Contrast effects in photoelectron microscopy; UV dose-dependent quantum yields of biological surface components.
The relative brightness of photoelectron microscopy images as a function of exposure to UV light has been determined from model systems representative of biological cell surface components. Quantitative data for amino acid homopolymers, yields. The photoelectron quantum yields, increase substantially over the initial values. For example, the quantum yields fo poly-L-tyrosine at 200 nm is initially about 5 X 10(-8) electron/incident photon. The quantum yield increases with 254 nm irradiation, leveling off at about 5 X 10(-4) electrons/incident photon after a dose of 3 X 10(21) quanta cm-2. Pre-irradiation of poly-L-tyrosine in the presence of certain chemical agents, for example, the Lewis base diborane (B2H6), results in a substantial reduction of the dose-dependent increase in quantum yield. Exposure to the reducing agent stannane (SnH4) essentially eliminates the effect. These chemical treatments provide methods of controlling the UV dose-dependent effects in the photoelectron images.


Natural killer-cell cytotoxicity in HIV-positive and HIV-negative patients with and without severe course of hepatitis B virus infection.
Natural killer (NK) cells represent the first line of defence against viral infections but, in the case of hepatitis B virus (HBV), may also be involved in liver injury. We here compared NK-cell activity of 11 patients with acute HBV infection, either HIV-positive or HIV-negative, with that of 11 healthy subjects. One of the HIV-positive patients, characterized by a severe immunodeficiency, died 3 weeks after hospitalization for HBV-related fulminant hepatitis (FH). He displayed a remarkable NK-cell cytotoxicity against both cell lines and autologous dendritic cells, whereas the NK-cell activity of the remaining patients was significantly reduced as compared with healthy individuals. Our findings suggest that NK-cell-mediated cytotoxicity could contribute to the development of HBV-related acute liver failure in HIV-positive patients with severe immunodeficiency. An immunopathological model of FH in immunocompromised patients was proposed.


Wrist rotations about one or two axes affect maximum wrist strength.
Most wrist strength studies evaluate strength about one axis, and postural deviations about that same axis. The purpose of this study was to determine if wrist posture deviations about one axis (e.g. flexion/extension), or two axes (e.g. flexion/extension and pronation/supination), affect the strength about another axis (e.g. ulnar deviation). A custom-built instrumented handle was used to measure maximum static isometric torque exertions at 18 wrist postures (combinations of flexion/extension, radial/ulnar deviation, and pronation/supination). Ulnar deviation torques were highest when the wrist was in neutral. This pattern was not maintained for the other torque directions; the generated torque tended to be highest when the wrist posture was not neutral. The effects were similar for male and female subjects, although male subjects exerted significantly larger torques in all directions. This study illustrates that there is a complex relationship between wrist posture and maximal wrist torques.


Comparison of Cardiac Repolarization After Transcatheter Aortic Valve Implantation and Surgical Aortic Valve Replacement: A Longitudinal Study.
Transcatheter aortic valve implantation (TAVI) has been established as an alternative to surgical aortic valve replacement (SAVR) for high-risk patients. To assess the impact of TAVI on cardiac repolarization, we compared QT dispersion (QTD) and the interval from the peak to the end of the T wave (Tpeak-Tend: TpTe) between the patients who underwent TAVI and those who underwent SAVR and TpTe between the patients who underwent TAVI or SAVR. This retrospective study was approved by the ethics committee of Dokkyo Medical University Hospital. The study included 45 patients who underwent TAVI and 45 patients who underwent SAVR. The QT, corrected QT (QTc), QTD, QTc dispersion (QTcD), Tp-Te, Tp-Te/QT, and Tp-Te/QTc were manually measured in standard 12-lead electrocardiogram (ECG) recordings obtained before surgery, immediately after surgery, 1 month, 3 months, and 6 months after surgery and compared between the two groups. No change was observed in RR, QT, QTc, Tp-Te, Tp-Te/QT, and Tp-Te/QTc in the two groups throughout the study. The QTD and QTcD significant decreased immediately after surgery in the TAVI group as compared to the SAVR group (P < 0.001). In contrast, QTD and QTcD in the SAVR group gradually, but not significantly declined 6 months after surgery. QTD and QTcD immediately decreased after TAVI as compared to SAVR. Our findings indicate that TAVI more rapidly improved dispersion of spatial repolarization than SAVR.


Plasma metabolome identifies potential biomarkers of gastric precancerous lesions and gastric cancer risk.
Currently, metabolic biomarkers with great practicability of gastric cancer (GC) and gastric precancerous lesions (GPL) are scarce. Thus, we are devoted to determining the plasma metabolic profiles of patients with GPL or GC and validate candidate biomarkers for disease diagnosis. In this hospital-based case-control study, 68 plasma samples from 27 non-atrophic gastritis (NAG, control), 31 GPL, and 10 GC patients were collected for targeted metabolomics analysis. Univariate and multivariate analyses were used for selecting the differential metabolites. A receiver operating characteristic curve combined with binary logistic regression analysis was performed to test the diagnostic performance of the differential metabolites. Dietary data were obtained using a semiquantitative food frequency questionnaire. Distinct metabolomic profiles were noted for NAG, GPL, and GC. Compared to the NAG patients, the levels of 5 metabolites in the GPL group and 4 metabolites in the GC group were found to significantly elevate. Compared with the model involving 9 traditional risk factors (AUC: 0.89, 95%CI: 0.78-1.00), Trimethylamine N-oxide, the most significant metabolite (P = 2.00 × 10-5, FDR = 0.003, FC > 2, VIP > 2), showed a good diagnostic performance for the patients with GC (AUC: 0.90, 95%CI: 0.78-1.00), and its diagnostic performance has been further improved with the integration of Rhamnose (AUC: 0.96, 95%CI: 0.89-1.00). In our study, 9 defined metabolites might serve as meaningful biomarkers for identifying the high-risk population of GPL and GC, possibly enhancing the prevention and control of GPL and GC.


Steel slag and biochar amendments decreased CO2 emissions by altering soil chemical properties and bacterial community structure over two-year in a subtropical paddy field.
Waste amendments, such as steel slag and biochar, have been reported as a strategy for improving soil fertility, crop productivity, and carbon (C) sequestration in agricultural lands. However, information regarding the subsequent effects of steel slag and biochar on C cycling and the underlying microbial mechanisms in paddy soils remains limited. Hence, this study aimed to examine the effect of these waste amendments (applied in 2015-2017) on total soil CO2 emissions, total and active soil organic C (SOC) contents, and microbial communities in the early and late seasons in a subtropical paddy field. The results showed that despite the exogenous C input from these waste amendments (steel slag, biochar and slag + biochar), they significantly (P < 0.05) decreased total CO2 emissions (e.g., by 41.9-59.6% at the early season), compared to the control soil. These amendments also significantly (P < 0.001) increased soil salinity and pH. The increased soil pH had a negative effect (r = -0.37, P < 0.05) on microbial biomass C (MBC). The biochar and slag + biochar treatments (cf. control) significantly (P < 0.001) increased SOC contents in the both seasons. The amendments altered the soil microbial community structure that associated with soil C cycling: (1) all three amendments increased the relative abundance of Agromyces and Streptomyces, which was associated with higher soil pH (cf. control); and (2) biochar and slag + biochar treatments caused a higher relative abundance of Sphingomonas, which was supported by high SOC contents under those amendments. Overall, this study demonstrated that the steel slag and biochar amendments altered microbial community composition due to changes in key soil properties, such as salinity, pH and SOC contents, with implications for increasing soil C stocks while mitigating CO2 emissions in the paddy field.


The Women's Preventive Services Initiative Well-Woman Chart: A Helpful Tool for the Practice of Internal Medicine.
The Women's Preventive Services Initiative (WPSI) is a national coalition of 21 professional organizations and patient representatives that develops, reviews, updates, and disseminates evidence-based clinical recommendations for women's preventive health care services, from adolescence into the postreproductive years. The aim of the WPSI is to provide a clinically useful tool for practicing clinicians to help them identify and implement recommended preventive care services. The Well-Woman Chart (WWC) was created to serve as a central reference of the evidence-based reviews and recommendations. The chart provides a quick summary of screening, risk assessment, and counseling recommendations, along with links to obtain further clarification. The topics included are updates to the 2011 Institute of Medicine recommendations, as well as any other topics that were deemed relevant to the well-being of women. A brief summary of preventive services recommended during the pregnancy and postpartum periods are also included, though the WWC is not meant to be a comprehensive guide for perinatal care. We encourage clinicians to familiarize themselves with the contents of the WWC and use this tool to educate others to ensure women receive optimized preventive services.


Enhancing immune responses against a plasmid DNA vaccine encoding a FMDV empty capsid from serotype O.
Various parameters have been examined for the improvement of immune responses induced by immunisation with foot-and-mouth disease virus (FMDV) DNA vaccine (pcDNA 3.1/P1-2A3C3D, P1) in swine. Our findings show that increasing the amount of P1 DNA plasmids and pGMCSF adjuvant plasmids induces stronger FMDV specific and neutralising antibody responses, as well as promoting cytokines IL-8 and IFNgamma secretion, in immunised pigs via multiple inoculation sites.


Early posttransplantation hypertension and poor long-term renal allograft survival in pediatric patients.
To evaluate the effect of early hypertension on long-term allograft survival in children with kidney transplantation. Data from a total of 159 patients (mean age, 12.8+/-4.8 years) who underwent kidney transplantation between 1978 and 1998 and whose allograft was functioning for at least 1 year were analyzed retrospectively. Patients were divided according to the presence of hypertension within the first year after transplantation. Primary outcome was time of allograft failure (death, return to dialysis, or retransplantation). Kaplan-Meier analysis showed that systolic (P<.0001) and diastolic (P=.016) hypertension was associated with overall worse allograft survival. Children with systolic hypertension had a significantly higher graft failure rate regardless of the type of donor, cause of kidney failure, presence or absence of acute rejection, and allograft function at 1 year after transplantation. The multivariate Cox regression model proved that systolic hypertension was a significant and independent risk factor for poor graft survival (hazard ratio [HR], 1.79; P<.0001). Other predictors included allograft function at 1 year after transplantation (HR, 0.97; P<.0001), acquired cause of end-stage kidney disease (HR, 1.96; P=.01) and age <6 years (HR, 2.61; P=.045). Early posttransplantation systolic hypertension strongly and independently predicts poor long-term graft survival in pediatric patients.


