Partial Cervical Agenesis and Complete Vaginal Atresia.
The objective of this study was to report 2 cases of the combined congenital anomalies of complete vaginal atresia and partial cervical agenesis, and highlight the limitations of magnetic resonance imaging for definitive initial diagnosis, and consequently the importance of early definitive management, to avoid life-threatening sepsis. Herein we provide a retrospective case audit of two patients with congenital abnormalities between 2005 and 2013 who were treated in a quaternary statewide pediatric and adolescent gynecology center. Two patients with the combined congenital anomalies of complete vaginal agenesis and partial cervical agenesis highlight the difficulties encountered with the limitations of magnetic resonance imaging in accuracy of diagnosis, as well as development of life-threatening sepsis that requires hysterectomy. Both patients were initially imaged as having distended endometrial cavities and cervical canals with what was thought to be an obstructive upper vaginal septum and absent lower vagina. Both required initial neovagina creation, however the cervices were never clinically or surgically visualized. Partial cervical agenesis is a relatively rare form of Müllerian abnormality which, if not diagnosed and definitively treated early, can have significant morbidity and mortality. Although magnetic resonance imaging is the diagnostic imaging gold standard for Müllerian abnormalities, it is important to recognize the limitations of this modality, the potential sequelae of these limitations, and to appreciate the importance of early accurate diagnosis and treatment of this condition. Importantly, if the imaging diagnosis does not completely correlate with the clinical and surgical findings, then a high suspicion of complete or partial cervical agenesis is prudent, because the consequences of nondefinitive early treatment can be life-threatening and potentially fatal.


Co-fermented milk beverage has better stability and contains more health-promoting amino acid metabolites than single-strain-fermented milk beverage over one-month storage.
Few studies investigated the effects of co-fermentation with bifidobacteria on post-storage changes of probiotic fermented beverages (PFBs). Thus, this study compared the post-storage changes in physicochemical index and metabolomes of PFBs produced singly by Lacticaseibacillus paracasei PC-01 (PC-01) or in combination with Bifidobacterium adolescentis B8589 (B8589). No significant differences were observed in the pH, titratable acidity, and viable cell counts between the two PFBs over 30-day storage. However, adding B8589 not only increased the stability of PFB (based on evaluating differences in PFBs metabolomics), but also the contents of beneficial amino acid metabolites, including 4-hydroxystyrene, gamma-aminobutyric acid, N-acetyl-l-aspartic acid, d-alanyl-d-alanine, and l-malic acid, after storage. Our study showed that B8589 is preferred to single-strain fermentation by PC-01. This study supports the concept of using bifidobacteria as starter culture in PFB production.


Copper and zinc in an ecological series of talitroidean Amphipoda (Crustacea).
Cu and Zn concentrations were determined for the following talitroidean amphipods, Hyale nilssoni (Rathke), Talitrus saltator (Montagu), Talorchestia deshayesii (Audouin), Orchestia mediterranea Costa, O. gammarellus (Pallas), O cavimana Heller and Arcitalitrus dorrieni (Hunt) in September 1986 from sites in W. Britain (mostly Scottish). To minimize size effects, only animals >2mg body dry weight were included in analyses. Only Talorchestia (Cu & Zn) and O. cavimana (Zn) showed any residual relationship between metal concentration and dry weight. Log transformed data for concentrations of each metal against log dry wt. in all species were compared by ANCOVA. Copper and zinc concentrations of males and females were not significantly different in O. gammarellus, O. mediterranea and T. deshayesii, though Cu (but not Zn) concentrations differed with sex in O. cavimana. The order of species when ranked according to an ascending series of Cu concentrations (at standard body weight) reflected their ecological zonation from sea to land closely, with species living proximal to the sea having lowest Cu concentrations. The 6 talitrid species all had similar Zn concentrations but the Zn concentration of H. nilssoni was considerably lower. There was a relationship between Cu and Zn concentrations in individuals of only one species (O. gammarellus). Data on Cu and Zn concentrations for O. gammarellus derived from the same site in September 1983 were almost exctly the same as in September 1986. The possible impact of seasonal variation on haemocyanin levels is discussed.


Muscle deoxygenation in aerobic and anaerobic exercise.
It has been generally accepted that the use of oxygen is a major contributor of ATP synthesis in endurance exercise but not in short sprints. In anaerobic exercise, muscle energy is thought to be initially supported by the PCr-ATP system followed by glycolysis, not through mitochondrial oxidative phosphorylation. However, in real exercise practice, we do not know how much of this notion is true when an athlete approaches his/her maximal capacity of aerobic and anaerobic exercise, such as during a graded VO2max test. This study investigates the use of oxygen in aerobic and anaerobic exercise by monitoring oxygen concentration of the vastus lateralis muscle at maximum intensity using Near Infra-red Spectroscopy (NIRS). We tested 14 sprinters from the University of Penn track team, whose competitive events are high jump, pole vault, 100 m, 200 m, 400 m, and 800 m. The Wingate anaerobic power test was performed on a cycle ergometer with 10% body weight resistance for 30 seconds. To compare oxygenation during aerobic exercise, a steady-state VO2max test with a cycle ergometer was used with 25 watt increments every 2 min. until exhaustion. Results showed that in the Wingate test, total power reached 774 +/- 86 watt, about 3 times greater than that in the VO2max test (270 +/- 43 watt). In the Wingate test, the deoxygenation reached approximately 80% of the established maximum value, while in the VO2max test resulted in approximately 36% deoxygenation. There was no delay in onset of deoxygenation in the Wingate test, while in the VO2max test, deoxygenation did not occur under low intensity work. The results indicate that oxygen was used from the beginning of sprint test, suggesting that the mitochondrial ATP synthesis was triggered after a surprisingly brief exercise duration. One explanation is that prior warm-up (unloaded exercise) was enough to provide the mitochondrial substrates; ADP and Pi to activate oxidative phosphorylation by the type II a and type I myocytes. In addition, transmural pressure created by the muscle contraction reduces blood flow, causing relative hypoxia.


Effect of ammonia on taurine transport in C6 glioma cells.
Both short-term and prolonged treatment with ammonia stimulate Tau efflux from C6 glioma cells, which confirms earlier observations with different CNS preparations. In addition, prolonged, but not short-term treatment reversibly decreases Tau uptake. The results are consistent with in vivo observations showing robust extracellular accumulation of Tau in the CNS under hyperammonemic conditions. Enhancement of Tau efflux by short term ammonia treatment is associated with its passage via a channel (or channels) which in contrast to the release from control cells is (are) not inhibited by NA. However, the increased Tau efflux does not appear to involve active Tau transport. Insensitivity to NA distinguishes ammonia-dependent Tau efflux from C6 cells from that reported in other CNS-derived preparations. Tau release evoked by prolonged ammonia treatment likewise shows a NA-insensitive component, but also a component associated with activation of Tau transport in a reverse mode. Increased outward transport of Tau may be associated with transiently increased expression of TauT mRNA. Mutual relation of the two components, but also the identity of the NA-insensitive efflux route with the anion channels so far described remains to be analyzed.


Factors facilitating trained NIMART nurses' adherence to treatment guidelines: a vital matter in the management of TB/HIV treatment in South Africa.
Globally, the burden of tuberculosis or human immunodeficiency virus (TB/HIV) is at 24% and this alarming rate compelled the World Health Organization (WHO) to declare the African region as a critical workforce shortage area. To facilitate adherence to treatment guidelines, WHO recommended a strategy of task shifting for countries with high health workforce shortages. The strategy aimed at the redistribution of health care tasks to available workers. The study aimed to determine the factors facilitating nurse-initiated management of antiretroviral therapy (NIMART) trained nurses' adherence to TB/HIV treatment guidelines. The study employed an exploratory-descriptive design. The study was conducted in Ugu and Ngaka Modiri Molema Districts of KwaZulu-Natal (KZN) and North West (NW) Provinces of South Africa. The population comprised of 24 participants who were purposively selected. The in-depth focus group discussions were conducted and ATLAS T.I. was used for data analysis following the basic steps of notice-collect-think (NCT) analysis. Trustworthiness and adherence to ethics were ensured. The singular theme of factors facilitating NIMART trained nurses' adherence to treatment guidelines which included positive attitudinal needs and positive behavioural change emerged from raw data. Continuous training, support supervision, and improved relationships with colleagues need to be enhanced to enable NIMART trained nurses to adhere to treatment guidelines.


Investigation of ion/molecule reactions as a quantification method for phosphorylated positional isomers. an FT-ICR approach.
A rapid and accurate method of quantifying positional isomeric mixtures of phosphorylated hexose and N-acetylhexosamine monosacchrides by using gas-phase ion/molecule reactions coupled with FT-ICR mass spectrometry is described. Trimethyl borate, the reagent gas, reacts readily with the singly charged negative ions of phosphorylated monosaccharides to form two stable product ions corresponding to the loss of one or two neutral molecules of methanol from the original adduct. Product distribution in the ion/molecule reaction spectra differs significantly for isomers phosphorylated in either the 1- or the 6-position. As a result, the percents of total ion current of these product ions for a mixture of the two isomers vary with its composition. In order to determine the percentage of each isomer in an unknown mixture, a multicomponent quantification method is utilized in which the percents of total ion current of the two product ions for each pure monosaccharide phosphate and the mixture are used in a two-equation, two-unknown system. The applicability of this method is demonstrated by successfully quantifying mock mixtures of four different isomeric pairs: Glucose-1-phosphate and glucose-6-phosphate; mannose-1-phosphate and mannose-6-phosphate; galactose-1-phosphate and galactose-6-phosphate; N-acetylglucosamine-1-phosphate and N-acetylglucosamine-6-phosphate. The effects of mixture concentrations and ion/molecule reaction conditions on the quantification are also discussed. Our results demonstrate that this assay is a fast, sensitive, and robust method to quantify isomeric mixtures of phosphorylated monosaccharides.


[Antimutagenic effects of para-aminobenzoic acid in experiments with bacterial cells. Noninterference in the mutation process controlled by plasmid pKM101].
The dependence of expression of PABA antimutagenic action in bacterial cells on the character of genetic control of the mutagenic process was studied. PABA antimutagenic activity was largely connected with the negative control of SOS repair which is controlled by bacterial cell genes, but not by pKM101 plasmid genes. These results are in agreement with the idea that the systems of repair and mutagenesis specified by cell genome and plasmids are not identical.


