Treatment failure after uterine artery embolization: prospective cohort study with multifactorial analysis of possible predictors of long-term outcome.
To evaluate the impact of baseline characteristics and residual leiomyoma perfusion after uterine artery embolization (UAE) on clinical long-term outcome. One hundred fifteen patients underwent UAE. All patients were divided into three groups according to achieved infarction rate determined on contrast-enhanced magnetic resonance imaging within 48-72 h after UAE (I: 100%, n=60; II: 90-99%, n=32; and III: 0-89%, n=23). Treatment failure and subsequent re-interventions (surgery, repeat UAE) were assessed for each group and compared using Cox regression analysis (CRA) with respect to the following baseline variables: age, uterine and dominant fibroid volume, number of fibroids, location of largest fibroid, and clinical symptoms. Long-term follow-up was completed after a median of 7.2 years (range 5.1-9.6) with a response rate of 84%. CRA revealed that patients in group III had a 22.2-fold higher risk (p<0.001) of treatment failure than patients in group I, whereas groups I and II did not differ significantly (p=0.578). For patients with bleeding-related symptoms only, CRA showed a 5.1-fold higher risk (p=0.025) of treatment failure than for patients with equally dominant bleeding- and bulk-related symptoms. A 40.5-fold higher likelihood (p<0.001) of treatment failure was observed for patients in group III with bleeding-related symptoms only compared to those in group I with combined bleeding- and bulk-related symptoms. Incomplete fibroid infarction after UAE is strongly associated with the risk of experiencing treatment failure. Patients with bleeding-related complaints only face the highest likelihood of treatment failure if UAE results in less than 90% fibroid devascularization.


The effect of miR-223 on cellular behaviour in non-5q myelodysplastic syndromes through targeting RPS14.
Myelodysplastic syndromes (MDS) are characterised by impaired haematopoiesis and a high risk of leukaemic transformation. A decrease in RPS14 expression in non-5q MDS patients was confirmed by immunohistochemical analyses of MDS bone marrow biopsies. To determine the cause of RPS14 reduction in non-5q MDS, we analysed the 3'-UTR of RPS14 and demonstrated that miR-223 binds to the 3'-UTR of RPS14 by bioinformatics-based approach combined with the luciferase reporter assay. Using quantitative real-time polymerase chain reaction (qRT-PCR) analysis, we observed a significantly increased expression of miR-223 in CD34+ cells and SKM-1 cells derived from non-5q MDS patients in vitro and demonstrated a correlation between miR-223 levels and red blood cell counts. Exogenous miR-223 expression in SKM-1 cells could also inhibit RPS14 expression. In functional studies, overexpression of miR-223 was shown to promote cell proliferation and inhibit cell apoptosis in SKM-1 cells, and to impair erythroid differentiation in haemin-induced K562 cells. Taken together, our results revealed that the overexpression of miR-223 in MDS is closely associated with cell transformation and erythroid differentiation arrest, which is most likely mediated by targeting RPS14.


Slowest first passage times, redundancy, and menopause timing.
Biological events are often initiated when a random "searcher" finds a "target," which is called a first passage time (FPT). In some biological systems involving multiple searchers, an important timescale is the time it takes the slowest searcher(s) to find a target. For example, of the hundreds of thousands of primordial follicles in a woman's ovarian reserve, it is the slowest to leave that trigger the onset of menopause. Such slowest FPTs may also contribute to the reliability of cell signaling pathways and influence the ability of a cell to locate an external stimulus. In this paper, we use extreme value theory and asymptotic analysis to obtain rigorous approximations to the full probability distribution and moments of slowest FPTs. Though the results are proven in the limit of many searchers, numerical simulations reveal that the approximations are accurate for any number of searchers in typical scenarios of interest. We apply these general mathematical results to models of ovarian aging and menopause timing, which reveals the role of slowest FPTs for understanding redundancy in biological systems. We also apply the theory to several popular models of stochastic search, including search by diffusive, subdiffusive, and mortal searchers.


Risk Factor for Superimposed Nosocomial Bloodstream Infections in Hospitalized Patients with COVID-19.
Corticosteroids are a component of the standard therapy for patients with coronavirus disease 2019 (COVID-19) because of the immunological dysregulation and hyperinflammation associated with the condition. This study aimed to evaluate the potential risk factors for nosocomial bloodstream infections in hospitalized patients with COVID-19, including the exploration of corticosteroid dosage and treatment duration. A retrospective cohort study of hospitalized patients with COVID-19 was conducted in a tertiary care hospital. We performed univariate and multivariate analyses of various parameters to identify risk factors for nosocomial bloodstream infection. Of 252 patients, 19% had nosocomial bloodstream infections. The mortality rate of nosocomial bloodstream infections was 62.5%. Multivariate analysis revealed that male sex (odds ratio [OR] 3.43; 95% confidence interval [CI]: 1.60-7.33), receiving methylprednisolone (OR: 3.01; 95% CI: 1.24-7.31), receiving an equivalent dexamethasone dose of 6-12 mg/day (OR: 7.49; 95% CI: 2.08-26.94), and leukocytosis on admission (OR: 4.13; 95% CI: 1.89-9.01) were significant predictors of nosocomial bloodstream infections. Unmodified risk variables for nosocomial bloodstream infections included male sex and leukocytosis at admission. Using methylprednisolone and obtaining a cumulative dosage of dexamethasone were adjusted risk variables associated with superimposed nosocomial bloodstream infections in hospitalized patients with COVID-19.


Biobased epoxidized natural rubber/sodium carboxymethyl cellulose composites with enhanced strength and healing ability.
Conventional vulcanized rubbers cause a non-negligible waste of resources due to the formation of 3D irreversible covalently cross-linked networks. The introduction of reversible covalent bonds, such as reversible disulfide bonds, into the rubber network, is an available solution to the above problem. However, the mechanical properties of rubber with only reversible disulfide bonds cannot meet most practical applications. In this paper, a strengthened bio-based epoxidized natural rubber (ENR) composite reinforced by sodium carboxymethyl cellulose (SCMC) was prepared. SCMC forms a mass of hydrogen bonds between its hydroxyl groups and the hydrophilic groups of ENR chain, which gives the ENR/2,2'-Dithiodibenzoic acid (DTSA)/SCMC composites an enhanced mechanical performance. With 20 phr SCMC, the tensile strength of the composite increases from 3.0 to 10.4 MPa, which is almost 3.5 times that of the ENR/DTSA composite without SCMC. Simultaneously, DTSA covalently cross-linked ENR with the introduction of reversible disulfide bonds, which enables the cross-linked network to rearrange its topology at low temperatures and thus endows the ENR/DTSA/SCMC composites with healing properties. The ENR/DTSA/SCMC-10 composite has a considerable healing efficiency of about 96 % after healing at 80 °C for 12 h.


Cost-effectiveness analysis of neurocognitive-sparing treatments for brain metastases.
Decisions regarding how to treat patients who have 1 to 3 brain metastases require important tradeoffs between controlling recurrences, side effects, and costs. In this analysis, the authors compared novel treatments versus usual care to determine the incremental cost-effectiveness ratio from a payer's (Medicare) perspective. Cost-effectiveness was evaluated using a microsimulation of a Markov model for 60 one-month cycles. The model used 4 simulated cohorts of patients aged 65 years with 1 to 3 brain metastases. The 4 cohorts had a median survival of 3, 6, 12, and 24 months to test the sensitivity of the model to different prognoses. The treatment alternatives evaluated included stereotactic radiosurgery (SRS) with 3 variants of salvage after recurrence (whole-brain radiotherapy [WBRT], hippocampal avoidance WBRT [HA-WBRT], SRS plus WBRT, and SRS plus HA-WBRT). The findings were tested for robustness using probabilistic and deterministic sensitivity analyses. Traditional radiation therapies remained cost-effective for patients in the 3-month and 6-month cohorts. In the cohorts with longer median survival, HA-WBRT and SRS plus HA-WBRT became cost-effective relative to traditional treatments. When the treatments that involved HA-WBRT were excluded, either SRS alone or SRS plus WBRT was cost-effective relative to WBRT alone. The deterministic and probabilistic sensitivity analyses confirmed the robustness of these results. HA-WBRT and SRS plus HA-WBRT were cost-effective for 2 of the 4 cohorts, demonstrating the value of controlling late brain toxicity with this novel therapy. Cost-effectiveness depended on patient life expectancy. SRS was cost-effective in the cohorts with short prognoses (3 and 6 months), whereas HA-WBRT and SRS plus HA-WBRT were cost-effective in the cohorts with longer prognoses (12 and 24 months).


An epidemiologic case-control study in a population with vitiligo.
Previous epidemiologic studies of vitiligo have not included a sex- and age-matched population. Our purpose was to attempt to determine possible risk factors and clinical differences associated with unilateral and bilateral vitiligo. Two hundred thirty-four patients and 234 normal control subjects were examined and questioned. Patients with unilateral vitiligo were younger and had an earlier age at onset. Koebner's phenomenon and halo nevus were infrequent in the total vitiligo group, but no difference between vitiligo types was observed. Subjects with bilateral vitiligo more frequently had light skin (types I, II, and III) and more commonly had an associated autoimmune disease. Unilateral and bilateral vitiligo differ substantially in several clinical aspects, which suggests a different pathogenic mechanism for each condition.


Influence of inoculation with plant growth promoting rhizobacteria (PGPR) on tomato plant growth and nematode reproduction under greenhouse conditions.
Numerous species of soil bacteria which flourish in the rhizosphere of plants or around plant tissues stimulate plant growth and reduce nematode population by antagonistic behavior. These bacteria are collectively known as PGPR (plant growth promoting rhizobacteria). The effects of six isolates of PGPR Pseudomonas putida, Pseudomonas fluorescens, Serratia marcescens, Bacillus amyloliquefaciens, Bacillus subtilis and Bacillus cereus, were studied on tomato plant growth and root knot nematode reproduction after 45 days from nematode infection. The highest number of shoot dry weight/g (43.00 g) was detected in the plant treated with S. marcescens; then P. putida (34.33 g), B. amyloliquefaciens (31.66 g), P. fluorescens (30.0 g), B. subtilis (29.0 g), B. cereus (27.0 g) and nematode alone (untreated) 20 g/plant. While the highest number of plant height was observed when plant was treated with S. marcescens, P. fluorescens, P. putida, B. amyloliquefaciens and P. putida 52.66, 50.66, 48 and 48 cm respectively. No significant differences were seen between previous treatments but only had significant differences compared with untreated plant. The highest number of fruit/plant was observed when plants were treated with S. marcescens (10.66), then B. amyloliquefaciens (8.66), P. putida (8), P. fluorescens (8) and B. cereus (7.66). No significant differences between the last 4 treatments, but all had significant differences compared with untreated plants. The highest weight of plant yield (g) was observed with S. marcescens (319.6 g/plant) and the lowest weight of plant yield was observed in plants treated with nematode alone (untreated). On the other hand, the lowest numbers of J2/10 g of soil (78), galls/root, (24.33) galls/root, egg masses/root (12.66) and egg/egg masses were observed in the plants treated with S. marcescens.


