Point of Care Ultrasound in Exotic Animal Emergency and Critical Care.
Exotic pets are presented to veterinary clinics with increasing frequency for routine, urgent, and emergency needs. With these increased visits, owners' expectations for high-quality veterinary care are also increasing. Many presenting complaints of reptiles, birds, and small mammals can benefit from the use of point of care ultrasound (POCUS) to establish a minimum database, aid in triage, and help guide further diagnostics, treatment, and prognostic discussions with the owner. Hospitalized exotic patients can also have their progress tracked and better assessed with the aid of POCUS.


Hidden treasure in an endoscopically retrieved oesophageal trichobezoar.
A 12-year-old girl with Smith-Lemli-Opitz syndrome and gastrostomy dependency presented with multiple episodes of coffee ground vomits. An upper gastrointestinal endoscopy revealed a trichobezoar in the lower oesophagus, with a 'hidden treasure'-a retained end of a G tube at the core. Endoscopic retrieval led to resolution of symptoms. Literature is scant with only one previous report of an oesophageal trichobezoar. Techniques of removal of percutaneous endoscopic gastrostomy in children are reviewed. The pathogenesis, preventative measures and management for oesophageal trichobezoars are discussed.


Potent and selective inhibitors of the proteasome: dipeptidyl boronic acids.
Potent and selective dipeptidyl boronic acid proteasome inhibitors are described. As compared to peptidyl aldehyde compounds, boronic acids in this series display dramatically enhanced potency. Compounds such as 15 are promising new therapeutics for treatment of cancer and inflammatory diseases.


[6,6'-2 H2 ] fructose as a deuterium metabolic imaging probe in liver cancer.
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related deaths. Imaging plays a crucial role in the early detection of HCC, although current methods are limited in their ability to characterize liver lesions. Most recently, deuterium metabolic imaging (DMI) has been demonstrated as a powerful technique for the imaging of metabolism in vivo. Here, we assess the metabolic flux of [6,6'-2 H2 ] fructose in cell cultures and in subcutaneous mouse models at 9.4 T. We compare these rates with the most widely used DMI probe, [6,6'-2 H2 ] glucose, exploring the possibility of developing 2 H fructose to overcome the limitations of glucose as a novel DMI probe for detecting liver tumors. Comparison of the in vitro metabolic rates implies their similar glycolytic metabolism in the TCA cycle due to comparable production rates of 2 H glutamate/glutamine (glx) for the two precursors, but overall higher glycolytic metabolism from 2 H glucose because of a higher production rate of 2 H lactate. In vivo kinetic studies suggest that HDO can serve as a robust reporter for the consumption of the precursors in liver tumors. As fructose is predominantly metabolized in the liver, deuterated water (HDO) produced from 2 H fructose is probably less contaminated from whole-body metabolism in comparison with glucose. Moreover, in studies of the normal liver, 2 H fructose is readily converted to 2 H glx, enabling the characterization of 2 H fructose kinetics. This overcomes a major limitation of previous 2 H glucose studies in the liver, which were unable to confidently discern metabolic flux due to overlapped signals of 2 H glucose and its metabolic product, 2 H glycogen. This suggests a unique role for 2 H fructose metabolism in HCC and the normal liver, making it a useful approach for assessing liver-related diseases and the progression to oncogenesis.


Internal cantholysis for full thickness eyelid defects.
Eyelid reconstruction requires an understanding of normal eyelid anatomy and function. A thorough understanding of the basic anatomy, contour, and mobility of the eyelids is essential in restoring the tissue to its presurgical level. There are many different surgical options to assist in the repair of full thickness eyelid defects involving the margin. Direct wound closure depends on eyelid laxity and is often possible with smaller defects. Moderate to larger sized defects are often under undue wound tension if direct closure is attempted. We have developed a new technique for closure of eyelid defects using a transconjunctival cantholysis to release the lateral canthal tendon cruces, thereby avoiding the external incision while still allowing for eyelid mobility. Using this technique for defects 15 mm in horizontal eyelid margin length or greater, we have found positive results. Direct closure of eyelid defects represents the most straightforward technique to repair any full-thickness eyelid defect and provides maximal functional and cosmetic results. Internal cantholysis represents an excellent option for repairing smaller and even larger full thickness eyelid defects. Eyelid mobility increases by 4-10 mm, sometimes more, and allows for closure of defects larger than even 20 mm.


Green economy performance and sustainable development achievement: empirical evidence from Saudi Arabia.
As a pillar of United Nations, the Kingdom of Saudi Arabia pursues to greener its economy and achieve the Sustainable Development Goals of the 2030 Agenda. The green economy represents a catalyzer for sustainable development in its three dimensions -economic, social and environmental- aiming to improve human well-being and social equity and reduce environmental risks. However, the relevant previous studies lacked the role of green economy on sustainable development for the Saudi Arabia. For this purpose, this paper aims to explore how green is the kingdom and analyze its performance toward sustainable development from 2015 to 2020. To do so, we adopt the EEPSE Green Economy Index that combines educational, economic, political, societal and environmental indicators associated with the pillars of the Quintuple Helix Innovation Model. In this study, this index is composed of 42 indicators related to the green economy and the sustainable development. The empirical results suggest that the Saudi Arabia witnessed a significant progress of EEPSE GEI score. In addition, the findings support that the performance of the kingdom regarding the green economy is affected after the COVID-19 crisis. Thus, the paper provides original visions for policy makers to encourage the transition to green economy which constitutes the main locomotive to attain the economic, social and environment sustainability for the kingdom.


The effects of acute 17beta-estradiol treatment on gene expression in the young female mouse hippocampus.
Previous studies have demonstrated that treatment with 17beta-estradiol (E(2)) improves both spatial and nonspatial memory in young female mice. Still unclear, however, are the molecular mechanisms underlying the beneficial effects of E(2) on memory. We have previously demonstrated that a single post-training intraperitoneal (i.p.) injection of 0.2 mg/kg E(2) can enhance hippocampal-dependent spatial and object memory consolidation (e.g., Gresack & Frick, 2006b). Therefore, in the present study, we performed a microarray analysis on the dorsal hippocampi of 4-month-old female mice injected i.p. with vehicle or 0.2 mg/kg E(2). Genes were considered differentially expressed following E(2) treatment if they showed a greater than 2-fold change in RNA expression levels compared to controls. Overall, out of a total of approximately 25,000 genes represented on the array, 204 genes showed altered mRNA expression levels upon E(2) treatment, with 111 up-regulated and 93 down-regulated. Of these, 17 of the up-regulated and 6 of the down-regulated genes are known to be involved in learning and memory. mRNA expression changes in 5 of the genes were confirmed by real-time quantitative PCR analysis, and protein changes in these same genes were confirmed by Western blot analysis: Hsp70, a heat shock protein known to be estrogen responsive; Igfbp2, an IGF-I binding protein; Actn4, an actin binding protein involved in protein trafficking; Tubb2a, the major component of microtubules; and Snap25, a synaptosome-specific protein required for neurotransmitter release. The types of genes altered indicate that E(2) may induce changes in the structural mechanics of cells within the dorsal hippocampus that could be conducive to promoting memory consolidation.


Simian virus 40 specific cytotoxic lymphocyte clones localize two distinct TSTA sites on cells synthesizing a 48 kD SV40 T antigen.
Simian virus 40 specific antigenic sites (TSTA) which react with SV40 specific cytotoxic lymphocytes (CTL) were localized on the surface of mouse embryo fibroblasts (H-2b) transformed with a recombinant plasmid which contain SV40 large T antigen coding DNA sequences (0.65-0.37 map units). These cells (B6/pSV-20-GV) synthesize a large T antigen polypeptide of 48 kD and could be lysed with two independently isolated CTL clones which recognize distinct antigenic sites on SV40 transformed cell surface. These results suggest that at least two distinct TSTA sites are present in cells synthesizing only the amino terminal half of SV40 T antigen.


Esophageal motility and symptoms after endoscopic injection sclerotherapy.
Endoscopic injection sclerotherapy is known to cause a variety of motility abnormalities, but the correlation between these changes and symptomatology has not been clearly defined. To assess the effects of endoscopic sclerosis of varices on esophageal function and symptoms, we prospectively studied esophageal motility in 25 patients undergoing sclerotherapy (group I). Thirteen patients underwent studies before and after sclerosis, and 12 patients were studied after completion of therapy. Acid clearance was studied in five patients (group I). Twenty-four of the 25 patients (group I) completed a course of sclerosis without the development of persistent dysphagia. We found that endoscopic sclerotherapy did not significantly alter the velocity of peristalsis or lower esophageal sphincter pressure, amplitude of contraction, or the duration of contraction. Acid clearance was diminished in three of five patients. Four patients who developed an esophageal stricture following sclerotherapy were studied manometrically (group II). Three of these four patients had a manometric pattern characterized by repetitive, nonperistaltic contractions, and all four patients experienced dysphagia which was relieved by bougienage. We conclude that esophageal motility is generally well preserved following endoscopic injection sclerotherapy and does not result in a long-lasting disturbance of swallowing. Dysphagia and disordered esophageal motility do occur after sclerotherapy when a sufficient fibrotic response has resulted in an esophageal stricture.


Validation of a novel reconstruction method of laparoscopic gastrectomy for proximal early gastric cancer: a systematic review and meta-analysis.
Recently, a novel surgical procedure, named as laparoscopic proximal gastrectomy (LPG) with double-tract reconstruction (DTR), has been reported to provide surgical benefits in the treatment of proximal early gastric cancer (EGC) over traditional laparoscopic total gastrectomy (LTG). These benefits include a lower incidence of some surgical complications and better postoperative nutritional status. However, the number of relevant studies is still too low to validate such benefits. Therefore, this systematic review and meta-analysis aimed to assess the surgical features, complications, and postoperative nutritional status of LPG with DTR in comparison to those of LTG. Online databases (PubMed, Web of Science, Cochrane Library, and EMBASE) were scoured for relevant studies published by April 2020. The quality assessment of the included articles was evaluated using the Newcastle-Ottawa scale. Egger's test was utilized to assess publication bias. Nine studies (687 patients) were enrolled for this meta-analysis, and we found that LPG with DTR and LTG had similar surgical features. However, LPG with DTR was superior to LTG in the incidence of reflux syndrome [OR = 0.185; 95%CI 0.083, 0.414; P = 0.000], postoperative nutritional status (hemoglobin [WMD = - 2.326; 95%CI - 4.491, - 0.160; P = 0.035], vitamin B12 [WMD = - 13.072; 95%CI - 22.850, - 3.294; P = 0.009], and body weight [WMD = - 3.514; 95%CI - 5.579, - 1.449; P = 0.001]). LPG with DTR has better performance in the incidence of reflux syndrome and postoperative nutritional status compared with LTG. This surgical procedure may therefore have more benefits for patients with proximal EGC.