Natural history of saccular aneurysms of the left ventricle.
We have studied the natural history of left ventricular aneurysms (LVA) in 40 patients not treated surgically who were followed for a mean period of 5 years, 8 months. These patients have been divided into two groups according to the presence (Group B) or absence (Group A) of significant symptomatology. The causes of death are dominated by arrhythmias and congestive heart failure (CHF). The survival rate at 10 years is 66.7% for the entire group. In asymptomatic patients the 10 year survival rate is 90%, but it is only 46.3% in those who were symptomatic at the time of the initial diagnosis. In general, the clinical course of survivors is stable in Group A but has deteriorated steadily in Group B. Nonfatal complications include arrhythmias (observed in 34% of all patients), thromboembolic phenomena (29%), CHF (29%), and recurrent myocardial infarction (22.5%). Factors influencing prognosis are the extent of the aneurysm, the association of asynergic segments, the ejection fraction of the residual ventricle, the left ventricular end-diastolic pressure (LVEDP), and the presence of ventricular extrasystoles at the time of diagnosis. The mere presence of aneurysm is not, in itself, an indication for operation. Incapacitating angina and refractory CHF are the most valuable indications for surgical resection. The question is raised as to the value of operation in patients with little or no symptoms, in those with isolated life-threatening arrhythmias, and in those in whom a mural thrombus is the only distressing feature.


Lung Transplant Outcomes for Idiopathic Pulmonary Fibrosis: Are We Improving?
After implementation of the Lung Allocation Score in 2005, idiopathic pulmonary fibrosis (IPF) emerged as the most common indication for lung transplantation (LT) in the United States. The age and comorbidity of patients undergoing LT have since increased, and the indications for LT have evolved. However, limited data have been used to analyze more recent outcomes among the IPF population. This study analyzed LTs for the primary indication of IPF by using the United Network for Organ Sharing database. An eras-based analysis was performed, comparing patient characteristics, survival, and related outcomes during 2005 to 2009 (era 1) and 2010 to 2014 (era 2) with χ2, Wilcoxon rank sum, and Kaplan-Meier analyses. The study compared 1-year survival from 2005 to 2020 and survival at milestones ranging from 1 month to 5 years. Two adjusted Cox proportional hazards models were conducted: 5-year survival by era and 1-year survival annually from 2010 to 2020. From era 1 (n = 1818) to era 2 (n = 3227), the median age of LT recipients increased from 61 to 63 years (P < .001). The percentage of patients in the intensive care unit before LT climbed from 7.7% to 12.1% (P < .001), and the percentage of patients with diabetes grew from 17.9% to 19.4% (P = .003). Despite increased severity of illness, 5-year survival increased from 51.9% in era 1 to 55.2% in era 2 (P = .02). Adjusted modeling indicated that LT during era 2 featured a 17% hazard reduction compared with era 1 (hazard ratio, 0.83; 95% CI, 0.76-0.91). Survival is improving for patients undergoing LT for IPF, despite the challenges of transplant recipients with progressively higher risk profiles.


National trends and coding patterns in fall-related mortality among the elderly in the United States.
Because good information on deaths caused by a fall would be important for prevention policies, we analyzed the influence of coding differences on variability in state-level fall death rates in the elderly. We examined state differences in the number of cause of death codes on death certificates, death certifiers, completeness of E-coding, and indicators of specificity of coding. We found that state-specific fall mortality rates ranged from 13.9 to 140.4 in people aged 65 years and above. States employing a coroner to investigate injury deaths had 14 per cent fewer recorded fall deaths than those where a medical examiner conducted the investigations. Each unit increase in the median number of cause of death codes was associated with a 10 per cent increase in the number of falls. For each 1 per cent increase in the use of unspecified codes for the underlying cause of death, the number of falls dropped by 2 per cent. Current fall mortality data do not appear to identify all instances of falls. Variability in unintentional fall-related death rates among states may be partly explained by death certification coding practices. Standardization of coding and training for documentation of fall events and death certificate reporting could help uncover the actual fall mortality burden in the elderly.


Isotherm of alcohol-cooled cryoprobe.
The spread of cooling from the tip of a cryoprobe placed in the ventral posterior lateral nucleus of the thalamus in 10 cats was determined. A 20 degrees C isotherm was described as having a diameter of 4 mm and extending 2 mm below the tip of the cryoprobe and tapering up along the shaft of the cryoprobe for a distance of 2 mm, when the cryoprobe tip temperature was maintained at 3 degrees C.


Cocaethylene produces conditioned place preference in rats.
The ability of cocaethylene to produce either a conditioned place preference or a conditioned place aversion was tested in rats. Twelve male rats were administered 10 mg/kg cocaethylene and confined to their nonpreferred side of the conditioned place preference apparatus as determined on a baseline test day. Subsequently, these rats spent a greater amount of time in that cocaethylene-paired nonpreferred side when later tested in a drug-free state. In contrast, rats conditioned with the same dose of cocaethylene and confined in their preferred side, as well as other rats treated with saline on both sides, did not show a significant shift in their preference or aversion. Results are discussed in light of the rewarding activity of cocaethylene, a compound formed in humans who concurrently use cocaine and ethanol.


Platelet-activating factor (PAF) inhibitory profile of KO-286011 on blood platelets in vitro and in vivo.
A newly synthesised structural analogue of PAF, coded KO-286011 (1-O-hexadecyl-2-O-ethyl-rac-glycero-3-phosphoric acid 4-(N,N-dimethylamino)pyridinium butylester), was proved for its ability to inhibit PAF-mediated platelet responses in vitro and in vivo. The compound inhibited effectively the PAF-induced aggregation and secretion of human and rabbit platelets. In contrast, there was little influence on ADP-, collagen-, and arachidonic acid-triggered platelet responses. Schild-analysis of aggregation data ascertained in human platelet-rich plasma was consistent with a simple competitive antagonism and yielded a pA2 of 6.44. Proaggregatory activity of KO-286011 was excluded turbidimetrically as well as by means of a single cell counting technique. [3H]PAF binding studies provided evidence that KO-286011 exerts its inhibitory action at the PAF-receptor level. A significant inhibition of the ex vivo PAF-induced platelet aggregation was found after i.v. administration of 0.5 mg/kg KO-286011 to rabbits. The effect was most pronounced 5 min after dosing the inhibitor and detectable over a period of 30 min. Intravenous administration of 10 and 25 micrograms/kg KO-286011 to guinea pigs prevented dose-dependently the PAF-induced formation of thromboxane A2. The PAF-inhibitory action of KO-286011 was more potent than that of the ginkgolide BN 52021.


The Influence of Sagittal Plane Hip Position on Lower-Extremity Muscle Activity and Torque Output.
Hip muscle strength has previously been evaluated in various sagittal plane testing positions. Altering the testing position appears to have an influence on hip muscle torque during hip extension, abduction, and external rotation. However, it is unknown how altering the testing position influences hip muscle activity during these commonly performed assessments. To evaluate how hip sagittal plane position influences hip muscle activation and torque output. Cross-sectional. Laboratory. A total of 22 healthy females (age = 22.1 [1.4] y; mass = 63.4 [11.3] kg; height = 168.4 [6.2] cm) were recruited. None. Participants completed isometric contractions with surface electromyography on the superior and inferior gluteus maximus; anterior, middle, and posterior gluteus medius; biceps femoris, semitendinosus, adductor longus, and tensor fascia latae. Extension and external rotation were tested in 0°, 45°, and 90° of hip flexion and abduction was tested in -5°, 0°, and 45° of hip flexion. Repeated-measures analysis of variances were used for statistical analysis (P ≤ .01). Activation of gluteal (P < .007), semitendinosus (P = .002), and adductor longus (P = .001) muscles were lesser for extension at 90° versus less flexed positions. Adductor longus activity was greatest during 90° of hip flexion for external rotation torque testing (P < .001). Tensor fascia latae (P < .001) and gluteus maximus (P < .001) activities were greater in 45° of hip flexion. Significant differences in extension (P < .001) and abduction (P < .001) torque were found among positions. Position when assessing hip extension and abduction torque has an influence on both muscle activity and torque output but only muscle activity for hip external rotation torque. Clinicians should be aware of the influence of position on hip extension, abduction, and external rotation muscle testing and select a position most in line with their clinical goals.


Multi-channel telephone transmission and quantitative on-line analysis of EEG in brain surgery.
During the last ten years clinical neurophysiology has used computerized quantitative methods for analysis. Evaluation of the information previously hidden in the signals from the nervous system offers previously unknown uses and applications for neurosurgery. The quantitative EEG (QEEG) for example may offer more reliable and easily understandable information of brain activity than the conventional analogue EEG. The techniques for QEEG-analysis have now reached such an advanced stage that they extract at the same time more information from the EEG than can be achieved by visual interpretation. The problems of distances between neurosurgical departments and computer centers can be overcome by means of telephone transmitter systems, as has been done in the present study. Patients with epilepsy or brain tumour undergoing surgery were analyzed and monitored with the peroperative tele-QEEG-system. Our experiences were encouraging since the neurophysiological part of the work at the operation unit was reduced considerably thanks to the tele-system. At the same time we obtained easily understandable EEG-information which has never previously been available to us.


A role for visual areas in physics simulations.
To engage with the world, we must regularly make predictions about the outcomes of physical scenes. How do we make these predictions? Recent computational evidence points to simulation-the idea that we can introspectively manipulate rich, mental models of the world-as one explanation for how such predictions are accomplished. However, questions about the potential neural mechanisms of simulation remain. We hypothesized that the process of simulating physical events would evoke imagery-like representations in visual areas of those same events. Using functional magnetic resonance imaging, we find that when participants are asked to predict the likely trajectory of a falling ball, motion-sensitive brain regions are activated. We demonstrate that this activity, which occurs even though no motion is being sensed, resembles activity patterns that arise while participants perceive the ball's motion. This finding thus suggests that mental simulations recreate sensory depictions of how a physical scene is likely to unfold.


Longitudinal Impact of APRNs on Nursing Home Quality Measures in the Missouri Quality Initiative.
To measure the impact of advanced practice nurses (APRNs) on quality measures (QM) scores of nursing homes (NHs) in the CMS funded Missouri Quality Initiative (MOQI) that was designed to reduce avoidable hospitalizations of NH residents, improve quality of care, and reduce overall healthcare spending. A four group comparative analysis of longitudinal data from September 2013 thru December 2019. NHs in the interventions of both Phases 1 (2012-2016) and 2 (2016-2020) of MOQI (n=16) in the St. Louis area; matched comparations in the same counties as MOQI NHs (n=27); selected Phase 2 payment intervention NHs in Missouri (n=24); NHs in the remainder of the state (n=406). NHs in Missouri Intervention: Phase 1 of The Missouri Quality Initiative (MOQI), a Centers for Medicare and Medicaid (CMS) Innovations Center funded research initiative, was a multifaceted intervention in NHs in the Midwest, which embedded full-time APRNs in participating NHs to reduce hospitalizations and improve care of NH residents. Phase 2 extended the MOQI intervention in the original intervention NHs and added a CMS designed Payment Intervention; Phase 2 added a second group of NHs to receive the Payment. Intervention Only. Eight QMs selected by CMS for the Initiative were falls, pressure ulcers, urinary tract infections, indwelling catheters, restraint use, activities of daily living, weight loss, and antipsychotic medication use. For each of the monthly QMs (2013 thru 2019) an unobserved components model (UCM) was fitted for comparison of groups. The analysis of QMs reveals that that the MOQI Intervention + Payment group (group with the embedded APRNs) out-performed all comparison groups: matched comparison with neither intervention, Payment Intervention only, and remainder of the state. These results confirm the QM analyses of Phase 1, that MOQI NHs with full-time APRNs are effective to improve quality of care.