How does nutritional state change during a subacute admission? Findings and implications for practice.
Nutritional status influences patients' clinical and functional outcomes. The aims were to identify changes in nutritional state during subacute care and associated participant characteristics. A longitudinal study was undertaken with consecutive patients admitted to subacute care wards during a 3-month period. Participants were recruited under a waiver of consent to reflect the usual demographic. Change in classification (malnourished, at risk of malnutrition, well nourished) of the full Mini Nutritional Assessment (full MNA) between admission and discharge was the primary outcome. Weight (kg), mid-arm and calf circumference (cm) change were secondary outcomes. Hand grip strength (kg) and fat-free mass (kg) (assessed using bioelectrical impedance analysis) were measured for a consenting subgroup. Participants (n=248, 36.7% male) had a median age of 80 years and a length of stay of 17 days. On admission, 29.1% were classified as malnourished. By discharge, nutritional classification remained stable for 62.0% of participants (n=132), declined for 10.3% (n=22) and improved for 27.7% (n=59, including 52.5% malnourished on admission). Impaired cognition (odds ratio (OR)=0.169, P=0.002) and higher full MNA score at admission (OR=0.870, P=0.001) reduced odds of improvement in full MNA. There was no change in hand grip strength (n=46), but there was a decline in mean fat-free mass (-1.1 kg, 95% confidence interval: -0.1 to -2.2 kg, P=0.043, n=24). Multidisciplinary care supports the nutritional state of most patients admitted to subacute care. Those with cognitive impairments or at risk of malnutrition were less likely to demonstrate improvement and may benefit from more intensive or tailored nutritional care.


A path based approach to assessing molecular complexity.
An atom environment, path based approach to calculating molecular complexity is described. Based on Shannon's equation, the method transforms the number and diversity of paths emanating from an atom to an atom-complexity from which a number of molecular complexity measures are derived. The method is independent of explicitly predefined features such as ring membership, bond types, chirality or symmetry. These path-based measures of complexity can distinguish subtle differences in molecular structure and an application to the visualization of marketed drugs, including a number of biologics, is presented.


The design of clinical trials in psoriasis: lessons for clinical practice.
Understanding the process by which drugs are approved gives clinicians a better understanding of the medications they prescribe and how these medications are best used to care for patients. The development of new drugs in the United States proceeds through a series of studies culminating in well-designed, large-scale human trials. These studies result from a coordinated collaboration between industry and the Food and Drug Administration (FDA). The results of these studies determine whether drugs are approved for use or not. They also determine the labeling and marketing of products and guide (but do not fully determine) physicians' use of the drug. This article follows a hypothetical drug for use in psoriasis through the approval process, in order to illustrate the process and its implications for clinical practice.


Zirconocene dichlorides as catalysts in alkene carbo- and cyclometalation by AlEt3: intermediate structures and dynamics.
A series of zirconocenes L2ZrCl2 (23 examples) were studied as catalysts in the reaction of alkenes with AlEt3. The catalyst activity and reaction chemoselectivity were found to depend on the ligand structure in the complex and the nature of the solvent. The alkyl exchange in the triethylaluminum dimer was studied by NMR spectroscopy; a solvent effect on the alkyl exchange parameters was established. In the reaction between L2ZrCl2 and AlEt3, the formation of intermediates L2ZrEtCl, L2Zr(μ-Cl)CH2CH2AlEt2, L2Zr(μ-H)CH2CH2AlEt2, and L2Zr(μ-Cl)CH2CH(AlEt2)2 was shown; the ratio of the intermediates depends on the ligand structure in the initial complex and the solvent. The exchange in the ethanediyl bridge ZrCH2CH2Al, proceeding via zirconocenecyclopropane structures, was demonstrated for the first time for five-membered bimetallic complexes L2Zr(μ-Cl)CH2CH2AlEt2 with ansa-ligands (L2 = Me2SiCp2, H2CInd2, Me2CInd2, Me2SiInd2, and C2H4Ind2). Five-membered bimetallic complexes were shown to participate in the formation of cyclic organoaluminum products - 3-substituted alumolanes.


Posterior bilateral supernumerary atlantoaxial facets: true or false joint?
Case report. To describe a symptomatic patient with bilateral posterior accessory C1-C2 joints and their differences from the true synovial joints. Accessory joints between C1-C2 are rarely described. Origin and functional importance of such joints is unknown. Moreover only gross anatomic features of such joints were discussed in the past. The emphasis here is to review the morphology of such joints and to differentiate it from normal synovial joints. A 17-year-old male presented with progressive spastic ataxia precipitated by episodic transient quadriparesis secondary to trivial trauma. Radiology revealed bilateral posterior C1-C2 accessory joints compressing the cervicomedullary junction. Both C1-C2 posterior arches were removed, excising the accessory joints. Fusion was achieved using C1-C2 lateral mass screws and is doing well at follow-up. The surfaces of these joints were smooth. Histopatholgy showed opposing osseous surfaces with articular cartilage but no synovium or articular capsule. Accessory C1-C2 joints are possibly a result of genetic aberration giving rise to abnormality in segmentation of C1 sclerotome. These joints are dysmorphic and partially formed as evidenced by the absence of synovial membrane and capsule. The function of such joints remains questionable.


Potential toxicity of quercetin: The repression of mitochondrial copy number via decreased POLG expression and excessive TFAM expression in irradiated murine bone marrow.
The cytotoxicity of quercetin is not well understood. Using an ICR murine model, we unexpectedly found that mice exposed to 7 Gy total body irradiation (TBI) exhibited general in vivo toxicity after receiving quercetin (100 mg/kg PO), whereas this result was not observed in mice that received TBI only. In order to understand the involvement of alterations in mitochondrial biogenesis, we used a real-time qPCR to analyze the mitochondrial DNA copy number (mtDNAcn) by amplifying the MTRNR1 (12S rRNA) gene in murine bone marrow. We also utilized reverse transcription qPCR to determine the mRNA amounts transcribed from the polymerase gamma (POLG), POLG2, and mammalian mitochondrial transcription factor A (TFAM) genes in the tissue. In the mice exposed to TBI combined with quercetin, we found: (1) the radiation-induced increase of mtDNAcn was inhibited with a concurrent significant decrease in POLG expression; (2) TFAM expression was significantly increased; and (3) the expression of POLG2 was not influenced by the treatments. These data suggest that the overall toxicity was in part associated with the decrease in mtDNAcn, an effect apparently caused by the inhibition of POLG expression and overexpression of TFAM; unaltered POLG2 expression did not seem to contribute to toxicity.


Lipid-lowering diets enriched with monounsaturated or polyunsaturated fatty acids but low in saturated fatty acids have similar effects on serum lipid concentrations in hyperlipidemic patients.
The aim of this study was to compare the effects of a diet enriched with monounsaturated (MUFAs) with one enriched with polyunsaturated (PUFAs) fatty acids on the serum lipoprotein composition in patients with hyperlipidemia. A new model for conducting controlled dietary treatment studies in free-living hyperlipidemic patients was tested. Twenty-six patients with an average age of 51 y participated in a crossover study during two consecutive 3.5-wk treatment periods. The mean serum cholesterol and LDL cholesterol decreased by 17% and 19%, respectively, on the MUFA diet. The corresponding figures on the PUFA diet were 19% and 23%, respectively. The HDL-cholesterol concentration was significantly decreased after both dietary periods. No significant differences in any of the variables studied were found between the diets. It is concluded that MUFAs and PUFAs, within a diet with a restricted content of saturated fat and total fat, are interchangeable with regard to lipid-lowering effects among free-living hyperlipidemic patients.


The journal club and its role in hand surgery education.
Journal clubs are a time-honored method of teaching literature appraisal skills in many residency programs. A questionnaire was completed by 57 hand surgery fellowship directors and 91 hand fellows to define the role of the journal club in hand fellowship training. We sought to identify definitive characteristics of hand surgery journal clubs and assess their strengths and weaknesses. One hundred forty-eight of 164 (90%) directors and fellows responded, yielding information on 57 of 58 accredited hand fellowships. Forty-nine of 57 (86%) responding fellowships have a journal club. The majority of clubs meet monthly for 1 to 2 hours, usually within the hospital. The primary purpose is to familiarize both fellows and attendings with the current literature. Most often, fellows choose the articles, which are most commonly original research and review articles. Usually, faculty presides, and residents and fellows present. Increased faculty participation was the most frequently suggested improvement. The great majority of those surveyed felt that their journal club was successful and was an important part of the fellowship training. We conclude that journal clubs have a high perceived value by participants, and recommend the journal club to all hand surgery communities, with or without fellowship involvement.


Activin-A co-opts IRF4 and AhR signaling to induce human regulatory T cells that restrain asthmatic responses.
Type 1 regulatory T (Tr1) cells play a pivotal role in restraining human T-cell responses toward environmental allergens and protecting against allergic diseases. Still, the precise molecular cues that underlie their transcriptional and functional specification remain elusive. Here, we show that the cytokine activin-A instructs the generation of CD4+ T cells that express the Tr1-cell-associated molecules IL-10, inducible T-Cell costimulator (ICOS), lymphocyte activation gene 3 protein (LAG-3), and CD49b, and exert strongly suppressive functions toward allergic responses induced by naive and in vivo-primed human T helper 2 cells. Moreover, mechanistic studies reveal that activin-A signaling induces the activation of the transcription factor interferon regulatory factor (IRF4), which, along with the environmental sensor aryl hydrocarbon receptor, forms a multipartite transcriptional complex that binds in IL-10 and ICOS promoter elements and controls gene expression in human CD4+ T cells. In fact, IRF4 silencing abrogates activin-A-driven IL10 and ICOS up-regulation and impairs the suppressive functions of human activin-A-induced Tr1-like (act-A-iTr1) cells. Importantly, using a humanized mouse model of allergic asthma, we demonstrate that adoptive transfer of human act-A-iTr1 cells, both in preventive and therapeutic protocols, confers significant protection against cardinal asthma manifestations, including pulmonary inflammation. Overall, our findings uncover an activin-A-induced IRF4-aryl hydrocarbon receptor (AhR)-dependent transcriptional network, which generates suppressive human Tr1 cells that may be harnessed for the control of allergic diseases.


Successful salvage of complicated calcaneal blastomycosis in disseminated disease with staged surgical reconstruction and local-systemic antifungal therapy.
Disseminated blastomycosis can be a devastating disease, affecting multiple organ systems, including the musculoskeletal system. Osteomyelitis from disseminated disease can be difficult to eradicate but is particularly important to successfully manage in the load-bearing bones of the lower extremity. We present a staged protocol for salvage of blastomycotic calcaneal osteomyelitis in the presence of disseminated disease.


