Enhanced recovery versus conventional care in gastric cancer surgery: a meta-analysis of randomized and non-randomized controlled trials.
Enhanced recovery after surgery (ERAS) protocols have been successfully integrated into peri-operative management of different cancer surgeries such as colorectal cancer. Their value for gastric cancer surgery, however, remains uncertain. A search for randomized and observational studies comparing ERAS versus conventional care in gastric cancer surgery was performed according to PRISMA guidelines. Random-effects meta-analyses with inverse variance weighting were conducted, and quality of included studies was assessed using the Cochrane risk-of-bias tool and Newcastle-Ottawa scale (PROSPERO: CRD42017080888). Twenty-three studies involving 2686 patients were included. ERAS was associated with reduced length of hospital stay (WMD-2.47 days, 95% CI - 3.06 to - 1.89, P < 0.00001), time to flatus (WMD-0.70 days, 95% CI - 1.02 to - 0.37, P < 0.0001), and hospitalization costs (WMD-USD$ 4400, 95% CI - USD$ 5580 to - USD$ 3210, P < 0.00001), with consistent results across open and laparoscopic surgery. Postoperative morbidity and 30-day mortality were similar, although a higher rate of readmission was observed in the ERAS group (RR = 1.95, 95% CI 1.03-3.67, P = 0.04). Patients in the ERAS arm had significantly attenuated C-reactive protein levels on days 3/4 and 7, interleukin-6 levels on days 1, and 3/4, and tumor necrosis factor-α levels on days 3/4 postoperatively. Compared to conventional care, ERAS reduces hospital stay, costs, surgical stress response and time to return of gut function, without increasing post-operative morbidity in gastric cancer surgery. However, precaution is necessary to reduce the increased risk of hospital readmission when adopting ERAS.


A compact respiratory-triggering device for routine microimaging of laboratory mice.
A partial-body plethysmograph was developed for measuring the respiratory flow of anesthetized mice during routine microimaging experiments performed in the close confines of an 89-mm-diameter, vertical-bore magnet. Respiratory flow patterns were used for synchronizing conventional T2-weighted spin-echo imaging with the respiratory cycle, thereby, significantly reducing motion-induced artifacts and increasing observed liver lesion contrast.


Sibling genes as environment: Sibling dopamine genotypes and adolescent health support frequency dependent selection.
While research consistently suggests siblings matter for individual outcomes, it remains unclear why. At the same time, studies of genetic effects on health typically correlate variants of a gene with the average level of behavioral or health measures, ignoring more complicated genetic dynamics. Using National Longitudinal Study of Adolescent Health data, we investigate whether sibling genes moderate individual genetic expression. We compare twin variation in health-related absences and self-rated health by genetic differences at three locations related to dopamine regulation and transport to test sibship-level cross-person gene-gene interactions. Results suggest effects of variation at these genetic locations are moderated by sibling genes. Although the mechanism remains unclear, this evidence is consistent with frequency dependent selection and suggests much genetic research may violate the stable unit treatment value assumption.


Early weaning stimulates intestinal brush border enzyme activities in piglets, mainly at the posttranscriptional level.
Weaning-associated anorexia is the main factor responsible for structural alterations of the small intestine. However, whether weaning and the postweaning feed intake level affect disaccharidase and peptidase gene expression remains to be elucidated. Adaptation of the small intestine to early weaning at 7 days of age and the effects of postweaning feed intake were investigated on 56 pigs in two trials. Structural parameters and gene expression and activities of intestinal lactase, maltase, sucrase, aminopeptidases A and N, and dipeptidyl peptidase IV were determined along the small intestine. Within 3 days, weaning induced increases in maltase, sucrase, and peptidase specific activities (P < 0.05) and a decrease in lactase activity and villous height (P < 0.05). Only for maltase activity were the weaning-induced changes closely correlated with corresponding mRNA levels. In weaned piglets, aminopeptidase N activity was consistently stimulated and dipeptidyl peptidase IV depressed by high level of feed intake but without effects on the corresponding mRNA levels. Furthermore, the longitudinal distribution of enzyme activities along the small intestine showed poor correlation with the corresponding mRNA levels. Early weaning in pigs is associated with a remarkable capacity of the small intestine to rapidly increase the activity of key brush border enzymes. This adaptation, largely independent on feed intake for intestinal enzyme mRNAs and disaccharidase activities, occurred at the posttranscriptional rather than at the transcriptional level of enzyme biosynthesis (except for maltase). The length of the postweaning anorexia period did not affect the subsequent intestinal capacity for villous elongation but may postpone maturation of peptidase activities.


The effect of medication adherence on psychosocial adjustment to body weight, image, and self-esteem in patients with schizophrenia.
The present study aimed to evaluate the effect of medication adherence on psychosocial adjustment to body weight, image, and self-esteem in patients with schizophrenia. This cross-sectional and correlational study consisted of 154 patients with schizophrenia registered in a Community Mental Health Center. The patients had moderate psychosocial adjustment to body weight, image, and self-esteem, and 56.5% had poor medication adherence. There was a significant positive correlation between participants' medication adherence and psychosocial adjustment to body weight, image, and self-esteem. Psychiatric nurses should support patients regarding medication adherence, and psychosocial adjustment to body weight, image, and self-esteem.


Viscoplastic properties of laponite-CMC mixes.
In this dataset, 15 samples of laponite-CMC mixes were realized and their viscoplastic properties are determined. Rheological parameters are then expressed as a function of age and components concentrations.


A comparative pilot study of the professional ethical thinking of Quebec pharmacy residents and French pharmacy interns.
The main objective of this pilot study is to compare the professional ethical thinking of Quebec pharmacy residents and French pharmacy interns. The secondary objective is to compare the professional ethical thinking of Quebec pharmacy residents and first year French pharmacy interns. Hospital pharmacy residents from Quebec, Canada and pharmacy interns from France. This is a cross-sectional, descriptive, web-based survey. For this study, professional ethical thinking was defined as the level of agreement/disagreement with statements about pharmacy ethics/dilemmas. A total of 208 usable questionnaires were completed (response rate 91% in Quebec and 11% in France). There were no significant differences between Quebec residents and French interns for 29/43 items (67%). However, there were significant differences in their level of agreement with 14/43 items (33%) surveyed by our questionnaire. The differences related to the following themes: economic aspects (four statements), pharmaceutical care, code of ethics, evaluation, clinical research (two statements each) and training and education, dispensing medications (one statement each). There were statistically significant differences between the two groups in terms of exposure to ethics during academic training and experiential practice. There were significant statistical differences between the two groups of first year pharmacy respondents for 11 statements (26%), with only two out of 11 statements being different from those reported in the overall comparison. Published data on the professional ethical thinking of pharmacy residents and interns remain limited. We believe the higher exposure of Quebec residents to ethics during academic courses and experiential/practical training may have contributed to a higher level of agreement with some ethical statements.


Analytical determination of the [Ln-aminoxyl radical] exchange interaction taking into account both the ligand-field effect and the spin-orbit coupling of the lanthanide ion (Ln = DyIII and HoIII).
Numerous compounds in which a paramagnetic LnIII ion is in an exchange interaction with a second spin carrier, such as a transition metal ion or an organic radical, have been described. However, except for GdIII, very little has been reported about the magnitude of the interactions. Indeed, for these ions both the ligand-field effects and the exchange interactions between the magnetic centers become relevant in the same temperature range; this makes the analysis of the magnetic behavior of such compounds more difficult. In this study, quantitative analyses of the thermal variations of the static isothermal initial magnetic susceptibility measured on powdered samples of the [Ln(NO3)3-[organic radical]2] (Ln = DyIII and HoIII) compounds were performed. The ligand-field effects on the Ln ions were taken into account, and the exchange interactions within a molecule were treated exactly within an appropriate Racah formalism. Values of the intramolecular [Ln-aminoxyl radical] exchange parameter have thus been rigorously deduced for both the Dy Kramers and Ho non-Kramers ion-based compounds. Ferromagnetic [Ln-radical] interactions are found for both the Dy and Ho derivatives with J = 8 cm(-1) and J = 4.5 cm(-1), respectively.


Recent omics advances in hair aging biology and hair biomarkers analysis.
Aging is a complex natural process that leads to a decline in physiological functions, which is visible in signs such as hair graying, thinning, and loss. Although hair graying is characterized by a loss of pigment in the hair shaft, the underlying mechanism of age-associated hair graying is not fully understood. Hair graying and loss can have a significant impact on an individual's self-esteem and self-confidence, potentially leading to mental health problems such as depression and anxiety. Omics technologies, which have applications beyond clinical medicine, have led to the discovery of candidate hair biomarkers and may provide insight into the complex biology of hair aging and identify targets for effective therapies. This review provides an up-to-date overview of recent omics discoveries, including age-associated alterations of proteins and metabolites in the hair shaft and follicle, and highlights the significance of hair aging and graying biomarker discoveries. The decline in hair follicle stem cell activity with aging decreased the regeneration capacity of hair follicles. Cellular senescence, oxidative damage and altered extracellular matrix of hair follicle constituents characterized hair follicle and hair shaft aging and graying. The review attempts to correlate the impact of endogenous and exogenous factors on hair aging. We close by discussing the main challenges and limitations of the field, defining major open questions and offering an outlook for future research.


Socioeconomic differences in the progression of carotid atherosclerosis in middle-aged men and women with subclinical atherosclerosis in Sweden.
While the persistence of socioeconomic differences in cardiovascular disease (CVD) has been recognized for many years, less is known about whether socioeconomic factors are of importance to CVD before symptoms of the disease appear. In this study the associations among educational level, occupational status and progression of atherosclerosis were investigated in 1016 Swedish middle-aged men and women with signs of subclinical atherosclerosis, i.e., carotid plaque (defined as focal intima-media thickness (IMT) > 1.2 mm). IMT in the common carotid artery (CCA) and in the carotid bifurcation area, as well as carotid plaque score, was determined by B-mode ultrasound. Results showed only weak associations between educational level, occupational status and age-, sex- and baseline IMT-adjusted progression of IMT in the CCA. However, in the age, sex- and baseline IMT-adjusted analyses, those in unskilled manual occupations showed a significantly higher yearly progression of carotid IMT in the bifurcation area compared to those in high- or medium-level non-manual occupations. Those with primary education tended to show a higher yearly progression of carotid IMT in the bifurcation area compared to those with completed secondary education. After adjustment for risk factors, the magnitude of these associations were somewhat attenuated. Similar patterns of associations were seen for the change of carotid plaque score. We conclude that low socioeconomic status (SES) is associated with progression of atherosclerosis in a middle-aged population with signs of subclinical atherosclerosis. Even though socioeconomic differences in cardiovascular risk factor levels could explain part of the found differences in progression rate in women, the mechanisms involved remain to be further established.


