Early results with cryopreserved saphenous vein allografts for infrainguinal bypass.
Cryopreserved saphenous vein allografts (CSVA) are available for use in arterial reconstructions; however, patency rates in the infrainguinal position are not well described. We reviewed our experience with 38 patients who underwent 43 infrainguinal bypasses with CSVA as the conduit. The group includes 21 women and 17 men with a mean age of 69 +/- 11 years. Mean follow-up is 8.2 +/- 5.5 months. Logistic regression was used to analyze five variables in an attempt to identify predictors of success or failure: distal anastomosis to the popliteal artery versus a crural artery, one-vessel versus two- or three-vessel runoff, postoperative anticoagulation versus none, primary reconstructions versus reoperations, and one segment versus two segments of CSVA required. The cumulative patency rate at 12 months by life-table analysis is 66%. Logistic regression revealed that primary reconstructions were more likely to succeed than reoperations (p = 0.03) and operations completed with one segment of CSVA were more likely to succeed than those requiring more than one segment of vein (p = 0.03). We conclude that (1) the short-term patency of infrainguinal bypasses with CSVA suggests that they may be acceptable alternatives to prosthetic grafts in the below-knee position, and (2) primary reconstructions performed with one segment of CSVA are more likely to succeed.


Prolonged hospital stay after parathyroidectomy for secondary hyperparathyroidism.
Protracted hypocalcemia is the most common complication after parathyroidectomy for secondary hyperparathyroidism. Several parameters have been identified to predict the degree of postoperative hypocalcemia. The purpose of this study was to determine whether there were any factors associated with prolonged hospitalization in these patients. A total of 81 consecutive patients with end-stage renal disease and advanced secondary hyperparathyroidism who underwent parathyroidectomy between January 2004 and December 2006 were studied. The postoperative calcium infusion protocol and discharge criteria were standardized. Clinical variables were compared between patients with a shorter or longer postoperative stay. The mean postoperative hospital stay was 5.6 days. Preoperative alkaline phosphatase levels were significantly higher in patients with a longer stay (p=0.035). In a linear regression model, the postoperative length of stay was moderately but significantly correlated with preoperative alkaline phosphatase levels (R2=0.254; p<0.001). Receiver operating characteristic analysis showed a significant area under the curve (0.678; 95% confidence interval 0.550-0.805; p=0.014). With a cutoff of preoperative alkaline phosphatase levels at 200 IU/L, the sensitivity was 0.57 and the specificity was 0.59 for predicting a prolonged stay. A high preoperative alkaline phosphatase level is significantly associated with prolonged hospital stay in patients undergoing parathyroidectomy for secondary hyperparathyroidism.


Big data is essential for further development of integrative medicine.
To give a short summary on achievements, opportunities and challenges of big data in integrative medicine (IM) and explore the future works on breaking the bottleneck to make IM develop rapidly, this paper presents the growing field of big data from IM, describes the systems of data collection and the techniques of data analytics, introduces the advances, and discusses the future works especially the challenges in this field. Big data is increasing dramatically as the time flies, whatever we face it or not. Big data is evolving into a promising way for deep insight IM, the ancient medicine integrating with modern medicine. We have great achievements in data collection and data analysis, where existing results show it is possible to discover the knowledge and rules behind the clinical records. Transferring from experience-based medicine to evidence-based medicine, IM depends on the big data technology in this great era.


Localization of the primary sites of genetic influence.
When studying the nervous system of animal lines developed for specific genetically-determined behavioral differences, how does one tell whether a difference between the lines found at one specific location was caused by a direct genetic interaction at that location or by an interaction at some distant site which was then imposed on the tested location? The form of the line difference can help to answer this question. One particular form, called an inverse line difference, is shown to have a higher probability of being close to the location of the direct gentic interaction.


Lipoamide dehydrogenase from streptomyces seoulensis: biochemical and genetic properties.
Lipoamide dehydrogenase was purified around 22-fold relative to the crude extracts of Streptomyces seoulensis with an overall yield of 9. 5%. The enzyme was composed of two identical subunits with a molecular mass of 54 kDa and contained 1 mol of FAD per mol of subunit. The absorption spectra of the enzyme revealed the absorption maxima of flavoprotein at 272, 349, and 457 nm. Catalytically active two-electron reduced lipoamide dehydrogenase was produced by anaerobic reduction with one equivalent of NADH. Addition of excess amount of NADH led to the four-electron reduced lipoamide dehydrogenase. The reaction of the enzyme in the reduction reaction of lipoamide or lipoic acid could be explained by a ping-pong mechanism like many other lipoamide dehydrogenases reported earlier. The enzyme also catalysed the reduction of various quinone compounds with NADH as electron donor via a ping-pong mechanism. The enzyme can catalyse a single electron transfer in case of quinone-reducing process, evidenced by the production of 1, 4-naphthosemiquinone radical anion. The quinone-reducing activity of the enzyme was dramatically inhibited by NAD+, indicating the involvement of four-electron reduced form. The structural gene for the enzyme was cloned using a DNA fragment PCR-amplified with the primers designed from N-terminal and internal amino acid sequences. The deduced amino acid sequence shared striking similarity with those of lipoamide dehydrogenases from prokaryotes and eukaryotes. The gene was named lpd. All tested Streptomyces contained one homologue of the lpd gene, which is consistent with the fact that most organisms contain only one lipoamide dehydrogenase.


