Prior endoscopic resection does not affect the outcome of secondary surgery for T1 colorectal cancer, a systematic review and meta-analysis.
It remains unclear the effect of prior endoscopic resection (ER) on the secondary surgery (SS) for T1 colorectal cancer (CRC). This study aimed to compare the short- and long-term outcomes between primary surgery (PS) and ER followed by SS for T1 CRC. A systematic literature search was performed in PubMed and Ovid for studies comparing PS with ER followed by SS for T1 colorectal cancer. The last search was performed on 18 May 2021. The primary outcomes were surgical parameters and the secondary outcomes were survival indicators. The meta-analysis was performed with Review Manager Software (version 5.3). A total of fifteen studies published between 2013 and 2021 with 4349 patients were included in this meta-analysis finally. No significant difference was observed between the two groups for operative time (P = 0.75, WMD = 3.16, 95%CI [-15.88, 22.19], I2 = 64%), blood loss (P = 0.86, WMD = 12.33, 95%CI [-122.99, 147.65], I2 = 95%), and postoperative complications (P = 0.59, OR = 0.93, 95%CI [0.71, 1.22], I2 = 0%). Besides, the two groups showed comparable survival outcomes, including overall recurrence rate (P = 0.15, OR = 0.78, 95%CI [0.56, 1.09], I2 = 23%) and 5-year overall survival (P = 0.76, OR = 0.86, 95%CI [0.33, 2.25], I2 = 0%). In the subgroup analysis for studies with propensity matching score or lesions located in the rectum, the results were not changed. ER followed by SS is feasible for T1 CRC with high-risk factors. The prior ER would not bring additional adverse effects to the SS. More advanced tools should be developed to improve the diagnostic accuracy for the high-risk factors before treatment for T1 CRC.


Sortilin as a regulator of lipoprotein metabolism.
Elevated low-density lipoprotein cholesterol (LDL-C) is associated with increased risk of atherosclerotic cardiovascular disease (ASCVD) and myocardial infarction (MI). Much of the insight into LDL metabolism has been gained through the study of Mendelian disorders of lipid metabolism. Genome-wide associations studies (GWAS) are now being used to identify novel genes and loci that contribute to variations in LDL-C levels, and they have identified the SORT1 gene as an important modulator of LDL-C levels and ASCVD risk. Mechanistic studies in mice and cell culture also suggest that the SORT1 gene is an important regulator of lipoprotein metabolism; however, these studies disagree on the directionality of the effect of Sort1 expression on plasma lipids and the mechanism for the lipid changes. Here we review the identification of the SORT1 locus as a modulator of LDL-C levels and ASCVD risk and the first mechanistic studies that explore the role of Sortilin in lipid metabolism.


Cutaneous and mucosal phaeohyphomycosis caused by Exophiala spinifera in a pregnant patient: case report and literature review.
We report a case of mucocutaneous phaeohyphomycosis caused by Exophiala spinifera. Crusty plaques and nodules were major clinical features. Histological examination revealed brown yeast-like cells and hyphae. Mycological and molecular data identified E. spinifera as etiologic agent. Oral itraconazole was effective, which was in accordance with the results of in vitro susceptibility testing. We speculated that her pregnancy may play a role of risk factor in the infection by E. spinifera.


Apatinib regulates the growth of gastric cancer cells by modulating apoptosis and autophagy.
Apatinib is a novel, highly selective small-molecule inhibitor of the tyrosine kinase VEGFR-2. Although its safety and efficacy in the treatment of advanced gastric cancer (GC) and other solid tumors have been confirmed, the precise molecular mechanism underlying its efficacy remains unclear. The purpose of this study was to investigate the mechanism by which apatinib regulates the biological functions of GC cells in vitro. The CCK-8 assay was used to detect the inhibitory effect of apatinib at different concentrations on the proliferation of SGC7901 and MKN45 human GC cells. The effects of apatinib on apoptosis, autophagy, and cell cycle-related genes in SGC7901 and MKN45 cells were detected by Western blotting and real-time quantitative PCR (RT-qPCR). JC-1 staining, flow cytometry, Hoechst 33342 staining, dansylcadaverine (MDC) staining, and Transwell assays were used to detect the effects of apatinib on apoptosis, the cell cycle, autophagy, and invasion and migration capacities, respectively, in SGC7901 and MKN45 cells. The inhibitory effect of apatinib on the proliferation of GC cells was dependent on concentration. Apatinib significantly promoted apoptosis and autophagy. It also altered the cell cycle distribution and inhibited the invasion and migration of GC cells. In general, apatinib inhibited the proliferation of GC cells by promoting apoptosis and autophagy, regulating the cell cycle and inhibiting the invasion and migration capacities of GC cells.


[The possibility of heart-muscle damage through fenoterol (elektrocardiographic and blood-chemistry studies with particular reference to the heart-muscle-specific isoenzym creatinkinase MB.) (author's transl)].
Fifty patients with premature uterine contractions were treated with the uterine relaxant Fenoterol in combination with the calcium antagonist Verapamil. In order to exclude the possibility of myocardial damage, the heart-muscle-specific isoenzym Creatinkinase MB was routinely evaluated, in addition to ECG-checks. In none of the cases could a significant enzyme activity be shown, even in long-term therapy with high doses of Fenoterol.


Comparison of the performance of rapid prescreening, 10% random review, and clinical risk criteria as methods of internal quality control in cervical cytopathology.
Rapid prescreening (RPS) is an internal quality-control (IQC) method that is used both to reduce errors in the laboratory and to measure the sensitivity of routine screening (RS). Little direct comparison data are available comparing RPS with other more widely used IQC methods. The authors compared the performance of RPS, 10% random review of negative smears (R-10%), and directed rescreening of negative smears based on clinical risk criteria (RCRC) over 1 year in a community clinic setting. In total, 6,135 smears were evaluated. The sensitivity of RS alone was 71.3%. RPS detected significantly more (132 cases) false-negative (FN) cases than either R-10% (7 cases) or RCRC (32 cases). RPS significantly improved the overall sensitivity of the laboratory (71.3-92.2%; P = .001); neither R-10% nor RCRC significantly changed the sensitivity of RS. RPS was not as specific as the other methods, although nearly 68% of all abnormalities detected by RPS were verified as real. RPS of 100% of smears required the same amount of time as RCRC but required twice as much time as R-10%. The current results demonstrated that RPS is a much more effective IQC method than either R-10% or RCRC. RPS detects significantly more errors and can improve the overall sensitivity of a laboratory with either a modest increase or no increase in overall time spent on IQC. R-10% is an insensitive IQC method, and neither R-10% nor RCRC can significantly improve the overall sensitivity of a laboratory.


Lubricin as a Therapeutic and Potential Biomarker in Sepsis.
Proteoglycan 4 (or lubricin), a mucin-like glycoprotein, was originally classified as a lubricating substance within diarthrodial joints. More recently, lubricin has been found in other tissues and has been implicated in 2 inflammatory pathways within the cell, via the Toll-like receptors (TLRs) and CD44. Lubricin is an antagonist of TLR2 and TLR4, and appears to enter cells via the CD44 receptor. Because of lubricin's action on these receptors, downstream processes of inflammation are halted, thereby preventing release of cytokines (a hallmark of inflammation and sepsis) from the cell, indicating lubricin's role as a biomarker and possible therapeutic for sepsis.


Coronary artery fistula related to dilatation of totally occluded vessel.
Percutaneous transluminal coronary angioplasty (PTCA) is widely used to treat patients with coronary artery disease. Experience and improvement in catheters has led to its wider utilization. A case of coronary recanalization, complicated by coronary fistula created by an angioplasty guidewire, is reported.


Differential evolution and cost-maps for needle path planning in Baker's cyst aspiration.
The Baker's cysts appear within the popliteal fossa along with the progression of degenerative changes. Removal of its contents through aspiration is often a necessary complement to treatment at various stages of the development of gonarthritis. The paper presented a procedure for needle automatic needle path planning in cyst aspiration in transverse plane. The method was based on optimization and used a custom objective function, which utilized cost maps obtained from preprocessed, segmented images of the knee. The optimization was carried out with Differential Evolution. Furthermore, a preliminary sensitivity analysis was carried out. The obtained paths were compared to the reference paths proposed by an experienced surgeon. The procedure was tested on 165 numerical simulations. In all of the obtained paths, the needle successfully avoided crucial objects, such as veins, arteries and nerves. Furthermore, the overall travel distance in the joint was also minimized. When compared to the reference from the surgeon, 90% of the paths were almost the same or only slightly different. Furthermore, the remaining 10% of the generated paths were viable but different. Based on the obtained results, the proposed solution could be a viable solution for planning the aspiration of Baker's cyst.


Cultural Competence and the Postoperative Experience: Pain Control and Rehabilitation.
Healthcare inequities exist across healthcare and have been shown to influence patient care and outcomes. In the field of orthopaedic surgery, healthcare disparities have been shown to manifest in the realms of postoperative pain management and rehabilitation. Previous literature has demonstrated that socioeconomic status, sex, gender, race, and ethnicity influence postoperative pain management and can precipitate a negative patient experience, manifesting as poorly managed pain and undertreatment of minorities and patients of lower socioeconomic status. A similar body of literature has revealed similar barriers in postoperative rehabilitation, particularly with regard to accessibility, language, rapport, and culture. These disparities impact patients, ranging from diminished surgical satisfaction to postoperative morbidity. As the United States becomes increasingly diverse, cultural competence plays a major role in combating these disparities. This article presents methods to promote cultural competence, including greater diversity in the medical field, a greater emphasis on cultural competency in education and training programs at all levels of healthcare, increased resources allocated to researching healthcare inequities, and more effective mechanisms of patient education.


The Haircut.
The article describes my experience - and the lessons learned - with a terminally ill patient in 1977 as a clinical pastoral education chaplain intern.