Cerebral correlates of motor imagery of normal and precision gait.
We have examined the cerebral structures involved in motor imagery of normal and precision gait (i.e., gait requiring precise foot placement and increased postural control). We recorded cerebral activity with functional magnetic resonance imaging while subjects imagined walking along paths of two different widths (broad, narrow) that required either normal gait, or exact foot placement and increased postural control. We used a matched visual imagery (VI) task to assess the motor specificity of the effects, and monitored task performance by recording imagery times, eye movements, and electromyography during scanning. In addition, we assessed the effector specificity of MI of gait by comparing our results with those of a previous study on MI of hand movements. We found that imagery times were longer for the narrow path during MI, but not during VI, suggesting that MI was sensitive to the constraints imposed by a narrow walking path. Moreover, MI of precision gait resulted in increased cerebral activity and effective connectivity within a network involving the superior parietal lobules, the dorsal precentral gyri, and the right middle occipital gyrus. Finally, the cerebral responses to MI of gait were contiguous to but spatially distinct from regions involved in MI of hand movements. These results emphasize the role of cortical structures outside primary motor regions in imagining locomotion movements when accurate foot positioning and increased postural control is required.


Inhibition and ADP-ribose pyrophosphatase-I by nitric-oxide-generating systems: a mechanism linking nitric oxide to processes dependent on free ADP-ribose.
Rat liver ADP-ribose pyrophosphatase-I (ADPRibase-I; EC 126.96.36.199) hydrolyzes ADP-ribose with high specificity and a low Km. Thus it can participate in the control of free ADP-ribose and nonenzymatic ADP-ribosylation of proteins. Here we show that ADPRibase-I was inactivated by acidified nitrite, whereas sodium nitroprusside (SNP) or 3-morpholinosydnonimine (SIN-1) at pH 7.5 produced a dose- and time-dependent Km increase from 0.5 microM to 2 microM. The effects of SNP and SIN-1 depended on the presence and concentration of dithiothreitol, pointing to S-nitrosylation of enzyme thiols. It is suggested that, by inhibiting ADPRibase-I, NO can stimulate nonenzymatic ADP-ribosylation of targets susceptible to micromolar free ADP-ribose. This is discussed in relation to apparently contradictory earlier reports on the role of NO in the ADP-ribosylation of actin.


"Problematizing" carbon emissions from international aviation and the role of alternative jet fuels in meeting ICAO's mid-century aspirational goals.
Alternative jet fuels are one of the four mechanisms by the United Nations International Civil Aviation Organization (ICAO) to limit and reduce carbon emissions from international aviation. By using Carol Bacchi's what's the problem represented to be? method of discourse analysis, the objective of this paper was to identify and understand the premises and effects of the problem-solving paradigm underlying ICAO's alternative jet fuel strategy. As a result, three problem representations were identified, from which two out of four underlying assumptions have reinforced ICAO's weak sustainability approach to international aviation's growth and have led to a number of discursive, subjectification and lived effects. The selected method also allowed the authors to identify several options to disrupt those premises in favor of the implementation of more aggressive mitigation and adaptation strategies without constraining air travel demand, including: (i) raising awareness of the environmental impacts of aviation beyond the tailpipe emissions, (ii) improving the understanding of the effects of climate change on the air transport sector, and (iii) reassessing the sectoral approach to the Sustainable Development Goals so as to gain consistency with the aims of the UN 2030 Agenda for Sustainable Development.


Biodiversity of the species Listeria monocytogenes and the genus Listeria.
This review describes the Listeria monocytogenes genome sequences available today and their comparison with that of Listeria innocua and Listeria welshimeri by highlighting their characteristic features and common traits. The diversity present among them is analysed with emphasis on putative virulence and host-pathogen interaction related functions. Then large-scale studies comparing gene content of Listeria and how these studies contributed to typing applications will be discussed. Finally, evolutionary conclusions and future perspectives in Listeria genomics are presented.


Endothelial adherens and tight junctions in vascular homeostasis, inflammation and angiogenesis.
Endothelial cells lining the vessel wall are connected by adherens, tight and gap junctions. These junctional complexes are related to those found at epithelial junctions but with notable changes in terms of specific molecules and organization. Endothelial junctional proteins play important roles in tissue integrity but also in vascular permeability, leukocyte extravasation and angiogenesis. In this review, we will focus on specific mechanisms of endothelial tight and adherens junctions.


m6A-dependent mevalonate kinase in juvenile hormone synthesis pathway regulates the diapause process of bivoltine silkworm (Bombyx mori).
Research has shown that epigenetic modification are involved the regulation of diapause in bivoltine silkworms (Bombyx mori), but it remains unclear how epigenetic modification in response to environmental signals precisely to regulate the diapause processing of bivoltine B. mori. In this study, the diapause terminated eggs of bivoltine B. mori, Qiufeng (QF) were divided into two groups: a QFHT group incubated at 25 °C with a natural day/night cycle to produce diapause eggs, and a QFLT group incubated at 16.5 °C in darkness to produce non-diapause eggs. On the 3rd day of the pupal stage, the total RNAs of the eggs were extracted and their N6-adenosine methylation (m6A) abundances were analyzed to explore the effects of m6A methylation on diapause in the silkworm. The results showed that 1984 m6A peaks are shared, 1563 in QFLT and 659 in QFHT. The m6A methylation level of the QFLT group was higher than that of the QFHT one in various signaling pathways. The m6A methylation rate of mevalonate kinase (MK) in the insect hormone synthesis pathway was significantly different between the two groups. The knockdown of MK by RNA interference in the pupae of QFLT resulted in females laying diapause eggs rather than non-diapause eggs after mating. m6A methylation involves in the diapause regulation of bivoltine B. mori by changing the expression levels of MK. This result provides a clearer image of the environmental signals on the regulation of diapause in bivoltine silkworms.


Proximal humerus exposure with the inverted-L anterolateral deltoid flip approach, anterolateral deltoid splitting approach, and deltopectoral approach: A comparative cadaveric study.
Reduction of the posterior aspect of proximal humerus fracture, such as far-retracted greater tuberosity or posterior articular head split fracture via a deltopectoral or deltoid splitting approach, is difficult and usually needs extensive dissection. The inverted-L anterolateral deltoid flip approach, which is developed from the deltoid splitting approach, accesses the proximal humerus via lateral deltoid flap lifting. This study compared the area and arc of surgical exposure to the proximal humerus of this proposed approach to existing approaches. Eleven cadaveric specimens were used. Deltopectoral and deltoid splitting approaches were carried out on the right and left shoulder, respectively. Soft tissue was retracted after completion of a surgical approach to expose the proximal humerus, and dot-to-dot marking pins were placed along the border of exposed area. An additional area with a full shoulder rotation was also marked on the deltopectoral side. An inverted-L deltoid flip approach was further carried out on a deltoid splitting side with a posterior extending incision along the acromion process and the deltoid detachment from the acromion process. The additional area of exposure was subsequently marked. All soft tissue around the proximal humerus was taken down, and the glenohumeral joint was disarticulated. Area of exposure and axial images were taken for further processing and measurement. An average distance of the axillary nerve from the acromion process of the deltoid splitting and the deltopectoral approaches were 49.15 mm and 57.35 mm, respectively (P < 0.05). The average area of exposure of the inverted-L deltoid flip, deltoid-splitting, deltopectoral, and deltopectoral with full rotation approaches were 2729.81mm2, 1404.39mm2, 1325.41mm2, and 2354.78mm2, respectively (P < 0.05). Mean arc of exposure lateral to bicipital groove of the inverted-L deltoid flip, deltoid splitting, deltopectoral, and deltopectoral with full rotation approaches were 151.75degrees, 105.02degrees, 61.68°, and 110.64°, respectively (P < 0.05). The inverted-L anterolateral deltoid flip approach provides the most posterior access to the proximal humerus. However, it requires more soft tissue dissection and awareness of tension on the axillary nerve. This approach could be an alternative for displaced posterior head splits or far-retracted greater tuberosity proximal humerus fractures.


Isolation and characterization of lactic acid bacteria from suan-tsai (fermented mustard), a traditional fermented food in Taiwan.
To isolate, characterize, and identify lactic acid bacteria (LAB) in suan-tsai (fermented mustard), a traditional fermented food in Taiwan. Suan-tsai samples were collected at five time points from a fixed fermenting bucket. Fifty cultures were isolated from suan-tsai samples, and isolates were divided into classes by phenotype and then into groups by restriction-fragment length polymorphism analysis and sequencing of 16S ribosomal DNA. Phenotypic and biochemical characteristics identified two different bacterial groups (A and B), and the results showed that Pediococcus pentosaceus was the most abundant LAB during the initial fermentation time. However, the more NaCl-tolerant species Tetragenococcus halophilus took the place of P. pentosaceus and became the most abundant LAB later. All isolates were grown in de Man, Rogosa, and Sharpe (MRS) broth containing 6% NaCl, but T. halophilus could grow only in MRS broth containing 10% NaCl. These results suggest that the LAB P. pentosaceus and T. halophilus play roles in the fermentation of suan-tsai. This is the first report describing the distribution and varieties of LAB that exist in the suan-tsai fermentation process.


Bilateral hemodynamic responses to auditory stimulation in newborn infants.
We studied hemodynamic auditory evoked responses of 20 healthy full-term neonates with near-infrared spectroscopy. The instrument used allows the measurements to be performed simultaneously above both auditory cortices. The stimulation consisted of 5-s trains of sound (700-ms interstimulus interval) with a 25-s silent interval. In response to the stimulation, a significant increase in concentration of oxygenated hemoglobin was detected in 14 out of 21 measurements. The mean latency of the largest response was 9.63+/-2.20 s (mean+/-SD) and the mean amplitude was 1.02+/-0.53 microM. The response amplitude was significantly larger in active (1.28+/-0.59 microM) than in quiet sleep (0.76+/-0.32 microM). The latency of the oxygenated hemoglobin concentration response was significantly shorter (r=-0.70 and p=0.0023) for infants with higher gestational age.