Spreading of B16 F1 cells on laminin and its proteolytic fragments P1 and E8: involvement of laminin carbohydrate chains.
The properties of EHS laminin and its proteolytic fragments E8 and P1 to promote spreading of B16 F1 murine melanoma cells were studied in short-term adhesion assays. The cells exhibited similar attachment rates but distinct spread morphologies on laminin, P1, and E8 fragments. The extent of spreading and the shape of the cells were quantitatively defined by two geometrical parameters: the surface and the form factor. These parameters were computed with an automatic image analyzer. Wheat germ agglutinin (WGA), applied to laminin-coated substrates, totally blocked cell spreading, but did not modify attachment percentages. Under similar conditions, WGA partially inhibited cell spreading on the E8 fragment and had no effect on the P1 fragment. In Western blot analysis, P1 fragment, contrary to laminin and E8, did not bind WGA. Laminin galactosylation and cell treatment with alpha-lactalbumin, which should prevent cell galactosyltransferase (GalTase) from binding to N-acetylglucosamine (GlcNAc) residues of the substrate, had no effect on the spreading ability of B16 F1 cells. The role of laminin N-linked carbohydrate chains in the induction of B16 F1 cell spreading was studied further after endoglycosidase F (Endo F) treatment of the substrates. The loss of carbohydrate chains was estimated by the reduction of iodinated lectin binding and by SDS-PAGE. Endo F treatment of laminin (85% of WGA binding inhibition) and E8 (40-50%) had no effect on cell spreading. In contrast, Endo F treatment of P1 fragment (85% of Con A binding inhibition) reduced both cell surface and form factor of B16 F1 cells. These results suggest that: (i) other spreading systems may act in concert with or in place of GalTase/GlcNAc interactions, (ii) the N-linked sugar chains of P1, which are not recognized by WGA, are involved in the spreading process of B16 F1 cells on this fragment, (iii) the epitopes of E8 fragment and E8 domain in laminin which are responsible for spreading are differently masked by WGA, (iv) the binding of WGA to laminin may impair cell spreading by steric hindrance.


Ofuji's disease: high circulating titers of IgG and IgM directed to basal cell cytoplasm.
A patient with Ofuji's eosinophilic pustulosis and peculiar immunofluorescence findings is described. High titers of circulating IgG and IgM have been found directed to the cytoplasm of the basal cells of epidermis and the outer sheath of hair follicles. Such antibodies appear to be related to the course of the disease.


Preliminary studies on scoring micronuclei by computerised image analysis.
Initial studies of the use of computerised image analysis to determine micronucleus frequencies in human lymphocytes that have completed one nuclear division are described. Two methods, based on (a) bromodeoxyuridine incorporation and (b) cytokinesis blocking with cytochalasin-B, were studied. The former method is directly amenable to automation. Cytokinesis-blocked cells could not be automatically recognised by image analysis but it was possible to obtain the correct micronucleus frequency from the integrated optical density histograms by using the mononucleate/binucleate cell ratio obtained by visual analysis. The mean (+/- 1 S.E.) integrated optical density of X-ray-induced micronuclei was 11.2% (+/- 1.1) of that measured for nuclei of G1 cells.


Intersexual and Intrasexual Differences in Mate Selection Preferences Among Lesbian Women, Gay Men, and Bisexual Women and Men.
Sex differences in mating strategies and partner preferences are well established. However, most research solely focused on heterosexual women and men. We examined the mate selection, marriage, and age preferences of a sample of lesbian women, gay men, and bisexual women and men (LGB) who took part in an online dating survey. Additionally, we analyzed inter- and intrasexual differences in these preferences. A total of 710 participants rated the importance of 82 mate selection criteria and 10 marriage criteria, and they also indicated their age preferences and short-term and long-term relationship orientation. An exploratory factor analysis suggested 11 relevant domains of mate selection in the LGB sample, with sex, age, and long-term relationship orientation being relevant predictors of differences in these domains. We compared the LGB data with data collected from 21,245 heterosexual women and men on the same mate selection criteria. Results showed that the participants' sex was the most important predictor of differences in mate selection and marriage preferences, while intrasexual variables (sexual orientation and relationship orientation) explained only a small part of the variance. We incorporated the results into the current discussion about partner preferences and sexual orientation.


Pathogenesis of dermatophytosis.
Despite the superficial localization of most dermatophytosis, host-fungus relationship in these infections is complex and still poorly elucidated. Though many efforts have been accomplished to characterize secreted dermatophytic proteases at the molecular level, only punctual insights have been afforded into other aspects of the pathogenesis of dermatophytosis, such as fungal adhesion, regulation of gene expression during the infection process, and immunomodulation by fungal factors. However, new genetic tools were recently developed, allowing a more rapid and high-throughput functional investigation of dermatophyte genes and the identification of new putative virulence factors. In addition, sophisticated in vitro infection models are now used and will open the way to a more comprehensive view of the interactions between these fungi and host epidermal cells, especially keratinocytes.