Down-regulation of endothelial adhesion molecules and leukocyte adhesion by treatment with superoxide dismutase is beneficial in chronic immune experimental colitis.
Modulation of adhesion molecule expression that govern trafficking of leukocytes into the inflamed intestine is envisioned as a new strategy for treatment of inflammatory bowel disease (IBD). This study was designed to determine the impact of reducing oxidative stress on adhesion molecules expression and leukocyte recruitment in experimental chronic colitis. For that purpose, colitic interleukin-10 knockout and wild-type mice were studied. Groups of animals were treated with Cu/Zn superoxide dismutase (SOD1) 13 mg/kg/d or vehicle for either 7 or 14 days. Expression of vascular cell adhesion molecule-1 and mucosal addressin cell adhesion molecule-1 were determined; leukocyte-endothelial cell interactions in colonic venules were studied with intravital microscopy; and changes in colon pathology and biomarkers of colitis severity were determined. Development of colitis was associated with a marked increase in endothelial vascular cell adhesion molecule-1 and mucosal addressin cell adhesion molecule-1 expression, which were significantly reduced by treatment with SOD1. The increase in leukocyte rolling and adhesion in colonic venules of colitic mice were significantly reduced by administration of SOD1. This treatment markedly reduced colonic lipid hydroperoxidation, myeoloperoxidase activity, and plasma levels of serum amyloid A protein and resulted in significant, although modest, reductions in histologic damage score. The therapeutic value of SOD1 when administered prophylactically was assessed in the dextran sulfate sodium model of colitis with similar positive results. These results indicate that SOD1 affords significant amelioration of colonic inflammatory changes in experimental colitis. Down-regulation of adhesion molecule expression, reduction of lipid hydroperoxidation, and recruitment of leukocytes into the inflamed intestine contribute to this beneficial effect.


Upper-limb virtual rehabilitation for traumatic brain injury: a preliminary within-group evaluation of the elements system.
The aim of this study was to assess the efficacy of the Elements virtual reality (VR) system for rehabilitation of upper-limb function in patients with traumatic brain injury (TBI). Using a within-group design, patients were tested three times, each 4 weeks apart: Pre-intervention 1 and 2 and Post-intervention. During intervention, participants received 12 1-hour training sessions over 4 weeks in addition to their usual care. Five males and four females aged 18-48 years with severe TBI were recruited. The Elements system consisted of a 100-cm tabletop LCD, camera tracking system, tangible user interfaces (i.e. graspable objects of basic shape) and software. The system provided two modes of interaction with augmented feedback: goal-directed and exploratory. Upper-limb performance was assessed using system-rated measures (movement speed, accuracy and efficiency) and standardized tests. Planned comparisons revealed little change in performance over the pre-test period apart from an increase in movement speed. There were significant training effects, with large effect sizes on all measures except the nuts-and-bolts task. These preliminary findings support the results of an early case study of the Elements system, further demonstrating that VR training is a viable adjunct to conventional physical therapy in facilitating motor learning in patients with TBI.


Sequential histologic evolution of gallbladder inflammation in acute cholecystitis over the first 10 days after onset of symptoms.
The timing of cholecystectomy during acute cholecystitis (AC) is controversial, especially whether it is advisable to perform in patients with duration of symptoms between 3 and 10 days. The purpose of this study is to define clearly the sequential evolution of histological changes following symptoms onset to guide recommendations regarding timing of cholecystectomy. We identified patients with AC (2005-2018) who had cholecystectomy within 10 days of symptom onset of a first attack of AC. Histologic features of gallbladder injury including cellular and exudative inflammatory response to injury were determined on blinded pathologic slides. One hundred and forty-nine patients were divided into three groups; early-who underwent cholecystectomy 1-3 days after symptom-onset, intermediate-4-6 days, and late-7-10 days. Key features of injury were necrosis and hemorrhage. A subgroup of patients in the early phase developed severe necrosis and hemorrhage of an extent associated with difficult cholecystectomy. Large spikes in extent of necrosis and hemorrhage occurred at 7-10 days. Major inflammatory responses to injury were eosinophilic and lymphocytic infiltration and early fibrosis. Severe necrosis may develop rapidly and be present in the early period after symptom onset of AC. Cholecystectomy may be reasonable in some patients but by day 7-10, severe necrosis and hemorrhage may be expected to be present in most patients.


Know thy agency in predictive coding: Meta-monitoring over forward modeling.
Though the computation of agency is thought to be based on prediction error, it is important for us to grasp our own reliability of that detected error. Here, the current study shows that we have a meta-monitoring ability over our own forward model, where the accuracy of motor prediction and therefore of the felt agency are implicitly evaluated. Healthy participants (N=105) conducted a simple motor control task and SELF or OTHER visual feedback was given. The relationship between the accuracy and confidence in a mismatch detection task and in a self-other attribution task was examined. The results suggest an accuracy-confidence correlation in both tasks, indicating our meta-monitoring ability over such decisions. Furthermore, a statistically identified group with low accuracy and low confidence was characterized as higher schizotypal people. Finally, what we can know about our own forward model and how we can know it is discussed.


Wheat-based foods and non celiac gluten/wheat sensitivity: Is drastic processing the main key issue?
While gluten and wheat must be absolutely avoided in coeliac disease and allergy, respectively, nutritional recommendations are largely more confused about non-coeliac wheat/gluten sensitivity (NCWGS). Today, some even recommend avoiding all cereal-based foods. In this paper, the increased NCWGS prevalence is hypothesized to parallel the use of more and more drastic processes applied to the original wheat grain. First, a parallel between gluten-related disorders and wheat processing and consumption evolution is briefly proposed. Notably, increased use of exogenous vital gluten is considered. Drastic processing in wheat technology are mainly grain fractionation and refining followed by recombination and salt, sugars and fats addition, being able to render ultra-processed cereal-based foods more prone to trigger chronic low-grade inflammation. Concerning bread, intensive kneading and the choice of wheat varieties with high baking quality may have rendered gluten less digestible, moving digestion from pancreatic to intestinal proteases. The hypothesis of a gluten resistant fraction reaching colon and interacting with microflora is also considered in relation with increased inflammation. Besides, wheat flour refining removes fiber co-passenger which have potential anti-inflammatory property able to protect digestive epithelium. Finally, some research tracks are proposed, notably the comparison of NCWGS prevalence in populations consuming ultra-versus minimally-processed cereal-based foods.


Characteristic pollutants and microbial community in underlying soils for evaluating landfill leakage.
Leachate leakage poses a serious environmental risk to the safety of surrounding soils and groundwater. A much faster approach to reflect landfill leakage is the premise to mitigate the ecological risk of landfills. In this study, two landfills (BJ and WZ) were selected to investigate the leaching characteristics of various pollutants along the vadose soil depths. The physiochemical properties of underlying soils including NO3--N, NO2--N, NH4+-N, OM, TN, EC and Cl- exhibited a typical leaching dynamic along the depths. Among them, TN, NH4+-N, OM, NO3--N, and EC might be used as characteristic pollutants to evaluate the leachate leakage issues in landfilled sites. The genera Thiopseudomonas, Acinetobacter, Pseudomonas, and Hydrogenispora dominated in underlying soils. Compared to BJ samples, a more diverse and active microbiome capable of carbon and nitrogen cycles was observed in WZ samples, which was mainly ascribed to nutrients and elements contained in different types of soils. Among the environmental factors, nitrogenous compounds, SO42-, pH and EC had significant effects on the microbial community structures in the underlying soils. The relative abundances of Hydrogenispora and Caldicoprobacter might be used as characteristic microorganisms to evaluate the leachate leakage issues in landfilled sites. These results provided a deep insight into effects of leachate leakage in underlying soils, especially the pollutants vertical distribution and the corresponding microbial community structures.


Distribution of bleomycin in ethylnitrosourea-induced gliomas in rats.
We used a microbioassay to study the distribution of bleomycin in rat brain tumors induced in newborn Sprague-Dawley rats with 1-ethyl-1-nitrosourea (ENU, 50 mg/kg s.c.). Upon suspected successful tumor induction bleomycin (0.1 g/kg i.v.) was administered, and 2 hr later bleomycin concentrations in major organs and tumor tissues were bioassayed using Bacillus subtilis PCI 219 IMC. To determine their histology, the tumors were stained by the immunofluorescence- or immunoperoxidase method using antiserum to astroprotein in addition to the conventional staining methods. There were 11 gliomas each of the brain and spinal cord, 14 schwannomas of the trigeminal nerve and 4 adenomas of the pituitary gland; they developed within 8 (gliomas), 7.3 (schwannomas) and 15 (adenomas) months on average after ENU treatment. The bleomycin concentration and the tumor:plasma concentration ratio were 7.69 +/- 2.84 micrograms/g and 0.13 +/- 0.05 (brain gliomas), 7.10 +/- 3.15 micrograms/g and 0.27 +/- 0.12 (spinal cord gliomas), 5.40 +/- 1.41 micrograms/g and 0.23 +/- 0.05 (schwannomas), 4.83 +/- 1.05 micrograms/g and 0.21 +/- 0.08 (adenomas). Normal brain- and spinal cord tissues scarcely contained bleomycin.


Homocysteine levels and total antioxidant capacity in children with acute rheumatic fever.
The aim of the study was to investigate total antioxidant capacity (TAC) and homocysteine levels in children with acute rheumatic fever (ARF). Nineteen patients with ARF and twenty healthy children, age- and sex-matched were included in the study. Follow-up studies were made at the 7(th), 14(th), 21(st) and 28(th) day of diagnosis. Children with ARF had significantly higher serum homocysteine levels and lower TAC than the same parameters of the controls at all measurements. Following the anti-inflammatory therapy, we found a progressive increase in TAC and a decrease in homocysteine levels of the patients. We concluded that increased serum homocysteine levels and decreased serum TAC of the patients with ARF can be considered as a sign of increased inflammation and oxidative stress in these patients which needs to be considered during therapy. Further studies are needed to understand the underlying mechanisms of these findings.


Selectivity for harmonic structure in complex sounds by the green treefrog (Hyla cinerea).
1. A psychophysical technique based on reflex modification was used to study the detection of two-tone complexes in background noise by the green treefrog (Hyla cinerea). Three different two-tone complexes were synthesized and presented to measure detection thresholds--a harmonic complex of 900 + 3000 Hz (periodicity of 300 Hz, mimicking the structure of the natural advertisement call); an inharmonic complex of 830 + 3100 Hz; and a second harmonic complex of 828 + 2760 Hz (periodicity of 276 Hz). 2. Masked thresholds and 'critical ratios' (signal-to-noise ratios at threshold) were lowest for the two harmonic complexes (900 + 3000 Hz, mean 'critical ratio' of 16 dB; 828 + 2760 Hz, mean 'critical ratio' of 14 dB). For the inharmonic complex, for which there is no stable first-harmonic periodicity, the mean 'critical ratio' was 24 dB. These data suggest that the green treefrog is sensitive to the harmonic structure of complex sounds as a specific acoustic feature. 3. Because of the unique structure of the treefrog's inner ear, the heightened behavioral sensitivity to harmonic complexes must be due to processing in the central, rather than peripheral, auditory system.


Economics of Sickle Cell Disease and Evidence to Support Comprehensive Care.
Sickle cell disease (SCD) is a serious blood disorder leading to complex care needs. Comprehensive, multidisciplinary programs are ideally suited to deliver patient-centered care and address other relevant social determinants of health. Patients with SCD face many inequities in health care, further reinforcing the need for comprehensive care models to address these relevant issues. Comprehensive care models can be financially advantageous to institutions that care for vulnerable patients with SCD while simultaneously increasing care quality.