Molecular insights into the history of plague.
Because of the limits inherent in historical sources on ancient plague epidemics, many questions concerning their etiology and epidemiology remain unanswered. Molecular biology tools and the use of dental pulp as a preserved source of bacterial DNA enabled us to demonstrate that Yersinia pestis was the etiologic agent of the 1347 European Black Death and of two additional epidemics in 1590 and 1722 in southern France.


A mechanism of S-(1,2,3,4,4-pentachloro-1,3-butadienyl)-L-cysteine toxicity to rabbit renal proximal tubules.
S-(1,2,3,4,4-Pentachloro-1,3-butadienyl)-L-cysteine (PCBC) has been identified as the penultimate compound responsible for hexachlorobutadiene-induced nephrotoxicity. The primary goal of these studies was to determine the mechanism of PCBC-induced toxicity in rabbit renal proximal tubules by examining the early changes in tubular physiology. PCBC (20-500 microM) induced a specific sequence of toxic events. Following 15 min of exposure, 200 microM PCBC increased basal (25%) and ouabain-insensitive (78%) respiration. This was followed by a decrease in basal (46%), nystatin-stimulated (54%), and ouabain-insensitive (21%) respiration and a decrease in glutathione content (79%). Finally, there was a decrease in cell viability as measured by a decrease in LDH retention at 60 min. Direct probing of mitochondrial function revealed that the initial increase in respiration resulted from the uncoupling of oxidative phosphorylation, while the late changes in respiration appeared to result from gross mitochondrial damage characterized by inhibited state 3 respiration, inhibited cytochrome c-cytochrome oxidase, and inhibited electron transport. Studies utilizing tubules with decreased glutathione content revealed that glutathione plays little if any role in the early events of PCBC-induced toxicity. These results suggest that PCBC-induced mitochondrial dysfunction may initiate the renal proximal tubule injury.


Development of six immune-related lncRNA signature prognostic model for smoking-positive lung adenocarcinoma.
Smoking is one of the most hazardous risk factors for the development of lung adenocarcinoma (LUAD). Many survival and prognosis-related biomarkers were discovered using database mining. However, the precision of immune-related long noncoding RNAs (lncRNAs) predictions is insufficient. We identified a novel signature to improve the estimate of smoking-related LUAD prognosis. The Cancer Genome Atlas database (TCGA) was used to obtain the LUAD lncRNA expression profiles. The smoking-related LUAD cohort was randomly split into discovery and validation cohorts. To determine the risk score, use the LASSO Cox regression technique on the prognostic immune-related lncRNA. The risk signature has been developed. A total of 643 immune-related lncRNAs were identified as potential candidates for a risk signature. Finally, six immune-related lncRNAs (AL359915.2, AP000695.1, HSPC324, TGFB2-AS1, AC026355.1, and AC002128.2) were identified and used to carry out risk signature, which showed a close association with overall survival in the discovery cohort. We classified patients as high risk or low risk based on a median risk score of 1.0783. In the discovery cohort, overall survival was marginally longer in the low-risk group than in the high-risk category (p = 2.28e08). The area under the curves (AUC) for 1-, 3-, and 5-year survival was 0.67, 0.7, and 0.82, respectively. Furthermore, we successfully validated and combined cohorts using this risk profile. We discovered a strong positive connection between HSPC324 and VIPR1 as a possible novel biomarker for smoking-related LUAD development in our study. Our research has established a six immune-lncRNA signature that may be used to predict the prognosis of smoking-related LUAD with great accuracy.


Studies on the mechanism of Indigo Carmine removal by solvent sublation.
Indigo Carmine (C16H8N2Na2O8S2), an anionic dye, was removed from aqueous solution by solvent sublation of Indigo Carmine-cetyltrimethylammonium bromide (CTAB) complex (sublate) into 2-octanol. A stoichiometric amount of surfactant (surfactant:dye=2:1) was demonstrated to be able to remove over 93% IC from the aqueous solution in 5 min. The apparent activation energy of attachment of the sublate to bubbles was calculated as 1.3 kJ/mol. Parameters were considered. At the same time, on the base of the complete transport mechanism, a mathematical model for the dye-surfactant complexation was obtained. Furthermore, the simulation of the mathematical and experimental data was made with good results.


Effect of race/ethnicity on risk, presentation and course of connective tissue diseases and primary systemic vasculitides.
Understanding the effects of race/ethnicity on the risk and expression of systemic rheumatic diseases has potential clinical implications and provides insight into their etiopathogeneses. This review summarizes knowledge of the effects of race/ethnicity on the following nine conditions: antineutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV), Behçet's disease, dermatomyositis/polymyositis, Henoch-Schönlein purpura, Kawasaki disease, large-vessel vasculitis (LVV), primary Sjögren's syndrome (pSS), systemic lupus erythematosus (SLE) and systemic sclerosis (SSc). Distinct racial/ethnic patterns have emerged for most of the conditions considered here. Areas of progress include the finding that the two AAVs, granulomatosis with polyangiitis (Wegener's) (GPA) and microscopic polyangiitis, exhibit distinct racial/ethnic susceptibilities in disease risk. In addition, nonwhites, with known high risk of SLE and SSc, may also be at a high risk for pSS and have more severe disease. Evidence is accumulating that nonwhites are rarely affected by the LVV giant-cell arteritis. Race/ethnicity-specific genetic risk factors were recently detected for GPA. Epidemiologic data have allowed discerning the racial/ethnic profiles for many of the considered systemic rheumatic conditions. Future challenges will be to unravel the genetic, environmental and/or socio-econonomic determinants of the observed racial/ethnic disparities. More research is needed to clarify the impact of race/ethnicity on the AAV Churg-Strauss syndrome, dermatomyositis/polymyositis and Takayasu arteritis.


In situ hybridization of atrial natriuretic peptide mRNA in the endothelial cells of human umbilical vessels.
The localization of mRNA encoding preproatrial natriuretic peptide (ANP) was investigated in cultured human umbilical vein endothelial cells (HUVEC) and tissue preparations of umbilical vein and artery. The techniques used were in situ hybridization and in situ hybridization combined with immunocytochemistry, using 32P-radiolabelled and non-radioactive digoxigenin labelled complementary RNA probes. Human ANP mRNAs are mainly localized in the endothelial cells of the umbilical vein and, to a lesser extent, in the endothelial cells of the umbilical artery. The autoradiographic labelling and the intensity of digoxigenin staining were significantly reduced by treatment with RNase before in situ hybridization. This study provides unequivocal evidence for the expression of the ANP gene in the endothelial cells of human umbilical vessels, confirming that these endothelial cells have the ability to synthesize this peptide. The functional significance of the presence of the ANP mRNA in the endothelial cells of human umbilical vessels is discussed.


Avian community assembly rules: The foliage-gleaning guild.
The theory of animal community organization has been dominated by general models based on the Lotka-Volterra equations. The predictions of these models are difficult to test in particular situations. Moreover, a great deal of ecological information is incommensurate with the data requirements of these models. A different approach to community organization addresses the "ecosystem assembly problem". This problem is defined to be that of constructing an algorithm which assembles a subset of a species pool in a specified environment.A model of ecosystem assembly, based on generative grammars as used in theoretical linguistics, is described. It was constructed from and validated with data collected by D.H. Morse on a guild of foliage-gleaning birds inhabiting spruce forests on islands off the coast of Maine. The data were divided into two groups. One group, from the years 1967-1970, was used for model construction; the second group, from 1971-1975, was used to validate the model.The model has two major components. One component inserts species onto islands according to the microhabitat used by each species and the resources available on each island. A second component deletes those inserted species from islands on which they were not observed to occur during 1967-1970. This component is composed of deletion rules that remove species depending on (a) their sizes and resource requirements, (b) the sizes and resource requirements of other species present in the ecosystem, and (c) the structure of the vegetation on the islands. Model validation was performed by comparing the predicted distributions of species against observed distributions not used in model construction. Model accuracy for the later data (1971-1975) was slightly higher than for the earlier data (1967-1970), approximately 88% and 84%, respectively.The behavior of the model was investigated with several simulations. These included the effects of the removal of certain deletion rules and the effects of the application of the rules without regard to their order. Other simulations demonstrated the application of the model to the prediction of the effects of habitat manipulation and the removal of particular species from the species pool.


Comparison of the Denka Seiken slide agglutination method to the quellung test for serogrouping of Streptococcus pneumoniae isolates.
This study compared a slide agglutination test (Denka Seiken, Tokyo, Japan) to the "gold standard" quellung reaction (Pneumotest; Statens Serum Institut, Copenhagen, Denmark) for the serogrouping of pneumococci. Two hundred clinical isolates of Streptococcus pneumoniae were used for the comparison. Each assay was performed according to the manufacturer's instructions. There was an overall agreement of 95.7% between the two methods. Only 4 of 10 isolates of serogroup 22 were detected with the slide agglutination assay. Two isolates that were untypeable by the Pneumotest method were typed as serogroups 6 and 31 by the slide agglutination method. The Pneumotest method was unable to type 22 isolates, and the slide agglutination method was unable to type 16 isolates. The slide agglutination method compares favorably with the Pneumotest method and is easier to perform and to interpret.


Copy number variations analysis in a cohort of 47 fetuses and newborns with congenital diaphragmatic hernia.
The congenital diaphragmatic hernia (CDH), characterized by malformation of the diaphragm and lung hypoplasia, is a common and severe birth defect that affects around 1 in 4000 live births. However, the etiology of most cases of CDH remains unclear. The aim of this study was to perform a retrospective analysis of copy number variations (CNVs) using a high-resolution array comparative genomic hybridization (array-CGH) in a cohort of fetuses and newborns with CDH. Forty seven fetuses and newborns with either isolated or syndromic CDH were analyzed by oligonucleotide-based array-CGH Agilent 180K technique. A mean of 10.2 CNVs was detected by proband with a total number of 480 CNVs identified based on five categories: benign, likely benign, of uncertain signification, likely pathogenic, and pathogenic. Diagnostic performance was estimated at 19.15% (i.e., likely pathogenic and pathogenic CNVs) for both CDH types. We identified 11 potential candidate genes: COL25A1, DSEL, EYA1, FLNA, MECOM, NRXN1, RARB, SPATA13, TJP2, XIRP2, and ZFPM2. We suggest that COL25A1, DSEL, EYA1, FLNA, MECOM, NRXN1, RARB, SPATA13, TJP2, XIRP2, and ZFPM2 genes may be related to CDH occurrence. Thus, this study provides a possibility for new methods of a positive diagnosis.


