Is the Prevalence of Coronary Artery Anomalies Different in Countries with Small Populations? - A Retrospective Study in Northern Cyprus.
Although the prevalence of coronary artery anomalies (CAA) is due to accidental and rare discoveries, it varies between different countries or geographies. CAA are rare congenital disorders having various clinical definitions. Its prevalence varies in angiographic and autopsy series in adult populations and is approximately 1% in average. While the incidence ranges from 0.2% to 5.64% in coronary angiographic (CAG) studies, it is around 0.3% in autopsy series. We aimed to estimate the frequency of CAA in our patient population. The coronary angiographic data of 4099 consecutive adult patients, who underwent CAG between January 2019 and December 2020, were analyzed and retrospectively studied. The mean age of the total patients who underwent CAG was 61.59 ± 13.67 years (range, 18-98 years). CAA were found in 76 patients (1.85% incidence), origin and course anomaly in 62 patients (81.6%), and coronary artery termination anomaly in 14 patients (18.4%). Separate exits of the left anterior descending (LAD) and left circumflex (LCX) coronary artery from the left sinus of Valsalva (LSV) were the most common anomalies (36.84%). Coronary artery fistulas were seen in 14 (18.42%) patients. Abnormal origin of left circumflex artery (LCX) from the right coronary artery (RCA) or right sinus valsalva (RSV) was seen in 13 (17.11%) patients. Outflow anomalies from the contralateral coronary sinus were detected in 10 (13.16%) patients. The incidence and pattern of CAA in our patient population showed similarity with previous studies. Physicians should be aware of CAA that may be associated with potentially serious cardiac incidents, because recognition of these CAA is important for the decision of treatment procedures.


Gendered working environments as a determinant of mental health inequalities: a systematic review of 27 studies.
'Gendered working environments' describes the ways in which (1) differential selection into work, (2) variations in employment arrangements and working hours, (3) differences in psychosocial exposures and (4) differential selection out of work may produce varied mental health outcomes for men and women. The aim of this study was to conduct a systematic review to understand gender differences in mental health outcomes in relation to the components of gendered working environments. The review followed a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) search approach and focused on studies published in 2008-2018. The protocol for the review was prospectively registered with PROSPERO (CRD42019124066). Across the 27 cohort studies included in the review, we found that (1) there was inconclusive evidence on the effect of occupational gender composition on the mental health of men and women, (2) women's mental health was more likely to be affected by long working hours than men's; however, precarious employment was more likely to be negatively associated with men's mental health, (3) exposure to traditional constructs of psychosocial job stressors negatively affected the mental health of both women and men, and (4) unemployment and retirement are associated with poorer mental health in both genders. The findings from this review indicate that gendered working environments may affect the mental health of both men and women, but the association is dependent on the specific exposure examined. There is still much to be understood about gendered working environments, and future research into work and health should be considered with a gender lens.


Activated isoforms of MMP-2 are induced in U87 human glioma cells in response to beta-amyloid peptide.
Prior studies using rat primary hippocampal cultures indicated induction of matrix metalloproteinases (MMPs) in response to beta-amyloid (A beta). Hence, it was of interest to determine whether MMP activity in a human cell line is influenced by A beta. A beta, but not interleukin-1beta (IL-1beta) or lipopolysaccharide (LPS), stimulated an active form of MMP-2 in human U87 glioblastoma cells, as well as increased the expression of the well-known activator of MMP-2, membrane-type (MT)-MMP. Activation experiments carried out with amino phenyl mercuric acetate (APMA), immunoprecipitation, as well as immunoblotting, suggest that the lower molecular weight, gelatin-degrading activity was an activated form of MMP-2. Furthermore, it was demonstrated that a synthetic furin convertase inhibitor, decanoyl-Arg-Val-Lys-Arg-chloromethylketone, decreased the production of A beta-induced active MMP-2 in U87 cells. The induction of MMP-3 by cytokines, but not by A beta, suggests that the effect of A beta on MMP-2 is selective. Although A beta stimulated tissue inhibitor of metalloproteinase-1 (TIMP-1), there was no obvious effect of A beta on TIMP-2 production in U87 cells. These results demonstrate that A beta induces an active form of MMP-2 likely by increasing the expression of MT-MMP in a human glioblastoma cell line. Active MMP-2 may degrade A beta or act on ECM components critical in neuronal survival mechanisms and possibly play a role in Alzheimer's disease (AD) neuropathology.


Intraoperative electrical ablation of ventricular arrhythmias: a "closed heart" procedure.
Both intraoperative endocardial mapping and surgical ablation for ventricular arrhythmias have until now required a ventriculotomy. Such an incision may be associated with an increase in morbidity and mortality, especially when performed through friable myocardium. A "closed heart" technique of intraoperative endocardial mapping and ablation of ventricular arrhythmias was developed in which a balloon array of 112 electrodes was introduced into the left ventricular cavity by a transmitral approach. The array permitted safe delivery of repeated electrical discharges of up to 150 J at each electrode. In four patients with coronary artery disease and no ventricular aneurysm, this "closed heart" technique was used to map and treat seven distinct ventricular tachycardias. The time taken to map each tachycardia varied from 3 to 13 minutes. Between 100 and 150 J was then delivered at each of 10 to 42 electrode sites, and the ablation procedure took 7 to 16 minutes per patient to complete. One patient died 24 hours postoperatively from preexisting thrombocytopenic purpura. There was no significant deterioration in left ventricular function in the three survivors and all have remained arrhythmia free, without antiarrhythmic agents, for 4 to 11 months. This technique offers a new method of surgical treatment of ventricular tachycardia without ventriculotomy, and is particularly suited to patients without a discernible left ventricular aneurysm.


Prevalence and service assessment of cataract in Tibetan areas of Sichuan Province, China: population-based study.
To assess the prevalence of visual impairment (VI) and blindness (BL) due to cataract and cataract surgical outcomes in remote dispersed and high-altitude Tibetan areas of China. A cross-sectional study was conducted among people aged 50 and above in Tibetan Autonomous Prefecture of Kandze (TAPK), China, in 2017. The Rapid Assessment of Avoidable Blindness protocol was followed. Of 5000 eligible participants, 4764 were examined (response rate 95.3%). Cataract VI was defined as lens opacity at visual acuity (VA) levels of <3/60 (Blindness (BL)), ≥3/60 and <6/60 (severe visual impairment (SVI)), ≥6/60 and <6/18 (moderate visual impairment (MVI)), ≥6/18 and <6/12 (early visual impairment (EVI)). The estimated prevalence of cataract BL was 0.61% (95% CI 0.42 to 0.87). With best corrected VA, the estimated prevalence of SVI from cataract was 0.86% (95% CI 0.63 to 1.17); MVI was 2.39% (95% CI 2.00 to 2.87) and EVI was 5.21% (95% CI 4.61 to 5.87). Women in TAPK had a significantly higher prevalence of cataract BL (0.82%, 95% CI 0.54 to 2.15) than men (0.34%, 95% CI 0.16 to 0.70). Women had lower cataract surgical coverage (CSC) by eyes (60.8%, 95% CI 55.5 to 65.8) compared with men (70.1%; 95% CI 63.7 to 75.7). The prevalence of cataract BL was higher among Tibetan (2.28%; 95% CI 1.98 to 2.62) than Han Chinese (1.01%%; 95% CI 0.54% to 1.87%). Overall CSC by person with BL (by better eye) was 82.0% (95% CI 75.2 to 87.6). Among cataract-operated participants, 71.2% had VA equal to or better than 6/18. The study detected a low prevalence of VI and BL due to cataract with high CSC in the study area compared with many other places in China. Further actions should be taken to improve cataract surgical outcome.


Ventilation of patients with asthma and obstructive lung disease.
Mechanical ventilation in a patient with obstructive airway disease may be a lifesaving measure; however, it may also be associated with significant morbidity and mortality. It is important for a physician to be familiar with the potential complications of mechanical ventilation in this group of patients and to know how to avoid them by carefully applying safe ventilator strategies. The cornerstone of such strategies is to minimize minute ventilation, maximize time for expiration, and avoid hyperinflation of the lung. Several bedside parameters (iPEEP, VEI, Pplat) that reflect presence of gas trapping and potential hyperinflation may be measured. In addition to mechanical ventilation, management should include inhaled bronchodilators and systemic corticosteroid therapies. In the event controlled hypoventilation is necessary, sedation with or without the use of muscle relaxants may be required. Unconventional therapies such as the use of Heliox, magnesium sulfate, ketamine, and inhalational anesthetics may be attempted in severe cases that do not respond to conventional management. With appropriate use of ventilator strategies, a reduction in the mortality and morbidity of patients with obstructive airway disease requiring mechanical ventilation has recently been noted.


The astrocyte mitogen, tumor necrosis factor-alpha, inhibits the proliferative effect of more potent adult human astrocyte mitogens, gamma-interferon and activated T-lymphocyte supernatants.
The proliferative response of adult human astrocytes to tumor necrosis factor-alpha (TNF-alpha) was examined. Applied alone, TNF-alpha was dependent on the content of serum in the feeding medium, being mitogenic only in conditions of over 15% serum in medium. In accordance with previous results, supernatants from activated human CD8+ T-lymphocytes (CD8 SN) and recombinant human interferon-gamma (IFN-gamma) enhanced proliferation of adult human astrocytes in 5% serum-containing medium. Simultaneous administration of TNF-alpha (10-1000 units), however, abrogated the mitogenic effects of either CD8 SN or IFN-gamma; the inhibitory effect of TNF-alpha was lost if applied 2 days following IFN-gamma treatment. These studies show that while TNF-alpha is an astrocyte mitogen under selected conditions, it inhibits proliferation induced by other mitogens. In this manner, TNF-alpha may be important in regulating the proliferative response of astrocytes during reactive astrogliosis in vivo.


