Violence among individuals in substance abuse treatment: the role of alcohol and cocaine consumption.
This study examined factors associated with expressed violence in the 90 days prior to substance abuse (SA) treatment among 125 men and 125 women recently enrolled in treatment. Approximately 85% of the sample reported a significant conflict situation, and over 32% reported an incident of physical violence. Both general alcohol and cocaine use patterns (on days not involving significant interpersonal conflict), as well as alcohol and cocaine use on the day of the violent incident, were associated with violence severity. Regression analyses revealed that race, education, age, and both general drinking and cocaine use patterns were associated with violence severity for the most severe violent incident reported. Similarly, regression analyses focusing on alcohol and cocaine use on the day of the most severe incident revealed that higher drinking levels, younger age, minority status, and the interaction of alcohol and cocaine use were associated with violence severity. The results provide important information regarding factors associated with expression of violence among men and women in SA treatment, and have implications regarding the assessment of violence risk factors. Further, the findings suggest that screening and intervention approaches for violence-related problems should be routine in SA treatment, and appear to be especially indicated for patients reporting alcohol consumption, and co-occurring alcohol and cocaine consumption.


Smoking cessation assistance for patients with bladder cancer: a national survey of American urologists.
Cigarette smoking is a known risk factor for bladder cancer. How urologists address smoking cessation among patients with bladder cancer is not well-known. We assessed the practice patterns of American urologists regarding smoking cessation assistance for patients with bladder cancer. A questionnaire regarding smoking cessation practice patterns was sent to 1,821 American urologists in the 2008 American Urological Association membership directory. Responses were summarized with frequency and percent. Statistical comparison was made using chi-square tests. Multiple logistic regression was used to detect significant predictors of providing smoking cessation assistance. Responses were received from 601 urologists who collectively treated an estimated 14,713 patients with bladder cancer in the last year. More than half (55.6%) of urologists never discuss smoking cessation while only 19.8% always discuss smoking cessation with patients with bladder cancer. Of urologists who never discuss smoking cessation 40.7% believe that smoking cessation may not alter the course or outcome of the disease and 37.7% do not feel qualified giving smoking cessation counseling. Most urologists (93.7%) have never had formal smoking cessation training. Urologists with smoking cessation training were more likely to always provide smoking cessation assistance compared to those without training (20.6% vs 6.0%, p = 0.0011). Number of patients with bladder cancer treated (OR 3.96) and formal smoking cessation training (OR 13.49) were significant predictors of providing smoking cessation assistance. American urologists demonstrate a low rate of providing smoking cessation assistance to patients with bladder cancer. Urologists who are trained in smoking cessation most commonly provide smoking cessation assistance. We recommend integrating formal smoking cessation instruction into courses that address bladder cancer and strongly encourage the American Urological Association to adopt practice pattern guidelines.


A Potential Novel Indication for Preventing Thromboembolism in Patients with Atrial Arrhythmias: Remodeling of the Left Atrium.
Thrombosis in patients with atrial arrhythmias might be associated with remodeling of the left atrium (LA). We aimed to describe this relationship and identify a novel factor, in addition to the CHA2DS2-VASc score, to guide therapeutic strategies for preventing thromboembolism in the hope of improving the prognosis for such patients. Patients diagnosed with atrial arrhythmias and who met our inclusion criteria were enrolled in this study. Various clinical parameters were recorded; diameters reflecting remodeling of the LA were measured and thrombosis was diagnosed by enhanced CT. Totally, 192 patients were enrolled in the study. The overall prevalence of left atrial thrombosis was 8.3%. Patients with persistent atrial fibrillation exhibited the highest anteroposterior diameter of the LA (45.1±7.2 mm) and prevalence of thrombosis (15.6%). An anteroposterior LA diameter of ≥50 mm was a strong independent impact risk factor for thrombosis (OR=10.1, 95%CI: 2.8-36.9, P<0.001). The prevalence of LA thrombosis in patients with and without anteroposterior LA diameter of ≥50 mm was 25.8% and 5.0%, respectively. Marked remodeling of the LA characterized by an anteroposterior LA diameter of ≥50 mm is a strong independent risk factor of thrombosis, and should be considered for the prevention of thromboembolism through various strategies.


Increased cortical porosity is associated with daily, not weekly, administration of equivalent doses of teriparatide.
The pharmacokinetic profile of parathyroid hormone (PTH) determines its effects on bone resorption and formation. When administered intermittently, anabolic effects are favored in comparison with the continuous treatment. Among the intermittent treatment regimens, lower frequency of administration may have a lower effect on bone remodeling. We therefore hypothesized that weekly administration of teriparatide will produce less increase in intracortical remodeling and porosity than reported using daily treatment. We treated 17 female New Zealand white rabbits aged 6months for 1month with teriparatide [human PTH(1-34)] as follows. (i) Vehicle-treated Control (n=4); (ii) 20μg/kg daily (n=3); (iii) 40μg/kg daily (n=3); (iv) 140μg/kg weekly (n=3); (v) 280μg/kg weekly (n=4). Proximal femurs were imaged ex vivo using micro-CT (Scanco Viva CT-40) at 15μmvoxel size. Areas, pore size, and porosity were analyzed on the total, compact cortex (CC), and transitional zones in a 10mm length region of interest (ROI) starting at the midshaft using StrAx1.0. Compared to controls, the 20μg/kg daily was associated with 3.0% higher porosity in the transitional zone (p=0.09) while the 40μg/kg daily was associated with a higher porosity in the cortex (8.7%; p=0.04) and in the transitional zone (5.7%; p=0.007). The daily regimens were also associated with a greater proportion of porosity due to pores >15μm2; particularly in the transitional zone where 20 and 40μg/kg daily increased porosity 2 fold (p=0.06) and 5 fold (p=0.04) relative controls respectively. The 140 and 280μg/kg weekly were not associated with an increase in porosity. There was no difference in total, compact or transitional zone cross sectional areas between the groups. Effects of intermittent teriparatide depend on the dose and frequency of administration. Daily dosing, particularly the higher dose, but not weekly dosing, increased cortical porosity. Work is needed to investigate the effects of the regimens on bone formation.


Epitope Mapping Using Peptide Microarray in Autoantibody Profiling.
The use of peptide microarrays for epitope mapping of autoantibodies greatly facilitates the early diagnosis of allergic, cytotoxin-associated diseases and especially inflammatory diseases. A common approach to create the microarrays utilizes nitrocellulose-coated glass slides for peptide probe binding, which is based on surface adsorption. Advantages of this method include excellent peptide binding capacity and long-term stability. To ensure equal accessibility to all antibodies on the peptide microarray during epitope mapping, all probes are immobilized in a random manner, thus avoiding concentration-dependent effects on signal intensity.In this chapter, we provide a step-by-step protocol on how to construct the peptide microarrays and perform epitope mapping of autoantibodies using them. Finally we present a comparative approach for the evaluation of the data.


RAGE inhibition reduces acute lung injury in mice.
The receptor for advanced glycation end-products (RAGE) is involved in inflammatory response during acute respiratory distress syndrome (ARDS). Growing body of evidence support strategies of RAGE inhibition in experimental lung injury, but its modalities and effects remain underinvestigated. Anesthetised C57BL/6JRj mice were divided in four groups; three of them underwent orotracheal instillation of acid and were treated with anti-RAGE monoclonal antibody (mAb) or recombinant soluble RAGE (sRAGE), acting as a decoy receptor. The fourth group served as a control. Lung injury was assessed by the analysis of blood gases, alveolar permeability, histology, AFC, and cytokines. Lung expression and distribution epithelial channels ENaC, Na,K-ATPase, and aquaporin (AQP)-5 were assessed. Treatment with either anti-RAGE mAb or sRAGE improved lung injury, arterial oxygenation and decreased alveolar inflammation in acid-injured animals. Anti-RAGE therapies were associated with restored AFC and increased lung expression of AQP-5 in alveolar cell. Blocking RAGE had potential therapeutic effects in a translational mouse model of ARDS, possibly through a decrease in alveolar type 1 epithelial cell injury as shown by restored AFC and lung AQP-5 expression. Further mechanistic studies are warranted to describe intracellular pathways that may control such effects of RAGE on lung epithelial injury and repair.


Molecular study of WISP3 in nine families originating from the Middle-East and presenting with progressive pseudorheumatoid dysplasia: identification of two novel mutations, and description of a founder effect.
Progressive pseudorheumatoid dysplasia (PPD) is a rare autosomal recessive syndrome characterized by the presence of spondyloepiphyseal dysplasia associated with pain, stiffness, and swelling of multiple joints, osteoporosis, and the absence of destructive bone changes. The disorder is caused by mutations of the WISP3 gene located on chromosome 6q22. We hereby report the molecular study of the WISP3 gene in nine unrelated consanguineous families originating from the Middle-East: three from Lebanon, five from Syria, and one from Palestinian Bedouin descent, all affected with PPD. Five different sequence variations were identified in the WISP3 gene, two of them being new mutations: the c.589G --> C transversion at codon 197, responsible for a splicing defect (A197fsX201); and the c.536_537delGT deletion (C179fsX), both in exon 3. In all other families, the affected patients were homozygous for a previously described nonsense mutation, namely c.156C --> A (C52X). Interestingly, in the latter families, the C52X mutation was always found associated with a novel c.248G --> A (G83E) variation, suggesting the existence of a founder effect.


E3-ligase knock down revealed differential titin degradation by autopagy and the ubiquitin proteasome system.
The sarcomere protein titin is a major determinant of cardiomyocyte stiffness and ventricular distensibility. The constant mechanical stress on titin requires well-controlled protein quality control, the exact mechanisms of which have not yet been fully elucidated. Here, we analyzed E3-ligases potentially responsible for cardiac titin ubiquitination and specifically studied the involvement of the autophagosomal system in titin degradation. Pharmacological inhibition of autophagy and the proteasome in cultured primary rat cardiomyocytes significantly elevated titin ubiquitination and increased titin degradation. Using in-vitro pull down assays we identified binding of E3-ligases MuRF1-3, CHIP and Fbx32 to several titin domains. Immunofluorescence analysis showed sarcomeric localization of the E3-ligases. siRNA-mediated knock-down of the E3-ligases MuRF-1, -3 and a combination of CHIP/Fbx32 significantly reduced autophagy-related titin ubiquitination, whereas knock-down of MuRF-2 and -3 reduced proteasome-related titin ubiquitination. We demonstrated that the proteasomal and the autophagosomal-lysosomal system participate in degradation of the titin filament. We found that ubiquitination and degradation of titin are partially regulated by E3-ligases of the MuRF family. We further identified CHIP and Fbx32 as E3-ligases involved in titin ubiquitination.