Soil contamination by heavy metals in landfills: measurements from an unlined leachate storage basin.
Landfills are sources of groundwater and soil pollution due to the production of leachate and its migration through refuse. This study was conducted in order to determine the extent of soil pollution within and around the Jebel Chakir landfill, located in the Tunis City, Tunisia. The main objective was to characterize soil samples of an unlined storage basin in relation to heavy metal concentrations in the Jebel Chakir landfill to the southwest of Tunis, Northern Tunisia. Twenty-four soil samples taken from different locations around the storage basin were analyzed by atomic absorption spectrophotometry for Cr, Cu, Ni, Pb, and Zn investigation. Our results indicated high concentrations of Cr (54.4-129.9 mg/kg of DM), Zn (4.1-81.8 mg/kg of DM), Ni (15.1-43.9 mg/kg of DM), Pb (5.6-16.1 mg/kg of DM), and Cu (0.2-1.84 mg/kg of DM). These results suggested that contaminant migration is controlled by an active clay layer acting as an insulating material in the landfill. It is therefore necessary to set a treatment system for the landfill leachates and place a liner under the storage basin to reduce the pollution threat.


Ultrahigh stress and strain in hierarchically structured hollow nanoparticles.
Nanocrystalline materials offer very high strength but are typically limited in their strain to failure, and efforts to improve deformability in these materials are usually found to be at the expense of strength. Using a combination of quantitative in situ compression in a transmission electron microscope and finite-element analysis, we show that the mechanical properties of nanoparticles can be directly measured and interpreted on an individual basis. We find that nanocrystalline CdS synthesized into a spherical shell geometry is capable of withstanding extreme stresses (approaching the ideal shear strength of CdS). This unusual strength enables the spherical shells to exhibit considerable deformation to failure (up to 20% of the sphere's diameter). By taking into account the structural hierarchy intrinsic to novel nanocrystalline materials such as this, we show it is possible to achieve and characterize the ultrahigh stresses and strains that exist within a single nanoparticle during deformation.


Sequence of the hemagglutinin gene of influenza virus A/Memphis/1/71 and previously uncharacterized monoclonal antibody-derived variants.
A cDNA copy of the hemagglutinin (HA) gene of Mem/1/71HA Bel/42NA was cloned into the plasmid pBR322. The cloned gene contained the coding information for all of the HA except for the hydrophobic membrane insertion sequence of the C-terminus of HA2. The cloned HA DNA was used to make HA-specific primers from restriction fragments for internal priming on the viral RNA. These primers were used to sequence the complete HA gene of Mem/1/71, and to determine nucleotide sequence changes in four previously uncharacterized monoclonal antibody generated variants of Mem/1/71 (Webster, Laver, Air, Ward, Van Wyke, and Gerhard, Ann. N.Y. Acad. Sci. 354, 142-161, 1980).


Mood and thyroid immunity assessed by ultrasonographic imaging in a primary health care.
Psychiatric morbidity is highly prevalent in the primary health care settings and it may be related to autoimmune thyroid disease (AITD). The aim of this study was to evaluate the impact of thyroid immunity, evident by hypo-echoic thyroid ultrasound pattern, on prevalence of depression and anxiety in a primary care setting. In a cross-sectional design, 504 consecutive primary care patients were invited to the study and 474 patients completed the study. They were screened for depression and anxiety using the Hospital Anxiety and Depression Scale (HADS), were interviewed for affective disorders using the Mini International Neuropsychiatric Interview, and were evaluated by ultrasonographic imagining of the thyroid gland. Among patients with hypo-echoic thyroid (n=122) prevailed women and those patients were older than patients with normo-echoic thyroid (n=352). Women, but not men, with hypo-echoic thyroid compared to those with normo-echoic thyroid had higher scores on the anxiety subscale of the HADS (p=0.03). Among women with hypo-echoic thyroid, only those pre-menopause, but not those post-menopause, had greater prevalence of high scores on the depression subscale of the HADS (p=0.02) and a greater likelihood of using psychiatric medications (p=0.001). Lack of cytological evaluation of the thyroid gland; lack of serum thyroid antibodies concentrations; and lack of thyroid hormone concentrations. Thyroid immunity is related to mood symptoms in primary care patients. These effects are gender specific and in women, they are most evident before menopause.


Hypoxia and hypotension transform the blood flow response to cortical spreading depression from hyperemia into hypoperfusion in the rat.
Cortical spreading depression (CSD) evokes a large cerebral blood flow (CBF) increase in normal rat brain. In contrast, in focal ischemic penumbra, CSD-like periinfarct depolarizations (PID) are mainly associated with hypoperfusion. Because PIDs electrophysiologically closely resemble CSD, we tested whether conditions present in ischemic penumbra, such as tissue hypoxia or reduced perfusion pressure, transform the CSD-induced CBF response in nonischemic rat cortex. Cerebral blood flow changes were recorded using laser Doppler flowmetry in rats subjected to hypoxia, hypotension, or both. Under normoxic normotensive conditions, CSD caused a characteristic transient CBF increase (74+/-7%) occasionally preceded by a small hypoperfusion (-4+/-2%). Both hypoxia (pO(2) 45+/-3 mm Hg) and hypotension (blood pressure 42+/-2 mm Hg) independently augmented this initial hypoperfusion (-14+/-2% normoxic hypotension; -16+/-6% hypoxic normotension; -21+/-5% hypoxic hypotension) and diminished the magnitude of hyperemia (44+/-10% normoxic hypotension; 43+/-9% hypoxic normotension; 27+/-6% hypoxic hypotension). Hypotension and, to a much lesser extent, hypoxia increased the duration of hypoperfusion and the DC shift, whereas CSD amplitude remained unchanged. These results suggest that hypoxia and/or hypotension unmask a vasoconstrictive response during CSD in the rat such that, under nonphysiologic conditions (i.e., mimicking ischemic penumbra), the hyperemic response to CSD becomes attenuated resembling the blood flow response during PIDs.


Krüppel-like factor 2a (KLF2A) suppresses GCRV replication by upregulating serpinc1 expression in Ctenopharyngodon idellus kidney (CIK) cells.
Krüppel-like factor 2a (KLF2A), a transcription factor of the krüppel-like family, is involved in regulating the immune molecules and is associated with viral infection. However, the function of KLF2A during viral infections in fish remains unclear. In this study, grass carp (Ctenopharyngodon idellus) was used to predict the target genes regulated by KLF2A. The results showed that the candidate target genes included four members of the serpin gene family (serpinb1l2, serpinc1, serpinh1a, and serpinh1b). Dual-luciferase experiments showed that klf2a positively regulates serpinc1 expression. Dose-dependent klf2a overexpression in C. idellus kidney (CIK) cells significantly upregulated the expression of serpinc1. Overexpressing klf2a or serpinc1 in CIK cells activated interferon responses and suppressed grass carp reovirus (GCRV) replication. Klf2a and serpinc1 co-expression inhibited GCRV replication. These results show that klf2a upregulates serpinc1 mRNA expression, promotes type 1 interferon responses, and suppresses GCRV infection. This study provides insights into the regulatory role and biological functions of KLF2A in host-virus interactions in fish.


Increased calcium-independent lipoprotein phospholipase A2 but not protein S100 in patients with schizophrenia.
The aim of this paper was to investigate serum concentrations of calcium-independent lipoprotein phospholipase A2 (PLA2) and protein S100 in schizophrenia patients in comparison to healthy controls and correlate them with the clinical severity, duration, and number of schizophrenia relapses. This study included 65 schizophrenia patients and 70 controls. Schizophrenia was diagnosed according to DSM-IV-TR criteria. Clinical severity was determined by PANSS. PLA2 and protein S100 concentration were assessed by the enzyme-linked immunosorbent assay (ELISA). PLA2 concentrations were higher in patients with schizophrenia, whereas protein S100 concentrations were not. Higher concentrations of PLA2 were positively correlated with the duration of illness and number of episodes, as determined by multivariate analysis. PLA2 might be considered a possible biochemical trait marker for schizophrenia. Further research with larger and more homogeneous clinical samples is required.


Unilateral breast mass in an infant: a rare presentation of spontaneously regressing myofibromatosis.
Breast tumors are very rare in infants. We describe a 4-month-old female infant who presented with a firm and painless right breast mass. It was first noticed at the age of 1 month and then gradually increased in size. Further physical examination and imaging studies revealed other subcutaneous masses and lytic bone lesions. True-cut biopsy from the breast lesion was consistent with infantile myofibromatosis. Infantile myofibromatosis is a group of uncommon mesenchymal tumors that tend to occur in infancy and regress spontaneously, as demonstrated in our case. Surgical excision of such lesion might have led to permanent loss of breast tissue. The report discusses the clinical, radiological, and pathologic features, in addition to the previously described treatment options for this condition.


Clonal distribution and possible microevolution of methicillin-resistant Staphylococcus aureus strains in a teaching hospital in Malaysia.
To genotypically characterize methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from medical and surgical wards in Universiti Kebangsaan Malaysia Medical Centre (UKMMC) in 2009. MRSA strains were collected and molecularly typed by pulsed-field gel electrophoresis (PFGE). PFGE typing on 180 MRSA isolated in UKMMC identified 5 pulsotypes (A-E) and 6 singletons, where pulsotypes B and C were suspected to be divergent clones originating from a single ancestor. This study also showed that most MRSA strains were isolated from swab (119 isolates), followed by blood (22 isolates), tracheal aspirate (11 isolates) and sputum (10 isolates). On the other hand, urine and bone isolates were less, which were 4 and 1 isolates, respectively. The distribution of different pulsotypes of MRSA among wards suggested that MRSA was communicated in surgical and medical wards in UKMMC, with pulsotype B MRSA as the dominant strain. Besides, it was found that most deceased patients were infected by pulsotype B MRSA, however, no particular pulsotype could be associated with patient age, underlying disease, or ward of admittance. Five pulsotypes of MRSA and 6 singletons were identified, with pulsotype B MRSA as the endemic strains circulating in these wards, which is useful in establishment of preventive measures against MRSA transmission.


New-onset and relapse of nephrotic syndrome following COVID-19 vaccination: a questionnaire survey in Japan.
Recent clinical reports indicate a correlation between new-onset and relapse of nephrotic syndrome (NS) following coronavirus 2019 (COVID-19) vaccination in patients with glomerular diseases. However, there are no reports of a nationwide survey on NS following COVID-19 vaccination in Japan. We conducted a web-based survey of council members of the Japanese Society of Nephrology (581 members, 382 facilities) to elucidate the relationship between COVID-19 vaccination and new-onset and relapse of NS. Following COVID-19 vaccination, 27 patients (male: 15, 55.6%) with new-onset (n = 6) and relapse (n = 21) of NS were reported. Of them, 12 (44.4%) patients were diagnosed with minimal change disease at the occurrence of NS. Five patients developed a slight increase in serum creatinine levels; however, none progressed to severe renal dysfunction. Our findings clarify the clinical features of new-onset and relapse of NS following COVID-19 vaccination. Although there was no obvious progression to severe renal dysfunction, clinicians and pathologists should be aware that NS is a potential adverse effect of the vaccines.