Formation and Physical Stability of Zanthoxylum bungeanum Essential Oil Based Nanoemulsions Co-Stabilized with Tea Saponin and Synthetic Surfactant.
The purpose of this work was to evaluate the possibility of adding tea saponin (TS) to reduce the synthetic surfactant concentration, and maintain or improve the shelf stability of nanoemulsions. The Zanthoxylum bungeanum essential oil (2.5 wt%) loaded oil-in-water nanoemulsions were co-stabilized by Tween 40 (0.5-2.5 wt%) and TS (0.1-5 wt%). A combination of several analytical techniques, such as dynamic laser scattering, interfacial tension, zeta potential, and transmission electron microscope, were used for the characterization of nanoemulsions. Low levels of TS (0.1-0.5 wt%) with Tween 40 had significant effects on the emulsification, and a nanoemulsion with the smallest droplet diameter of 89.63 ± 0.67 nm was obtained. However, in the presence of high TS concentration (0.5-5 wt%), micelles generated by the non-adsorbed surfactants in the aqueous lead to droplets growth. In addition, the combinations of Tween 40 and TS at the high level (>3.5 wt%) exerted a synergistic effect on stabilizing the nanoemulsions and preventing both Ostwald ripening and coalescence. The negative charged TS endowed the droplets with electrostatic repulsion and steric hinderance appeared to prevent flocculation and coalescence. These results would provide a potential application of natural TS in the preparation and stabilization of nanoemulsions containing essential oil.


Needleless i.v. therapy: comparing three systems for safety.
Three needleless systems were compared for general usability and cost. A closed, one-piece, nonmechanical unit was chosen as it proved safe in both peripheral and central lines, required minimal inservicing and yielded significant cost savings.


Coital risk factors for cervical cancer. Sexual activity among white middle class women.
This study reports the sexual history of a group of young women participating in an epidemiologic project. The methods used to recruit and interview the participants minimized self-selection bias. Results of over 11,000 interviews with 1,892 participants showed that 72.3% should be considered at high risk for developing cervical cancer and its precursors and should be screened regularly for this disease.


The anti-inflammatory feature of glucagon-like peptide-1 and its based diabetes drugs-Therapeutic potential exploration in lung injury.
Since 2005, GLP-1 receptor (GLP-1R) agonists (GLP-1RAs) have been developed as therapeutic agents for type 2 diabetes (T2D). GLP-1R is not only expressed in pancreatic islets but also other organs, especially the lung. However, controversy on extra-pancreatic GLP-1R expression still needs to be further resolved, utilizing different tools including the use of more reliable GLP-1R antibodies in immune-staining and co-immune-staining. Extra-pancreatic expression of GLP-1R has triggered extensive investigations on extra-pancreatic functions of GLP-1RAs, aiming to repurpose them into therapeutic agents for other disorders. Extensive studies have demonstrated promising anti-inflammatory features of GLP-1RAs. Whether those features are directly mediated by GLP-1R expressed in immune cells also remains controversial. Following a brief review on GLP-1 as an incretin hormone and the development of GLP-1RAs as therapeutic agents for T2D, we have summarized our current understanding of the anti-inflammatory features of GLP-1RAs and commented on the controversy on extra-pancreatic GLP-1R expression. The main part of this review is a literature discussion on GLP-1RA utilization in animal models with chronic airway diseases and acute lung injuries, including studies on the combined use of mesenchymal stem cell (MSC) based therapy. This is followed by a brief summary.


Abnormal number cell division of human thyroid anaplastic carcinoma cell line, SW 1736.
Cell division, during which a mother cell usually divides into two daughter cells during one cell cycle, is the most important physiological event of cell biology. We observed one-to-four cell division during imaging of live SW1736 human thyroid anaplastic carcinoma cells transfected with a plasmid expressing the hybrid protein of green fluorescent protein and histone 2B (plasmid eGFP-H2B). Analysis of the images revealed a mother cell divided into four daughter cells. And one of the abnormally divided daughter cells subsequently formed a dinucleate cell.


Novel rechargeable calcium fluoride dental nanocomposites.
Composite restorations with calcium fluoride nanoparticles (nCaF2) can remineralize tooth structure through F and Ca ion release. However, the persistence of ion release is limited. The objectives for this study were to achieve long-term remineralization by developing a rechargeable nCaF2 nanocomposite and investigating the F and Ca recharge and re-release capabilities. Three nCaF2 nanocomposites were formulated: (1) BT-nCaF2:Bisphenol A glycidyl dimethacrylate (BisGMA) and triethylene glycol dimethacrylate (TEGDMA); (2) PE-nCaF2:Pyromellitic glycerol dimethacrylate (PMGDM) and ethoxylated bisphenol A dimethacrylate (EBPADMA); (3) BTM-nCaF2:BisGMA, TEGDMA, and Bis[2-(methacryloyloxy)ethyl] phosphate (Bis-MEP). All formulations contained 15% nCaF2 and 55% glass particles. Initial flexural strength and elastic modulus, F and Ca ion release, recharge and re-release were tested and compared to three commercial fluoride-containing materials. BT and BTM nCaF2 composites were 3-4 times stronger and had elastic modulus 2 times that of resin-modified glass ionomer controls. PE-nCaF2 had comparable strength to RMGIs. All nCaF2 composites had significant F and Ca ion release and ion rechargeability. In F and Ca recharging cycles, PE-nCaF2 had the highest ion recharging capability among nCaF2 groups, followed by BT-nCaF2 and BTM-nCaF2 (p < 0.05). For all recharge cycles, ion release maintained similar levels, demonstrating long-term ion release was possible. Furthermore, after the final recharge cycle, nCaF2 nanocomposites provided continuous ion release for 42 days without further recharge. Novel nCaF2 rechargeable nanocomposites exhibited significant F and Ca ion release over multiple recharge cycles, demonstrating continuous long-term ion release. These nanocomposites are promising restorations with lasting remineralization potential.


Chemotherapy for the treatment of malignant peripheral nerve sheath tumors in neurofibromatosis 1: a 10-year institutional review.
Neurofibromatosis 1 (NF1) is the most common autosomal dominant disorder, with an incidence of 1 in 2,500-3,300 live births. NF1 is associated with significant morbidity and mortality because of complications, especially malignant peripheral nerve sheath tumors (MPNSTs), which mainly develop during adulthood. We evaluated our experience with management of NF1 with MPNSTs by standard chemotherapy with anthracycline and/or ifosfamide in terms of time to treatment failure and overall survival. We performed a retrospective review of consecutive patients with NF1 and a diagnosis of MPNSTs between 1993 and 2003 in our referral center for NF1. Prognostic factors were evaluated by univariate analysis. We evaluated data for 21 patients with grade 1 (n=1), grade 2 (n=8) and grade 3 (n=12) MPNST; 16 presented localized disease and underwent surgery: margins for 6 were tumor-free (including 3 patients with amputation), 2 showed microscopic residual disease and 8 showed macroscopic residual disease. All patients received chemotherapy and 9 radiotherapy. Median time to treatment failure and overall survival were 7.8 and 17 months, respectively. Two patients were still alive at 138 and 167 months. We found no significant relationship between type of chemotherapy and time to treatment failure or overall survival. MPNSTs are highly aggressive in NF1. Conventional chemotherapy does not seem to reduce mortality, and its role must be questioned. Recent advances in the molecular biology of MPNSTs may provide new prognostic factors and targeted therapies.


Disparities in human papillomavirus vaccination coverage in the United States, National Health and Nutrition Examination Survey, January 2017-March 2020.
We assessed disparities in HPV vaccination coverage by sociodemographic characteristics in the United States. Using 2017-March 2020 National Health and Nutrition Examination Survey data, we estimated vaccination coverage of ≥ 1 dose of HPV vaccine by race/ethnicity and poverty, insurance, and nativity status for females and males aged 9-14, 15-19, and 20-29 years. Among those aged 9-14 years, coverage among non-Hispanic Black (NHB), Hispanic, and non-Hispanic Asian (NHA) females (40.0%, 33.6%, 34.0%) and males (27.1%, 35.3%, 30.9%) was higher than non-Hispanic White (NHW) females (26.5%) and males (25.2%). Among those aged 15-19 and 20-29 years, coverage varied among NHB, Hispanic, and NHA compared to NHW females and was lower among NHB, Hispanic, and NHA than NHW males. Coverage was lower among uninsured than insured in most comparisons. HPV vaccination coverage varied by race/ethnicity and other characteristics. Efforts are needed to increase HPV vaccination coverage in all populations.


Achondroplasia.
Achondroplasia (MIM 100800) is the most common non-lethal skeletal dysplasia. Its incidence is between one in 10,000 and one in 30,000. The phenotype is characterized by rhizomelic disproportionate short stature, enlarged head, midface hypoplasia, short hands and lordotic lumbar spine, associated with normal cognitive development. This autosomal-dominant disorder is caused by a gain-of-function mutation in the gene encoding the type 3 receptor for fibroblast growth factor (FGFR3); in more than 95% of cases, the mutation is G380R. The diagnosis is suspected on physical examination and confirmed by different age-related radiological features. Anticipatory and management care by a multidisciplinary team will prevent and treat complications, including cervical cord compression, conductive hearing loss and thoracolumbar gibbosity. Weight counselling, psychosocial guidance and professional integration programmes play an important role in the global quality of life of these patients and their families.


Does cytomegalovirus infection contribute to socioeconomic disparities in all-cause mortality?
The social patterning of cytomegalovirus (CMV) and its implication in aging suggest that the virus may partially contribute to socioeconomic disparities in mortality. We used Cox regression and inverse odds ratio weighting to quantify the proportion of the association between socioeconomic status (SES) and all-cause mortality that was attributable to mediation by CMV seropositivity. Data were from the National Health and Nutrition Examination Survey (NHANES) III (1988-1994), with mortality follow-up through December 2011. SES was assessed as household income (income-to-poverty ratio ≤1.30;>1.30 to≤1.85;>1.85 to≤3.50;>3.50) and education (<high school; high school; >high school). We found strong associations between low SES and increased mortality: hazard ratio (HR) 1.80; 95% confidence interval (CI): 1.57, 2.06 comparing the lowest versus highest income groups and HR 1.29; 95% CI: 1.13, 1.48 comparing <high school versus >high school education. 65% of individuals were CMV seropositive, accounting for 6-15% of the SES-mortality associations. Age modified the associations between SES, CMV, and mortality, with CMV more strongly associated with mortality in older individuals. Our findings suggest that cytomegalovirus may partially contribute to persistent socioeconomic disparities in mortality, particularly among older individuals.