Deletion of obscurin immunoglobulin domains Ig58/59 leads to age-dependent cardiac remodeling and arrhythmia.
Obscurin comprises a family of giant modular proteins that play key structural and regulatory roles in striated muscles. Immunoglobulin domains 58/59 (Ig58/59) of obscurin mediate binding to essential modulators of muscle structure and function, including canonical titin, a smaller splice variant of titin, termed novex-3, and phospholamban (PLN). Importantly, missense mutations localized within the obscurin-Ig58/59 region that affect binding to titins and/or PLN have been linked to the development of myopathy in humans. To elucidate the pathophysiological role of this region, we generated a constitutive deletion mouse model, Obscn-ΔIg58/59, that expresses obscurin lacking Ig58/59, and determined the consequences of this manipulation on cardiac morphology and function under conditions of acute stress and through the physiological process of aging. Our studies show that young Obscn-ΔIg58/59 mice are susceptible to acute β-adrenergic stress. Moreover, sedentary Obscn-ΔIg58/59 mice develop left ventricular hypertrophy that progresses to dilation, contractile impairment, atrial enlargement, and arrhythmia as a function of aging with males being more affected than females. Experiments in ventricular cardiomyocytes revealed altered Ca2+ cycling associated with changes in the expression and/or phosphorylation levels of major Ca2+ cycling proteins, including PLN, SERCA2, and RyR2. Taken together, our work demonstrates that obscurin-Ig58/59 is an essential regulatory module in the heart and its deletion leads to age- and sex-dependent cardiac remodeling, ventricular dilation, and arrhythmia due to deregulated Ca2+ cycling.


Citrate functionalized gold nanoparticles assisted micro extraction of L-cysteine in milk and water samples using Fourier transform infrared spectroscopy.
This paper describes the sensing application of citrate functionalized gold nanoparticles (AuNPs) employing for the determination of L-cysteine in food and water samples. It is established with diffuse reflectance Fourier transform infrared (DRS-FTIR) spectroscopic analysis. The disappearance of the thiol (-SH) band in the FTIR spectra and the shift in the peaks of the amino group (NH3+) and carboxylate group (-COO-) indicated the Au-S interaction and the aggregation of the NPs. The signal intensity of L-cysteine was enhanced due to hot-spots formed by the aggregation of AuNPs producing the effective absorption of electromagnetic radiation in the IR region for molecular vibration. The relationship between AuNPs and L-cysteine was theoretically investigated by the Density Function Theory (DFT) based on LANL2DZ with the aid of the Gaussian 09 (C.01) software. Interaction between AuNPs and L-cysteine molecules resulted to a shift to higher wavelengths in the plasmon bands, further verified by transmission electron microscopes (TEM), which have indicated random aggregated particles. Further dynamic light scattering (DLS) measurements showed a relatively high degree of polydispersity confirming the aggregation of the particles. Under optimized conditions, the calibration curve showed a good linearity range from 20 to 150 μg mL-1 with a correlation coefficient (R2) 0.990. The limit of detection and quantification were 1.04 and 3.44 μg mL-1, respectively by DRS-FTIR. This modified AuNPs sample was used successfully in milk and water samples with adequate results to determine L-cysteine.


Postoperative care of the critically ill child.
Postoperative care of the pediatric surgical patient requires knowledge of the signs of cardiorespiratory and neurologic deterioration in the child as well as familiarity with particular postoperative complications associated with various types of surgery. This article briefly reviewed the principles of postoperative care of the critically ill child, and included references for more comprehensive sources of information.


Fetal and placental growth in young, primiparous and old, multiparous rats.
Fetal and placental weights and peripheral blood progestagen concentrations were examined on days 13, 16 and 22 of gestation in young (3-5 month) nulliparous and old (9-12 month) multiparous, albino Wistar rats. There was no difference in fetal weights at any stage examined whereas placental weights were significantly heavier in the old rats at days 16 (71%) and 22 (38%). Blood progesterone concentrations were similar in the two groups at days 16 and 22 although concentrations of the less biologically active progestagen, 20 alpha-dihydroprogesterone, were higher (61%) at day 16 in the old rats. The relative hypertrophy of the placentas in the old rats could not be explained by reduced litter size or progesterone concentrations: it may represent a compensatory effect in response to a less favorable uterine environment.


Identification of two HLA-C alleles with new amino acid residues in the α-3 domain, HLA-C*03:581 and -C*05:267.
Characterization of two new HLA-C alleles, C*03:581 and C*05:267.


Characterization of a β-glucosidase from Sulfolobus solfataricus for isoflavone glycosides.
The specific activity of a recombinant β-glucosidase from Sulfolobus solfataricus for isoflavones was: daidzin > glycitin > genistin > malonyl genistin > malonyl daidzin > malonyl glycitin. The hydrolytic activity of this enzyme for daidzin was highest at pH 5.5 and 90°C with a half-life of 18 h, a K (m) of 0.5 mM, and a k (cat) of 2532 s(-1). The enzyme converted 1 mM daidzin to 1 mM daidzein after 1 h with a molar yield of 100% and a productivity of 1 mM h(-1). Among β-glucosidases, that from S. solfataricus β had the highest thermostability, k (cat), k (cat)/K (m), conversion yield, and productivity in the hydrolysis of daidzin.


Metabolic efficiency and energy expenditure during short-term overfeeding.
To investigate whether efficiency of weight gain during a short period of overfeeding is related to adaptive differences in basal metabolic rate (BMR) and physical activity. Fourteen healthy females (age 25+/-4 years, BMI 22.1+/-2.3 kg/m2). Subjects were overfed with a diet supplying 50% more energy than baseline energy requirements for 14 days. Overfeeding diets provided 7% of energy from protein, 40% from fat and 53% from carbohydrates. Body composition was determined using hydrodensitometry and isotope dilution, total energy expenditure (TEE) with doubly labeled water and basal metabolic rate (BMR) with indirect calorimetry. Physical activity (PA) was recorded with a tri-axial accelerometer. Body weight increased by 1.45+/-0.86 kg (mean+/-S.D.) (P<0.0001), fat mass increased by 1.05+/-0.75 kg. Energy storage was 57.0+/-17.9 MJ, which is the difference between energy intake (207.2 MJ) and energy expenditure (150.2 MJ) during overfeeding. There was no difference between metabolically efficient and metabolically inefficient subjects in changes in BMR and PA. These results indicate that the metabolic efficiency of weight gain was not related to adaptive changes in energy expenditure.


When your patient is enrolled in a research study.
Framed in a research context, this article gives you some insight into your roles and responsibilities as an advocate for patient's rights, a support person, and a healthcare monitor. Ethical principles guiding research and implications for practice are discussed.


IP3Rs are sufficient for dendritic cell Ca2+ signaling in the absence of RyR1.
Calcium (Ca(2+)) signaling plays a pivotal role in the function of dendritic cells (DC). The Type 1 ryanodine receptor (RyR), a major intracellular Ca(2+) channel, is highly expressed in immature DC. We therefore investigated whether RyR1 plays a role in DC development and function by studying properties of DC derived from wild-type (WT) and RyR1 null [knockout (KO)] mice. Fetal liver cells from WT and RyR1 KO mice retained full hematopoietic competence. Adoptive transfer of these cells into congenic hosts resulted in the generation of functionally equivalent DC populations. WT and RyR1 KO DC exhibited a similar capacity to mature in response to inflammatory and/or activation stimuli, to endocytose antigen, and to stimulate T cell proliferation. Moreover, the absence of RyR1 did not lead to de novo expression of RyR2 or RyR3. WT and RyR KO DC express all three isoforms of inositol 1,4,5-trisphosphate receptor (IP(3)R), although Type 3 IP(3)R gene transcripts are predominant. Further, IP(3)-mediated Ca(2+) transients proceed normally after inhibition of RyRs with dantrolene. Signaling via IP(3)R may therefore be sufficient to drive essential DC Ca(2+) signaling processes in the absence of RyR expression or function.


Improved detection of antibiotic compounds by bacterial reporter strains achieved by manipulations of membrane permeability and efflux capacity.
The occurrence of pharmaceuticals, including antibacterial compounds, in the environment has been acknowledged as an emerging and troubling issue in environmental safety; their usage is constantly on the rise, and their effects on the environment are only partially understood. Such compounds can accumulate, contaminate the ecosystem, and contribute to the spreading of antibiotic resistance among bacteria, hindering human health. Bioluminescent Escherichia coli reporter strains, engineered to detect antibiotic compounds by fusing the promoter of the global regulator soxS to the Photorhabdus luminescens luxCDABE cassette, were further modified by altering their membrane permeability and efflux capabilities. This was accomplished by introducing several mutations in the efflux system (ΔemrE, ΔacrB, and ΔtolC) and by overexpressing OmpF, a porin located in the outer membrane that allows passive diffusion of molecules. Combinations of these alterations had a cumulative effect in lowering the detection threshold of several antibiotics, in some of the cases to concentrations reported from pharmaceutical-polluted environments.


The mystery of phantom pain: growing evidence for psychophysiological mechanisms.
The direct, and much of the indirect, evidence supporting the existence psychophysiological mechanisms for phantom limb pain is reviewed. Phantom pain is shown to be a symptom class composed of different, but similarly described problems, each having its own underlying mechanisms. At least some descriptive types of phantom pain probably have mainly peripheral, as opposed to only central, origins. Although much of the direct data are preliminary, burning phantom pain is probably related to decreased blood flow in the residual limb, while cramping phantom pain is mainly related to spikelike muscle spasms in the major muscles of the residual limb. Little support is provided for psychological causes for phantom pain, but the expression of phantom pain does appear to be influenced by psychological mechanisms similarly to the ways other chronic pain conditions are influenced. The importance of a careful psychophysiological assessment of patients to treatment success is discussed. Because several different mechanisms are involved, no one treatment is likely to be effective for all of the different types of phantom pain. Appropriate combinations of self-regulation strategies aimed at controlling the underlying physiological problems are likely to be effective in reducing the incidence and severity of burning and cramping types of phantom pain.


The Coherent X-ray Imaging instrument at the Linac Coherent Light Source.
The Coherent X-ray Imaging (CXI) instrument specializes in hard X-ray, in-vacuum, high power density experiments in all areas of science. Two main sample chambers, one containing a 100 nm focus and one a 1 µm focus, are available, each with multiple diagnostics, sample injection, pump-probe and detector capabilities. The flexibility of CXI has enabled it to host a diverse range of experiments, from biological to extreme matter.