Properties of Na-K pump in primary cultures of kidney cells.
Activities related to Na-K transport were measured in cell cultures of ground squirrel kidney cortex in order to compare these cells with those of intact kidney and of continuous cell lines. A microsomal preparation containing plasma membrane Na,K-ATPase from fresh kidney showed twice the activity of a similar preparation from 72-hour cultured cells. Na,K-ATPase of homogenates of 72-hour cells showed one-third to one-fourth the specific activity of that from 6-hour cultured cells. The associated K-dependent phosphatase activity also declined as a function of time in culture. The ouabain-sensitive influx of K into 6-hour cultured cells was twice as great as the K influx into 72-hour cells. The number of sites binding 3H-ouabain in intact cultured cells declined 81% on a cell protein basis between 6 and 72 hours in culture. This decline in ouabain binding sites was relatively greater than that of K influx, so that the K turnover number increased over this same time period. The decline in ouabain-sensitive K influx during culture was complementary to an increase in furosemide-sensitive K influx. Measurements of unidirectional and net K fluxes showed that there were three components of K influx into 3-day cultured cells: ouabain-sensitive Na:K exchange, furosemide-sensitive K:K exchange, and K diffusion. In the 6-hour cultures, however, there was no furosemide-sensitive K:K exchange. Thus, after three days in culture ground squirrel kidney cells lose a feature characteristic of the original parent cells (high Na,K-ATPase activity), and gain a feature common to many undifferentiated cultured cells (furosemide-sensitive K:K exchange).


The effect of diet and litter size on the elimination of 2,4,5,2',4',5'-[14C]hexachlorobiphenyl from lactating mice.
It was shown that 2,4,5,2',4',5'-hexachlorobiphenyl (6-CB) administered to adult female mice accumulated in their nursing offspring more rapidly than a dose administered to weanling mice when treated animals were bred at equivalent ages. This suggested that the PCB was eliminated from the maternal animal relative to its time of sequestration into storage depots. Using a model which more closely approximates conditions during human lactation, the influence of a high-fat diet and decreased litter size on this phenomenon was examined. Female ICR mice were treated with 4 mg/kg [14C]-6-CB as 13-g weanlings (dW) at 3 weeks of age or as adults (dA) at 11 weeks of age. All animals were mated at 11 weeks of age. On Day 1 of pregnancy, mice were placed on a low-fat (11.5% of the total calories) or high-fat (43.8% of total calories) diet. At parturition, litters were adjusted to either two or eight within each diet group. Elimination of maternal 6-CB was determined by assessing radioactivity in offspring carcasses on Day 15 of gestation or Day 1, 3, 5, 10, or 15 postpartum. Consumption of a high-fat diet significantly extended the t1/2 of elimination of 6-CB from mothers nursing a litter of two in the dW group (low fat = 7.3 days; high fat = 12.4 days) and in both the dW and dA groups nursing litters of eight (dW: low fat = 4.6 days; high fat = 6.8 days; and dA: low fat = 1.8 days; high fat = 3.0 days). Within diet and group, reducing litter size to two also significantly decreased the rate of elimination of 6-CB from maternal animals. 6-CB was eliminated to offspring more rapidly from the dA group when compared to the dW group regardless of diet in animals nursing litters of eight. This relationship was not observed in maternal animals nursing litters of two. In general, exposure to a high-fat diet increased the t1/2 of elimination of 6-CB from maternal animals. Reducing litter size had a greater influence and also masked the ordered mobilization of 6-CB relative to its time of sequestration. Thus, under experimental conditions which more closely mimic the human situation, 6-CB was eliminated less rapidly in the rodent, and sequential 6-CB doses were equally available to nursing offspring.


Association of social support and socio-demographic characteristics with poor self-rated health and depressive symptomatology among single mothers in Cyprus: a descriptive cross-sectional study.
The number of single-parent families headed by mothers is rapidly growing worldwide. A large part of the international literature reveals that single motherhood is associated with increased levels of chronic stress, mainly due to economic distress and reduced levels of social support, which may eventually lead to physical and psychological illness. Most published research comes from Northern Europe and the US, while it is accepted that both social welfare systems and societal factors vary substantially across countries. These issues haven't been explored in Southern Europe and this study aims to fill this gap by a) assessing the health of single mothers in Cyprus in terms of self-assessed general health and the prevalence of clinical depressive symptoms and b) investigating the effect of perceived social support relation to their health status. General health was assessed in terms of Self-Rated Health (SRH), while the prevalence of clinical depressive symptoms was assessed with the Center of Epidemiological Studies-Depression Scale (CES-D). Perceived social Support was assessed with the Social Provision Scale. All scales were completed anonymously and voluntary by 316 single mothers. Univariable and multivariable associations between SRH and depressive symptoms with socio-demographic characteristics were investigated using chi-square tests and in multivariable backward stepwise logistic regression models respectively. Odd ratio of clinically significant depressive symptoms and SRH across decreasing levels of social support were estimated in logistic regression models. The prevalence of depressive symptoms (CES-D score ≥ 22) was 38.9 %, which is almost three times greater than the general population. Strong associations with all health assessment tools were observed with variables relating to the lowest monthly family income and the presence of economic difficulties, unemployment, the single motherhood status and pre-existing illness. Social support as perceived by the mothers displayed a strong negative independent association with all tools, even after adjusting confounders. These findings can be a challenge for health care professionals, especially those working in the field of community-family nursing and highlight the necessity of interventions and strategies at community level in order to support this vulnerable population group.


Mineralocorticoid receptor antagonists for therapy of coronary artery disease and related complications.
The perception of aldosterone action to be restricted to regulation of fluid balance via sodium reabsorption and potassium excretion is incomplete; plenty of experimental and clinical studies have shown that aldosterone plays a pivotal role in a variety of (patho-) physiologic conditions within the cardiovascular continuum. Deleterious effects include cardiovascular inflammation, endothelial dysfunction, structural and electrical remodelling. Mineralocorticoid receptor antagonists (MRAs), such as spironolactone and eplerenone, prevent some of these maladaptive effects on the cardiovascular system and have proven to be a highly efficacious pharmacological therapy. In this article we review the current clinical impact of MRAs in the treatment of coronary artery disease (CAD) and its related complications, for example, acute myocardial infarction (MI) and chronic heart failure.