Reconstruction of High-Tension Scalp Defects by the Twizzler Technique: A Retrospective Case Series.
Scalp wounds are difficult to close primarily because of the inelasticity of the galea, often requiring adjacent tissue transfer or grafting. It is still debated whether intraoperative tissue expansion can occur on the scalp. We report our experience with the Twizzler technique, a form of intraoperative tissue expansion and load cycling, to achieve primary closure of high-tension scalp wounds. In this case series, scalp defects repaired by the Twizzler were identified and those with minimum 3 month follow-up underwent assessment by physicians and patients. All 50 scalp defects that could not be otherwise closed primarily were repaired successfully with the Twizzler. The average defect width was 2.0 cm (range 0.9-3.9 cm), the average physician aesthetic rating was 3.71 on a 5-point scale (very good; n = 25), and most patients rated the scars as "near normal skin" on the Patient and Observer Scar Assessment Scale 3.0 ( n = 32). Based on the findings of this case series, the Twizzler can be used to repair small and medium high-tension scalp defects after Mohs micrographic surgery. Intraoperative tissue expansion and creep deformation on the scalp is limited, but seemingly possible.


Predictors of Receipt of Clinical Preventive Services in Adolescents and Adults with Down Syndrome Accessing Medicaid.
Persons with Down syndrome (DS) require preventive care that addresses their age-/gender- and syndrome-specific needs. Yet, adolescents and adults with DS do not receive these preventive care services as recommended. To identify factors that predict receipt of age-/gender- and syndrome-specific preventive healthcare among adolescents and adults with DS. We hypothesized that more healthcare encounters and greater medical complexity would increase receipt of preventive care due to more opportunities to complete these activities. Using Medicaid claims (2006-2010) for California, Colorado, Michigan, and Pennsylvania, we conducted a retrospective cohort study of adolescents and adults with DS (≥12 years old). We modeled receipt of both ≥1 wellness examination and ≥1 thyroid function test (TFT) in 2009-2010 as a function of receipt of those same healthcare activities in 2006-08, adjusting for demographics, key comorbidities, and medical complexity using multivariable logistic regression. In this cohort of 3487 adolescents and adults with DS accessing Medicaid, 17% received both ≥1 wellness examination and ≥1 TFT in 2006-2008, 15% in 2009-2010, and only 7% during both time periods. Despite medical complexity and frequent healthcare interactions, the best predictor of future receipt of these activities was past receipt. State of residence variably impacted receipt of these preventive activities. Although past receipt of wellness examination and TFT was the best predictor of future receipt of these activities, overall rates were quite low in this cohort of adolescents and adults with DS. Further work is needed to improve preventive healthcare delivery to this vulnerable population.


Storing carbon in leaf lipid sinks enhances perennial ryegrass carbon capture especially under high N and elevated CO2.
By modifying two genes involved in lipid biosynthesis and storage [cysteine oleosin (cys-OLE)/diacylglycerol O-acyltransferase (DGAT)], the accumulation of stable lipid droplets in perennial ryegrass (Lolium perenne) leaves was achieved. Growth, biomass allocation, leaf structure, gas exchange parameters, fatty acids, and water-soluble carbohydrates were quantified for a high-expressing cys-OLE/DGAT ryegrass transformant (HL) and a wild-type (WT) control grown under controlled conditions with 1-10 mM nitrogen (N) supply at ambient and elevated atmospheric CO2. A dramatic shift in leaf carbon (C) storage occurred in HL leaves, away from readily mobilizable carbohydrates and towards stable lipid droplets. HL exhibited an increased growth rate, mainly in non-photosynthetic organs, leading to a decreased leaf mass fraction. HL leaves, however, displayed an increased specific leaf area and photosynthetic rate per unit leaf area, delivering greater overall C capture and leaf growth at high N supply. HL also exhibited a greater photosynthesis response to elevated atmospheric CO2. We speculate that by behaving as uniquely stable microsinks for C, cys-OLE-encapsulated lipid droplets can reduce feedback inhibition of photosynthesis and drive greater C capture. Manipulation of many genes and gene combinations has been used to increase non-seed lipid content. However, the cys-OLE/DGAT technology remains the only reported case that increases plant biomass. We contrast cys-OLE/DGAT with other lipid accumulation strategies and discuss the implications of introducing lipid sinks into non-seed organs for plant energy homeostasis and growth.


Driving with Type 1 Diabetes: Real-World Evidence to Support Starting Glucose Level and Frequency of Monitoring During Journeys.
There is limited evidence supporting the recommendation that drivers with insulin-treated diabetes need to start journeys with glucose >90 mg/dL. Glucose levels of drivers with type 1 diabetes were monitored for 3 weeks using masked continuous glucose monitoring (CGM). Eighteen drivers (median [IQR] age 40 [35, 51] years; 11 men) undertook 475 trips (duration 15 [13, 21] min). Hypoglycemia did not occur in any trip starting with glucose >90 mg/dL (92%; n = 436). Thirteen drivers recorded at least one trip (total n = 39) starting with glucose <90 mg/dL. Among these, driving glucose was <70 mg/dL in five drivers (38%) during 10 trips (26%). Among five drivers (28%), a ≥ 36 mg/dL drop was observed within 20 min of starting their journey. Journey duration was positively associated with maximum glucose change. These findings support current guidelines to start driving with glucose >90 mg/dL, and to be aware that glucose levels may change significantly within 20 min. A CGM-based, in-vehicle display could provide glucose information and alerts that are compatible with safe driving. Clinical Trial Registration number: ACTRN12617000520336.


ParD: a new gene coding for a protein required for chromosome partitioning and septum localization in Escherichia coli.
A new gene, parD, has been located at 88.5 min on the genetic map of E. coli. Cells carrying an amber mutation in this gene, together with a temperature-sensitive suppressor tRNA, are able to grow, synthesize DNA and divide at both 30 degrees C and 42 degrees C. At 42 degrees C, however, they are defective both in the separation of replicated chromosomes and in the placement of septa. Both the amount of DNA and the number of septa per cell mass are normal in cells growing at 42 degrees C: only the localization of the chromosomes and septa are altered. As a result, cells of random sizes are produced at 42 degrees C and the smallest of these contain no DNA.


Pharmacokinetics of flomoxef in plasma, peritoneal fluid, peritoneum, and subcutaneous adipose tissue of patients undergoing lower gastrointestinal surgery: Dosing considerations based on site-specific pharmacodynamic target attainment.
Flomoxef is generally used to treat abdominal infections and as antibiotic prophylaxis during lower gastrointestinal surgery. It is reportedly effective against extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae and an increasingly valuable alternative to carbapenems. However, its abdominal pharmacokinetics remain unclear. Herein, pharmacokinetic analysis of flomoxef in the abdominal tissue was conducted to simulate dosing regimens for pharmacodynamic target attainment in abdominal sites. Flomoxef (1 g) was administered intravenously to a patient 30 min before commencing elective lower gastrointestinal surgery. Samples of plasma, peritoneal fluid, peritoneum, and subcutaneous adipose tissue were collected during surgery. The flomoxef tissue concentrations were measured. Accordingly, non-compartmental and compartmental pharmacokinetic parameters were calculated, and simulations were conducted to evaluate site-specific pharmacodynamic target values. Overall, 41 plasma samples, 34 peritoneal fluid samples, 38 peritoneum samples, and 41 subcutaneous adipose samples from 10 patients were collected. The mean peritoneal fluid-to-plasma ratio in the areas under the drug concentration-time curve was 0.68, the mean peritoneum-to-plasma ratio was 0.40, and the mean subcutaneous adipose tissue-to-plasma was 0.16. The simulation based on these results showed the dosing regimens (q8h [3 g/day] and q6h [4 g/day]) achieved the bactericidal effect (% T > minimum inhibitory concentration [MIC] = 40%) in all tissues at an MIC of 1 mg/L. We elucidated the pharmacokinetics of flomoxef and simulated pharmacodynamics target attainment in the abdominal tissue. This study provides evidence concerning the use of optimal dosing regimens for treating abdominal infection caused by strains like ESBL-producing bacteria.


Herbert screw fixation of a capitellum fracture. A case report and review.
Fractures of the capitellum frequently result in significant osteochondral fragments that require internal fixation to restore the anatomic integrity of the elbow joint. Precise reduction is mandatory to maximize articular congruency and diminish the potential for arthrosis. Successful repair of a Type I capitellum fracture in a 54-year-old-woman was accomplished using the Herbert bone screw. This alternative treatment modality allowed for efficient and rigid fixation with less soft-tissue dissection and articular penetration than previously reported.


The Effects of Adding Reassurance Statements: Cancer Patients' Preferences for Phrases in End-of-Life Discussions.
When discussing end-of-life issues with cancer patients, the addition of reassurance statements is considered helpful. However, patients' preferences for such statements have not been systematically demonstrated. The objectives of this study were to clarify if phrases with additional reassurance statements would be more preferable to phrases without them and explore variables associated with patients' preferences. In a cross-sectional survey, 412 cancer patients assessed their own preferences for phrases with/without additional statements using a six-point scale (1 = not at all preferable; 6 = very preferable). These included the statements of "hope for the best and prepare for the worst" ("hope/prepare") when discussing prognosis; symptom palliation when discussing code status; and specific goals, continuity of care, and nonabandonment when discussing hospice referral. We evaluated demographic data and the coping style and conducted multivariate regression analysis. Compared with the phrase of life expectancy (i.e., median + typical range) alone [mean (SD), 3.5 (1.2); 95% CI, 3.4-3.6], the phrase with the additional "hope/prepare" statement was more preferable [3.8 (1.4); 3.7-3.9]. Compared with the phrase of do-not-resuscitate alone (3.1(1.3); 3.0-3.3), the phrase with the additional statement of symptom palliation was more preferable [3.9 (1.3); 3.7-4.0]. Compared with the phrase of hospice referral alone [3.4 (1.2); 3.3-3.5], phrases with the addition of a specific goal [3.9 (1.0); 3.8-4.0], specific goal and continuity (4.4(1.0); 4.3-4.5), and specific goal, continuity, and nonabandonment [4.8 (1.2); 4.7-4.9] were more preferable. In multivariate analyses, task-oriented coping was significantly correlated with preferences for phrases including additional reassurance statements. Cancer patients systematically preferred reassurance statements. In end-of-life discussions, especially with patients with task-oriented coping, clinicians may provide additional reassurance statements.