Template Synthesis of Decaphyrin without Meso-Bridges: Cyclo[10]pyrrole.
An acenaphthylene-fused cyclo[10]pyrrole 1b was selectively synthesized via an oxidative coupling reaction of the corresponding 2,2'-bipyrrole with the appropriate dianion template, croconate anion. The structure of 1b as the isolated largest cyclo[n]pyrrole was elucidated by X-ray crystallographic analysis. The absorption spectrum exhibited a markedly red-shifted, intensified L band at 1982 nm, which was interpreted by application of Michl's perimeter and Gouterman's 4-orbital models, supported by magnetic circular dichroism (MCD) data and theoretical calculations.


Gastroepiploic artery graft angiography via brachial approach using a Yumiko catheter.
We report here our initial experience in angiography of gastroepiploic artery (GEA) grafts via a brachial approach using the Yumiko catheter regarding technical aspect. Good-quality GEA angiography was obtained in 12 (86%) of 14 patients using our technique. GEA graft angiography can be performed using the Yumiko catheter via a brachial approach. This technique may be less stressful for patients receiving coronary catheterization, including GEA graft angiography.


Urine biochemistry to predict long-term outcomes in fetuses with posterior urethral valves.
Because the literature on the predictive value of fetal urinalysis is controversial in fetuses with lower urinary tract obstruction, we determined the best model of fetal urine biochemical markers correlated with long-term postnatal renal function based on glomerular filtration rate (GFR). This retrospective study concerned 89 fetuses with lower urinary tract obstruction and their renal function after 10 years of age. We correlated fetal urine biochemical markers (total protein, β2-microglobulin, sodium, chloride, glucose, calcium, and phosphorus) with GFR at 10 to 30 years of age in 89 patients with posterior urethral valves. We defined five stages of chronic kidney disease (CKD). Of the 89 patients, 18 (20%) are 20 years old or over. Postnatal renal function was good in 67.4% (GFR > 60 mL/min/1.73 m2 ) and poor in 17% (GFR < 30 mL/min/1.73 m2 ). All fetal urine markers differed between CKD stage 1 + 2 and CKD stage 4 + 5 (P < 0.001). β2-microblobulin showed an 87% sensitivity for a 72% specificity. A combination of β2-microglobulin and chloride gave the best results (93% sensitivity and 71% specificity) versus amniotic fluid volume (80% sensitivity and 73% specificity). Fetal urine biochemistry predicts long-term (10-30 years) postnatal renal function.


Cytochemical demonstration of lysosomes in skeletal and cardiac striated muscle of fish and turtles.
Skeletal and cardiac striated muscle from two species of fish and turtles were incubated for the cytochemical detection of trimetaphosphatase (TMPase) activity. The results showed that striated muscle from these animals has TMPase-positive structures, which are presumed to be lysosomes.


Thoracic epidural lipomatosis with associated syrinx: case report.
A 54-year-old black male with a 15-year history progressive lower extremity weakness was evaluated with a thoracic MRI that revealed epidural lipomatosis extending from T1-T10 with an associated syrinx at T1-3. He was neither overweight nor taking steroids. A multilevel thoracic laminectomy with resection of lipoma was performed without directly addressing the syrinx. Postoperatively, his symptoms improved and an MRI obtained 1 year after surgery demonstrated resolution of the syrinx. This is the only case of epidural lipomatosis with an associated syrinx that we have seen reported in the world literature.


New amphiphiles for membrane protein structural biology.
A challenging requirement for X-ray crystallography or NMR structure determination of membrane proteins (MPs), in contrast to soluble proteins, is the necessary use of amphiphiles to mimic the hydrophobic environment of membranes. A number of new detergents, lipids and non-detergent-like amphiphiles have been developed that stabilize MPs, and these have contributed to increased success in MP structural determinations in recent years. Despite some successes, currently available reagents are inadequate and there remains a pressing need for new amphiphiles. Literature examples and some new developments are selected here as a framework for discussing desirable properties of new amphiphiles for MP structural biology.


Phenotypic differences among and within extant populations of Chrysanthemum arcticum L. and C. a. subsp. arcticum.
Chrysanthemum arcticum, arctic daisy and its two subspecies (Chrysanthemum arcticum subsp. arcticum, Chrysanthemum arcticum subsp. polaré) are the only chrysanthemum species native to North America. A study on species' variation in morphological and diagnostic traits is important to link morphological traits with previously described single nucleotide polymorphism (SNP) markers, particularly when the genomes are sequenced. The purpose of this study was to establish phenotypic differences and soil conditions among wild C. arcticum and C. a. subsp. arcticum populations, when grown in a uniform environment for two years, for potential linkages with our SNP library. Sixteen quantitative morphological traits and five qualitative morphological traits were investigated for 255 individuals from nine C. arcticum populations and 326 individuals from 21 C. a. subsp. arcticum populations. In long-day controlled environment, C. arcticum flowering rate was 0% in Year 1, increased to 2.7% in Year 2, while C. a. subsp. arcticum flowering rate was 98.5% in Year 2. Two distinct clusters, distributed by taxonomic classification, were detected by Principal component analysis (PCoA) for 551 individuals from C. arcticum and C. a. subsp. arcticum. Pearson's correlation coefficient analysis indicated a positive and significant correlation between plant height, flower fresh and dry weights. Flower fresh weights were correlated with Δflower weight, while inflorescence length had showed a negative correlation with leaf number. Soil samples had high Na levels along with heavy metals. Thus, the species are salt-tolerant. A high level of salt tolerance (Na) is tolerated by these maritime species which is a unique trait in Chrysanthemum. A new diagnostic trait of inflorescence length was discovered to distinguish among C. arcticum and C. a. subsp. arcticum. Significant flowering differences occurred among the species C. arcticum and C. a. subsp. arcticum under same photoperiodic environment, including flowering rates and visible bud date. This study on the species' variation in morphological and diagnostic traits is of importance to link morphological traits with single nucleotide polymorphism (SNP) markers.


Human and veterinary pharmaceutical abundance and transport in a rural central Indiana stream influenced by confined animal feeding operations (CAFOs).
Previous research has documented the ubiquity of human and veterinary pharmaceuticals and personal care products (PPCPs) in freshwater, though their persistence and transport is relatively unknown. The objective of this study was to quantify the abundance and transport of human and veterinary PPCPs in a rural, central Indiana stream influenced by confined animal feeding operations (CAFOs). Research objectives also aimed to identify mechanisms controlling abundance and transport. PPCP concentrations and stream physicochemical characteristics were measured monthly over one year at multiple sites along a 60 km reach. Overall, human PPCPs were more abundant and measured at higher concentrations than veterinary pharmaceuticals. Veterinary pharmaceutical concentrations (lincomycin, sulfamethazine) were greatest in stream reaches adjacent to CAFOs. No distinct spatial variation was observed for human PPCPs. However, caffeine and paraxanthine had significant temporal variation with higher concentrations in winter. In contrast, DEET had higher concentrations in summer. Pharmaceutical load (μg/s) ranged from<0.005 to 1808 μg/s across sites, sampling events and pharmaceutical compounds with human PPCPs having higher loads relative to veterinary pharmaceuticals. Reach input ranged from net retention (sulfamethazine in August) to 1667 μg/m/d paraxanthine in March. Triclosan had the highest measured mean input into the reach (661 μg/m/d) and sulfamethazine had the lowest mean input (32 μg/m/d). Across measured compounds, input of PPCPs into the reach was two orders of magnitude lower than nitrate-N input (57,000 μg/m/d). Transport metrics indicated acetaminophen and caffeine are transported farther than triclosan though had lower loss velocities (loss relative to abundance). Loss rate of PPCPs was an order of magnitude lower than nitrate-N loss rate. Human PPCPs were more abundant than veterinary pharmaceuticals in this rural watershed influenced by CAFOs. Further, concentrations had significant temporal and spatial variation highlighting differential sources and fates. Thus, mechanisms driving PPCP retention and transport need to be identified to aid management of these emerging contaminants.


Exposure reduction and image quality in orthodontic radiology: a review of the literature.
This article summarizes the use of rare earth screen technology to achieve high-quality panoramic and cephalometric radiographs with sizable reductions in patient radiation dosage. Collimation, shielding, quality control, and darkroom procedures are reviewed to further reduce patient risk and improve image quality.


Aortobronchial fistula after unilateral lung transplantation.
An aortobronchial fistula resulting in massive hemoptysis developed in a 48-year-old man 13 months after unilateral lung transplantation. His posttransplantation recovery was complicated by bronchial dehiscence requiring revision and subsequent stricture formation treated by granulation tissue excision, placement of endobronchial stents, dilation, and laser photoablation. Early and aggressive treatment using these modalities is necessary in the successful management of airway complications after pulmonary transplantation.


Flap opening mechanism of HIV-1 protease.
The active site of aspartic proteases, such as HIV-1 protease (PR), is covered by one or more flaps, which restrict access to the active site. For HIV-1 PR, X-ray diffraction studies suggested that in the free enzyme the two flaps are packed onto each other loosely in a semi-open conformation, while molecular dynamics (MD) studies observed that the flaps can also separate into open conformations. In this study, the mechanism of flap opening and the structure and dynamics of HIV-1 PR with semi-open and open flap conformations were investigated using molecular dynamics simulations. The flaps showed complex dynamic behavior as two distinct mechanisms of flap opening and various stable flap conformations (semi-open, open and curled) were observed during the simulations. A network of weakly polar interactions between the flaps were proposed to be responsible for stabilizing the semi-open flap conformation. It is hypothesized that such interactions could be responsible for making flap opening a highly sensitive gating mechanism which control access to the active site.


Protective effects of low-magnitude high-frequency vibration on high glucose-induced osteoblast dysfunction and bone loss in diabetic rats.
Low-magnitude high-frequency vibration (LMHFV) has been reported to be capable of promoting osteoblast proliferation and differentiation. Reduced osteoblast activity and impaired bone formation were related to diabetic bone loss. We investigated the potential protective effects of LMHFV on high-glucose (HG)-induced osteoblasts in this study. In addition, the assessment of LMHFV treatment for bone loss attributed to diabetes was also performed in vivo. MC3T3-E1 cells induced by HG only or treated with LMHFV were treated in vitro. The experiments performed in this study included the detection of cell proliferation, migration and differentiation, as well as protein expression. Diabetic bone loss induced by streptozotocin (STZ) in rats was established. Combined with bone morphometric, microstructure, biomechanical properties and matrix composition tests, the potential of LMHFV in treating diabetes bone loss was explored. After the application of LMHFV, the inhibiting effects of HG on the proliferation, migration and differentiation of osteoblasts were alleviated. The GSK3β/β-catenin pathway was involved in the protective effect of LMHFV. Impaired microstructure and biomechanical properties attributed to diabetes were ameliorated by LMHFV treatment. The improvement of femur biomechanical properties might be associated with the alteration of the matrix composition by the LMHFV. LMHFV exhibited a protective effect on osteoblasts against HG by regulating the proliferation, migration and differentiation of osteoblasts. The function of promoting bone formation and reinforcing bone strength made it possible for LMHFV to alleviate diabetic bone loss.