Dosimetric comparison of helical tomotherapy, RapidArc, and a novel IMRT & Arc technique for esophageal carcinoma.
To compare radiotherapy treatment plans for mid- and distal-esophageal cancer with primary involvement of the gastroesophageal (GE) junction using a novel IMRT & Arc technique (IMRT & Arc), helical tomotherapy (HT), and RapidArc (RA1 and RA2). Eight patients treated on HT for locally advanced esophageal cancer with radical intent were re-planned for RA and IMRT&Arc. RA plans employed single and double arcs (RA1 and RA2, respectively), while IMRT&Arc plans had four fixed-gantry IMRT fields and a conformal arc. Dose-volume histogram statistics, dose uniformity, and dose homogeneity were analyzed to compare treatment plans. RA2 plans showed significant improvement over RA1 plans in terms of OAR dose and PTV dose uniformity and homogeneity. HT plan provided best dose uniformity (p=0.001) and dose homogeneity (p=0.002) to planning target volume (PTV), while IMRT&Arc and RA2 plans gave lowest dose to lungs among four radiotherapy techniques with acceptable PTV dose coverage. Mean V(10) of the lungs was significantly reduced by the RA2 plans compared to IMRT&Arc (40.3%, p=0.001) and HT (66.2%, p<0.001) techniques. Mean V(15) of the lungs for the RA2 plans also showed significant improvement over the IMRT&Arc (25.2%, p=0.042) and HT (34.8%, p=0.027) techniques. These improvements came at the cost of higher doses to the heart volume compared to HT and IMRT&Arc techniques. Mean lung dose (MLD) for the IMRT&Arc technique (21.2 ± 5.0% of prescription dose) was significantly reduced compared to HT (26.3%, p=0.004), RA1 (23.3%, p=0.028), and RA2 (23.2%, p=0.017) techniques. The IMRT&Arc technique is a good option for treating esophageal cancer with thoracic involvement. It achieved optimal low dose to the lungs and heart with acceptable PTV coverage. HT is a good option for treating esophageal cancer with little thoracic involvement as it achieves superior dose conformality and uniformity. The RA2 technique provided for improved treatment plans using additional arcs with low doses to the lungs at the cost of increased heart dose. Plan quality could still be improved through the use of additional arcs.


Iuliacumite: A Novel Chemical Short-Range Order in a Two-Dimensional Wurtzite Single Monolayer InAs1-xSbx Shell on InAs Nanowires.
A chemical short-range order is found in single monolayer InAs1-xSbx shells, which inherit a wurtzite structure from the underlying InAs nanowire, instead of crystallizing in the energetically preferred zincblende structure. The chemical order is characterized by an anticorrelation ordering vector in the ⟨112̅0⟩ direction and arises from strong Sb-Sb repulsive interactions along the atomic chains in the ⟨112̅0⟩ direction.


Experiences with the chevron (V-)osteotomy on adolescent hallux valgus.
The results of a distal chevron (V-)osteotomy in 31 adolescent patients are reported. The distal V-osteotomy of the first metatarsal appeared to provide excellent correction of hallux valgus deformities. The surgical technique and the advantages over other forms of distal osteotomy are described. The authors recommend that distal V-osteotomy be considered as an alternative to other forms of distal osteotomy when treating hallux valgus in adolescents and growing children.


Plasma concentrations of four pregnancy proteins in complications of pregnancy.
Toxemia of pregnancy was associated with an elevation of the pregnancy-associated plasma protein (PAPP)-A concentration, as compared to the level in normal pregnancy in the last month of gestation. The other pregnancy proteins measured were not altered in toxemia. In twin pregnancies, the PAPP-A, PAPP-C, and human placental lactogen levels were all increased, particularly PAPP-A. On the other hand, pregnancy zone protein was not affected by twinning. Pregnancy with diabetes showed normal levels of these proteins.


Antilipolytic nature of gut GLI, and mode of action of two highly potent intestinal lipolytic species in birds.
Three major lipolytic factors, termed peaks 1, 2 and 3, according to their elution sequence from Biogel P6 columns, have been identified in duck intestinal extracts. The small molecular weight peaks 2 and 3, were even more lipolytically potent on chick adipocytes than pancreatic glucagon; peak 1, called gut GLI, because of its cross-reactivity in a radioimmunoassay for glucagon, modified the lipolytic activity of peak 2 and pancreatic glucagon. It did so by modifying their capacity to stimulate cyclic AMP production. Peaks 2 and 3 exert their lipolytic effects via different intermediary pathways: only peak 2 induced the formation of cyclic AMP. Insulin in birds is devoid of any antilipolytic activity; this fundamental role may be assumed by gut GLI.


Promoting Gender Equity in the #MeToo Era.
The recent #MeToo movement in social media has brought the important issue of gender-based violence and harassment in the workplace to the forefront of public attention. As in other fields, gender-based discrimination and sexual harassment continue to be a problem in medicine, and gender inequalities are particularly apparent in surgical specialties. Whereas the #MeToo movement has successfully raised awareness and held some perpetrators accountable, there have been unintended backlashes, including reluctance from some male surgeons to mentor female surgeons for fear of false accusations of sexual misconduct at both the trainee and the faculty levels. Gender-based neglect is harmful to the career advancement of female surgeons and threatens to continue to promote gender inequalities in surgery. We propose systems-level strategies to promote gender equity at the academic-training level and within the field of hand surgery.


Accessibility of some regions of DNA in chromatin (chicken erythrocytes) to single strand-specific nucleases.
The susceptibility of the DNA in chromatin to single strand-specific nucleases was examined using nuclease P1, mung bean nuclease, and venom phosphodiesterase. A stage in the reaction exists where the size range of the solubilized products is similar for each of the three nucleases and is nearly independent of incubation time. During this stage, the chromatin fragments sediment in the range of 30 to 100 S and contain duplex DNA ranging from 1 to 10 million daltons. Starting with chromatin depleted of histones H1 and H5 similar fragments are generated. In both cases these nucleoprotein fragments are reduced to nucleosomes and their multimers by micrococcal nuclease. Thus, chromatin contains a limited number of DNA sites which are susceptible to single strand-specific nucleases. These sites occur at intervals of 8 to 80 nucleosomes and are distributed throughout the chromatin. Nucleosome monomers, dimers, or trimers were not observed at any stage of single strand-specific nuclease digestion of nuclei, H1- and H5-depleted chromatin, or micrococcal nuclease-generated oligonucleosomes. Each of the three nucleases converted mononucleosomes (approximately 160 base pairs) to nucleosome cores (approximately 140 base pairs) probably by exonucleolytic action that was facilitated by the prior removal of H1 and H5. The minichromosome of SV40 is highly resistant to digestion by nuclease P1.


Male breast cancer: a 22-year experience.
To carry out a retrospective study of male breast cancer over a 22-year experience. Data from 121 male patients with breast cancer treated between the years 1972 and 1994 at the Surgical Clinic of Ankara Oncology Hospital were reviewed. Distribution of cases according to stage was: 2.5% stage I, 28.9% stage II, 55.4% stage III and 13.2% stage IV (AJCC staging method). The surgical treatment for 23 of the patients (19%) was Halsted's radical mastectomy or modified radical mastectomy. Seventy-three cases (60.3%) had total mastectomy without axillary node dissection and 25 (20.7%) had local tumour excision only. Seventy-two of 121 patients had adjuvant treatment. In general the prognosis of men with breast cancer was worse than for women. In the analysis of patients in stages I, II and III-A (operable disease group), the 5-year survival rates were 73% in axillary node-negative patients and 77% in those with tumours sized under 5 cm (P<0.001). In these patients, univariate analysis demonstrated that axillary status (relative risk of death in positive status vs. negative=3.6), tumour size (relative risk in T3 vs. T1-2=2), surgical treatment type (relative risk in simple mastectomy vs. radical mastectomy=1.9) and adjuvant chemotherapy (relative risk if no chemotherapy=1.4) were statistically significant factors associated with survival. Cox's regression model revealed that axillary status, tumour size and type of surgical treatment were the most important independent prognostic factors (P<0.001).


The concomitant detection of gene mutation and micronucleus induction by mitomycin C in vivo using lacZ transgenic mice.
A new assay system that can simultaneously provide gene mutagenicity and clastogenicity data in vivo is described. Transgenic mice (Muta Mouse) harboring the lacZ gene as a target for mutation analysis were injected intraperitoneally with mitomycin C (MMC), either once or on 5 successive days. Micronucleus assays were performed with small amounts of peripheral blood collected from a tail vessel. The spontaneous frequency of micronucleated reticulocytes was 0.42%. For the mutation analysis, DNA was extracted from bone marrow and liver cells at several harvest times. The lacZ gene was rescued by lambda packaging and infection of E. coli C (lac-), followed by plating on agarose plates containing X-gal. The spontaneous lacZ mutant frequencies were 37 and 29 x 10(-6) in bone marrow and liver, respectively. In the micronucleus assay, single treatments with 1.0 and 2.0 mg/kg of MMC induced micronuclei in 3.6 and 5.8% of reticulocytes, respectively, peaking 48 h after treatment. Muta Mouse sensitivity to micronucleus induction was similar to nontransgenic strains used routinely for the micronucleus test. On the other hand, single treatments with MMC at 1.0 and 2.0 mg/kg did not induce any significant increases in the frequency of lacZ- mutants in bone marrow or liver. N-Ethyl-N-nitrosourea, used at 100 mg/kg as a positive control, yielded a 5-fold increase in mutant frequency above untreated animals in bone marrow only. After 5-day treatments, MMC induced approximately a 2-fold increase in mutant frequency in bone marrow only for the sublethal dose of 2 mg/kg. Therefore, this study indicated that the strong clastogenic activity of MMC in bone marrow was not accompanied by significant gene mutagenic activity.


High Bad and Bax mRNA expression correlate with negative outcome in acute myeloid leukemia (AML).
The search for molecular markers in AML that allow prediction of outcome has recently focused on genes involved in the regulation of programmed cell death (PCD). The aim of our study was to determine whether mRNA levels of Mdm-2, Bcl-2, Bcl-x(L), Bad, and Bax are independent prognostic parameters for outcome. Transcript levels were analyzed by real-time quantitative RT-PCR in 232 samples collected either at diagnosis or following induction chemotherapy (ICT). Multivariate COX regression analysis adjusted for chemotherapy protocol, de novo vs secondary AML, and de novo vs relapsed AML indicated: (1) At diagnosis, high expression of Bad (P = 0.015) and even more so high Bax and Bad levels (P = 0.018) predicted adverse outcome, regardless of the response to ICT. In patients who subsequently failed to enter complete remission (CR), high levels of Bad, Bax and Bax high/Bad high were associated with an increased relative risk (RR) to die from tumor (RR = 5.0 for Bad, 3.4 for Bax and 6.14 for Bax high/Bad high). (2) Following ICT, high expression of Bax (P= 0.005) and high Bcl-2/Bax ratios (P = 0.004) were independent predictors of unfavorable outcome, regardless of response to ICT. We conclude that high levels of Bax and Bad correlate with poor outcome, particularly in patients who do not enter CR and may serve as prognostic markers in AML.