Low-risk meningioma: Initial outcomes from NRG Oncology/RTOG 0539.
Three- and five-year progression-free survival (PFS) for low-risk meningioma managed with surgery and observation reportedly exceeds 90%. Herewith we summarize outcomes for low-risk meningioma patients enrolled on NRG/RTOG 0539. This phase II trial allocated patients to one of three groups per World Health Organization grade, recurrence status, and resection extent. Low-risk patients had either gross total (GTR) or subtotal resection (STR) for a newly diagnosed grade 1 meningioma and were observed after surgery. The primary endpoint was 3-year PFS. Adverse events (AEs) were scored using Common Terminology Criteria for Adverse Events (CTCAE) version 3. Among 60 evaluable patients, the median follow-up was 9.1 years. The 3-, 5-, and 10-year rates were 91.4% (95% CI, 84.2 to 98.6), 89.4% (95% CI, 81.3 to 97.5), 85.0% (95% CI, 75.3 to 94.7) for PFS and 98.3% (95% CI, 94.9 to 100), 98.3%, (95% CI, 94.9 to 100), 93.8% (95% CI, 87.0 to 100) for overall survival (OS), respectively. With centrally confirmed GTR, 3/5/10y PFS and OS rates were 94.3/94.3/87.6% and 97.1/97.1/90.4%. With STR, 3/5/10y PFS rates were 83.1/72.7/72.7% and 10y OS 100%. Five patients reported one grade 3, four grade 2, and five grade 1 AEs. There were no grade 4 or 5 AEs. These results prospectively validate high PFS and OS for low-risk meningioma managed surgically but raise questions regarding optimal management following STR, a subcohort that could potentially benefit from adjuvant therapy.


Children's judgments of and reasoning about people with disabilities who produce norm violations.
People with disabilities may behave in non-normative ways because they cannot act otherwise. This study explored whether U.S. children aged 3.00 to 8.99 years (N = 105) differ in their evaluations of people who commit norm violations when those persons have perceptual or physical disabilities. Across 12 scenarios, children were asked to explain different characters' non-normative behaviors and to evaluate each character's naughtiness. Characters were typically developing, had a physical disability, or had a hearing disability. Disabilities were described to participants but were not visually depicted. Across moral and conventional norm violations, children aged 4.5 years and older judged characters with disabilities as less naughty than characters without disabilities, whereas younger children (3 and 4 years) judged all characters as equally naughty. Children's explanations for characters' non-normative behaviors (acknowledging characters' physical/auditory limitations and inferring negative attributes) significantly predicted their naughtiness judgments; this was true for participants across the sampled age range. Thus, preschool children demonstrated flexibility in their moral judgments across a variety of everyday behavioral violations, tempering their negative evaluations of persons who committed non-normative behaviors when those persons had unseen disabilities that could reasonably account for their actions. Parents and teachers may be able to build on these early moral intuitions to foster greater acceptance of persons with disabilities.


Immunohistochemical analysis of the binding of human IgM to secretory component present in normal adult colon epithelia, but not in colon cancer and fetal colon epithelia.
We have analysed the binding of human IgM to fetal, normal adult and malignant colo-rectal tissues. Using an indirect immunoperoxidase technique on sections of frozen tissues human IgM binds to all normal adult colo-rectal epithelia (n = 15) tested. By contrast, 9 out of 25 colo-rectal adenocarcinomas were negative, and in the remaining 16 the staining reaction varied from staining of all the cancer areas to focal staining of a few areas. Human IgM did not bind to 14 samples of fetal intestinal epithelium (gestational age of 6-14 weeks). The binding of IgM was found to be mediated by secretory component (SC) as anti-SC antibody (anti-SC) showed a similar staining pattern as IgM and the IgM binding could be blocked by anti-SC. SC was also demonstrated in glandular epithelia of sections of all normal breast epithelia but only in 10 out of 15 breast adenocarcinomas. The loss of IgM binding and SC could not be correlated to the morphology of the adenocarcinomas. The observations on fetal, normal adult and malignant tissue suggest that IgM binding and SC may be gradually lost during dedifferentiation of normal cells, to malignant colo-rectal or breast epithelia.


Sorting out the Relationship Between Esophageal and Pulmonary Disease.
The aim of this review is to explore the relationship between esophageal syndromes and pulmonary diseases considering the most recent data available. Prior studies have shown a close relationship between lung diseases such as asthma, chronic obstructive pulmonary disorders (COPD), Idiopathic pulmonary fibrosis (IPF), and lung transplant rejection and esophageal dysfunction. Although the association has long been demonstrated, the exact relationship remains unclear. Clinical experience has shown a bidirectional relationship where esophageal disease may influence the outcomes of pulmonary disease and vice versa. The impact of esophageal dysfunction on pulmonary disorders may also be related to 2 different mechanisms: the reflux pathway leading to microaspiration and the reflex pathway triggering vagally mediated airway reactions. The aim of this review is to further explore these relationships and pathophysiologic mechanisms. Specifically, we discuss the proposed hypotheses for the relationship between the 2 diseases, as well as the pathophysiology and new developments in clinical management.


Phase I dose-escalating study of raltitrexed ('Tomudex') and cisplatin in metastatic non-small cell lung cancer.
The aim of this Phase I, dose-escalation study was to determine the maximum tolerated dose (MTD), recommended dose (RD), and dose-limiting toxicity (DLT) of a raltitrexed ('Tomudex') and cisplatin combination in patients with previously untreated, metastatic non-small cell lung cancer (NSCLC). Patients received raltitrexed (15-min intravenous infusion), followed by cisplatin (1-h intravenous infusion), every 3 weeks at escalating dose levels. In total, 21 patients entered the study. No DLT was observed up to dose level 4 (raltitrexed 3.0 mg/m(2) plus cisplatin 80 mg/m(2)), or in the first 3 patients who received dose level 5 (raltitrexed 3.5 mg/m(2) plus cisplatin 80 mg/m(2)). However, 1 patient, entered at dose level 6 (raltitrexed 4.0 mg/m(2) plus cisplatin 80 mg/m(2)) experienced severe toxicity (including grade 3 diarrhea), and no further patients were recruited at this level. Of 4 additional patients who received raltitrexed 3.5 mg/m(2) plus cisplatin 80 mg/m(2), 3 also experienced DLTs. The most common adverse events included nausea/vomiting, asthenia, diarrhea, and hematologic toxicities. Of 19 patients evaluated for response, 3 achieved a partial response, 13 had stable disease, and 3 progressed. The MTD is raltitrexed 3.5 mg/m(2) plus cisplatin 80 mg/m(2), and the RD for future studies is raltitrexed 3.0 mg/m(2) plus cisplatin 80 mg/m(2); DLTs were diarrhea and asthenia. The combination of raltitrexed and cisplatin shows clinical activity in patients with metastatic NSCLC.


Bariatric surgery is a cost-saving treatment for obesity-A comprehensive meta-analysis and updated systematic review of health economic evaluations of bariatric surgery.
Demand for bariatric surgery to treat severe and resistant obesity far outstrips supply. We aimed to comprehensively synthesise health economic evidence regarding bariatric surgery from 1995 to 2018 (PROSPERO registration number: CRD42018094189). Meta-analyses were conducted to calculate the annual cost changes "before" and "after" surgery, and cumulative cost differences between surgical and nonsurgical groups. An updated narrative review also summarized the full and partial health economic evaluations of surgery from September 2015. N = 101 studies were eligible for the qualitative analyses since 1995, with n = 24 studies after September 2015. Quality of reporting has increased, and the inclusion of complications/reoperations was predominantly contained in the full economic evaluations after September 2015. Technical improvements in surgery were also reflected across the studies. Sixty-one studies were eligible for the quantitative meta-analyses. Compared with no/conventional treatment, surgery was cost saving over a lifetime scenario. Additionally, consideration of indirect costs through sensitivity analyses increased cost savings. Medication cost savings were dominant in the before versus after meta-analysis. Overall, bariatric surgery is cost saving over the life course even without considering indirect costs. Health economists are hearing the call to present higher quality studies and include the costs of complications/reoperations; however, indirect costs and body contouring surgery are still not appropriately considered.


Massive marine methane emissions from near-shore shallow coastal areas.
Methane is the second most important greenhouse gas contributing to climate warming. The open ocean is a minor source of methane to the atmosphere. We report intense methane emissions from the near-shore southern region of the North Sea characterized by the presence of extensive areas with gassy sediments. The average flux intensities (~130 μmol m(-2) d(-1)) are one order of magnitude higher than values characteristic of continental shelves (~30 μmol m(-2) d(-1)) and three orders of magnitude higher than values characteristic of the open ocean (~0.4 μmol m(-2) d(-1)). The high methane concentrations (up to 1,128 nmol L(-1)) that sustain these fluxes are related to the shallow and well-mixed water column that allows an efficient transfer of methane from the seafloor to surface waters. This differs from deeper and stratified seep areas where there is a large decrease of methane between bottom and surface by microbial oxidation or physical transport. Shallow well-mixed continental shelves represent about 33% of the total continental shelf area, so that marine coastal methane emissions are probably under-estimated. Near-shore and shallow seep areas are hot spots of methane emission, and our data also suggest that emissions could increase in response to warming of surface waters.


Is a paediatrician required at caesarean section?
In a series of 460 consecutive deliveries there were 55 caesarean sections (mainly under epidural anaesthesia) without evidence of fetal distress and with a cephalic presentation. There was no statistically significant difference in the frequency of resuscitation in this group compared with 296 spontaneous vertex deliveries. It is concluded that a paediatrician is not routinely required at caesarean section under epidural provided there is no fetal distress and the presentation is cephalic.


Characterization of Escherichia coli isolated from urinary tract infection and association between virulence expression and antimicrobial susceptibility.
The capacity of antibiotics to modulate bacterial virulence has raised concerns over the appropriateness of antibiotic therapies, including when dosing strategies fall below sub-therapeutic levels. In this work, we investigated the ability of antibiotics to influence virulence in Escherichia coli isolated from urinary tract infection (UTI). Out of 120 isolates, 32.5% carried pap, 21.7% carried hlyA, and 17.5% carried cnf. The predominant B2 phylogroup was significantly associated with the quinolone-resistant isolates. A significant association was seen between the presence of hlyA hemolysin and susceptibility to ceftriaxone and ciprofloxacin (P < 0.05). Sub-inhibitory concentrations of both antibiotics reduced the levels of hlyA expression and hemolysis in isolates treated with antibiotics compared to untreated isolates (P < 0.05). Growth rate assay showed that the decrease in hlyA expression was not an effect of decreased growth rate. Our study indicated the inhibitory effect of ciprofloxacin and ceftriaxone on the level of hemolysis, suggesting that the sub-inhibitory concentrations of these antibiotics may affect the outcome of infections. Further studies, including animal models may elucidate the outcome of virulence modulation by these antibiotics in UTI pathogenesis.


Euptychia boulleti (Le Cerf) n. comb. (Lepidoptera: Nymphalidae: Satyrinae), a rare and endangered butterfly from Southeastern Brazil.
This paper discusses the systematic position of the rare and endangered satyrine butterfly Caenoptychia boulleti Le Cerf, the only included species in Caenoptychia (type species), based on adult morphology and molecular data. The results showed that Caenoptychia Le Cerf belongs to the Euptychia Hübner clade, and the genus is synonymized with Euptychia, new synonymy. Euptychia boulleti (Le Cerf) is a new combination. The male genitalia of E. boulleti showed at least one important synapomorphy with the other species of Euptychia, which is the presence of a posterior projection of the tegumen above the uncus. Molecular data reinforces the position of Caenoptychia within the genus Euptychia.