Acoustic parameters of ocular tissues.
The sound velocity and the impedance of animal eyes and human eyes are measured by high frequency RF echograms (10 MHz) using a digital computer. The results are compared to literature data from 1955 to 1965, which were obtained with completely different techniques. The pig's eye appears to be a good animal model for the human eye in ultrasonic experiments. The reflectivity levels predicted from the impedance values correspond to known relative reflectivity levels obtained in clinical routine.


Mental state and other prognostic factors in femoral fractures of the elderly.
Fifty elderly patients with fractured femurs were followed up for six months. A hospital stay of less than 28 days and a good prefracture mental state were such important favourable prognostic factors that their absence made the outlook poor and carried clear implications concerning management.


Occupational health risk assessment of BTEX in municipal solid waste landfill based on external and internal exposure.
Benzene, toluene, ethylbenzene, and xylenes (BTEX) released from landfills have received increased attention because of their health risks. In this study, individual external and internal exposures of BTEX in a municipal solid waste (MSW) landfill were simultaneously studied for the first time. Eight workers from the landfill (as the case group) and eight control subjects were enrolled in the study. In total, 88 air samples and 232 urine samples (194 samples from the case group and 38 samples from the control group) were obtained from 2018 to 2019. According to the results of external exposure monitoring, benzene was the predominant component of BTEX, and the exposure level was higher in winter than in other seasons. Carcinogenic (RiskT) and noncarcinogenic (HIT) risks were calculated based on a dose-response model. The RiskT (1.64 × 10-8-1.09 × 10-6) might exceeded the limit, whereas HIT (9.84 × 10-4-1.40 × 10-2) was within their thresholds. Benzene was the major contributor to both RiskT and HIT. Internal exposures were evaluated by measuring urinary metabolites of BTEX. Levels of urinary BTEX metabolites for case group were higher than those for control group. A remarkable increase in urinary metabolites was observed from the urine samples of the case group after their shift compared with those before their shift. t,t-MA, the metabolite of benzene, was found to exceed the biomonitoring guidance limits of both China and the United States of America. Landfills can be considered as a potential BTEX exposure source for landfill employees. Minimizing occupational exposures and appropriate personal protective equipment are needed in reducing BTEX exposures.


Evaluation of the quality of life and satisfaction in patients using complete dentures versus mandibular overdentures. Systematic review and meta-analysis.
The World Health Organization (WHO) recognizes edentulism as a physical impairment that results in a negative impact in the daily activities. The study aimed to compare the satisfaction and the quality of life, in patients treated with implant retained overdentures with two mandibular implants (IOD) against those with mandibular conventional complete dentures (CCD). Different search strategies were used to screen for articles in Pubmed/Medline, Cochrane Library and Scielo of the last 17 years (2003-2020). The keywords used were: "quality of life OR satisfaction" AND "complete denture OR conventional denture" AND "overdenture OR implant retained." Six articles and two more were added by manual search. The population was 400 in the CCD and 412 for IOD. The mean age was 64.3 ± 6.41 years. The group was comprised of 283 men and 427 women. The scores obtained in the visual analog scale (VAS) before and after the treatment were statistically significant in favor of the IOD for overall satisfaction, (WMD: 12.329; 95% CI: 4.873 to 19.784, p-value = 0.001), comfort, speech and stability. For esthetics and chewing there was non-significant improvement while hygiene worsened for the IOD. For the comparison after the treatment between both treatment modalities a statistically significant improvement was found in overall satisfaction (WMD: 14.408; 95% CI: 8.589 to 20.226, p-value < 0.001), comfort, speech, chewing and stability in favor of the IOD but not in esthetics or hygiene. This systematic review and meta-analysis show the superiority of the IOD, despite is not achieved in all aspects.


Safety and tolerability of solifenacin in children and adolescents with overactive bladder- a systematic review.
Solifenacin is an anticholinergic that is used to treat overactive bladder syndrome (OAB) in children. It is important to ascertain the safety and tolerability of solifenacin in the paediatric population as solifenacin offers an alternative, is more bladder specific, and should have less anticholinergic side effects than other therapies. The aim of this study is to systematically evaluate the safety and tolerability of solifenacin in children and adolescents with OAB. We included studies that reported the safety and tolerability of solifenacin in children and adolescents. All study types were included. Electronic searches were conducted in Ovid MEDLINE, Ovid Embase, TRIP, CINAHL and ICTRP on the 18th of January 2022. Risk of bias was assessed with the Cochrane Risk of Bias tool 2.0 (ROB-2) for randomised controlled trials (RCTs) and the Newcastle-Ottowa scale for cohort studies. A total of twelve studies including two RCTs were included in this review. Results from the meta-analysis of RCTs showed the commonest side effects were constipation (RR 3.5, 95%CI 0.9-13.7) and dry mouth (RR 3.1 95%CI 0.2-53). In terms of tolerability, the effect estimate of ceasing solifenacin due to an adverse effect was 2.7 (95%CI 0.8-9.1). Within the cohort studies, out of the 779 patients 21.7% experienced side effects. The most common side effects were constipation (6.8%) and dry mouth/lips (6.0%) and 3.5% of patients ceased solifenacin due to adverse effects. Overall, the certainty of the evidence for side effects and tolerability were very low. The reported incidence of side effects is low, and less than reported with oxybutynin use. However, the very low certainty of the evidence means the findings should be interpreted with caution. There is limited reporting of a prolonged QTc interval on ECG. Studies that described this only had an increase of QTc from baseline and not a clinically significant prolonged QTc that resulted in arrhythmias. Solifenacin is an alternative anticholinergic for the treatment of OAB in children. However, given the paucity of good quality data on safety and tolerability it should be used cautiously in children with close monitoring for potential side effects.


The in vitro treatment with vitamin D3 is ineffective on the expression of PKC isoenzymes, but decreases further the impaired production of IL-2 in the T lymphocytes of SLE patients.
The objective of the study was to investigate the possibility whether the in vitro treatment with vitamin D3 can restore the impaired expression of protein kinase C (PKC) isoenzymes and IL-2 production in the lymphocytes of patients with systemic lupus erythematosus (SLE). Purified T lymphocytes from 14 patients with SLE and 13 healthy controls were cultured for 48 h in the presence and absence of 1 and 100 nM doses of vitamin D3. The expressions of various PKC isoenzymes were tested by Western blot analysis, and the amounts of various cytokines were detected by ELISA in the culture supernatants. Neither the low (1 nM) nor the high (100 nM) doses of vitamin D3 (1α,-25-dihydroxyvitamin) applied in vitro for 48 h were able to restore the decreased expression of PKC isoenzymes in the T cells of SLE patients. However, 100 nM of vitamin D3 significantly increased the release of IL-10, but suppressed the production of IL-2, IL-6, interferon γ and TNF α in the culture supernatants of both groups. As the low production of IL-2 is one of the main pathologic features of SLE, we recommend to avoid the use of high doses of vitamin D3 for treatment of lupus patients with vitamin D3 deficiency.


Nurse-midwives speak out on research. Results of the 1987-88 needs assessment survey, Part 2.
Part 1 of this 2 part article appeared in the preceding (January/February) issue of this journal. Results from the 1987-88 ACNM Needs Assessment Survey pertaining to research are presented. As with other topics addressed in Part 1 of the Needs Assessment Survey, subgroup analysis was conducted to determine if certain groups of CNMs had differing views and perceived needs regarding research. Survey responses were categorized to include: 1) CNM attitudes about research, 2) importance of ACNM research related services and activities, 3) use of a uniform data collection instrument, 4) CNM access to research resources, and 5) views on funding for ACNM research activities. Discussion of the implications of the results as they relate to development of the goals and objectives of the newly formed ACNM Division of Research is included.


Trajectory of ambulatory blood pressure after adenotonsillectomy in children with obstructive sleep apnea: comparison at three- and six-month follow-up.
Limited information is currently available on 24-h ambulatory blood pressure (ABP) changes after adenotonsillectomy (T&A) in children with obstructive sleep apnea (OSA). In this study, the trajectory of 24-h ABP changes after surgery in children with OSA was examined at three-month and six-month follow-up. Children aged 4-16 years with clinical symptoms of OSA and polysomnography (PSG)-diagnosed OSA (apnea-hypopnea index [AHI] >1) were included. All the children received T&A. PSG was conducted before and after surgery. Twenty four hour ABP was monitored using the linear mixed model before, three months after, and six months after surgery. In total, 122 children were examined (mean age: 7.9 years; 71% were boys). The AHI significantly decreased from 12.7 ± 16.7 to 2.4 ± 3.2 events/h after T&A (P < 0.001). Overall diastolic blood pressure (DBP; from 65.1 to 63.4 mmHg, P = 0.01) and night-time DBP (from 57.4 to 55.4 mmHg, P = 0.032) decreased nonsignificantly during the six-month postoperative period. The OSA children with presurgical hypertension exhibited significant reductions in overall systolic blood pressure (SBP), overall DBP, daytime DBP, night-time SBP, and night-time DBP at the three-month and six-month postoperative follow-up (all P < 0.05). The three-month and six-month ABP data did not differ significantly in the entire cohort, even between children with presurgical hypertension and non-hypertensive children. The 24-h ABP decreased significantly in the OSA children with hypertension at three and six months after surgery. Moreover, ABP findings did not differ significantly between the three- and six-month follow-up.


Changes in local interaction rules during ontogeny underlie the evolution of collective behavior.
Collective motion emerges from individual interactions which produce group-wide patterns in behavior. While adaptive changes to collective motion are observed across animal species, how local interactions change when these collective behaviors evolve is poorly understood. Here, we use the Mexican tetra, Astyanax mexicanus, which exists as a schooling surface form and a non-schooling cave form, to study differences in how fish alter their swimming in response to neighbors across ontogeny and between evolutionarily diverged populations. We find that surface fish undergo a transition to schooling mediated by changes in the way fish modulate speed and turning relative to neighbors. This transition begins with the tendency to align to neighbors emerging by 28 days post-fertilization and ends with the emergence of robust attraction by 70 days post-fertilization. Cavefish exhibit neither alignment nor attraction at any stage of development. These results reveal how evolution alters local interactions to produce striking differences in collective behavior.