Implementation of chromosomal microarrays in a cohort of patients with intellectual disability at the Argentinean public health system.
Intellectual disability is a neurodevelopmental disorder in which genetic, epigenetic and environmental factors are involved. In consequence, the determination of its etiology is usually complex. Though many countries have migrated from conventional cytogenetic analysis to chromosomal microarrays as the first-tier genetic test for patients with this condition, this last technique was implemented in our country a few years ago. We report on the results of the implementation of chromosomal microarrays in a cohort of 133 patients with intellectual disability and dysmorphic features, normal karyotype and normal subtelomeric MLPA results in an Argentinean public health institution. Clinically relevant copy number variants were found in 12% of the patients and one or more copy number variants classified as variants of uncertain significance were found in 5.3% of them. Although the diagnostic yield of chromosomal microarrays is greater than conventional cytogenetics for these patients, there are financial limitations to adopt this technique as a first-tier test in our country, especially in the public health system.


The effect of temperature and hematocrit level of oxygenated cardioplegic solutions on myocardial preservation.
The ideal temperature and hematocrit level of blood cardioplegia has not been clearly established. This study was undertaken (a) to determine the optimal temperature of blood cardioplegia and (b) to study the effect of hematocrit levels in blood cardioplegia. A comparison of myocardial preservation was done among seven groups of animals on the basis of variations in hematocrit levels and temperature of oxygenated cardioplegic solution. The experimental protocol consisted of a 2-hour hypothermic cardioplegic arrest followed by 1 hour of normothermic reperfusion. Group 1 received oxygenated crystalloid cardioplegic solution at 10 degrees C. Groups 2 through 7 received oxygenated blood cardioplegic solution with the following hematocrit values and temperatures: (2) 10%, 10 degrees C; (3) 10%, 20 degrees C; (4) 10%, 30 degrees C; (5) 20%, 10 degrees C; (6) 20%, 20 degrees C; and (7) 20%, 30 degrees C. Parameters studied include coronary blood flow, myocardial oxygen extraction, myocardial oxygen consumption, and myocardial high-energy phosphate levels of adenosine triphosphate and creatine phosphate during control (prearrest), arrest, and reperfusion. Myocardial oxygen consumption at 30 degrees C during arrest was significantly higher than at 10 degrees C and 20 degrees C, which indicates continued aerobic metabolic activity at higher temperature. Myocardial oxygen consumption and the levels of adenosine triphosphate and creatine phosphate during reperfusion were similar in all seven groups. Myocardial oxygen extraction (a measure of metabolic function after ischemia) during initial reperfusion was significantly lower in the 30 degrees C blood group than in the 10 degrees C blood group at either hematocrit level and in the oxygenated crystalloid group, which suggests inferior preservation. The hematocrit level of blood cardioplegia did not affect adenosine triphosphate or myocardial oxygen consumption or extraction. It appears from this study that blood cardioplegia at 10 degrees C and oxygenated crystalloid cardioplegia at 10 degrees C are equally effective. Elevating blood cardioplegia temperature to 30 degrees C, however, reduces the ability of the solution to preserve metabolic function regardless of hematocrit level. Therefore, the level of hypothermia is important in blood cardioplegia, whereas hematocrit level has no detectable impact, and cold oxygenated crystalloid cardioplegia is as effective as hypothermic blood cardioplegia.


All together now: Analogies between chimera state collapses and epileptic seizures.
Conceptually and structurally simple mathematical models of coupled oscillator networks can show a rich variety of complex dynamics, providing fundamental insights into many real-world phenomena. A recent and not yet fully understood example is the collapse of coexisting synchronous and asynchronous oscillations into a globally synchronous motion found in networks of identical oscillators. Here we show that this sudden collapse is promoted by a further decrease of synchronization, rather than by critically high synchronization. This strikingly counterintuitive mechanism can be found also in nature, as we demonstrate on epileptic seizures in humans. Analyzing spatiotemporal correlation profiles derived from intracranial electroencephalographic recordings (EEG) of seizures in epilepsy patients, we found a pronounced decrease of correlation at the seizure onsets. Applying our findings in a closed-loop control scheme to models of coupled oscillators in chimera states, we succeed in both provoking and preventing outbreaks of global synchronization. Our findings not only advance the understanding of networks of coupled dynamics but can open new ways to control them, thus offering a vast range of potential new applications.


Usefulness of layer-specific strain for evaluating and predicting recovery of left ventricular myocardial function in patients undergoing hybrid coronary revascularization.
This study aimed to determine if layer-specific strain (LSS) can be used to evaluate and predict left ventricular (LV) recovery in patients with multi-vessel coronary artery disease (CAD) undergoing hybrid coronary revascularization (HCR) using speckle tracking echocardiography (STE). A total of 187 consecutive CAD patients who received HCR in our hospital were prospectively enrolled. 30 healthy individuals with matched age and gender were enrolled as a control group. Echocardiography was performed for CAD patients before and 1, 2, and 6 months after HCR. Comprehensive conventional and LSS echocardiography parameters were collected. LV recovery was defined as improvement in LV ejection fraction (LVEF) > 5% at 6-months follow-up compared with baseline. Logistic regression analysis was used to test the correlates of LV recovery. Receiver operating characteristic curve analysis was used to determine the optimal cutoff value of correlates for predicting LV recovery. LVEF and LV strain in CAD patients were significantly decreased compared with control subjects. Endocardial global longitudinal strain (Endo-GLS) improved significantly at 1-month follow-up (14.2 ± 1.6% vs. 13.8 ± 1.5%, P < 0.05), and LVGLS and global circumferential strain (GCS) improved significantly at 2-months follow-up. Multivariate regression revealed that Endo-GLS, GLS, and SYNTAX score before HCR were independently correlated to LV recovery. Endo-GLS had an optimal cutoff value of 13.2% for predicting LV recovery with sensitivity of 91% and specificity of 78%. LV myocardial systolic function in CAD patients was impaired before HCR and significantly improved after HCR. Endo-GLS was independently correlated to and has optimal predictive value for LV recovery.


Induction and displacement of an helix in the 6725 SERA peptide analogue confers protection against P. falciparum malaria.
The protein called serine repeat antigen (SERA) is a Plasmodium falciparum malaria antigen; high activity erythrocyte binding peptides have been identified in this protein. One of these, the 6725 peptide (non-immunogenic and non-protective), was analyzed for immunogenicity and protective activity in Aotus monkeys, together with several of its analogues. These peptides were studied by 1H NMR to try to correlate their structure with their biological function. These peptides showed helical regions having differences in their position, except for randomly structured 6725. It is shown that replacing some amino acids induced immunogenicity and protectivity against experimental malaria and changed their three-dimensional (3D) structure, suggesting that such modifications may allow a better fit with immune system molecules.


[Chromomycosis in Guadeloupe].
Chromomycosis is a widespread subcutaneous fungal infection seen essentially in tropical and subtropical regions and transmitted via skin injury caused by the prickles of plants or infected wood splinters. It is prevalent throughout the West Indies including Guadeloupe, where its incidence is not well known. This retrospective and descriptive study concerns five histologically established cases of chromomycosis in Guadeloupe between 1995 and 2005. The five patients were diagnosed and treated at Pointe-à-Pitre University Teaching Hospital. The study concerned four male patients and one female patient with an average age of 78 years; four were from the Basse-Terre district and one was from the Grande-Terre district. The most frequent clinical aspect was nodular or verrucous. The most common initial topography was the upper limbs. Fonsecaea pedrosoi was the only species identified. Diagnosis was confirmed by histopathology, which in all cases revealed sclerotic cells. Three patients underwent surgical treatment and two received medical treatment; only two patients were cured by 2005. Our study confirms the presence of a source of chromomycosis in Guadeloupe, where Fonsecaea pedrosoi is clearly the best adapted species. It also highlights the difficulties of therapeutic care in tropical areas.


Fabrication and evaluation of a bilayer hydrogel-electrospinning scaffold prepared by the freeze-gelation method.
This study presents a bilayer structure as a skin scaffold comprised of an electrospun sheet layer made of polycaprolactone and polyvinil alcohol and a porous hydrogel layer made of chitosan and gelatin. The hydrogel layer was fabricated by employing the freeze-gelation technique. The bilayer structure was achieved by pouring the hydrogel solution on the electrospun sheet at the bottom of a mold followed by the freeze-gelation technique to obtain a porous structure in the hydrogel. The hydrogel and hydrogel-electrospun samples were characterized by scanning electron microscopy, swelling, tensile strength, in vitro and in vivo analyses. From a mechanical strength standpoint, the combination of hydrogel and electrospun layers produced 110 and 133% increases in mean tensile strength and elastic modulus values, respectively compared to the single layer hydrogel sample. While the results of swelling and cell proliferation tests did not yield significant differences between the two groups, the bilayer scaffold performed better considering the results of the in vivo analysis. It was also seen that there was a good connection between the two layers in the bilayer scaffold, making the necessary manipulations and clinical handling convenient.


Polio revisited: reviving knowledge and skills to meet the challenge of resurgence.
To date, polio has not been eradicated and there appears to be a resurgence of the disease. Hence, there is a need to revive decision-making skills to treat the effects of polio. Here, we outline the aspects of treatment of paralysis following polio based on the literature and personal experience of the authors. The surgical treatment of the lower and upper extremities and the spine have been reviewed. The scope of bracing of the lower limb has been defined. The effects of polio can be mitigated by judicious correction of deformities, restoration of muscle balance, stabilising unstable joints and compensating for limb length inequality. As polio has not been eradicated and there is a risk of resurgence of the disease, paediatric orthopaedic surgeons need to be prepared to deal with fresh cases of polio. Revival of old techniques for managing the effects of paralysis following polio is needed.


Large increase in bloodstream infections with carbapenem-resistant Acinetobacter species during the first 2 years of the COVID-19 pandemic, EU/EEA, 2020 and 2021.
Recent data from the European Antimicrobial Resistance Surveillance Network (EARS-Net) show a large increase of +57% in Acinetobacter species bloodstream infections in the European Union and European Economic Area in the first years of the COVID-19 pandemic (2020-2021) compared with 2018-2019. Most were resistant to carbapenems, from intensive care units, and in countries with ≥ 50% carbapenem resistance in Acinetobacter spp. in 2018-2019. This highlights the requirement for reinforced Acinetobacter preparedness and infection prevention and control in Europe.