Narrative fragmentation in child sexual abuse: The role of age and post-traumatic stress disorder.
The present study aimed to assess the effects of age and PTSD on the narrative fragmentation in memories for child sexual abuse. Lexical complexity, cohesion and coherence were analyzed within a group of 86 allegations of children (M=10years; SD=3.7; range: 4-17) who were victims of sexual abuse. Results illustrated that age played an important role in establishing narrative coherence and predicted the level of orientation, the sequence of events and the level of evaluation of the event. Instead, PTSD was related to narrative coherence and cohesion. Therefore, in children, the narrative fragmentation could be an effective diagnostic tool for understanding the effects of PTSD. Moreover in a legal setting the traumatic effects of PTSD on the narrative coherence and cohesion could be significant indices in the evaluation of child testimony.


The correlation of fine structure with endocrine function of ovarian follicle cells in tadpoles.
Electron microscopic study of the ovaries of metamorphosing Rana catesbeiana tadpoles stimulated by anterior pituitary implantation revealed striking alterations of several organelles in the follicle cells and oocytes when compared with the controls. Pituitary implantation caused activation of the follicle cells as shown by activation of mitochondria, voluminous Golgi complexes, mobilization of the lipid droplets, increased rough endoplasmic reticulum, and increased numbers of glycogen granules. Activation of oocyte mitochondria was also observed. These findings are discussed with respect to the correlation of the ultrastructure and endocrine function in the tadpole ovaries.


Bone marrow transplantation into hemochromatotic mice decreases hepatic and duodenal iron overload.
Human hereditary hemochromatosis is a disorder of iron homeostasis characterized by increased absorption of iron and its deposition in parenchymal organs. The maintenance of iron homeostasis is regulated by molecules involved in the absorption, transport, storage and redox of iron. The potential of hematopoietic stem cell therapy for liver diseases has been studied in some experimental animal models. Our objective was to evaluate the effect of bone marrow transplantation from wild type mice on the status of iron overload in Hfe knockout hemochromatotic mice (Hfe(-/-)). The transplanted cells were detected in the liver (11% of the total cells) and characterized as hepatocytes and myofibroblasts. They were also detected in the duodenum and characterized as myofibroblasts. The iron content in the Hfe(-/-) mice descended 2.9-fold in the liver and 2.4-fold in the duodenum 6 months after transplantation. Non-significant changes of relative mRNA abundance of genes of iron metabolism were observed in the liver and duodenum of Hfe(-/-) transplanted mice. At 6 months after transplantation the proportion of Hfe mRNA in Hfe(-/-) mice reached 3.8% of the levels in wild type mice in the liver and 1.6% in the duodenum. In conclusion, adult stem cells from bone marrow transplant were able to differentiate into hepatocytes and myofibroblasts in hemochromatotic mice. Bone marrow transplantation assisted in reducing the iron overload in this murine model of hemochromatosis. These findings might contribute to the knowledge of pathways involved in the regulatory system of iron homeostasis.


Review article: moderate sedation for endoscopy: sedation regimens for non-anaesthesiologists.
Moderate sedation is a drug-induced depression of consciousness during which patients respond purposefully to verbal commands with or without light tactile stimulation. Moderate sedation is typically accepted in the anaesthesia community as an appropriate target for sedation by non-anaesthesiologists. To describe drug regimens that can be successfully and safely targeted to moderate sedation for endoscopy by non-anaesthesiologists. Moderate sedation can be achieved using narcotics and benzodiazepines. There is interest in some countries in propofol for endoscopy, which is often viewed as an agent for deep sedation. Indeed, propofol cannot be targeted to moderate sedation for endoscopy as a single agent because of coughing during upper endoscopy and pain withdrawal responses during colonoscopy. Pre-treatment with low doses of narcotic and/or benzodiazepine blocks these effects, allowing propofol to be targeted to moderate sedation. Fospropofol, a prodrug of propofol in clinical development, can also be targeted to moderate sedation if co-administered with narcotic. Moderate sedation provides a safety margin when compared with deep sedation and general anaesthesia. Development of protocols that target agents such as propofol to moderate sedation will expand the sedation agents available to non-anaesthesiologists and help ensure that this expansion occurs safely.


Evidence for the identity of shared 5'-terminal sequences between genome RNA and subgenomic mRNA's of B77 avian sarcoma virus.
The polyribosomal fraction from chicken embryo fibroblasts infected with B77 avian sarcoma virus contained 38S, 28S, and 21S virus-specific RNAs in which sequences identical to the 5'-terminal 101 bases of the 38S genome RNA were present. The only polyadenylic acid-containing RNA species with 5' sequences which was detectable in purified virions had a sedimentation coefficient of 38S. This evidence is consistent with the hypothesis that a leader sequence derived from the 5' terminus of the RNA is spliced to the bodies of the 28S and 21S mRNA's, both of which have been shown previously to be derived from the 3' terminal half of the 38S RNA. The entire 101-base 5' terminal sequence of the genome RNA appeared to be present in the majority of the subgenomic intracellular virus-specific mRNA's, as established by several different methods. First, the extent of hybridization of DNA complementary to the 5'-terminal 101 bases of the genome to polyadenylic acid-containing subgenomic RNA was similar to the extent of its hybridization to 38S RNA from infected cells and from purified virions. Second, the fraction of the total cellular polyadenylic acid-containing RNA with 5' sequences was similar to the fraction of RNA containing sequences identical to the extreme 3' terminus of the genome RNA when calculated by the rate of hybridization of the appropriate complementary DNA probes. This suggests that most intracellular virus-specific RNA molecules contain sequences identical to those present in the 5'-terminal 101 bases of the genome. Third, the size of most of the radioactively labeled DNA complementary to the 5'-terminal 101 bases of the genome remained unchanged after the probe was annealed to either intracellular 38S RNA or to various size classes of subgenomic RNA and the hybrids were digested with S1 nuclease and denatured with alkali. However, after this procedure some DNA fragments of lower molecular weight were present. This was not the case when the DNA complementary to the 5'-terminal 101 bases of the genome was annealed to 38S genome RNA. These results suggest that, although the majority of the intracellular RNA contains the entire 101-base 5'-terminal leader sequence, a small population of virus-specific RNAs exist that contain either a shortened 5' leader sequence or additional splicing in the terminal 101 bases.


Immunohistochemical study of the extracellular matrix proteins laminin, fibronectin and type IV collagen in secretory meningiomas.
The extracellular matrix plays a pivotal role in numerous cellular functions during normal and pathological processes. Secretory meningiomas are rare histological meningioma subtypes that have benign behavior, are highly vascularized and are frequently accompanied by massive peritumoral edema. The aim of this study was to assess in secretory meningiomas the immunohistochemical expression of laminin, fibronectin and type IV collagen, proteins found in the extracellular matrix. Extracellular matrix proteins were evaluated in samples from six secretory meningiomas using a semiquantitative scale ranging from not detected (0) to marked (3). Laminin expression was not detected in two cases, but was minimal in one, moderate in one and marked in the remaining cases. Fibronectin expression was absent in two cases, minimal in two, moderate in one and marked with generalized distribution in the remaining case. Type IV collagen expression was minimal in three cases, moderate in two and marked with generalized distribution in the remaining case. Our results are indicative of significant neoangiogenic activity. Meningiomas increase in size through increased production of extracellular matrix; furthermore, the proliferation of cells typically associated with neoplasia requires considerable interaction with the extracellular matrix.


Perceptions of Emergency Medicine Residency and Hand Surgery Fellowship Program Directors in the Appropriate Disposition of Upper Extremity Emergencies.
To survey emergency medicine (EM) residency and hand surgery fellowship program directors (PDs) to identify consensus in their perceptions of appropriate emergency care of upper extremity emergencies. We created a framework to group common upper extremity emergency diagnoses and surveyed PDs to evaluate the training background--EM, general orthopedic or plastic surgery, or hand fellowship--most appropriate to provide acute, point-of-care management for each of these diagnostic groupings. Responses were pooled and consensus was established with greater than 75% agreement between groups. We received 79 responses from hand fellowship PDs (90% response rate) and 151 responses from EM PDs (49% response rate). We identified consensus for the training background that PDs in both specialties felt was appropriate to care for 17 of 21 diagnostic groupings in the framework. There was a high level of consensus between EM and hand surgery PDs regarding diagnoses that acutely require training in hand surgery versus those that can be managed by an EM physician. Our diagnostic framework may help reduce unnecessary hand surgery consultation and may help to identify patients who do not require more specialized acute care and thus decrease unnecessary transfers. Economic and Decision Analyses IV.


Zinner's syndrome: Masquerading as pyonephrotic ectopic kidney.
Zinner's syndrome is a rare developmental anomaly of Wolffian duct, comprising a triad of seminal vesicle cyst, ipsilateral renal agenesis and ejaculatory duct obstruction, first described by Zinner in 1914. Several aberrations have been reported like renal dysplasia, ectopic ureteric orifice in one of the derivatives of Wolffian duct. Usually it presents in second to fourth decade of life with symptoms of urinary bladder irritation/obstruction, cyst distension, ejaculatory duct obstruction. The diagnosis is principally based on imaging studies, usually confirmed by MRI. Treatment is based upon the persistent symptoms or complications related to it. Excision of cyst is gold standard.


Nitrogen removal performance and bacterial communities in zeolite trickling filter under different influent C/N ratios.
In this study, the degradation performance of nutrients in zeolite trickling filter (ZTF) with different influent C/N ratios and aeration conditions was investigated. Microaeration was beneficial for enhancing NH4+-N removal performance. Due to the sufficient carbon source supply under a C/N ratio of 8, a high removal efficiency of NH4+-N and TN was simultaneously observed in ZTF. In addition, TN removal mainly occurred at the bottom, which might be explained by the sufficient nutrients available for bacteria to multiply in this zone. The abundant genera were Acinetobacter, Gemmobacter, Flavobacterium, and Pseudomonas, all of which are heterotrophic nitrification-aerobic denitrification (HNAD) bacteria. In addition, biofilm only slowed down the adsorption rate but did not significantly reduce the adsorption capacity of zeolite. Bio-zeolite had NH4+-N well adsorption capacity and bio-desorption capacity. Biological nitrogen removal performance was superior to physicochemical absorption of zeolite. The results suggested that the physicochemical of zeolite and biochemical reactions of microorganism coupling actions may be the main nitrogen transformation pathway in ZTF. Our research provides a reference for further understanding the nitrogen removal mechanism of zeolite bioreactors.