High expression of long non-coding RNA Linc-A associates with poor survival in patients with colorectal cancer.
Long intergenic non-coding RNA for kinase activation (Linc-A) has been reported to enhance the occurrence and progression of breast cancer. Nevertheless, whether Linc-A is related to the tumorigenesis of colorectal cancer (CRC) remains unknown. In this study, we aimed to evaluate the expression of Linc-A in colon adenocarcinoma and explore the correlation between Linc-A and prognosis of CRC. The expression of Linc-A in human colon tissues was evaluated by qRT-PCR, which contained 15 pairs of human colon adenocarcinoma and paracancerous tissues and other 65 colon adenocarcinoma tissues. A total of 80 patients were divided into low and high expression groups according to the Linc-A levels. The levels of Linc-A in colon adenocarcinoma was higher than that in paracancerous tissues (p = 0.047). Furthermore, high expression of Linc-A was associated with advanced TNM stage (p = 0.013), positive lymph nodes (p = 0.024), low 5-year survival rate (p = 0.024) and even 10-year survival rate (p = 0.007). Besides, Linc-A, advanced age, advanced TNM stage, deep infiltration degree and positive lymph nodes were also found to be positively related to poor overall 5-year survival by Kaplan-Meier survival analysis(p < 0.05). Then, multivariable Cox regression analysis revealed that Linc-A was an independent risk factor for prognosis of colon adenocarcinoma (p = 0.047). In conclusion, high expression of Linc-A is associated with advanced TNM stage, lymphatic metastasis and poor survival in patients with CRC. Linc-A may be served as a candidate prognostic biomarker for CRC.


Effect of mouth cleaning with hinokitiol-containing gel on oral malodor: a randomized, open-label pilot study.
The aim of the study was to evaluate the effect of mouth cleaning with hinokitiol-containing gel on oral malodor. An open-label, randomized, controlled trial was conducted to assess oral malodor and clinical parameters related to oral malodor before and after mouth cleaning with hinokitiol-containing gel (n = 9) or with gel not including hinokitiol (n = 9). Mouth cleaning included the teeth, gingiva, and tongue and was carried out 3 times per day for 4 weeks. Organoleptic test (OLT) scores (P = .021), levels of hydrogen sulfide (P = .008) and methyl mercaptan (P = .020), frequency of bleeding on probing, average probing pocket depth, and plaque index significantly improved in the group using hinokitiol. In contrast, only the OLT score (P = .031) significantly improved in the control group after the treatment regimen. Mouth cleaning with hinokitiol-containing gel may be effective for reduction of oral malodor.


A nationwide survey on the implementation of infection prevention and control components in 1442 hospitals in the Republic of Korea: comparison to the WHO Infection Prevention and Control Assessment Framework (IPCAF).
The current SARS-CoV-2 pandemic continues to underscore the inadequacy of infection prevention and control (IPC) and the importance of its sound establishment in healthcare facilities. The Infection Prevention and Control Assessment Framework (IPCAF) by the World Health Organization allows systematic assessment of IPC capacity in healthcare facilities and has been applied in many national-level surveys. This study aims to assess the IPC capacity of Korean hospitals as well as their strengths and pitfalls by analyzing the results of the first government-led nationwide IPC survey in comparison to the IPCAF frame. The Korean National Infection Prevention and Control Survey (KNIPCS) was conducted from February to March 2018. The survey questionnaire for KNIPCS was developed through a series of expert consultations and a round of pre-testing in two randomly selected hospitals. The survey questionnaire was distributed to a total of 2108 hospitals. Although the survey preceded the release of IPCAF, its contents complied with IPCAF to a large extent, allowing exploration of its results with regards to IPCAF. All tertiary hospitals and 96.5% of general hospitals had implemented IPC teams, whereas the percentage was lower for long-term care hospitals (6.3%). A similar trend was observed for IPC surveillance and monitoring activities across hospital types. The percentage of interactive IPC training was lower than 30% in all hospital groups. Disinfection was frequently monitored in all hospital types (e.g. 97.3% in general hospitals and 85.3% in long-term care hospitals). However, activities regarding antimicrobial resistance, such as multi-drug resistant pathogen screening, were weak in hospitals (25%) and long-term care hospitals (25%), compared to tertiary hospitals (83.3%) and general hospitals (57.7%). In general, essential IPC structures, such as IPC teams and programs, were well in place in most tertiary and general hospitals in Korea. These hospital groups also actively conducted various IPC activities. As most previous legislative and multimodal policy measures have targeted these hospital groups, we speculate that future policy efforts should encompass long-term care hospitals and smaller-sized hospitals to strengthen the IPC capacity of these hospital groups. Efforts should also be put forth to promote IPC training and antimicrobial activities.


Controlled failure mechanisms toughen the dentino-enamel junction zone.
The dentino-enamel junction (DEJ) durably unites dissimilar hard brittle enamel and tough flexible dentin. In contrast to artificial bonds between restorations and dentin, the DEJ rarely fails except when it is affected by inherited disorders. Knowledge of DEJ toughening mechanisms is important in understanding inherited disorders, in biomimetic engineering of junctions between artificial restorations and teeth, and in tissue-engineering a DEJ. The purpose of this study was to identify specific DEJ-zone failure mechanisms and to survey the fracture toughness of the human DEJ zone. Fracture toughness indentations were made at 3 sites across the DEJ zone of 10 human incisor teeth. Failure modes identified using optical microscopy and fracture toughness (MPa.m(1/2)) were calculated following Vickers microindentation. Site mean values were then calculated and compared using 1-way analysis of variance (alpha=.05). The DEJ did not undergo catastrophic interfacial delamination; instead, damage was distributed over a broad zone. The primary damage mode involved cracking and damage dispersion in the specialized first-formed enamel close to the DEJ. Multiple, somewhat convoluted and sometimes branching, cracks spread and diffused damage over a wide area of adjacent enamel rather than producing catastrophic interfacial failure. Other secondary mechanisms included short microcracks in the DEJ adjacent dentin with possible cracked bridging, as well as plastic deformation of the DEJ without delamination. A DEJ-zone fracture toughness of approximately 0.8 to 0.9 MPa.m(1/2) was calculated. DEJ-zone damage occurred primarily within the adjacent layer of specialized first-formed enamel, and the optical DEJ interface resisted delamination.


Cytotoxic constituents of Amanita subjunquillea.
As part of our systematic study of Korean toxic mushrooms, we have investigated the constituents of Amanita subjunquillea. The column chromatographic separation of the MeOH extract of A. subjunquillea led to the isolation of four ergosterols, two cerebrosides and four cyclopeptides. Their structures were determined by spectroscopic methods to be (22E,24R)-5alpha,8alpha-epidioxyergosta-6,9,22-triene-3beta-ol (1), (22E,24R)-5alpha,8alpha-epidioxyergosta-6,22-dien-3beta-ol (2), (22E,24R)-5alpha,6alpha-epoxyergosta-8,22-diene-3beta,7beta-diol (3), (24S)-ergost-7-en-3beta-ol (4), 8,9-dihydrosoyacerebroside I (5), soyacerebroside I (6), beta-amanitin (7), phalloin (8), alpha-amanitin (9), and phalloidin (10). The compounds 1-6 and 8 were isolated for the first time from this mushroom. The isolated compounds were evaluated for the cytotoxicity against A549, SK-OV-3, SK-MEL-2 and HCT15 cells. Compound 9 exhibited significant cytotoxic activity against A549, SK-OV-3, SK-MEL-2 and HCT15 with ED(50) values of 1.47, 0.26, 1.57 and 1.32 microM, respectively.


Disseminated histoplasmosis in systemic lupus erythematosus: case report and review of the literature.
To report a patient who developed both central nervous system systemic lupus erythematosus (SLE) and disseminated histoplasmosis and to review the literature regarding histoplasma infection in patients with SLE. MEDLINE review of the medical literature published in English. Disseminated histoplasmosis occurs rarely in patients with SLE. The main risk factor is treatment with corticosteroids at doses of 20 mg/d or greater. Fever, dyspnea, pleurisy, and weight loss are typical presenting symptoms. The most commonly involved tissues are lung, liver, and bone marrow. In our patient, both SLE flare and disseminated histoplasmosis were present simultaneously. Opportunistic infection is an important complication of SLE and may be difficult to diagnose. Symptoms of infection may mimic those of a lupus flare, or conversely, symptoms may be masked by the use of corticosteroids. Fever, unexplained tissue involvement, atypical clinical patterns, and poor response to immunosuppressive therapy should alert the clinician to aggressively pursue evaluation of possible infection in patients with SLE.


The willingness to pay of parties to traffic accidents for loss of productivity and consolation compensation.
In this study, willingness to pay (WTP) for loss of productivity and consolation compensation by parties to traffic accidents is investigated using the Tobit model. In addition, WTP is compared to compensation determined by Taiwanese courts. The modelling results showed that variables such as education, average individual monthly income, traffic accident history, past experience of severe traffic accident injuries, the number of working days lost due to a traffic accident, past experience of accepting compensation for traffic accident-caused productivity loss and past experience of accepting consolation compensation caused by traffic accidents have a positive impact on WTP. In addition, average WTP for these two accident costs were obtained. We found that parties to traffic accidents were willing to pay more than 90% of the compensation determined by the court in the scenario of minor and moderate injuries. Parties were willing to pay approximately 80% of the compensation determined by the court for severe injuries, disability and fatality. Therefore, related agencies can use our study findings as the basis for determining the compensation that parties should pay for productivity losses caused by traffic accidents of different types.