Calcium/calmodulin-dependent protein kinase II regulates the phosphorylation of CREB in NMDA-induced retinal neurotoxicity.
We examined the role of the phosphorylation of calcium/calmodulin-dependent protein kinase II (CaMKII) and cyclic AMP-response element binding protein (CREB) in N-methyl-d-aspartate (NMDA)-induced neurotoxicity in the rat retina. Western blot analysis showed early elevation of phosphorylated CaMKII (p-CaMKII) protein levels and subsequential elevation of phosphorylated CREB (p-CREB) protein after NMDA injection. Immunohistochemistry showed that p-CaMKII was colocalized with Thy-1-positive retinal ganglion cells (RGCs) after NMDA injection. The increase in the p-CaMKII protein level was significantly inhibited by the preinjection of CaMKII small interfering RNA (siRNA), whereas negative control siRNA did not affect. Moreover, the increase in the p-CREB protein level after NMDA injection was also prevented by preinjection of CaMKII siRNA. In addition, our morphometric study of neurotracer retrograde labeling and Thy-1-positive cells showed that CaMKII siRNA significantly accelerated NMDA-induced RGC loss. Furthermore, the prevention of CREB binding by CRE decoy oligonucleotide also exacerbated RGC loss. These results suggest that the activation of CaMKII may regulate CREB phosphorylation and that the transient phosphorylation of CaMKII and CREB may be a neuroprotective response against NMDA-induced neurotoxicity.


Comparison of outcomes with extensive segmental pectoralis major myocutaneous flap via the anterior axillary line and the conventional technique in oral and oropharyngeal cancer.
This study compared the outcomes of an extensive segmental pectoralis major myocutaneous flap (esPMMF) and a conventional pectoralis major myocutaneous flap (PMMF). The study enrolled 91 patients with primary oral and oropharyngeal squamous cell carcinoma (SCC) who underwent radical resection followed by reconstruction of the defect using either an esPMMF via the anterior axillary line or a PMMF. The pedicle lengths of the esPMMF and PMMF were 22-28 and 18-22 cm, respectively. The esPMMF and PMMF had skin paddle dimensions of 5 × 8 to 7 × 14 cm and 6 × 7 to 8 × 17 cm, respectively. The esPMMF pedicle was longer than that of the PMMF. The range of shoulder abduction was significantly greater in the esPMMF group and the donor-site aesthetic results were better. The esPMMF has a longer pedicle flap, enables a greater range of shoulder abduction, and has a better aesthetic result than the conventional technique.


C5 Palsy of Patients with Proximal-Type Cervical Spondylotic Amyotrophy.
An observational cohort study design was adopted in this study. This study was designed to investigate preoperative factors that predict poor outcomes following surgery in patients with proximal-type cervical spondylotic amyotrophy (PCSA) using radiological findings. We evaluated the preoperative factors associated with poor outcomes using electrophysiological and neurological findings. However, the preoperative factors associated with poor outcomes remained unclear. Sixty patients with PCSA who underwent surgical treatment of the cervical spine were enrolled. The radiological findings on plain radiographs, computed tomography (CT), and magnetic resonance imaging (MRI) were evaluated. The cervical lordotic angles, C2-C7 sagittal vertical axis (SVA), and T1 slope were assessed on a lateral radiograph in the neutral position. CT was used to assess the width of the intervertebral foramen and the anterior protrusion of the superior articular process on the axial view. MRI was used to determine the number of levels of compression (NLC) and the presence of a high-intensity area in the spinal cord in the T2- weighted midsagittal view. The preoperative and postoperative strengths of the most atrophic muscles were evaluated using manual muscle testing. Improvements in strength were classified as excellent (five grades recovered), good (more than one grade recovered), fair (no improvement), or poor (worsened). The prevalence of C5 palsy was 17% (10/60). Patients with poor outcomes had higher NLC and Δ C2-C7 SVA than patients with excellent, good, and fair outcomes (p =0.015; odds ratio [OR], 5.758; 95% confidence interval [CI], 1.397-23.726 for a change of 10% and p =0.048; OR, 1.068; 95% CI, 0.992-1.141 for a change of 10%, respectively). ΔC2-C7 SVA and NLC may be used as prognostic factors for achieving a poor outcome following surgery in patients with PCSA. More focus is needed on preventing the increase in ΔC2-C7 SVA.


Interpreting non-coding disease-associated human variants using single-cell epigenomics.
Genome-wide association studies (GWAS) have linked hundreds of thousands of sequence variants in the human genome to common traits and diseases. However, translating this knowledge into a mechanistic understanding of disease-relevant biology remains challenging, largely because such variants are predominantly in non-protein-coding sequences that still lack functional annotation at cell-type resolution. Recent advances in single-cell epigenomics assays have enabled the generation of cell type-, subtype- and state-resolved maps of the epigenome in heterogeneous human tissues. These maps have facilitated cell type-specific annotation of candidate cis-regulatory elements and their gene targets in the human genome, enhancing our ability to interpret the genetic basis of common traits and diseases.


Machine learning aided construction of the quorum sensing communication network for human gut microbiota.
Quorum sensing (QS) is a cell-cell communication mechanism that connects members in various microbial systems. Conventionally, a small number of QS entries are collected for specific microbes, which is far from being able to fully depict communication-based complex microbial interactions in human gut microbiota. In this study, we propose a systematic workflow including three modules and the use of machine learning-based classifiers to collect, expand, and mine the QS-related entries. Furthermore, we develop the Quorum Sensing of Human Gut Microbes (QSHGM) database ( http://www.qshgm.lbci.net/ ) including 28,567 redundancy removal entries, to bridge the gap between QS repositories and human gut microbiota. With the help of QSHGM, various communication-based microbial interactions can be searched and a QS communication network (QSCN) is further constructed and analysed for 818 human gut microbes. This work contributes to the establishment of the QSCN which may form one of the key knowledge maps of the human gut microbiota, supporting future applications such as new manipulations to synthetic microbiota and potential therapies to gut diseases.


A meta-analysis of voxel-based morphometry studies on gray matter volume alteration in juvenile myoclonic epilepsy.
The findings of structural neuroimaging studies on gray matter volume (GMV) of juvenile myoclonic epilepsy (JME) with voxel-based morphometry (VBM) were inconsistent. We aim to evaluate consistent gray matter changes in JME quantitatively. A systematic review of VBM studies on GMV of patients with JME and healthy control (HC) subjects indexed in PubMed and EMBASE from January 1990 to June 2012 was conducted. Coordinates were extracted from clusters of significant GMV difference between patients with JME and HC subjects. Meta-analysis was performed using Effect Size Signed Differential Mapping (ES-SDM). Seven studies with a total of 211 JME patients and 241 HC subjects were included in the meta-analysis. Increased GMV were observed in the bilateral medial frontal gyrus and anterior cingulate, whereas decreased GMV in the bilateral thalamus. The findings remain largely unchanged in the jackknife sensitivity analyses. The meta-analysis not only identified consistent changes in some regions of gray matter in patients with JME, but also supports the notion of thalamocortical circuitry involved in the pathogenesis of JME.


Electrodiagnostic features of acute paralytic poliomyelitis associated with West Nile virus infection.
West Nile virus (WNV) infection is a potentially fatal disease, with meningoencephalitis being its most common neurological manifestation. Guillain-Barré syndrome (GBS) has also been described, but acute paralytic poliomyelitis has only recently been recognized. We report the clinical and electrodiagnostic findings of five patients with WNV infection, who presented with acute paralytic poliomyelitis. Three patients manifested focal asymmetrical weakness, and two had rapid ascending quadriplegia mimicking GBS. Electrodiagnostic studies during the acute illness showed normal sensory nerve action potentials, compound motor action potentials of normal or reduced amplitude, and no slowing of nerve conduction velocities. Depending on the timing of the examination, fibrillation potentials were widespread, including in those with focal weakness. Cervical magnetic resonance imaging in one patient showed abnormal T2-weighted signals in the spinal cord gray matter. On follow-up, signs of clinical improvement were seen in one patient, whereas two remained quadriplegic and ventilator-dependent 5 months after the onset. This report highlights the value of the electrodiagnostic studies in the diagnosis and prognosis of focal or generalized weakness due to acute paralytic poliomyelitis associated with WNV infection.


Oral gabapentin suppresses pentylenetetrazole-induced seizure-like behavior and cephalic field potential in adult zebrafish.
We report the effect of orally administered gabapentin (GBP) on pentylenetetrazole (PTZ)-induced seizure-like activity in adult zebrafish. Zebrafish were pretreated with vehicle or GBP using a novel method of precise oral administration, followed by an intraperitoneal administration of PTZ. Behavioral assessment was carried out using locomotion-based video-tracking analysis and seizure score assignment using visual observation. Cephalic field potential recordings of the zebrafish brain were conducted using an electrical data acquisition system. Orally administered GBP significantly suppressed the seizure-like locomotor activity and strong slow-wave (~3Hz) activity in the cephalic field potential caused by PTZ. This work is the first report of the activity of an orally delivered anticonvulsant in adult zebrafish. Our study provides behavioral and physiological evidence in support of an adult zebrafish model for studying seizures including excitotoxic brain injury and a novel in vivo framework for the evaluation of pharmacological modulators of epilepsy.


A novel form of TNF/cachectin is a cell surface cytotoxic transmembrane protein: ramifications for the complex physiology of TNF.
Tumor necrosis factor (TNF) is a monocyte-derived cytotoxin that has been implicated in tumor regression, septic shock, and cachexia. The mechanism by which TNF induces these different disease states is unclear. We have identified and characterized a novel, rapidly inducible cell surface cytotoxic integral transmembrane form of TNF. The existence and behavior of this novel form of TNF may explain the complex physiology of this molecule. We suggest that activated monocytes synthesize transmembrane TNF at the site of inflammation and kill their targets by either cell-to-cell contact or local release of the TNF secretory component. In contrast, septic shock and cachexia may result from either acute or chronic systemic activation of monocytes, resulting in the widespread release of TNF secretory component into the circulation of the affected individual. We further suggest that cell borne cytokines and cytotoxins may be the primary mediators of directed inflammatory responses.