A luminol chemiluminescence method for sensing histidine and lysine using enzyme reactions.
The analysis of free amino acids in urine and plasma is useful for estimating disease status in clinical diagnoses. Changes in the concentration of free amino acids in foods are also useful markers of freshness, nutrition, and taste. In this study, the specific interaction between aminoacyl-tRNA synthetase (aaRS) and its corresponding amino acid was used to measure amino acid concentrations. Pyrophosphate released by the amino acid-aaRS binding reaction was detected by luminol chemiluminescence; the method provided selective quantitation of 1.0-30 μM histidine and 1.0-60 μM lysine.


Analysis of the primary and compensatory curvatures following Zielke instrumentation for idiopathic scoliosis.
The behavior of the primary and compensatory curvatures of 34 patients (follow-up, 24-48 months) with solid fusions following Zielke instrumentation were evaluated. All patients showed correction of their primary curvatures (range, 40-112%; average, 70%) postoperatively. Thirty-one showed loss of correction (range, 2.8-78.5%; mean, 25%). There was a higher tendency to lose correction if the curve was fused short of the Cobb measurement (35% vs. 17%). The majority of both the thoracic and the lumbosacral compensatory curves improved postoperatively (average of 38.6 and 66%, respectively). However, when the instrumentation was carried cephalad to the primary curve, there was a high probability that the upper compensatory curve would be worse after the surgery. Trunk list tended to improve during the course of follow-up.


The novel chemokine receptor, G-protein-coupled receptor 75, is expressed by islets and is coupled to stimulation of insulin secretion and improved glucose homeostasis.
Chemokine (C-C motif) ligand 5 (CCL5) acts at C-C chemokine receptors (CCRs) to promote immune cell recruitment to sites of inflammation, but is also an agonist at G-protein-coupled receptor 75 (GPR75), which has very limited homology with CCRs. GPR75 is coupled to Gq to elevate intracellular calcium, so we investigated whether islets express this receptor and whether its activation by CCL5 increases beta cell calcium levels and insulin secretion. Islet CCL5 receptor mRNA expression was measured by quantitative RT-PCR and GPR75 was detected in islets by western blotting and immunohistochemistry. In some experiments GPR75 was downregulated by transient transfection with small interfering RNA. Real-time changes in intracellular calcium were determined by single-cell microfluorimetry. Dynamic insulin secretion from perifused islets was quantified by radioimmunoassay. Glucose homeostasis in lean and obese mice was determined by measuring glucose and insulin tolerance, and insulin secretion in vivo. Mouse and human islets express GPR75 and its ligand CCL5. Exogenous CCL5 reversibly increased intracellular calcium in beta cells via GPR75, this phenomenon being dependent on phospholipase C activation and calcium influx. CCL5 also stimulated insulin secretion from mouse and human islets in vitro, and improved glucose tolerance in lean mice and in a mouse model of hyperglycaemia and insulin resistance (ob/ob). The improvement in glucose tolerance was associated with enhanced insulin secretion in vivo, without changes in insulin sensitivity. Although CCL5 is implicated in the pathogenesis of diabetes through activation of CCRs, it has beneficial effects on beta cells through GPR75 activation.


Trends in Mortality Following Acute Myocardial Infarction Among Dialysis Patients in the United States Over 15 Years.
We sought to determine 15-year trends in mortality rates among dialysis patients with acute myocardial infarction (AMI) in the contemporary era. Using the US Renal Data System database, we assembled 4 study cohorts of period-prevalent dialysis patients in 1993, 1998, 2003, and 2008 who were hospitalized for an index AMI in that calendar year. ST-segment elevation myocardial infarction (STEMI) and non-STEMI were identified, and in-hospital mortality was calculated. Cumulative probability of death during 2-year follow-up after AMI admission was estimated by the Kaplan-Meier method and adjusted for patient characteristics. A total of 42 933 dialysis patients with AMI were included. Between 1993 (n=4494) and 2008 (n=16 361), proportional increases occurred in patient groups aged ≥75 years (23% and 31%, respectively; P<0.001), of black race (25% and 31%, respectively; P<0.001), with end-stage renal disease due to diabetes (42% and 55%, respectively; P<0.001), and with non-STEMI (42.2% and 80.7%, respectively; P<0.001). For all patients with AMI, in-hospital mortality rates decreased (31.9% in 1993, 18.8% in 2008; P<0.001), as did unadjusted 2-year cumulative probability of death after AMI admission (76.5% in 1993, 71.5% in 2008; P<0.001). Between 1993 and 2008, among STEMI patients, in-hospital mortality (38.2% and 25.9%, P<0.001) and unadjusted 2-year cumulative probability of mortality (77.3% and 71.2%, P<0.001) decreased, but decreases did not occur among NSTEMI patients (14.2% and 14.9%, P=0.47, and 70.9% and 70.1%, P=0.52 respectively). In-hospital mortality and 2-year cumulative probability of death following AMI among dialysis patients decreased between 1993 and 2008 but only among STEMI patients, coincident with increased in-hospital percutaneous coronary intervention rates. Period-prevalent cases of non-STEMI markedly increased without interval change in survival.


Key properties of expert movement systems in sport : an ecological dynamics perspective.
This paper identifies key properties of expertise in sport predicated on the performer-environment relationship. Weaknesses of traditional approaches to expert performance, which uniquely focus on the performer and the environment separately, are highlighted by an ecological dynamics perspective. Key properties of expert movement systems include 'multi- and meta-stability', 'adaptive variability', 'redundancy', 'degeneracy' and the 'attunement to affordances'. Empirical research on these expert system properties indicates that skill acquisition does not emerge from the internal representation of declarative and procedural knowledge, or the imitation of expert behaviours to linearly reduce a perceived 'gap' separating movements of beginners and a putative expert model. Rather, expert performance corresponds with the ongoing co-adaptation of an individual's behaviours to dynamically changing, interacting constraints, individually perceived and encountered. The functional role of adaptive movement variability is essential to expert performance in many different sports (involving individuals and teams; ball games and outdoor activities; land and aquatic environments). These key properties signify that, in sport performance, although basic movement patterns need to be acquired by developing athletes, there exists no ideal movement template towards which all learners should aspire, since relatively unique functional movement solutions emerge from the interaction of key constraints.


Work-Related Quality of Life of US General Surgery Residents: Is It Really so Bad?
The quality of working life of US surgical residents has not been studied, and given the complexity of interaction between work and personal life there is a need to assess this interaction. We utilized a validated Work Related Quality of Life (WRQoL) questionnaire to evaluate the perceived work-related quality of life of general surgery residents, using a large, nationally representative sample in the United States. Between January 2016 and March 2016, all US general surgery residents enrolled in an ACGME general surgery training program were invited to participate. The WRQoL scale measures perceived quality of life covering six domains: General Well-Being (GWB), Home-Work Interface (HWI), Job and Career Satisfaction (JCS), Control at Work (CAW), Working Conditions (WCS) and Stress at Work (SAW). After excluding for missing data, the final analysis included 738 residents. The average age was 30 (±3) years, of whom 287 (38.9%) were female, 272 (36.9%) were from a community hospital, and 477 (64.6%) were juniors (postgraduate year ≤ 3). Demographically, the respondents matched expected percentages. When male and female residents were compared, males had statistically better HWI (p<0.001), better GWB (p = 0.03), more CAW (p = 0.0003) and WCS (p = 0.001). Junior residents had a lower JCS (p = 0.002) and CAW (p = 0.04) compared to seniors. There were no differences between university and community residents in any of the domains of WRQoL. Although residents were more stressed than other professions but the overall WRQoL was comparable. The nature of surgical residency and a surgical career may in fact be more "stressful" than other professions, yet may not translate into a worsened Quality of Life. Our findings suggest further study is needed to elucidate why female residents have or experience a lower perceived WRQoL than their male colleagues.


An ensemble learning approach for brain cancer detection exploiting radiomic features.
The brain cancer is one of the most aggressive tumour: the 70% of the patients diagnosed with this malignant cancer will not survive. Early detection of brain tumours can be fundamental to increase survival rates. The brain cancers are classified into four different grades (i.e., I, II, III and IV) according to how normal or abnormal the brain cells look. The following work aims to recognize the different brain cancer grades by analysing brain magnetic resonance images. A method to identify the components of an ensemble learner is proposed. The ensemble learner is focused on the discrimination between different brain cancer grades using non invasive radiomic features. The considered radiomic features are belonging to five different groups: First Order, Shape, Gray Level Co-occurrence Matrix, Gray Level Run Length Matrix and Gray Level Size Zone Matrix. We evaluate the features effectiveness through hypothesis testing and through decision boundaries, performance analysis and calibration plots thus we select the best candidate classifiers for the ensemble learner. We evaluate the proposed method with 111,205 brain magnetic resonances belonging to two freely available data-sets for research purposes. The results are encouraging: we obtain an accuracy of 99% for the benign grade I and the II, III and IV malignant brain cancer detection. The experimental results confirm that the ensemble learner designed with the proposed method outperforms the current state-of-the-art approaches in brain cancer grade detection starting from magnetic resonance images.


Input coding in animal and human associative learning.
Two appetitive conditioning experiments with rats investigated whether the degree of generalization between a compound and its component parts is fixed or variable. Both experiments used a two-stage transfer design. In Stage 1, the elemental groups learned that a compound and its component parts signaled the same outcome (i.e. C+, D+, CD+), whereas the configural groups learned that a compound and its component parts signaled different outcomes (i.e. C+, D+, CD-, where '+' is pellets and '-' is no pellets). In Stage 2, the rats were tested for reductions in generalization. Experiment 1 found no evidence that past configural learning reduced generalization when a new set of alike-treated A and B elements were presented in compound for the first time. Experiment 2 found no evidence that past configural learning reduced generalization when the stimuli of Stage 1 were presented in a new C-, D-, CD+ relation. In contrast to findings with humans, these results suggest that past experience plays a minor role in how stimuli are encoded in animal conditioning.