Dysregulated Tfr/Tfh2 cells in patients with polycystic ovarian syndrome.
Recent research revealed the pathogenic role of B cells in the pathogenesis of polycystic ovary syndrome (PCOS), while the Tfh cell plays a critical role in the B cell mediated autoantibody production and humoral immunity, but had not been investigated in PCOS patients. The frequency of Tfh and B cell subsets (Tfh1, Tfh2, Tfh17, naïve B, memory B, and plasma cells) in the peripheral blood of 21 PCOS patients and 15 healthy controls were investigated by flow cytometry. And the levels of follicle-stimulating hormone, luteinizing hormone, testosterone, prolactin and estradiol progesterone were measured by using the immunoluminescence method. Also, the associations between these hormone levels and Tfh cell subsets or B cell subsets were analyzed. No significant difference was observed in total Tfh cells between 21 PCOS patients and 15 healthy controls (p > 0.05). But the percentages of Tfh2 and plasma cells were significantly higher in 21 PCOS patients compared to 15 healthy controls (p < 0.05). In contrast, the frequency of Tfr cells and Tfr/Tfh2 ratio were significantly lower than healthy controls (p < 0.01). Importantly, among these cells, only the percentage of Tfh2 cells was positively correlated with the levels of testosterone (r = 0.513, p = 0.018). And the percentage of Tfr cells and Tfr/Tfh2 ratio were also positively correlated with the levels of testosterone (r = 0.567, p = 0.007; r = 0.434, p = 0.05) and prolactin (r = 0.511, p = 0.018; r = 0.490, p = 0.024). These new findings provide unique insights into dysregulated Tfh/Tfr cells in mediating the immunopathogenesis of PCOS patients.


Root growth and architecture of Tamarix chinensis in response to the groundwater level in the Yellow River Delta.
Investigate the growth adaptation law of the Tamarix chinensis root system in response to the groundwater level in a muddy coastal zone. The high groundwater level (0.7-0.9 m), medium groundwater level (1.1-1.3 m) and low groundwater level (1.5-1.7 m) T. chinensis forests on the beaches of the Yellow River Delta were used as the research objects. Full excavation methods were used to excavate root systems with different groundwater levels; then, the aboveground biomass, root biomass, root spatial distribution, root topological structure and fractal characteristics of T. chinensis response characteristics to groundwater level were measured and analysed. The results showed that with the decrease in the groundwater level, the soil water content and soil salt content showed upward trends. At high groundwater levels, T. chinensis reduced root biomass allocation to reduce the damage to roots caused by salinity. At low groundwater levels, T. chinensis strengthened the development of root systems, which greatly enhanced the ability of T. chinensis to balance its water intake. The root biomass at the high groundwater level was 43.06% lower than that at the low groundwater level. The relationship between root and shoot growth of T. chinensis at high groundwater levels and medium groundwater levels indicated allometric growth, and at low groundwater levels, roots and shoots grew uniformly. The root distribution of T. chinensis tended to be shallow at the different groundwater levels, showing the characteristics of a horizontal root type. At high groundwater levels, the root topological structure tended to be dichotomous, and the fractal dimension and fractal abundance values were both large, at 1.31 and 2.77, respectively. The branch complexity increased to achieve spatial expansion and increase plant stability. However, the topological structure of the medium and low groundwater level T. chinensis tended to be herringbone-like, the fractal dimension and fractal abundance values were small, the second branch was limited, and the structure was simple. The topological structure and fractal characteristics of the T. chinensis root system responded to different groundwater levels in a coordinated manner. Based on the differences in the growth and architecture of the T. chinensis root system, the T. chinensis root system has strong phenotypic plasticity to the heterogeneous water-salt habitat of the groundwater-soil system, and the T. chinensis root system shows strong root adaptability to water and salt stress.


Postnatal management of antenatally diagnosed ureteropelvic junction obstruction.
The management of antenatally diagnosed ureteropelvic junction obstruction (PUJO) is controversial. Here, we present our experience over a period of 13 years and discuss our management protocol. We reviewed the files of 234 patients with antenatally diagnosed congenital hydronephrosis due to PUJO. Management was tailored to each patient, based on a combination of diethylenetetraminepentacetic acid renogram outcome, pelvic diameter, as well as the patient's symptoms. Pyeloplasty was carried out early in 52 kidneys. Of the total, 182 patients were managed expectantly. Out of these, 45 underwent delayed pyeloplasty. The remaining 137 patients (189 units) were managed non-operatively. In patients who underwent early pyeloplasty, the mean split differential renal function was 37% before and 40.05% after surgery. In those with delayed intervention, the mean renal function was 37.8% before and 42.2% after surgery. In patients who did not have surgery, the mean differential renal function was 45.7% initially and 48.2% at the last accepted follow up. The overall operative success rate was 97.9%. We believe that pyeloplasty is the proper treatment for babies with congenital PUJO and <40% split differential function and/or pelvic diameter >35 mm at the initial visit. In other patients a period of observation is warranted, and pyeloplasty should be carried out only if their kidney function deteriorates or the renogram curve does not show improvement. With the excellent results of pyeloplasty we believe that a safer approach is to operate on more kidneys rather than risk of losing valuable kidney function.


Accuracy of body weight perception and obesity among Chinese Americans.
Accuracy of body weight perception is an individual's perception of their body weight in comparison with actual body weight and is associated with weight-related behaviors. Chinese Americans have increased risk for obesity but no studies have examined accuracy of body weight perception. This study was a descriptive and cross-sectional study, which was conducted in a community health center in New York. Study subjects were all Chinese-American adults. Demographic information, accuracy of perception of body weight, anthropometric measures (weight, height, body mass index [BMI], waist circumference [WC], hip circumference [HC], weight to height ratio, weight to hip ratio), fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1C) and obesity-related diseases (hypertension, diabetes, heart disease, and stroke) were assessed. A total of 162 Chinese Americans were recruited. 52 subjects (32%) did not perceive body weight correctly: 32 subjects had underestimation and 20 subjects had overestimation of body weight. Significant differences were found among subjects in the three groups of different accuracy of body weight perception in terms of gender (p=0.003), age (p=0.003), education years (p=0.047), WC (p<0.001), HC (p≤0.001), weight/height ratio (p=0.001), and BMI (p<0.001). Accuracy of perception of body weight significantly predicted WC (p<0.001), HC (p<0.001), weight to height ratio (p=0.001), BMI (p<0.001) and weight (<0.001) even after controlling for all demographic factors. The study identified that around one-third of Chinese Americans did not perceive their body weight correctly. Intervention studies for obesity management in Chinese Americans should address gender difference, target on older subjects, and focus on educating the normal values and significances of WC, HC and HbA1C among Chinese Americans.


[The possibilities for the correction of the co-morbid anxiety and depressive disorders in the patients suffering from chronic obstructive pulmonary disease by the methods of climatic therapy].
The present study included 142 patients presenting with grade I-III chronic obstructive pulmonary disease (COPD) treated based at a spa and health resort (SHR) facility located on the southern coast of the Crimea. The psycho-diagnostic testing was performed with the use of the Hamilton Rating Scale for Depression (HDRS) and the Ch.D. Spielberger - Yu.L. Khanin scale for reactive (situational) and personal anxiety. The anxiety-depressive disorders were diagnosed in 59,2% of the patients; their intensity correlated with the severity of COPD. The questionnaire study based at the Spilberger-Khanin made it possible to document the presence of moderate and severe anxiety in 68,3% of the patients. It was shown that a course of the spa and health resort-based treatment produced beneficial effect on the psycho-functional status of the patients with COPD that was especially well apparent in those with the mild form of COPD.


Psychometric properties of a structured interview guide for the rating for anxiety in dementia.
The Rating Anxiety in Dementia (RAID; Shankar, K.K., Walker, M., Frost, D., & Orrell, M.W. (1999). The development of a valid and reliable scale for rating anxiety in dementia (RAID). Aging and Mental Health, 3, 39-49.) is a clinical rating scale developed to evaluate anxiety in persons with dementia. This report explores the psychometric properties and clinical utility of a new structured interview format of the RAID (RAID-SI), developed to standardize administration and scoring based on information obtained from the patient, an identified collateral, and rater observation. The RAID-SI was administered by trained master's level raters. Participants were 32 persons with dementia who qualified for an anxiety treatment outcome study. Self-report anxiety, depression, and quality of life measures were administered to both the person with dementia and a collateral. The RAID-SI exhibited adequate internal consistency reliability and inter-rater reliability. There was also some evidence of construct validity as indicated by significant correlations with other measures of patient-reported and collateral-reported anxiety, and non-significant correlations with collateral reports of patient depression and quality of life. Further, RAID-SI scores were significantly higher in persons with an anxiety diagnosis compared to those without an anxiety diagnosis. There is evidence that the RAID-SI exhibits good reliability and validity in older adults with dementia. The advantage of the structured interview format is increased standardization in administration and scoring, which may be particularly important when RAID raters are not experienced clinicians.


Gender and age differentials in risk factors for childhood malnutrition in Bangladesh.
A case-control study of risk factors of clinical marasmus was undertaken to determine which factors differed according to gender and age groups. Case patients were children whose mid-upper arm circumference measured less than 110 mm and control subjects were children matched for age and sex with an arm circumference more than 120 mm. Between June 1988 and June 1989, 164 such pairs of children aged 1 to 4 years were studied. The effect of various demographic, socioeconomic, environmental, and health factors was investigated in a multivariate analysis using conditional logistic regression. Results showed an increased risk of marasmus among children with siblings under 5 years old. This increased risk was observed irrespective of gender or age. Children who consumed formula foods also had an increased risk of marasmus. Again, this elevated risk was maintained for boys and girls. Overall, higher maternal education was associated with a reduced risk of marasmus; however, this was only statistically significant for boys and for children 18 months or older. Religion was also associated with marasmus but only in older children (> or = 18 months). These results indicate that better strategic planning is necessary to formulate effective interventions to reduce severe malnutrition, particularly in societies where strong age- and sex-preferential behavior exists.


Sulfonated modification of cotton linter and its application as adsorbent for high-efficiency removal of lead(II) in effluent.
Sulfonated modification of cotton linter and its novel application as adsorbent for Pb(2+) in effluent were investigated. Results show that sulfonated cotton linter (SCL) has strong adsorbability for Pb(2+), more than 85% of Pb(2+) can be removed at lower Pb(2+) concentration (<20 mg/L). Its adsorbability for Pb(2+) is related to effluent pH, temperature, and initial Pb(2+) concentration. The adsorption process can reach equilibrium within 8 min, which can be described through the pseudo-second-order kinetic model. The adsorption isotherm is closely fitted with the Temkin isotherm model, which suggests that the adsorption of Pb(2+) on SCL can be regarded as chemical adsorption. The adsorption process of Pb(2+) on SCL is non-spontaneous and endothermic, based on the value of Gibbs free energy and enthalpy. Compared with commercial activated carbon, SCL is simple to prepare and does not require any special technology.


Inhibitory effects of dihydroagarofuran sesquiterpenes on Epstein-Barr virus activation.
To search for possible antitumor promoters, we carried out a primary screening of thirty-seven dihydroagarofuran sesquiterpenes from Tripterygium wilfordii Hook fil. var. regelii Makino and Euonymus sieboldianus Blume, using their possible inhibitory effects on the Epstein-Barr virus early antigen (EBV-EA) activation which is induced by 12-O-tetradecanoylphorbol-13-acetate (TPA) in Raji cells. Some of these sesquiterpenes, triptofordin F-2 (Takaishi et al., 1988), 1,2,6,8,15-pentaacetoxy-9-benzoyloxy-4-hydroxy-beta-dihydroagarofuran and triptogelin A-1 (Takaishi et al., 1990) were observed to significantly inhibit the EBV-EA activation at low doses. Based on the results, the structural requirements for the activity of these compounds were discussed [corrected].