Exploring dental academics' perceptions of and experience with discrimination in the UK and Ireland: a qualitative study.
Introduction Diversity is known to be important but diversity of dental school academics in the UK and Ireland is low in comparison with the dental profession and the overall population. The aims were to explore whether UK and Ireland dental school academics are satisfied with their career progression, whether they believe that there are barriers to career progression in dental schools based on protected characteristics, and experience of discrimination at work.Methods An online survey, including four free-text questions related to the study aims, was circulated by the Dental Schools Council to dental academics at all UK and Ireland dental schools. Qualitative content analysis was used to analyse free-text comments.Results and discussion There were 192 responses from 20 dental schools. Five data categories were constructed which highlight the impact of discrimination in dental academia, the importance of opportunities and support, different perspectives of diversity and discrimination, and academic and institutional culture.Conclusion Staff perceived and experienced barriers to career progression. Many were satisfied with their career progression, but a proportion of staff expressed dissatisfaction and attributed this to discrimination based upon protected characteristics. The culture in dental schools is beginning to change to address factors contributing to inequality in dental academia.


Neighborhood and parental supports for physical activity in minority adolescents.
Few studies have examined environmental, home, and parental supports for physical activity in underserved adolescents (low income, ethnic minority). Given the increasing incidence of obesity in minority adolescents, it is important to better understand ecologic determinants of physical activity in these youth. This study used an ecologic model to evaluate the significance of neighborhood, home, and parental supports for physical activity on moderate-to-vigorous (MV) physical activity in underserved adolescents. The study was a secondary data analysis of a randomized controlled school-based trial "Active by Choice Today" (ACT) for increasing physical activity in underserved sixth-graders. Schools were matched on school size, percentage minorities, percentage entitled to free or reduced-price lunch, and urban or rural setting prior to randomization. This study used a randomly selected sample of parents (n=280) from the intervention and control schools whose adolescent was enrolled in the larger trial. A total of 679 6th-grade students (mean age=11.4 years, 70% African-American, 76% free or reduced-price lunch, 52% female) participated in the larger trial. Parents of 280 youth were contacted to participate in a telephone survey and 198 (71%) took part in the study. The ACT trial was designed to test the efficacy of a 17-week (1 academic year) motivational plus behavioral skills intervention versus comparison after-school programs on increasing physical activity. A telephone survey was developed and was administered within 6 months after the trial began on parents of 198 adolescents from the ACT randomized school-based trial during 2005-2007. The primary outcome measure was adolescent MVPA based on 7-day accelerometry estimates from baseline to mid-intervention. The data were analyzed in 2010-2011 and included both parent and adolescent self-reports of environmental, home, and family supports for physical activity. Regression analyses indicated a significant effect of parental and neighborhood supports for physical activity on adolescent MVPA. Adolescents who perceived higher (vs lower) levels of parental support for physical activity engaged in more minutes of MVPA (B=3.01, SE=1.38, p<0.05) at mid-intervention. Adolescents who lived in neighborhoods with more (vs fewer) supports for physical activity (parks, lighting), also engaged in more minutes MVPA (B=4.27, SE=2.15, p<0.05). Support from parents and neighborhood quality are both associated with increased physical activity in underserved adolescents.


A novel method for detection of camellia oil adulteration based on time-resolved emission fluorescence.
In this study, time-resolved emission fluorescence (TRES) combined with chemometrics was developed and employed for adulteration analysis of camellia oil. TRES was first decomposed by parallel factors analysis (PARAFAC). Next, an artificial neural network (ANN) model was built for the adulteration analysis. A linear range of 5-50%, a limit of detection (LOD) of 3% and root mean square error of prediction (RMSEP) values lower than 3% were achieved. Compared with the steady-state measurement, easy access to the information from fluorophores of low concentration was shown to be an intrinsic advantage of the time-resolved measurement; this advantageous characteristic was helpful for optimizing adulteration analysis. It was demonstrated that TRES combined with chemometrics was a simple, rapid and non-intrusive method for adulteration analysis of vegetable oil.


High-dose thiotepa with autologous bone marrow rescue in recurrent malignant oligodendroglioma: a case report.
High-dose thiotepa with autologous bone marrow rescue is a new and promising treatment modality in several kinds of solid tumors. We used this regimen in a pediatric patient who had the third recurrence of his malignant oligodendroglioma of brain that developed during '8 in 1' chemotherapy. We achieved complete response after a total dose of 1125 mg/m2 of intravenous thiotepa. Good penetration into the CNS renders thiotepa potentially useful for chemosensitive brain tumors, and one course of high-dose thiotepa can be administered with acceptable toxicity by utilizing autologous bone marrow rescue.


Transcorneal alternating current stimulation after severe axon damage in rats results in "long-term silent survivor" neurons.
Transcorneal alternating current stimulation (tACS) was proposed to decrease acute death of retinal ganglion cells after optic nerve transection in rats, but it is not known if cell survival is long-term and associated with functional restoration. We therefore evaluated the effects of tACS in a rat model of optic nerve crush using anatomical, electrophysiological and behavioural measures. Rats were trained in a brightness discrimination visual task and the retinal ganglion cell number was quantified with in vivo confocal neuroimaging. Thereafter, severe optic nerve crush or sham crush was performed and rats were treated under anaesthesia either with tACS or sham stimulation immediately after the lesion and on day 3, 7, 11, 15, 19 and 23. Brightness discrimination was evaluated for 6 weeks and retinal ganglion cells were counted in vivo on post-crush days 7 and 28. In additional rats we studied the influence of tACS on bioelectrical activity. On post-lesion day 28, the tACS-treated group showed a neuronal survival of 28.2% which was significantly greater than in sham operates (8.6%). All animals with optic nerve crush were significantly impaired in brightness discrimination and did not recover performance, irrespective to which group they belonged. In accordance with this, there was no significant influence of the stimulation on EEG power spectra. In conclusion, tACS induced long-term neuronal protection from delayed retrograde cell death, but in this case of severe axonal damage tACS did not influence functional restoration and EEG signals recorded over the visual cortex.


Pulse wave velocity normal levels in a Uruguayan population: differences between 'adjusted' and measured values vary depending on age and the calculation algorithm used.
Carotid-femoral pulse wave velocity (PWV) has emerged as the gold standard for non-invasive evaluation of aortic stiffness. However, the absence of standardized methodologies of study and lack of normal and references values have limited wider implementation of PWV in clinical practice. In this work normal PWV levels were determined in a Uruguayan population and the obtained values were analyzed taking into account data from other populations. The differences between the 'real' PWV levels and the PWV calculated using different wave detection algorithms and path lengths were assessed, and compared the taking into account the changes in PWV with aging. The Uruguayan population showed a rate of PWV increase comparable to that reported previously in non-hypertensive European subjects, although overall, PWV values were approximately 2 m/s higher in the Uruguayan population. The different approaches used to calculate the PWV showed differences in their availability to follow aging-variations in 'adjusted' (or 'real') PWV.


Comparative spatial and temporal localisation of perlecan, aggrecan and type I, II and IV collagen in the ovine meniscus: an ageing study.
This is the first study to immunolocalise perlecan in meniscal tissues and to demonstrate how its localisation varied with ageing relative to aggrecan and type I, II and IV collagen. Perlecan was present in the middle and inner meniscal zones where it was expressed by cells of an oval or rounded morphology. Unlike the other components visualised in this study, perlecan was strongly cell associated and its levels fell significantly with age onset and cell number decline. The peripheral outer meniscal zones displayed very little perlecan staining other than in small blood vessels. Picrosirius red staining viewed under polarised light strongly delineated complex arrangements of slender discrete randomly oriented collagen fibre bundles as well as transverse, thick, strongly oriented, collagen tie bundles in the middle and outer meniscal zones. The collagen fibres demarcated areas of the meniscus which were rich in anionic toluidine blue positive proteoglycans; immunolocalisations confirmed the presence of aggrecan and perlecan. When meniscal sections were examined macroscopically, type II collagen localisation in the inner meniscal zone was readily evident in the 2- to 7-day-old specimens; this became more disperse in the older meniscal specimens. Type I collagen had a widespread distribution in all meniscal zones at all time points. Type IV collagen was strongly associated with blood vessels in the 2- to 7-day-old meniscal specimens but was virtually undetectable at the later time points (>7 month).


HIV testing sites' communication about adolescent confidentiality: potential barriers and facilitators to testing.
This study sought to evaluate HIV testing locations in New York City in terms of staff communication of confidentiality policies for adolescent clients. Using the New York State Directory of HIV Counseling and Testing Resources as a sampling frame, this study made telephone contact with 164 public HIV testing locations in New York City and used a semistructured interview to ask questions about confidentiality, parental permission, and parent access to test results. At 48% of locations, either HIV testing was not offered or we were unable to reach a staff member to ask questions about testing options and confidentiality. At the remaining sites, information provided regarding confidentiality, parental consent, and privacy of test results was correct only 69% to 85% of the time. Additionally, 23% of sites successfully contacted offered testing exclusively between 9:00 a.m. and 3:00 p.m. weekdays, when most adolescents are in school. Our findings point to a need for increased training and quality control at the clinical level to ensure that consumers in need of HIV testing are provided with accurate information and accessible services. Furthermore, these results highlight the need for more "patient-centric" sites with enhanced accessibility for potential clients, particularly youth.


Developing, Implementing, and Validating a Social Toxicity Assessment Tool of Cancer.
The social impact of cancer on patients and their family is well known. Yet, unlike with physical and financial toxicities, no validated tools are available to measure this impact. This study aimed at developing, validating, and implementing a novel social toxicity assessment tool for patients with cancer diagnosis (STAT-C). Questions were generated through multiple steps including focus groups of patients, their families, and oncology care professionals. These steps along with relevant literature resulted in the development of an initial 20-item questionnaire. Content validity and relevance of the tool were assessed using Content Validity Index for individual items and Content Validity Index for the entire scale. Following expert examination, the constructed STAT-C tool consisted of 14 items grouped into three domains-social relations, social activities, and economic impact. Based on the total possible score for the survey in 150 patients for all the items, three levels of a socioeconomic toxicity were determined-severe social toxicity, mild social toxicity, and no social toxicity. The 14 items were marked as relevant, and the Content Validity Index for individual items ranged between 0.80 and 1.00. An overall average Content Validity Index for the entire scale of 0.87 showed high content validity of the constructed tool. Exploratory factor analysis revealed retention of 13 items of the constructed STAT-C Tool, which loaded across three factors that mapped groupings into measures of social relations, social activities, and economic impact domains. Our study revealed that STAT-C is a valid, reliable tool, and well captures and measures unique and pertinent social toxicity constructs for Arabic-speaking patients. The tool should enable oncology professionals to deliver better patient-centered care as a component of a comprehensive approach.