In vitro and in vivo osteogenesis of gelatin-modified calcium silicate cement with washout resistance.
The purpose of this study was to evaluate the physicochemical properties and the in vitro and in vivo osteogenesis of the newly developed calcium silicate containing 5 wt% gelatin (CSG) cement compared with calcium silicate (CS) and calcium sulfate hemihydrate (CSH) cements. In addition to the phase composition and microstructure, washout resistance, setting time, and diametral tensile strength of the bone cements were also performed. In vitro examination of cell growth, differentiation, and mineralization were performed with macrophage cell line (RAW 264.7), MG63 human osteoblast-like cells, and human mesenchymal stem cells (hMSCs). The mini-pig model with mandibular alveolar bone defect was used to assess the in vivo function of cement. Histological and histomorphometric assessments were performed at 6 and 12 weeks after implantation. The results indicated that the CS and CSG powders were mainly composed of poorly crystalline β-dicalcium silicate, and the irregular CSH powders had a highly crystalline phase. After setting, the product of CS and CSG was calcium-silicate-hydrate gel and CSH exhibited a plate-like gypsum crystal structure. The setting time of CS, CSG, and CSH was 19, 35, and 10 min, respectively. Gelatin effectively improved the washout resistance and diametral tensile strength of CS from 2.4 MPa to 3.4 MPa, while CSH had no washout resistance and its strength was 7.6 MPa. The osteogenic activity of MG63 and hMSC cells on the CSG cement surface was consistently shown to be significantly higher than that on the CSH cement surface. Interestingly, CS and CSG cements exhibited lower macrophage expression compared to CSH cements. Twelve week after implantation, the amount of new bone in the defect area of the CS group was slightly higher than that of the CSG and CSH groups. It is concluded that CSG cement had improved anti-washout performance, favorable osteogenesis in vitro and in vivo, which was beneficial for clinical application.


[Polyarticular juvenile idiopathic arthritis and rheumatoid arthritis : Common features and differences].
The spectrum of polyarthritic diseases in childhood as well as in adulthood is wide. In the differential diagnostics different age-related diseases must be taken into consideration. Although, a clear similarity is obvious in all age groups for the classical diseases of polyarticular juvenile idiopathic arthritis and rheumatoid arthritis with respect to the pathogenesis, clinical manifestation and treatment options, this review points to specific differences. The prognosis of polyarthritis in children mainly depends on the joint manifestation, whereas extra-articular comorbidities play a predominant role in the older adult population.


Epithelial Myoepithelial Carcinoma of Parotid Gland.
Epithelial myoepithelial carcinoma (EMC) is a rare biphasic tumor of salivary glands with low malignant potential. Although known to occur in submandibular gland and minor salivary glands, its most common location is parotid. Clinical and radiological findings often mimic a benign tumor. Because of rarity of EMC a standard treatment guideline is not yet known. Surgical resection is the most widely used approach. Although it is a low grade tumor, local recurrence rates of 23-50 % have been reported with 25 % chance of distant metastasis. Patients with histo-pathologic markers of aggressive disease should be considered for adjuvant radiotherapy. We report a case of epithelial myoepithelial carcinoma of parotid in a 40 year male that was treated with surgery followed by post-operative radiotherapy.


Sedative effects of PK 9084 and PK 8165, alone and in combination with chlordiazepoxide.
1 The sedative effects in rats of two phenylquinolines, PK 9084 and PK 8165 (5-50 mg/kg), were examined in a holeboard: both when given alone and when given in conjunction with chlordiazepoxide (5 mg/kg). 2 Both phenylquinolines produced significant dose-related decreases in locomotor activity and rearing, with an ED50 about twice that for chlordiazepoxide. 3 When the phenylquinolines were combined with chlordiazepoxide the degree of sedation was equal to that seen with either drug given alone, whichever produced the greater sedation; the sedative effects of the two drugs were never additive. 4 PK 9084 (10 and 50 mg kg) significantly reduced rectal temperature, as did chlordiazepoxide (5 mg/kg), but there was no addition nor interaction of their effects. 5 Both phenylquinolines also reduced exploratory head-dipping, as did chlordiazepoxide, but in combination they antagonized each other's effects. 6 The classification of the phenylquinolines as non-sedative anxiolytics, acting as agonists at the benzodiazepine receptors needs revision.


Production of mouse offspring from zygotes fertilized with freeze-dried spermatids.
Mouse cloning by nuclear transfer using freeze-drying (FD) somatic cells is now possible, but the success rate is significantly lower than that of FD spermatozoa. Because spermatozoa, unlike somatic cells, are haploid cells with hardened nuclei due to protamine, the factors responsible for their tolerance to FD treatment remain unclear. In this study, we attempt to produce offspring from FD spermatid, a haploid sperm progenitor cell whose nuclei, like somatic cells, have not yet been replaced by protamine. We developed a method for collecting FD spermatids from testicular suspension. Despite the significantly lower success rate than that of FD spermatozoa, healthy offspring were obtained when FD spermatids were injected into oocytes. Offspring were also obtained from FD spermatids derived from immature male mice that had not yet produced spermatozoa. These results suggest that nuclear protaminization, rather than haploid nuclei, is one of the key processes responsible for tolerance to FD treatment.


Effect of salinity on nest building behaviour in the nine-spined stickleback Pungitius sinensis.
The authors evaluated the adaptability of male nine-spined sticklebacks (Pungitius sinensis) at three salinity levels (0, 5 and 10 psu) by comparing nest building success rates with nest structures. Successful nest building decreased as salinity increased. In addition, nests built in fresh water (i.e., 0 psu) were glued together, whereas those built in brackish water (5 and 10 psu) broke easily and fell from the nest site to the gravel bottom. Based on these findings, the authors suggest that P. sinensis adapts to freshwater environments.


Isolated bacterial meningitis as the key syndrome of infective endocarditis.
Bacterial meningitis is an unusual first manifestation but a major complication of infective endocarditis. We present three well documented cases of isolated bacterial meningitis in endocarditis. Against this background we review the literature. All patients presented with bacterial meningitis. Staphylococcus aureus was isolated in blood cultures of all patients, but was found only in the cerebrospinal fluid (CSF) of one patient. The underlying endocarditis was confirmed histologically in all three cases. Two patients recovered completely and one died. An extensive search for endocarditis is recommended in every case of an unusual isolate in bacterial meningitis whether it is isolated from blood or CSF.


Effect of coal rank on the interferon system.
Studies on the induction of interferon by influenza virus in monkey kidney (LLC-MK2) cell monolayers pretreated with coal dust revealed that the inhibitory activity of the mineral on this process was related to coal rank. Maximal inhibition of viral interferon induction was noted with high rank coal and the degression of this activity was related to coal's position in the carboniferous series; anthracite, bituminous, subbituminous, lignite, and peat. The cytocidal activity of each rank of coal, however, was comparable in relation to the corresponding quantities of coal dust that were tested indicating that findings related to interferon production are not explicable on the basis of remaining viable cells. Coal dust, irrespective of rank, also did not affect the ability of exogenous interferon to confer antiviral cellular protection. An inverse relationship mediated by coal of different rank occurred between influenza virus growth and interferon levels which suggested that increased virus growth reflected the ability of higher rank coal to affect adversely interferon production.


The relationship between contraceptive use and maternal and infant health outcomes in Tajikistan.
There has been no evaluation of the association between contraceptive use and maternal and child health (MCH) in Tajikistan, though the government has made concerted efforts to improve accessibility to family planning methods. The aim of this study is to understand the relationship between current contraceptive utilization and specific MCH outcomes in Tajikistan. Using data from the 2012 Tajikistan Demographic and Health Survey, a total weighted sample of 6716 women aged 15 to 49 years who had at least one child at the time of interview was analyzed. Logistic regression analyses were performed to assess the relationship between current contraceptive utilization and birth spacing, birth limiting and infant mortality. Modern contraceptive use was low among women studied (27.1%). Modern contraceptive users were more likely to present with a longer birth interval [adjusted odds ratio (aOR) = 2.4, 95% confidence interval (CI) = 2.0-2.8] than traditional or nonusers. Women who used modern contraceptives were half as likely to limit births to three or fewer children compared to traditional or nonusers (aOR = 0.5, 95% CI = 0.4-0.6). Among women whose most recent live birth resulted in death, modern contraceptive use was not associated with lower levels of infant mortality. Efforts made by the Tajik government to increase utilization of family planning have had mixed effects on overall uptake and the MCH outcomes analyzed in this study. These findings can help to inform the government's policy on family planning. Contraceptive utilization has not yet translated into beneficial MCH outcomes. Policy makers in Tajikistan might consider placing more emphasis on family planning education, while maximizing accessibility of contraceptive methods.


Genotypic and phenotypic diversity of rhizobia isolated from Lathyrus japonicus indigenous to Japan.
Sixty-one rhizobial strains from Lathyrus japonicus nodules growing on the seashore in Japan were characterized and compared to two strains from Canada. The PCR-based method was used to identify test strains with novel taxonomic markers that were designed to discriminate between all known Lathyrus rhizobia. Three genomic groups (I, II, and III) were finally identified using RAPD, RFLP, and phylogenetic analyses. Strains in genomic group I (related to Rhizobium leguminosarum) were divided into two subgroups (Ia and Ib) and subgroup Ia was related to biovar viciae. Strains in subgroup Ib, which were all isolated from Japanese sea pea, belonged to a distinct group from other rhizobial groups in the recA phylogeny and PCR-based grouping, and were more tolerant to salt than the isolate from an inland legume. Test strains in genomic groups II and III belonged to a single clade with the reference strains of R. pisi, R. etli, and R. phaseoli in the 16S rRNA phylogeny. The PCR-based method and phylogenetic analysis of recA revealed that genomic group II was related to R. pisi. The analyses also showed that genomic group III harbored a mixed chromosomal sequence of different genomic groups, suggesting a recent horizontal gene transfer between diverse rhizobia. Although two Canadian strains belonged to subgroup Ia, molecular and physiological analyses showed the divergence between Canadian and Japanese strains. Phylogenetic analysis of nod genes divided the rhizobial strains into several groups that reflected the host range of rhizobia. Symbiosis between dispersing legumes and rhizobia at seashore is discussed.