The Youth Daily Life Before Fulfilling Socio-educational Measures of Deprivation of Liberty in Brazil: Ordinary Experiences That Are Tangent to the Inclusion in Drug Trafficking.
The aim of this paper is to demonstrate some understanding of the daily lives of young people facing socio-educational measures of incarceration, especially regarding the predisposing factors that may explain their involvement in criminal occupations and activities (Although the socio-educational measures applicable to adolescents configures as a response to committing of an offence, it has a mostly educational and not punitive character.). This is an exploratory study with a qualitative approach. The data collection instrument used was semi-structured interviews with 22 young men aged between 12 and 17 years, on condition of deprivation of freedom in four youth centres in Belo Horizonte, Minas Gerais, Brazil. The results showed that these adolescents had a way of life associated with a scarcity of resources owned by households (including little control over them, despite the efforts of their mothers); low adherence to school; limited institutional access to activities in their free time; exposure to predisposing factors to crime, such as early contact with crime through neighbourhood and family relationships; and profiting from crime. Copyright © 2016 John Wiley & Sons, Ltd.


Mechanical endovascular thrombectomy for acute ischemic stroke: a retrospective multicenter study in Belgium.
Clinical trials have shown a beneficial effect of mechanical thrombectomy in acute ischemic stroke patients treated within six up to even 12 h after symptom onset. This treatment was already performed in selected hospitals in Belgium before completion of the randomized controlled trials. Outcome data on these procedures in Belgium have not been published. We performed a retrospective multicenter study of all patients with acute ischemic stroke treated with mechanical endovascular therapy in four hospitals in Belgium. Clinical outcomes, as measured by the modified Rankin Scale (mRS), site of arterial occlusion, reperfusion and the association between these variables were studied. The study included 80 patients: 65 patients with an occlusion in the anterior circulation and 15 with an occlusion in the posterior circulation. Good functional outcome (GFO) rates, defined as mRS 0-2 at 90 days, were 42 % in all patients, 44 % in anterior circulation stroke and 34 % in posterior circulation stroke. Reperfusion was achieved in 78 % of patients; more (100 %) in patients with posterior compared to patients with anterior circulation stroke (72 %; p = 0.02). The rate of GFO was greater in patients with reperfusion versus patients in whom reperfusion was not achieved (adjusted OR 8.2, 95 % CI 2.0-34.2). Symptomatic intracerebral hemorrhage was documented in 5 % of all patients. Endovascular treatment with mechanical devices for acute ischemic stroke in Belgium results in GFO and reperfusion rates similar to recently published results in the endovascular-treated arms of randomized clinical trials. Rates of symptomatic intracranial hemorrhage are low and comparable to other cohort studies and clinical trials.


Lower urinary tract symptoms, benign prostatic obstruction and the overactive bladder.
Lower urinary tract symptoms (LUTS), benign prostatic obstruction (BPO), and the overactive bladder have increasing prevalence with age in both men and women (with the obvious exception). The question is, are they interrelated or independently related to age? The specific issue is whether BPO causes the overactive bladder. There are two pieces of evidence that might appear to suggest such a cause and effect. First, the overactive bladder is more common in men than in women of the same age, although physiologically, men are 5-10 years older at the same biological age. Second, the overactive bladder resolves in two-thirds of individuals after surgical interventions such as transurethral prostatectomy. The symptoms suggestive of an overactive bladder are the most troublesome, even though they may not be the most prevalent. Long-term follow-up studies with repeated urodynamic investigations have shown that the incidence of the overactive bladder and its attendant symptoms increases despite there being no deterioration in outlet obstruction over follow-up periods of 10 and 20 years. These data, and others, indicate that the situation is not as straightforward as some believe. The statement that 'the overactive bladder is secondary to BPO' cannot be made, as there are too many unanswered questions and pieces of the puzzle that do not fit. The overactive bladder is undoubtedly associated with BPO, and it leads to the most troublesome LUTS in older men. Epidemiological research, coupled with urodynamic evaluation, may provide further evidence. We also need better and more relevant models (e.g. ageing animals), together with further histological and other biological data before the waters become crystal clear.


Percutaneous ultrasonographically guided ablation of an acardiac twin.
Acardiac twinning is caused by twin reversed arterial perfusion (TRAP). Normal "pump" twins may face early delivery and cardiac decompensation and have a high perinatal mortality. A primagravid patient had serial evaluation of a TRAP pregnancy beginning early in the second trimester. Rapid growth of the acardiac sibling, high diastolic velocity Doppler waveforms in the perfusing vessel, and early hydramnios prompted ablation of blood flow by a percutaneous ultrasonographically guided infusion of absolute alcohol. A term birth of a normal pump twin was the outcome. Ablation of blood flow into an acardiac sibling of a TRAP pregnancy may be indicated in cases with a poor prognosis by use of an effective percutaneous ultrasonographically guided technique.


Maintenance of remission of ulcerative colitis: a comparison between balsalazide 3 g daily and mesalazine 1.2 g daily over 12 months. ABACUS Investigator group.
Despite widespread use of aminosalicylates as maintenance treatment for ulcerative colitis (UC), patients still report troublesome symptoms, often nocturnally. To compare the efficacy and safety of balsalazide (Colazide) with mesalazine (Asacol) in maintaining UC remission. A randomized, double-blind comparison of balsalazide 3 g daily (1.04 g 5-ASA) and mesalazine 1.2 g daily for 12 months, in 99 (95 evaluable) patients in UC remission. Balsalazide patients experienced more asymptomatic nights (90% vs. 77%, P=0.0011) and days (58% vs. 50%, N.S.) during the first 3 months. Balsalazide patients experienced more symptom-free nights per week (6.4+/-1.7 vs. 4.7+/-2.8; P=0.0006) and fewer nights per week with blood on their stools or on the toilet paper, mucus with their stools or with sleep disturbance resulting from symptoms or lavatory visits (each P < 0.05). Fewer balsalazide patients relapsed within 3 months (10% vs. 28%; P=0.0354). Remission at 12 months was 58%, in both groups. Similar proportions of patients reported adverse events (61% balsalazide vs. 65% mesalazine). There were five serious adverse events (two balsalazide, three mesalazine) and four withdrawals due to unacceptable adverse events (three balsalazide, one mesalazine), of which one in each group was also a serious adverse event. Balsalazide 3 g/day and mesalazine 1.2 g/ day effectively maintain UC remission and are equally well tolerated over 12 months. At this dose balsalazide prevents more relapses during the first 3 months of treatment and controls nocturnal symptoms more effectively.


Severe bone marrow edema on sacroiliac joint MRI increases the risk of low BMD in patients with axial spondyloarthritis.
To determine the association between inflammatory and structural lesions on sacroiliac joint (SIJ) MRI and BMD and to identify risk factors for low BMD in patients with axial spondyloarthritis (axSpA). Seventy-six patients who fulfilled the ASAS axSpA criteria were enrolled. All underwent SIJ MRI and BMD measurement at the lumbar spine, femoral neck, and total hip. Inflammatory and structural lesions on SIJ MRI were scored. Laboratory tests and assessment of radiographic and disease activity were performed at the time of MRI. The association between SIJ MRI findings and BMD was evaluated. Among the 76 patients, 14 (18%) had low BMD. Patients with low BMD showed significantly higher bone marrow edema (BME) and deep BME scores on MRI than those with normal BMD (p < 0.047 and 0.007, respectively). Inflammatory lesions on SIJ MRI correlated with BMD at the femoral neck and total hip. Multivariate analysis identified the presence of deep BME on SIJ MRI, increased CRP, and sacroiliitis on X-ray as risk factors for low BMD (OR = 5.6, 14.6, and 2.5, respectively). The presence of deep BME on SIJ MRI, increased CRP levels, and severity of sacroiliitis on X-ray were independent risk factors for low BMD.


China nationwide landscape of 16 types inherited metabolic disorders: a retrospective analysis on 372,255 clinical cases.
Inherited metabolic disorders (IMDs) usually occurs at young age and hence it severely threatening the health and life of young people. While so far there lacks a comprehensive study which can reveals China's nationwide landscape of IMDs. This study aimed to evaluate IMDs incidence and regional distributions in China at a national and province level to guide clinicians and policy makers. The retrospective study conducted from January 2012 to March 2021, we analyzed and characterized 372255 cases' clinical test information and diagnostic data from KingMed Diagnostics Laboratory. The samples were from 32 provincial regions of China, the urine organic acids were detected by gas chromatography-mass spectrometry (GC-MS), amino acids and acylcarnitines in dried blood spots were detected by liquid chromatography-tandem mass spectrometry (LC-MS/MS). We did a statistical analysis of the distribution of the 16 most common IMDs in amino acid disorders and organic acidemias, and then paid special attention to analyze the age and regional distributions of different IMDs. The statistical analyses and visualization analysis were performed with the programming language R (version 4.2.1). There were 4911 positive cases diagnosed, which was 1.32% of the total sample during the ten-year study period. Most diseases tended to occur at ages younger than 18 year-old. The Ornithine Transcarbamylase Deficiency tended to progress on male infants who were less than 28 days old. While the peak of the positive case number of Citrin Deficiency disease (CD) was at 1-6 months. Different IMDs' had different distribution patterns in China's provinces. Methylmalonic Acidemias and Hyperphenylalaninemia had an imbalanced distribution pattern in China and its positive rate was significantly higher in North China than South China. Conversely, the positive rate of CD was significantly higher in South China than North China. Results of this work, such as the differences in distribution pattern of different diseases in terms of age, region, etc. provide important insights and references for clinicians, researchers and healthcare policy makers. The policy makers could optimize the better health screening programs for covering children and infants in specific ages and regions based on our findings.


Has there been a change in the natural history of Crohn's disease? Surgical rates and medical management in a population-based inception cohort from Western Hungary between 1977-2009.
Medical therapy for Crohn's disease (CD) has changed significantly over the past 20 years with increasing use of immunosuppressives. In contrast, surgery rates are still high and there is little evidence that disease outcomes for CD have changed over the past decades. The objective of this study was to analyze the evolution of the surgical rates and medical therapy in the population-based Veszprem province database. Data of 506 incident CD patients were analyzed (age at diagnosis: 31.5 years, s.d. 13.8 years). Both hospital and outpatient records were collected and comprehensively reviewed. The study population was divided into three groups by the year of diagnosis (cohort A: 1977-1989, cohort B: 1990-1998 and cohort C: 1999-2008). Overall, azathioprine (AZA), systemic steroid, and biological (only available after 1998) exposure was 45.8, 68.6, and 9.5%, respectively. The 1- and 5-year probability of AZA use were 3.2 and 6.2% in cohort A, 11.4 and 29.9% in cohort B, and 34.8 and 46.2% in cohort C. In a multivariate Cox-regression analysis, decade of diagnosis (P < 0.001, hazard ratio (HR)(cohorts B-C): 2.88-6.53), age at onset (P = 0.008, HR: 1.76), disease behavior at diagnosis (P < 0.001, HR(complicated): 1.76-2.07), and need for systemic steroids (P < 0.001, HR: 2.71) were significantly associated with the time to initiation of AZA therapy. Early AZA use was significantly associated with the time to intestinal surgery in CD patients; in a multivariate Cox analysis (HR: 0.43, 95% confidence interval (CI): 0.28-0.65) and after matching on propensity scores for AZA use (HR: 0.42, 95% CI: 0.26-0.67). This population-based inception cohort has shown that the recent reduction in surgical rates was independently associated with increased and earlier AZA use.