Zimberelimab: First Approval.
Zimberelimab (®) is an anti-programmed cell death protein-1 (PD-1) monoclonal antibody being developed by Gloria Biosciences, Arcus Biosciences and Taiho Pharmaceutical Co. for the treatment of various cancers including cervical cancer, non-small cell lung cancer and classical Hodgkin's lymphoma. Based on the results of a phase II trial, zimberelimab was recently approved for marketing in China as treatment for relapsed or refractory classical Hodgkin's lymphoma. This article summarizes the milestones in the development of zimberelimab leading to this first approval.


Gas chromatographic-mass spectrometric assessment of the pharmacokinetics of amineptine and its main metabolite in volunteers with liver impairment.
A pharmacokinetic study of amineptine (Survector) and its C5 metabolite, resulting from a beta-oxidation of the heptanoic acid side-chain, was undertaken with ten human volunteers, who received a single 100-mg tablet of amineptine orally. They were affected with liver impairment in order to determine if this situation would alter greatly the pharmacokinetic parameters. The internal standard was the octanoic acid homologue. Analyses were carried out by gas chromatography (GC) and GC-mass spectrometry using TMS ester derivatives. Plasma samples were extracted using a C18 reversed-phase cartridge at pH 4.0. Mass fragmentographic measurements on the plasma samples were performed on the m/z ions (M + H)+ and (base peak)+ using ammonia chemical ionization. The global evaluation of precision was good and the coherence between the two modes of measurements, (base peak)+ and (M + H)+ ions, gave a regression factor r close to unity. For amineptine the total body clearance and mean residence time were accurate and precise with eight volunteers, but only four volunteers showed such coherent data for the slope of the elimination curve, beta, and half-life. However, the beta value, half-life and mean residence time of the C5 metabolite were accurate and precise with seven, eight and ten volunteers, respectively. It is concluded that the drug was still detoxified at normal levels.


Malignant Peripheral Nerve Sheath Tumors are not a Feature of Neurofibromatosis Type 2 in the Unirradiated Patient.
The published literature suggests that malignant peripheral nerve sheath tumors (MPNST) occur at increased frequency in neurofibromatosis type 2 (NF2). A recent review based on incidence data in North America showed that 1 per 1000 cerebellopontine angle nerve sheath tumors were malignant. To determine whether MPNST occurred spontaneously in NF2 by reviewing our NF2 database. The prospective database consists of 1253 patients with NF2. One thousand and nine are known to be alive at last follow-up. The presence and laterality/pathology of vestibular schwannoma at diagnosis and last follow-up was sought. There were no cases of spontaneous MPNST with 2114 proven (n = 1150) and presumed benign (n = 964) vestibular schwannomas found. Two patients had developed MPNST (1 presumed) after having previously undergone stereotactic radiosurgery for a vestibular schwannoma. In this series, and from the literature, malignant transformation of a vestibular schwannoma was not a feature of NF2 in the unirradiated patient. NF2 patients should not be told that they have an increased risk of malignant change in a vestibular schwannoma unless they undergo radiation treatment. However, very much larger datasets are required before it can be determined whether there is any association between NF2 and MPNST in the unirradiated patient.


Dlg5 interacts with the TGF-β receptor and promotes its degradation.
Discs large homolog 5 (Dlg5) is a member of the membrane-associated guanylate kinase adaptor family of proteins and is involved in epithelial-to-mesenchymal transition via transforming growth factor-β (TGF-β) signaling. However, the mechanism underlying the regulation of TGF-β signaling is unclear. We show here that Dlg5 interacts and colocalizes with both TGF-β type I (TβRI) and type II (TβRII) receptors at the plasma membrane. TβRI activation is not required for this interaction. Furthermore, the overexpression of Dlg5 enhances the degradation of TβRI. Proteasome inhibitors inhibited this enhanced degradation. These results suggest that Dlg5 interacts with TβRs and promotes their degradation.


Transcription by RNA polymerase II during Acanthamoeba differentiation.
The rates of transcription of several protein coding genes during Acanthamoeba differentiation have been examined by nuclear run-on and RNase protection assays. During early encystment, transcription by RNA polymerase II increases approximately 4-fold, whereas transcription by RNA polymerases I and III is decreased, as previously described. The rates of transcription from a wide variety of individual genes are only slightly affected during the first 16 h of encystment, although profilin gene expression is markedly increased. The levels of mRNAs encoding TPBF, TATA binding protein, cyclin-dependent kinase, protein disulfide isomerase, profilin, myosin II heavy chain, ubiquitin and extendin are stable during mature cyst formation, whereas mRNAs encoding actin, S-adenosyl methionine synthase and tubulin are substantially decreased in abundance within 16 h of starvation-induced encystment. We conclude that in contrast to the negative regulation of large rRNA and 5S rRNA synthesis during differentiation, the RNA polymerase II transcription apparatus is not negatively regulated. Control of Acanthamoeba differentiation is likely to be mediated by positive regulation of genes necessary for cyst maturation.