The Modified Tampa-Scale of Kinesiophobia for Anterior Shoulder Instability.
To assess content validity and to modify the Tampa Scale of Kinesiophobia (TSK) to make it suitable for application in patients with anterior shoulder instability. A four-round Delphi method was performed to establish expert consensus on developing the Tampa Scale of Kinesiophobia for patients with anterior shoulder instability (TSK-SI) using an expert group of Dutch shoulder-specialized orthopedic surgeons and physiotherapists. During round 1, experts were asked to score the 17 items of the original TSK on relevance and construction using the COSMIN guidelines. With this feedback, questions were reviewed and modified. During round 2, experts were asked to score the modified items. This process was repeated until consensus was established. Then, patients were asked to participate in a moderator-guided, three-step-test interview using a Web-based platform to assess the modified scale. Sessions were recorded and evaluated by the working group. The modified scale was finally adjusted on the basis of the input of these patients. Thirty Dutch shoulder experts were included, of which 25 completed all 4 rounds, after which consensus was established. One question was added to the modified scale based on feedback in round 1, establishing the 18-item TSK-SI. Sixteen patients with shoulder instability were included, which all completed the three-step test interview. Following this, question 4 (changed to present tense) and question 7 (hypothetical component added) were adjusted, resulting in the final TSK-SI. This consensus modification of the TSK to TSK-SI can support the content validity of the instrument to assess kinesiophobia in patients with anterior shoulder instability. These modifications may improve the responsiveness and validity of the TSK-SI, as it does not match all the items of the original TSK. Level V, consensus statement.


Lipoprotein lipase in liver. Release by heparin and immunocytochemical localization.
We have previously demonstrated that infusion of Intralipid to rats causes a pronounced increase of the lipoprotein lipase activity in the liver. In this paper we study where in the liver this lipoprotein lipase is located. When isolated livers from Intralipid-treated rats were perfused with heparin, substantial amounts of lipoprotein lipase were released into the perfusate. The identity of the lipase activity was demonstrated by specific inhibition with antisera to lipoprotein lipase, and to hepatic lipase, respectively, and by separation of the two lipase activities by chromatography on heparin-Sepharose. We have also studied the localization of both enzymes by an immunostaining procedure based on post-embedding incubation of ultrathin tissue sections with specific antibodies which were then visualized using protein A-colloidal gold complexes. There was no marked difference in localization for the two enzymes which were both seen at the luminal side of endothelial cells, at the interdigitations of the space of Disse and inside both hepatocytes and endothelial cells. Thus, lipoprotein lipase is present in the liver in positions similar to where the functional pool of hepatic lipase is located and analogous to where lipoprotein lipase is found in extrahepatic tissues. These results raise the possibility that the enzyme has a functional role in the liver.


Elevation of dopamine induced by cigarette smoking: novel insights from a [11C]-+-PHNO PET study in humans.
Positron emission tomography (PET) has convincingly provided in vivo evidence that psychoactive drugs increase dopamine (DA) levels in human brain, a feature thought critical to their reinforcing properties. Some controversy still exists concerning the role of DA in reinforcing smoking behavior and no study has explored whether smoking increases DA concentrations at the D3 receptor, speculated to have a role in nicotine's addictive potential. Here, we used PET and [(11)C]-(+)-PHNO ([(11)C]-(+)-4-propyl-3,4,4a,5,6,10b-hexahydro-2H-naphtho[1,2-b][1,4]oxazin-9-ol) to test the hypothesis that smoking increases DA release (decreases [(11)C]-(+)-PHNO binding) in D2-rich striatum and D3-rich extra-striatal regions and is related to craving, withdrawal and smoking behavior. Ten participants underwent [(11)C]-(+)-PHNO scans after overnight abstinence and after smoking a cigarette. Motivation to smoke (smoking topography), mood, and craving were recorded. Smoking significantly decreased self-reported craving, withdrawal, and [(11)C]-(+)-PHNO binding in D2 and D3-rich areas (-12.0 and -15.3%, respectively). We found that motivation to smoke (puff rate) predicted magnitude of DA release in limbic striatum, and the latter was correlated with decreased craving and withdrawal symptoms. This is the first report suggesting that, in humans, DA release is increased in D3-rich areas in response to smoking. Results also support the preferential involvement of the limbic striatum in motivation to smoke, anticipation of pleasure from cigarettes and relief of withdrawal symptoms. We propose that due to the robust effect of smoking on [(11)C]-(+)-PHNO binding, this radiotracer represents an ideal translational tool to investigate novel therapeutic strategies targeting DA transmission.


Ttll9-/- mice sperm flagella show shortening of doublet 7, reduction of doublet 5 polyglutamylation and a stall in beating.
Nine outer doublet microtubules in axonemes of flagella and cilia are heterogeneous in structure and biochemical properties. In mammalian sperm flagella, one of the factors to generate the heterogeneity is tubulin polyglutamylation, although the importance of the heterogeneous modification is unclear. Here, we show that a tubulin polyglutamylase Ttll9 deficiency (Ttll9(-/-)) causes a unique set of phenotypes related to doublet heterogeneity. Ttll9(-/-) sperm axonemes had frequent loss of a doublet and reduced polyglutamylation. Intriguingly, the doublet loss selectively occurred at the distal region of doublet 7, and reduced polyglutamylation was observed preferentially on doublet 5. Ttll9(-/-) spermatozoa showed aberrant flagellar beating, characterized by frequent stalls after anti-hook bending. This abnormal motility could be attributed to the reduction of polyglutamylation on doublet 5, which probably occurred at a position involved in the switching of bending. These results indicate that mammalian Ttll9 plays essential roles in maintaining the normal structure and beating pattern of sperm flagella by establishing normal heterogeneous polyglutamylation patterns.


Neodymium:YAG laser trabeculopuncture in juvenile open-angle glaucoma.
The authors performed neodymium:YAG (Nd:YAG) laser trabeculopuncture (YLT) in eight eyes of six patients with uncontrolled juvenile open-angle glaucoma. Two methods of treatment were evaluated: either two confluent trabeculotomies, each 1 clock hour in extent; or focal treatment in four quadrants. In six eyes (75%), the intraocular pressure (IOP) was controlled (less than or equal to 19 mmHg) after a mean follow-up period of 6 +/- 2 months. All successful treatments were associated with blood reflux from the site of trabeculopuncture into the anterior chamber at the time of the procedure. Energy levels required for a single trabeculotomy (1 clock hour in extent) and for one focal trabeculopuncture, were 156 +/- 59 mJ and 42 +/- 24 mJ, respectively. The clinical results suggested that confluent trabeculotomy may be superior to focal treatment. No major complications were encountered with either treatment. The authors propose the use of YLT in uncontrolled juvenile glaucoma before surgically invasive goniotomy or filtration operations.


Regulation of Hedgehog signaling by ubiquitination.
The Hedgehog (Hh) signaling pathway plays crucial roles both in embryonic development and in adult stem cell function. The timing, duration and location of Hh signaling activity need to be tightly controlled. Abnormalities of Hh signal transduction lead to birth defects or malignant tumors. Recent data point to ubiquitination-related posttranslational modifications of several key Hh pathway components as an important mechanism of regulation of the Hh pathway. Here we review how ubiquitination regulates the localization, stability and activity of the key Hh signaling components.


Temporal trends in prevalence and outcomes of atrial fibrillation in patients undergoing percutaneous coronary intervention.
Atrial fibrillation (AF) is the most common arrhythmia in patients undergoing percutaneous coronary intervention (PCI). Large administrative data may provide further insight into temporal trends in the prevalence and burden of AF in patients who underwent PCI. Using the National Inpatient Sample database in the U.S., AF patients ≥18 years who underwent PCI between 2005 and 2014 and were identified by the International Classification of Diseases, ninth revision, Clinical Modification, were examined. In-hospital mortality, morbidity, resource use, and medical costs were evaluated in crude and propensity-matched analyses. Among an estimated 6 272 232 hospitalizations, of patients undergoing PCI, AF prevalence was 9.9% and steadily increased from 8.6% to 12.0% between 2005 and 2014 (P < .001); there was also a greater proportion of comorbidities. There was a marked increase in AF prevalence among those aged ≥65 years and those undergoing elective PCIs. AF was independently associated with higher in-hospital mortality and higher rates of transient ischaemic attack/stroke, bleeding complications, and non-home discharge. Excessive in-hospital mortality, stroke rate, gastrointestinal bleeding, blood transfusion, length of stay, and costs among AF hospitalizations were consistently observed throughout the study period. AF becomes more prevalent in patients undergoing PCI, possibly due to a higher comorbidity, particularly in elderly patients with non-acute indications. Less favorable trends in mortality, bleeding, and stroke among AF patients who underwent PCI were consistent over time. Continuous efforts are needed to improve outcomes and manage strategies for AF patients undergoing PCI.


A comparison of methods for enumerating lymphocyte classes.
We have evaluated a novel kit method for enumerating B and T lymphocytes using antibody-coupled beads. The technique proved to be an unsuitable alternative to sheep red blood cell rosettes and immunofluorescence. However, the principle is potentially valuable and we suggest certain modifications which would make the method more suitable for routine use.


Calcium alginate immobilized marine microalgae: experiments on growth and short-term heavy metal accumulation.
Growth of 11 calcium alginate immobilized marine microalgal species belonging to eight taxonomical groups has been checked in the present work. Cellular densities inside the calcium alginate beads were monitored during 17 days. Good growth and maintenance of the structure of the beads were both found for some of the assayed species. One of those species (Tetraselmis chui, Prasinophyceae) was selected in order to perform a short term (up to 24 h) heavy metal accumulation experiment. Beads of calcium alginate containing (or not) cells of T. chui were exposed to 820 microg L(-1) Cu and 870 microg L(-1) Cd separately during a 24 h period, and accumulation of heavy metals in the beads was measured after this time and compared. Concentration of each metal in the supernatants was monitored at 5, 10, 60 min and 24 h from the beginning of the experiment. After 24 h, practically all Cu was removed by the beads. Beads with immobilized algae removed around 20% of total Cd, while beads without algae removed half of that percentage.


Life-threatening respiratory pasteurellosis associated with palliative pet care.
Pasteurella multocida is a zoonotic Gram-negative cocco-bacillus often associated with soft tissue infections due to dog and cat bites. Here we report 3 patients who developed life-threatening P. multocida respiratory tract infections after providing palliative care to their dying pets.