Inhibitory effect of serum from rats administered with coffee on the proliferation and invasion of rat ascites hepatoma cells.
The action of coffee on the proliferation and invasion of a rat ascites hepatoma cell line of AH109A was investigated using in vitro and ex vivo assay systems. When rats were given oral intubation of instant coffee powder solution, the sera of those rats had the potent inhibitory activity on both the proliferation and invasion of AH109A. The activity of rat serum was both time- and dose-dependent. The instant coffee powder also inhibited the proliferation and invasion of AH109A in vitro. These results indicate that coffee has anti-proliferative and anti-invasive activity both in vitro and ex vivo. They also suggest that some anti-proliferative and anti-invasive material(s), which may be the ingredient(s) of coffee or their metabolites, appear in rat serum when rats are given oral intubation of coffee, although a possibility that host defense systems may be activated by the oral intubation of coffee cannot be ruled out.


Quantitative structure-activity relationships of alpha1 adrenergic antagonists.
A quantitative structure-activity relationship study with respect to selectivity for alpha1 adrenoreceptor subtypes (alpha1a, alpha1b and alpha1d) of a wide series of structurally heterogeneous alpha1 adrenoreceptor antagonists has been performed. A large variety of molecular descriptors have been calculated and then analyzed by a heuristic method. The orthogonalization of the descriptors has been applied to build the QSAR equations. Ad hoc defined shape descriptors calculated by the Connolly algorithm with respect to reference supermolecules have also been considered in the rationalization of the mechanism of the activity of the ligands acting as antagonists on all three subtypes of alpha1 adrenoreceptors.


Angiotensin II upregulates K(Ca)3.1 channels and stimulates cell proliferation in rat cardiac fibroblasts.
The proliferation of cardiac fibroblasts is implicated in the pathogenesis of myocardial remodeling and fibrosis. Intermediate-conductance calcium-activated K⁺ channels (K(Ca)3.1 channels) have important roles in cell proliferation. However, it is unknown whether angiotensin II (Ang II), a potent profibrotic molecule, would regulate K(Ca)3.1 channels in cardiac fibroblasts and participate in cell proliferation. In the present study, we investigated whether K(Ca)3.1 channels were regulated by Ang II, and how the channel activity mediated cell proliferation in cultured adult rat cardiac fibroblasts using electrophysiology and biochemical approaches. It was found that mRNA, protein, and current density of K(Ca)3.1 channels were greatly enhanced in cultured cardiac fibroblasts treated with 1 μM Ang II, and the effects were countered by the angiotensin type 1 receptor (AT₁R) blocker losartan, the p38-MAPK inhibitor SB203580, the ERK1/2 inhibitor PD98059, and the PI3K/Akt inhibitor LY294002. Ang II stimulated cell proliferation and the effect was antagonized by the K(Ca)3.1 blocker TRAM-34 and siRNA targeting K(Ca)3.1. In addition, Ang II-induced increase of K(Ca)3.1 expression was attenuated by transfection of activator protein-1 (AP-1) decoy oligodeoxynucleotides. These results demonstrate for the first time that Ang II stimulates cell proliferation mediated by upregulating K(Ca)3.1 channels via interacting with the AT₁R and activating AP-1 complex through ERK1/2, p38-MAPK and PI3K/Akt signaling pathways in cultured adult rat cardiac fibroblasts.


Targeting histone deacetylase-3 blocked epithelial-mesenchymal plasticity and metastatic dissemination in gastric cancer.
Histone deacetylase (HDAC) inhibitors (HDIs) can modulate the epithelial-mesenchymal transition (EMT) progression and inhibit the migration and invasion of cancer cells. Emerging as a novel class of anti-cancer drugs, HDIs are attracted much attention in the field of drug discovery. This study aimed to discern the underlying mechanisms of Honokiol in preventing the metastatic dissemination of gastric cancer cells by inhibiting HDAC3 activity/expression. Clinical pathological analysis was performed to determine the relationship between HDAC3 and tumor progression. The effects of Honokiol on pharmacological characterization, functional, transcriptional activities, organelle structure changes, and molecular signaling were analyzed using binding assays, differential scanning calorimetry, luciferase reporter assay, HDAC3 activity, ER stress response element activity, transmission electron microscopy, immune-blotting, and Wnt/β-catenin activity assays. The in vivo effects of Honokiol on peritoneal dissemination were determined by a mouse model and detected by PET/CT tomography. HDAC3 over-expression was correlated with poor prognosis. Honokiol significantly abolished HDAC3 activity (Y298) via inhibition of NFκBp65/CEBPβ signaling, which could be reversed by the over-expression of plasmids of NFκBp65/CEBPβ. Treatments with 4-phenylbutyric acid (a chemical chaperone) and calpain-2 gene silencing inhibited Honokiol-inhibited NFκBp65/CEBPβ activation. Honokiol increased ER stress markers and inhibited EMT-associated epithelial markers, but decreased Wnt/β-catenin activity. Suppression of HDAC3 by both Honokiol and HDAC3 gene silencing decreased cell migration and invasion in vitro and metastasis in vivo. Honokiol acts by suppressing HDAC3-mediated EMT and metastatic signaling. By prohibiting HDAC3, metastatic dissemination of gastric cancer may be blocked. Conceptual model showing the working hypothesis on the interaction among Honokiol, HDAC3, and ER stress in the peritoneal dissemination of gastric cancer. Honokiol targeting HDAC3 by ER stress cascade and mitigating the peritoneal spread of gastric cancer. Honokiol-induced ER stress-activated calpain activity targeted HDAC3 and blocked Tyr298 phosphorylation, subsequently blocked cooperating with EMT transcription factors and cancer progression. The present study provides evidence to demonstrate that HDAC3 is a positive regulator of EMT and metastatic growth of gastric cancer cells. The findings here imply that overexpressed HDAC3 is a potential therapeutic target for honokiol to reverse EMT and prevent gastric cancer migration, invasion, and metastatic dissemination. • Honokiol significantly abolished HDAC3 activity on catalytic tyrosine 298 residue site. In addition, Honokiol-induced ER stress markedly inhibited HDAC3 expression via inhibition of NFκBp65/CEBPβ signaling. • HDAC3, which is a positive regulator of metastatic gastric cancer cell growth, can be significantly inhibited by Honokiol. • Opportunities for HDAC3 inhibition may be a potential therapeutic target for preventing gastric cancer metastatic dissemination.


Antibiotic prophylaxis for infective endocarditis from an international group of experts towards a European consensus. Group of Experts of the International Society for Chemotherapy.
Antibiotic prophylaxis for infective endocarditis is recommended for cardiac patients at risk who undergo an at-risk procedure. Efforts should focus on patients with the highest risk, i.e., those with a prosthetic valve undergoing a dental procedure. Amoxicillin is the main recommendation in patients who are not allergic to penicillin. In patients allergic to penicillin clindamycin orally or vancomycin intravenously are proposed. Aminoglycosides are added for gastrointestinal or urological procedures.


Factors associated with engagement in a police-advocacy home-visit intervention to prevent domestic violence.
This study examines factors related to engagement in the services offered by police officer-advocate teams on the basis of police and clinical records for 301 female victims referred to the Domestic Violence Home Visit Intervention (DVHVI) program. The authors find that the severity of intimate partner violence charges and ethnicity of the victim, advocate, and police officer are all significantly related to engagement in the DVHVI, with Hispanic women served by Hispanic advocate-officer teams more engaged in services than African American or Caucasian women. The data suggest that this intervention model may be particularly beneficial for Hispanic victims of intimate partner violence when implemented by a Spanish-speaking officer-advocate team.


1,25(OH)2D3 increases membrane associated protein kinase C in MDBK cells.
To determine whether 1,25-dihydroxycholecalciferol [1,25(OH)2D3] affects protein kinase C (PKC) activity in kidney, as has been demonstrated in HL-60 cells we measured 1,25(OH)2D3 binding, PKC activity and PKC immunoreactivity in Madin Darby bovine kidney (MDBK) cells, a normal renal epithelial cell line derived from bovine kidney. Our data demonstrate that MDBK cells exhibit specific high affinity binding for 1,25(OH)2D3, indicating the presence of the vitamin D receptor (VDR). Treatment of MDBK cells with 1,25(OH)2D3 for 24 h increased membrane PKC activity and immunoreactivity. The effect of 1,25(OH)2D3 was dose-dependent, with a peak effect observed at 10(-7)M 1,25(OH)2D3. The 1,25(OH)2D3 induced increase in membrane PKC was paralleled by a comparable decrease in cytosolic PKC activity and amount. Although time course studies were consistent with a VDR mediated effect of 1,25(OH)2D3 on PKC protein synthesis, total PKC activity was not increased by 1,25(OH)2D3, suggesting an effect on PKC translocation or localization. These results suggest that 1,25(OH)2D3 modulates PKC mediated events in kidney, a classic target for this steroid hormone.


IgG immune response to B19 parvovirus VP1 and VP2 linear epitopes by immunoblot assay.
Human B19 parvovirus recombinant capsid proteins VP1 and VP2 were expressed in E. coli and purified. Recombinant proteins were used to detect a specific IgG immune response against VP1 and VP2 linear epitopes by immunoblot assay. A total of 222 serum samples from 218 apparently immunocompetent subjects with different clinical conditions and laboratory evaluations with regards to B19 infection were analyzed. The sera had previously been tested for B19 DNA and for specific IgM and IgG against VP2 conformational antigens by ELISA assay. The data show that, during the active or very recent phase of infection, IgG anti-VP1 linear epitopes appear in concomitance and with the same frequency as IgG anti-VP2 conformational antigens. IgG against conformational VP2 antigens and against linear VP1 epitopes seem to persist for months or years in the majority of individuals. IgG against VP2 linear epitopes are generally present during the active or very recent phase of infection and during the convalescent phase, while they are present only in about 20% of subjects with signs of a past B19 infection.


Exposure duration affects the sensitivity of vernier acuity to target motion.
Threshold vernier acuity was measured under different conditions of target movement and exposure duration. In the case of a simple two-line vernier target, image motion up to about 3 deg/sec had little effect upon threshold for a briefly exposed (150 msec) target, which is relatively poor even for a stationary stimulus, but produced a decrement in acuity for a continuously exposed stimulus. This finding was repeated in a second experiment, which used a centroid cue to vernier offset, and which compared the effects of horizontal and vertical target orientation. It is suggested that image motion and reduced exposure duration restrict the proportion of the light spread function that can be usefully sampled by the neural networks responsible for hyperacuity.