Apical/basolateral surface expression of drug transporters and its role in vectorial drug transport.
It is well known that transporter proteins play a key role in governing drug absorption, distribution, and elimination in the body, and, accordingly, they are now considered as causes of drug-drug interactions and interindividual differences in pharmacokinetic profiles. Polarized tissues directly involved in drug disposition (intestine, kidney, and liver) and restricted distribution to naive sanctuaries (blood-tissue barriers) asymmetrically express a variety of drug transporters on the apical and basolateral sides, resulting in vectorial drug transport. For example, the organic anion transporting polypeptide (OATP) family on the sinusoidal (basolateral) membrane and multidrug resistance-associated protein 2 (MRP2/ABCC2) on the apical bile canalicular membrane of hepatocytes take up and excrete organic anionic compounds from blood to bile. Such vectorial transcellular transport is fundamentally attributable to the asymmetrical distribution of transporter molecules in polarized cells. Besides the apical/basolateral sorting direction, distribution of the transporter protein between the membrane surface (active site) and the intracellular fraction (inactive site) is of practical importance for the quantitative evaluation of drug transport processes. The most characterized drug transporter associated with this issue is MRP2 on the hepatocyte canalicular (apical) membrane, and it is linked to a genetic disease. Dubin-Johnson syndrome is sometimes caused by impaired canalicular surface expression of MRP2 by a single amino acid substitution. Moreover, single nucleotide polymorphisms in OATP-C/SLC21A6 (SLCO1B1) also affect membrane surface expression, and actually lead to the altered pharmacokinetic profile of pravastatin in healthy subjects. In this review article, the asymmetrical transporter distribution and altered surface expression in polarized tissues are discussed.


A Role for Genitourinary Reconstruction in Locally Advanced Bilateral Wilm's Tumor.
Wilm's tumor, an embryonal tumor that develops from remnants of the immature kidney, is the most common primary malignant renal tumor of childhood and accounts for approximately 6%-7% of all childhood cancers. Here, we present a case of a 10-year-old female with stage IV Wilm's tumor involving the bilateral kidneys. She ultimately required complex genitourinary reconstruction via a transureteroureterostomy following extensive oncologic resection. This case highlights the critical role of Urologists at an early stage in cases requiring complex genitourinary reconstruction.


Congenital ureteral valves--an abnormality of ureteral embryogenesis?
Congenital ureteral valves are a rare cause of obstructive uropathy and the majority of cases are diagnosed only at surgery or autopsy. A case of congenital ureteral valve associated with an incompletely duplicated kidney is reported and the literature on ureteral valves is reviewed. Modern uroradiological and endoscopic diagnostic techniques should result in a more precise preoperative diagnosis. The high incidence of associated genitourinary anomalies, particularly duplication anomalies, suggests abnormal ureteral embryogenesis as an etiological factor in congenital ureteral valve formation.


Effect of acute stress and gender on isatin in rat tissues and serum.
Isatin is an endogenous indole present in mammalian tissues and fluids. This study was designed to test the effect of both acute stress (AS) and gender on isatin's levels in rat serum, heart and brain, using a HPLC-UV detection method. Basal brain isatin levels were higher in females than in males. AS resulted in increased isatin levels in male serum, heart and brain, and in female serum and heart, but not in the brain. The percentage increases were greater in males than in females in all three sources. After stress, there were significant correlations between isatin levels in the serum and the heart. However, there were no correlations between brain levels and those in the other sources. These results consolidate previous evidence that isatin levels are altered by stress and suggest that brain isatin is under separate control from that in the periphery.


Comparative toxicity of five dispersants to test organisms at different trophic levels: Platymonas helgolandica, Ruditapes philippinarum, and Acinetobacter sp. Tox2.
Nowadays, although dispersants have been widely applied for emergency response to oil spills, they are potentially hazardous to the marine ecosystem. Therefore, it is necessary to evaluate dispersants' toxicity in a practical and integrated way before their large-scale application. Here, we compared the acute toxicity of five chemical dispersants (concentrate RS-I, conventional RS-I, HLD-501, Fuken-2, and Weipu) to three species (a microalgae Platymonas helgolandica, a mollusk Ruditapes philippinarum, and a luminescent bacterium Acinetobacter sp. Tox2) which represent different trophic levels. Our results showed that (1) conventional RS-I was slightly toxic to all the three test organisms; (2) concentrate RS-I and Weipu were slightly toxic to R. philippinarum, but were not toxic to the other two test species; (3) Fuken-2 and HLD-501 exhibited no acute toxicity to the three test organisms. Our results could provide information on toxicity data derived from multiple test organisms for the use of these five dispersants in the future.


Repurposed therapeutic agents targeting the Ebola virus: a protocol for a systematic review.
The recent Ebola epidemic in western Africa developed into an acute public health emergency of unprecedented level in modern times. The treatment provided in most cases has been limited to supportive care, as no approved therapies are available to date. Several established, licenced drugs have been suggested as potential repurposed therapeutic agents for Ebola. However, scientific data on their efficacy in treating Ebola is limited. The purpose of this review is to systematically assess scientific evidence on potential drugs targeting Ebola. In specific, we aim to (1) identify drug library screens involving therapeutic agents targeting the Ebola virus, (2) list potential approved drugs identified from drug screens and review their mechanism of action against the Ebola virus and (3) summarise the outcome of preclinical and clinical trials investigating approved drugs targeting the Ebola virus. We will develop comprehensive systematic search strategies and will perform a systematic literature search in MEDLINE, Embase and Cochrane Central Register of Controlled Trials (CENTRAL). Two authors will independently screen the titles, abstracts and the references of all selected articles on the basis of inclusion criteria. These include any available drug screening, preclinical studies and clinical studies examining the efficacy of approved therapeutic agents targeting the Ebola virus. There will be no restrictions on the type of participants, the type of comparator, time or setting. Data extraction and quality assessment will be undertaken by two review authors working independently. This systematic review will provide systematic knowledge on potential repurposed therapeutic agents targeting Ebola. It aims to help guide future investigations on repurposed drugs and avoid repetitive studies. PROSPERO CRD42015024349.


A prospective, randomized double-blind study in children comparing two doses of nebulized L-epinephrine in postintubation croup.
To compare the effectiveness and side effects of nebulized l-epinephrine (NLE) at a dose of 0.05 mL/kg versus 0.5 mL/kg in the treatment of postintubation croup in children. Thirty-nine children, who developed signs and symptoms of upper airway obstruction (UAO) after extubation, were randomized to receive either 0.05 mL/kg or 0.5 mL/kg of NLE. UAO scores, vital signs (VS) and possible side effects were recorded before and at 20 and 40 minutes after the treatment. Twenty-one and 18 patients were allocated to the 0.05 and 0.5 mL/kg groups, respectively. Both groups showed improvements in UAO scores over time. There were no significant differences in UAO scores and VS between the groups at all time points. Side effects of epinephrine were not observed. In children with postintubation croup, the administration of NLE at the dose of 0.05 mL/kg results in similar improvements in the UAO scores, compared with the dose of 0.5 mL/kg. No complications were seen in either dose.


Determination of leaf heat resistance: comparative investigation of chlorophyll fluorescence changes and tissue necrosis methods.
Heat tolerance limits for a variety of vascular plant leaves were determined both with the conventional post-culture necrosis method and by measurements of the heat-induced increase in chlorophyll fluorescence (F-T curves). The reliability of the fluorescence test was improved with the addition of far-red background light which counteracts dark reduction of the Photosystem II acceptor pool by heat-stimulated endogenous electron donors. This was of particular importance in the case of xeromorphic leaves in which the diffusion barrier for oxygen is high. A satisfactory correlation was found between T L50, the temperature at which a 30 min exposure results in 50% necrotic leaf area following post culture, and the critical temperature, T c ,the temperature at which the dark fluorescence level begins to increase during slow heating of a leaf sample at a rate of 0.7 K min-1, in the fluorescence test. The correlation can be described by a linear function, T L50=1.12 T c -5.37,with a correlation coefficient, r=0.87. Maximal deviation of the regression line from the line T L50=T c was 1.2 K, with 22 determinations for leaves with widely varying heat tolerance limits. This shows that heat-induced fluorescence changes within the thylakoid membrane may be connected with the irreversible leaf tissue damage which occurs following prolonged exposure to high temperature. On the basis of the heat dosage equation of Lepeschkin, a more general expression can be obtained which allows calculation of the accumulated heat dosage under the experimental conditions of the standard fluorescence test (slow heating, 0.7 K min-1). Such calculations reveal that for a given species the 'fraction of critical dosage' begins to increase, i.e. accumulating heat reaches an injurious level, at a temperature which approximately coincides both with T L50, obtained with the necrosis method, and with T c ,the critical temperature derived from the fluorescence test. Hence, the increase in fraction of critical dosage and the rise in chlorophyll fluorescence seem to concur. It is concluded that the fluorescence assay provides a rapid and reliable means of determining the heat tolerance limit of leaf tissue.


Sub-acute cardiac magnetic resonance to predict irreversible reduction in left ventricular ejection fraction after ST-segment elevation myocardial infarction: A DANAMI-3 sub-study.
To predict irreversible reduction in left ventricular ejection fraction (LVEF) during admission for ST-segment elevation myocardial infarction (STEMI) using cardiac magnetic resonance (CMR) in addition to classical clinical parameters. Irreversible reduction in LVEF is an important prognostic factor after STEMI which necessitates medical therapy and implantation of prophylactic implantable cardioverter defibrillator (ICD). A post-hoc analysis of DANAMI-3 trial program (Third DANish Study of Optimal Acute Treatment of Patients With ST-elevation Myocardial Infarction) which recruited 649 patients who had CMR performed during index hospitalization and after 3 months. Patients were divided into two groups according to CMR-LVEF at 3 months: Group 1 with LVEF≤35% and Group 2 with LVEF>35%. Group 1 included 15 patients (2.3%) while Group 2 included 634 patients (97.7%). A multivariate analysis showed that: Killip class >1 (OR 7.39; CI:1.47-36.21, P = 0.01), symptom onset-to-wire ≥6 h (OR 7.19; CI 1.07-50.91, P = 0.04), LVEF≤35% using index echocardiography (OR 7.11; CI: 1.27-47.43, P = 0.03), and infarct size ≥40% of LV on index CMR (OR 42.62; CI:7.83-328.29, P < 0.001) independently correlated with a final LVEF≤35%. Clinical models consisted of these parameters could identify 7 out of 15 patients in Group 1 with 100% positive predictive value. Together with other clinical measurements, the assessment of infarct size using late Gadolinium enhancement by CMR during hospitalization is a strong predictor of irreversible reduction in CMR_LVEF ≤35. That could potentially, after validation with future research, aids the selection and treatment of high-risk patients after STEMI, including implantation of prophylactic ICD during index hospitalization.