SBA-15-functionalized sulfonic acid confined acidic ionic liquid: a powerful and water-tolerant catalyst for solvent-free esterifications.
Incorporating a hydrophobic Brønsted acid ionic liquid (HBAIL) inside the nanospaces of SBA-15-Pr-SO(3)H led to a hydrophobic super Brønsted acid catalyst, which showed excellent catalytic performance in direct esterification of alcohols and carboxylic acids at ambient temperature under solvent-free conditions.


Minimization of the gliding index: criterion for the generation of the surfaces of a knee endoprosthesis.
Previous studies on removed failed artificial knees revealed significant degradation of the articular surfaces, including pitting and shredding, as well as burnishing accompanied by score marks and scratches, the latter damage group being related to the gliding motion of the joint. In an attempt to introduce an improved version of an artificial knee joint, we have proposed a general model by which the opposing surfaces of the prosthesis components can be synthesized. The criterion applied was that of minimization of a defined gliding index. The femoral condyles in this model were expressed in terms of torus geometry, and the kinematics of motion fed into the model was that of normal motion in the sagittal plane, including angles as well as the displacement vector in the knee joint. Geometry of the tibial component was obtained from the tangents of the femoral surface, in subsequent positions of motion. The optimal surfaces were those for which the gliding index assumed a minimal value. The solutions obtained for various input motions are presented and discussed.


Prediction of total daily fecal excretion during acute childhood diarrhea.
Clinical data from 133 male patients between 3 and 36 months of age were reviewed to identify factors that could predict high rates of fecal excretion during acute diarrhea. Diarrheal severity after hospitalization was measured by separate 4-h quantitative collections of feces during 6 days: the number of these 4-h collection periods with any stool output was used as an estimate of the number of bowel movements each day. The number of 4-h periods with any stool output was highly correlated with total fecal excretion expressed as grams per kilogram of body weight per day (p less than 0.001). The age of the patient, type of diarrhea, and type of diet had little effect on the relationship between stool "number" and amount. The number of bowel movements, as estimated during this study, was a highly sensitive (greater than 90%) and reasonably specific (greater than 70%) predictor of children at risk of high fecal excretion rates (greater than 50 g/kg/day or greater than 100 g/kg/day) during acute diarrhea.


Risk factors for secondary membrane formation after removal of pediatric cataract.
To evaluate the incidence of secondary membrane formation, factors that lead to its development, and the frequency of procedures to treat these membranes in children after cataract surgery. Department of Pediatric Ophthalmology, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA. Clinical records of 152 patients (190 eyes) who had cataract extraction between January 1986 and 1996 were reviewed retrospectively. The mean follow-up was 6 years (range 2 to 13 years). Cataract surgery was performed through a limbal incision in all cases. Twenty-eight eyes had a primary posterior capsulectomy, and 120 eyes had posterior capsulectomy combined with an anterior vitrectomy. In 42 eyes, the posterior capsule was left intact. Nineteen eyes received a primary intraocular lens (IOL), 15 eyes received a secondary IOL, and 156 eyes were rehabilitated with spectacles or contact lenses. Seventy-two eyes (37.9%) developed secondary membrane a mean of 8.9 months postoperatively (range 3 weeks to 53 months). Membranes occurred in 78.6% of eyes with an intact posterior capsule, 42.9% with posterior capsulectomy, and 22.5% with combined posterior capsulectomy and anterior vitrectomy. Secondary membrane formation was associated with not performing a posterior capsulectomy with anterior vitrectomy (P < .001) and the presence of a primary IOL (P < .001). Younger age at surgery increased the chance of secondary membrane formation in patients who had posterior capsulectomy and anterior vitrectomy (P < .01). The younger the child at cataract surgery, the greater the risk of secondary membrane. Primary posterior capsulectomy combined with an anterior vitrectomy decreased but did not eliminate the incidence of secondary membrane.


First detection of taste buds in a chimaeroid fish (Chondrichthyes: Holocephali) and their Gαi-like immunoreactivity.
The mucosa covering the tongue of the Chimaera monstrosa has been investigated with histological and immunohistochemical methods allowing to describe, for the first time, gustatory structures (taste buds) in this subclass of cartilaginous fish. G-protein-alpha-subunit-inhibitory-like (Gαi-like) immunoreactivity has been detected in the taste buds of C. monstrosa, as described in other vertebrates. In order to gain confidence on the antiserum used, able to recognize three Gαi proteins in mammals, alignments of the antigenic sequence in mammals and other vertebrates were performed. The data were used for a research of putative genes in the genome of the holocephalan Callorhinchus milii, to date the only cartilaginous fish with a sequenced genome; the highlighted sequences could suggest the presence of all three genes (gnai1, gnai2 and gnai3) in holocephalans. The sequences of the predicted proteins present a high identity with the mammalian proteins.


Immunization status of patients with spinal muscular atrophy receiving nusinersen therapy.
Children with chronic neurological diseases, including spinal muscular atrophy (SMA), are particularly susceptible to vaccine-preventable infections. We aimed to evaluate the age-appropriate immunization status and its relationship with nusinersen therapy in pediatric patients with SMA. Children with SMA who received nusinersen treatment were included in this cross-sectional prospective study. Data were collected on SMA characteristics, nusinersen therapy, vaccination status according to the National Immunization Program (NIP), administration, and influenza vaccination recommendation. A total of 32 patients were enrolled. In patients with SMA type 1, the frequency of under-vaccination of hepatitis B, BCG, DTaP-IPV-HiB, OPV, and MMR was statistically higher than in patients with SMA type 2-3 (p<0.001). The influenza vaccine was administered to only 9.3% of patients and was never recommended to 13 (40.6%) parents. The frequency of under-vaccination of hepatitis B, BCG, DTaP-IPV-HiB, OPV, and MMR was statistically higher in patients receiving nusinersen maintenance therapy than in those with loading doses (p<0.001). Physician recommendations for influenza and pneumococcal vaccines were significantly higher in the nusinersen maintenance group (p = 0.029). There was no statistical significance between the groups in terms of administration of influenza and pneumococcal vaccines (p = 0.470). Children with SMA had lower immunization rates and poor compliance with immunization programs. Clinicians should ensure that children with SMA receive the same preventive health measures as healthy children, including vaccinations.


Autopsy findings of heart and lungs in a patient with primary pulmonary hypertension associated with use of fenfluramine and phentermine.
A 36-year-old woman (height, 157 cm; weight, 117 kg; body mass index, 47.5) received fenfluramine and phentermine (fen-phen) for 7 months, and pulmonary hypertension subsequently developed. Her pulmonary arterial pressure was 56 mm Hg, and echocardiography showed right ventricular dilatation and hypokinesia. Cardiopulmonary arrest developed during right-heart catheterization, and she died 3 days later. At autopsy, right ventricular dilatation with fibroproliferative tricuspid valve was identified. The pulmonary arteries, including the main arteries and elastic arteries to the arterioles, revealed fibroproliferative plaque; the latter was more severe and more prominent in the upper lobes than in the lower lobes. Combined cardiac valvular disease and pulmonary hypertension appear to occur frequently in patients receiving fen-phen, and more autopsy cases of patients with a history of fen-phen usage are warranted to document the frequency of combined cardiac valvular disease and pulmonary hypertension in the United States.


Synthesis and physicochemical characterization of a new material (PUPA) based on polyurethane and poly(amido-amine) components capable of strongly adsorbing quantities of heparin.
The synthesis of new materials (PUPAs) based on a commercial polyurethane and a heparin-complexing polymer, poly(amido-amine), was studied. PUPAs are capable of adsorbing heparin because the basic nitrogens of poly(amido-amine), once protonated, interact with the negative charges carried by the heparin molecule. Six different samples of PUPA were synthesized having a varied ratio of the components. The quantity of basic nitrogen on the surface and the bound heparin for each sample was determined. Two different kinds of heparin are present on a PUPA surface: one is strongly bound but can be detached by 0.1 M NaOH solution, the other is physically adsorbed and is slowly released by a stream of saline solution. A relationship between the quantity of strongly bound heparin and basic nitrogen was found. SEM and FTIR-ATR analysis were performed on all the PUPA samples. The mechanical characteristics change according to chemical composition.


Lasiolactols A and B Produced by the Grapevine Fungal Pathogen Lasiodiplodia mediterranea.
A strain of Lasiodiplodia mediterranea, a fungus associated with grapevine decline in Sicily, produced several metabolites in liquid medium. Two new dimeric γ-lactols, lasiolactols A and B (1 and 2), were characterized as (2S*,3S*,4R*,5R*,2'S*,3'S*,4'R*,5'R*)- and (2R*,3S*,4R*,5R*,2'R*,3'S*,4'R*,5'R*)-(5-(4-hydroxymethyl-3,5-dimethyl-tetrahydro-furan-2-yloxy)-2,4-dimethyl-tetrahydro-furan-3-yl]-methanols by IR, 1D- and 2D-NMR, and HR-ESI-MS. Other four metabolites were identified as botryosphaeriodiplodin, (5R)-5-hydroxylasiodiplodin, (-)-(1R,2R)-jasmonic acid, and (-)-(3S,4R,5R)-4-hydroxymethyl-3,5-dimethyldihydro-2-furanone (3 - 6, resp.). The absolute configuration (R) at hydroxylated secondary C-atom C(7) was also established for compound 3. The compounds 1 - 3, 5, and 6, tested for their phytotoxic activities to grapevine cv. Inzolia leaves at different concentrations (0.125, 0.25, 0.5, and 1 mg/ml) were phytotoxic and compound 5 showed the highest toxicity. All metabolites did not show in vitro antifungal activity against four plant pathogens.


Laparoscopic nephrectomy, hysterectomy and rectovaginal endometriotic mass removal in a single session.
The authors reported the first case of endometriosis with ureteral involvement causing nonfunctioning kidney, which was managed by laparoscopic nephrectomy, hysterectomy, and endometriotic mass removal in a single session.