Vitamin B12 on Graphene for Highly Efficient CO2 Electroreduction.
Combining the advantages of homogeneous and heterogeneous catalytic systems has emerged as a promising strategy for electrochemical CO2 reduction although developing robust, active, product-selective, and easily available, catalysts remains a major challenge. Herein, we report the electroreduction of CO2 catalyzed by cobalt and benzimidazole containing Vitamin B12 immobilized on the surface of reduced graphene oxide (rGO). This hybrid system with a naturally abundant molecular catalyst produces CO with high selectivity and a constant current density in an aqueous buffer solution (pH 7.2) for over 10 h. A Faradaic efficiency (FE) of 94.5% was obtained for converting CO2 to CO at an overpotential of 690 mV with a CO partial current density (jCO) of 6.24 mA cm-2 and a turnover frequency (TOF) of up to 28.6 s-1. A higher jCO (13.6 mA cm-2) and TOF (52.4 s-1) can be achieved with this system at a higher overpotential (790 mV) without affecting the product selectivity (∼94%) for CO formation. Our experimental findings are corroborated with density functional theory (DFT) studies to understand the influence of the covalently attached and redox-active benzimidazole unit. To the best of our knowledge, this is the first example of naturally abundant vitamin being immobilized on a conductive surface for highly efficient CO2 electroreduction.


[Cataract surgery. Effect on the posterior segment of the eye].
Cataract surgery is a safe procedure with a high patient satisfaction rate. However, pseudophakia changes the physiology of the eye and immediate changes include release of inflammatory cytokines. Deformation of the globe and intraoperative fluctuations of intraocular pressure may induce microlesions and alterations of ocular perfusion. The barrier function between the anterior and the posterior segment is compromised after surgery and the geometry of the intraocular chambers changes. Especially the vitreous body is subject to increased destruction during the years after surgery. The occurrence of pseudophakic cystoid macular edema after cataract surgery is a well known complication. Several studies have described a progression of diabetic retinopathy, especially of diabetic macular edema after cataract surgery. In contrast cataract surgery does not seem to have a significant impact on the progression of age-related macular degeneration. However the risk for retinal detachment is significantly increased in pseudophakia for at least 10 years after surgery. Awareness of special risk factors can make cataract surgery, one of the most effective procedures in medicine, even safer.


Proteins regulating Ras and its relatives.
GTPases of the Ras superfamily regulate many aspects of cell growth, differentiation and action. Their functions depend on their ability to alternate between inactive and active forms, and on their cellular localization. Numerous proteins affecting the GTPase activity, nucleotide exchange rates and membrane localization of Ras superfamily members have now been identified. Many of these proteins are much larger and more complex than their targets, containing multiple domains capable of interacting with an intricate network of cellular enzymes and structures.


Dissecting glucose signalling with diversity-oriented synthesis and small-molecule microarrays.
Small molecules that alter protein function provide a means to modulate biological networks with temporal resolution. Here we demonstrate a potentially general and scalable method of identifying such molecules by application to a particular protein, Ure2p, which represses the transcription factors Gln3p and Nil1p. By probing a high-density microarray of small molecules generated by diversity-oriented synthesis with fluorescently labelled Ure2p, we performed 3,780 protein-binding assays in parallel and identified several compounds that bind Ure2p. One compound, which we call uretupamine, specifically activates a glucose-sensitive transcriptional pathway downstream of Ure2p. Whole-genome transcription profiling and chemical epistasis demonstrate the remarkable Ure2p specificity of uretupamine and its ability to modulate the glucose-sensitive subset of genes downstream of Ure2p. These results demonstrate that diversity-oriented synthesis and small-molecule microarrays can be used to identify small molecules that bind to a protein of interest, and that these small molecules can regulate specific functions of the protein.


Periprosthetic Joint Infection in Patients with Inflammatory Joint Disease: Prevention and Diagnosis.
Periprosthetic joint infection (PJI) is a devastating complication that can occur following total joint arthroplasty (TJA), causing significant morbidity and often requiring revision surgery. This goal of this manuscript is to review the current evidence for the prevention and diagnosis of PJI in patients with inflammatory arthritis. Patients with inflammatory arthritis have a higher risk of PJI after TJA; however, there are several preventive, diagnostic, and therapeutic measures that can be optimized to lower the burden of PJI in this population. This manuscript will review the current evidence and clinical practice recommendations that support specific features of preoperative evaluation, perioperative medication management, and surgical planning in inflammatory arthritis patients undergoing TJA. Evidence and recommendations for the diagnosis of PJI in this patient population will also be reviewed. Despite increased research efforts directed towards PJI, specific approaches directed at the inflammatory arthritis patient population remain surprisingly limited. Optimization strategies such as adequately managing disease-modifying medications, treating preoperative anemia, encouraging smoking cessation, and improving weight management are strongly encouraged before entering the perioperative period. If PJI does occur in the inflammatory arthritis patient, establishing the diagnosis is challenging, since guidelines were created from investigations of PJI in primarily patients without inflammatory arthritis. Future prospective research is required to better guide clinicians in preventing and diagnosing PJI in inflammatory arthritis patients undergoing TJA.


Procyanidins and Their Therapeutic Potential against Oral Diseases.
Procyanidins, as a kind of dietary flavonoid, have excellent pharmacological properties, such as antioxidant, antibacterial, anti-inflammatory and anti-tumor properties, and so they can be used to treat various diseases, including Alzheimer's disease, diabetes, rheumatoid arthritis, tumors, and obesity. Given the low bioavailability of procyanidins, great efforts have been made in drug delivery systems to address their limited use. Nowadays, the heavy burden of oral diseases such as dental caries, periodontitis, endodontic infections, etc., and their consequences on the patients' quality of life indicate a strong need for developing effective therapies. Recent years, plenty of efforts are being made to develop more effective treatments. Therefore, this review summarized the latest researches on versatile effects and enhanced bioavailability of procyanidins resulting from innovative drug delivery systems, particularly focused on its potential against oral diseases.


Tributyltin Induces the Tissue-Specific Stresses in Zebrafish, a Study in Various Tissues of Muscle, Gill and Intestine.
Because the mechanism of tissue-specific toxicity of tributyltin (TBT) in aquatic organisms has not been explained clearly, the aim of this study is to investigate the effect of chronic exposure to TBT on muscle-related energy metabolism, gill-related ATPase enzymatic system and intestine-related digestive enzymes activities in zebrafish. Male zebrafish were exposed to sub-lethal concentrations of TBT (10, 100 and 300 ng/L) for 6 weeks. Multiple biomarkers were measured (such as glucose, lactate, hexokinase, pyruvate kinase, lactate dehydrogenase, ATP content, ATPases, trypsin, lipase and amylase), which reflected more serious physiological stress with increasing TBT concentrations during the experimental period. Through principal component analysis (PCA) and integrated biomarker response (IBR) analysis, the toxic effect of TBT in zebrafish was in a concentration-dependent manner. Shortly, the results of this study can provide new evidence for a comprehensive understanding of the toxic effects of TBT.


Breaking through to improved community health.
Michigan's nonprofit community hospitals serve the state's citizens in extraordinary ways--regardless of whether anyone pays for that service. In 2001, these community-based organizations provided $885 million in free health care to area residents who were uninsured or otherwise could not pay for it. In addition, the state's nonprofit hospitals contributed more than $276 million in services such as health education, outreach, screening, counseling and free clinics. The total worth of these traditional and nontraditional benefits to Michigan communities in 2001 was a staggering $1.16 billion.


Interrupting the cascade: orienting contributes to decision making even in the absence of visual stimulation.
Most systematic studies of human decision making approach the subject from a cost analysis point of view and assume that people make the highest utility choice. Very few articles investigate subjective decision making, such as that involving preference, although such decisions are very important for our daily functioning. We have argued (Shimojo, Simion, Shimojo, & Scheier, 2003) that an orienting bias effectively leads to the preference decision by means of a positive feedback loop involving mere exposure and preferential looking. The illustration of this process is a continually increasing gaze bias toward the eventual choice, which we call the gaze cascade effect. In the present study, we interrupt the natural process of preference selection, but we show that gaze behavior does not change even when the stimuli are removed from observers' visual field. This demonstrates that once started, the involvement of orienting in decision making cannot be stopped and that orienting acts independently of the presence of visual stimuli. We also show that the cascade effect is intrinsically linked to the decision itself and is not triggered simply by a tendency to look at preferred targets.


A nanoparticle based chromogenic chemosensor for the simultaneous detection of multiple analytes.
Quantum Dot-Schiff base conjugate displays selectivity for Cu(2+) and Fe(3+) enabling the simultaneous detection of these ions in semi-aqueous solution; in contrast, the Schiff base itself displayed no selectivity.


Draft genome sequence of Bacillus paralicheniformis TRQ65, a biological control agent and plant growth-promoting bacterium isolated from wheat (Triticum turgidum subsp. durum) rhizosphere in the Yaqui Valley, Mexico.
The strain denominated TRQ65 was isolated from wheat (Triticum turgidum subsp. durum) commercial fields in the Yaqui Valley, Mexico. Here, we report its draft genome sequence, which presented ~ 4.5 million bp and 45.5% G + C content. Based on the cutoff values on species delimitation established for average nucleotide identity (> 95 to 96%), genome-to-genome distance calculator (> 70%), and the reference sequence alignment-based phylogeny builder method, TRQ65 was strongly affiliated to Bacillus paralicheniformis. The rapid annotation using subsystem technology server revealed that TRQ65 contains genes related to osmotic, and oxidative stress response, as well as auxin biosynthesis (plant growth promotion traits). In addition, antiSMASH and BAGEL revealed the presence of genes involved in lipopeptides and antibiotic biosynthesis. The function of those annotated genes was validated at a metabolic level, observing that strain TRQ65 was able to tolerate saline (91.0%), and water (155.0%) stress conditions, besides producing 28.8 ± 0.9 µg/mL indoles. In addition, strain TRQ65 showed growth inhibition (1.6 ± 0.4 cm inhibition zone) against the causal agent of wheat spot blotch, Bipolaris sorokiniana. Finally, plant-microbe interactions assays confirm the ability of strain TRQ65 to regulate wheat growth, showing a significant increment in shoot height (26%), root length (40%), shoot dry weight (48%), stem diameter (55%), and biovolume index (246%). These findings provide insights for future agricultural studies of this strain.