Initial experience with hysteroscopic endometrial resection/ablation using a new specialized tissue aspirating resectoscope.
Hysteroscopy is gaining increasing acceptance among surgeons as the initial surgical treatment of choice for managing abnormal uterine bleeding and submucous fibroids. With refinements in electrosurgery and laser ablation instruments, and the development of continuous-flow resectoscopes, hysteroscopic techniques are proving to be cost-effective alternatives to hysterectomy for an ever expanding range of treatment indications.


Mandatory gunshot wound reporting in Nova Scotia: a pre-post-evaluation of firearm-related injury rates.
Mandatory gunshot wound reporting laws have been enacted in much of Canada, yet there is a lack of evidence on whether these laws are effective in preventing firearm injuries. Our objective was to determine if the Gunshot Wounds Reporting Act in Nova Scotia had an effect on the number of firearm-related injuries in the province. Pre-post-study of major trauma patients in Nova Scotia who sustained a gunshot wound injury before and after enactment of the Gunshot Wounds Reporting Act (Bill 10) in 2008. Data were collected from the Nova Scotia Trauma Registry and the Nova Scotia Medical Examiner Service for a 6-year pre-period (2002-2007) and an 11-year post-period (2009-2019), allowing for a 1-year washout period. Patient characteristics in the pre- and post-periods were compared using t tests and Chi-square analysis. Gunshot wound traumas were analyzed as a time series using the AutoRegressive Integrated Moving Average (ARIMA) model. A total of 722 firearm injuries were observed during the study period (pre-period = 259, post-period = 463). Mean age was 45.2 ± 19.3 years with males accounting for 95.3% (688/722) of cases. The majority of injuries were self-inflicted (65.1%; 470/722). The mean overall annualized rate of firearm injuries was 4.61 per 100,000 population in the pre-period and 4.45 per 100,000 in the post-period (reduction of 3.4%). No linear trends in the annual number of firearm injuries were observed over the study period. ARIMA modelling was an extremely poor predictor for gunshot wound trauma (R2 = 0.012). Although our findings suggest that there is no association between the Gunshot Wounds Reporting Act and the incidence of firearm injury, it is difficult to draw firm conclusions due to the complexity of this topic. Physicians need to be aware of the legal requirements of mandatory reporting when they encounter patients with gunshot wounds.


Forehead plaque: a presenting skin sign in tuberous sclerosis.
The forehead plaque can be the earliest skin manifestation of tuberous sclerosis and its presence may lead to early diagnosis and appropriate genetic counselling.


Isolation and culture of Kupffer cells from human liver. Ultrastructure, endocytosis and prostaglandin synthesis.
Kupffer cells and other sinusoidal cells were isolated after perfusion and incubation with pronase and collagenase of pieces of liver tissue obtained from organ donors. The resulting cell preparations contained endothelial cells, Kupffer cells and fat-storing cells as well as considerable numbers of leucocytes. Attempts to purify the different sinusoidal cell types by density centrifugation and centrifugal elutriation were successful only for Kupffer cells. Kupffer cells, in contrast to endothelial cells and fat-storing cells, could be kept in maintenance culture for at least 5 days. Cultured Kupffer cells were active in the endocytosis of foreign substances, such as colloidal carbon, latex beads, horseradish peroxidase and bacterial endotoxin. The cultured Kupffer cells synthesized and secreted considerable amounts of prostaglandins PGE2, PGF2 alpha, 6-keto-PGF1 alpha and thromboxane B2. The production of prostaglandins was influenced by the presence of Escherichia coli endotoxin.


Use of laxative medication in older persons and associations with low serum albumin.
To study laxative use among older persons and the association of laxative intake with hypoalbuminemia. Cross-sectional study in a population-based cohort. Community and institutions in the Iowa and Washington counties, Iowa site of the Established Populations for Epidemiologic Studies of the Elderly. Persons aged 71 years or older, who were interviewed at the 6th year of follow-up and for whom drug intake information was obtained (n = 2,529). Laxative medication use and prevalence of hypoalbuminemia. The prevalence rate of laxative use was 8.8% in the community and 74.6% in nursing homes. Increasing age was independently associated with laxative use (odds ratio [OR] = 1.66, 95% confidence interval [CI] = 1.33 to 2.07 for a 10-year increase), after adjusting for gender, institutionalization, disability in activities of daily living, body mass index, and use of the following drugs: furosemide, benzodiazepines, antidepressants, codeine, and calcium antagonists. Laxative use was independently associated with hypoalbuminemia (OR = 3.17, 95% CI = 1.42 to 7.08) after adjusting for age, gender, anemia, number of comorbid conditions, disability in activities of daily living, body mass index, use of furosemide, and institutionalization status. Compared with those who never used laxatives, those who took laxatives only at the 6th year of follow-up were at increased risk of hypoalbuminemia (OR = 2.65, 95% CI = 1.04 to 6.77), and those who used laxatives at both the 3rd and 6th years of follow-up were at greatest risk (OR = 4.02, 95% CI = 1.53 to 10.06). Laxatives are used by large numbers of older persons, and the investigation on unknown adverse effects is important. Prospective studies are needed to confirm the association of laxative use with hypoalbuminemia found in this study and to assess the mechanisms of this association.


Impact of an excise tax on the consumption of sugar-sweetened beverages in young people living in poorer neighbourhoods of Catalonia, Spain: a difference in differences study.
Sugar-sweetened beverage consumption is contributing to the obesity epidemic. On 28 March 2017, Catalonia enacted a law levying an excise tax on sugar-sweetened beverages for public health reasons. The purpose of this study is to assess the impact of the tax on the consumption of sugar-sweetened beverages in Catalonia (Spain). Before-and-after study to assess changes in the prevalence of consumption of sugar-sweetened beverages among 1929 persons aged 12 to 40 years residing in low-income neighbourhoods of Barcelona (intervention) and Madrid (control). Beverage consumption frequency was ascertained via a validated questionnaire administered during the month prior to the tax's introduction (May 2017) and again at 1 year after it had come into force. The effect of the tax was obtained using Poisson regression models with robust variance weighted using propensity scores. While the prevalence of regular consumers of taxed beverages fell by 39% in Barcelona as compared to Madrid, the prevalence of consumers of untaxed beverages remained stable. The main reason cited by more than two-thirds of those surveyed for reducing their consumption of sugar-sweetened beverages was the increase in price, followed by a heightened awareness of their health effects. The introduction of the Catalonian excise tax on sugar-sweetened beverages was followed by a reduction in the prevalence of regular consumers of taxed beverages.


[Is magnetic resonance imaging absolutely necessary for musculotendinous disease?].
Disorders of the musculoskeletal system are very prevalent in our society, especially those involving muscles and tendons, above all related to sports and work. These conditions are normally diagnosed and treated according to their clinical symptoms and signs, but a precise diagnosis is often necessary. The most widely used techniques for diagnosing these conditions are ultrasonography and magnetic resonance imaging. In this article, we propose ultrasonography as the technique of choice for diagnosing the most prevalent musculotendinous diseases, because it is accurate, versatile, dynamic, and effective.


Use of computer simulation to explore analytical issues in nested case-control studies of cancer involving extended exposures: methods and preliminary findings.
A Monte Carlo simulation program has been designed to generate case-control study data from hypothetical cohorts of individuals exposed to one or more carcinogens at intensities which vary over time. Exposure distributions are specified by such parameters as the probability of any exposure, the distributions of age at first and last exposure, the distribution of intensity as a function of time, and the correlations between exposures. Within subcohorts generated in this way, age-specific cancer rates are computed based on the multistage model of carcinogenesis (other models will be considered in the future). Age and possibly exposure-dependent censoring rates are also computed. Cancer cases are randomly generated from the resulting age and cause of death distribution and age-matched controls are drawn by sampling from the survival distribution. The "true" exposure histories, used to generate the cases and controls, are then corrupted by various random and systematic sources of error. The resulting case-control data are fitted to simple exposure indices as well as more sophisticated models of carcinogenesis. In preliminary simulations of a single carcinogen, it appeared that exposure indices derived from the multistate model could correctly estimate the stage at which the carcinogen acted when exposure is limited to a constant intensity over time, even when that intensity was measured with considerable error. These indices also fitted substantially better than simple duration, average intensity, or cumulative exposure. Further investigations will assess such issues as the additional information obtained by appropriately exploiting a time-dependent history, the effect of time-dependent exposure measurement errors, and the robustness of inferences when the assumed model is incorrect.


Increased melatonin may play dual roles in the striata of a 6-hydroxydopamine model of Parkinson's disease.
To investigate dynamic changes and roles of melatonin (MLT) in the striata of 6-hydroxydopamine (6-OHDA)-treated rats. A Parkinson's disease (PD) rat was established by a unilateral injection of 6-OHDA into the right substantia nigra pars compacta (SNc) and the right medial forebrain bundle (MFB) to achieve a complete lesion of the ipsilateral nigrostriatal DA system. Dialysates were collected in the lesioned striatum at different time intervals by in vivo microdialysis. In addition, both contralateral and ipsilateral striatum tissues were collected at two time intervals (10:00 and 22:00 h) at 3 and 6 weeks after lesioning. The levels of DA, 3, 4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) in the dialysates, as well as MLT in the dialysates and tissues were determined using HPLC. The dialysate contents of DA, DOPAC and HVA in the lesioned striatum were significantly decreased (P<0.001) in comparison with those in the controls or in the unlesioned side 3 weeks after lesioning while the extracellular level of MLT in the lesioned striatum in these corresponding time intervals distinctly increased when compared with those in the controls (P<0.05). The tissue MLT contents increased in the bilateral striata in different degrees at 6 weeks post-lesion (P<0.05). Moreover, increased MLT levels correlate well with rotations or DA changes in the lesioned striatum. These data suggest that 6-OHDA lesion manipulates the MLT secretion pattern. Increased striatal MLT level by a unilateral intracerebral injection of 6-OHDA may play dual roles in the progression of PD in rats.