Analysis of CDKN2A gene alterations in recurrent and non-recurrent meningioma.
Assessment of the risk of recurrence is essential to determine the therapeutic strategy of meningioma treatment. Many relapsing or aggressive meningiomas show elevated mitotic and/or Ki67 indices, reflecting cell cycle deregulation. As CDKN2A is a key tumor suppressor gene involved in cell cycle control, we investigated whether CDKN2A alterations may be involved in tumor recurrence. We carried out a comparative analysis of 17 recurrent and 13 non-recurrent meningiomas. CDKN2A single nucleotide variations (SNVs), deletions, methylation status of the promotor, and p16 expression were investigated. Results were correlated with the recurrent or non-recurrent status and clinicopathological data. We identified a CDKN2A SNV (NM_000077, exon2, c.G442A, p.Ala148Thr) in five meningiomas that was significantly associated with recurrence (p = 0.03). This mutation, confirmed by Sanger sequencing and referenced in the COSMIC database in various cancers, has not been reported in meningioma. The presence of one of the three following CDKN2A alterations-p.(Ala148Thr) mutation, whole homozygous or heterozygous gene loss, or promotor methylation > 8%-was observed in 13 of the 17 relapsing meningiomas and was strongly associated with recurrence (p < 0.0001) and a Ki67 labeling index > 7% (p = 0.004). We report an undescribed p.(Ala148Thr) CDKN2A mutation in meningioma that was only present in relapsing tumors. In our series, CDKN2A gene alterations were only found in recurrent meningiomas. However, our results need to be evaluated on a larger series to ensure that these CDKN2A alterations can be used as biomarkers of recurrence in meningioma.


Esophageal perforation following pedicle screw placement for the treatment of upper thoracic spinal tuberculosis: a case report and review of the literature.
The technique of posterior pedicle screw fixation has already been widely applied in the treatment of upper thoracic spinal tuberculosis. However, lesions of tuberculosis directly invade the vertebrae and surrounding soft tissues, which increases the risk of esophageal perforation induced by the posterior pedicle screw placement. Herein, we report the first case of esophageal perforation following pedicle screw placement in the upper thoracic spinal tuberculosis, and describe the underlying causes, as well as the treatment and prognosis. A 48-year-old female patient with upper thoracic spinal tuberculosis presented sputum-like secretions from the wound after she was treated with one-stage operation through the posterolateral approach. Endoscopy was immediately conducted, which confirmed that the patient complicated with postoperative esophageal perforation caused by screws. CT scan showed that the right screw perforated the anterior cortex of the vertebrae and the esophagus at the T4 level. Fortunately, mediastinal infection was not observed. The T4 screw was removed, Vacuum Sealing Drainage (VSD) was performed, and jejunum catheterization was used for enteral nutrition. After continuous treatment with sensitive antibiotics for 2.5 months and 5 times of VSD aspiration, the infected wound recovered gradually. With 18-month follow-up, the esophagus healed well, without symptoms of dysphagia and stomach discomfort, and CT scan showed that T2-4 had complete osseous fusion without sequestrum. Tuberculosis increases the risk of postoperative esophageal perforation in a certain degree for patients with upper thoracic tuberculosis. The damages to esophagus during the operation should be prevented. The screws with the length no more than 30 mm should be selected. Moreover, close monitoring after operation should be conducted to help the early identification, diagnosis and treatment, which could help preventing the adverse effects induced by the delayed diagnosis and treatment of esophageal perforation.


Forensic isotope analysis leads to identification of a mutilated murder victim.
The relationship between diet, geographic location and isotopic composition of human tissue has been successfully exploited in archaeological and palaeodietary studies, i.e. on ancient man, but cases in which this approach has been applied to present-day people e.g. to aid identification of mutilated or deteriorated bodies are far and few between. Stable isotope data are presented here from a case where for the first time stable isotope based intelligence aided victim identification by DNA analysis and subsequent apprehension of the perpetrators thus demonstrating that it is possible in principal for stable isotope data of present-day people to be useful for human provenancing, i.e. to yield valuable information about a person's life history and geographic origin.


The impact of nephrostomy balloon inflation volume on post percutaneous nephrolithotomy hemorrhage.
the study aims to match different volumes of nephrostomy balloon inflation to point out the foremost effective volume size of post percutaneous nephrolithotomy (PCNL) bleeding control. we have retrospectively reviewed "560" medical records of patients who underwent percutaneous nephrolithotomy between (the years 2017 and 2018) at Prince Hussein Urology Center. The Patients were divided into two teams, group-1 (a number of 280 patients) with nephrostomy balloon inflated concerning three ml and group-2 (a number of 280 patients) the balloon inflated concerning one ml. The preoperative and postoperative hematocrit, the operation duration, the stone size, the postoperative pain severity, the transfusion rate and the duration of hematuria between the two groups were compared during hospitalization. regarding patients with ages (between 18 and 68 years); the preoperative hematocrit (mean values ± SDs) was (40.35% ± 3.57) vs (39.95% ± 3.43) for groups-1 and 2, respectively; the p value=0.066. The postoperative hematocrit was (37.91% ± 3.96) vs (34.38 ± 2.78), respectively; the p value was (0.008); the blood transfusion rate was 11.2% vs 13.4% (the p value was 0.039), respectively. The Postoperative pain score was (4.93 ± 1.44) vs (3.89 ± 1.45) (the p value was 0.012), respectively. increasing the nephrostomy balloon volume to a "3cc" competes for a task to decrease bleeding which was found to be as a secure and considerable effective procedure-related factor. However, the disadvantage of this technique resulted in increasing the postoperative pain in patients undergoing such a procedure.