PPARgamma antagonists reverse the inhibition of neural antigen-specific Th1 response and experimental allergic encephalomyelitis by Ciglitazone and 15-deoxy-Delta12,14-prostaglandin J2.
Peroxisome proliferator-activated receptor-gamma is a nuclear receptor transcription factor that regulates cell growth, differentiation and homeostasis. PPARgamma agonists have been used to treat obesity, diabetes, cancer and inflammation and recent studies have shown the protective effects of PPARgamma agonists on experimental allergic encephalomyelitis (EAE), a Th1 cell-mediated autoimmune disease model of multiple sclerosis (MS). Our studies have further demonstrated that the PPARgamma agonists, 15d-PGJ2 and Ciglitazone, inhibit EAE through blocking IL-12 signaling leading to Th1 differentiation and the PPARgamma deficient heterozygous mice (PPARgamma+/-) or those treated with PPARgamma antagonists develop an exacerbated EAE in association with an augmented Th1 response. In this study, we show that the PPARgamma antagonists, Bisphenol A diglycidyl ether (BADGE) and 2-chloro-5-nitro-N-(4-pyridyl)benzamide (T0070907), reverse the inhibition of EAE by the PPARgamma agonists, Ciglitazone and 15-Deoxy-Delta(12,14)-Prostaglandin J2, in C57BL/6 wild-type and PPARgamma+/- mice. The reversal of EAE by BADGE and T0070907 was associated with restoration of neural antigen-induced T cell proliferation, IFNgamma production and Th1 differentiation inhibited by Ciglitazone and 15d-PGJ2. These results suggest that Ciglitazone and 15d-PGJ2 ameliorate EAE through PPARgamma-dependent mechanisms and further confirm a physiological role for PPARgamma in the regulation of CNS inflammation and demyelination in EAE.


Roles of YopN, LcrG and LcrV in controlling Yops secretion by Yersinia pestis.
Control of Yops secretion in pathogenic Yersinia is achieved at several levels. These levels likely include transcriptional, post-transcriptional, translational and secretional controls. Secretion control appears to be mediated by two pathways. One pathway involves YopN and proteins that interact with YopN. The second pathway consists of LcrG and its interaction with LcrV. LcrV is a postive regulator of Yops secretion that exerts control over Yops secretion by negating the secretion blocking role of LcrG. However, the intersection of these two control pathways is not understood. Recent work has allowed the development of a speculative model that brings YopN-mediated and LcrG-LcrV-mediated control together in the context of the ability of the needle complex to respond to Ca2+.


Ultrafast isomerization initiated by X-ray core ionization.
Rapid proton migration is a key process in hydrocarbon photochemistry. Charge migration and subsequent proton motion can mitigate radiation damage when heavier atoms absorb X-rays. If rapid enough, this can improve the fidelity of diffract-before-destroy measurements of biomolecular structure at X-ray-free electron lasers. Here we study X-ray-initiated isomerization of acetylene, a model for proton dynamics in hydrocarbons. Our time-resolved measurements capture the transient motion of protons following X-ray ionization of carbon K-shell electrons. We Coulomb-explode the molecule with a second precisely delayed X-ray pulse and then record all the fragment momenta. These snapshots at different delays are combined into a 'molecular movie' of the evolving molecule, which shows substantial proton redistribution within the first 12 fs. We conclude that significant proton motion occurs on a timescale comparable to the Auger relaxation that refills the K-shell vacancy.


The novel biomarker circ_0020339 drives septic acute kidney injury by targeting miR-17-5p/IPMK axis.
Sepsis is a systemic life-threatening inflammatory disease, which leads to septic acute kidney injury (AKI). Circular RNAs (circRNAs) are involved in septic AKI. Herein, we aimed to expound the action of circ_0020339 in septic AKI. The dysregulation of plasma circRNAs between patients with septic non-AKI and patients with septic AKI were screened by circRNA chip. The dysregulation of circ_0020339, microRNA (miR)-17-5p, and inositol polyphosphate multi kinase (IPMK) mRNA was detected by quantitative real-time polymerase chain reaction (qRT-PCR). Cell viability and apoptosis were measured by cell counting kit-8 (CCK-8) and flow cytometry, respectively. The release of serum creatinine (SCr), tissue inhibitor metalloproteinase-2 (TIMP-2), insulin-like growth factor binding protein-7 (IGFBP7), tumor necrosis factor (TNF)α and interleukin (IL)-1β was evaluated by enzyme-linked immunosorbent assay (ELISA). Bioinformatic analysis, dual-luciferase reporter assay and miRNA pull down assay were used to confirm the interaction between miR-17-5p and circ_0020339 or IPMK 3'untranslated region (UTR). Protein level of IPMK, TNF receptor-associated factor 6 (TRAF6), phosphorylated AKT (p-AKT)/total (t)-AKT, p-nuclear factor kappa-B (NF-κB) kinase (p-IKK)/t-IKK, p-inhibitor of NF-κB (p-IκB)α/t-IκBα, and p-p65/t-p65 were conducted by western blot. Circ_0020339 was upregulated in the plasma of patients with septic AKI as well as LPS-treated HK2 cells and C57BL/6 mice relative to the corresponding counterparts. Functionally, circ_0020339 was positively correlated with markers of renal functional injury and inflammation in patients with septic AKI; si-circ_0020339 facilitated cell proliferation, while restrained cell apoptosis and inflammation in LPS-triggered HK2 cells; meanwhile, si-circ_0020339 restrained survival rate, renal functional injury and inflammation in LPS-triggered C57BL/6 mice. Furthermore, circ_0020339 and IPMK 3'UTR shared the same complementary sites with miR-17-5p. si-circ_0020339 attenuated LPS-induced cell damage by targeting miR-17-5p/IPMK axis and inactivation of TRAF6/p-AKT/p-IKK/p-IκBα/p-p65. Altogether, plasma circ_0020339 serves as a novel diagnostic marker of patients with septic AKI.


Impact of pre-existent areas of complex fractionated atrial electrograms on outcome after pulmonary vein isolation.
Atrial fibrillation (AF) drivers outside pulmonary veins (PV) may account for failure after PV isolation. The aim of this study was to characterize pre-existent areas of complex fractionated atrial electrograms (CFAEs) recorded in right atrium (RA) and in coronary sinus (CS) during catheter-based PV isolation and to assess their relation to outcome. With a tricuspid annulus and CS mapping, CFAEs were retrospectively identified in consecutive patients who underwent PV isolation. Of 224 patients, 161 were found to have CFAEs (81%). No clinical variable was found to be predictive of CFAEs presence. By Kaplan-Meier analysis, following a median follow-up of 23.7 months after a single ablation procedure, 62.8% of patients in the CFAEs+ group and 85.4% of those in the CFAEs- group were free from recurrent atrial tachyarrhythmias (p=0.013). Multivariable Cox regression analysis showed that CFAEs evidence was an independent predictor of recurrence (p=0.007). Pre-existent CFAEs, that can be easily identified in RA and CS during PV isolation, are a powerful independent predictor for AF recurrence. This finding may be helpful for refining AF ablation strategies.


Autonomous Growing Neural Gas for applications with time constraint: optimal parameter estimation.
This paper aims to address the ability of self-organizing neural network models to manage real-time applications. Specifically, we introduce fAGNG (fast Autonomous Growing Neural Gas), a modified learning algorithm for the incremental model Growing Neural Gas (GNG) network. The Growing Neural Gas network with its attributes of growth, flexibility, rapid adaptation, and excellent quality of representation of the input space makes it a suitable model for real time applications. However, under time constraints GNG fails to produce the optimal topological map for any input data set. In contrast to existing algorithms, the proposed fAGNG algorithm introduces multiple neurons per iteration. The number of neurons inserted and input data generated is controlled autonomous and dynamically based on a priory or online learnt model. A detailed study of the topological preservation and quality of representation depending on the neural network parameter selection has been developed to find the best alternatives to represent different linear and non-linear input spaces under time restrictions or specific quality of representation requirements.


Effect ofin vitro digestion on fumonisin B1 in corn flakes.
Low levels of fumonisins have been found frequently in corn based breakfast cereals and can occur bound to protein and other matrix components.In vitro digestion of two samples of corn flakes was carried out under "fed conditions." Fumonisins were measured as o-phthaldialdehyde/mercaptoethanol derivatives by LC-fluorescence. One sample of corn flakes (FN12) had high concentrations of fumonisin B1 (FB) (average 125 ng/g) and total bound FB1, (TB FB1) (average 92 ng/g) and the other (FN11) had a low level of free FB1 (average 29 ng/g) and no detectable TB FB1. After incubation of the samples with gastrointestinal tract solutions simulating saliva plus stomach and duodenal juices, chyme was analysed for FB1, hydrolyzed FB1 (HFB1) and partially hydrolyzed fumonisin B1 (PHFB1). The bioaccessibility (percentage of FB1 released from corn flakes into chyme) was 38-78% for incurred FB1 in FN12, 8-54% for incurred plus spiked FB1 in FN12, and 19-66% for incurred plus spiked FB1 in FN11. HFB1 and PHFB1 were not detected. If free FB1 was first extracted from sample FN12, no FB1 was detected in the chyme, indicating no contribution from TB FB1. Concentrations were corrected for method recovery of FB1 or, for bound FB1, partial method recovery of HFB1.


Discriminative stimulus effects of cholinergic agonists and the actions of their antagonists.
Both muscarinic- and nicotinic-cholinergic agonists have been used for discrimination training, but only nicotine has been studied extensively. The limited information available suggests that the discriminative stimulus effects of drugs classified as muscarinic-cholinergic agonists are blocked competitively by atropine but not by ganglion-blockers. The discriminative effects of nicotine are blocked non-competitively by ganglion-blocking drugs that penetrate into the CNS (e.g. mecamylamine), but they are not blocked by atropine. The specificity of the block is shown by the failure of mecamylamine to block several non-nicotinic drugs. The ganglion-blocking drug chlorisondamine penetrates poorly into the CNS when injected systemically; when injected intraventricularly, it is a potent and specific nicotine antagonist with a 4-week duration of effect. Haloperidol attenuates discriminative effects of nicotine but this is not a specific block; there are marked reductions in response rate, the morphine stimulus is also attenuated, and other neuroleptics have much weaker effects. The results support the view that the discriminative effect of nicotine involves predominantly cholinoceptive sites, and they suggest that it is not mediated primarily by the dopamine system. The transduction mechanisms for the nicotine stimulus may include the receptor sites that mediate many of its other CNS effects, but more information is needed about possible subtypes of nicotinic receptors before definitive conclusions are possible.


Monoclonal antibodies against foot-and-mouth disease virus 146S and 12S particles.
This paper is the first description of monoclonal antibodies specific for foot-and-mouth disease virus (FMDV). Using these antibodies, it was possible to distinguish similar and unique antigenic sites on complete (146S) or subunit (12S) virus particles. Some of these monoclonal antibodies could also distinguish between 12S subunits made by acid degradation of 146S virus (12SA) and those viral components found in infected cell lysates which sediment in sucrose density gradients as "12S subunits" (12SN).