The surgical treatment of breast cancer.
Controversy regarding the efficacy of surgical treatment of breast cancer has persisted since the earliest descriptions of this disease in the first and second centuries AD. It has been acknowledged for many years that patients with untreated breast cancer survive for a surprisingly predictable period of 5 yr. Hence, in recommending extensive surgical procedures, the surgeon must recognize the unique biology of breast cancer and the need for long-term follow-up. In spite of a voluminous body of literature concerning the treatment of breast cancer, the distention and contention still continue. However, there is now increasing support for conservative treatment, including the less radical modified mastectomy, and in selected cases, wide local excision, axillary dissection and radiotherapy. As knowledge accumulates, it is clear that the treatment of breast cancer requires a multidisciplinary approach reflecting our understanding of the biology of this disease.


Distinct mechanisms mediate the reinstatement and spontaneous recovery of extinguished fear in rats.
It is controversy whether the summation of new contextual conditioning with residual conditioned response contributes to the reinstatement phenomenon. Here, we examined the summation hypothesis in the auditory conditioned fear paradigm by comparing the freezing levels during pre-tone and tone presentation periods. Unexpectedly, we found that the onset of tone relieves fear during the reinstatement test, which is not predicted by the summation hypothesis; whereas the onset of tone enhances fear during the spontaneous recovery test and early extinction session. These results implicated that return of fear in two conventional assays after extinction, i.e., reinstatement assay and spontaneous recovery assay, are mediated by different mechanisms.


Semaphorin-3F/Neuropilin-2 Transcriptional Expression as a Predictive Biomarker of Occult Lymph Node Metastases in HNSCC.
The expression of the semaphorin-3F (SEMA3F) and neuropilin-2 (NRP2) is involved in the regulation of lymphangiogenesis. The present study analyzes the relationship between the transcriptional expression of the SEMA3F-NRP2 genes and the presence of occult lymph node metastases in patients with cN0 head and neck squamous cell carcinomas. We analyzed the transcriptional expression of SEMA3F and NRP2 in a cohort of 53 patients with cN0 squamous cell carcinoma treated with an elective neck dissection. Occult lymph node metastases were found in 37.7% of the patients. Patients with occult lymph node metastases (cN0/pN+) had significantly lower SEMA3F expression values than patients without lymph node involvement (cN0/pN0). Considering the expression of the SEMA3F-NRP2 genes, patients were classified into two groups according to the risk of occult nodal metastasis: Group 1 (n = 34), high SEMA3F/low NRP2 expression, with a low risk of occult nodal involvement (14.7% cN0/pN+); Group 2 (n = 19), low SEMA3F or high SEMA3F/high NRP2 expression, with a high risk of occult nodal involvement (78.9% cN0/pN+). Multivariate analysis showed that patients in Group 2 had a 26.2 higher risk of lymph node involvement than patients in Group 1. There was a significant relationship between the transcriptional expression values of the SEMA3F-NRP2 genes and the risk of occult nodal metastases.


Tweens are not teens: the problem of amalgamating broad age groups when making pandemic recommendations.
Demarcating childhood into two distinct and broad 10-year age bands of over and under age 10 is a disservice to our tween population (9-12 years), and may be overlooking our role in understanding the negative impacts of SARS-CoV-2 (COVID-19) during a formative period of development. In this commentary, we discuss the importance of considering tweens as a unique population of youth who are differentially impacted by the COVID-19 pandemic. We first describe the distinctive progress of tweens across various facets of developmental health, followed by recommendations to improve understanding and address impact of the pandemic and its restrictions on tweens. The COVID-19 pandemic has had a large impact on the day-to-day lives of tweens and what we do now will have long-lasting effects on their lifelong trajectories.


Pre-treatment of two contrasting water-stressed genotypes of cassava (Manihot esculenta Crantz) with ascorbic acid. I. Growth, physiological and antioxidant responses.
Water deficit-stress at early growth stage is a major constraint of cassava production. Ascorbic acid is a non-enzymatic antioxidant that mitigates oxidative damage caused by water stress in plants. Growth, physiological and antioxidant defense system responses of two contrasting water-stressed cassava genotypes to pre-treatment with foliar application of ascorbic acid (AA) were investigated. The objectives of this study were to assess the growth, proline, photosynthesis pigments and antioxidant activities of young water-stressed cassava plants pre-treated with ascorbic acid. The study consisted of IITA-TMS-IBA980581 (drought tolerant) and IITA-TMS-IBA010040 (drought sensitive) cassava genotypes treated with six doses (0.00, 0.25, 0.50, 0.75 and 1.00 mM) of AA before being subjected to water deficit (45.0% field capacity) and a water sufficient AA-untreated control. In both genotypes, water stress reduced shoot height (40.3%), leaf area (42.5%), and number of root (54.5%), biomass (28.6%), relative water content (RWC, 3.2%) and photosynthetic pigments (300.0%). However, water stress increased proline (91.3%), endogenous AA (112.0%), catalase (CAT, 300.0%) and superoxide dismutase (SOD, 15.3%) in both genotypes. Compared with IITA-TMS-IBA010040, leaf area, biomass, number of root and shoot height of IITA-TMS-IBA980581 were higher by 7.3, 24.6, 25.9 and 13.1%, respectively. By less than a quarter, chlorophylls a and b, activity of superoxide dismutase and relative water content of IITA-TMS-IBA980581 were higher compared with IITA-TMS-IBA010040. However, proline content of IITA-TMS-IBA010040 was higher than IITA-TMS-IBA980581 by 14.3%. Pre-treatment with AA improved growth parameters, photosynthetic pigments, RWC, endogenous AA, activity of CAT and SOD, but decreased proline in both genotypes with an optimum concentration at 0.5 mM. Pre-treatment with 0.5 mM AA increased shoot height, area of leaves, leaf number, number of root and dry weight by 46.3, 44.7, 14.4, 88.2 and 37.5%, respectively. Pre-treatment with 0.5 mM AA doubled chlorophylls, tripled carotenoids content, doubled endogenous AA and slightly enhanced RWC (2.1%) and SOD (2.0%) when compared with AA-untreated water stressed plants. But pre-stress application of AA reduced proline content by one-fold, increased CAT activity by one-fold in IITA-TMS-IBA980581 and by one-third in IITA-TMS-IBA010040. The study concluded that pre-treatment of cassava young plants with AA before water deficit could alleviate oxidative stress.


Regional dynamics of fractal dimension of the left ventricular endocardium from cine computed tomography images.
We present a method to leverage the high fidelity of computed tomography (CT) to quantify regional left ventricular function using topography variation of the endocardium as a surrogate measure of strain. 4DCT images of 10 normal and 10 abnormal subjects, acquired with standard clinical protocols, are used. The topography of the endocardium is characterized by its regional values of fractal dimension ( F D ), computed using a box-counting algorithm developed in-house. The average F D in each of the 16 American Heart Association segments is calculated for each subject as a function of time over the cardiac cycle. The normal subjects show a peak systolic percentage change in F D of 5.9 % ± 2 % in all free-wall segments, whereas the abnormal cohort experiences a change of 2 % ± 1.2 % ( p < 0.00001 ). Septal segments, being smooth, do not undergo large changes in F D . Additionally, a principal component analysis is performed on the temporal profiles of F D to highlight the possibility for unsupervised classification of normal and abnormal function. The method developed is free from manual contouring and does not require any feature tracking or registration algorithms. The F D values in the free-wall segments correlated well with radial strain and with endocardial regional shortening measurements.


Detection of subclinical mastitis in dromedary camels (Camelus dromedarius) using somatic cell counts and the N-acetyl-beta-D-glucosaminidase test.
Somatic cell counts, N-acetyl-beta-D-glucosaminidase (NAGase) activity and the infection status of the udder were determined in quarter milk samples (n = 86) from 22 multiparous, clinically healthy camels, traditionally managed by Bedouin nomads in the Negev desert, Israel. Seventy (81.4%) of the 86 samples examined contained bacteria, of which 35 (40.7%) gave mixed isolations of two or more bacteria, suggesting the existence of subclinical mastitis in the camel herds studied. Sixteen samples (18.6%) yielded no growth of bacteria. Staphylococcus aureus, Micrococcus spp., Bacillus spp., Streptococcus dysgalactiae and Escherichia coli were the main organisms isolated. The somatic cell count (SCC) ranged from 1.01 x 105 to 11.78 x 106 cells/ml. NAGase values were between 41.4 and 372 NAGase units. Quarter milk samples that contained bacteria had significantly (p < 0.01) higher mean values for SCC but the mean NAGase levels were not significantly different for the bacteriologically negative and positive samples. There was a low correlation coefficient (r2 = 0.097) between the SCC and NAGase in the quarter milk samples from which bacteria were not isolated (n = 16) and a low negative correlation (r2 = -0.038) with the samples that contained bacteria (n = 70). The type of bacteria had a significant effect (p < 0.01) on the SCC but not on the NAGase activity. Quarter samples from which Staphylococcus aureus (coagulase positive) was isolated showed the highest mean SCC and this organism is therefore suspected to be the underlying cause of the subclinical mastitis. The SCC gave a better indication of the presence of pathogenic microorganisms in milk samples than did NAGase.


Measurement of specific laryngeal muscle function by ultrasound.
Ultrasonic dimension gauges were implanted in the crico-arytenoideus dorsalis muscle in a mature horse. Resting and contracted muscle length and average contraction rate were measured serially in the conscious state over a period of 25 days. Results suggest that specific laryngeal muscle function in the horse may be defined with this approach. Since man and horse are both known to suffer from laryngeal hemiplegia, this experimental preparation may help provide information of benefit to both species.


HNSCC cell lines positive for HPV and p16 possess higher cellular radiosensitivity due to an impaired DSB repair capacity.
When treated by radiotherapy, patients with squamous cell carcinomas of the head and neck (HNSCC) positive for HPV and p16(INK4a) possess a clearly favorable prognosis as compared to those with HPV-negative HNSCC. The aim of this work was to study whether the better outcomes might be caused by an enhanced cellular radiosensitivity. The radiation response of five HPV/p16(INK4a)-positive and five HPV-negative cell lines was characterized with regard to cellular radiosensitivity by colony formation assay. Furthermore G1- and G2-arrest, apoptosis and residual DNA double-strand breaks (DSB) were analyzed by the colcemid-based G1-efflux assay, propidium iodide staining, the detection of PARP cleavage, the fluorescence-based detection of caspase activity and the immunofluorescence staining of γH2AX and 53BP1 foci. On average, the cellular radiosensitivity of the HNSCC cell lines positive for HPV and p16(INK4a) was higher as compared to the sensitivity of a panel of five HPV-negative HNSCC cell lines (SF3=0.2827 vs. 0.4455). The higher sensitivity does not result from increased apoptosis or the execution of a permanent G1-arrest, but is rather associated with both, elevated levels of residual DSBs and extensive G2-arrest. Increased cellular radiosensitivity due to compromised DNA repair capacity is likely to contribute to the improved outcome of patients with HPV/p16(INK4a)-positive tumors when treated by radiotherapy.