Imaging Assessment of Thoracic Outlet Syndrome.
Imaging studies play a significant role in assessment of thoracic outlet syndrome. In this article, we discuss the etiology and definition of thoracic outlet syndrome and review the spectrum of imaging findings seen in patients with thoracic outlet syndrome. We then discuss an optimized technique for computed tomography and MRI of patients with thoracic outlet syndrome, based on the experience at our institution and present some representative examples. Based on our experience, a combination of computed tomography angiography and MRI (with postural maneuvers) effectively demonstrate thoracic outlet syndrome abnormalities.


Radiotherapy in the management of Kaposi's sarcoma in Nigeria.
Although Kaposi's sarcoma is now known to be far more common in the black African than was originally thought, it is rare in Nigeria. Facilities for radiotherapy are not available in areas of Africa where this condition occurs frequently. Various chemotherapeutic agents have been used either singly or in combination, with different results. In the locally confined lesions, it is believed that radiotherapy has an edge over the use of cytotoxic drugs. Five patients were seen and treated with radiation at the Lagos University Teaching Hospital in five years. They were all males, adults and came from the southern part of the country. All had histological confirmation of their disease as well as full investigations. Their histories are briefly reported. Response to chemotherapy from the literature has been discussed in order to highlight similar peculiarities attending the use of radiation on the normal tissues of the limbs. Ten different dose--time relationships were used on the five patients and these were plotted on double log scale. The results show that good response to curative radiotherapy varies inversely with the duration of the disease.


Early and late determinants of survival after surgery of left ventricular aneurysm.
The fate of 103 patients consecutively operated upon for chronic left ventricular aneurysm between 1978 and 1986 was examined with a multivariate statistical approach to verify the operative indications and results. In the early risk phase, up to 39 days after operation, 15 patients (15%) died. Mortality was mostly due to a low output syndrome and was significantly related to older age and to functional (NYHA) and anginal (CCS) class. In the late risk phase, starting 1.9 years after surgery, 9 patients died (10%) and the significant risk factors were anterior aneurysm and older age at operation. Actuarial survival curves showed 82% survival at 5 years and 61% at 9.5 years. In 25 patients older than 50 years and with an anterior aneurysm, these rates were 51% and 34%, respectively. Improved functional class was observed in 87% of the patients interviewed, but 30% complained of angina or new infarctions. Survival free of ischemia was 64% at 5 years and 13% at 9.5 years. This development of ischemic recurrences was significantly related to older age and to incomplete revascularization despite multiple grafts. These results suggest modification of the grafting policy and of the techniques of repair in identified high-risk subsets.


Transcriptional and post-translational regulation of Bim is essential for TGF-β and TNF-α-induced apoptosis of gastric cancer cell.
Tumor necrosis factor-α (TNF-α) and transforming growth factor-β (TGF-β) are well known as central signaling molecules in natural antitumor mechanisms. However, some cancer cells are resistant to TNF-α or TGF-β-induced death signaling. Herein, we investigated synergistic activities of TGF-β and TNF-α and molecular mechanisms involved in apoptosis of gastric cancer cells. SNU620, a human gastric carcinoma cell line was tested for cell viability by treatment of TGF-β in combination with TNF-α. Cell apoptosis, proliferation, caspase activation and gene expression were tested using flow cytometry, Western blot, MTT assay, luciferase assay and real-time qRT-PCR analysis. Knockdown of target genes were performed using lentiviral shRNA system. TGF-β sensitizes SNU620 cells undergoing TNF-α-induced caspase-dependent apoptosis. TNF-α and TGF-β synergistically induced the degradation of poly(ADP-ribose) polymerase (PARP) and caspase cascade activation. We also confirmed that c-Jun NH2-terminal kinase (JNK) and Smad3 play critical roles in the apoptotic pathway. In addition, a pro-apoptotic protein Bim was critical for apoptosis and was regulated by TGF-β and TNF-α at the transcriptional and post-translational levels. Expression of Bim was induced at the transcriptional level by Smad3 while Bim protein stability was maintained by a JNK-mediated pathway. By understanding the synergistic activation of TGF-β and TNF-α in apoptosis, we may have a chance to identify good therapeutic approaches for the treatment of cancers that are resistant to death signals. Our results indicate that TGF-β and TNF-α act in concert to activate apoptosis in gastric cancer cell through crosstalk between Smad and JNK signaling pathways.


[Animal experimental scintigraphic studies of closed lower leg fractures during the 1st 24 hours following the fracture trauma].
A closed fracture in the medium third part of the tibia was carried out in 50 rabbits. The scintigraphy was performed in groups of 5 animals at a time 2, 4, 6, 10, 12, 14, 16, 18, and 24 hours after the fracture trauma, in each case 45 minutes after the injection of 8 MBq 99mTc diphosphonat per kg body weight. The ROI activity quotient of both shank diaphysis was analysed. The first ascent was observed at the tenth postoperative hour. The ROI activity quotient was 2.1 24 hours after the fracture trauma. No marking of the fracture area was observed but an increase of the activity altogether above the diaphysis, and no ascent of the activity quotient in the neighbouring joints was observed.


Transcription of complementary repeat sequences in amphibian oocytes.
Repeat sequences are transcribed in the germinal vesicles of amphibian oocytes. In the hnRNA population both complements of the repeats are found and can be readily detected because they form intermolecular duplex structures. The structure and formation of duplex regions have been studied in the hnRNA of Xenopus laevis, Triturus cristatus, Amphiuma means and Necturus maculosus, a series of amphibians of increasing genome size (C-value). In T. cristatus, the duplex structures are mostly 600-1200 bp in length, whereas in X. laevis they are shorter and in N. maculosus they tend to be longer. Although the proportion of RNA sequence capable of rapidly forming duplex structures is different in different organisms, this property bears no relationship to C-value. However the sequence complexity of complementary repeats, as estimated from the rate of duplex formation, does show an increasing trend with C-value. The complementary repeats found in oocyte hnRNA are transcribed from families of DNA sequence that are each represented in the genome by thousands of copies. The extent of cross-species hybridization is low, indicating that the repeat sequences transcribed in different amphibian genera are not the same. In situ hybridization experiments indicate that the repeat sequences are spread throughout the genome. The evolution and possible function of complementary repeats are considered.


Nickel (II) chloride schiff base complex: Synthesis, characterization, toxicity, antibacterial and leishmanicidal activity.
The use of schiff base complex against microbial agentes a has recently received more attention as a strategy to combat infections caused by multidrug-resistant bacteria and leishmania. This study aimed to evaluate the toxicity, antibacterial and leishmanicidal activities of the nickel (II) chloride schiff base complex ([Ni(L2)] against Leishmania amazonensis promastigote, multi-resistant bacterial strains and evaluate to modulate antibiotic activity against multi-resistant bacterial. The schiff base complex was characterized by the techniques of elemental analysis, Fourier transform infrared spectroscopy (FTIR), UV-vis absorption spectroscopy and thermal analysis (TGA/DTG/DSC). The [Ni(L2)] complex presented moderate toxicity in saline artemia (LC50 = 150.8 μg/mL). In leishmanicidal assay, the NiL2 complex showed values of IC50 of (6.079 μg/mL ± 0.05656 at the 24 h), (0.854 μg/mL ± 0.02474, 48 h) and (1.076 μg/mL ± 0.04039, 72 h). In antibacterial assay, the [Ni(L2)] complex presented significant inhibited the bacterial growth of P. aeruginosa (MIC = 256 μg/mL). However, [Ni(L2)] complex did not present clinically relevant minimum inhibitory concentration (MIC ≥1024 μg/mL) against S. aureus and E. coli. The combination of [Ni(L2)] complex and antibacterial drugs resulted in the increased antibiotic activity of gentamicin and amikacin against S. aureus and E.coli multi-resistant strains. Thus, our results showed that [Ni(L2)] complex is a promising molecule for the development of new therapies associated with aminoglycoside antibiotics and in disease control related to resistant bacteria and leishmaniasis.


Metastatic gastric adenocarcinoma to the uterine cervix-a case report and review of the literature.
Poorly differentiated diffuse-type gastric adenocarcinoma often presents at an advanced stage. While gastric cancer typically metastasizes to the liver, lung and bone, metastasis to the uterine cervix is extremely rare. To our knowledge, less than forty cases have been described in the medical literature. We report a case of a 47-year-old woman who presented to us with symptomatic uterine leiomyomas and subsequently underwent a successful total laparoscopic hysterectomy and bilateral salpingo-oophorectomy. The diagnosis of metastatic cancer involving the cervix was established incidentally on histopathology, which demonstrated atypical signet ring cells in the lymphovascular spaces of the cervix. Further investigations for a primary malignancy revealed a poorly differentiated diffuse-type gastric adenocarcinoma. Gastric cancer involving the uterine cervix is rare and associated with a poor prognosis. When presented with isolated cervical metastases, the gastrointestinal tract should be considered as a possible primary source. Due to the limited publications on this clinical entity, we expect to raise awareness and study this unique manifestation of gastric cancer by presenting our case.


Effect of Single-Level Transforaminal Lumbar Interbody Fusion on Segmental and Overall Lumbar Lordosis in Patients with Lumbar Degenerative Disease.
To investigate the ability of transforaminal lumbar interbody fusion (TLIF) to improve lumbar lordosis (LL). In this retrospective study, 92 patients undergoing single-level TLIF to treat lumbar degenerative disease were divided into a low back pain, radiculopathy, and neurogenic claudication group according to their symptoms. Preoperative and postoperative measures, including segmental LL, whole LL, pelvic incidence (PI), pelvic tilt, thoracic kyphosis, sagittal vertical axis, visual analog scale for back and leg pain, and Oswestry Disability Index, were used to evaluate radiographic and clinical outcomes. All clinical parameters were significantly improved after TLIF. There was no significant difference in any radiographic parameters in the low back pain group. In the radiculopathy and neurogenic claudication groups, all radiographic parameters were significantly changed after TLIF except for segmental LL and PI in both groups and pelvic tilt in the radiculopathy group. No statistically significant differences were found in improvement of segmental LL, PI, thoracic kyphosis, and visual analog scale (leg) between the radiculopathy and neurogenic claudication groups, whereas the differences in improvement of whole LL, pelvic tilt, PI-LL, sagittal vertical axis, visual analog scale (back), and Oswestry Disability Index were significant between the 2 groups. For patients with neurogenic leg symptoms owing to single-level lumbar degenerative disease, whole LL was improved after TLIF as a result of spontaneous restoration of lordosis at the unfused lumbar levels.