Anatomical considerations in the management of the hanging columella.
To review the anatomy and dynamics of the hanging columella and to describe a technique to correct the causative anatomical deformity. Case series. A facial plastic surgery private practice in Highland Park, NJ. Consecutive sample of 10 patients (6 women and 4 men), aged from 27 to 52 years (mean age, 32 years). Through an external approach, the principal method of repair used in all cases involved transecting the medial and lateral crura at their angles to allow straightening of the medial crura. Comparative, standardized measurements of the alar-columellar complex in preoperative and postoperative photographs. Angle transection changed the spatial relation of the medial and lateral crura to each other resulting in straightening of the excessively curved medial crura. All patients had successful correction of the hanging columella. In our prospective study of 10 patients who required correction of hanging columellas, we have found the primary cause to be C-shaped curvature of the medial crura and their relation to the lateral crura. We observed long medial crura that were excessively curved, of normal width, and held in place by their continuity with the lateral crura. Dividing the alar cartilages at the angle of the medial and lateral crura released the connection of these structures allowing the medial crura to assume a straighter configuration. Tailoring of the feet of the medial crura and minimal septal shortening were occasionally used. Columellar struts, which were often used for other reasons, also provided additional medial crural straightening.


Spatial and temporal summation of pain evoked by mechanical pressure stimulation.
Chronic pain patients often suffer from widespread and long lasting pain. The integrative effect of combined spatial and temporal summation on pain intensity has not been quantitatively tested. The present study was designed to investigate: (1) if the size of the stimulation area would facilitate the temporal summation of pain to repetitive pressure stimulation, and (2) if temporal summation is effective when stimulating separated sites, repetitively. Twenty healthy male subjects participated in this study. The test sites were located on the bilateral upper trapezius and tibialis anterior muscles. The ten stimuli (each with a duration of 1s) were applied to a single site at three inter-stimulus intervals (ISI: 1, 5, 30s) using five different probe sizes (0.5, 1, 2, 4 and 8cm(2)). The stimulation intensity was equal to the pressure pain threshold (PPT) determined for each probe size. Similar repetitive stimulations at two inter-stimulus intervals (5s and 30s) using two sizes of probes (0.5cm(2) and 2cm(2)) were applied to ten separate sites. The PPT at the trapezius muscle decreased significantly with the increase in stimulus area from 0.5cm(2) to 8cm(2) (P<0.001) due to spatial summation. Temporal summation of pain was evoked by repetitive pressure stimuli on the same site for all ISI and was more pronounced at 5s and 30s ISI with larger probe areas (2, 4, and 8cm(2)) compared to smaller probe areas. There was no temporal summation of pain to stimuli with ISI 5 and 30s when stimulating the separated sites. The current study indicated that spatial summation facilitated the temporal summation of pain for stimuli given at 5s and 30s ISI. The combination of temporal and spatial integration of nociceptive input facilitates the pain intensity, suggesting that temporal summation is clinically relevant in conditions with widespread pain.


Physicochemical and immunochemical proofs of short-term insulin regulation of hepatic M2 pyruvate kinase.
In isolated rat hepatocytes, the short-term regulation of the M2 pyruvate kinase isozyme by insulin is demonstrated. This hormone dependence, which is a function of dose and incubation time, is checked by the activity of the pyruvate kinase, using enzyme assay, cellulose acetate electrophoresis and electroimmunodiffusion methods.


Thermal distribution analysis of three-dimensional tumor-embedded breast models with different breast density compositions.
Breast cancer is the most common cancer among women globally, and the number of young women diagnosed with this disease is gradually increasing over the years. Mammography is the current gold-standard technique although it is known to be less sensitive in detecting tumors in woman with dense breast tissue. Detecting an early-stage tumor in young women is very crucial for better survival chance and treatment. The thermography technique has the capability to provide an additional functional information on physiological changes to mammography by describing thermal and vascular properties of the tissues. Studies on breast thermography have been carried out to improve the accuracy level of the thermography technique in various perspectives. However, the limitation of gathering women affected by cancer in different age groups had necessitated this comprehensive study which is aimed to investigate the effect of different density levels on the surface temperature distribution profile of the breast models. These models, namely extremely dense (ED), heterogeneously dense (HD), scattered fibroglandular (SF), and predominantly fatty (PF), with embedded tumors were developed using the finite element method. A conventional Pennes' bioheat model was used to perform the numerical simulation on different case studies, and the results obtained were then compared using a hypothesis statistical analysis method to the reference breast model developed previously. The results obtained show that ED, SF, and PF breast models had significant mean differences in surface temperature profile with a p value <0.025, while HD breast model data pair agreed with the null hypothesis formulated due to the comparable tissue composition percentage to the reference model. The findings suggested that various breast density levels should be considered as a contributing factor to the surface thermal distribution profile alteration in both breast cancer detection and analysis when using the thermography technique.


Predictive Value of Absent Septal q Wave in Patients with Significant Stenosis of Proximal Left Anterior Descending Coronary Artery.
There is conflicting data about the predictive value of absent septal q wave in patients with significant stenosis of proximal Left Anterior Descending coronary artery. To clarify the exact role of this simple electrocardiographic sign we conducted this prospective descriptive study. Patients who were referred for coronary angiography in Milad Hospital between December 2008 and September 2009 were chosen randomly. Standard ECG was performed and reviewed for presence or absence of septal q wave, and then the coronary angiography was done and reported by another cardiologist. Of 148 patients with absent septal q wave in ECG, 85 patients (57%) had significant stenosis of proximal LAD in coronary angiography. Statistical analysis showed that significant stenosis of proximal LAD could be predicted by absence of septal q wave in ECG with sensitivity of 59% and specificity of 47%. However, Kappa statistic (Kappa = 0.36) showed low agreement between them. Absence of normal septal q wave in ECG could be a low value predictor of coronary artery disease mainly significant proximal LAD stenosis.


Psychometric assessment of the Concerns about Late Effects in Oncology Questionnaire (CLEO) among female breast cancer survivors.
The Concerns about Late Effects in Oncology (CLEO) questionnaire was developed to measure concerns cancer survivors may have about late effects. The current study sought to assess the Concerns about Late Effects in Oncology's (CLEO) psychometric properties - factor structure, construct validity, discriminatory power, and internal consistency. 147 breast cancer survivors completed a survey. Factor structure was determined by exploratory factor analysis (EFA). Construct validity was assessed against fear of cancer recurrence, anxiety, depression, quality of life, and neuroticism. Discriminatory power was assessed against participants' age and clinical characteristics. The EFA confirmed a 4-factor structure; health professionals' support, psychological impacts, adapting, and daily functional impacts. There was only partial support for construct validity and discriminatory power. The CLEO demonstrated excellent internal consistency, with an overall Cronbach's α = 0.87 (health professionals' support: α = 0.89, psychological impacts: α = 0.93, adapting: α = 0.82, and daily functional impacts: α = 0.89). The findings suggest further development of the CLEO should focus on the psychological and functional impacts of late effects. Use of the CLEO may enhance communication about the impact of late effects, ensuring earlier identification and management of late effects in this population.


A methyl-deficient diet modifies histone methylation and alters Igf2 and H19 repression in the prostate.
Folate and methyl-group deficiency has been linked to prostate cancer susceptibility, yet the mechanisms underlying these observations are incompletely understood. The region of the genome containing the imprinted genes insulin-like growth factor 2 (Igf2) and H19, both of which display oncogenic functions, may be particularly sensitive to environmental influences. To determine whether a methyl-deficient diet impacts epigenetic controls at the Igf2-H19 locus, we placed C57BL/6 mice containing a polymorphism at the imprinted Igf2-H19 locus on a choline and methionine deficient (CMD) diet. We interrogated this locus for expression and epigenetic changes in prostate tissues. A significant increase in both Igf2 and H19 expression was found in CMD prostate tissues compared to controls. These expression changes were reversible with shorter exposure to the CMD diet. Chromatin immunoprecipitation (ChIP) revealed significant decreases in repressive histone modifications (dimethyl-H3K9) within the H19 promoter, as well as Igf2 P2 and P3 promoters. DNA methylation within these promoters was not altered. No significant change in Igf2 or H19 imprinting was observed. These findings highlight the plasticity of the epigenome in an epithelial organ vulnerable to neoplastic change. They further suggest that chromatin modifications are more susceptible to methyl-deficient diets than DNA methylation at this locus.


Dietary intervention study in children (DISC) with elevated low-density-lipoprotein cholesterol. Design and baseline characteristics. DISC Collaborative Research Group.
The Dietary Intervention Study in Children (DISC) is a multicenter prospective study designed to assess the efficacy and safety of a lipid-lowering diet in 8- to 10-year-old children with moderately elevated low-density-lipoprotein cholesterol (LDL-C) levels. Six-hundred sixty-three children were randomized to a dietary intervention group (n = 334) and a usual-care group (n = 329). At baseline, mean LDL-C levels, nutrient intakes, anthropometric measures, and blood pressures were similar in the two groups. The intervention consists of a series of group and individual sessions to teach children and their families to follow a diet containing 28% of calories as total fat (< 8% as saturated fat, up to 9% as polyunsaturated fat, 11% as monounsaturated fat) and dietary cholesterol intake less than 75 mg/1000 kcal (< 150 mg/d) and designed to meet nutritional requirements of growing children. The usual-care group was provided with a packet of general dietary information only. Efficacy of the intervention will be assessed by comparing changes in LDL-C levels between the two groups at 36 months. Primary safety outcome assessments will involve comparisons of linear growth and serum ferritin levels. Secondary safety outcomes include serum zinc, folate, retinol, and albumin levels; ratio of LDL-C to high-density-lipoprotein cholesterol; sexual maturation; cognitive development; and child behavior. Thus, DISC aims to address long-term efficacy and concerns about the overall safety of dietary modifications in growing children.


Idiopathic transverse myelitis presenting as the Brown-Sequard syndrome.
Case report. To report an unusual case of Brown-Sequard syndrome (BSS) associated with idiopathic transverse myelitis (TM). Department of Neurosurgery, Chonnam National University Hospital, Gwangju, South Korea. A 38-year-old man presented with left leg weakness and right-sided decrease in sensation at the T11 level below. Magnetic resonance images (MRI) of the thoracic spine showed diffuse swelling of the spinal cord spanning the fifth to the eighth thoracic vertebra. The lesion had high signal intensity on T2-weighted images. Eccentric nodular enhancement within the left anterolateral aspect of the spinal cord was appreciated with gadolinium administration. The patient was treated with pulsed methylprednisone and showed marked improvement in neurological function within 3 days. An MRI at 5-month follow-up demonstrated complete resolution of the abnormalities. This case illustrates a rare case of BSS caused by idiopathic TM of the thoracic spinal cord. TM should be considered in the differential diagnosis of BSS.