Silicone granulomas: report of three cases and review of the literature.
Since silicone is rapidly becoming one of the most commonly used biomaterials in modern medicine, pathologists will be observing increasing numbers of cases of silicone-related disease. Although numerous case reports have established that silicone elicits a characteristic response in tissues, the varying tissue reactions to silicone gels, liquids, and elastomers (rubber) have not been emphasized. Three cases are reported, and the literature is reviewed to illustrate the varying features of tissue reaction to silicone in its different forms. The first case is an example of silicone lymphadenopathy in an inguinal lymph node. This case demonstrates exuberant foreign body granuloma formation in response to particles of silicone elastomer. The second case involves a patient who had facial subcutaneous liquid silicone injections, and the third case is that of a woman in whom breast carcinoma developed 13 years after mammary augmentation with liquid silicone injections. These two cases illustrate the characteristic reaction to silicone liquid, with numerous cystic spaces and vacuoles in the soft tissues but minimal or no foreign body giant cell reaction. Scanning electron microscopy and energy dispersive x-ray analysis were performed in the first two cases, confirming the presence of silicon. Silicone migration and the clinical significance of various silicone-induced lesions are discussed.


Development of High-Density Genetic Linkage Maps and Identification of Loci for Chestnut Gall Wasp Resistance in Castanea spp.
Castanea sativa is an important multipurpose species in Europe for nut and timber production as well as for its role in the landscape and in the forest ecosystem. This species has low tolerance to chestnut gall wasp (Dryocosmus kuriphilus Yasumatsu), which is a pest that was accidentally introduced into Europe in early 2000 and devastated forest and orchard trees. Resistance to the gall wasp was found in the hybrid cultivar 'Bouche de Bétizac' (C. sativa × C. crenata) and studied by developing genetic linkage maps using a population derived from a cross between 'Bouche de Bétizac' and the susceptible cultivar 'Madonna' (C. sativa). The high-density genetic maps were constructed using double-digest restriction site-associated DNA-seq and simple sequence repeat markers. The map of 'Bouche de Bétizac' consisted of 1459 loci and spanned 809.6 cM; the map of 'Madonna' consisted of 1089 loci and spanned 753.3 cM. In both maps, 12 linkage groups were identified. A single major QTL was recognized on the 'Bouche de Bétizac' map, explaining up to 67-69% of the phenotypic variance of the resistance trait (Rdk1). The Rdk1 quantitative trait loci (QTL) region included 11 scaffolds and two candidate genes putatively involved in the resistance response were identified. This study will contribute to C. sativa breeding programs and to the study of Rdk1 genes.


Magnetic resonance imaging in vascular malformations: studies with and without gadolinium-DTPA.
MRI and gadolinium-DTPA enhanced dynamic MRI increase the information available for and from diagnosis of vascular malformations since it appears possible to obtain nearly specific information about these lesions. Further investigations are needed with fast imaging, flow imaging, and MR substraction angiography to obtain information similar to that obtained by angiography and CT. The value of X-ray CT for the diagnosis of vascular malformations seems to be inferior to MRI since MRI can delineate vessels and flow better and also allows direct multiplanar imaging.


High density of cholinergic muscarinic receptors accompanies high intensity acetylcholinesterase-staining in layer IV of infant rat somatosensory cortex.
In this study the laminar localization of binding sites for the muscarinic radioligand [3H]3-quinuclidinylbenzilate was studied in somatosensory cortex of infant rat. Using light autoradiographic techniques, [3H]QNB was found to be concentrated in layer IV. Atropine-pretreated pups showed evenly dispersed, nonspecific binding in all layers. We conclude that cholinergic muscarinic receptors are concentrated in layer IV of infant rat somatosensory cortex. It is also in this lamina that an acetylcholinesterase-rich pathway terminates.


Studies on the chemical composition and biological properties of transfer factor.
Dialyzable transfer factor (dTF) was fractionated on Sephadex G-10 and G-25 fine columns, and biological activity was found in 3 fractions. One of these, designated VIa, and having a tendency to adsorb to the Sephadex G-10 gel, was shown to have a therapeutic effect on certain immunological diseases. Analysis of this fraction on thin-layer and gas chromatography and with infrared and mass spectroscopy indicated that about half of this fraction was composed of uracil; additional unidentified heterocyclic and aromatic substances were present in this fraction. Adjacent fraction V contained tyrosine and a small polyribonucleotide, and fraction VII hypoxanthine and additional unidentified components. Our results suggest that the therapeutic activity of dTF is not mediated through an immunologically specific informational molecule, but is rather based on non-specific stimulation of the expression of the immune response.


Exploring the short-term and long-term linkages between carbon price and influence factors considering COVID-19 impact.
Because of global lock-downs caused by the unexpected COVID-19, the interactions between emission trading and related markets have changed significantly compared to the pre-COVID-19 period. Considering the pandemic effect, this paper established an integrated system to identify the relationship trajectories between carbon trading market and impact factors. A noise-assisted multivariate empirical mode decomposition (N-A MEMD) method was utilized to simultaneously decompose the original multi-dimensional time series into intrinsic mode functions (IMFs), after which the Lempel-Ziv (LZ) complexity algorithm was applied to reconstruct the IMFs into high-frequency (HF), low-frequency (LF), and trend modules. Vector autoregression (VAR) and vector error correction (VEC) models were then used to systematically simulate the correlations. The time span was split into pre-COVID-19 and post-COVID-19 periods for comparison, and the mobility trends data during the outbreak period released by the Apple company was chosen to reflect the pandemic effects. The empirical analysis results revealed the energy prices, macroeconomic index, and exchange rate are the main external impact factors of carbon price in the short term. Summarizing from the cointegration models over the long term, the market stability reserve (MSR) mechanism was found to have ability on stabilizing the carbon price under the epidemic shock. Furthermore, the COVID-19 was found to complicate the relationships between carbon price and influence factors, which resulted in fluctuating markets.


Creation and implementation of a national emergency medicine fourth-year student examination.
A National Board of Medical Examiners examination does not exist for Emergency Medicine (EM) students. To fill this void, the Clerkship Directors in Emergency Medicine tasked a committee with development of an examination for 4th-year (M4) EM students, based on a published syllabus, and consisting of questions written according to published question-writing guidelines. Describe examination development and statistics at 9 months. The committee reviewed an existing EM student question database at www.saemtests.org for statistical performance, compliance with item-writing guidelines, and topic inclusion within the published EM M4 syllabus. For syllabus topics without existing questions, committee members wrote new items. LXR 6.0 software (Applied Measurement Professionals, Inc., Georgetown, SC) was used for examination administration. Data gathered included numbers of examinations completed, mean scores with SD, and point biserial correlation (rpb). Of the 553 questions assessed, 157 questions met the stated criteria, and 37 were included in the examination. Thirteen new questions were written by committee members to cover all curriculum topics. The National EM M4 Examination was released online August 1, 2011. Nine months later, the examination had been completed 1642 times by students from 27 clerkships. Mean score was 79.69% (SD 3.89). Individual question difficulties ranged from 26% to 99%. Question rpbs ranged from 0.067 to 0.353, mean 0.213 (SD 0.066). A national group of EM educators developed an examination to assess a published clerkship syllabus. The examination contains questions written according to published item-writing guidelines, and exhibits content validity, appropriate difficulty levels, and adequate question discriminatory ability.


Interleukin-6 production by murine macrophage cell lines P388D1 and J774A.1: stimulation requirements and kinetics.
The murine macrophage tumor lines, P388D1 and J774A.1 were stimulated with LPS, IL-6, IL-1 alpha, TNF-alpha, IFN-gamma, PMA, or combinations of these reagents to induce the production of IL-6, IL-1, and TNF-alpha. Using Northern blot analysis and bioassays for the detection of cytokine production, it was noted that identical stimuli induced all three inflammatory mediators. However, unlike fibroblasts or endothelial cells, neither P388D1 nor J774A.1 macrophages respond to IL-1 alpha or TNF-alpha by producing IL-6. The results imply that these cytokines are not autoregulatory for macrophages and may be tissue-specific in their stimulatory effects. IFN-gamma and PMA synergize with LPS in the production of IL-6 as well as IL-1 and TNF-alpha. These observations suggest that IFN-gamma may mediate amplification pathways important in the production of inflammatory mediators. Kinetic studies on the transcription of mRNA and secretion of IL-6, IL-1, and TNF-alpha revealed that TNF-alpha mRNA transcription and cytokine production occur very rapidly. TNF-alpha mRNA accumulation peaked 1-2 hr after stimulation and maximum concentrations of cytokine are found in supernatants collected after 2-4 hr of culture. IL-6 and IL-1 alpha mRNA accumulation peaked simultaneously after 4-8 hr. However, IL-6 bioactivity peaks between 8 and 12 hr whereas maximum concentrations of IL-1 bioactivity are not detected in supernatants from stimulated cells collected prior to 12 hr of culture. Thus even though TNF-alpha production precedes that of IL-1 and IL-6, and stimulates IL-6 production in fibroblasts, there is no evidence that TNF-alpha acts to amplify the production of IL-6 or IL-1 by murine macrophage cell lines. The results suggest differential regulation of IL-6 expression between fibroblasts and macrophages.


Confirmation Testing of Essure Microinserts in Unintended Pregnancies Using a 10-Year Retrospective Database.
To examine the imaging modality used in cases of Essure failures and determine the cause of the unintended pregnancies (noncompliance to follow-up recommendations, misinterpretation of the imaging test, or device failure). Retrospective, single-center interventional cohort (Canadian Task Force classification II-2). Tertiary level hospital. Women who have had Essure placement and subsequent pregnancy. Coding data from the Regina General Hospital was examined for any pregnancy occurring after an Essure procedure. The hospital charts were then reviewed for data collection. A separate imaging database established over the same time frame was then reviewed to determine the imaging modality used in each case (transvaginal ultrasound [TVU], hysterosalpingogram [HSG], or none). Results of the imaging study were reviewed and the cause of the failure determined. Twenty-four pregnancies in 25 women were identified after Essure procedures from January 1, 2003 to March 31, 2013. There were 4 in vitro fertilization pregnancies and 4 pregnancies where the woman had been instructed not to rely on the devices because of incomplete placement noted at time of the procedure. Therefore, 17 unintended pregnancies occurred of a total 2080 procedures performed. Examination of the imaging studies revealed that 11 were due to patient noncompliance (either early cessation of backup contraception or failure to go for confirmatory imaging), 5 due to misinterpretation of the imaging tests (3 HSG, 2 TVU), and 1 device failure. This reveals a cumulative failure rate of 6 of 2080 or .29% over 10 years with only .04% (1/2080) being device related. Essure sterilization is an effective means of permanent contraception with a device failure rate of only .04%. Most unintended pregnancies after the Essure procedure result from a failure to comply with follow-up recommendations, and strategies to improve compliance should be emphasized.


