its relationship with visual outcomes.
To investigate the changes in the external limiting membrane (ELM), ellipsoid zone (EZ), and interdigitation zone (IZ) integrity and their relationship with visual outcomes after idiopathic epiretinal membranes peeling. Clinical records of 150 eyes from 144 consecutive patients who underwent vitrectomy were reviewed. The status of IZ, EZ, and ELM was assessed by spectral-domain optical coherence tomography at baseline and 1, 4, 10, and 24 months postoperatively. Sixty-one eyes presented with photoreceptor layer disruption preoperatively, and IZ disruption (40.7%) was the primary type. The best-corrected visual acuity (BCVA) in the photoreceptor disruption group was significantly lower than that in the intact group at baseline and the final follow-up. Of them, ELM + EZ + IZ disruption showed the worst BCVA (P = 0.001). After surgery, 62 eyes were observed with disruption aggravated. EZ + IZ disruption (51.0%) was the most frequent type at 1 month postoperatively. The eyes with longer symptom duration, better BCVA, earlier stage, thinner CFT at baseline, and combined cataract surgery more tended to be observed with photoreceptor damage progressed after surgery (P < 0.05). There was no significant difference in the final BCVA between the eyes with and without damage progressed (P = 0.332). Finally, 28.1% of the eyes recovered photoreceptor continuity. The eyes with foveal photoreceptor integrity restored had better BCVA than those remaining discontinuous (P < 0.001). ERM-induced photoreceptor disruption mainly manifests as IZ disruption and has a negative effect on BCVA, whereas surgery mainly causes EZ and IZ disruption, which does not have a significant impact on the final BCVA.


Comparison of the effects of transfusions of cryopreserved and liquid-preserved platelets on hemostasis and blood loss after cardiopulmonary bypass.
The aim of the study was to compare the clinical effects and hemostatic efficiency of transfusions of platelets preserved in the frozen state for as long as 2 years with transfusions of platelets preserved in the conventional manner for as long as 5 days in patients undergoing cardiopulmonary bypass. Seventy-three patients were prospectively randomly assigned to receive transfusions of cryopreserved or liquid-preserved platelets. Nonsurgical blood loss was measured during and after the operation. Bleeding time, hematologic variables, and the bleeding time site shed blood were assayed before cardiopulmonary bypass and at 30 minutes and 2, 4, and 24 hours after transfusion. In vitro platelet function tests were conducted on platelets obtained from healthy volunteers. No adverse sequelae of the transfusions were observed. Blood loss and the need for postoperative blood product transfusions were lower in the group receiving cryopreserved platelets. Lower posttransfusion platelet increments and a tendency toward decreased platelet survival were observed in patients receiving cryopreserved platelets. Hematocrit and plasma fibrinogen were significantly higher in this group, and the duration of intubation was shorter. In vitro, cryopreserved platelets demonstrated less aggregation, lower pH, and decreased response to hypotonic stress but generated more procoagulant activity and thromboxane. (1) Cryopreserved platelet transfusions are superior to liquid-preserved platelets in reducing blood loss and the need for blood product transfusions after cardiopulmonary bypass. (2) The reduction in blood loss in the patients receiving cryopreserved platelet transfusions after cardiopulmonary bypass probably reflects improved in vivo hemostatic function of cryopreserved platelets. (3) Some in vitro measures of platelet quality (aggregation, pH, hypotonic stress) may not reflect in vivo quality of platelet transfusions after cardiopulmonary bypass, whereas other in vitro measures (platelet procoagulant activity and thromboxane) do.