Author Correction: Innovations present in the primate interneuron repertoire.
An amendment to this paper has been published and can be accessed via a link at the top of the paper.


Alternating potentials assisted electrochemical deposition of mineralized collagen coatings.
Mineralized collagen coatings were synthesized by electrochemical deposition with alternating negative and positive potentials. The obtained coatings demonstrated a multi-layer structure alternating consisting of weakly and highly mineralized collagen layers and the proportion of each layer could be controlled by adjusting the deposition time. The coatings deposited using alternating potentials assisted electrochemical deposition (AP-ECD) showed significantly enhanced osteoblasts proliferation, and rhBMP-2 loading capability compared to those of the coatings deposited using constant potential electrochemical deposition (CP-ECD). The enhanced cytocompatibility and rhBMP-2 loading capability of the coatings might be attributed to their high proportion of weakly mineralized collagen layer. Furthermore, the deposition mechanism for alternating potentials is proposed as that positive potential induces deposition of negatively charged collagen fibrils to form a weakly mineralized collagen layer. Our results suggest that the present deposition method could be a promising approach to engineer mineralized collagen coating with better biological performances.


Antipyrine metabolism in patients with disseminated testicular cancer and the influence of cytostatic treatment.
Antipyrine plasma clearance and rates of metabolite formation were measured on four occasions in eight patients with disseminated nonseminomatous testicular cancer. Antipyrine tests were performed before, during (2X), and after treatment with a combination of cisplatin (P), vinblastin (V), and bleomycin (B). Pretreatment values were compared with a male control group (n = 14) matched for age and body weight. Antipyrine plasma clearance was 20% higher in patients with testicular cancer (first experiment) than in the control group. This difference was mainly due to a 35% higher clearance for production of 3-hydroxymethylantipyrine (HMA), while clearance for production of norantipyrine (NORA) and 4-hydroxyantipyrine (OHA) was not significantly different from the control group. A reduction in CLHMA was observed after complete remission (fourth experiment), indicating that the presence of the tumor may be related to a selective increase of HMA formation. Treatment with the PVB combination resulted in a 30% increase in antipyrine plasma clearance (second and third experiments), whereas the rates of formation of the main metabolites of antipyrine were all increased to the same extent. These accelerating effects of PVB treatment persisted for at least 6 weeks after the start of the last treatment cycle. The data presented in this paper demonstrate that the presence of a testicular tumor and the use of cytostatics can have an accelerating and partially selective effect on oxidative drug-metabolizing enzyme activity in man.


Problem-based learning in clinical practice: employment and education as development partners.
In this project tutorial small group working sessions of problem-based learning were carried out in the long-term care practice period of nursing students. The purpose was to describe nursing students' learning when tutorial work was carried out during their first clinical practice period. The students had one PBL cycle during their four weeks' clinical practice consisting of two tutorial sessions where clinical mentors and the teacher worked together as tutors. The students were pre-tested before the clinical practice and post-tested afterwards using a questionnaire. The questionnaire had been used in pilot projects during 2004-2005. Altogether, 40 nursing students participated in the study. There were statistically significant differences between pre- and post-test in "PBL-learning skills" (p<0.001) and "interaction with old patients" (p<0.001). The means of items "Interested in work in long-term care" and "Own attitude towards long-term care" had increased between pre- and post-test. In conclusion it can be suggested that carrying out tutorials in nursing students' clinical practice is beneficial.


Hypoglycemic effect of hot-water extract of adzuki (Vigna angularis) in spontaneously diabetic KK-A(y) mice.
Recently, we reported that 40% ethanol fraction of hot-water extracts of adzuki (Vigna angularis; EtEx.40) suppressed the postprandial blood glucose level and serum insulin level in normal mice and streptozotocin-induced type 1 diabetic rats. The present study examined the hypoglycemic effect of EtEx.40 on blood glucose, insulin concentrations, organ weight, serum composition, and hepatic lipid content in spontaneously diabetic KK-A(y)/Ta Jcl mice, a model for type 2 diabetes. To investigate the prevention of type 2 diabetes by EtEx.40 ingestion, 4-wk-old non-diabetic KK-A(y) mice were fed an AIN-76 diet containing 5000 mg of EtEx.40/kg of body weight per day (EtEx.40) or an AIN-76 diet without EtEx.40 for 8 wk. Furthermore, to investigate the improvement of type 2 diabetes, 7-wk-old diabetic KK-A(y) mice were fed EtEx.40 for 4 wk. Compared with the control group, EtEx.40 supplementation had a significant effect in lowering blood glucose levels, water intake, serum insulin levels, urinary glucose, urinary microalbumin/creatinine ratio, liver triacylglycerol, and total cholesterol levels. Similar results were observed in 7-wk-old diabetic KK-A(y) mice fed EtEx.40 for 4 wk. These effects were also found after short-term administration of EtEx40. Overall, EtEx.40 improved several diabetic symptoms in KK-A(y) mice. EtEx.40 obtained from hot-water adzuki extracts showed preventive and ameliorative effects on the progression of diabetes in genetically diabetic KK-A(y) mice. In the present study, we conclude that the preventive and ameliorative effects by EtEx.40 were due to the modulation of blood glucose levels and the protective effect against oxidative damage in diabetes mellitus.


Moniliformin In wheat and triticale grain.
Fusarium avanacoum infected wheat and triticale heads in Poland in each season between 1985 and 1989. The average number of heads infected byF avonacaum was 26 % for wheat and 46 % for triticale out of all examined heads withFusarium head blight symptoms.Fusarium-damaged wheat grain, naturally infected byF avenaceum, contained an average of 15.9±7.7 mg moniliformin/kg, healthy looking kernels from the same heads an average of 0.42±0.19 mg moniliformin/kg. Fusarfum-damaged kernels of triticale contained an average of 3.5 mg moniliformin/kg while healthy looking kernels from the same ears contained 0.25 mg/kg.


Isopycnal mixing of interhemispheric intermediate waters by subthermocline eddies east of the Philippines.
Both sporadic observations and modelling studies suggest that subthermocline eddies (SEs) exist east of the Philippines, where interhemispheric waters meet. However, effects of SEs on water mass mixing have never been observed. Here, using data from mooring and buoy deployed in the frontal region of the interhemispheric water masses, we show for the first time that the SEs act as an "underwater mixer" of intermediate waters from north and south Pacific oceans. The SEs have typical swirl speeds of 0.1~0.4 m s-1 between 200 and 800 m depth with a dominant period of ~90 days. Variation in intermediate water salinity also had a period of ~90 days, lagging eddy speed by ~8 days. Horizontal eddy diffusivity representative of eddy mixing rate was quantified using a mixing-length framework. Horizontal eddy diffusivity had both surface and subthermocline maxima. The vertically varying eddy diffusivity can be used to improve parameterization of eddy stirring in the tropical Pacific by coarse-resolution ocean climate models. The effect of the SEs on mixing of intermediate water masses seems not resolved by available eddy-resolving ocean models typically used for this region.


Colorectal neuroendocrine tumors: A case series.
Neuroendocrine tumors (NET) of the colon and sigmoid colon are uncommon compared to colorectal adenocarcinoma. Few reports have been made of NET of the colon and sigmoid colon that presents with peritonitis and large bowel obstruction. Here, we report two cases of NET of the colon and sigmoid colon, which were diagnosed and treated at our institution. In our first case, a 66-year-old man with a history of abdominal distension was diagnosed with NET via histopathology of the sigmoid colon. The second case involved a 45-year-old woman with the chief complaints of abdominal distention and inability to defecate; specimen histopathology of the descending colon showed neuroendocrine carcinoma features. Clinical outcome was very poor in our patients: eight months after the resection, the second patient demonstrated a sign of metastasis on the liver. An uncommon case of colon and sigmoid colon carcinoma with neuroendocrine and diagnostic difficulties precludes an exact description of the initial diagnostic criteria and management. Thus, our case series offers an overview of initial symptoms, radiological and histopathological features for early diagnosis, and proper management of NET.


Diosmin: A Daboia russelii venom PLA2s inhibitor- purified, and characterized from Oxalis corniculata L medicinal plant.
Oxalis corniculata L is a medicinal plant that belongs to the Oxalidaceae family. It is a little, slow-growing plant with a frail appearance typically found in mild temperate and tropical areas like Pakistan and India. This plant also includes many other bioactive substances, including alkaloids, flavonoids, terpenoids, cardiac glycosides, saponins, phlobatannins, and steroids. To investigate the anti-inflammatory effects of Compound diosmin, which is derived from Oxalis corniculata L, on VRV-PL-5 and VRV-PL-8a isolated from Vipera russelli. Extraction, purification, and characterization of bioactive by TLC, HPTLC, FT-IR analysis, UV-Vis spectrophotometer, LC-MS/MS Analysis, NMR, XRD Analysis, In vitro evaluation, Circular dichroism spectroscopy, in vivo, and in silico studies. In this study, the extract of Oxalis corniculata was evaluated for its in vitro and in vivo anti-inflammatory effect against PLA2. The methanolic extract decreased hemolytic activity by about 60% at 1:75 w/w and neutralized the hemolytic activity completely at 1:100 w/w concentration. Diosmin inhibited VRV-PL-5 and VRV-PL-8a in a dose-dependent manner, with the extent of inhibition being about 56% for VRV-PL-5120 μM and VRV-PL-8a by 62% at the same concentration with IC50 concentrations of 87.08 μM for VRV-PL-5 and 82.08 μM for VRV-PL-8a, while at 75 μM. Diosmin inhibited the hemolytic activity of VRV-PL-5 by about 85%, and at the same concentration, VRV-PL-8a inhibited by about 75%. UV-CD spectra at the IC50 concentration of diosmin disrupted the secondary structure of VRV-PL-5 &VRV-PL-8a. In vivo, studies showed decreased myotoxicity and cardiotoxicity of the VRV-PL-5 &VRV-PL-8a, which was seen in the decrease in cytoplasmic markers LDH and CPK levels in the serum when incubated with diosmin. Furthermore, Histopathological studies of Muscles and lungs revealed that diosmin considerably protects against cellular abnormality caused by VRV-PL-5 & VRV-PL-8a. Molecular docking, MM/GBSA, and molecular dynamics simulation studies show that the diosmin is a potent inhibitor for VRV-PL-5 and VRV-PL-8a. This study shows that diosmin is a potentially effective VRV-PL-5 and VRV-PL-8a.