Data on Vulnerability Detection in Android.
The data in this article have been collaborated from mainly four sources- Google Playstore, Wandoujia (third party app store market), AMD and Androzoo. These data include ~85,000 APKs (Android Package Kit), both malicious and benign from these data sources. Static and dynamic features are extracted from these APK files, and then supervised machines learning algorithms are employed for malware detection in Android. This data article also provides the Python code for data analysis. For feature extraction, a generic algorithm has also been incorporated, thereby, selecting important and relevant feature subset. Conclusive results obtained from this data set are further comprehended and interpreted in our latest research study "A Novel Parallel Classifier Scheme for Vulnerability Detection in Android" (Garg et al., 2018). This proved to be precious contribution for ensembling classifiers in machine learning to detect malware in Android.


Antibacterial activity of recombinant murine beta interferon.
Recombinant murine beta interferon was protective and therapeutic for mice against Listeria monocytogenes infection in vivo. The recombinant murine beta interferon caused enhanced H2O2 release by macrophages in vivo, but not in vitro.


[Neoplasms of the male breast. Case report and review of the literature].
Fourteen cases of breast cancer in males observed between 1950 and 1974 at the Busto Arsizio Hospital Surgery Divsion are presnted. The literature is reviewed and attention is given to the incidence of this form, its symptoms and treatments, and to the length of survival after surgical management.


Lighting up our waterways: Impacts of a current mitigation strategy on riparian bats.
Increasing levels of artificial light at night (ALAN) are a major threat to global biodiversity and can have negative impacts on a wide variety of organisms and their ecosystems. Nocturnal species such as bats are highly vulnerable to the detrimental effects of ALAN. A variety of lighting management strategies have been adopted to minimise the impacts of ALAN on wildlife, however relatively little is known about their effectiveness. Using an experimental approach, we provide the first evidence of negative impacts of part-night lighting (PNL) strategies on bats. Feeding activity of Myotis spp. was reduced along rivers exposed to PNL despite no reduction in overall bat activity. We also provide the first evidence of negative effects of PNL on both feeding and activity for Pipistrellus pipistrellus which has previously been recorded feeding under artificial light. Despite having considerable energy-saving benefits, we outline the potential negative impacts of PNL schemes for bats in riparian habitats. PNL are unlikely to provide desired conservation outcomes for bats, and can potentially fragment important foraging habitats leading to a breakdown of functional connectivity across the landscape. We highlight the potential dichotomy for strategies which attempt to simultaneously address climate change and biodiversity loss and recommend alternative management strategies to limit the impacts of ALAN on biodiversity.


Incorporation of amino acids into protein in different brain areas of rat, subjected to enriched and restricted environment.
The incorporation of [14C]valine into acid-insoluble brain material from rats living in enriched and restricted environment, respectively, was studied. Quantitative estimations showed higher incorporation into brain protein of frontal, entorhinal, cerebellar and visual cortex and the hippocampus in enriched environment animals compared to restricted environment animals. This finding was confirmed by autoradiography.


[Experimental study of hemodynamics and oxygen regimen in the body during replacement of massive blood loss with a suspension of erythrocytes in a solution of modified deionized gelatin].
In experiments on dogs with acute massive hemorrhage the effectiveness has been studied of red blood cell suspension in glucose-saline solution N 8 prepared in the Central Research Institute of Hematology and Blood Transfusion, and in a preservative based on gelatin developed in the Leningrad Research Institute of Hematology and Blood Transfusion. The advantage of the colloid preservative has been proved by the parameters of macro- and microdynamics of the blood, oxygen-basic state, oxygen budget and rheologic properties of the blood.


Bilateral giant abdominoscrotal hydroceles complicated by appendicitis.
Abdominoscrotal hydrocele is a rare entity, with fewer than 100 cases reported in children. Bilateral abdominoscrotal hydroceles are even less common, with 14 cases reported in children. Various complications of abdominoscrotal hydrocele have been reported in the literature. We present a 4-month-old boy with bilateral giant abdominoscrotal hydroceles who developed appendicitis apparently because of obstruction from the right hydrocele. We discuss the various imaging modalities used to establish the diagnosis and plan the operative approach.


Fight against novel coronavirus: A perspective of medicinal chemists.
The ongoing novel coronavirus disease (COVID-19) pandemic makes us painfully perceive that our bullet shells are blank so far for fighting against severe human coronavirus (HCoV). In spite of vast research work, it is crystal clear that the evident does not warrant the commercial blossoming of anti-HCoV drugs. In this circumstance, drug repurposing and/or screening of databases are the only fastest option. This study is an initiative to recapitulate the medicinal chemistry of severe acute respiratory syndrome (SARS)-CoV-2 (SARS-CoV-2). The aim is to present an exquisite delineation of the current research from the perspective of a medicinal chemist to allow the rapid development of anti-SARS-CoV-2 agents.


A Primer on Pacemakers and Defibrillators for Nurses.
Although the concepts of pacing have been around for more than half a century, technological advances in cardiac implantable electronic devices (CIEDs) have changed the landscape for patients in need of pacing support or sudden death prevention. Nurses encounter patients with CIEDs in all aspects of the health care setting. Because exciting CIED therapies are on the horizon, nurses must stay up-to-date to promote optimal outcomes for CIED patients. This essential guide provides nurses with a comprehensive overview of the principles of pacing and implantable cardioverter defibrillators (ICDs), as well as innovative technologies such as leadless cardiac pacemakers and subcutaneous ICDs.


Can patients with chest pain and normal coronary arteries be discriminated from those with coronary artery disease prior to coronary angiography?
To determine whether the precatheterization clinical data in patients with chest pain could be used to discriminate patients with normal coronary arteries (NCA) from those with coronary artery disease, the authors compared 125 consecutive patients with less than 30% stenosis of all major coronary arteries and 125 patients with greater than 60% stenosis of one or more major coronary arteries. Clinical characteristics that occurred more frequently in patients with NCA were: nonexertional pain, pain to the left of the sternum, sharp pain, associated palpitations, absence of typical relief with sublingual nitroglycerin, pain commencing less than one week or more than ten years prior to coronary angiography, a normal electrocardiogram, and negative results from a treadmill stress test or from thallium scintigraphy. However, none of these clinical features, either singly or in combination, could be used to identify the patients with NCA with certainty.


Concentrations of volatile organic compounds in vehicular cabin air - Implications to commuter exposure.
In this study, 117 volatile organic compounds (VOCs) were identified and quantified inside passenger cars and buses operating city and intercity routes. The paper presents data for 90 compounds with frequency of detection equal or greater than 50% that belong to various chemical classes. Total VOC concentration (TVOCs) was dominated by alkanes followed by organic acids, alkenes, aromatic hydrocarbons, ketones, aldehydes, sulfides, amines, and phenols, mercaptans, thiophenes. VOCs concentrations were compared between different vehicle types (passenger cars - city buses - intercity buses), fuel type (gasoline - diesel - liquefied petroleum gas (LPG)), and ventilation type (air condition - air recirculation). TVOCs, alkanes, organic acids and sulfides followed the order: diesel cars > LPG cars > gasoline cars. On the contrary, for mercaptans, aromatics, aldehydes, ketones, and phenols the order was: LPG cars > diesel cars > gasoline cars. Excepting ketones that were found to be higher in LPG cars with air recirculation mode, most compounds were higher with exterior air ventilation in both, gasoline cars and diesel buses. Odor pollution, expressed by the odor activity value (OAV) of VOCs, was highest in LPG cars and minimum in gasoline cars. In all vehicle types, mercaptans and aldehydes were the major contributors to odor pollution of the cabin air with lower contributions from organic acids. The total Hazard Quotient (THQ) was less than 1 for bus and car drivers and passengers indicating that adverse health effects are not likely to occur. Cancer risk from the three VOCs following the order naphthalene > benzene > ethylbenzene. For the three VOCs the total carcinogenic risk was within the safe range. The results of this study expand our knowledge of in-vehicle air quality under real commuting conditions and give an insight into the commuters' exposure levels during their normal travel journey.


Correction to: Use of an Integrated Pan-Cancer Oncology Enrichment Next-Generation Sequencing Assay to Measure Tumour Mutational Burden and Detect Clinically Actionable Variants.
This article was originally published under a [CC BY NC 4.0] license.


Intellectual stimulation in family medicine: an international qualitative study of student perceptions.
Globally, medical schools struggle to ensure there is a sufficient number of graduates choosing family medicine as a career to meet societal needs. While factors impacting career choice are complex, one possible disincentive to choosing family medicine is the perception that it is less intellectually stimulating than specialty care. The study sought to elicit student views on intellectual stimulation in family medicine, and their understanding of academic family medicine. This is a qualitative focus group study of volunteer students from the University of Calgary, Canada, and Newcastle University, UK. Six focus groups were conducted with 51 participants. The data were analysed thematically. Students associated intellectual stimulation in family medicine with clinical practice. Intellectual stimulation was related to problem solving and the challenge of having to know a little about everything, along with clinical uncertainty and the need to be vigilant to avoid missing diagnoses. Student awareness of academic family medicine was limited, and students identified it with teaching rather than research. Promoting intellectual stimulation in family medicine requires educators to highlight the breadth and variety of knowledge required in family medicine, as well as the need to manage clinical uncertainty and to be vigilant to avoid missing diagnoses. Exposure to academic family medicine could enhance students' understanding and appreciation of the role of research in family medicine.


32P-postlabeling analysis of DNA adducts from non-alternant PAH using thin-layer and high performance liquid chromatography.
DNA adduct formation in vivo in mouse skin following a single topical application of benzo[a]fluoranthene (BbF), benzo[j]fluoranthene (BjF), benzo[k]fluoranthene (BkF), or indeno[1,2,3-cd]pyrene (IP) was investigated in female CD-1 mice using 32P-postlabeling analysis. Distinct adduct profiles were detected for each of the non-alternant hydrocarbons examined. Two adducts, one major and one minor, were detected using polyethyleneiminecellulose (PEI-cellulose) thin-layer chromatography (TLC) for BbF and BjF while a single major adduct was detected for BkF and IP. The relative extent of binding to mouse skin DNA was in the order BbF greater than BjF greater than BkF greater than IP. 32P-Postlabeled DNA adducts separated by PEI-cellulose TLC were further analyzed by high performance liquid chromatography (HPLC). A single radioactive peak was detected for 32P-labeled DNA adducts of BjF and BkF. Three general areas of radioactivity were detected when 32P-labeled DNA adducts of BbF were separated on HPLC.