Lead, cadmium, iron, zinc, copper, manganese, calcium and magnesium in SPF male rats exposed to a dilution of automotive exhaust gas throughout their lives.
Male pathogen free CFE albino Sprague Dawley rats were exposed 8 h per day, 5 days per week, for three years to a 1/1000 dilution of automotive exhaust gas, containing 58 ppm carbon monoxide, 0.37% carbon dioxide, 23 ppm nitrogen oxides, 2 ppm aldehydes, less than 5 mg/l hydrocarbons and 8.5 micrograms/m3 lead. Lead, cadmium, iron, zinc, calcium and magnesium were measured by atomic absorption in the femurs and tibias of the rats which died during the experiment. A comparison with two control groups revealed that the only significant difference in the elements measured in the bones was a 500% increase in lead concentration. The calculations of the correlations between the percentages of the elements in bones, the ages and the body weights of the rats, as well as cluster analysis, did not show consistent variations of the water, calcium, magnesium concentrations nor of the other studied metals related to this increase in lead concentration. Moreover, longevity was the same in the 3 groups of rats, but the body weight was statistically smaller (4%) in the group exposed to the auto exhaust dilution.


Kidney transplant in the next decade: Strategies, challenges and vision of the future.
Although the results of kidney transplantation (KT) have improved substantially in recent years, a chronic and inexorable loss of grafts mainly due to the death of the patient and chronic dysfunction of the KT, continues to be observed. The objectives, thus, to optimize this situation in the next decade are fundamentally focused on minimizing the rate of kidney graft loss, improving patient survival, increasing the rate of organ procurement and its distribution, promoting research and training in health professionals and the development of scientific registries providing clinical and reliable information that allow us to optimize our clinical practice in the field of KT. With this perspective, this review will deep into: (1) strategies to avoid chronic dysfunction and graft loss in the medium and long term; (2) to prolong patient survival; (3) strategies to increase the donation, maintenance and allocation of organs; (4) promote clinical and basic research and training activity in KT; and (5) the analysis of the results in KT by optimizing and merging scientific registries.


High-field MRI.
High-field MRI is moving rapidly from the research realm to clinical use. This modality has intrinsic advantages in signal to noise ratio, which allows images that have im-proved resolution, are obtained faster, or have less noise. Perhaps most importantly these scanners will allow functional imaging to become a reality in the musculoskeletal system. Care must be used in protocols because of the energy deposition and worsened artifacts at higher fields.


Management of recurrent cervical cancer: a review of the literature.
The aim of this narrative review is to update the current knowledge on the treatment of recurrent cervical cancer based on a literature review. A web based search in Medline and CancerLit databases has been carried out on recurrent cervical cancer management and treatment. All relevant information has been collected and analyzed, prioritizing randomized clinical trials. Cervical cancer still represents a significant problem for public health with an annual incidence of about half a million new cases worldwide. Percentages of pelvic recurrences fluctuate from 10% to 74% depending on different risk factors. Accordingly to the literature, it is suggested that chemoradiation treatment (containing cisplatin and/or taxanes) could represent the treatment of choice for locoregional recurrences of cervical cancer after radical surgery. Pelvic exenteration is usually indicated for selected cases of central recurrence of cervical cancer after primary or adjuvant radiation and chemotherapy with bladder and/or rectum infiltration neither extended to the pelvic side walls nor showing any signs of extrapelvic spread of disease. Laterally extended endopelvic resection (LEER) for the treatment of those patients with a locally advanced disease or with a recurrence affecting the pelvic wall has been described. The treatment of recurrences of cervical carcinoma consists of surgery, and of radiation and chemotherapy, or the combination of different modalities taking into consideration the type of primary therapy, the site of recurrence, the disease-free interval, the patient symptoms, performance status, and the degree to which any given treatment might be beneficial.


Syndromology: an updated conceptual overview. VII. Aspects of teratogenesis.
Principles of teratogenesis are reviewed, including adverse environmental factors and the genotype, timing of exposure, mechanisms and pathogenesis, the nature of teratogenic agents, manifestations of deviant development, and dosage. Human teratogenic conditions are summarized with special emphasis on the fetal alcohol syndrome, fetal hydantoin syndrome, fetal trimethadione syndrome, fetal valproate syndrome, warfarin embryopathy, retinoic acid embryopathy, congenital rubella syndrome, radiation effects, and diabetic embryopathy.


Planting Jatropha curcas on constrained land: emission and effects from land use change.
A study was carried out to assess carbon emission and carbon loss caused from land use change (LUC) of converting a wasteland into a Jatropha curcas plantation. The study was conducted for 12 months at a newly established Jatropha curcas plantation in Port Dickson, Malaysia. Assessments of soil carbon dioxide (CO(2)) flux, changes of soil total carbon and plant biomass loss and growth were made on the wasteland and on the established plantation to determine the effects of land preparation (i.e., tilling) and removal of the wasteland's native vegetation. Overall soil CO(2) flux showed no significant difference (P < 0.05) between the two plots while no significant changes (P < 0.05) on soil total carbon at both plots were detected. It took 1.5 years for the growth of Jatropha curcas to recover the biomass carbon stock lost during land conversion. As far as the present study is concerned, converting wasteland to Jatropha curcas showed no adverse effects on the loss of carbon from soil and biomass and did not exacerbate soil respiration.


The petrous apex.
Petrous apex lesions are rare, but when present, they can usually be precisely defined. The key to their identity consists of answering five questions: 1) Is the abnormality arising in the petrous apex or from contiguous areas? 2) Are the bony walls of the apex and the septations in the air cells smoothly remodeled? 3) What are the MR imaging signal characteristics of the lesion? 4) Is there enhancement of the internal "matrix" of the lesion? 5) What is the relationship of the lesion to the carotid artery?


A walk around the application of nanocatalysts for cross-dehydrogenative coupling of C-H bonds.
Cross-dehydrogenative coupling reactions between two unmodified C-H bonds are one of the most attractive and fundamental strategies for the construction of C-C bonds. As these reactions avoid pre-functionalization and de-functionalization of the substrates, they are cleaner, safer, and faster than traditional cross-coupling reactions. After the introduction of the modern area of cross-dehydrogenative coupling in 2003, many efforts have been devoted to the development of more efficient and selective catalytic systems for these appealing reactions. Among the different types of catalytic systems that have been investigated, nanostructured metal catalysts are highly attractive in view of their high catalytic performance, easy separability and good reusability. The purpose of this review is to focus on the application of nanocatalysts for cross-dehydrogenative coupling of C-H bonds with particular emphasis on the mechanistic aspects of the reactions. Specifically, we have structured this review based on the type of C-C bonds. Thus, the review is divided into six major sections: (i) C(sp3)-C(sp3) coupling; (ii) C(sp3)-C(sp2) coupling; (iii) C(sp3)-C(sp) coupling; (iv) C(sp2)-C(sp2) coupling; (v) C(sp2)-C(sp) coupling; and (vi) C(sp)-C(sp) coupling.


Thrombosis on implanted device for atrial septal defect closure or echocardiographic beam width artifact? A diagnostic enigma!
A 29 year old woman with NYHA functional class II and large secundum type atrial septal defect (ASD) underwent successfully percutaneous ASD closure with Figula ASD occluder (no. 30) without any peri-procedural complication. After 2 days she underwent transthoracic echocardiography and a large hypo-echoic mass was seen on left atrial side of implanted device in multiple views, suggestive of thrombosis or echocardiographic beam width artifact? A diagnostic enigma!


Progress in understanding the neuronal SNARE function and its regulation.
Vesicle budding and fusion underlies many essential biochemical deliveries in eukaryotic cells, and its core fusion machinery is thought to be built on one protein family named soluble N-ethylmaleimide-sensitive factor attachment protein receptor (SNARE). Recent technical advances based on site-directed fluorescence labelling and nano-scale detection down to the single-molecule level rapidly unveiled the protein and the lipid intermediates along the fusion pathway as well as the molecular actions of fusion effectors. Here we summarize these new exciting findings in context with a new mechanistic model that reconciles two existing fusion models: the proteinaceous pore model and the hemifusion model. Further, we attempt to locate the points of action for the fusion effectors along the fusion pathway and to delineate the energetic interplay between the SNARE complexes and the fusion effectors.


The action of human pancreatic and salivary isoamylases on starch and glycogen.
The hydrolytic properties of the isoenzymes of human pancreatic and salivary alpha-amylase (1,4-glucan 4-glucanohydrolase, EC 126.96.36.199) were studied. The eight pancreatic isoenzymes split glycogen and starch into glucose, maltose, maltotriose, maltotetraose and oligosaccharides of 5-10 glucose units. Maltotetraose is further digested to lower homologues. The percentage of conversion to those products is dependent on the substrate and varies from one isoenzyme to another. The six salivary isoenzymes split glycogen and starch into maltose, maltotriose, maltotetraose, pannose and oligosaccharides of 5--10 glucose units. Maltotetraose and pannose are further digested to lower homologues. The percentage of conversion to these products is dependent on the substrate and is specific for each isoenzyme.


Rhabdomyoma of the Larynx: A Case Report and Literature Review of a Rare Tumor in an Uncommon Location.
Laryngeal rhabdomyomas are extremely rare, benign striated muscle tumors that have been documented only ∼50 times in the literature. They can be subdivided into two types: fetal and adult types, with the adult type being more common. Common presenting symptoms include hoarseness or progressive dysphagia. Diagnosis is made via immunohistochemical and microscopic analysis. Management is typically surgical, most commonly endoscopic, or open resection. A comprehensive literature review was conducted with PubMed's MEDLINE index using the following search string: "rhabdomyoma" AND ("larynx" OR "laryngeal" OR "head" OR "neck"). After exclusion criteria were applied, a total of 58 cases were included. The purpose of our literature review was to elucidate information about age/gender, location, size, chief complaint and duration, treatment, and recurrence from each of the 58 cases to identify trends that could guide future diagnosis and management. The average age at diagnosis of laryngeal rhabdomyoma was 52.6 years with a 2.22:1 male predominance. Hoarseness and/or dysphonia was the most common chief complaint (42/58 cases, 72%), followed by dysphagia (12/58 cases, 21%). Common treatment options included endoscopic excision (18/48 cases, 37.5%) or open surgical resection (10/48 cases, 21%). Tumor recurrence was reported in 5/40 cases (14%), most likely due to incomplete removal of the tumor. Although laryngeal rhabdomyomas are rare, they should be considered in the differential diagnosis for patients with a submucosal laryngeal mass. Curative treatment is surgical via endoscopic resection. It is the preferred technique because of decreased morbidity compared to open resection. However, endoscopic resection was shown to have both higher rates of recurrence and shorter time to recurrence compared to open resection, necessitating frequent postoperative surveillance.