Focal odontodysgenesis of the maxillary second premolars in a child.
A few months before her sixth birthday, a Caucasian girl suffered progressively worse episodes of painful, nontender, erythematous swellings of the palate lingual to apparently healthy primary second molars. Neither of the developing maxillary second premolars was discerned clearly in radiographs, but, upon surgical exploration, incomplete crowns were found in both follicles. All the other premolars appeared to be developing normally. Histologic, histochemical, and chemical analyses showed that the enamel was hypocalcified, apparently as a result of hypomaturation; the dentin was essentially normal; and morphogenesis had ceased when the heights of contour of the crowns had not yet been reached. This pattern of developmental defects differs from those of well-characterized odontogenic disorders, such as regional odontodysplasia and amelogenesis imperfecta. We suggest that focal odontodysgenesis might be an appropriate term for it. The bilateral symmetry suggests a genetic component in the etiology.


Linking DOM characteristics to microbial community: The potential role of DOM mineralization for arsenic release in shallow groundwater.
Dissolved organic matter (DOM) play critical roles in arsenic (As) biotransformation in groundwater, but its compositional characteristics and interactions with indigenous microbial communities remain unclear. In this study, DOM signatures coupled with taxonomy and functions of microbial community were characterized in As-enriched groundwater by excitation-emission matrix, Fourier transform ion cyclotron resonance mass spectrometry and metagenomic sequencing. Results showed that As concentrations were significantly positively correlated with DOM humification (r = 0.707, p < 0.01) and the most dominant humic acid-like DOM components (r = 0.789, p < 0.01). Molecular characterization further demonstrated high DOM oxidation degree, with the prevalence of unsaturated oxygen-low aromatics, nitrogen (N1/N2)-containing compounds and unique CHO molecules in high As groundwater. These DOM properties were consistent with microbial composition and functional potentials. Both taxonomy and binning analyses demonstrated the dominance of Pseudomonas stutzeri, Microbacterium and Sphingobium xenophagum in As-enriched groundwater which possessed abundant As-reducing gene, with organic carbon degrading genes capable of labile to recalcitrant compounds degradation and high potentials of organic nitrogen mineralization to generate ammonium. Besides, most assembled bins in high As groundwater presented strong fermentation potentials which could facilitate carbon utilization by heterotrophic microbes. This study provides better insight into the potential role of DOM mineralization for As release in groundwater system.


Immunohistochemical indications of gastrin releasing peptide--bombesin-like immunoreactivity in the nervous system of the rat. Codistribution with substance P-like immunoreactive nerve terminal systems and coexistence with substance P-like immunoreactivity in dorsal root ganglion cell bodies.
Weak to strong gastrin releasing peptide--bombesin (GRP-Bn)-like immunoreactivity was found in fine varicose nerve terminal systems of low to high densities in several parts of the CNS. The highest densities of strongly immunoreactive terminals were found in the marginal layer and in the substantia gelatinosa of the spinal cord, and in parts of the nuc. tractus spinalis nervi trigemini. Morphometrical analysis in the spinal cord demonstrates that GRP-BN-like-immunoreactive and substance P (SP), but not somatostatin (SS)-immunoreactive nerve terminals strikingly codistribute. Coexistence of SP and GRP-BN-like immunoreactivities was demonstrated in trigeminal and spinal ganglion nerve cells. Thus, GRP-BN-like immunoreactivity may coexist with SP in certain SP-immunoreactive nerve terminal systems.


First reported case of leishmaniasis in a cat in Trinidad and Tobago.
A 3-year-old, female, domestic shorthair cat, was presented to the Veterinary Teaching Hospital at the School of Veterinary Medicine (SVM), Trinidad and Tobago for a swollen nose, and multiple, variably sized small masses on both ears. The initial diagnostic tests included a CBC, serum biochemistry profile, cytological evaluation of masses on the ear and nose, and FeLV/FIV testing. The CBC and biochemistry results were unremarkable except for a hyperproteinaemia and hyperglobulinemia. Cytology of the nose and ear lesions revealed mixed inflammation and high numbers of intracellular and extracellular organisms consistent with Leishmania amastigotes. The cat was FeLV/FIV negative. Histopathology and Leishmania IFA and PCR analysis were subsequently performed, confirming the Leishmania diagnosis. The PCR, DNA sequencing and phylogenetic tree analyses identified L. amazonensis. This is the first reported case of L. amazonensis infection in a domestic animal in Trinidad with molecular characterization indicating it exists in the region and is likely being transmitted by sandflies.


Mitral Annular Disjunction: Associated Pathologies and Clinical Consequences.
To provide an overview of mitral annular disjunction (MAD) and to discuss important challenges in diagnosis and management of MAD. MAD has regained interest in the context of sudden cardiac death (SCD) in patients with mitral valve prolapse (MVP), coined as the "arrhythmic" MVP syndrome. In addition, MAD in isolation was recently suggested to be associated with severe arrhythmia and SCD. There is a lack of consensus on the definition of MAD and the imaging modality to be used for diagnosing MAD, and the therapeutic implications of MAD remain uncertain. Furthermore, the exact mechanism underlying the association of MAD with SCD remains largely unexplored.


Monitoring the influence of additives on the crystallization processes of glycine with dynamic nuclear polarization solid-state NMR.
Crystallization is fundamental in many domains, and the investigation of the sequence of solid phases produced as a function of crystallization time is thus key to understand and control crystallization processes. Here, we used a solid-state nuclear magnetic resonance strategy to monitor the crystallization process of glycine, which is a model compound in polymorphism, under the influence of crystallizing additives, such as methanol or sodium chloride. More specifically, our strategy is based on a combination of low-temperatures and dynamic nuclear polarization (DNP) to trap and detect transient crystallizing forms, which may be present only in low quantities. Interestingly, our results show that these additives yield valuable DNP signal enhancements even in the absence of glycerol within the crystallizing solution.


Effect of Hypertonic Saline in Intra-Articular Hydraulic Distension for Adhesive Capsulitis.
Maintaining the integrity of the capsule along with infusing a sufficient amount of fluid is 1 of the therapeutic concepts in intra-articular hydraulic distension (IHD) for adhesive capsulitis. It has been known that hypertonic saline solution decreases tissue edema and increases the fluid volume within the epidural space, causing microdissection, in epidural adhesiolysis. To investigate the effect of hypertonic saline solution in capsule-preserving intra-articular hydraulic distension (CPIHD) for adhesive capsulitis. Prospective randomized controlled trial. University outpatient clinic of physical medicine and rehabilitation. A total of 64 patients who were diagnosed as adhesive capsulitis of shoulder were randomly assigned to 1 of 2 treatment groups. The hypertonic saline group was treated by CPIHD with hypertonic saline (3% NaCl), and the normal saline group with normal saline solution (0.9% NaCl). Both groups were treated with CPIHD, a method that preserves the capsule with maximal distension without inducing capsule rupture. The volume of saline solution necessary to adequately distend the capsule was recorded. Injection materials contained 4 mL of 1% lidocaine, 1 mL of triamcinolone (10 mg), and saline solution (hypertonic or normal saline). The intra-articular injection was monitored with ultrasound to maximize the infused volume while preserving the capsule. The Shoulder Pain and Disability Index (SPADI) and shoulder passive range of motion (PROM) was measured before the procedure and 2 weeks after CPIHD. The mean CPIHD volume was 20.2 ± 5.2 mL for the hypertonic saline group and 19.5 ± 5.9 mL for the normal saline group. The hypertonic saline group showed statistically significant improvement in shoulder PROM and SPADI score compared with the normal saline group. Side effects such as soreness or complications related to injection were not reported. Our results suggest that CPIHD with hypertonic saline solution is more effective than that using normal saline solution in patients with adhesive capsulitis.


Spoligotypes of Mycobacterium tuberculosis isolates of a high tuberculosis burden aboriginal township in Taiwan.
To understand the genotype of Mycobacterium tuberculosis isolates circulating in the aboriginal Sioulin Township, the highest tuberculosis (TB) endemic area in Taiwan, a total of 138 isolates were collected between January 2003 and December 2004 for genotyping. Genotyping consisted of spacer oligonucleotide typing (spoligotyping), IS6110-restriction fragment length polymorphism (RFLP) and mgtC and ogt single nucleotide polymorphisms (SNPs) characterizations. Spoligotyping data were compared with those from the fourth international spoligotyping database, SpolDB4. Of 27 resolved spoligotypes, 14 spoligotype patterns matched those found in SpolDB4 and 13 (TW1-13) were identified as novel. The most common among the 14 defined spoligotypes was Beijing ST1 (35.5%, 49/138), followed by Haarlem ST742 (10.9%, 15/138), Latin-American-Mediterranean (LAM) ST33 (5.8%, 8/138) and Haarlem ST50 (3.6%, 5/138). Of the 13 novel spoligotypes, 5 (TW 6-8, 12 and 13) were identified as "Haarlem-like" lineages according to clade analyses of spoligotyping and RFLP dendrograms. Overall, major spoligotypes found in Sioulin Township were Haarlem and Haarlem-like (39.1%), Beijing (38.4%), and LAM (5.8%) lineages. Interestingly, the results did not indicate any East-African-Indian lineages, which are highly prevalent in Far-East Asia. Our data also contained the first evidence of ST33 (LAM3 lineage) in Asia. This study provides first depiction of molecular epidemiology of M. tuberculosis in this isolated aboriginal population and further elucidation of the global historical expansion of the isolates.


Gastric cancer presenting with obstructive jaundice.
Gastric cancer is rarely associated with obstructive jaundice, which is associated with poor survival. We describe five patients with gastric cancer who presented with jaundice. Two patients had primary gastric cancer and three had recurrent disease. The patients were treated by operation, chemotherapy, and percutaneous transhepatic biliary drainage (PTBD) according to the stage of the cancers. Although these treatments often fail to prolong survival, chemotherapy and PTBD can improve patient's quality of life.


Traditional versus marginal structural models to estimate the effectiveness of beta-blocker use on mortality after myocardial infarction.
Observational studies of the effect of beta-blockers on all-cause mortality after an acute myocardial infarction (AMI) have tended to overestimate the effectiveness of this treatment. To compare the estimates of the effect of beta-blocker use on mortality post-AMI derived from a traditional adjusted regression model with those from a marginal structural model. A population-based cohort spanning the period of 2002-2004 was formed from the United Kingdom General Practice Research Database (GPRD). The cohort included all subjects who survived 90 days after their first AMI, who were then followed for 9 months. beta-Blocker use and blood pressure were identified in both the 90-day period before and the 90-day period after the AMI. Rate ratios (RR) were estimated using pooled logistic regression. The cohort included 9939 participants who survived 90 days after their AMI, of whom 633 died during the 9-month follow-up. Over 23% were taking beta-blockers pre-AMI, compared with 71% post-AMI. Using the traditional adjusted regression analysis, the RR of death with post-AMI beta-blocker use was 0.54 (95% confidence interval (CI): 0.45-0.67), while using the inverse probability of treatment weighting (IPTW) model it was 0.72 (95%CI: 0.61-0.84). The IPTW estimate is compatible with the estimate derived from a meta-analysis of randomized controlled trials (RCTs) while the adjusted regression estimate exaggerates the effectiveness. Observational studies of the association of anti-hypertensive medications with all-cause mortality should consider adding a marginal structural model to their armamentarium of data analysis.