Co-expression of mesothelin and CA125/MUC16 is a prognostic factor for breast cancer, especially in luminal-type breast cancer patients.
The expression of mesothelin correlates with a poor prognosis in patients with breast cancer. Since mesothelin plays a role in cancer metastasis in association with CA125, we herein examined the expression of mesothelin and CA125, and the clinicopathological meaning and prognosis of the co-expression of mesothelin and CA125 in breast cancer. Our results showed that among 478 patients, mesothelin and CA125 were co-expressed in 48 (10 %), mesothelin only in 75 (16 %), CA125 only in 217 (45 %), and neither in 234 (49 %). A high correlation was observed between the expression of mesothelin and CA125 (P =0.0004). The co-expression of mesothelin and CA125 correlated with poor patient relapse-free survival (RFS) (P = 0.0001) and was identified as an independent predictor of RFS by Cox's multivariate analysis. In conclusion, this is the first to report the prognostic significance of the co-expression of mesothelin and CA125 in breast cancer. The co-expression of mesothelin and CA125 may be clinically useful for prognostication after surgical therapy in patients with breast cancer.


Method comparison of four clinically available assays for serum free light chain analysis.
Background Serum free light chain (sFLC) measurements are increasingly important in the context of screening for monoclonal gammopathies, prognostic stratification and monitoring of therapy responses. In this study we have performed a method comparison of four sFLC assays that are currently available for routine clinical use. Methods In a retrospective study, sFLC analyses were performed on a cohort that included 139 patients with various monoclonal gammopathies and 54 control sera without an M-protein. Method comparisons of the following four FLC assays were performed: Freelite (Binding Site), N-Latex FLC (Siemens), Seralite (Abingdon Health) and Sebia FLC (Sebia). Results Bland-Altman agreement analysis showed biases varying between -0.1 and 16.2 mg/L for κFLC, -6.0 and 6.8 mg/L for λFLC and -0.04 and 0.38 for the ratio of the involved to uninvolved FLC. Strong agreements were observed for FLC-concentrations below 100 mg/L. The clinical concordance of the κ/λFLC-ratio of the four methods varied between 86% and 92%. Significant quantitative differences were observed between the different methods, mainly in sera with high FLC concentrations. Most assays consistently overestimated FLC concentrations compared to SPE. Conclusions Good overall clinical concordances were observed between the four sFLC assays that were compared in this study. Although good agreements were observed between the FLC assays, significant absolute differences in FLC concentrations in individual patients can be seen, particularly at higher FLC concentrations. Because of inequivalent absolute sFLC values between the methods in individual patients, none of the four sFLC assays can be used interchangeably.


Anatomical partition of the clival region and adjacent structures via extended endoscopic endonasal approach.
To explore the anatomy of the ventral clivus and adjacent structure in the endoscopic surgery through the anterior approach, particularly in accurate locating lesions in transnasal endoscopic surgery. A total of 9 formalin-fixed adult cadaver heads were injected with red and blue latex to observe the arteries and veins, respectively. The relationships between various parts of internal carotid artery (ICA) and anatomic structures of clivus were investigated, followed by the measurement of the posterior pharyngeal wall, anterior wall and posterior wall of clivus, cerebral dura mater, subdural space and adjacent regions to determine their correlations, as well as the clivus and adjacent structures. The clivus structure was divided into the bone segment, the ICA segment and subdural segment for anatomic division according to the anatomic landmarks in the anatomic process. The clivus can be classified in a shape of '' with the ICA, including the middle superior region, middle inferior region, bilateral lateral superior and lateral inferior regions. The ICA is closely related to the ventral clivus and adjacent structure, which can be used as the basis of anatomic division via anterior approach.


Role of peroxide in AC electrical field exposure effects on friend murine erythroleukemia cells during dielectrophoretic manipulations.
The effects of AC field exposure on the viability and proliferation of mammalian cells under conditions appropriate for their dielectrophoretic manipulation and sorting were investigated using DS19 murine erythroleukemia cells as a model system. The frequency range 100 Hz-10 MHz and medium conductivities of 10 mS/m, 30 mS/m and 56 mS/m were studied for fields generated by applying signals of up to 7V peak to peak (p-p) to a parallel electrode array having equal electrode widths and gaps of 100 micrometer. Between 1 kHz and 10 MHz, cell viability after up to 40 min of field exposure was found to be above 95% and cells were able to proliferate. However, cell growth lag phase was extended with decreasing field frequency and with increasing voltage, medium conductivity and exposure duration. Modified growth behavior was not passed on to the next cell passage, indicating that field exposure did not cause permanent alterations in cell proliferation characteristics. Cell membrane potentials induced by field exposure were calculated and shown to be well below values typically associated with cell damage. Furthermore, medium treated by field exposure and then added to untreated cells produced the same modifications of growth as exposing cells directly, and these modifications occurred only when the electrode polarization voltage exceeded a threshold of approximately 0.4 V p-p. These findings suggested that electrochemical products generated during field exposure were responsible for the changes in cell growth. Finally, it was found that hydrogen peroxide was produced when sugar-containing media were exposed to fields and that normal cell growth could be restored by addition of catalase to the medium, whether or not field exposure occurred in the presence of cells. These results show that AC fields typically used for dielectrophoretic manipulation and sorting of cells do not damage DS19 cells and that cell alterations arising from electrochemical effects can be completely mitigated.


Limited evidence that cancer susceptibility regions are preferential targets for somatic mutation.
Genome wide-association studies have successfully identified several hundred independent loci harboring common cancer susceptibility alleles that are distinct from the more than 110 cancer predisposition genes. The latter are generally characterized by disruptive mutations in coding genes that have been established as 'drivers' of cancer in large somatic sequencing studies. We set out to determine whether, similarly, common cancer susceptibility loci map to genes that have altered frequencies of mutation. In our analysis of the intervals defined by the cancer susceptibility markers, we observed that cancer susceptibility regions have gene mutation frequencies comparable to background mutation frequencies. Restricting analyses to genes that have been determined to be pleiotropic across cancer types, genes affected by expression quantitative trait loci, or functional genes indicates that most cancer susceptibility genes classified into these subgroups do not display mutation frequencies that deviate from those expected. We observed limited evidence that cancer susceptibility regions that harbor common alleles with small estimated effect sizes are preferential targets for altered somatic mutation frequencies. Our findings suggest a complex interplay between germline susceptibility and somatic mutation, underscoring the cumulative effect of common variants on redundant pathways as opposed to driver genes. Complex biological pathways and networks likely link these genetic features of carcinogenesis, particularly as they relate to distinct polygenic models for each cancer type.


Deep neural network and molecular docking supported toxicity profile of prometryn.
In this study, the versatile toxicity profile of prometryn herbicide on Allium cepa was investigated. In this context, 4 different groups were formed. While the control group was treated with distilled water, Groups II, III and IV were treated with 200 mg/L, 400 mg/L and 800 mg/L prometryn, respectively. After 72 h of germination, cytogenetic, biochemical, physiological and anatomical changes were investigated. As a result increase in malondialdehyde levels, decrease in glutathione level, changes in superoxide dismutase and catalase activities in root tip cells show that prometryn causes oxidative stress. The decrease in mitotic index values and the increase in the frequency of micronucleus and chromosomal abnormalities observed after prometryn treatment indicate genotoxic effects. The genotoxic effects may be due to the induced oxidative stress as well as the promethryn-DNA interaction. Molecular docking analyses revealed that prometryn interacts with various bases in DNA. As a result of the Comet assay, exposure to prometryn was found to cause DNA fragmentation. In physiological parameters final weight, germination percentage and root length decreased by 23.8%, 59.1% and 87.3%, respectively, in the 800 mg/L prometryn applied group. Deep neural network (DNN) model was optimized to predict the effects of different doses of prometryn on 4 different endpoints: micronucleus, mitotic index, chromosomal abnormalities and DNA Damage. The predicted data was found to be very similar to the actual data. The performance of the model was evaluated using MAE, MAPE, RMSE and R2, and these metrics indicate that the model performed well. Overall, the findings of this study suggest that the DNN model developed here is a valuable tool for predicting genotoxicity biomarkers in response to the application doses of prometryn, and has the potential to contribute to the development of safer and more sustainable agricultural practices.


An improved assay with 4-(2-thiazolylazo)-resorcinol for non-esterified fatty acids in biological fluids.
A simple and rapid colorimetric assay for non-esterified fatty acids (NEFA) was developed employing extraction of samples with 0.1 mol/l glycine (pH 2.7) and methoxyethanol : butyl ether, and formation of a copper-fatty acid soap detected with 4-(2-thiazolylazo)-resorcinol. The method developed is sensitive enough to detect as little as 11 nmol/0.25 ml sample. Results are not affected by marked molar excesses of phospholipids, cholesterol, cholesterol esters, triglycerides, bilirubin, or lactate. Recovery of palmitate in the extract averages 94.2 +/- 3.2% (S.D.) and other long chain fatty acids are recovered equally. The copper-NEFA-indicator complex formed is stable. Extracted samples can be stored for as long as 2 weeks without appreciable changes in measured NEFA content. The method developed is suitable for both manual and semi-automated procedures for determining NEFA content in biological fluids.


[The Ensemble Program: Making sense of your actions through ACT].
The Ensemble program supports informal caregivers of people with mental health problems. Tailor-made support is offered in order to target the tools that will be most useful to them in their personal situation. Acceptance and commitment therapy can be used to help them give meaning to their actions.


Detection of new psychoactive substance use among emergency room patients: results from the Swedish STRIDA project.
The "STRIDA" project monitors the occurrence and trends of new psychoactive substances (NPS; "Internet drugs/designer drugs/legal highs") in Sweden, and collects information about their clinical symptoms, toxicity and associated health hazards. The initial results of the project documented a widespread use of many different NPS by mainly adolescents and young (age range 13-63 years, median 20), male (79%) adults, among cases of drug intoxications presenting at emergency departments and intensive care units across the country. The new substances were identified in samples of urine and blood by a multi-component LC-MS/MS method, and the severity of clinical symptoms were graded by the Poisoning Severity Score (PSS). Of the initial 189 samples submitted for laboratory investigation, 156 (83%) tested positive for at least one drug. Besides classical substances such as ethanol, cannabis and amphetamines, many NPS were detected comprising synthetic cannabinoid receptor agonists ("Spice"), piperazines, substituted phenethylamines, synthetic cathinones, hallucinogenic tryptamines, piperidines, opioid related substances, ketamine and related substances, and GABA analogues (in total more than 50 substances). About half of the cases were demonstrated to be multiple drug intoxications, sometimes making it hard to associate the clinical presentations with one specific substance. In conclusion, the STRIDA project has documented use of a broad variety of NPS among mainly young people all over Sweden.