Induction of prolonged electrographic seizures in vitro has a defined threshold and is all or none: implications for diagnosis of status epilepticus.
To study whether induction of prolonged (>30-min duration) in vitro electrographic seizure discharges resembling status epilepticus (SE) is graded or all-or-none, and to determine the critical factors mediating SE induction. Prolonged electrographic seizure discharges were induced in combined hippocampal-entorhinal cortical (HEC) brain slices by electrical stimulation of the Schaeffer collaterals. Discharges were recorded by using field-potential electrodes in the dentate gyrus, CA3, CA1, and entorhinal cortex. Slices were prepared from rats that were (a). 21- to 30-day-old naive, (b). 60- to 120-day old naive, (c). epileptic, and (d). status post a prior traumatic brain injury. Induction of SE discharges was dependent on the duration, but not amplitude of the preceding stimulus train-induced afterdischarge in HEC slices from 21- to 30-day-old control, brain-injured, and epileptic animals, but not from 60- to 120-day-old animals. In slices from 21- to 30-day-old control animals, once afterdischarges exceeded 4 min in duration, SE was induced in 50% of slices, and after >or=6 min 37 s seizure activity; SE was induced in 95% of slices. A defined SE threshold also was evident in brain-damaged rats, including rats in which an epileptic condition was induced by pilocarpine injection 4-16 weeks before recording, and rats subjected to a fluid percussive head trauma 1-8 weeks before recording. However, in these brain-damaged animals, mean SE threshold was considerably lower (24 and 44 s, respectively). HEC slices from 60- to 120-day-old controls for the brain-injured and epileptic animals did not develop SE even after 20 stimulations, demonstrating the pronounced effect of brain injury and epilepsy on the development of SE in the HEC slice preparation compared with that in age-matched controls. In vitro, SE discharges have a defined temporal threshold for initiation. Once a seizure exceeds 6-7 min in duration in control animals, and 30-55 s in brain-damaged animals, the probability of SE induction is greatly increased. This demonstrates that brain injury lowers the afterdischarge duration required to produce SE and suggests that brains injured from trauma or SE are more susceptible to develop status epilepticus.


Utility of the new cobas HCV test for viral load monitoring during direct-acting antiviral therapy.
The COBAS AmpliPrep/COBAS TaqMan assay HCV (CAP/CTM) is widely used in clinical routine for HCV testing. Recently, the new cobas HCV test was established for high throughput testing with minimal operator intervention. As different assays may yield different quantitative/qualitative results that possibly impact treatment decisions, the aim of this study was to externally evaluate the cobas HCV test performance in comparison to CAP/CTM in a clinically relevant setting. Serum samples were obtained from 270 patients who received direct acting antiviral therapy with different treatment regimens at two study sites (Hannover and Frankfurt) in 2016. Overall, 1545 samples (baseline, on-treatment and follow-up) were tested in parallel by both assays. The mean difference between cobas HCV and CAP/CTM for the quantification of HCV RNA was 0.008 log10 IU/ml HCV RNA (95% limits of agreement: -0.02-0.036) showing excellent agreement of both assays. With respect to clinical cut offs (HCV RNA detectable vs. target not detected and HCV RNA above the lower limit of quantification (LLOQ) vs. <LLOQ), discordant results were obtained in 9.5% and 4.6%, respectively; the greatest differences were observed during early stages of antiviral therapy (week 1, week 2 and week 4), but none were statistically significant. Overall percent agreement for SVR between cobas HCV and CAP/CTM at the 15 IU/ml cutoff was 99.2% (95%CI 92.7%-100%). The performance of the new cobas HCV test was comparable to CAP/CTM in a clinical setting representing a large patient population with HCV GT 1 and 3 treated with DAAs.


[Value of liver needle-biopsy in Djibouti (1.1110 specimens) (author's transl)].
Liver diseases, specially hepatomegalies and hepatosplenomegalies are very frequent in Republic of Dijibouti. Needle-biopsy of the liver is a good approach of this pathology as demonstrated by controlling 1.110 specimens within a period of 9 years, leading to very different diagnosis.


Kit-based preparation of [68Ga]Ga-P16-093 (PSMA-093) using different commercial 68Ge/68Ga generators.
Prostate-specific membrane antigen (PSMA) is an important biomarker for molecular imaging and a target for radionuclide therapy of prostate cancer. Recently, U.S. Food and Drug Administration (FDA) has approved [68Ga]Ga-PSMA-11 as a PSMA-targeted positron emission tomography (PET) imaging agent for the diagnosis of prostate cancer. As an alternative PSMA imaging agent, [68Ga]Ga-P16-093 ([68Ga]Ga-PSMA-093) showed excellent blood clearance and rapid tumor uptake, desirable in vivo properties for avidly detecting primary tumor and metastatic lesions in patients. To improve the availability and test the robustness of radiolabeling reaction, eluents of 68Ga/HCl from different sources of generators were evaluated. Commercially available 68Ge/68Ga generators from Eckert & Ziegler, ITG and iThemba were eluted with varying molarities of hydrochloric acid (0.05-0.6 M, as recommended by each company) and reacted with P16-093 kits. Radiolabeling yields, in vitro stabilities, in vitro cell uptakes and drug release criteria of different preparations were investigated. PET/computed tomography (CT) imaging of prostate cancer patients with [68Ga]Ga-P16-093 produced by using different sources of 68Ga were performed. Optimized P16-093 kit containing 15 μg of P16-093 (precursor) and 68 mg of sodium acetate trihydrate (buffer), a formulation previously tested in humans, was successfully labeled with eluents from Eckert & Ziegler, ITG and iThemba's generators. In vitro cell uptake studies showed that [68Ga]Ga-P16-093, formulated with ITG and iThemba's generators, exhibited equivalent PSMA-specific uptakes. Clinical studies in prostate cancer patients exhibited exceedingly comparable maximum standardized uptake value (SUVmax) for each lesion regardless of source of the generator used in preparation. Using different vendors' generator and lyophilized P16-093 kits, [68Ga]Ga-P16-093 could be conveniently and reliably prepared by a simple one-step reaction with excellent yields. Clinically useful doses of [68Ga]Ga-P16-093 imaging tracer could be made available using different 68Ge/68Ga generators.


[Psychopharmacoepidemiology: differences in prescribing strategies in the inpatient and outpatient settings].
Doctors' prescribing behaviour in 34 psychiatric hospitals in southern Germany was investigated and compared with outpatient prescribing behaviour of doctors licensed to practise within the German health insurance system. On the basis of the AGATE cut-off dates for 2000-2006, we analysed developments in the drug groups antidepressants, neuroleptics, benzodiazepines, and antidementia drugs over time. The proportion of inpatient prescriptions of antidepressants and antidementia drugs is increasing, whereas neuroleptics and benzodiazepines are undergoing the reverse trend. The proportion of generics in inpatient prescriptions is notably lower than in outpatient prescriptions. The differences between inpatient and outpatient prescribing behaviour results in a lack of continuity of care. Health economic incentive systems therefore require standardisation.


The role of actin in the surface integrity of cultured rat liver parenchymal cells.
Adult rat hepatocytes grown in a primary culture showed a homogenous actin distribution during the first 24 hr in culture as seen with anti-actin antibodies in indirect immunofluorescence microscopy. When exposed to phalloidin the cells formed rapidly numerous blebs. In these cells bright fluorescent spots were seen at the base of the blebs with anti-actin antibodies. Aggregates of fibrillar material were analogously seen in electron microscopy both at the base of the blebs and in the cytoplasm of the phalloidin-treated cells. The results indicate that phalloidin-induced aggregation of actin in hepatocytes leads to a weakening and subsequent blebbing of hepatocyte surface, suggesting that the cortical meshwork of actin-containing filaments plays an important role in the surface integrity of hepatocytes.


The association between sequences of sexual initiation and the likelihood of teenage pregnancy.
Few studies have examined the health and developmental consequences, including unintended pregnancy, of different sexual behavior initiation sequences. Some work suggests that engaging in oral-genital sex first may slow the transition to coital activity and lead to more consistent contraception among adolescents. Using logistic regression analysis, we investigated the association between sequences of sexual initiation (i.e., initiating oral-genital or vaginal sex first based on reported age of first experience) and the likelihood of subsequent teenage pregnancy among 6,069 female respondents who reported vaginal sex before age 20 years and participated in waves I and IV of the National Longitudinal Study of Adolescent Health. Among female respondents initiating vaginal sex first, 31.4% reported a teen pregnancy. Among female respondents initiating two behaviors at the same age, 20.5% reported a teen pregnancy. Among female respondents initiating oral-genital sex first, 7.9% reported a teen pregnancy. In multivariate models, initiating oral-genital sex first, with a delay of at least 1 year to vaginal sex, and initiating two behaviors within the same year were each associated with a lower likelihood of adolescent pregnancy relative to teens who initiated vaginal sex first (odds ratio = .23, 95% confidence interval: .15-.37; and odds ratio = .78, 95% confidence interval: .60-.92, respectively). How adolescents begin their sexual lives may be differentially related to positive and negative health outcomes. To develop effective pregnancy prevention efforts for teens and ensure programs are relevant to youths' needs, it is important to consider multiple facets of sexual initiation and their implications for adolescent sexual health and fertility.


Modelling change in neurocognition, symptoms and functioning in young people with emerging mental disorders.
Mental disorders and their functional impacts evolve dynamically over time. Neurocognition and clinical symptoms are commonly modelled as predictors of functioning, however, studies tend to rely on static variables and adult samples with chronic disorders, with limited research investigating change in these variables in young people with emerging mental disorders. These relationships were explored in a longitudinal clinical cohort of young people accessing early intervention mental health services in Australia, around three-quarters of whom presented with a mood disorder (N = 176, aged 12-30 at baseline). Bivariate latent change score models quantified associations between neurocognition (a latent variable of working memory, verbal memory, visuospatial memory, and cognitive flexibility), global clinical symptoms, and functioning (self- and clinician-rated) and their relative change over follow-up (median = 20 months). We found that longitudinal changes in functioning were coupled with changes in global clinical symptoms (β = -0.43, P < 0.001), such that improvement in functioning was related to improvement in clinical symptoms. Changes in neurocognition were not significantly associated with changes in functioning or clinical symptoms. Main findings were upheld in three sensitivity analyses restricting the sample to: (a) adults aged 18-30; (b) participants with 12-24 months of follow-up; and (c) participants without a psychotic disorder. Our findings show that global symptom reduction and functional improvement are related in young people with emerging mental disorders. More work is needed to determine the temporal precedence of change in these variables. Future studies should apply this methodology to intervention studies to untangle the causal dynamics between neurocognition, symptoms, and functioning.