Determination of tobramycin in eye drops with an open-source hardware ion mobility spectrometer.
The analysis of tobramycin was demonstrated successfully as an example for electrospray ionization on an open-source hardware ion mobility spectrometer. This instrument was assembled inexpensively in-house, and required only very few purpose-made components. The quantitative determination of tobramycin required 20 s for a reading. The calibration curve for the range from 50 to 200 μM was found to be linear with a correlation coefficient of r = 0.9994. A good reproducibility was obtained (3% relative standard deviation) and the limit of detection was determined as 8 μM. As the concentration of the active ingredient in the eye drops (ophthalmic solutions) is too high for the sensitivity of the instrument, the samples had to be diluted appropriately.


Sulfobromophthalein and indocyanine green binding by the hepatic cytoplasmic proteins.
The elution patterns of human and rat liver supernate mixed with BSP or ICG have been demonstrated using G-100 Sephadex gel filtration. The elution pattern in the rat liver remained the same as that shown by Levi et al. In the human liver BSP localized to Y protein could hardly be demonstrated, whereas ICG was detected. This pattern was quite similar in Rotor's hyperbilirubinemia and in Crigler-Najjar syndrome Type II. These observations suggest that the impaired hepatic transportation of organic anions in congenital hyperbilirubinemias may not be related to cytoplasmic organic anion-binding proteins.


Magnetic copper smelter slag as heterogeneous catalyst for tetracycline degradation: Process variables, kinetics, and characterizations.
The treatment of solid wastes and wastewater for sustainable development has been a hot topic. This work proposes a novel process of "waste treating waste" using magnetic copper smelter slag (CSS) as heterogeneous catalyst. The effect of process variables and water matrix was studied on catalytic performance. Under conditions of CSS 10 g/L, H2O2 100 mM, pH 4.4, and temperature 25 °C, tetracycline can be effectively degraded within 30 min. The apparent rate constant is comparable to or higher than previous reports, and the activation energy is 37 kJ/mol. The broad operation pH, slight effect of water matrix, and magnetic property of CSS are favorable for potential application. CSS was characterized by N2 adsorption-desorption isotherm, SEM-EDS, XRD, XPS, ICP and zeta potential. The dominant components of CSS are fayalite and magnetite, and the major metals of Fe and Cu provide active sites for H2O2 activation. Hydroxyl radical generated by H2O2 activation is dominant oxidative specie for tetracycline degradation. The plausible mechanism of tetracycline degradation in the solution and on catalyst surface is proposed.


Mechanochemical tuning of a kinesin motor essential for malaria parasite transmission.
Plasmodium species cause malaria and kill hundreds of thousands annually. The microtubule-based motor kinesin-8B is required for development of the flagellated Plasmodium male gamete, and its absence completely blocks parasite transmission. To understand the molecular basis of kinesin-8B's essential role, we characterised the in vitro properties of kinesin-8B motor domains from P. berghei and P. falciparum. Both motors drive ATP-dependent microtubule gliding, but also catalyse ATP-dependent microtubule depolymerisation. We determined these motors' microtubule-bound structures using cryo-electron microscopy, which showed very similar modes of microtubule interaction in which Plasmodium-distinct sequences at the microtubule-kinesin interface influence motor function. Intriguingly however, P. berghei kinesin-8B exhibits a non-canonical structural response to ATP analogue binding such that neck linker docking is not induced. Nevertheless, the neck linker region is required for motility and depolymerisation activities of these motors. These data suggest that the mechanochemistry of Plasmodium kinesin-8Bs is functionally tuned to support flagella formation.


Aperiodic flow-induced oscillations of collapsible tubes: a critical reappraisal.
The evidence for the aperiodic self-excited oscillations of flow-conveying collapsible tubes being mathematically chaotic is re-examined. Many cases which powerfully suggest nonlinear deterministic behaviour have not been recorded over time-spans which allow their exhaustive examination. The present investigation centred on a previously recorded robust and generic oscillation, but more recent and more discerning tests were applied. Despite hints that a low embedding dimension might suffice, the data appeared on most indices high-dimensional. A U-shaped return map was found and modelled using both radial basis functions and polynomials, but lack of detailed structure in the map prevented effective parameter estimation. On the basis of power-law rather than exponential divergence of nearby trajectories, and of inability to discriminate against behaviour which would also be manifested by a surrogate consisting of a noise-perturbed nonlinear periodic oscillator, it is concluded that the data do not support the idea that the aperiodicity in the particular oscillation examined is caused by deterministic chaos. There was evidence that the distributed nature of the physical system might underlie aspects of the high dimensionality. We advocate equally searching testing of any future candidate chaotic oscillations in the investigation of collapsed-tube flows.


Synthesis and in vitro anti-leishmanial activity of 1-[5-(5-nitrofuran-2-yl)-1,3,4-thiadiazol-2-yl]- and 1-[5-(5-nitrothiophen-2-yl)-1,3,4-thiadiazol-2-yl]-4-aroylpiperazines.
The synthesis and anti-leishmanial activity of nitroheteroaryl-1,3,4-thiadiazole-based compounds including 1-[5-(5-nitrofuran-2-yl)-1,3,4-thiadiazol-2-yl]-4-aroylpiperazines and 1-[5-(5-nitrothiophen-2-yl)-1,3,4-thiadiazol-2-yl]-4-aroylpiperazines were described. Most of the synthesized compounds exhibited potent anti-leishmanial activity against both promastigote and amastigote forms of Leishmania major at non-cytotoxic concentrations. In general, 5-nitrofuran derivatives were more active than the corresponding 5-nitrothiophene analogues.


Picomolar Sensitivity Analysis of Multiple Bradykinin-Related Peptides in the Blood Plasma of Patients With Hereditary Angioedema in Remission: A Pilot Study.
Hereditary angioedema (HAE) is a rare autosomal dominant disease; the most well understood forms concern the haplodeficiency of C1 esterase inhibitor (C1INH) and a gain of function mutation of factor XII (FXII). The acute forms of these conditions are mediated by an excessive bradykinin (BK) formation by plasma kallikrein. A validated LC-MS/MS platform of picomolar sensitivity developed for the analysis of eleven bradykinin-related peptides was applied to the plasma of HAE-C1INH and HAE-FXII sampled during remission. In HAE-C1INH plasma, the concentrations of the relatively stable BK1-5 fragment (mean ± S.E.M.: 12.0 ± 4.2 pmol/L), of BK2-9 (0.7 ± 0.2 pmol/L) and of the sums of BK and its tested fragments (18.0 ± 6.4 pmol/L) are significantly greater than those recorded in the plasma of healthy volunteers (1.9 ± 0.6, 0.03 ± 0.03 and 4.3 ± 0.8 pmol/L, respectively), consistent with the previous evidence of permanent plasma kallikrein activity in this disease. Kinin levels in the plasma of HAE-FXII patients did not differ from controls, suggesting that triggering factors for contact system activation are not active during remission. BK1-5, BK2-9 and the sum of BK and its fragments determined by the sensitive LC-MS/MS technique are proposed as potential biomarkers of HAE-C1INH in remission while this was not applicable to HAE-FXII patients.


The Effects of Broiler Breeder Dietary Vitamin E and Egg Storage Time on the Quality of Eggs and Newly Hatched Chicks.
This study was conducted to investigate the effects of broiler breeder dietary vitamin E and egg storage time on the egg characteristics, hatchability, and antioxidant status of the egg yolks and newly hatched chicks. A total of 512 71-week-old Ross 308 breeder hens were fed the same basic diets containing 6 or 100 mg/kg vitamin E for 12 weeks. During this time, a total of 1532, 1464, and 1316 eggs were independently collected at weeks 8, 10, and 12, respectively, and subsequently stored for 0 or 14 d before hatching. The outcomes from three trials showed that prolonged egg storage time (14 vs. 0 d) negatively affected (p < 0.05) the egg characteristics, hatchability traits, and the yolk total antioxidant capacity (T-AOC) (p < 0.05). Chicks derived from the stored eggs exhibited higher malonaldehyde (MDA) and T-AOC in the serum and yolk sac (p < 0.05). Broiler breeder dietary vitamin E (100 vs. 6 mg/kg) increased (p < 0.05) the hatchability and the antioxidant status of the yolks as indicated by a higher α-tocopherol content and T-AOC and lower MDA level (p < 0.05). The supplementation of vitamin E also remarkably increased (p < 0.05) the total superoxide dismutase (T-SOD) activity (yolk sac, weeks 8 and 12) and T-AOC (serum, weeks 8, 10, and 12; yolk sac, weeks 8 and 12) and decreased (p < 0.05) the MDA content of chicks (yolk sac, week 10; serum, week 12). Interactions (p < 0.05) were found between the broiler breeder dietary vitamin E and egg storage time on the hatchability and antioxidant status of chick tissues. Broiler breeder dietary vitamin E (100 vs. 6 mg/kg) increased (p < 0.05) the hatchability and the T-AOC in the serum and liver of chicks, and decreased (p < 0.05) the early embryonic mortality and the MDA content in the yolk sacs of chicks derived from eggs stored for 14 d but not for 0 d. In conclusion, prolonged egg storage time (14 vs. 0 d) increased the embryonic mortality, decreased the hatchability, and impaired the antioxidant status of egg yolks and newly hatched chicks, while the addition of broiler breeder dietary vitamin E (100 vs. 6 mg/kg) could partly relieve these adverse impacts induced by long-term egg storage.


[Long-term radiation injuries following neutron therapy].
The paper is concerned with the data on late radiation injuries of normal tissues and critical organs in a group of 35 patients after fast neutron therapy in a period of 12 mos.-3.5 yrs. The value of radiation exposure of critical organs and tissues was considered for patients with head and neck tumors in relation to methods of fast neutron therapy and photon radiation with 60Co after a radical program.