De novo assembly, characterization, functional annotation and expression patterns of the black tiger shrimp (Penaeus monodon) transcriptome.
The black tiger shrimp (Penaeus monodon) remains the second most widely cultured shrimp species globally; however, issues with disease and domestication have seen production levels stagnate over the past two decades. To help identify innovative solutions needed to resolve bottlenecks hampering the culture of this species, it is important to generate genetic and genomic resources. Towards this aim, we have produced the most complete publicly available P. monodon transcriptome database to date based on nine adult tissues and eight early life-history stages (BUSCO - Complete: 98.2% [Duplicated: 51.3%], Fragmented: 0.8%, Missing: 1.0%). The assembly resulted in 236,388 contigs, which were then further segregated into 99,203 adult tissue specific and 58,678 early life-history stage specific clusters. While annotation rates were low (approximately 30%), as is typical for a non-model organisms, annotated transcript clusters were successfully mapped to several hundred functional KEGG pathways. Transcripts were clustered into groups within tissues and early life-history stages, providing initial evidence for their roles in specific tissue functions, or developmental transitions. We expect the transcriptome to provide an essential resource to investigate the molecular basis of commercially relevant-significant traits in P. monodon and other shrimp species.


The Occurrence Rate and Diameter of Arteries Traveling Near the Mandible and an Assessment of the Relative Hemorrhage Risk in Implant Surgery.
Bleeding in the floor of the mouth during implant surgery is attributed to arterial injuries in the sublingual space. This study aimed to assess the relative hemorrhage risk during implant surgery. We investigated the occurrence rate and diameter of submental and sublingual arteries with special reference to their relationship with the course patterns of these arteries using 26 human cadavers. Three types of arteries were distinguished: main duct (MD), mucoperiosteal branches (MB), and cortical branches (CB). The occurrence rate of MB and CB was significantly high at the central incisor region in the upper part of the mylohyoid muscle, whereas the diameter of the MB and CB was significantly smaller than the occurrence rate of MD at the incisor regions. The occurrence rate of MD in the submental artery was significantly higher at the lateral incisor, canine, and premolar regions in the lower parts, whereas the occurrence rate of MD was significantly lower at the second and third molars in the upper parts. The susceptibility of the submental artery to injury is suggested at the incisors, canine, premolars, and first molar regions during implant surgery.


Measuring light-induced fungal ethylene production enables non-destructive diagnosis of disease occurrence in harvested fruits.
Pathogenic fungi cause enormous losses to fruits, and ethylene (ET) is associated with disease development in fruit crops. In this study, ET production of several fungal pathogens was enhanced by light, probably through the free radicals produced by photochemical reactions. Real-time gas analysis showed a sharp increase in ET production when fungal cultures were moved from dark-to-light (DTL). Similarly, light accelerated ET production in the Botrytis cinerea-infected Arabidopsis thaliana plants even when pyrazinamide, the inhibitor for plant ET synthesis, was applied, suggesting that the fungus is responsible for ET production during host invasion. Furthermore, a sharp increase in ET production after DTL transition was observed in B. cinerea-infected tomatoes and grapes, but not in healthy or physically wounded fruits. Taken together, these findings indicate that the DTL-induced ET is specific to the plant materials with fungal infection, and thus represents a candidate marker for non-destructive disease diagnosis of harvested fruits.


Corrigendum: Vascular endothelial growth factor levels in diabetic peripheral neuropathy: a systematic review and meta-analysis.
[This corrects the article DOI: 10.3389/fendo.2023.1169405.].


Cerebral oxygenation monitoring during resuscitation by emergency medical technicians: a prospective multicenter observational study.
To assess the feasibility and predictive ability of regional cerebral oxygen saturation monitoring during cardiopulmonary resuscitation by emergency medical technicians. This prospective observational study included 33 cardiac arrest patients who received cardiopulmonary resuscitation in a prehospital setting. Patients were connected to a near-infrared spectrometer through two disposable probes immediately after entering the ambulance. The monitor, which showed regional cerebral oxygen saturation readings, was obscured by covering it with a sheet of paper. Regional cerebral oxygen saturation was measured continuously until hospital arrival. Outcome variables included the prehospital return of spontaneous circulation, survival to hospital admission, and survival at 90 days. For patients who survived >90 days after hospital admission (n = 2), the mean regional cerebral oxygen saturation values upon ambulance and hospital arrival were 24% and 60%, respectively; for patients who did not survive (n = 31), the mean regional cerebral oxygen saturation values were 15% and 17%, respectively. Regional cerebral oxygen saturation values increased to a greater extent between ambulance arrival and hospital arrival in patients who survived >90 days (median, 36%; interquartile range, 32-40%) than in those who did not survive (0; 0-6%; P = 0.07). Additionally, regional cerebral oxygen saturation values were not related to the prehospital return of spontaneous circulation or survival to hospital admission. Regional cerebral oxygen saturation could be monitored during resuscitation by emergency medical technicians, and it can be used during physiological monitor-guided cardiopulmonary resuscitation.