Dysregulation of Inflammasomes in Human Dental Pulp Cells Exposed to Porphyromonas gingivalis and Fusobacterium nucleatum.
Interleukin-1β (IL-1β) is a major proinflammatory cytokine that plays a significant role in pulpal inflammation. The regulation of IL-1β as well as different cytokines and chemokines is controlled by multiprotein complexes named inflammasomes, which are known to be involved in pulpal inflammation. The goal of this study was to evaluate the effects of well-established endodontic bacteria and periodontal pathogens Fusobacterium nucleatum and Porphyromonas gingivalis on NLRP3 and AIM2 inflammasomes; the inflammasome regulatory proteins POP1, CARD16, and TRIM16; inflammasome components ASC and caspase-1; and IL-1β levels in human dental pulp cells (HDPCs) in vitro. HDPCs were exposed to either F. nucleatum or P. gingivalis or to the combination of both with an additional 30 minutes of 5 mmol/L adenosine triphosphate (ATP) incubation for 24 hours. Escherichia coli lipopolysaccharide exposure was used as a control. Gene expression of NLRP3, AIM2, POP1, CARD16, TRIM16, ASC and caspase-1, and IL-1β were evaluated by reverse transcription polymerase chain reaction. The presence and levels of pro- and mature IL-1β were monitored by immunocytochemistry and the release with enzyme-linked immunosorbent assay. Up-regulation of NLRP3 and AIM2 was detected in all exposure groups. IL-1β was up-regulated in all groups, except for the F. nucleatum + ATP group. CARD16 was significantly down-regulated by F. nucleatum or P. gingivalis with or without ATP; however, POP1 was down-regulated only in P. gingivalis and E. coli LPS + ATP groups. P. gingivalis alone significantly increased intracellular pro- and mature IL-1β levels. P. gingivalis and F. nucleatum in the presence of ATP may play a significant role in IL-1β-induced pulpal inflammation by dysregulating inflammasomes and their regulators.


Small cell carcinoma with neurosecretory granules arising in an ovarian dermoid cyst.
A rare small cell carcinoma with neurosecretory granules arising in an ovarian dermoid cyst with 7 years survival after conservative surgery and adjuvant chemotherapy with cisplatin, adriamycin, and cyclophosphamide is described. Light microscopy showed the typical uniformly small cells with hyperchromic nuclei and scanty basophilic cytoplasm within the mature cystic teratoma. Although none of the immunohistochemical stains were reactive, electron microscopy demonstrated the membrane-bound neurosecretory granules in some tumor cells. The related literature is reviewed and the issues concerning treatment options in this unusual malignancy are discussed.


Is EEG useful in assessing patients with acute encephalitis treated with acyclovir?
EEG has been used widely in diagnosing encephalitis, as it demonstrates rather typical abnormalities, especially in herpes simplex virus encephalitis (HSVE). We analysed 204 EEG recordings from 98 consecutive acyclovir-treated patients with acute encephalitis between 1984 and 1994. Periodic complexes (PC) in the acute phase predicted poor outcome (Kendall tau 0.40, P < 0.001). However, unlike in many other diseases, e.g. stroke and intracerebral haemorrhage, the diffuse slowing of the background activity at acute phase did not predict outcome (Kendall tau -0.6, P = 0.35). At follow-up, the emergence of diffuse slow background activity was significantly associated with a less favourable outcome (Kendall tau 0.33, P = 0.0016). Among clinical variables, only epileptic seizures early during the course of the disease correlated significantly with outcome. EEG does have value as a prognostic indicator in acute encephalitides, but it seems that diffuse slowing of background activity or irritative features acutely are not as important as previously thought, based on the experiences of the pre-acyclovir era.


Gonadotrophin and alpha subunit secretion by human 'functionless' pituitary adenomas in cell culture: long term effects of luteinizing hormone releasing hormone and thyrotrophin releasing hormone.
The long-term effects of LHRH and TRH on gonadotrophin alpha subunit, FSH and LH secretion by cell cultures of four human chromophobic pituitary tumours have been examined. The tumours derived from one male and three female patients who presented because of visual disturbance but had no evident endocrine symptoms. Subsequent serum hormone analysis showed the FSH to be high in the male but low or normal in the post-menopausal females whereas LH levels were low in all patients. In culture, basal hormone secretion could be maintained for periods up to 63 d. All tumours secreted alpha subunit and FSH, but much lower amounts of LH. Addition of LHRH or TRH for a period of 12 to 41 d showed that alpha subunit, FSH and LH secretion were stimulated by LHRH from one tumour, by LHRH and TRH from two tumours. There was always a rapid decline in the LH secretion. The tumour which secreted FSH predominantly was stimulated by TRH. We conclude that human pituitary 'functionless' adenomas can secrete gonadotrophin alpha subunit and FSH in vitro and that secretion can be stimulated during long term releasing hormone experiments. LH secretion, however, cannot be maintained.


Lipid peroxidation. Biopathological significance.
Peroxidation of unsaturated lipids, initially studied in the chemistry of oil and fat rancidity, has become a problem of increasing interest in the biological field, because of its proposed role in a variety of pathological conditions. The general mechanism of the process, the formation of toxic aldehydes capable to react with protein and non protein thiols, and the overall effects in cellular membranes are reviewed. The possible implications of lipid peroxidation as one of the main mechanisms of cellular damage in both toxic injury and other pathological conditions are discussed.


Perception of the coronavirus pandemic by patients with atopic dermatitis - Results from the TREATgermany registry.
TREATgermany, a registry for patients with moderate to severe atopic dermatitis (AD), established an additional questionnaire in spring 2020 to investigate the effects of the coronavirus pandemic on the daily life of patients with AD. A questionnaire was used to analyze general information regarding a patient's experience of the coronavirus pandemic and, using the Inventory of Life-Changing Events, the resulting personal burden. To analyze possible associations between disease severity (EASI score, oSCORAD, IGA, PGA, POEM), quality of life (DLQI) and personal burden, t-tests, analyses of variance and correlations were evaluated, controlled for sex and age. 58 % (n = 233) of the included 400 registry patients reported high burden scores caused by the coronavirus pandemic, regardless of an actual infection. Men showed significantly higher burden scores than women, and younger than older respondents (both P = 0.03). There were no differences in burden scores related to the physician's assessment of disease severity. However, patients with higher quality of life impairments and higher disease severity perceived the burden of the coronavirus pandemic as less severe (DLQI P = 0.019, PGA P = 0.044). Our data show that registry patients considered the coronavirus pandemic as a life-changing event and perceived the burden differently. This should be taken into account in the treatment of patients with moderate to severe AD as well as in further studies.


Ewing tumor after treatment of Ki-1+ anaplastic large cell lymphoma. Therapy-associated secondary neoplasm or unrelated coincidence?
We report on a 20-year-old woman who developed a pelvic small round cell tumor with lung metastases 8 years after diagnosis and successful treatment for Ki-1-positive anaplastic large cell lymphoma (Ki-1+ ALCL) with histiocytic differentiation. Molecular genetic detection of EWS/FLI-1 fusion gene expression in the second tumor by RT-PCR unambiguously confirmed the histopathologic diagnosis of Ewing tumor (ET), whereas no evidence for the presence of this specific gene rearrangement was obtained in a retrospective analysis of the lymphoma tissue. In contrast, expression of a NPM/ALK chimeric gene was observed which was absent in the ET. Moreover, the lymphoma contained a monoallelic D delta 2-D delta 3 T-cell receptor gene rearrangement which was also absent in the ET. Thus, our histopathologic, immunohistochemical, and, in particular, molecular genetic studies support the notion that these tumors were most probably pathogenetically unrelated. Since this is the first report describing such an association between a non-Hodgkin's lymphoma and ET and, since the latter has only rarely been observed as a second malignant neoplasm, it remains a matter of speculation whether in this patient ET developed as a therapy-related secondary neoplasm or independently from the lymphoma as a consequence of either genetic tumor predisposition or mere accidental coincidence.


Radiation therapy in the horse.
This article covers the principles and applications of radiation therapy in horses. The goal in treating tumors by irradiation is tumor control with minimum treatment complications. Various treatment techniques are available to achieve this goal. The prognosis depends on many factors such as the extent and location of the tumor, tumor type and tumor cell proliferation. Radiation therapy is a very effective treatment modality for equine tumors but logistical reasons limit its impact in equine oncology.


Motility and oxidative metabolism of normal polymorphonuclear leukocytes in acute non-lymphoid leukemia in complete remission.
Polymorphonuclear leukocytes (PMN) from 11 patients with acute non-lymphoid leukemia (ANLL) in complete remission and off therapy for at least 22 months were studied for their oxidative metabolism and motility. In all patients, PMN motility tests revealed no consistent abnormality, whereas cells from 2 patients showed a selective impairment of oxidative metabolism, as assessed by the low capacity to reduce nitroblue tetrazolium and/or to generate chemiluminescence when stimulated with phorbol myristate acetate. No morphological change was detectable in PMN from these patients. However, the functional alterations appeared related to an early tendency to relapse, as both patients developed an acute phase after 5 and 9 months from testing, respectively. This suggests that abnormal PMN may circulate in ANLL patients in complete remission in spite of a normal differential count and that functional studies may be useful for detecting such a population.


Intracortical Directed Connectivity for Information Retention in Visual-Spatial Working Memory.
A group of 27 healthy young adults solved a task involving the working memory (WM) activation, consisting of the comparison between the spatial orientations of two sequentially presented square-wave luminance gratings. We investigated the effective (directed) connectivity patterns between the frontal and postcentral cortical regions related to the visual system. The connectivity was assessed using vector autoregression modeling of EEG. It was shown that the strength of the top-down right-hemispheric connectivity patterns directed from the frontal cortex to the visual areas in θ frequency was significantly lower at the stage of stimulus retention in the WM than at the stage of stimulus anticipation. On the contrary, in the α band the descending influences were slightly more intense. The results of the study showed the frequency-dependent dynamics of the descending influences of the frontal cortex on visual areas and confirm that the frontal cortex plays the role of a controlling and modulating center in the brain system underlying WM.