Hydration and meal habits of physicians and medical learners: a literature review.
Nutrition and hydration are important components of physician and medical learner well-being; meal-skipping and insufficient hydration are known to negatively impact cognition. Existing data on these phenomena are sparse and rarely considered together; furthermore, there is a lack of literature on interventions to address these problems. We therefore aimed to characterize existing literature on this topic. We conducted a literature review of existing literature on the prevalence of and reasons for meal-skipping and insufficient hydration in physicians and medical learners. Reported prevalences varied widely, as did the ways in which the data were collected. Reasons for meal-skipping and insufficient hydration are less studied, but a lack of time is the most commonly reported reason, among a variety of other barriers. Further research is required to better characterize the prevalences and reasons for meal-skipping in physicians and medical learners. By consolidating the state of current knowledge on this topic in this work, we establish the groundwork for future studies and allow intervention studies to be based on a broader data set.


Symptomatic Giant Primary Nonparasitic Splenic Cyst Treated with Laparoscopic Decapsulation: A Case Report and Literature Review.
BACKGROUND Primary nonparasitic splenic cysts (PNSC) are unusual epithelial fluid lesions of the spleen. They are considered congenital cysts and are often discovered incidentally in young people. Larger cysts can be symptomatic and are traditionally managed with splenectomy. This report is of a woman with a large symptomatic PNSC that was managed surgically by laparoscopic decapsulation. CASE REPORT A 22-year-old Lebanese woman presented with left upper-quadrant pain, left pleuritic pain, food intolerance, and significant weight loss. Investigations showed a 20×17×15 cm cystic lesion in the spleen. Secondary causes were ruled out and tumor marker and hydatid serology were unremarkable. Laparoscopic decapsulation of the cyst with spleen preservation was performed with no perioperative complications. The patient's 3-year follow-up visit revealed no clinical or radiological recurrence. CONCLUSIONS True congenital splenic cysts are rare clinical findings. Generally, they do not have malignant potential. The development of minimally invasive techniques has shifted the trend toward splenic salvaging procedures. Literature review revealed an acceptable recurrence rate with near-total rather than partial unroofing. Laparoscopic decapsulation can be a safe and adequate therapeutic option in selected cases.


Benefits of ambulatory axillary intra-aortic balloon pump for circulatory support as bridge to heart transplant.
Axillary intra-aortic balloon pump therapy has been described as a bridge to transplant. Advantages over femoral intra-aortic balloon pump therapy include reduced incidence of infection and enhanced patient mobility. We identified the patients who would benefit most from this therapy while awaiting heart transplantation. We conducted a single-center, retrospective observational study to evaluate outcomes from axillary intra-aortic balloon pump therapy. These included hemodynamic parameters, duration of support, and success in bridging to transplant. We selected patients on the basis of history of sternotomy, elevated panel-reactive antibody, and small body habitus. Patients were made to ambulate aggressively beginning on postoperative day 1. Between September 2007 and September 2010, 18 patients underwent axillary intra-aortic balloon pump therapy. All patients had the devices placed through the left axillary artery with a Hemashield side graft (Boston Scientific, Natick, Mass). Before axillary placement, patients underwent femoral placement to demonstrate hemodynamic benefit. Duration of support ranged from 5 to 63 days (median = 19 days). There was marked improvement in ambulatory potential and hemodynamic parameters, with minimal blood transfusion requirements. There were no device-related infections. Some 72% of the patients (13/18) were successfully bridged to transplantation. Axillary intra-aortic balloon pump therapy provides excellent support for selected patients as a bridge to transplant. The majority of the patients were successfully bridged to transplant and discharged. Although this therapy has been described in previous studies, this is the largest series to incorporate a regimen of aggressive ambulation with daily measurements of distances walked.


[Inferior temporal electrodes in 24-h EEG].
To improve the sensitivity of the EEG in the diagnosis and classification of seizures or epilepsy, long-term recording with inferior temporal electrodes are recommended. The spatial distribution of epileptiform discharges from 24‑h EEG with 25 electrodes (10-20, extended by F9/F10, T9/T10, P9/P10) was retrospectively analyzed in 25 cases. Maximum negativity was located below the 10-20 electrodes in 84%. Epileptiform discharges were more clearly detected on inferior temporal electrodes in 64%. In the intention-to-test population of 77 patients the number needed to test with extra electrodes was estimated as 5. Recording EEG with 25 electrodes for 24 h improves the detection and localization of temporal epileptiform discharges also in geriatric patients with suspected nonlesional epilepsy.


Characterization of type I IGF receptor and IGF-I mRNA expression in cultured human and bovine glomerular cells.
Glomerular hypertrophy is reported in several endocrine disorders such as acromegaly and diabetes mellitus, where abnormalities of growth hormone and insulin-like growth factor (IGF-I) have been reported. In the present report, we have cultured bovine and human glomerular endothelial cells, and bovine glomerular epithelial and mesangial cells, and characterized the expression of IGF-I mRNA and its receptor in these cells. High affinity, specific receptors for IGF-I were identified in all three types of cells by radioreceptor assays. Receptor number (Ro) derived by Scatchard analysis revealed an unusually high number of Type I IGF receptors, approx. 1.2 x 10(5) receptors/cell in glomerular endothelial cells. Affinity crosslinking studies and immunoprecipitation with antibodies against the Type I IGF receptor identified the alpha-subunit of the IGF-I receptor as having a molecular mass of 140 kDa. Biologically, IGF-I was more potent than insulin or IGF-II in stimulating DNA synthesis in glomerular endothelial cells. Northern blot analysis showed that glomerular and aortic endothelial cells expressed IGF-1 mRNA of 1.7 kb. In contrast, renal glomeruli showed several IGF-1 mRNAs of 7.5, 1.7 and 1.2 kb. Thus, the demonstration of both a prepondence of Type I IGF receptors coupled with the growth promoting effects of IGF-I in glomerular endothelial and epithelial cells, as well as the local production of IGF-I mRNA suggests that IGF-I serves an important role as an autocrine or paracrine regulator of the growth of renal glomeruli.


Spherical aberration correction with threefold symmetric line currents.
It has been shown that N-fold symmetric line current (henceforth denoted as N-SYLC) produces 2N-pole magnetic fields. In this paper, a threefold symmetric line current (N3-SYLC in short) is proposed for correcting 3rd order spherical aberration of round lenses. N3-SYLC can be realized without using magnetic materials, which makes it free of the problems of hysteresis, inhomogeneity and saturation. We investigate theoretically the basic properties of an N3-SYLC configuration which can in principle be realized by simple wires. By optimizing the parameters of a system with beam energy of 5.5keV, the required excitation current for correcting 3rd order spherical aberration coefficient of 400 mm is less than 1AT, and the residual higher order aberrations can be kept sufficiently small to obtain beam size of less than 1 nm for initial slopes up to 5 mrad.


Infiltration of a cerebral artery aneurysm by malignant lymphoma cells with acute rupture: Report of a case.
A 55 year old woman died suddenly of a ruptured cerebral artery aneurysm. The aneurysm. was infiltrated by cells from a silent, nodular, poorly differentiated lymphocytic lymphoma, which also involved the spleen and abdominal lymph nodes. Compared to leukemias, the incidence of cerebral hemorrhage in non-Hodgkin's lymphomas is exceedingly rare, this being the first case reported in detail. A brief discussion of the etiology of cerebral hemorrhage in lymphomas is provided.


Altered maturation and function of peritoneal macrophages: possible role in pathogenesis of endometriosis.
Human peritoneal macrophages from healthy women and patients with endometriosis were analyzed with flow cytometry for size distribution, cell membrane antigen expression, and membrane function. Endometriosis was associated with a significantly increased number of peritoneal macrophages and a higher proportion of large macrophages with increased expression of three antigen markers. Peritoneal macrophages from normal patients exhibited diminished cell membrane capping function as compared with that of endometriosis-related macrophages or blood monocytes. On the basis of these findings, a hypothesis is formulated suggesting that endometriosis is associated with an increased influx of macrophages that are allowed to undergo further maturation-activation. The resultant population of large macrophages may contribute to the maintenance of the disease or associated infertility.


Inhibition of long-term potentiation of the hippocampal CA1 EPSP by a negative cooperativity.
Tetanization of commissural-CA1 input to the apical dendrites of the dorsal hippocampal CA1 area was found to produce a marked long-term potentiation of the field EPSP. Whereas by concurrent tetanization of the commissural pathway and medial septo-CA1 input, this potentiation was significantly reduced. Thus a negative cooperativity in LTP induction was revealed.


Abdomen cocoon causing chronic abdominal pain and intestinal obstruction; a case series.
Abdomen cocoon is a rare disease in which a thick peritoneal membrane wraps the intestine causing the bowel loops to adhere to each other. It may be either primary(idiopathic) or secondary to other causes like previous abdominal surgery. Most patients present with abdominal pain and intestinal obstruction. The condition is usually diagnosed intraoperatively. A 30-year-old male patient presented with abdominal pain and bilious vomiting. The patient had similar previous attacks. Examination showed distension abdominal distension with central tenderness. Plain abdominal X-ray showed multiple air fluid levels. During surgery most of ileum was enclosed by thin membrane with dilated proximal jejunum. Release of the bowel loops was done. The patient was well after surgery and was discharged with no post-operative complications. A 35-year old male presented with chronic right lower quadrant abdominal pain, the past medical and surgical histories were non-relevant. Abdominal examination showed tenderness on deep palpation at the right iliac fossa, abdominal ultrasound and abdominal X-ray were normal. During diagnostic laparoscopy the terminal ileum was enclosed with a thick whitish membrane with dilated proximal ileum. Release of the adhesions was done. The patient was well in the post-operative period and he was discharged home with no post-operative complications.In both cases the biopsy from the membranes showed features of chronic inflammatory process.Abdomen cocoon is one of the rare causes of small bowel obstruction. The bowel adhesions should be opened and nonviable segments resected. Most patients have good long term outcome.


Metastatic pattern and response to endocrine therapy in human breast cancer.
The effect of endocrine therapy in 465 postmenopausal patients with advanced breast cancer who entered four consecutive, randomized trials has been related to the site of the metastases. Patients received either tamoxifen (T) alone or T in combination with medroxyprogesterone acetate, diethylstilbestrol, halotestin, or aminoglutethimide. The overall response rate was 40%. Responses were most frequently seen in patients with metastases in soft tissue, and the duration of response to endocrine therapy in these patients was longer than for those with metastases in bone or viscera (p less than 0.00001). In addition, the response rate was inversely correlated with the number of main metastatic sites in patients with soft tissue metastases, whereas the response rate was not associated with the number of metastatic sites in patients with metastases in bone and viscera. Survival after first recurrence was significantly longer in responding patients with soft tissue lesions compared to those with recurrence in bone or viscera. In contrast, survival after first recurrence was identical in patients with nonresponding disease, irrespective of dominant site of metastases. The outcome of endocrine therapy depends partially upon the dominant site of metastases. This may reflect a difference in biological characteristics of human breast cancer tumor cells that metastasize to different sites.