Effects of high-intensity interval exercise under hyperoxia on HSP27 and oxidative stress responses.
Hypoxia in working muscles during exercise may be associated with increased oxidative stress. Inhalation of hyperoxic gas diminishes the hypoxia within working muscles during exercise. Exposure to hyperoxia increases the expression of the antioxidant HSP27. We investigated the effects of acute high-intensity interval exercise (HIE) under hyperoxia on HSP27 levels and oxidative stress responses. Eight male subjects participated in two experiments: 1) normoxic HIE (NHIE) and 2) hyperoxic (60 % oxygen) HIE (HHIE). HIE consisted of four 30-s all-out cycling bouts with 4-min rest between bouts. Levels of serum oxidative stress markers (d-ROMs and LPO), HSP27, BAP, IL-6, and TNF-α significantly increased after both trials. The HIE-induced changes in d-ROMs, LPO, and HSP27 levels were significantly lower in the HHIE trial than in the NHIE trial. These findings suggest that inhaling hyperoxic gas during exercise might diminish oxidative stress induced by all-out HIE.


Heterologous C-terminal signals effectively target fluorescent fusion proteins to leaf peroxisomes in diverse plant species.
Peroxisomes are functionally diverse organelles that are wholly dependent on import of nuclear-encoded proteins. The signals that direct proteins into these organelles are either found at the C-terminus (type 1 peroxisomal targeting signal; PTS1) or N-terminus (type 2 peroxisomal targeting signal; PTS2) of the protein. Based on a limited number of tests in heterologous systems, PTS1 signals appear to be conserved across species. To further test the generality of this conclusion and to establish the extent to which the PTS1 signals can be relied on for biotechnological purposes across species, we tested two PTS1 signals for their ability to target fluorescent proteins in diverse plant species. Transient assays following microprojectile bombardment showed that the six amino acid PTS1 sequence (RAVARL) from spinach glycolate oxidase effectively targets green fluorescent fusion protein to the leaf peroxisomes in all 20 crops tested, including four monocots (sugarcane, wheat, corn and onion) and 16 dicots (carrot, cucumber, broccoli, tomato, lettuce, turnip, radish, cauliflower, cabbage, capsicum, celery, tobacco, petunia, beetroot, eggplant and coriander). Similarly, results indicated that the 10 amino acid PTS1 sequence (IHHPRELSRL) from pumpkin malate synthase effectively targets red fluorescent fusion protein to the leaf peroxisomes in all four crops tested including monocot (sugarcane) and dicot (cabbage, celery and pumpkin) species. These signal sequences should be useful metabolic engineering tools to direct recombinant proteins to the leaf peroxisomes in diverse plant species of biotechnological interest.


Synergistic interactions between footshocks and non-osmotic hypovolemia on vasopressin secretion in rats.
The effects of i.p. injected hypertonic NaCl and polyethylene glycol on the magnitude of increase in plasma vasopressin after footshocks were studied in male rats, to determine whether hypovolemia and body fluid osmolality interact with noxious stimuli on vasopressin secretion. Present data have demonstrated that non-osmotic hypovolemia but not body fluid hyperosmolarity interact significantly and synergistically with footshocks to potentiate vasopressin secretion.


Effect of Feeding Soy Milk Fermented by Probiotic Bacteria on Some Blood Criteria and Weight of Experimental Animals.
The chemical composition of soy milk fermented by probiotic starter (Log.11.1 CFU/ml) which consists of Streptococcus thermophilus, Lactobacillus acidophilus LA-5, and Bifidobacterium bifidum Bb-12 was studied. The percentage of each moisture, protein, fat, ash, carbohydrate and total acidity were 88.8, 4.2, 2.3, 0.82, 4.6, and 0.83, respectively, and the phytic acid rate was 0.075% after fermentation. The experimental animals were fed with 3 mL and 2 mL of soy milk fermented for 40 days. The result showed decreasing the rate of cholesterol and triglyceride in T1 treatment (3 mL of soy milk fermented) which were (114.24, 74.5 mg/deciliter) respectively compared with sample control (97.78, 124.67 mg/deciliter). The hematocrit, hemoglobin, white blood cells, thrombocytes, red blood cells, and the average quantity of hemoglobin, the size of blood cells, and the hemoglobin concentration in T1 treatment were (49.66, 14.76, 18.96, 246.3, 6.4, 16.4, 62.33, 30.53) respectively compared with those in control (42.0, 12.0, 12.6, 206.3, 6.0, 13.53, 45.33, 24.6) respectively. The standard of immunity were investigated for the experimental animals the rate of neutrophil decreased in T1 treatment which was 7.83% while in control 14.72% the rate of lymphocyte increased in T1 treatment 90.62% while decreased in control 82.0%.


New methods for quantifying diplopia.
To develop new methods for quantifying diplopia and test their validity, test-retest reliability, and responsiveness to treatment. Prospective case series. Adult patients with diplopia in 2 tertiary referral practices. Diagnosis included cranial nerve palsies, thyroid eye disease, supranuclear palsies, and ocular myasthenia gravis. The new diplopia questionnaire and cervical range of motion (CROM) diplopia examination were tested in a 15-patient validity study against the standard diplopia field performed on the Goldmann perimeter (each scored 0 [no diplopia] to 100 [constant diplopia in all fields]). The test-retest reliability of the CROM diplopia examination was determined in 27 patients. The responsiveness to treatment of the diplopia questionnaire and the CROM examination was tested in 15 patients who underwent strabismus surgery or received systemic prednisone for ocular myasthenia gravis. Validity was evaluated by the intraclass correlation coefficient (ICC) compared with the standard Goldmann diplopia field. Test-rest reliability was evaluated by the ICC. Responsiveness to treatment was evaluated by comparing pretreatment and posttreatment scores. There was excellent agreement between the diplopia questionnaire score and Goldmann diplopia field score (ICC, 0.90) and between the CROM diplopia examination score and Goldmann diplopia field score (ICC, 0.88). Intertester reliability of the CROM diplopia examination score was excellent (ICC, 0.87; 95% confidence interval, 0.74-0.94). Postintervention scores were significantly lower than baseline (P = 0.0003 for CROM and P = 0.0001 for the questionnaire), with a median postintervention improvement of 48 for the CROM diplopia score (quartiles 12-68) and 36 for the diplopia questionnaire (quartiles 20-52). Our new diplopia questionnaire and new CROM diplopia examination are valid, reliable, and responsive measures of diplopia severity. The tests are easy to administer and require less expensive and less cumbersome equipment than previously available.


Fetal echocardiography: new grounds to explore during fetal cardiac intervention.
Over the past decade, revolutionary advances in ultrasound imaging technology have allowed the study of the evolution of congenital heart disease during fetal life. The frustration arising from watching the prenatal progression of severe semilunar valve obstructions and therapy-refractory fetal arrhythmias has prompted the interest in developing procedures for fetal cardiac intervention. Ultrasound techniques as the primary diagnostic and monitoring modalities in fetal medicine will play a key role in defining patient groups, peri-interventional assessment of fetal hemodynamics, and monitoring during these procedures. The purpose of this article is to provide pediatric cardiologists and perinatal medicine specialists an overview over the various technical approaches at fetal cardiac intervention and the special tasks that fetal echocardiography will have to accomplish. It also aims at illustrating the potential of fetal echocardiography for fetal selection.


Improved polygalacturonase production from Bacillus sp. MG-cp-2 under submerged (SmF) and solid state (SSF) fermentation.
To investigate the effect of amino acids, vitamins and surfactants on polygalacturonase production from Bacillus sp. MG-cp-2 under submerged (SmF) and solid state fermentation (SSF). Bacillus sp. MG-cp-2 was isolated from the outer covering of the seeds of Celastrus paniculatus. Out of the various surfactants, amino acids and vitamins, Tween-60, DL-serine and folic acid maximally enhanced polygalacturonase production by 2.7-fold (240.0 U x ml(-1)), 4.0-fold (360.0 U x ml(-1)) and 3.8-fold (342.0 U x ml(-1)) respectively, under submerged fermentation (SmF). In solid state fermentation (SSF), Tween-80, pyridoxine and DL-ornithine monohydrochloride induced highest enzyme production up to 1.73-fold (6956.5 U x g(-1)), 5.3-fold (21224.4 U x g(-1)) and 5.74-fold (23076.9 U x g(-1)), respectively. Amino acids and their analogues, vitamins and surfactants effect significantly polygalacturonase production by Bacillus sp. MG-cp-2 when grown under submerged (SmF) and solid state fermentation (SSF) conditions. The study provides useful information about regulation of polygalacturonase biosynthesis in Bacillus sp. MG-cp-2, which appears to be an interplay of nutritional and physical factors. Alkaline polygalacturonase from Bacillus sp. MG-cp-2 will be extremely useful in the treatment of alkaline pectic waste waters from vegetable and fruit processing industries and in degumming of bast fibres.


Characterization of a glycoside hydrolase family-51 α-l-arabinofuranosidase gene from Aureobasidium pullulans ATCC 20524 and its encoded product.
The genomic DNA and cDNA encoding α-l-arabinofuranosidase were cloned from the dimorphic fungus Aureobasidium pullulans ATCC 20524 and sequenced. The open reading frame (2097 bp) of the α-l-arabinofuranosidase gene abfB was interrupted by five introns of 49, 49, 50, 65, and 49 bp. The gene encoded a presumed signal peptide of 17 residues and a mature protein of 682 residues with a calculated Mr of 74,230 Da and a theoretical isoelectric point of 4.95. Glu-362 and Glu-440 residues are likely involved in catalytic reactions as an acid/base and a nucleophile, respectively. The protein possessed 15 potential N-glycosylation sites. The deduced amino acid sequence of the abfB gene product was 58% identical to the Penicillium purpurogenum ABF 2, which belongs to the glycoside hydrolase family-51 α-l-arabinofuranosidase. The abfB cDNA was functionally expressed in the yeast Pichia pastoris. The recombinant enzyme, AbfB, was purified from the culture filtrate, and it appeared as a single band on SDS-PAGE with an apparent Mr of 110 kDa. AbfB showed α-l-arabinofuranosidase activity of 56.6 U/mg of protein toward p-nitrophenyl (pNP) α-l-arabinofuranoside at optimal pH 4.5 and 75°C. The enzyme exhibited apparent Km and Vmax values of 6.27 mM and 78.1 μmol/mg/min, respectively, for pNP α-l-arabinofuranoside. The enzyme was highly active on rye arabinoxylan as well as pNP α-l-arabinofuranoside, but it showed weak activity toward α-(1→5)-l-arabinobiose, α-(1→5)-l-arabinotriose, branched l-arabinan, linear α-(1→5)-l-arabinan, and arabinogalactan.