Smog chamber simulation on heterogeneous reaction of O3 and NO2 on black carbon under various relative humidity conditions.
In this study, heterogeneous formation of nitrate from O3 reaction with NO2 on black carbon (BC) and KCl-treated BC surface in the presence of NH3 was simulated under 30-90% RH conditions by using a laboratory smog chamber. We found that O3 and NO2 in the chamber quickly reacted into N2O5 in the gas phase, which subsequently hydrolyzed into HNO3 and further neutralized with NH3 into NH4NO3 on the BC surface, along with a small amount of N2O5 decomposed into NO and NO2 through a reaction with the BC surface active site. Meanwhile, the fractal BC aggregates restructured and condensed to spherical particles during the NH4NO3 coating process. Compared to that during the exposure to NO2 or O3 alone, the presence of strong signals of CH2O+, CH2O2+ and CH4NO+ during the simultaneous exposure to both NO2 and O3 suggested a synergetic oxidizing effect of NO2 and O3, which significantly activated the BC surface by forming carbonyl, carboxylic and nitro groups, promoted the adsorption of water vapor onto the BC surface and enhanced the NH4NO3 formation. Under <75 ± 2% RH conditions the coating process of NH4NO3 on the BC surface consisted of a diffusion of N2O5 onto the surface and a subsequent hydrolysis, due to the limited number of water molecules adsorbed. However, under 90 ± 2% RH conditions N2O5 directly hydrolyzed on the aqueous phase of the BC surface due to the multilayer water molecules adsorbed, which caused an instant NH4NO3 formation on the surface without any delay. The coating rate of NH4NO3 on KCl-treated BC particles was 3-4 times faster than that on the pure BC particles at the initial stage, indicating an increasing formation of NH4NO3, mainly due to an enhanced hygroscopicity of BC by KCl salts.


Dicopper(II) and dizinc(II) complexes with nonsymmetric dinucleating ligands based on indolo[3,2-c]quinolines: synthesis, structure, cytotoxicity, and intracellular distribution.
Dicopper(II) and dizinc(II) complexes [Cu2((MeOOC)L(COO))(CH3COO)2] (1) and [Zn2((MeOOC)L(COO))(CH3COO)2] (2) were synthesized by reaction of Cu(CH3COO)2·H2O and Zn(CH3COO)2·2H2O with a new nonsymmetric dinucleating ligand (EtOOC)HL(COOEt) prepared by condensation of 6-hydrazinyl-11H-indolo[3,2-c]quinoline with diethyl-2,2'-((3-formyl-2-hydroxy-5-methylbenzyl)azanediyl)diacetate. The design and synthesis of this elaborate ligand was performed with the aim of increasing the aqueous solubility of indolo[3,2-c]quinolines, known as biologically active compounds, and investigating the antiproliferative activity in human cancer cell lines and the cellular distribution by exploring the intrinsic fluorescence of the indoloquinoline scaffold. The compounds have been comprehensively characterized by elemental analysis, spectroscopic methods (IR, UV-vis, (1)H and (13)C NMR spectroscopy), ESI mass spectrometry, magnetic susceptibility measurements, and UV-vis complex formation studies (for 1) as well as by X-ray crystallography (1 and 2). The antiproliferative activity of (EtOOC)HL(COOEt), 1, and 2 was determined by the MTT assay in three human cancer cell lines, namely, A549 (nonsmall cell lung carcinoma), CH1 (ovarian carcinoma), and SW480 (colon adenocarcinoma), yielding IC50 values in the micromolar concentration range and showing dependence on the cell line. The effect of metal coordination on cytotoxicity of (EtOOC)HL(COOEt) is also discussed. The subcellular distribution of (EtOOC)HL(COOEt) and 2 was investigated by fluorescence microscopy, revealing similar localization for both compounds in cytoplasmic structures.


Acute epidural hematoma developing during twist-drill craniostomy: a complication of percutaneous subdural tapping for the treatment of chronic subdural hematoma.
This case illustrates that although percutaneous subdural tapping for patients with chronic subdural hematoma (CSDH) is successful and minimally invasive, it can be complicated by acute epidural hematoma. A 62-year-old woman presented with headache two months after minor head trauma. Computed tomography (CT) scanning revealed CSDH with mixed density on the right side. Prior to percutaneous subdural tapping, twist-drill craniostomy was performed at the parietal tuber. When the drill-needle reached the dura mater, the patient began to complain of headache, which was followed by altered consciousness. CT scanning disclosed acute epidural hematoma abutting the CSDH; both hematomas were evacuated by emergency craniotomy. At surgery, no definite bleeding source was identified apart from oozing on the dura mater. Hemorrhagic complications after percutaneous subdural tapping are rare. The formation of acute epidural hematoma during twist-drill craniostomy has not been reported in the literature. This complication can occur when the blunt tip of the drill-needle remains on the dura mater without penetrating into the subdural hematoma cavity.


LASER THERAPY OF RETINAL TEARS.
To report the clinical results of treatment of patients with retinal tears or holes, including rhegmatogenous retinal detachment, who were treated primarily with laser retinopexy. The effect and results of the therapy of patients with one or more retinal tears who underwent therapy with the green laser IQ 532 IRIDEX between December 2019 and August 2022 at our center with a follow-up observation period of at least 3 months were retrospectively evaluated. A total of 14 eyes of 14 patients were treated by this method during the monitored period. All the tears found were primarily successfully repaired. The overall success rate of prophylaxis of rhegmatogenous retinal detachment was 93% in our cohort. In one patient, subsequent pars plana vitrectomy was required due to the progression of retinal detachment from another biomicroscopically inaccessible hole, which was part of lattice degeneration in the peripheral part of the retina. This pathology was only verified during intraocular surgery. Postoperatively, the retina was attached with a very good anatomical and functional effect. The other patients did not require any adjuvant therapy. Visual functions improved or remained stable in all patients in the cohort. The follow-up observation period ranged from 3 to 36 months. Laser retinopexy is a sparing, safe and effective method of retinal tear therapy. From our clinical experience, the technique is also applicable in the case of partial vitreous hemorrhage or incipient rhegmatogenous detachment. We did not record any complications of perioperative or postoperative treatment among our patients.


Directed evolution and identification of control regions of ColE1 plasmid replication origins using only nucleotide deletions.
Genes can be mutated by altering DNA content (base changes) or DNA length (insertions or deletions). Most in vitro directed evolution processes utilize nucleotide content changes to produce DNA libraries. We tested whether gain of function mutations could be identified using a mutagenic process that produced only nucleotide deletions. Short nucleotide stretches were deleted in a plasmid encoding lacZ, and screened for increased beta-galactosidase activity. Several mutations were found in the origin of replication that quantitatively and qualitatively altered plasmid behavior in vivo. Some mutations allowed co-residence of ColE1 plasmids in Escherichia coli, and implicate hairpin structures II and III of the ColE1 RNA primer as determinants of plasmid compatibility. Thus, useful and unexpected mutations can be found from libraries containing only deletions.


Evaluating HBsAg rapid test performance for different biological samples from low and high infection rate settings & populations.
Rapid tests (RTs) might have several advantages over standard laboratory procedures, increasing access to diagnosis, especially among vulnerable populations and/or those living in remote areas. The aim of this study was to evaluate the performance of RTs for the detection of hepatitis B virus surface antigen (HBsAg) in samples from different populations/settings. Three RTs for HBsAg detection (Vikia® HBsAg, HBsAg Teste Rápido®, and Imuno-Rápido HBsAg®) and different biological specimens (serum, whole blood, and saliva) were evaluated. Analyses comprised a reference panel and samples from field studies targeting suspected cases of hepatitis B virus (HBV) (G I), individuals living in deprived areas (G II), and highly vulnerable individuals (G III). Enzyme immunoassay (EIA) was defined as the gold standard in this study. Reproducibility, repeatability, and cross-reactivity with other infectious agents such as dengue, immunodeficiency (HIV), and hepatitis C (HCV) viruses and T. pallidum were determined. For the reference panel, the sensitivity and specificity of all HBsAg RTs were higher than 93.00 %. G I presented the highest kappa values for all rapid assays using sera samples. When using serum, the sensitivity values were higher than 93.40 for G I, 60.00 % for G II and 66.77 % for G III, and the specificity values were higher than 99.50 for GI, 97.20 for G II and 99.10 % for G III for all tests. For whole blood samples & the Vikia® HBsAg assay, the best performance was achieved for GIII (k = 79.75 %). For saliva samples, the Imuno-Rápido HBsAg® assay showed the highest concordance values with EIA for G I (40.68 %) and G II (32.20 %). The reproducibility and repeatability of all RTs for serum and saliva were excellent, and the concordance between HBsAg EIAs and RTs using samples reactive with other infectious agents varied from 70.10 % to 100.00 %. The overall performance of RTs for HBsAg in serum was high/moderately high for all groups, thereby promoting increased access to HBV diagnosis among vulnerable populations as well as samples from individuals in emergency settings or remote areas. Rapid tests for HBsAg using whole blood could be used in prevalence studies, though these assays should not be used for saliva samples.


Effect of landiolol in patients with tachyarrhythmias and acute decompensated heart failure (ADHF): a case series.
Tachycardia and rapid tachyarrhythmias are common in acute clinical settings and may hasten the deterioration of haemodynamics in patients with acute decompensated heart failure (ADHF), treated with inotropes. The concomitant use of a short-acting β1-selective beta-blocker, such as landiolol, could rapidly and safely restore an adequate heart rate without any negative inotropic effect. We present a case series of five patients with left ventricular dysfunction, admitted to our Intensive Cardiac Care Unit with ADHF deteriorated to cardiogenic shock, treated with a combination of landiolol and inotropes. Landiolol was effective in terms of rate control and haemodynamics optimization, enabling de-escalation of catecholamine dosing in all patients. The infusion was always well tolerated without hypotension. In conclusion, a continuous infusion of a low dose of landiolol (3-16 mcg/kg/min) to manage tachycardia and ventricular or supraventricular tachyarrhythmias in haemodynamically unstable patients may be considered.


Rhythm Control in Heart Failure Patients with Atrial Fibrillation.
AF and heart failure (HF) commonly coexist. Left atrial ablation is an effective treatment to maintain sinus rhythm (SR) in patients with AF. Recent evidence suggests that the use of ablation for AF in patients with HF is associated with an improved left ventricular ejection fraction and lower death and HF hospitalisation rates. We performed a systematic search of world literature to analyse the association in more detail and to assess the utility of AF ablation as a non-pharmacological tool in the treatment of patients with concomitant HF.