Corrigendum: Evaluation of self-reported confidence amongst radiology staff in initiating basic life support across hospitals in the Cape Town Metropole West region.
[This corrects the article DOI: 10.4102/sajr.v23i1.1720.].


A meta-analysis on decomposition quantifies afterlife effects of plant diversity as a global change driver.
Biodiversity loss can alter ecosystem functioning; however, it remains unclear how it alters decomposition-a critical component of biogeochemical cycles in the biosphere. Here, we provide a global-scale meta-analysis to quantify how changes in the diversity of organic matter derived from plants (i.e. litter) affect rates of decomposition. We find that the after-life effects of diversity were significant, and of substantial magnitude, in forests, grasslands, and wetlands. Changes in plant diversity could alter decomposition rates by as much as climate change is projected to alter them. Specifically, diversifying plant litter from mono- to mixed-species increases decomposition rate by 34.7% in forests worldwide, which is comparable in magnitude to the 13.6-26.4% increase in decomposition rates that is projected to occur over the next 50 years in response to climate warming. Thus, biodiversity changes cannot be solely viewed as a response to human influence, such as climate change, but could also be a non-negligible driver of future changes in biogeochemical cycles and climate feedbacks on Earth.


Uterine secretion during the sexual cycle in the rat and its capacity to disperse corona cells in vitro.
It was found that closure of the uterus disturbed the first 2 cycles after the operation; thereafter the normal cycle was resumed. The quantity of uterine fluid was increased at pro-oestrus and oestrus and reduced at met-oestrus and di-oestrus. Slight inverse changes in viscosity were observed. There was no significant difference in the pH. The corona-cell dispersing factor seems to be an oestrogen-dependent constituent of uterine secretion.


Correction: Defining the microbial transcriptional response to colitis through integrated host and microbiome profiling.
An amendment to this paper has been published and can be accessed via a link at the top of the paper.


Oral butyrate reduces oxidative stress in atherosclerotic lesion sites by a mechanism involving NADPH oxidase down-regulation in endothelial cells.
Butyrate is a 4-carbon fatty acid that has antiinflammatory and antioxidative properties. It has been demonstrated that butyrate is able to reduce atherosclerotic development in animal models by reducing inflammatory factors. However, the contribution of its antioxidative effects of butyrate on atherogenesis has not yet been studied. We investigated the influence of butyrate on oxidative status, reactive oxygen species (ROS) release and oxidative enzymes (NADPH oxidase and iNOS) in atherosclerotic lesions of ApoE(-/-) mice and in oxLDL-stimulated peritoneal macrophages and endothelial cells (EA.hy926). The lesion area in aorta was reduced while in the aortic valve, although lesion area was unaltered, superoxide production and protein nitrosylation were reduced in butyrate-supplemented mice. Peritoneal macrophages from the butyrate group presented a lower free radical release after zymosan stimulus. When endothelial cells were pretreated with butyrate before oxLDL stimulus, the CCL-2 and superoxide ion productions and NADPH oxidase subunit p22phox were reduced. In macrophage cultures, in addition to a reduction in ROS release, nitric oxide and iNOS expression were down-regulated. The data suggest that one mechanism related to the effect of butyrate on atherosclerotic development is the reduction of oxidative stress in the lesion site. The reduction of oxidative stress related to NADPH oxidase and iNOS expression levels associated to butyrate supplementation attenuates endothelium dysfunction and macrophage migration and activation in the lesion site.


Exogenous 25-hydroxycholecalciferol does not attenuate salt-induced hypertension.
We have reported that an inverse relationship exists between blood pressure and plasma concentration of 25-hydroxyvitamin D, the precursor of the hormonal form of vitamin D, for Dahl salt-sensitive rats fed a high salt diet. Plasma 25-hydroxyvitamin D concentrations decreased with time on the diet, as blood pressure increased. Experiments were conducted to determine whether the blood pressure increase of salt-sensitive rats fed a high salt diet could be attenuated by exogenous 25-hydroxycholecalciferol. Dahl salt-sensitive rats were fed a high salt diet and administered exogenous 25-hydroxycholecalciferol via subcutaneously implanted Alzet pumps. Exogenous 25-hydroxycholecalciferol (various doses from 28 to 80 microg/kg body weight-day) had no significant effect on the blood pressure of vitamin D-replete rats fed a high salt diet for 15 days. When exogenous 25-hydroxycholecalciferol (28 and 60 microg/day-kg body weight) was administered to vitamin D-depleted salt-sensitive rats, plasma 25-hydroxyvitamin D concentrations of the rats fed a low salt diet (26 +/- 2 and 59 +/- 6 nM) were proportional to the 25-hydroxycholecalciferol concentration in the pumps. Plasma 25-hydroxyvitamin D concentrations of the rats fed a high salt diet (18 +/- 1 and 23 +/- 3 nM) were not proportional to the 25-hydroxycholecalciferol concentration in the pumps, but were inversely proportional to the blood pressure of the rats. These data indicate no ameliorating effect of exogenous 25-hydroxycholecalciferol on salt-induced hypertension, but accelerated metabolism and/or clearance of 25-hydroxycholecalciferol in salt-induced hypertension.


The global regulator SpoVG regulates Listeria monocytogenes biofilm formation.
Biofilms provide a suitable environment for L. monocytogenes and are the cause of enormous risks in the food industry. SpoVG is a global regulatory factor that plays a vital role in physiological activity of L. monocytogenes. We constructed spoVG mutant strains to investigate the effects of these mutants on L. monocytogenes biofilms. The results show that L. monocytogenes biofilm formation was decreased by 40%. Furthermore, we measured biofilm related phenotypes to study the regulation of SpoVG. The motility capacity of L. monocytogenes was found to decrease after the deletion of spoVG. The cell surface properties changed in the spoVG mutant strains, with an increase in both the cell surface hydrophobicity and the auto-aggregation capacity after spoVG deletion. SpoVG mutant strains were found to be more sensitive to antibiotics, and had a reduced tolerance to inappropriate pH, salt stress and low temperature. The RT-qPCR results showed that SpoVG effectively regulated the expression of genes related to quorum sensing, flagella, virulence and stress factors. These findings suggest that spoVG has potential as a target to decrease biofilm formation and control L. monocytogenes contamination in the food industry.


Internalization of E. coli ST mediated by guanylyl cyclase C in T84 human colon carcinoma cells.
Internalization of Escherichia coli heat-stable enterotoxin (ST) mediated by guanylyl cyclase C was examined in T84 human colon carcinoma cells. Surface-associated, receptor-bound ST was quantitatively separated from intracellular ligand employing acidic guanidine-HCl. ST was internalized in a time-, temperature-, and ligand concentration-dependent fashion only by cells specifically expressing guanylyl cyclase C. Only receptors which bound reversibly to ST appeared to mediate endocytosis. The rate of internalization of ST empirically determined in these studies was 0.23 min-1. The density of surface receptors for ST was similar at 4 degrees C and 37 degrees C, suggesting that these receptors recycle back to the cell surface following internalization of ligand. Similarly, internalized ST was rapidly cleared from the intracellular compartment following endocytosis. These studies demonstrate that ST undergoes ligand-dependent receptor-mediated endocytosis in human colon carcinoma cells.


Malignant eccrine spiradenoma: a meta-analysis of reported cases.
Malignant eccrine spiradenoma is an aggressive sweat gland tumor with poorly understood behavior and no currently accepted therapeutic regimen. An individual patient data meta-analysis with Kaplan–Meier survival curves was performed on 72 reported cases of malignant eccrine spiradenoma. In 35 patients with no distant metastasis, local resection resulted in 100% disease-free survival. Of 7 patients with lymph node but no distant metastasis treated with surgical resection and lymph node dissection, 6 patients remained disease-free at final follow-up evaluation. For the 24 cases with confirmed distant metastatic disease, patient survival did not significantly differ between local resection and surgery with adjuvant chemoradiotherapy (P = .8763). Heightened awareness is recommended among surgeons likely to treat this entity. An aggressive surgical approach is supported in the absence of metastasis. When lymph nodes are not clinically involved, sentinel node may have a role followed by lymph node dissection in patients with a positive node.


Can an adjuvant treatment or a pharmacologic prevention be common to several diseases? The case of those associated to neuromediator defects.
The author has tried to extrapolate on several neurological diseases of the ageing, Knoll's proposition to treat Parkinson's disease chronically for relapse prevention, by MAO-B. At this occasion, the author makes a critical review of the clinical trial results concerning the new different series of depression treatments, as most authors propose today to use some new ones not only in depression, but in Parkinson's and Alzheimer's diseases and in ageing.


Increased susceptibility to quinolinic acid-induced seizures and long-term changes in brain oscillations in an animal model of glutaric acidemia type I.
Glutaric acidemia type I (GA-I) is an inborn error of metabolism of lysine, hydroxylysine, and tryptophan, caused by glutaryl-CoA-dehydrogenase (GCDH) deficiency, characterized by the buildup of toxic organic acids predominantly in the brain. After acute catabolic states, patients usually develop striatal degeneration, but the mechanisms behind this damage are still unknown. Quinolinic acid (QA), a metabolite of the kynurenine pathway, increases especially during infections/inflammatory processes, and could act synergically with organic acids, contributing to the neurological features of GA-I. The aim of this study was to investigate whether QA increases seizure susceptibility and modifies brain oscillation patterns in an animal model of GA-I, the Gcdh-/- mice taking high-lysine diet (Gcdh-/- -Lys). Therefore, the characteristics of QA-induced seizures and changes in brain oscillatory patterns were evaluated by video-electroencephalography (EEG) analysis recorded in Gcdh-/- -Lys, Gcdh+/+ -Lys, and Gcdh-/- -N (normal diet) animals. We found that the number of seizures per animal was similar for all groups receiving QA, Gcdh-/- -Lys-QA, Gcdh+/+ -Lys-QA, and Gcdh-/- -N-QA. However, severe seizures were observed in the majority of Gcdh-/- -Lys-QA mice (82%), and only in 25% of Gcdh+/+ -Lys-QA and 44% of Gcdh-/- -N-QA mice. All Gcdh-/- -Lys animals developed spontaneous recurrent seizures (SRS), but Gcdh-/- -Lys-QA animals had increased number of SRS, higher mortality rate, and significant predominance of lower frequency oscillations on EEG. Our results suggest that QA plays an important role in the neurological features of GA-I, as Gcdh-/- -Lys mice exhibit increased susceptibility to intrastriatal QA-induced seizures and long-term changes in brain oscillations.