The Czech National Diamond-Blackfan Anemia Registry: clinical data and ribosomal protein mutations update.
Diamond-Blackfan anemia is a rare inherited bone marrow failure syndrome diagnosed in early infancy that is characterized by a (a) macrocytic anemia with no other significant cytopenia, (b) reticulocytopenia, and (c) normal bone marrow cellularity with a paucity of erythroid precursors. Physical anomalies are often present. Mutations in several ribosomal proteins have been associated with the disease. Here we present a detailed description of 39 patients from 34 families enrolled in the Czech National Diamond-Blackfan Anemia Registry. Erythrocyte adenosine deaminase activity and serum erythropoietin levels were measured and bone marrow analysis and clonogenic assays were carried out. Twenty-two different ribosomal proteins were sequenced. We identified mutations in five different ribosomal proteins in 28/39 patients (71.8%) from 23/34 families (67.6%). Several new mutations are described. The most interesting data relate to genotype-phenotype correlations. All patients with ribosomal protein L5 or ribosomal protein L11 mutations have a thumb defect usually with one or more other anomalies. Most of these patients were born small for gestational age and currently have short stature. We also described five patients with a ribosomal protein S26 mutation. All of the latter are transfusion-dependent and they exhibit skeletal abnormalities rather than thumb or craniofacial deformities. Patients with ribosomal protein S19 seem to bear mildest associated anomalies, usually in a craniofacial region.


Combined Technique for the Treatment of Infected Nonunions of the Distal Femur With Bone Loss: Short Supracondylar Nail-Augmented Acute Shortening/Lengthening.
To evaluate a combined technique for treating distal femoral bone defects after debridement of osteomyelitis, using an external fixator together with a short supracondylar nail. Retrospective study. Single tertiary referral center. Between 2003 and 2018, 23 patients with a mean age of 37.2 years (26-56) underwent surgery with the same technique to manage postdebridement defects in the distal femur due to osteomyelitis. This involved acute shortening and intramedullary fixation of the defect site, together with relengthening from a proximal osteotomy using simultaneous external fixation. Radiographic union, range of motion of the hip and knee, external fixation time and external fixation index, and limb length discrepancy were assessed. The mean follow-up was 51 months (18-192). Union was achieved in all patients without recurrence of infection during this follow-up period. The mean knee flexion was 120 degrees, and the mean extension deficit was 5 degrees at final follow-up. The mean limb length discrepancy improved from 5.5 cm (3-7) to 0.5 cm (0-2). The mean external fixation index was 29.2 d/cm (20-50), and the mean external fixation time was 115 days (90-150). Radiographic scores were excellent in 15 cases, good in 6, and fair in 2. Functional scores were excellent in 14 cases, good in 7, and fair in 2. This combined strategy was an effective method for treating distal femoral segmental bone defects after debridement of osteomyelitis, with a high rate of union and acceptable complication rates. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.


[Lead automated microdetermination in capillary samples of blood by a flameless atomic absorption spectroscopy (author's transl)].
A method for lead determination in capillary samples of blood based on flameless atomic absorption spectroscopy in connection with an automated microsampling system is described. For such determinations 50 microliter of heparinized whole blood samples from the fingertip or from the ear lobe are sufficient. Immediately after sampling blood is diluted in ratio 1:5 by an aqueous 0.05% Silicon Antifoam solution. Correlation between lead capillary from the same subjects and venous blood levels sampled from the same subjects and in the same sampling session is highly significant and well suited for routine clinical use.


Increase of the relative frequency of penicillinase-producing Neisseria gonorrhoeae strains to more than five per cent in Munich.
The relative frequency of penicillinase-producing Neisseria gonorrhoeae strains isolated from Munich STD patients nowadays clearly exceeds five percent. Penicillin resistance is either due to the 3.2 or 4.4 Megadalton plasmid. Similar trends are reported from other European countries. Therefore, treatment with third generation cephalosporins such as ceftriaxone, cefotaxime or others is now generally advisable not only in the Far East and Central Africa but also in Central Europe.


Modeling methodology for the accurate and prompt prediction of symptomatic events in chronic diseases.
Prediction of symptomatic crises in chronic diseases allows to take decisions before the symptoms occur, such as the intake of drugs to avoid the symptoms or the activation of medical alarms. The prediction horizon is in this case an important parameter in order to fulfill the pharmacokinetics of medications, or the time response of medical services. This paper presents a study about the prediction limits of a chronic disease with symptomatic crises: the migraine. For that purpose, this work develops a methodology to build predictive migraine models and to improve these predictions beyond the limits of the initial models. The maximum prediction horizon is analyzed, and its dependency on the selected features is studied. A strategy for model selection is proposed to tackle the trade off between conservative but robust predictive models, with respect to less accurate predictions with higher horizons. The obtained results show a prediction horizon close to 40min, which is in the time range of the drug pharmacokinetics. Experiments have been performed in a realistic scenario where input data have been acquired in an ambulatory clinical study by the deployment of a non-intrusive Wireless Body Sensor Network. Our results provide an effective methodology for the selection of the future horizon in the development of prediction algorithms for diseases experiencing symptomatic crises.


An abnormality of nail growth associated with median nerve damage.
It has been recognised for a long time that damage to the median or ulnar nerves is usually followed by slowing of growth of the fingernails. In the past, this has always been ascribed to immobilization of the appropriate digits, rather than to a neurotrophic factor. No other nail changes appear to have been described in association with nerve damage. We present two patients with marked nail changes following median nerve injury, in which immobilization does not appear to be responsible.


Analysis of the ars gene cluster from highly arsenic-resistant Burkholderia xenovorans LB400.
The Burkholderia xenovorans LB400 multireplicon genome displays a relatively high proportion of redundant genes, including several genes predicted to be related to arsenic resistance. These comprise an ars gene cluster, composed of the arsR3, acr3, arsC1 and arsH genes, as well as two arsB, arsC2, and seven individual arsR genes. The objective of this work was to elucidate the involvement of the ars gene cluster in arsenic resistance by the LB400 strain. Susceptibility tests showed that B. xenovorans LB400 is highly resistant to arsenate and arsenite. Arsenic resistance was induced by prior exposure of LB400 to arsenate or arsenite. reverse transcription-polymerase chain reaction assays using total RNA from LB400 showed arsenite-induced transcription of the arsR3 gene, suggesting that the ars gene cluster constitutes an arsenite-responsive operon. Transfer of cloned LB400 ars genes to heterologous Escherichia coli or Pseudomonas aeruginosa strains demonstrated that the ArsR3 transcriptional repressor, ArsC1 arsenate reductase, and the Acr3 arsenite efflux pump encoded in the LB400 ars gene cluster, are all associated to the arsenic resistance phenotype of this strain. The ars gene cluster from Burkholderia xenovorans LB400 is responsible for the inducible arsenic-resistance phenotype of the bacterium.


Loss of focal adhesion kinase enhances endothelial barrier function and increases focal adhesions.
To determine the role of FAK in the regulation of endothelial barrier function. Stable FAK knockdown HLEC were generated by lentiviral infection of FAK shRNA. Measurements of isometric tension and transendothelial electrical resistance were performed. A FAK knockdown human pulmonary endothelial cell line was generated by lentiviral infection with FAK shRNA and resulted in greater than 90% reduction in FAK protein with no change in Pyk2 protein. Loss of FAK altered cell morphology and actin distribution in both pre- and post-confluent endothelial cells. Large, polygonal shaped endothelial cells with randomly organized stress fibers were identified in pre-confluent cultures, while in confluent monolayers, endothelial cells were irregularly shaped with actin bundles present at cell margins. An increase in the number and size of vinculin plaques was detected in FAK-depleted cells. FAK knockdown monolayers generated a greater transendothelial electrical resistance than controls. Thrombin treatment induced similar changes in TER in both FAK knockdown and control cell lines. FAK-depleted endothelial cells developed a higher stable basal isometric tension compared to control monolayers, but the increase in tension stimulated by thrombin does not differ between the cell lines. Basal myosin II regulatory light chain phosphorylation was unaltered in FAK-depleted cells. In addition, loss of FAK enhanced VE-cadherin localization to the cell membrane without altering VE-cadherin protein levels. The loss of FAK in endothelial cells enhanced cell attachment and strengthened cell-cell contacts resulting in greater basal tension leading to formation of a tighter endothelial monolayer.


Effect of sirolimus in the prevention of adhesions around intraabdominal prosthetic graft.
Adhesions due to the reactions caused by the grafts used in primary vascular operations can lead to various problems when a secondary operation is necessary. These problems include bleeding, injuries to neighboring organs, and complications occurring due to a prolonged operation. We investigated the effects of sirolimus, which has antiproliferative features, on vascular adhesions. The abdominal aorta of rats was explored and abrasions applied. Following the fixation of a polytetrafluoroethylene (PTFE) graft on the abdominal aorta, sirolimus (rapamycin) is applied (in powdered form) onto the grafts of the study group. Eight weeks later a laparotomy was repeated and any adhesions were evaluated. In the study group the adhesions were determined to be fewer in number and milder in severity. Severe cases of adhesion were determined in the control group. Therefore, sirolimus applied around the prosthesis in vascular operations was determined to be effective at preventing possible adhesions.


Strategies of Elicitation to Enhance Bioactive Compound Content in Edible Plant Sprouts: A Bibliometric Study.
Vegetable sprouts are a food source that presents high content of bioactive compounds which can also be enhanced through elicitation mechanisms. To better understand the scientific production and research trends on this topic, a bibliometric analysis by means of the Web of Science database was carried out. The results showed significant growth in research on the elicitation of edible plants sprouts. The three most productive journals were the Journal of Agricultural and Food Chemistry, followed by Food Chemistry and LWT-Food Science and Technology. The co-occurrence of keyword analysis of the different authors showed that the main research topics in this domain were 'germination', 'antioxidant activity', 'sprouts', 'glucosinolates' and 'phenolics'. The countries with the highest number of scientific publications were China, followed by India and USA. The productivity patterns of the authors conformed to Lotka's law. This study provides an overview of research on elicitation to enrich bioactive compounds in sprouts, and the need to review and update the trends on this subject.


A severe right-to-left intracardiac shunt after NobleStitch failure: when a device is needed.
Transcatheter closure of patent foramen ovale (PFO) has been demonstrated to be superior to medical therapy in stroke prevention in selected patients. Beyond traditional permanent metallic devices, NobleStitch EL, a suture-based system, has been developed as a potential alternative. A 50-year-old man underwent transcatheter closure of PFO with mild interatrial septal bulging and tunnel-like morphology with a NobleStitch device. A transthoracic echocardiography performed immediately after PFO closure showed residual shunt (RS), which persisted unchanged at staged controls, due to the inability of the delivery system to capture both the septum primum and the septum secundum. A second procedure was performed with the implantation of a Figulla Flex II 27/30 mm device, with no RS detectable at control echocardiography. The NobleStitch device is interesting in its concept, but several pitfalls may be encountered during its deployment. Opposite to permanent metallic devices, RSs after the procedure are not expected to decrease over time and should be managed with a different approach.