Prognostic significance of examined lymph node count in older patients with stage T1N0M0 pulmonary carcinoid tumours: a population-based propensity score-matched analysis.
The optimal number of examined lymph nodes (ELNs) for older early-stage pulmonary carcinoid tumour (PC) patients is unknown. To explore the prognostic effect of the ELN count in older patients with stage T1N0M0 PC resection. Clinical data from the Surveillance, Epidemiology, and End Results database on stage T1N0M0 PC older patients (age ≥ 65 years) who underwent sublobar resection and lobectomy between 2000 and 2018 were retrospectively analysed for two ELNs-stratified (≥ 7 vs. < 7 ELNs) propensity score-matched (PSM) groups. Overall survival (OS) was calculated and compared with Kaplan-Meier analysis and log-rank test, respectively, and the independent prognostic factors were estimated using a Cox proportional hazard model. Among 1077 participants (median dissected LN 4; mean ELNs 6.19 ± 7.04), 393 (36.49%) in the ≥ 7 ELNs group had better 5- and 10-year OS than the < 7 ELNs group (before PSM: 5-year OS = 93.01 vs. 85.22%, 10-year OS = 72.38 vs. 58.99%, p < 0.001; after PSM: 5-year OS = 93.12 vs. 85.97%, 10-year OS = 75.25 vs. 60.03%, p = 0.001). Subgroup analysis stratified by histologic type and surgical method showed a similar survival trend. Age-stratified analysis showed that, compared with the < 7 ELNs group, the ≥ 7 ELNs group had better 5- and 10-year OS but only better 5-year OS in participants > 75 years. Compared with the < 7 ELNs group, subgroup analysis by tumour size showed superior OS with 1.1-3.0 cm tumours in the ≥ 7 ELNs group, but no significant intergroup difference with tumours < 1.0 cm. Multivariate Cox analysis showed ≥ 7 ELNs was associated with improved OS. Higher ELNs correlated with increased long-term survival in older early‑stage PC patients, and a minimum of 7 ELNs are recommended for prognostication in these patients (especially those aged 65-75 years, with tumour size 1.1-3.0 cm).


Positive Association Between Limbic Metabotropic Glutamate Receptor 5 Availability and Novelty-Seeking Temperament in Humans: An 18F-FPEB PET Study.
Heritable temperament traits have been linked to several neuropsychiatric illnesses, including disorders associated with metabotropic glutamate receptor 5 (mGluR5) and dopaminergic dysfunctions. Considering its modulating effect on neurotransmission, we hypothesized that cerebral mGluR5 availability is associated with temperament traits in healthy humans. Forty-four nonsmoking healthy volunteers (mean age ± SD, 40 ± 14 y; age range, 22-66 y; 22 women) were included in this cross-sectional investigation. Brain mGluR5 availability was quantified on both a voxel-by-voxel and a volume-of-interest basis using the total distribution volume of the radioligand 18F-3-fluoro-5-[(pyridin-3-yl)ethynyl]benzonitrile (18F-FPEB) with 90-min dynamic PET and arterial input function. Moreover, glutamate-glutamine concentrations in the anterior cingulate cortex were measured using MR spectroscopy. These measures were related to the temperament traits of the 240-item Cloninger temperament and character inventory using a regression analysis with age and sex as nuisance variables. High novelty-seeking temperament was robustly associated with increased mGluR5 availability in various regions including the thalamus (r = 0.71; the strongest association), amygdala, parahippocampus, insula, anterior and posterior cingulate cortex, and several primary sensory areas (all r > 0.58; P < 0.05, corrected for familywise error). These associations were specific because no correlations were found with other temperament scales or with spectroscopic measures of glutamatergic transmission. Overall, these data posit mGluR5 in key paralimbic areas as a strong determinant of the temperament trait novelty seeking. These data add to our understanding of how brain neurochemistry accounts for the variation in human behavior and strongly support further research on mGluR5 as a potential therapeutic target in neuropsychiatric disorders associated with abnormal novelty-seeking behaviors.


Nucleotide and deduced amino acid sequence of stp: the bacteriophage T4 anticodon nuclease gene.
Pre-existing host tRNAs are reprocessed during bacteriophage T4 infection of certain Escherichia coli strains. In this pathway, tRNALys is cleaved 5' to the wobble base by anticodon nuclease and is later restored in polynucleotide kinase and RNA ligase reactions. Anticodon nuclease depends on prr, a locus found only in host strains that restrict T4 mutants lacking polynucleotide kinase and RNA ligase; and on stp, the T4 suppressor of prr restriction. stp was cloned and the nucleotide sequences of its wild-type and mutant alleles determined. Their comparison defined an stp open reading frame of 29 codons at 162.8 to 9 kb of T4 DNA (1 kb = 10(3) base-pairs). We suggest that stp encodes a subunit of anticodon nuclease, perhaps one that harbors the catalytic site; while additional subunits, such as a putative prr gene product, impart protein folding environment and tRNA substrate recognition.


Stereo-Encephalography Versus Subdural Electrodes for Seizure Localization.
In today's practice, epileptologists and neurosurgeons have several options for seizure localization with intracranial electrodes during phase II evaluations. Traditionally, centers in North America have used subdural electrode grids (SDE or SDG) for intracranial seizure localization. However, improvements in technology led to the popularization of stereo-encephalography (SEEG) using depth electrodes. Epilepsy surgery centers highest in volume now offer both SDE and SEEG for seizure localization. This article provides a general guide for considering SEEG versus SDE for intracranial seizure localization based on our experience with both. Several paradigmatic cases are used illustrate the advantages and disadvantages of the different approaches.