Ethylene glycol monomethyl ether II. Reproductive and dominant lethal studies in rats.
Groups of male and female Sprague-Dawley (CD) rats were exposed to 0, 30, 100, or 300 ppm ethylene glycol monomethyl ether (EGME) vapor 6 hours/day, 5 days/week for 13 weeks. The 0 and 30 ppm groups each contained 30 rats/sex and the 100 and 300 ppm groups each had 20 rats/sex. Following the exposure period, males were bred to unexposed females to evaluate reproductive capability and dominant lethality. Additional matings of control and 300 ppm exposed males were performed during the post-exposure period in order to evaluate the recovery of fertility. Exposed females were bred with unexposed males to assess reproductive parameters. Results of the present study indicate a potential for inhaled EGME to completely suppress fertility in male rats at the 300 ppm level. Fertility of these rats was partially restored at 13 weeks post-exposure. Body weights of animals in the 300 ppm group were reduced as a result of the exposures. No dominant lethal effect or impaired fertility was observed in male rats exposed to 30 or 100 ppm EGME. Treatment-related pathologic alterations were observed only in male rats at the 300 ppm level and induced decreased testicular size and atrophic seminiferous tubules. Female rats tolerated up to 300 ppm EGME without any adverse reproductive effects. Based on these results, it was concluded that the no-adverse effect level of EGME for fertility and reproduction was 100 ppm in rats.


Preliminary X-ray diffraction studies of acyl carrier protein from Escherichia coli.
Crystals of the acyl carrier protein of Escherichia coli have been grown and analyzed by X-ray diffraction. The crystals grow in space group C2 with unit cell dimensions a = 46.8 A, b = 52.1 A, c = 47.3 A and beta = 93.2 degrees. An isomorphous derivative, HgCl2, has been identified and characterized.


Cytokine profile in serum and gingival crevicular fluid of children with inflammatory bowel disease: A case-control study.
To evaluate the cytokine profile in gingival crevicular fluid (GCF) and serum of pediatric inflammatory bowel disease (IBD) patients and determine the cluster patterns of cytokines. Fifty IBD patients and 21 systemically healthy children were enrolled in the study. The GCF samples were collected from the participants during periodontal examination and periodontal indices were recorded. Based on activity indexes and response to conventional treatment, patients with IBD were further categorized into subgroups as: remission, active disease, and treatment-resistant. Serum samples were obtained from IBD patients to determine serum levels of cytokines. The levels of pro- (interleukin (IL)-1β, IL-12, IL-21, IL-22, IL-23, IL-17A, IL-17F) and anti-inflammatory (IL-4, IL-10) cytokines in serum and GCF were measured using Enzyme-linked Immunosorbent Assay (ELISA) kits. Among 50 IBD patients, 58% were in remission, 20% had active disease, and 22% were defined as treatment-resistant. The severity of gingival inflammation measured by the criteria of Löe had increasing trends in IBD patients with active disease and treatment resistance. GCF IL-1β level was lower and GCF IL-4 and GCF IL-23 levels were higher in IBD patients compared to healthy controls. In the active disease group, more cytokine clusters occurred compared to the control group and other IBD subgroups, as explained by increased cytokine-cytokine interactions. Considering the increased complexity of cytokine interactions and the increased severity of gingival inflammation in patients with active disease, it can be concluded that disease activity might have an impact on gingival inflammation in pediatric patients with IBD.


Fractional ablative CO2 laser and oral isotretinoin-A prospective randomized controlled split-face trial comparing concurrent versus delayed laser treatment for acne scars.
Therapeutic dogma has been to treat acne scars with ablative fractional laser no less than 6 months after isotretinoin (ITN) cessation. To evaluate the safety and efficacy of fractional ablative CO2 laser (FACL) in patients treated concurrently with ITN. We conducted a prospective split-face randomized control trial in patients treated with FACL concurrently with ITN versus patients treated with FACL 6 months post-ITN treatment. Patients received 3 monthly sessions of FACL with concurrent ITN treatment on half of the face; the other side of the face received the same FACL treatment regimen 6 months post-ITN cessation. Patients were followed for adverse effects up to 6 months post-FACL treatment. Final cosmesis was scored using the Quantitative Global Acne Scarring Grading System (GASGS) by three independent dermatologists. The GASGS of the concurrent ITN-FACL treated side of the face was significantly lower than the side treated with delayed laser therapy (4.7 ± 2.5 vs. 7.7 ± 2.9, respectively, p < 0.001). The laser's settings were standardized, and not adjusted per patient skin type. Per our prospective trial, concurrent treatment of FACL -ITN is superior to delayed FACL treatment 6 months post-ITN cessation. Fractional ablative laser treatment is effective in improving acne scars, which persist despite isotretinoin therapy.


Establishing Chlamydia trachomatis isolation capability in a local laboratory.
A system for the culture and identification of Chlamydia trachomatis was established in a local health department laboratory. The McCoy cell-cycloheximide procedure was adopted with use of on-site monolayer production and iodine staining. Several procedural modifications were analyzed for sensitivity, including two-vial vs. one-vial inoculation, overnight refrigeration vs. immediate inoculation of the monolayer, and use of transport media with vancomycin (100 micrograms/ml) vs. transport media without vancomycin. Costs associated with establishing and maintaining this procedure over a one-year period were documented. Inoculation of two monolayers improved sensitivity only slightly (87/292 vs. 85/292). Loss in sensitivity following overnight refrigeration of the sample was approximately 7%; 42 of 45 positive cultures were detected. Addition of 100 micrograms of vancomycin/ml to the transport media increased apparent sensitivity from 27.4% to 29.6% among females with gonorrhea. The cost was $.06 per culture. On the basis of this information, cultures for isolation of C. trachomatis are now offered to our clinic for sexually transmitted diseases as well as to some private physicians and clinics. We are using one-vial inoculation of a specimen transported in sucrose-phosphate buffer containing 100 micrograms vancomycin/ml. The specimen is either cultured immediately or snap frozen at -77 C.


Mitochondrial dysfunction in heart diseases: Potential therapeutic effects of Panax ginseng.
Heart diseases have a high incidence and mortality rate, and seriously affect people's quality of life. Mitochondria provide energy for the heart to function properly. The process of various heart diseases is closely related to mitochondrial dysfunction. Panax ginseng (P. ginseng), as a traditional Chinese medicine, is widely used to treat various cardiovascular diseases. Many studies have confirmed that P. ginseng and ginsenosides can regulate and improve mitochondrial dysfunction. Therefore, the role of mitochondria in various heart diseases and the protective effect of P. ginseng on heart diseases by regulating mitochondrial function were reviewed in this paper, aiming to gain new understanding of the mechanisms, and promote the clinical application of P. ginseng.


Complications of peripherally inserted central catheters in adult hospitalized patients and outpatients in the KTFIXPICC study: A randomized controlled trial evaluating a fixation device KT FIX Plussystem.
Poor securement potentiates Peripherally inserted central catheters (PICC) complications. A dressing device (KT FIX Plus) offers stronger skin attachment, which may reduce the risk of dressing disruption. We aimed to evaluate this device. We conducted a single-center parallel-group open-label randomized controlled trial. Hospitalized and outpatient consecutive adults requiring PICCs were randomized to KT FIX Plus or standard of care (SOC). The primary endpoint was the composite of PICC-associated complications until removal, including occlusion, migration, accidental withdrawal, infection, thrombosis, and hematoma. No statistically significant difference was observed in terms of complications: 67 (35%) in the KT FIX Plus group vs 36 (37%) in the SOC group (log-rank P = 0.76). In multivariate Cox analysis, independent risk factors for PICC-associated complications were obesity (adjusted hazard ratio (aHR), 1.08, P < .001) and diabetes (aHR, 1.85, P = .039), adjusting for chronic renal failure, number of lumens, catheter/vein diameter ratio and duration of home-based care. Multiple lumen catheters increased the risk of accidental withdrawal and migration (HR, 2.4, P = .008). In our study, the use of KT FIX Plus did not reduce the risk of complications adjusting for other risk factors such as obesity and diabetes. The number of catheter lumens is one of the modifiable factors to reduce complications. Further studies are required to find the best securement and dressing system.


Heat shock factor 1 inhibition sensitizes pancreatic cancer to gemcitabine via the suppression of cancer stem cell-like properties.
Pancreatic cancer is a fatal disease with poor prognosis. Gemcitabine has been regarded as the mainstay of chemotherapy for pancreatic cancer; however, it is accompanied with a high rate of chemoresistance. Cancer stem cells (CSCs) are characterized by resistance to traditional chemo- and radiotherapies. We have previously reported that heat shock factor 1 (HSF1) is involved in the invasion and metastasis of pancreatic cancer, a highly conserved transcriptional factor that mediates the canonical proteotoxic stress response. Here, we investigate whether HSF1 contributes to the chemoresistance of pancreatic cancer cells caused by gemcitabine and explore the underlying mechanisms. Genetically engineered mice (LSL-KrasG12D/+; Trp53fl/+; Pdx1-Cre mice), which spontaneously develop pancreatic cancer, were used to examine the sensitivity of pancreatic cancer to gemcitabine in vivo. We found that HSF1 was enriched in sphere-forming cancer cells. Panc-1 and MiaPaCa-2 cells treated chronically with gemcitabine displayed increased transcription and expression of CSC-associated markers. In addition, gemcitabine-surviving Panc-1 and MiaPaCa-2 cells showed an increased ability to form tumorspheres. Moreover, we observed that gemcitabine treatment increased the activity and expression of HSF1, as well as transcription of its downstream targets. Finally, HSF1 inhibition significantly suppressed the expression of CSC-associated markers, augmented the cancer-killing property of gemcitabine, and increased chemosensitivity to gemcitabine in vivo. Our study reveals a novel mechanism in which HSF1 promotes the chemoresistance of pancreatic cancer to gemcitabine by modulating CSC-like properties. Targeting HSF1 could be thus a rational strategy to improve treatment outcomes.


Burn resuscitation with a low-volume plasma regimen--analysis of mortality.
The results of a mortality analysis from the Burn Center in Rambam Medical Center, Haifa, Israel, over a 5-year period are presented. The management of severe burns during the 'shock' period included a low-volume resuscitation formula consisting mainly of plasma and a small volume of crystalloid solution. The efficacy of burn management was assessed by probit analysis of the mortality data. We derived the percentage of body surface area burned associated with a 50 per cent probability of death (LA50) for four different age groups. The LA50 values obtained were compared to those obtained from other series; they compared favourably, demonstrating that resuscitation with low volumes consisting mainly of colloids may reduce complications associated with fluid overloading and therefore improve the LA50.