Subunit composition of ATP-sensitive potassium channels in mitochondria of rat hearts.
Mitochondrial ATP-sensitive potassium (mitoKATP) channels play a pivotal role in early and late ischemic preconditioning, but the subunit composition of mitoKATP channels remains unclear. In this study, we investigated the subunit composition of mitoKATP channels in rat hearts using confocal microscopy, immunofluorescence, and Western blot analysis. The green fluorescent probe glibenclamide-BODIPY was colocalized with the red fluorescent mitochondrial marker MitroTracker Red in isolated ventricular myocytes and in ventricular myocyte mitochondria, indicating the presence of sulfonylurea receptors (SURs) in the mitochondria. Anti-Kir6.1, anti-Kir6.2, and anti-SUR2 immunofluorescence was colocalized with that of MitoTracker Red in isolated mitochondria, suggesting that Kir6.1, Kir6.2, and SUR2 subunits are present in the mitochondria. Similarly, Kir6.1 (approximately 46 kDa), Kir6.2 (approximately 46 and approximately 40 kDa), and SUR2 (approximately 140 kDa) proteins were found to be expressed in mitochondria using Western blot analysis. By contrast, SUR1 was not present in mitochondria. These results suggest that mitoKATP channels in rat hearts might comprise a combination of Kir6.1, Kir6.2, and SUR2 subunits.


Demystifying the spectral collapse in two-photon Rabi model.
We have investigated the eigenenergy spectrum of the two-photon Rabi model at the critical coupling, particularly the special feature "spectral collapse", by means of an elementary quantum mechanics approach. The eigenenergy spectrum is found to consist of both a set of discrete energy levels and a continuous energy spectrum. Each of these eigenenergies has a two-fold degeneracy corresponding to the spin degree of freedom. The discrete eigenenergy spectrum has a one-to-one mapping with that of a particle in a "Lorentzian function" potential well, and the continuous energy spectrum can be derived from the scattering problem associated with a potential barrier. The number of bound states available at the critical coupling is determined by the energy difference between the two atomic levels so that the extent of the "spectral collapse" can be monitored in a straightforward manner.


A mathematical approach to predict the solids concentration in anaerobic membrane bioreactos (AnMBR): Evaluation of the volatile solids solubilization.
Anaerobic Membrane Bioreactors (AnMBR) are gaining attention as a suitable approach for sustainable low-strength wastewater treatment, as they bring together the advantages of both anaerobic treatments and membrane bioreactors. However, increasing the sludge retention time (SRT) necessary to favor hydrolysis increases the suspended solids concentration potentially leading to decreased permeate flux. Therefore, the availability of a mathematical approach to predict the solids concentration within an AnMBR can be very useful. In this work, a mathematical model describing the volatile solids concentration within the reactor as a function of the operating parameters and the influent characteristics is developed. The solubilization of organic particulates was clearly influenced by temperature and the SRT, whereas the hydraulic retention time influence was negligible. Furthermore, the activation energy value of about 20 kJ mol-1 confirms the idea that diffusion of hydrolytic enzymes from the bulk solution to the particle surface is the rate-limiting step of hydrolysis.


Integrated metabolomics, network pharmacology, and molecular docking to reveal the mechanisms of Isodon excisoides against drug-induced liver injury.
Isodon excisoides (Y.Z.Sun ex C.H.Hu) H. Hara has been often used to treat liver diseases in folk medicine. However, the potential hepatoprotective mechanism of I. excisoides remains unclear. In this study, the mechanism of I. excisoides in alleviating drug-induced liver injury (DILI) was explored using a strategy combining metabolomics with network pharmacology for the first time. First, serum metabolomics was applied to identify differential metabolites and enrich metabolic pathways. The potential targets of I. excisoides for the treatment of DILI were investigated by network pharmacology. Subsequently, a comprehensive network of network pharmacology and metabolomics was established to find the key genes. Finally, molecular docking technology was used to further verify the key targets. As a result, four key genes including TYMS, IMPDH2, DHODH, and ASAH1 were identified. The proteins produced by these genes had high affinity with the corresponding diterpenoids. These results indicate that the components of I. excisoides play a liver-protective role by affecting the aforesaid key genes and key proteins. Our results offer a novel strategy for determining the pharmacological effects and potential targets of natural compounds.


A specific substance P antagonist attenuates non-cholinergic electrically induced contractures of the guinea pig isolated ileum.
The substance P (SP) analog, D-Pro2,D-Tryp7,9-SP attenuated in a dose-dependent fashion non-cholinergic excitatory responses of the guinea pig ileum to the exogenous administration of SP, but did not affect the atropine-resistant contractures produced by serotonin (1 microM), histamine (1 microM), bradykinin (0.01 microM) or prostaglandin F2 alpha (10 microM). Pretreatment with D-Pro2,D-Tryp7,9-SP also significantly reduced the magnitude of the non-cholinergic contracture evoked by field stimulation at 20 Hz. These results suggest that enteric SP-containing neurons can function in an efferent motor capacity to bring about non-cholinergic excitation of the longitudinal muscle layer of the guinea pig small bowel.


Cross-cultural adaptation and clinical evaluation of a Korean version of the disabilities of arm, shoulder, and hand outcome questionnaire (K-DASH).
We developed a Korean version of the disabilities of arm, shoulder, and hand outcome questionnaire (K-DASH) by performing cross-cultural adaptation and evaluated the reliability and validity of the K-DASH. The K-DASH, SF-36, and Visual Analog Scale (VAS) for pain were administered to 161 patients with arm, shoulder, and hand problems. The internal consistency of the disability/symptom scores of the K-DASH was high (Cronbach's alpha 0.94). The retest assessed 131 of the 161 patients. The intraclass correlation coefficient was 0.91. The construct validity was evaluated using the correlations between the K-DASH and the SF-36 and VAS. The physical and mental component summary scales of the SF-36 and the VAS at rest and during activity were significantly correlated with the DASH disability/symptom scores. Despite the linguistic and cultural differences, the reliability and validity of the K-DASH were just as excellent as those of the original DASH.


Ultrasonography: highly accuracy technique for preoperative localization of parathyroid adenoma.
This study evaluates the accuracy of ultrasonography in guided unilateral parathyroidectomy to treat primary hyperparathyroidism. Retrospective study. Two hundred fifty-three patients with primary hyperparathyroidism underwent preoperative ultrasonography. Two groups were defined. Group 1 included the patients in whom the preoperative cervical ultrasound localized one abnormal parathyroid gland; these patients underwent unilateral surgical exploration of the neck under local anesthesia. Group 2 included the patients who had a bilateral neck exploration under general anesthesia when the preoperative examination was equivocal or failed to localize the lesion, when concomitant thyroid pathology indicated thyroidectomy, and when justified by the surgical findings. Sensitivity and positive predictive value of ultrasonography in detecting abnormal parathyroid gland were 96% and 98%, respectively. Cervical ultrasound correctly identified, 96% and 85% of abnormal glands in groups 1 and 2, respectively. The presence of thyroid nodular disease did not affect ultrasonographic accuracy. Sonographic examination decreased the operative time of parathyroidectomy to an average of 15 minutes. Mediastinal and retroesophageal localizations of abnormal parathyroid gland adversely affected the accuracy of the ultrasound. No cervical hematoma was noted. Transient recurrent laryngeal nerve palsy occurred in four patients. Twenty-three patients required postoperative calcium supplementation for 2 to 4 months, and all were normocalcemic at follow-up. Cervical ultrasound is a reliable preoperative exploration allowing parathyroidectomy via unilateral approach under local anesthesia.


Oral phosphate binders in the treatment of pseudoxanthoma elasticum.
Pseudoxanthoma elasticum (PXE) is a systemic connective tissue disorder involving elastic fiber calcification and fragmentation with major clinical manifestations occurring in the cutaneous, ocular, and cardiovascular systems. Normalization of the serum calcium-phosphate product through hemodialysis in a previous patient with perforating periumbilical PXE and elevated serum phosphate resulted in regression of skin lesions. We sought to study the effect of pharmacologically limiting the intestinal absorption of phosphate in patients with PXE. Patients received baseline skin examinations, target skin lesion evaluation, and photography; renal function tests and serum calcium and phosphate levels; urine calcium, phosphate, and creatinine levels; skin biopsy; and eye examinations and indocyanine-green angiography. Patients were treated with aluminium hydroxide tablets or liquid and returned every 2 to 4 months for skin photography and lesion evaluation. Repeated skin biopsies were performed on clinically improved target sites. Ophthalmologic evaluation was obtained at yearly intervals. Of 6 patients, 3 showed significant clinical improvement of skin lesions and all 3 of these patients showed histopathologic regression of disease in their target lesions. No deterioration of eye disease was seen in any of the 6 patients at 1-year follow-up. Our results demonstrate that the calcification seen in PXE may be reversible in some patients. This could hold true for eye and vascular lesions and for skin. Further studies supporting these results could reveal the first real treatment option for PXE.


A duplication in a patient with 46,XX ovo-testicular disorder of sex development refines the SOX9 testis-specific regulatory region to 24 kb.
A custom CGH microarray that covers the SOX9 regulatory region. Log2 ratio scatterplot showing individual data points. Blue box highlights copy number gain with 3' breakpoint region magnified.


The influence of a new antitumor agent on hemopoietic colony forming cells.
The cytostatic and immunsuppressive agent N'-methyl-N'-beta-chloroethylbenzaldehyde hydrazone (B1) in in-vitro experiments has a stimulating effect on colony-forming culture (CFUc) of bone marrow from C57BL mice. This unusual behaviour, which is in contrast to other cytostatics, could also be observed in vitro with CFUc obtained from mice treated with therapeutic doses of B1 for 2 weeks. This stimulation is not a particular effect of B1 alone but seems to depend on a synergistic effect of the combination of B1 and the colony-stimulating activity (CSA) present in the serum from endotoxin-treated mice (MP) in the testing system. The results suggest that the described effect of B1 is due to an interference at the cell membrane of CFUc or their precursor cells.


Role of muscles in the stabilization of ligament-deficient wrists.
This article reviews the results of a series of cadaver investigations aimed at clarifying the role of muscles in the stabilization of ligament-deficient wrists. According to these studies, isometric contraction of some forearm muscles induces midcarpal (MC) supination (ie, the abductor pollicis longus, extensor carpi radialis longus, and flexor carpi ulnaris), whereas other muscles induce MC pronation (ie, the extensor carpi ulnaris). Because MC supination implies tightening of the volar scaphoid-distal row ligaments, the MC supination muscles are likely to prevent scaphoid collapse of wrists with scapholunate ligament insufficiency. MC pronator muscles, by contrast, would be beneficial in stabilizing wrists with ulnar-sided ligament deficiencies owing to their ability to tighten the triquetrum-distal row ligaments. Should these laboratory findings be validated by additional clinical research, proprioceptive reeducation of selected muscles could become an important tool for the treatment of dynamic carpal instabilities.