Visfatin-induced lipid raft redox signaling platforms and dysfunction in glomerular endothelial cells.
Adipokines have been reported to contribute to glomerular injury during obesity or diabetes mellitus. However, the mechanisms mediating the actions of various adipokines on the kidney remained elusive. The present study was performed to determine whether acid sphingomyelinase (ASM)-ceramide associated lipid raft (LR) clustering is involved in local oxidative stress in glomerular endothelial cells (GECs) induced by adipokines such as visfatin and adiponectin. Using confocal microscopy, visfatin but not adiponectin was found to increase LRs clustering in the membrane of GECs in a dose and time dependent manner. Upon visfatin stimulation ASMase activity was increased, and an aggregation of ASMase product, ceramide and NADPH oxidase subunits, gp91(phox) and p47(phox) was observed in the LR clusters, forming a LR redox signaling platform. The formation of this signaling platform was blocked by prior treatment with LR disruptor filipin, ASMase inhibitor amitriptyline, ASMase siRNA, gp91(phox) siRNA and adiponectin. Corresponding to LR clustering and aggregation of NADPH subunits, superoxide (O(2)(-)) production was significantly increased (2.7 folds) upon visfatin stimulation, as measured by electron spin resonance (ESR) spectrometry. Functionally, visfatin significantly increased the permeability of GEC layer in culture and disrupted microtubular networks, which were blocked by inhibition of LR redox signaling platform formation. In conclusion, the injurious effect of visfatin, but not adiponectin on the glomerular endothelium is associated with the formation of LR redox signaling platforms via LR clustering, which produces local oxidative stress resulting in the disruption of microtubular networks in GECs and increases the glomerular permeability.


Teen driver crash risk and associations with smoking and drowsy driving.
Motor vehicle crashes are the leading cause of death for young people in the United States. The goal of this study was to identify risk factor profiles of teen and young adult drivers involved in crashes. General demographic and behavioral as well as driving-related factors were considered. Analysis of a nationally representative telephone survey of U.S. young drivers ages 14 to 22 (N=900) conducted in 2005 was restricted to 506 licensed drivers (learners excluded). Statistically significant univariate associations between factors of interest and the primary outcome, crash involvement (ever) as a driver, were identified and included within a multivariate logistic regression model, controlling for potential demographic confounders. Aside from length of licensure, only driving alone while drowsy and being a current smoker were associated with having been in a crash. Gaining a better understanding of these behaviors could enhance the development of more customized interventions for new drivers.


Female patients with meningioma of the sphenoid ridge and additional primary neoplasms of the breast and genital tract.
Of 283 meningioma patients seen at the University of Kansas from 1948 to 1984, eight women acquired two primary extraneural cancers in addition to their meningiomas. Of these eight patients, six (75%) had sphenoid ridge meningiomas compared with 15% of meningioma patients overall (P less than 0.001). Seven (87.5%) had at least one breast or genital cancer (P less than 0.001). Of the six with sphenoid ridge meningiomas, five (83.3%) had both of their additional tumors in these two organ systems, and the sixth had one such tumor. It is proposed that this grouping of sphenoid ridge meningioma, breast cancer, and genital cancer represents a unique constellation of neoplasms in women.


Evaluation of long-term results of bicuspidalization annuloplasty for functional tricuspid regurgitation. A seventeen-year experience with 133 consecutive patients.
Between 1968 and 1985, 133 consecutive patients underwent bicuspidalization annuloplasty for moderate to severe functional tricuspid regurgitation associated with mitral or combined mitral and aortic valve disease. Over this period, the incidence of tricuspid valve replacement was only 2.3% (3/136 patients). There were 18 early deaths (13.5%) in the entire series--three (5.0%) of 60 patients in the last 5 years of the study--and 10 late deaths (8.7%). Actuarial survival rate for the entire series, excluding early deaths, was 91.0% +/- 3.0% at 10 and 17 years. There were seven reoperations (6.1%) on the tricuspid valve, needed because of residual or recurrent mitral valve lesions after the initial operation. Actuarial rates of freedom from reoperation on the tricuspid valve were 93.6% +/- 3.0% (10 years) and 69.7% +/- 16% (17 years) for the entire series: 78% +/- 10% (15 years) for the open mitral commissurotomy plus tricuspid annuloplasty group (44 patients); 90% +/- 9.0% (15 years) for the mitral plus tricuspid annuloplasty group (10); 75.2% +/- 22% (17 years) for the mitral replacement plus tricuspid annuloplasty group (58); and 92.6% +/- 7.0% (16 years) for the combined aortic and mitral valve surgery plus tricuspid annuloplasty group (21). Ninety-eight percent of the survivors were in New York Heart Association class I or II postoperatively. Of 21 randomly selected patients investigated by pulsed Doppler echocardiography, 14 (67%) had no regurgitation or grade 1/4 tricuspid regurgitation and the remaining seven (33%) had grade 2/4 regurgitation postoperatively. Our experiences suggest that bicuspidalization annuloplasty can be a reliable method in the vast majority of patients with functional tricuspid regurgitation.


Transplantation of a horseshoe kidney en bloc: report of a case.
Transplantation of a horseshoe kidney rarely has been reported. We report a case of successful en bloc transplantation of a horseshoe kidney. The kidney could not be divided because of a complex vascular situation in the isthmus region. The recipient was discharged from our hospital with normal kidney function 12 days postoperatively. We recommend the use of kidneys with anatomical malformations for transplantation.


Differences in the half-lives of some mitochondrial rat liver enzymes may derive partially from hepatocyte heterogeneity.
The different turnover rates of rat liver mitochondrial enzymes make autophagy unlikely to be the main mechanism for degradation of mitochondria. Although alternatives have been presented, hepatocyte heterogeneity has not been considered. Lighter hepatocytes isolated in a discontinuous Percoll gradient contain more glutamate dehydrogenase (GDH) (half-life 1 day) and a more active autophagic system than heavier hepatocytes. The latter contain more carbamoyl phosphate synthase (CPS) and ornithine carbamoyl transferase (OTC) (half-lives 8 days) but less lysosomal activity. As expected, isolated autophagic vacuoles contain, relative to the mitochondrial content, 3-times less OTC and CPS than GDH, probably reflecting a faster lysosomal engulfment of mitochondria in the light hepatocytes (which contain more GDH). These data may explain some of the half-life differences of the enzymes studied.


Defining a system suitability limit to decide on column deterioration and to facilitate column transfers in chiral supercritical fluid chromatography.
The separation of enantiomers is an important requirement during the entire drug life cycle in the pharmaceutical industry. High-performance liquid chromatography and supercritical fluid chromatography (SFC) are the main chromatographic techniques used to separate enantiomers. Since chiral stationary phases are often extensively used once a method has been developed, columns will age and must be replaced after a certain period. However, no practical guidelines exist to determine when a column is deteriorated or to decide whether a transfer to another column (with the same chiral selector) is successful. In this study, a system suitability limit for resolution was defined, based on an intermediate (time-different) precision study in SFC on four immobilized polysaccharide-based columns that only differed in manufacturer or particle size. This system suitability limit could be used to decide on column deterioration or as a requirement to evaluate whether a separation transfer was successful. Some method adaptations may be necessary to obtain successful transfers. An approach was proposed, which helped the analyst to make successful transfers. Graphical abstract.


Echocardiographic evaluation of potential cardiac transplant donors.
Since the initiation of the UTAH Cardiac Transplant Program, echocardiography has been used to evaluate 74 potential donors including 65 of 71 hearts ultimately used for transplantation. Of these 65 donors, 46 had normal studies, nine had pericardial effusions, five had mild septal hypokinesia with otherwise normal function, four had equivocal mitral valve prolapse, and only one heart could not be visualized. All transplants were successful and all donor hearts exhibited satisfactory hemodynamic function immediately after transplantation, including the hearts that were mildly abnormal before transplantation. These hearts included 21 (29%) that could have been excluded by conventional screening criteria. Nine potential donor hearts with grossly abnormal echocardiograms were not used for transplantation, including eight hearts with severe hypokinesia and one heart with significant mitral and tricuspid regurgitation. Inspection or histologic analysis confirmed the presence of severe dysfunction or morphologic damage in those hearts subjected to these additional measures. We conclude that echocardiographic screening is a useful method of evaluating potential cardiac transplant donors. It can identify potential donors that would otherwise have been excluded and it can identify potential donors with severe cardiac dysfunction without the need for direct surgical inspection.


The in-vitro effects of cAMP and cGMP modulators on inter-cellular dye transfer and gene expression levels in rat cumulus cell--oocyte complexes.
Supplementation of in-vitro maturation medium with reagents that inhibit meiotic resumption whilst supporting normal function of cumulus cell-oocyte complexes (COC) is challenging. This study compared the in-vitro effects of synthetic and physiologically-relevant reagents on meiotic resumption, gap junction activity and gene expression of rat COC. Higher doses of forskolin reduced gap junction activity. Whilst addition of phosphodiesterase inhibitors initially promoted gap junction activity, this decreased with time in-vitro. Moreover despite oocytes remaining in meiotic arrest, there was a concomitant decline in expression of genes critical for oocyte maturation, and evidence of a reduction in overall transcription rate. Similarly, supplementing media with C-type natriuretic peptide and/or oestradiol delayed meiotic resumption and only initially maintained gap junction activity. In contrast, several key genes were stimulated and overall transcription rates remained constant with time in-vitro. In summary, supplementation of media with physiologically-relevant reagents may better enable normal functions of the COC.


Electrocardiographic gating and monitoring in NMR imaging.
ECG gating and monitoring during NMR imaging may be achieved reliably by applying the principles in this tutorial. In order to use the ECG signal both for triggering and for patient monitoring it must have a prominent R-wave, while at the same time must have little artifact from gradient switches or the Lorentz voltage across the aorta, and not be significantly distorted by gradient switching artifacts. The twin goals of no image artifacts and minimal ECG artifacts may be achieved by the following means: (1) using ECG electrodes with minimal metal, (2) selecting electrodes and cables with no ferrous metals, (3) placing the limb electrodes close together, (4) placing the line between the limb electrodes and the leg electrode parallel to the magnetic flux lines and, if possible, parallel to the transverse component of the gradient flux lines, (5) keeping the area between the limb electrodes and the leg electrode small, (6) placing that area in the center of the imager and (7) twisting or braiding the cables. Following these principles allows artifact-free images and reliable ECG monitoring during ECG-gated NMR imaging examinations.