Silver-enhanced colloidal gold dip strip immunoassay integrated with smartphone-based colorimetry for sensitive detection of cardiac marker troponin I.
Cardiac troponin I (cTnI) is a specific cardiac biomarker for diagnosis of acute myocardial infarction (AMI). A sensitive and simple point-of-care test (POCT) is still required for early detection of AMI. To address this need, we developed a dip strip assay based on sandwich immunoassay coupled with a silver enhancement system. Pre-incubation and silver enhancement were introduced to the dip strip to increase sensitivity. Due to the catalytic reaction of the silver enhancement solution, the red color of AuNPs changed to dark brown as silver ions precipitated and enlarged the AuNPs. The obtained results were easily seen by the naked eye. For quantitative analysis, the color intensity of the results was analyzed using a smartphone with RGB color picker application. The effects of operating parameters (volume of AuNP-Ab conjugate, volume of sample, incubation time, and analysis time) were investigated and optimized. Under optimal conditions, the limit of detection (LOD) by the naked eye was 0.5 ng/mL. The LOD with silver enhancement was 50-fold lower than without. For quantitative analysis using the smartphone, linearity of detection was observed through the range of 0.5-50 ng/mL (R2 = 0.9952) and the LOD was 0.12 ng/mL. The developed method was successfully applied to detection of cTnI in serum samples, achieving analytical recoveries and %RSD in the ranges of 96.10-119.17% and 2.91-5.13%, respectively. Additionally, this developed assay was not cross reactive with the potentially interfering serum proteins. These results showed the great potential of this dip strip assay as an alternative POCT for detection of serum cTnI.


Congenital nasal pyriform aperture stenosis and single central maxillary incisor: CT and MRI findings.
The authors report five cases of congenital nasal pyriform aperture stenosis (CNPAS). Four cases are presented as neonatal nasal obstruction and also have single central maxillary incisor (SCMI). Computed tomography examination indicates three of the SCMI are unerupted and one is erupted. The fifth case has an erupted SCMI and short stature. The associated SCMI in CNPAS is believed to be more than an isolated anomaly. Awareness of the associated features of CNPAS among the radiologist and otolaryngologist may help the diagnosis and treatment of the patient.


Self-reported memory compensation: similar patterns in Alzheimer's disease and very old adult samples.
Evidence pertaining to self-reported use of memory compensation techniques was collected using the Memory Compensation Questionnaire (MCQ). Five forms of everyday memory compensation were evaluated: (a) external memory aids, (b) internal mnemonic strategies, (c) investing and managing processing time, (d) applying more effort, and (e) reliance on human memory aids. The sample was derived from the Kungsholmen Project in Stockholm, Sweden, and consisted of (n = 85) healthy older adults (M age = 81.80 years; M MMSE = 28.34) and (n = 21) diagnosed Alzheimer's Disease (AD) patients (Mage = 81.80 years; M MMSE = 23.55). Participants were tested on two occasions, 6 months apart. Results showed that the MCQ was a largely reliable instrument in these two groups. Moreover, we observed substantial sample similarity in frequency of using the five forms of everyday memory compensation techniques. The healthy sample reported using the external techniques more than the AD sample. Over the 6-month interval, however, AD patients differentially increased their use of others to assist them in everyday memory performance. Results are interpreted in terms of insight into changes in memory skills and inthe implementation of effective memory support systems.


Oxidation of [Fe(CN)6]4- and reduction of [Fe(CN)6]3- in VUV-irradiated aqueous solutions.
Vacuum ultraviolet (VUV) photolysis is one of the straightforward alternatives method among the advanced oxidation processes (AOPs) for the elimination of pollutants from water and air. The VUV photolysis of water produces hydroxyl radicals and hydrogen atoms, which have widely different oxidation and reduction abilities. In this work the oxidation and reduction properties of VUV-irradiated solutions were compared by investigating the reduction of [Fe(CN)6]3- and the oxidation of [Fe(CN)6]4-. The rate of oxidation of [Fe(CN)6]3- was found to be practically the same as the reduction rate of [Fe(CN)6]4- in the irradiated oxygen-free solutions under identical conditions. Dissolved oxygen strongly influences the redox properties of this system.


Reducing perceived health risk to attract hotel customers in the COVID-19 pandemic era: Focused on technology innovation for social distancing and cleanliness.
As an essential risk-reduction strategy, technology innovation is likely to play a key role in the hotel industry's recovery from the 2020 coronavirus pandemic. However, its impact on customer decision-making behavior is unknown. Focusing on technology innovation for reducing guest interaction with employees and enhancing cleanliness, the purpose of this research was to examine the impact of expected interaction and expected cleanliness on perceived health risk and hotel booking intention. Three experimental studies were conducted using online consumer samples. The studies found that low levels of expected interaction through technology-mediated systems lead to low levels of perceived health risk. Perceived health risk mediates the relationship between expected interaction and hotel booking intention. In addition, high levels of expected cleanliness through advanced cleaning technologies moderate the impacts of expected interaction on perceived health risk. Importantly, the proposed perceived risk mechanism was effective in post-pandemic scenarios. Theoretical and practical implications are discussed.


Disassembly of a rotablator: getting out of a trap.
The rotablator burr rarely becomes trapped within calcified lesions. Manual traction can be ineffective and dangerous. We report a case that illustrates a novel technique involving use of a percutaneous snare in conjunction with partial disassembly of the rotablator device to remove a trapped burr without need for open surgical intervention.


Polymer based sustained drug delivery to the ocular posterior segment: barriers and future opportunities for the treatment of neovascular pathologies.
There is an increasing momentum in research and pharmaceutical industry communities to design sustained, non-invasive delivery systems to treat chronic neovascular ocular diseases that affect the posterior segment of the eye including age-related macular degeneration and diabetic retinopathy. Current treatments include VEGF blockers, which have revolutionized the standard of care for patients, but their maximum therapeutic benefit is hampered by the need for recurrent and invasive administration procedures. Currently approved delivery systems intended to address these limitations exploit polymer technology to regulate drug release in a sustained manner. Here, we critically review sustained drug delivery approaches for the treatment of chronic neovascular diseases affecting the ocular posterior segment, with a special emphasis on novel and polymeric technologies spanning the spectrum of preclinical and clinical investigation, and those approved for treatment. The mechanism by which each formulation imparts sustained release, the impact of formulation characteristics on release and foreign body reaction, and special considerations related to the translation of these systems are discussed.


Effects of calcium and calmodulin antagonists on calpain II subunit conformations.
Only the 80-kD catalytic subunit of smooth muscle calpain II shows a change in intrinsic fluorescence on binding calcium, but both the 80-kD and 30-kD subunits show fluorescence changes in bound toluidinyl-naphthalenesulphonate as a result of calcium binding. Both subunits also show changes in intrinsic fluorescence in the presence of calmidazolium and felodipine. These studies indicate that both subunits have binding sites for calcium and the calmodulin antagonists, which are probably located in the calmodulin-like domain of each subunit.


Development and application of a quantification method for water soluble organosulfates in atmospheric aerosols.
In recent years, organosulfates have been found as a significant component of secondary organic aerosols from both smog chamber experiments and field measurements. In this study, an indirect method was developed to estimate organosulfates in aerosol particles as a whole based on their sulfate functional group. A series of experiments were conducted to optimize and validate the method, and it was then applied to quantify organosulfates in the aerosol samples collected at three sampling characteristic sites in Shenzhen, with one close to a power plant (PP), one at a heavy traffic intersection (HTI), and one on the campus of Harbin Institute of Technology Shenzhen graduate school (HITSZ). On average, the mass concentrations of organic sulfur (Sorg) were 1.98, 1.11, 0.25 μgS m-3 in PP, HTI and HITSZ respectively. The lower bounds of mass concentrations of organosuflates (OMs-related) were 6.86, 3.85 and 0.86 μg m-3 and the upper bounds of mass concentrations of organosulfates were 23.05, 12.93 and 2.90 μg m-3 in PP, HTI and HITSZ respectively. This indicates that primary emissions from coal burning and automobile exhaust can promote the secondary formation of organosulfates in the atmosphere. Overall, the mass concentrations observed in this work were higher than those reported by previous studies.


Time trends in mortality rates in type 1 diabetes from 2002 to 2011.
The aim of this study was to estimate absolute and relative mortality rates in patients with type 1 diabetes at the Steno Diabetes Centre relative to the general Danish background population. Patients with type 1 diabetes (n = 4,821) were followed from 1 January 2002 until 1 January 2011, with death from any cause as the main outcome. Poisson regression was used to model mortality rates by age, diabetes duration and calendar time, according to sex. In the period 2002-2010, a total of 673 deaths (402 men, 271 women) occurred in the study population during 33,847 years of follow-up of type 1 diabetes. The predominant cause of death in patients with type 1 diabetes was cardiovascular disease. Mortality rates were highest among those with the lowest age at onset, particularly men. The mortality rate in the diabetic population decreased over that time period by 6.6% and 4.8% per year in men and women, respectively; this was substantially greater than the decrease in mortality rates in the background population. The decline in standard mortality rate was 4.3% per year in men and 2.6% per year in women. Patients who did not develop nephropathy had only slightly elevated mortality rates compared with the background population. Despite advances in care, mortality rates in the past decade continue to be greater in patients with type 1 diabetes than in those without diabetes; however, the mortality rate in patients decreased over the study period faster than that of the background population. Nephropathy seems to be the main driver of the excess mortality.


[Prognostic importance of pulmonary hypertension in heart failure with preserved ejection fraction].
Pulmonary hypertension (PH) is a frequent complication in heart failure (HF). However, its impact factor in heart failure with preserved ejection fraction (HFPEF) is not well-known. This study has aimed to identify the prognostic value of PH in hospitalized patients with HFPEF. An observational and prospective trial of patients admitted due to HFPEF (LVEF >45%). Pulmonary hypertension was defined by Pulmonary artery systolic pressure (PASP) >35mm Hg measured by the tricuspid regurgitation velocity plus atrial pressure. The primary endpoint was all-cause mortality and/or readmissions during 1-year follow-up. Kaplan-Meier survival curves and Cox regression were performed to identify adjusted hazard ratios (HR). A total of 218 patients completed the follow-up period, 56 patients (32.2%) had PASP >35mm Hg. Primary endpoint was observed in 126 patients (57.8%) and 70 patients (32.2%) died. Kaplan-Meier survival curves showed increased significantly all-cause mortality and/or readmission in patients with PH (Log Rank <0.001) and mortality (Log Rank 0.019). Patients with PH were an increased adjusted risk for primary endpoint, HR 2.03 (CI 95%: 1.39-2.96; p<0.001) and all-cause mortality, HR 1.84 (CI 95%: 1.11-3.03; p=0.017). Pulmonary hypertension (PASP >35mm Hg) measured by non-invasive methods is a strong and independent predictor of an unfavorable outcome in patients hospitalized due to heart failure and normal or only mildly reduced ejection fraction.