Lignite effects on NH3, N2O, CO2 and CH4 emissions during composting of manure.
Production of compost from cattle manure results in ammonia (NH3) and greenhouse gas emissions, causing the loss of valuable nitrogen (N) and having negative environmental impacts. Lignite addition to cattle pens has been reported to reduce NH3 emissions from manure by approximately 60%. However, the effect of lignite additions during the manure composting process, in terms of gaseous emissions of NH3, nitrous oxide (N2O), carbon dioxide (CO2), and methane (CH4) is not clear. This composting study was conducted at a commercial cattle feedlot in Victoria, Australia. Prior to cattle entering the feedlot, we applied 4.5 kg m-2 of dry lignite to a treatment pen, and no lignite to a control pen. After 90 days of occupancy, the cattle were removed and the accumulated manure from each pen was used to form two separate compost windrows (control and treatment). During composting we collected manure samples regularly and quantified gaseous emissions of NH3, N2O, CO2, and CH4 from both windrows with an inverse-dispersion technique using open-path Fourier transform infrared spectroscopy (OP-FTIR). Over the 87-day measurement period, the cumulative gas fluxes of NH3, N2O, CO2, and CH4 were 3.4 (± 0.6, standard error), 0.4 (± 0.1), 932 (± 99), and 1.2 (± 0.3) g kg-1 (initial dry matter (DM)), respectively for the lignite amended windrow, and 7.2 (± 1.3), 0.1 (± 0.03), 579 (± 50) and -0.5 (± 0.1) g kg-1 DM, respectively for the non-lignite windrow. The addition of lignite reduced NH3 emissions by 54% during composting, but increased total greenhouse gas (GHG) emissions by 2.6 times. Total N losses as NH3-N and N2O-N were approximately 11 and 25% of initial N for the lignite and non-lignite windrows, respectively. The effectiveness of retaining N was obvious in the first three weeks after windrow formation. A cost-benefit analysis indicated that the benefit of lignite addition to cattle pens by reduced NH3 emission could justify the trade-off of increased GHG emissions.


Sustained levels of progesterone prior to the onset of cerebral ischemia are not beneficial to female mice.
Female gender, which is abolished following ovariectomy and reproductive senescence, is associated with improved outcome following cerebral stroke. Estrogen replacement partially restores this benefit of the female gender but the effect of progesterone in hormone-deficient animals is currently unknown. We evaluated various outcomes following middle cerebral artery occlusion (MCAO) in ovariectomised female mice, with a physiologically relevant restoration of progesterone levels. Ovariectomised female mice had significantly elevated plasma (P=<0.05) and brain progesterone levels (P=<0.01) following implantation of a 21-day release pellet (50mg) compared with mice that received placebo implants 7 days prior to undergoing 60 min MCAO. Assessment of well-being (body weight recovery) and neurological score at 24h and 48h post-MCAO indicated that MCAO significantly worsened outcome compared with sham-operated mice but progesterone had no effect. MCAO resulted in a substantial lesion formation and a significant increase (P<0.05) in ipsilateral brain water content, both of which were not affected by progesterone treatment. Furthermore, there was no significant alteration in ipsilateral Aquaporin-4 (AQP4) expression following MCAO or progesterone treatment. The present study indicates that sustained physiologically relevant levels of progesterone prior to cerebral ischemia neither benefited nor worsened outcomes in previously ovariectomised female mice.


Risk and prevalence of oral cancer in patients with different types of lupus erythematosus: a systematic review and meta-analysis.
The objective of this study was to assess the risk and prevalence of oral cancer in patients with systemic lupus erythematosus (SLE) or discoid lupus erythematosus (DLE). The review included observational cohort and cross-sectional studies that investigated the incidence or prevalence of oral cancer in adults with confirmed diagnoses of SLE or DLE. Studies were selected based on predefined eligibility criteria, including the use of specific diagnostic criteria for SLE and DLE. After searches in PubMed/MEDLINE, EMBASE, Scopus, Web of Science, LILACS, and LIVIVO databases and gray literature for relevant studies, the selection process was conducted by independent reviewers. A total of 5,545 articles were identified. After screening, 8 studies met the inclusion criteria. The pooled risk estimate indicated a significantly increased risk of oral cancer in patients with SLE (risk ratio = 2.69; 95% confidence interval, 1.75 to 4.16; I2 = 0%; P = .78) compared with the general population. The pooled prevalence of oral cancer in patients with DLE was 10% (95% ci, 0.03 to 0.13; I2 = 59%; P = .12). This review provides evidence supporting an elevated risk for individuals with SLE or DLE developing oral cancer. The findings highlight the importance of monitoring oral mucosa in patients with these conditions.


Syntheses and crystal structures of three salts of 1-(4-nitro-phenyl)-piperazine.
The crystal structures and Hirshfeld surface analyses of three salts of 1-(4-nitro-phenyl)-piperazine with 2-chloro-benzoic acid, 2-bromo-benzoic acid and 2-iodo-benzoic acid are reported. The chloro-benzoate salt, C10H14N3O2 +·C7H4ClO2 -, contains whole-ion-disordered cations and anions, which were modeled with two equivalent conformations with occupancies of 0.745 (10)/0.255 (10) and 0.563 (13)/0.437 (13), respectively. The bromo-benzoate and iodo-benzoate derivatives are isomorphous and crystallize as hemihydrates, viz. C10H14N3O2 +·C7H4BrO2 -·0.5H2O and C10H14N3O2 +·C7H4IO2 -·0.5H2O, respectively [the water mol-ecule is disordered over two locations with occupancies of 0.276 (3)/0.223 (3) for the iodo-benzoate derivative]. In the extended structures, all three salts feature an R 4 4(12) loop of two anions and two cations linked by N-H⋯O hydrogen bonds.


The other side to the use of active targeting ligands; the case of folic acid in the targeting of breast cancer.
Due to its overexpression in cancer cells, the folate receptor (FR) is heavily exploited in the active targeting of nanoparticles (NPs). Its ligand, folic acid (FA) is as a consequence widely used as a NP targeting ligand. Although rather popular and successful in principle, recent data has shown that FA may result in breast cancer initiation and progression, which questions the suitability of FA as NP cancer targeting ligand. In this work, intravenous administration of free FA to healthy female mice resulted in breast tissue dysplasia, hyperplasia and in the increased expression of human epidermal growth factor receptor-2 (HER2), folate receptor (FR), cancer antigen 15-3 (CA15.3), vascular endothelial growth factor (VEGF), signal transducer and activator of transcription 3 (STAT3) and the pro-inflammatory cytokines, tumor necrosis factor alpha (TNFα), interleukin-6 (IL-6) and interleukin-1β. In addition to the reduction in IL2. To evaluate the suitability and safety of FA as NP targeting ligand in breast cancer, small (≈ 150 nm) and large (≈ 500 nm) chitosan NPs were formulated and decorated with two densities of FA. The success of active targeting by FA was confirmed in two breast cancer cell lines (MCF-7 and MDA-MB-231 cells) in comparison to HEK293 cells. FA modified NPs that demonstrated successful active targeting in-vitro were assessed in-vivo. Upon intravenous administration, large NPs modified with a high density of FA accumulated in the breast tissue and resulted in similar effects as those observed with free FA. These results therefore question the suitability of FA as a targeting ligand in breast cancer and shed light on the importance of considering the activity (other than targeting) of the ligands used in NP active targeting.


Bridging Scales: a Hybrid Model to Simulate Vascular Tumor Growth and Treatment Response.
Cancer is a disease driven by random DNA mutations and the interaction of many complex phenomena. To improve the understanding and ultimately find more effective treatments, researchers leverage computer simulations mimicking the tumor growth in silico. The challenge here is to account for the many phenomena influencing the disease progression and treatment protocols. This work introduces a computational model to simulate vascular tumor growth and the response to drug treatments in 3D. It consists of two agent-based models for the tumor cells and the vasculature. Moreover, partial differential equations govern the diffusive dynamics of the nutrients, the vascular endothelial growth factor, and two cancer drugs. The model focuses explicitly on breast cancer cells over-expressing HER2 receptors and a treatment combining standard chemotherapy (Doxorubicin) and monoclonal antibodies with anti-angiogenic properties (Trastuzumab). However, large parts of the model generalize to other scenarios. We show that the model qualitatively captures the effects of the combination therapy by comparing our simulation results with previously published pre-clinical data. Furthermore, we demonstrate the scalability of the model and the associated C++ code by simulating a vascular tumor occupying a volume of 400mm3 using a total of 92.5 million agents.


Cytological and molecular characterization of Vicia barbazitae Ten. & Guss.
Vicia barbazitae, a taxon belonging to section Vicia of subgenus Vicia, was recovered and analysed by cytological, karyological and molecular methods with the aim of both proposing a general characterisation of this species and studying the relationships among the species of section Vicia . Phylogenetic relationships among the species of the section Vicia and those of the sections Microcarinae, Wiggersia and Atossa were also analysed. Automated karyotype analysis has been determined after Feulgen's reaction; chromosome banding was performed by sequence-specific fluorochrome staining. Fluorescent chromosome banding showed CMA(+)/DAPI(-) NOR-associated heterochromatin in the satellite pair. Karyomorphological parameters, based on symmetry indices, the dendrogram of linkage distance constructed on 37 chromosome parameters, as well as the molecular data based on internal transcribed spacer sequences provided information about phylogenetic position of this species inside the section Vicia and among the species belonging to the sections Microcarinae, Wiggersia, Atossa and Vicia. From our karyological and molecular results, it emerges that V. barbazitae can be considered a natural member of section Vicia.


In vitro exposure of leukemic cells to low concentration Arabinosyl Cytosine: no evidence of differentiation inducing activity.
Low dose Arabinosyl Cytosine (LD ARA-C) is widely used for treatment of acute non-lymphocytic leukemia (ANLL) and myelodysplastic syndrome (MDS) in the elderly, based on a favorable response rate and on the hypothesis that LD ARA-C can induce differentiation or maturation of leukemic cells. We investigated the effect of low concentration of ARA-C on the growth of marrow cells that were obtained from 6 cases of MDS and from 11 cases of ANLL by using the in vitro culture system for normal granulo-monocyte precursors (CFU-GM). At ARA-C concentrations equal to or higher than 1 ng/ml cell growth was inhibited in a dose-dependent manner. At ARA-C concentration of 0.1 ng/ml cell growth was slightly affected, but colony number and colony cell composition were identical to control cultures. This experiment did not support the hypothesis that ARA-C can induce leukemic cells to recover any normal growth patterns but confirmed that even very low ARA-C concentrations can inhibit or slow down leukemic cell proliferation.