The role of different Wx and BEIIb allele combinations on fine structures and functional properties of indica rice starches.
This study examined the effects of the combinations of Waxy (Wx) and starch branching enzyme IIb (BEIIb) alleles on starch fine structure and functional properties in indica rice cultivars. The results showed that be2b mutant starches with BEIIb deficiency had higher amylose content, shorter amylose long chains, a higher proportion of amylopectin long chains and molecular order, but a lower proportion of amylopectin short chains and relative crystallinity, resulting in higher gelatinization temperature but lower enthalpy and paste viscosity. Compared with the rice lines carrying Wxb allele, Wxa allele contributed to relatively higher amylose content, longer amylopectin chains, less short-range ordered structure and lower relative crystallinity, leading to a little lower gelatinization enthalpy. This study provides new insight into structure-function relations among rice lines with different allele combinations of starch synthesis related genes, which is a useful strategy for rice quality breeding.


Differences between motor unit firing rate, twitch characteristics and fibre type composition in an agonistic muscle group in man.
A comparison was carried out between the motor unit (MU) firing rate and the characteristics of the twitch and the fibre type composition of anconeus and triceps brachii. Fibre type composition (type I, type II) was determined in whole cross-sections of cadaver specimens. The proportion of type I fibre was 60%-67% in anconeus and 32-40% in the lateral head of triceps brachii. Reflecting these histochemical differences, the contraction time of anconeus and triceps was 92 +/- 9 ms and 68 +/- 9 ms respectively. It follows that anconeus can be classified as a slow muscle, as opposed to the lateral head of triceps. The relationship between MU firing rate and isometric force, tested at 90 degrees elbow flexion, differed between the two muscles for force values below 30% of maximal voluntary contraction. No significant increase in MU firing rate was found in anconeus at forces above 5% of maximal voluntary contraction. It is concluded that even within a single agonistic muscle group acting at a single joint there is an adaptation of MU firing rate to the contractile characteristics of each muscle.


Reendothelialization of tubular scaffolds by sedimentary and rotative forces: a first step toward tissue-engineered venous graft.
Uniform and tubular surface seeding is a prerequisite for tissue-engineered blood vessels to mature properly in a bioreactor. Our objective was to investigate reendothelialization of tubular scaffolds by the synergistic forces of sedimentation and rotation, so as to fabricate tissue-engineered venous grafts in vitro. Canine bone-marrow-derived endothelial progenitor cells were expanded in vitro. By means of a homemade horizontally rotative device, enzymatically decellularized porcine aortic scaffolds were tubularly seeded with the cells by precoating different matrices, under different rotation speeds, culture durations, and seeding techniques. Incorporation of lipoprotein and antiplatelet aggregation functions of seeded cells were evaluated. The seeding efficacies of various methods were compared by histology and scanning electronic microscopy. Uniform distribution and a larger area of cell coverage were demonstrated by precoating with fibronectin (Fn) and a rotation speed of 2.5 revolutions per hour (rph). The efficacy of rotative seeding was comparable to its static counterpart at 4 h, but decreased at 72 h. The result of single-spin seeding was not different from that of three-spin seeding. The seeded cells showed their natural functions of lipoprotein uptake and antiplatelet aggregative properties. Based on these, we constructed 12 tissue-engineered venous grafts with a cell coverage area of 87.4+/-6.2%. Efficient and reproducible endothelialization was demonstrated by precoating scaffolds with Fn and by performing single-spin seeding at a speed of 2.5 rph.


Hyponatremia-induced transient visual disturbances in acute spinal cord injury.
Case report and literature review. To report an unusual case of prolonged hyponatremia in acute cervical spinal cord injury complicated by visual disturbances and to review the literature regarding the issue. Spinal Cord Injury Unit in Göteborg, Sweden. Retrospective analysis of clinical charts of an individual with traumatic spinal cord injury. A previously healthy 28-year-old man sustained a C7 injury in a motor vehicle accident. His injury was managed surgically and he was overhydrated during the acute management and postoperatively. When weaned off the respirator he was confused and anxious and showed a S-Na of 127 mmol/1 and complained of visual disturbances. The hyponatremia was treated by extra sodium and fluid restriction but fell to a lowest value of 121 mmol/l (Day 14 post injury). Visual acuity was 0.2 on right eye and 0.06 on left eye and the eye examination revealed signs of fundus hypertonicus. CT scans and MRI revealed no signs of brain edema. The patient was further treated by mineral corticoids and fluid restriction for 4 months and his vision improved slightly, but on a final examination 125 days post injury he was found to have an afferent pupillary defect on his left eye, and bilateral atrophy of the visual nerves. The hyponatremia resolved and 6 months post injury he showed a normal S-Na. SCI individuals are at increased risk of developing hyponatremia. The reported complication of visual disturbances further stresses the importance of prevention of overhydration and of timely management of hyponatremia in this group of patients.


A peculiar brain scan pattern in necrotizing leukoencephalopathy after treatment for CNS-leukaemia.
Two patients with CNS-leukaemia who developed a leukoencephalopathy after cranial irradiation and methotrexate administration are described. Conventional brain scanning with 99m TC-pertechnetate showed a peculiar pattern which suggested the presence of radio-activity within enlarged ventricles, but were later interpreted as accumulation in the periventricular white matter. The brainscan pattern correlated well with the neuropathological findings in the case where autopsy was performed. This brain scan pattern is for unknown reasons only rarely mentioned in literature. It seems a useful tool in diagnostic procedures in similar patients.


Effects of exposure to chlorinated paraffins on human health: A scoping review.
Chlorinated paraffins (CPs) belong to an emerging class of persistent organic pollutants (POPs) widely detected in environmental matrices and human samples. The potential health risks of CPs on humans have initiated intense concerns but there have been few studies focusing on the said topic. Addressing the gap, we make a scoping review on the current global body of evidence from epidemiological and toxicological studies. Furthermore, the management strategies and regulations related to CPs are presented and discussed. There were 70 articles among 11,280 records, including four epidemiological studies, one case report, another twenty-nine studies reporting human body burden, and thirty-six toxicological studies, finally included in this review. Additionally, twenty-three management regulation relevant documents/websites were included. CPs exist in human blood, breast milk, placenta, and other tissues. Population-based and laboratory studies suggest that CPs may cause liver and kidney toxicity, developmental toxicity, neurotoxicity, endocrine disorder, immune dysfunction, and reproductive toxicity. CPs with shorter carbon chains and higher chlorine content may be more harmful. In particular, the combined effect of CPs with other pollutants is of great concern. Population-based studies are far from sufficient at present, and most of them are conducted in China or developed countries. Besides, the toxicity assessment studies of CPs are inadequate. In addition, most studies focus on short-chain CPs (SCCPs) while few studies explored the effect of long-chain CPs (LCCPs). Thus, conducting more epidemiological studies in larger populations and toxicological studies combined with new technology methods are of great significance for better understanding the adverse health effects of CPs, which may promote CPs management regulations.


Low potential detection of NADH based on Fe₃O₄ nanoparticles/multiwalled carbon nanotubes composite: fabrication of integrated dehydrogenase-based lactate biosensor.
Fe(3)O(4) magnetic nanoparticles were in situ loaded on the surface of multiwalled carbon nanotubes (MWCNTs) by a simple coprecipitation procedure. The resulting Fe(3)O(4)/MWCNTs nanocomposite brings new capabilities for electrochemical sensing by combining the advantages of Fe(3)O(4) magnetic nanoparticles and MWCNTs. It was found that Fe(3)O(4) has redox properties similar to those of frequently used mediators used for electron transfer between NADH and electrode. The cyclic voltammetric results indicated the ability of Fe(3)O(4)/MWCNTs modified GC electrode to catalyze the oxidation of NADH at a very low potential (0.0 mV vs. Ag/AgCl) and subsequently, a substantial decrease in the overpotential by about 650 mV compared with the bare GC electrode. The catalytic oxidation current allows the stable and selective amperometric detection of NADH at an applied potential of 0.0 mV (Ag/AgCl) with a detection limit of 0.3 μM and linear response up to 300 μM. This modified electrode can be used as an efficient transducer in the design of biosensors based on coupled dehydrogenase enzymes. Lactate dehydrogenase (LDH) and NAD(+) were subsequently immobilized onto the Fe(3)O(4)/MWCNTs nanocomposite film by covalent bond formation between the amine groups of enzyme or NAD(+) and the carboxylic acid groups of the Fe(3)O(4)/MWCNT film. Differential pulse voltammetric detection of lactate on Fe(3)O(4)/MWCNT/LDH/NAD(+) modified GC electrode gives linear responses over the concentration range of 50-500 μM with the detection limit of 5 μM and sensitivity of 7.67 μA mM(-1). Furthermore, the applicability of the sensor for the analysis of lactate concentration in human serum samples has been successfully demonstrated.


Screening for putative PGPR to improve establishment of the symbiosis Lactarius deliciosus-Pinus sp.
A screening for plant growth promoting rhizobacteria (PGPR) was carried out in the mycorrhizosphere of wild populations of Pinus pinea and P. pinaster, and in the mycosphere of associated Lactarius deliciosus. A total of 720 bacteria were isolated, purified, and grouped by morphological criteria. Fifty percent of the isolates were selected and tested for aminocyclopropanecarboxylic acid (ACC) degradation, auxin and siderophore production, and phosphate solubilization. Thirty eight percent of the isolates showed at least one of the evaluated activities. Nutrient-related traits were associated with P. pinaster, whereas hormone production traits predominated in P. pinea. These activities were found mostly in Gram positive isolates. After PCR-RAPDs (random amplified polymorphic DNA) analysis, 10 groups appeared with 85% similiarity when considering all isolates, indicating the low diversity in the system. One strain of each group was identified by 16S rDNA sequencing. Our results suggest that P. pinaster selects for mycorrhizosphere bacteria that mobilize nutrients, whereas P. pinea selects for bacteria that have the capacity to increase root growth via production of plant growth regulators.


Effect of amphotericin B on renal tubular acidification in the rat.
Amphotericin B, a polyene antibiotic known to induce cation-selective pore formation in biological cell membranes, was given to rats by peritoneal injection (10 mg/kg for 21-26 days) or added to luminal perfusates (2 x 10(-5) M). Kinetics of tubular acidification and alkalinization after perfusion with alkaline or acid phosphate Ringer's solution was studied by means of double barrelled antimony/reference microelectrodes in cortical distal tubules. Stationary pH increased both in early and late distal segments. Acidification and alkalinization half-times decreased markedly from 15-18 s to 6-8 s, a value similar to that found in proximal tubule. Net H-ion secretion rates as well as H-ion back-flux approximately doubled after Amphotericin B. Apparent H-ion permeability of distal tubule epithelium measured during perfusion of lumen and peritubular capillaries with phosphate Ringer's solutions doubled both in early and late segments. These data show that amphotericin B produces a distal acidification defect which impairs formation of normal transepithelial pH gradients by increasing H-ion back-flux without reducing rates of net H-ion secretion.