Galactin-1, 3 and 9: Potential biomarkers in idiopathic pulmonary fibrosis and other interstitial lung diseases.
Galectins are proteins that bind β-galactosides such as N-acetylactosamine present in N-linked and O-linked glycoproteins and that seem to be implicated fibrotic mechanisms. Here we aimed to define the role of serum galectins in idiopathic pulmonary fibrosis and idiopathic non-specific interstitial pneumonia (NSIP) by comparison with other chronic interstitial lung diseases (ILDs) and healthy subjects. Forty-one fibrotic ILD patients (median age (IQR), 65 years (20); 50 % male) were enrolled in the study. Peripheral blood concentrations of galectins-1, 3 and 9 were determined with commercial ELISA kits. Galectin-1 and 9 concentrations were higher in the ILD group than in healthy controls (p = 0.0318 and p < 0.0001, respectively). Galectin-3 was also higher in ILD patients (borderline significant p = 0.0617). In particular, significantly higher Gal-1 concentrations were found in sarcoidosis and NSIP patients (p = 0.0418 and p = 0.0015, respectively), while Gal-9 concentrations were significantly higher in all ILD subgroups. Specific cut-offs for all galectins were calculated by receiver operating curve (ROC) analysis. Several correlations with lung function parameters were found. Galectins 1, 3 and 9 concentrations were found altered in serum of ILD patients suggesting their potential utility as clinical, diagnostic and prognostic biomarkers. Inhibition of galectins may be useful in the therapeutic management of pulmonary fibrosis. Further studies on larger case series would be worthwhile.


Cytosolic ascorbate peroxidase 1 modulates ascorbic acid metabolism through cooperating with nitrogen regulatory protein P-II in tea plant under nitrogen deficiency stress.
Nitrogen (N) element is essential nutrient, and affect metabolism of secondary metabolites in higher plants. Ascorbate peroxidase (APX) plays an important role in ascorbic acid (AsA) metabolism of tea plant. However, the roles of cytosolic ascorbate peroxidase 1 (CsAPX1) in AsA metabolism under N deficiency stress in tea plant remains unclear in detail. In this work, nitrogen regulatory protein P-II (CsGLB1) and CsAPX1 were identified by isobaric tags for relative and absolute quantitation (iTRAQ) from tea plant. The cell growth rates in transgenic Escherichia coli overexpressing CsAPX1 and CsGLB1 were higher than empty vector under N sufficiency condition. Phenotype of shoots and roots, AsA accumulation, and expression levels of AtAPX1 and AtGLB1 genes were changed in transgenic Arabidopsis hosting CsAPX1 under N deficiency stress. These findings suggested that cytosolic CsAPX1 acted a regulator in AsA accumulation through cooperating with GLB1 under N deficiency stress in tea plant.


Anti-ulcer Activity.
This chapter explains the procedure of ethanol-induced ulcer to check the protective effect of drugs over induced ulcer in rats. Ulcer is defined as the erosion in the lining of the stomach or duodenum and is caused by the disruptions of the gastric mucosal defence and repair systems. Ulceration of stomach is called gastric ulcer and that of duodenum is called duodenal ulcer and together peptic ulcer. In clinical practice, peptic ulcer is one of the most prevalent gastrointestinal disorders, which commonly occurs in developed countries.


Results of reconstruction of the facial nerve.
The results of surgical treatment for facial paralysis are still difficult to compare as there is no universal scoring method. The purpose of this communication is to review the results of reconstruction of the extratemporal facial nerve with nerve grafts using our own evaluation system. Fifty-nine patients were operated on during the period 1981-1991. They had lacerations or other trauma to the face which resulted in loss of continuity of the facial nerve or branches. Three groups were considered: (a) 12 patients had injuries involving the trunk and extending up to the main branches of the facial nerve; (b) 32 patients had parotid laceration or contusion on the parotid area with resulting nerve defects extending from a main branch up to distal branches; and (c) 15 patients had injuries on the distal branches: frontal, zygomatic, or mandibular. The sural nerve was used as the graft in all instances. The grafting procedure was performed from three weeks to six months after the trauma. The method of evaluation compares the normal with the paralyzed side. A score is given of 0 (no motion), 1 (weak motion), or 2 (strong motion), for each of six voluntary contractions: forehead, closure of eyelids and lips, traction, elevation, and depression of the lips. The assessment of involuntary mimic actions was done while observing blinking, speaking, smiling, and laughing. Mass movements were scored negatively. The numbers were recorded and the ratio between the paralyzed and normal side gave an estimate of the lack of symmetry.(ABSTRACT TRUNCATED AT 250 WORDS)


PPARalpha gene expression is up-regulated by LXR and PXR activators in the small intestine.
LXR, PXR, and PPARalpha are members of a nuclear receptor family which regulate the expression of genes involved in lipid metabolism. Here, we show the administration of T0901317 stimulates PPARalpha gene expression in the small intestine but not in the liver of both normal and FXR-null mice. The administration of LXR specific ligand GW3965, or PXR specific ligand PCN has the same effect, indicating that ligand-dependent activation of LXR and PXR, but not FXR, is responsible for the increased gene expression of PPARalpha in the mouse small intestine.


Detection of crossed cerebellar diaschisis in hyperacute ischemic stroke using arterial spin-labeled MR imaging.
Arterial spin-labeling (ASL) was recently introduced as a noninvasive method to evaluate cerebral hemodynamics. The purposes of this study were to assess the ability of ASL imaging to detect crossed cerebellar diaschisis (CCD) in patients with their first unilateral supratentorial hyperacute stroke and to identify imaging or clinical factors significantly associated with CCD. We reviewed 204 consecutive patients who underwent MRI less than 8 hours after the onset of stroke symptoms. The inclusion criteria were supratentorial abnormality in diffusion-weighted images in the absence of a cerebellar or brain stem lesion, bilateral supratentorial infarction, subacute or chronic infarction, and MR angiography showing vertebrobasilar system disease. For qualitative analysis, asymmetric cerebellar hypoperfusion in ASL images was categorized into 3 grades. Quantitative analysis was performed to calculate the asymmetric index (AI). The patients' demographic and clinical features and outcomes were recorded. Univariate and multivariate analyses were also performed. A total of 32 patients met the inclusion criteria, and 24 (75%) presented CCD. Univariate analyses revealed more frequent arterial occlusions, higher diffusion-weighted imaging (DWI) lesion volumes and higher initial NIHSS and mRS scores in the CCD-positive group compared with the CCD-negative group (all p < .05). The presence of arterial occlusion and the initial mRS scores were related with the AI (all p < .05). Multivariate analyses revealed that arterial occlusion and the initial mRS scores were significantly associated with CCD and AI. ASL imaging could detect CCD in 75% of patients with hyperacute infarction. We found that CCD was more prevalent in patients with arterial occlusion, larger ischemic brain volumes, and higher initial NIHSS and mRS scores. In particular, vessel occlusion and initial mRS score appeared to be significantly related with CCD pathophysiology in the hyperacute stage.


The effects of observing different gestures during storytelling on the recall of path and event information in 5-year-olds and adults.
This study examined (a) how observing different types of gestures while listening to a story affected the recall of path and event information in 5-year-old children (n = 71) and adults (n = 55) and (b) whether the effects of gesture type on children's recall of information were related to individual differences such as working memory, language abilities, spontaneous gesture use, and gesture production during the recall task. Participants were asked four questions to measure their spontaneous gesture frequency. They then listened to a story that included different path and event information. Depending on the assigned condition, participants listened to the story with the narrator producing iconic gestures (gestures having semantic meaning), beat gestures (rhythmic hand movements), or no gesture. We then asked participants to relate what happened in the story and administered a recognition task about the story. Children were given standardized tests to assess their language and working memory skills. Children and adults best recalled the story after observing iconic gestures as compared with children and adults presented with beat gestures or no gestures. Children who were exposed to iconic gestures during encoding better recalled event information than children in the other conditions. Children's language abilities, but not working memory, were related to their recall performance. More important, children with better expressive language abilities benefitted more from seeing iconic gestures. These results suggest that observing iconic gestures at encoding facilitates recall and that children's language skills could play a role in encoding and using specific information provided by gestures.


Scaphoid excision and midcarpal arthrodesis: the effect of triquetral excision--a biomechanical study.
To evaluate the biomechanical alterations that occur after traditional scaphoid excision and midcarpal arthrodesis with and without excision of the triquetrum. The hypothesis of this study was that removal of the triquetrum increases the radiolunate contact pressure. We cyclically moved 10 fresh cadaver wrists using a wrist joint motion simulator while measuring the contact pressures between the proximal carpal row and the distal radius and ulna using a dynamic pressure sensor. We acquired data in the intact wrist, after a midcarpal arthrodesis with the scaphoid excised, and then again with the triquetrum removed, which is also known as a capitolunate arthrodesis. The peak pressures in the radiolunate fossa significantly increased with either of the midcarpal arthrodeses compared with the intact wrist during each of the 3 dynamic wrist motions. In comparing the 2 midcarpal arthrodeses, the peak pressure in the ulnocarpal fossa significantly decreased after the triquetrum was removed during wrist radioulnar deviation and in the static ulnarly deviated position. After arthrodesis, we could identify no differences during any motion or static wrist position in the peak radiolunate pressures with or without the triquetrum. We found that scaphoid excision and 4-corner arthrodesis shifts loads to the radiolunate joint. Isolated capitolunate arthrodesis with excision of the scaphoid and triquetrum further alters carpal kinematics and loading patterns. These findings raise concern about routine excision of the triquetrum when performing a midcarpal arthrodesis.


Noninvasive identification of severe coronary artery disease using exercise radionuclide angiography.
The ability of exercise radionuclide angiography to predict the risk of having significant left main or three vessel coronary artery disease was examined in 681 patients who underwent both radionuclide and coronary angiography. There were significant differences in multiple variables between patients with or without such disease. Logistic regression analysis identified seven variables as independently predictive of the presence of left main or three vessel disease. Using these variables, low, intermediate and high probability groups could be identified. The four most important variables--the magnitude of exercise ST segment depression, peak exercise ejection fraction, peak exercise rate-pressure product and sex of the patient--can provide practical estimates of the risk of having left main or three vessel disease. Exercise radionuclide angiography can provide a clinically useful noninvasive estimate of the risk of having significant left main or three vessel disease.