The relationship between sensory processing, childhood rituals and obsessive-compulsive symptoms.
Studies of Obsessive-Compulsive Disorder (OCD) and research in occupational therapy suggest a link between sensory hypersensitivity and excessive use of rituals. The present research constitutes an initial attempt to examine this potential link. In Study 1, parents of 4-6-year old children (N = 61) completed the Childhood Routine Inventory, the Sensory Profile and the Screen for Child Anxiety Related Emotional Disorders. In Study 2 we administered an adapted version of the sensory profile to an internet sample of adult participants (N = 314) together with the Obsessive-Compulsive Inventory-Revised, the anxiety subscale of the International Personality Item Pool - NEO and items measuring participants' recollection of their childhood oral and tactile hypersensitivity. Strong reactions to everyday sensory events were highly correlated with childhood ritualism, even after controlling for anxiety. In the adult sample, current and recollected oral and tactile hypersensitivity were significantly related to OCD symptoms. In Study 1, children's sensory sensitivity was not tested directly, but rather through parental report. The scale was developed ad hoc based on face validity and relationship with ritualism. The studies were cross-sectional in design. Study 2 partially relied on recollection of childhood behavior. The results suggest a strong relationship between sensory sensitivity, childhood ritualism and adult OCD symptoms. Oral and tactile hypersensitivity in childhood may be one pathway to adult OCD.


Metabolite Profiling of Diverse Rice Germplasm and Identification of Conserved Metabolic Markers of Rice Roots in Response to Long-Term Mild Salinity Stress.
The sensitivity of rice to salt stress greatly depends on growth stages, organ types and cultivars. Especially, the roots of young rice seedlings are highly salt-sensitive organs that limit plant growth, even under mild soil salinity conditions. In an attempt to identify metabolic markers of rice roots responding to salt stress, metabolite profiling was performed by ¹H-NMR spectroscopy in 38 rice genotypes that varied in biomass accumulation under long-term mild salinity condition. Multivariate statistical analysis showed separation of the control and salt-treated rice roots and rice genotypes with differential growth potential. By quantitative analyses of ¹H-NMR data, five conserved salt-responsive metabolic markers of rice roots were identified. Sucrose, allantoin and glutamate accumulated by salt stress, whereas the levels of glutamine and alanine decreased. A positive correlation of metabolite changes with growth potential and salt tolerance of rice genotypes was observed for allantoin and glutamine. Adjustment of nitrogen metabolism in rice roots is likely to be closely related to maintain the growth potential and increase the stress tolerance of rice.


Purification of a carboxypeptidase B-like enzyme from the starfish Dermasterias imbricata.
A carboxypeptidase B-like enzyme which catalyses the hydrolysis of synthetic esters of lysine and arginine has been isolated from the starfish Dermasterias imbricata. This carboxypeptidase B-like enzyme has a molecular weight of approximately 34 000 and shares this and other properties with bovine pancreatic carboxypeptidase B. The existence of zymogen for this activity in the pyloric caeca of the starfish is demonstrated. This zymogen has a molecular weight near 40 000 and appears to be analogous to other monomeric procarboxypeptidases B. The zymogen possesses an intrinsic low-level activity toward synthetic substrates of carboxypeptidase B and is activated by trypsin.


Sewer sediment adhesion reduction and hydraulic floating promotion by alkaline treatment.
Deposition of sediment in sewers decreased flow capacity, with harmful gases and pipe erosion. Sediment floating and removal remained challenges due to its gelatinous structure, which induced strong erosion resistance. This study proposed an innovative alkaline treatment for destructuring gelatinous organic matters and improving hydraulic flushing capacity of sediments. At the optimal pH 11.0 condition, the gelatinous extracellular polymeric substance (EPS) and microbial cells were disrupted, with numerous outward migration and solubilization of proteins, polysaccharides and humus. The aromatic protein solubilization (tryptophan-like and tyrosine-like proteins) and humic acid-like substance deconstruction were the major driving factors for sediment cohesion reduction, which disintegrated the bio-aggregation and increased the surface electronegativity. Meanwhile, the variations of functional groups (CC, CO, COO-, CN, NH, C-O-C, C-OH, OH) also contributed to the interaction breakage and glutinous structure disruption of sediment particles. It was found that the rising pH conditions reduced sediment adhesion and promoted particle floating. Solubilizations of total suspended solids and volatile suspended solids were increased by 12.8 and 9.4 times, respectively, while the sediment adhesion was reduced by 3.8 fold. The alkaline treatment greatly improved sediment erosion and flushing capacities under shear stress of gravity sewage flow. Such sustainable strategy only cost 36.4 CNY per sewer meter length, which was 29.5-55.0 % of the high-pressure water jet flushing and perforated tube flushing approaches.


Direct upper-lip lifting: a safe procedure.
Thin lips and an aging lower third of the face are increasingly the focus for surgical improvement. Thin and tightly pursed lips imply a certain resignation or even bitterness, especially in older women. Excessive application of lipstick to enhance the shape and color of thin lips was a solution but a poor camouflage. The desire for well-defined and full lips, as seen today on many models and actresses, is the motivation behind the increasing demand of women with relatively normal looking lips to turn to cosmetic surgery. They often present the surgeon with photographs of the shape and fullness of lips they desire to achieve. In this article the author recommends the use of the direct upper-lip lifting method as a more effective and successful approach to enhancing the shape of the upper lip. For plumping the lower and upper lip, the author recommends using autologous collagen augmentation.


Seminal vesicle cysts causing pelvic pain: importance of computed tomography.
A seminal vesicle cyst is a rare etiology of pelvic pain. However, its rarity may result in oversight or misinterpretation if the radiologist or emergency physician is unfamiliar with this entity. Seminal vesicle cysts may cause pelvic pain because of mass effect, infection, internal hemorrhage, or urinary and bladder obstruction. Because seminal vesicle cysts rarely result in physical examination findings or laboratory abnormalities, pelvic computed tomography plays a pivotal role in their diagnosis and in evaluating patients with pelvic pain. Recognition of the imaging findings of seminal vesicle cysts is necessary to allow prompt, accurate diagnosis. Therefore, emergency physicians and radiologists interpreting examinations from the emergency department should be familiar with these imaging findings because seminal vesicle cysts may be the etiology of pelvic pain and the patient may benefit from urologic consultation and cyst aspiration or resection. The purposes of this article are to provide examples of pelvic pain caused by seminal vesicle cysts, illustrate the key imaging findings on computed tomography, and briefly review the literature.


Hematuria induced by urethral catheterization.
The amount of traumatic hematuria induced by urethral catheterization was studied by comparing the pre- and post-catheterization urinalyses of 93 patients presenting to the emergency department with abdominal complaints of an acute nature. Thirty-nine male patients ranging in age from 4 to 91 years and 51 female patients ranging in age from 1 to 70 years were studied. Catheterizations were performed by nurses (54%), resident house-staff (38%), and nurse practitioners (8%). Overall, hematuria was induced in 16 of 93 patients (17.2%) and, when present, never exceeded 3 RBC/hpf.


Predictive value of the early clinical signs in Rett disorder.
The British Isles Survey for Rett has registered 1,159 cases over up to 20 years. Indicators of health and severity, recorded at intervals throughout life, are drawn from clinical examinations, reports and postal questionnaires. This study aimed to establish the stability and predictive value of an early severity score based on muscle tone, locomotor ability, feeding difficulty, scoliosis and epilepsy. Data from people with clinically documented classic or non-classic Rett and health records over 20-30 years indicate that severity scores tend to increase throughout the first 15 years and then to stabilise in mild and severe, classic and non-classic Rett. Severity scores before regression reflect later severity scores within relatively wide inter-quartile ranges. In general, the adult severity level is around 40 points above the pre-regression level for classic Rett and around 20 points for non-classic Rett. High early severity scores are associated with reduced cumulative survival. Used with caution, early signs are helpful in diagnosis and prognosis. The mutations T158M, R255X and R168X are generally associated with more severe and R306C and R133C with less severe disease but exceptions make these unreliable predictors of outcome.


Skin breakdown in children and high-frequency oscillatory ventilation.
To investigate the relationship of high-frequency oscillatory ventilation (HFOV) to skin breakdown on the scalp and ears in mechanically ventilated children. Retrospective cohort study of 32 patients supported with HFOV paired with 32 patients supported with conventional mechanical ventilation (CV) in a pediatric intensive care unit (PICU). By univariate analysis, more HFOV patients had skin breakdown than did the CV patients (53% vs 12.5%, p=.001); HFOV patients also had greater severity of illness (Pediatric Risk of Mortality scores), higher mortality, and longer durations of neuromuscular blockade, low systolic blood pressure, and time exposed to risk. Life table analysis demonstrated no difference in the rate of skin breakdown between HFOV and CV patients. Multifactorial analysis showed that only PICU time at risk was a risk factor for skin breakdown. HFOV was not an independent risk factor for the development of skin breakdown. PICU time at risk was the sole risk factor for the development of skin breakdown in all mechanically ventilated patients in the PICU.


Malnutrition risk at solid tumor diagnosis: the malnutrition screening tool in a large US cancer institute.
In cancer, malnutrition is common and negatively impacts tolerance and outcomes of anti-tumor therapies. The aim of this study was to evaluate the prevalence of malnutrition risk and compare the clinicodemographic features between those with high malnutrition screening tool (MST) scores (i.e., ≥ 2 of 5 = high risk for malnutrition, H-MST) to low scores (L-MST). A cohort of 3585 patients (May 2017 through December 2018), who completed the MST at least once at the time of diagnosis of any stage solid tumor, were analyzed. Logistic regression tested for associations between clinicodemographic factors, symptom scores, and H-MST prevalence. The median age was 64 years (25-75 IQR, 55-72), with 62% females and 81% White. Most common tumor primary sites were breast (28%), gastrointestinal (GI) (21%), and thoracic (13%). Most had non-metastatic disease (80%). H-MST was found in 28%-most commonly in upper (58%) and lower GI (42%), and thoracic (42%) tumors. L-MST was most common in breast (90%). Multivariable regression confirmed that Black race (OR 1.9, 95% CI 1.5-2.4, p = < 0.001), cancer primary site (OR 1.6-5.7, p = < 0.001), stage IV disease (OR 1.8, 95% CI 1.4-2.2, p = < 0.001), low BMI (OR 4.2, 95% CI 2.5-6.9 p = < 0.001), and higher symptom scores were all independently associated with H-MST. Twenty-eight percent of solid tumor oncology patients at diagnosis were at high risk of malnutrition. Patients with breast cancer rarely had malnutrition risk at diagnosis. Significant variation was found in malnutrition risk by cancer site, stage, race, and presence of depression, distress, fatigue, and trouble eating/swallowing.