Intense eosinophilic stromal infiltration in carcinoma of the uterine cervix: a clinicopathologic study of 14 cases.
Stromal responses to tumor, usually characterized by the intensity of the lymphoplasmacytic infiltration, have been felt to be of prognostic significance in a wide range of neoplasms. Little attention has been focused on stromal reactions composed primarily of infiltration by eosinophilic leukocytes. We describe here the clinical and histopathological findings in 14 patients with invasive carcinoma of the uterine cervix in whom pronounced eosinophilic infiltration was observed in the stroma in the initial diagnostic biopsy material. These patients tended to have early stage disease, had associated increased lymphoplasmacytic stromal response, and were somewhat younger than the patients lacking this intense eosinophilic infiltration. A suggestion of improved survival was noted in patients with intense stromal eosinophilia treated primarily with radiation therapy.


Effect of 2-amino-4-phosphonobutyrate on ERG OFF-response after glycinergic and GABAergic blockade.
Superfusion with 200 microM 2-amino-4-phosphonobutyrate (APB) of dark and chromatically adapted frog eyecups caused marked potentiation of the ERG OFF-response (d-wave). Blockade of the glycinergic synapses by strychnine did not change this effect at all. Blockade of the GABAergic synapses by picrotoxin slightly diminished the effect of APB in chromatically-adapted eyes with isolated cones' activity, and did not change it in dark-adapted eyes. The results indicate that the action of APB on ERG OFF-response does not depend significantly on GABAergic and glycinergic neurotransmission in frog retina.


Gene profiling of laser-microdissected brain regions and individual cells in drug abuse and schizophrenia research.
Application of transcriptomics approaches to accurately dissected anatomically defined brain regions and individual neuronal populations remains a central focus of current neurobiological investigations. A vast selection of methods and commercial products are currently available that allow one to implement routine gene quantitation and profiling from laser-microdissected brain regions, subregions, and neuronal populations. The present chapter reviews laser microdissection strategies for gene expression analyses, strategies for RNA extraction, reverse transcriptase-coupled PCR (RT-PCR), and target preparation for microarray analyses that are in use in our labs.


An in vivo comparison of working length determination by only root-ZX apex locator versus combining root-ZX apex locator with radiographs using a new impression technique.
The objective of this study was to compare, in vivo, the accuracy of working length determination using only the Root-ZX electronic apex locator versus adjusting Root-ZX measurements after obtaining a working length radiograph. The working length was determined in 25 premolar root canals using Root-ZX and K-files were fixed at these positions. Radiographs were acquired and interpreted, and the recorded working length measurement was adjusted, if necessary, for a combined measurement. The teeth were then extracted in an effort to determine the position of the file tip to the root canal constriction. On the basis of the position of the file tip to the apical foramen, polyvinylsiloxane impressions of the root apex were taken, or the root was imbedded in acrylic resin and ground in order to measure the position of the file tip to the apical constriction. The Root-ZX alone detected the apical constriction within +/- 0.5 mm in 84% of the samples (21 of 25 canals). However, 96% (24 of 25 canals) were within this range when the combination of Root-ZX and radiographs was used. We noted no statistical significance between these 2 methods (P > .05). Using a Root ZX Electronic Apex Locator combined with radiographs is recommended for the determination of working length, although there was no statistical significance between those 2 groups in this study.


[Surgical treatment of hernia of the esophageal foramen of the diaphragm in children].
The surgical treatment of hernia of the esophageal foramen of the diaphragm was performed in 57 children. The transabdominal access was used in operations in 6 of these 57 patients (4 of them had recurrent hernias). In 51 children operations were fulfilled by the transthoracic way. No recurrencies were noted. Good remote results were obtained in 30 patients observed.


The non-linear impact of data handling on network diffusion models.
Many computational models rely on real-world data, and the steps required in moving from data collection, to data preparation, to model calibration, and input are becoming increasingly complex. Errors in data can lead to errors in model output that might invalidate conclusions in extreme cases. While the challenge of errors in data collection have been analyzed in the literature, here we highlight the importance of data handling in the modeling and simulation process, and how particular data handling errors can lead to errors in model output. We develop a framework for assessing the impact of potential data errors for models of spreading processes on networks, a broad class of models that capture many important real-world phenomena (e.g., epidemics, rumor spread, etc.). We focus on the susceptible-infected-removed (SIR) and Threshold models and examine how systematic errors in data handling impact the predicted spread of a virus (or information). Our results demonstrate that data handling errors can have significant impact on model conclusions especially in critical regions of a system.


Spontaneous dissection of the arterial duct during continuous infusion of prostaglandin E1 in a neonate with aortic arch interruption.
We report a 3-day-old boy with double outlet of the right ventricle and interruption of the aortic arch who developed spontaneous dissection of the arterial duct (DA) despite use of continuous infusion of lipo-prostaglandin E1 (PGE1). Transthoracic echocardiography demonstrated the spontaneous dissecting aneurysm of DA, which was confirmed by histology at the modified Norwood procedure done at age of 18 days. This is the first report of spontaneous dissection of DA in a neonate receiving PGE1, suggesting a new closing mechanism of DA.


Health-related quality of life and its predictors among the type 2 diabetes population of Bangladesh: A nation-wide cross-sectional study.
We aimed to assess the health-related quality of life (HRQoL) and identify its predictors among type 2 diabetes patients of Bangladesh. This nationwide cross-sectional study assessed HRQoL among 1,806 type 2 diabetes patients using the EuroQol-5 Dimensions Questionnaire (EQ-5D-5L), and the responses were further translated into a single summary crosswalk index score using the UK time trade-off value set. The predictors were determined using multinomial logistic regression analysis. The mean EQ-5D-5L index score was 0.62 (standard deviation 0.25), and men scored better than women. More than half of the study participants (53.4%) were ranked as "average" HRQoL. Overall, 64% of respondents had a "problem" at least in one of the dimensions of the EQ-5D-5L, and the burden of reported "problems" was higher among women (70%). Among the five dimensions, the highest reported "problem" was 79.8% for anxiety/depression, 77.7% for pain/discomfort and 60.1% for mobility. However, younger participants (aged <30 years) showed a higher burden of anxiety/depression (95%) compared with the rest of the population. The specific predictors of average/good HRQoL (odds ratio >1) were being men, living in a rural area, married, literate, a monthly income >19,488 BDT, absence of comorbidity and had a duration of diabetes ≤5 years. The majority of Bangladesh's type 2 diabetes patients had an "average" HRQoL based on the EQ-5D-5L index score. In broad terms, the identified predictors were sex, place of residence, marital status, literacy, monthly income, comorbidity and duration of diabetes.


Enhancement of intestinal absorption of coenzyme Q10 using emulsions containing oleyl polyethylene acetic acids.
Emulsions have often been prepared to improve absorption of lipophilic compounds that have poor solubility. Coenzyme Q10 (CoQ10) is a lipophilic compound that has been used as an anti-aging supplement. We focused on oleyl polyethyleneoxy acetic acid, an oxa acid derivative, to prepare emulsions of CoQ10 with the expectation of application to oral pharmaceutics. Oxa acids were purified and classified into four groups based on the average length of the ethylene oxide chain. The emulsion that were prepared using the four oxa acid groups were administered to rats and the plasma concentration profiles of CoQ10 were analyzed. The absorption of CoQ10 was improved in all emulsion groups compared with that in the powder group. The emulsion using oxa acid (n = 9.0) greatly increased the plasma concentration of CoQ10. Absorption was also improved by using emulsions containing larger percentage of oxa acids (6%, 15% and 23%) to compared with the same oxa acid (n = 9.0). The effects of oxa acids on cell viability were almost the same as those of conventional surfactants such as polyoxyethylene (20) sorbitan monooleate (Tween 80). The results showed that oxa acids are useful to prepare emulsions for oral administration and that the absorption of CoQ10 using oxa acids is significantly improved by using our formulations.


Abdominal straining in benign prostatic hyperplasia.
We evaluated 46 patients who underwent transurethral resection of the prostate for abdominal straining associated with voiding. All patients were evaluated preoperatively by means of detailed symptom analysis, excretory urography, cystoscopy and urodynamic studies, including spontaneous uroflowmetry, medium fill water cystometry and pressure flow study. Of the patients 72 per cent strained preoperatively and the majority continued to strain 3 and 12 months postoperatively. No correlation was identified between straining and urodynamic or symptomatologic indicators of bladder outlet obstruction. Patients who strained and those who did not strain experienced neither subjective nor objective differences postoperatively. A positive correlation between straining and age was identified. We speculate that straining might be based on individual habits and that the tendency to strain increases with advancing age.


Hybrid pigment organelles in an invertebrate.
Observations of a number of vertebrate chromatophores have revealed the presence of more than one type of pigment organelles, suggesting that the different types are all derived from an equipotential organelle able to differentiate into any of the major pigment-containing organelles (Bagnara, 1972). Observations are presented concerning the occurrence of hybrid pigment inclusions, i.e., all kinds of intergrades between melanosomes, pterinosomes, and reflecting platelets in pigment cells of the daddy-long-legs. It therefore seems possible that pigment organelles in some invertebrates may also be derived from a common pluripotential primordial organelle.


Urinary fibrinogen is elevated in hospitalized patients undergoing angiography.
Previously, we found that urinary fibrinogen (Fg) levels were positively related to contrast-induced acute renal injury degree in mice. Reduction of fibrinogen in heterozygous mice can improve renal function. Here, we prospectively observed the variation in urinary Fg levels in patients undergoing angiography to determine the relationship between serum creatinine (Scr) and serum cystatin C (Cys C) levels. Serum Cys C and urinary Fg levels were evaluated by ELISA before and 2, 12, and 24 h after angiography in 115 enrolled inpatients. Scr was assessed before and 24 and 48 h after angiography. Data were analyzed using ANOVA or Kruskal-Wallis ANOVA and Spearman correlation. Urinary Fg levels were elevated as early as 2 h after angiography and decreased thereafter before returning to baseline levels 24 h after angiography. Urinary Fg was correlated with the amount of contrast agent ( r = 0.24, p = 0.036) and the presence of diabetes and hypertension ( r = 0.31, r = 0.28, p < 0.05, respectively). Urinary Fg levels 2 h after angiography were positively related with Cys C at 12 and 24 h and Scr at 48 h after angiography ( r = 0.34, r = 0.51, r = 0.85, p < 0.05, respectively). Our results showed that variations in urinary Fg levels are consistent with serum Cys C and Scr in patients undergoing angiography and that urinary Fg levels were the earliest parameter to become elevated. Urinary Fg should be investigated as a useful predictor for abnormal renal function after angiography.