Effect of fasting on free and esterified carnitine levels in human serum and urine: correlation with serum levels of free fatty acids and beta-hydroxybutyrate.
Serum levels of free L-carnitine, acylcarnitines, creatinine, beta-hydroxybutyrate, free fatty acids, cholesterol, triglycerides, and glucose were determined in healthy volunteers during a 24-36-hr fast. The effect of oral administration of free L-carnitine (1 g/person) on these parameters was studied. Urinary excretion of carnitine and creatinine was monitored throughout. Serum and urine levels of free carnitine and its renal clearance decreased during the fast. However, the serum concentration and urinary excretion of acylcarnitines increased during the same interval. Following the ingestion of free L-carnitine, both serum and urinary levels of free L-carnitine rose. Within 6 hr of ingestion, 10% of the administered dose could be accounted for by urinary excretion. No significant effect on the other serum constituents under study was seen following the oral L-carnitine dose. A significant negative correlation was found between serum levels of free L-carnitine and beta-hydroxybutyrate and free fatty acids (r equal -0.567, p less than 0.001 and r equal -0.607, p less than 0.001, respectively) during the fast.


Superselective angiography of the hip. Technique, normal features, and early results in idiopathic necrosis of the femoral head.
The vessels of the hip were studied by superselective injection of the various branches supplying it. The medial and lateral circumflex, obturator, and superior and inferior gluteal arteries were catheterized using a left axillary or brachial approach. The femoral head is supplied primarily by the capsular arteries arising from the medial circumflex artery. Good visualization of the superior capsular arteries is obtained by superselective injection with subtraction. Occlusion of these arteries is shown in the early phase of idiopathic necrosis of the femoral head. The capsular arteries may or may not be revascularized in later phases of this condition, whose evolution is discussed and correlated with the degree of revascularization.


Role of macrophages in age-related oxidative stress and lipofuscin accumulation in mice.
The age-related changes in the immune functions (immunosenescence) may be mediated by an increase of oxidative stress and damage affecting leukocytes. Although the "oxidation-inflammation" theory of aging proposes that phagocytes are the main immune cells contributing to "oxi-inflamm-aging", this idea has not been corroborated. The aim of this work was to characterize the age-related changes in several parameters of oxidative stress and immune function, as well as in lipofuscin accumulation ("a hallmark of aging"), in both total peritoneal leukocyte population and isolated peritoneal macrophages. Adult, mature, old and long-lived mice (7, 13, 18 and 30 months of age, respectively) were used. The xanthine oxidase (XO) activity-expression, basal levels of superoxide anion and ROS, catalase activity, oxidized (GSSG) and reduced (GSH) glutathione content and lipofuscin levels, as well as both phagocytosis and digestion capacity were evaluated. The results showed an age-related increase of oxidative stress and lipofuscin accumulation in murine peritoneal leukocytes, but especially in macrophages. Macrophages from old mice showed lower antioxidant defenses (catalase activity and GSH levels), higher oxidizing compounds (XO activity/expression and superoxide, ROS and GSSG levels) and lipofuscin levels, together with an impaired macrophage functions, in comparison to adults. In contrast, long-lived mice showed in their peritoneal leukocytes, and especially in macrophages, a well-preserved redox state and maintenance of their immune functions, all which could account for their high longevity. Interestingly, macrophages showed higher XO activity and lipofuscin accumulation than lymphocytes in all the ages analyzed. Our results support that macrophages play a central role in the chronic oxidative stress associated with aging, and the fact that phagocytes are key cells contributing to immunosenescence and "oxi-inflamm-aging". Moreover, the determination of oxidative stress and immune function parameters, together with the lipofuscin quantification, in macrophages, can be used as useful markers of the rate of aging and longevity.


Direct Visualization of the Two-step Nucleation Model by Fluorescence Color Changes during Evaporative Crystallization from Solution.
The two-step nucleation model for crystal nuclei formation explains several experimental and theoretical results better than the classical nucleation theory. We report here direct visualization of the two-step nucleation model for organic molecular crystallization. Evaporative crystallization from a solution of a dibenzoylmethane boron complex that displays mechanofluorochromism, a fluorescence color change induced by mechanical perturbation, was probed by fluorescence change. The dependence of fluorescence change on dispersion concentration of the complex in a polymer matrix was also investigated. We detected transitional emission from the amorphous cluster state prior to crystallization. This is the first demonstration of the two-step nucleation model based on fluorescence color changes.


Substance P inhibits the acute stimulation of ganglionic tyrosine hydroxylase activity by a nicotinic agonist.
Incubation of rat superior cervical ganglia with dimethylphenylpiperazinium (30 microM) for 30 min resulted in a two-fold increase in tyrosine hydroxylase activity. This effect was completely inhibited by substance P (30 microM) but not by substance P-free acid, kassinin or physalaemin. Neither of these four peptides alone produced any change in the activity of tyrosine hydroxylase. The IC50 for the inhibitory effect of substance P was approximately 3 microM. Substance P did not inhibit the stimulatory effects of bethanechol or vasoactive intestinal peptide on this enzyme activity. Thus substance P, acting at a site which has a different pharmacology than previously characterized substance P receptors, selectively inhibits nicotinic stimulation of tyrosine hydroxylase activity. These data raise the possibility that substance P may modulate the nicotinic regulation of catecholamine synthesis in sympathetic ganglia in vivo.


Up-regulation of ERG11 gene among fluconazole-resistant Candida albicans generated in vitro: is there any clinical implication?
A well-characterized matched pair of fluconazole (FLU)-susceptible and FLU-resistant isolates, in addition to a clinical resistant isolate, was analyzed. It was found a differential expression of genes: the resistant strains experimentally induced after fluconazole exposure in vitro were associated mainly with up-regulation of ERG11 gene and a clear trailing growth in broth microdilution tests, whereas the isolate with clinically acquired resistance expressed constitutively high level of CDR gene and fluconazole MIC >64 mg mL(-1) within 24 h of incubation. The phenotype of resistant cells generated in vitro was reversible, implying that an induced transcriptional up-regulation of ERG genes would be one adaptive mechanism allowing the cells to grow in the presence of azole drugs. These drugs could have a potential role in modulating genes whose up-regulation would allow cells to remain in the hosts, providing a source for further development of resistance.


Fat pad triacylglycerol fatty acid loss and oxidation as indices of total body triacylglycerol fatty acid mobilization and oxidation in starving mice.
We tested our hypothesis that, kinetically, triacylglycerol fatty acids in heterogeneously labeled adipocytes behave similarly to the whole fat pad triacylglycerol fatty acid during starvation in mice. Adipose triacylglycerol fatty acids were labeled with [1-14C]palmitate (complexed to albumin) by injection of a small bolus (2-5 microliter) into either epididymal or inguinal fat pads. Both 14C-labeled triacylglycerol fatty acid spec. act. and breath 14CO2 spec. act. were monitored 30 min after tracer injection and after 24-72 h starvation. Adipose triacylglycerol fatty acid spec. act. remained approximately constant during fasting, i.e., tracer and mass disappeared at similar rates. Negligible translocation of labeled triacylglycerol fatty acid from the injection site to other parts of the same fat pad or to distant fat pads occurred. Triacylglycerol fatty acid was mobilized more slowly from epididymal than from inguinal fat pads in two of three studies. Triacylglycerol fatty acid disappearance (loss) from inguinal fat pads was more replicable than from epididymal fat pads and more closely reflected the fall in whole body total lipid during starvation. The estimated percent of breath CO2-carbon derived from adipose triacylglycerol fatty acid increased from an average of approx. 32% in the postabsorptive state to about 77% after 48 h starvation. The data help to validate the direct tracer injection technique as a means of studying adipose triacylglycerol fatty acid turnover and oxidation. This approach should be particularly useful for studying the fate of adipose triacylglycerol fatty acid when it is mobilized. e.g., during states of inanition and starvation and in response to hormones and cancer-induced cachexia.


Use of serum copper and zinc levels in the diagnostic evaluation of endometrioma and epithelial ovarian carcinoma.
The aim of this study is to evaluate serum copper (Cu) and zinc (Zn) levels in patients with epithelial ovarian cancer and endometrioma. We included 21 epithelial ovarian cancer patients, 47 endometrioma patients, 31 healthy women of reproductive age, and 10 healthy women in menopause. Cu and Zn levels and Cu/Zn ratios were compared. In the endometrioma group, Cu levels (P = 0.04) and Cu/Zn ratio (P < 0.01) were higher, while Zn levels (P < 0.01) were lower compared to the control group. The threshold value of 1.15 with 62% sensitivity and 61% specificity was calculated for the Cu/Zn ratio using the ROC curve (AUC = 0.688; P = 0.005). In the ovarian cancer group, Cu levels (P ≤ 0.01) and Cu/Zn ratio (P = 0.02) were higher, whereas Zn levels (P ≤ 0.02) were lower compared to the control group. The Cu/Zn ratio threshold value of 1.37 was calculated with 76% sensitivity and 90% specificity (AUC = 0.829; P = 0.004). The Zn level was lower (P = 0.02), and the Cu/Zn ratio was higher (P = 0.01) in the ovarian cancer group compared to the endometrioma group. The threshold value of the Cu/Zn ratio for ovarian cancer could be determined with a specificity of 90%, whereas the sensitivity and specificity of the Cu/Zn ratio for endometrioma were low.


DNA flow cytometric values in bladder carcinoma biopsies obtained from fresh and paraffin-embedded material.
DNA-histograms were obtained by flow cytometry (FCM) of nuclei prepared from fresh bladder carcinoma biopsies and from 100 micron sections of paraffin-embedded material from the same biopsies. Linear regression analysis of ploidy values from fresh material versus those from paraffin blocks showed excellent correlation (R2 = 0.957). Owing to the high background, the paraffin-embedded material was less suited for analysis of S-phase fraction. It is concluded that DNA FCM of nuclei obtained from paraffin-embedded bladder carcinoma biopsies yields reliable results concerning ploidy, but does not permit evaluation of the S-phase fraction.