Validation of the Shin Pain Scoring System: A Novel Approach for Determining Tibial Bone Stress Injuries.
The incidence of adolescent overuse injuries, including bone stress injuries (BSIs), is on the rise. The identification of a BSI in the early stages is key to successful treatment. The Shin Pain Scoring System (SPSS) was developed to aid clinicians in identifying patients with a BSI. The SPSS will correlate with magnetic resonance imaging (MRI) grading of a BSI in an adolescent population. Cohort study (diagnosis); Level of evidence, 2. Enrolled in this study were 80 adolescent high school athletes between the ages of 13 and 18 years participating in a variety of sports with more than 1 week of atraumatic shin pain. The SPSS questionnaire was completed for each participant, and physical examination findings were recorded. Each question and physical examination item was allotted a point value, which totaled 29 points. Radiographs and MRI scans of both lower legs were obtained for each participant. The SPSS score was statistically analyzed using logistic regression, a classification matrix, and a 2 × 2 contingency table to evaluate validity and predictability. Logistic regression analysis of our data determined that 3 categories of SPSS scores provided the highest diagnostic value when compared with MRI grading based on the Fredericson classification (0-4). The SPSS correctly identified 43.5% of injuries for category 1 (MRI grades 0-1), 62.5% for category 2 (MRI grade 2), and 50.0% for category 3 (MRI grades 3-4). Overall, the SPSS correctly identified the degree of BSI in 54.4% of all tibias studied. Binary analysis for validity demonstrated a sensitivity of 96%, specificity of 26%, positive predictive value of 76%, and negative predictive value of 71% for the SPSS relative to the "gold standard" MRI results. The SPSS is a potentially valid method to identify tibial BSIs, given the sensitivity and negative and positive predictive values. It also provides helpful categorization to alert clinicians to the presence of a BSI and direct further diagnostics and/or interventions. The SPSS should be considered as an additional tool to use when evaluating adolescents with atraumatic tibial BSIs.


The non-visual impact of eye orientation on eye-hand coordination.
When a peripheral visual stimulus is briefly presented in an empty surround, and an observer is required, after a delay of a few seconds, to point toward the remembered location of that target, the responses are strongly influenced by eye orientation at the time of pointing. Remembered locations, as indicated in total darkness, are typically more precise (more reproducible across trials) when the subject's eyes are aimed toward the target before pointing, than when initial fixation (straight ahead) is maintained during pointing. Furthermore, when the eyes are aimed toward the target, the indicated directions are usually biased toward less eccentric locations than those indicated with eyes aimed straight ahead. These differences in scatter and in bias arise regardless of whether the eye movement toward target location, which precedes pointing, is made while the target is visible or occurs thereafter in total darkness, thus demonstrating that non-visual stimuli associated with eye orientation affect the spatial memory used by the skeletal muscle system.


[Problems in the collection and evaluation of menarche data, exemplified by empirical data from two Bremerhaven child development studies].
Two Bremerhaven growth studies serve as examples for analysing methods of collecting and evaluating data on menarche age. Problems are outlined which arise when inadequate methods are used.


Obesity as a risk factor for certain types of cancer.
In conclusion, obesity has been associated with increased risk for a number of different types of cancer. The evidence has been most consistent for endometrial cancer, breast cancer in postmenopausal women, and renal cell cancer. More variable results have been reported for colorectal, prostate and pancreatic cancer. Possible mechanisms by which obesity may influence cancer risk include alteration in hormonal patterns, including sex hormones and insulin, and factors such as the distribution of body fat and changes in adiposity at different ages. The increasing prevalence of obesity in many parts of the world emphasizes the importance of learning more about the relationship between obesity and cancer and the mechanisms involved in their interaction.


Treating Stubborn Cardiac Arrhythmias-Looking Toward the Future.
As animals can develop significant side effects or remain refractory while on antiarrhythmic medical therapy for tachyarrhythmias, interventional therapies are progressively being explored. This review will highlight the principles and utilities of implantable cardioverter-defibrillators, electrophysiological mapping and catheter ablation, three-dimensional electroanatomical mapping, and stereotactic arrhythmia radiotherapy. In particular, three-dimensional electroanatomical mapping is emerging as an adjunct electrophysiology tool to facilitate activation, substrate, and pace mapping for intuitive analysis of complex tachyarrhythmias. Unlike antiarrhythmic medications, these modalities offer potential for decreasing risk of sudden death and even permanent termination of tachyarrhythmias.


Stent-assisted coil embolization of intracranial wide-necked aneurysms.
The endovascular treatment of cerebral aneurysms with coils poses significant technical challenges, particularly with respect to wide-necked aneurysms. We present the results of our initial experiences in using a stent for endovascular treatment of aneurysms, with an emphasis on potential applications, technical aspects, and associated complications. Twenty-three wide-necked aneurysms from 22 patients were treated during the 13-month study period. Seven patients presented with subarachnoid hemorrhage. Aneurysms were located at the internal carotid artery (n=14), the vertebral artery (n=3), the basilar artery (n=5), and the middle cerebral artery (n=1). A Neuroform stent2 was used for stent-assisted procedures. Premedication with antithrombotic agents was available for unruptured cases. Postprocedural antithrombotic medication was prescribed for all patients. Nineteen aneurysms were primarily stented, followed by coil placement. For five of these aneurysms, stenting was performed subsequent to failure of an attempt to frame with an initial coil. Stenting for the remaining four aneurysms was performed as a rescue procedure to prevent the migration of previously placed coils. Complete occlusion was obtained in ten aneurysms, nearly complete occlusion (95% or more occluded) in 11 aneurysms, and partial occlusion (less than 95% occluded) in one aneurysm. In one aneurysm, we failed to navigate the microcatheter into the aneurysmal sac through the interstices of the stent. Stent thrombosis was noted during the procedure in one patient. Hemorrhagic complication on the 25th day after the procedure was noted in one patient. No procedure-related complications were observed during the procedure or during follow-up in the remaining 20 patients, including seven patients who did not receive antithrombotic agents prior to endovascular treatment owing to recent subarachnoid hemorrhage. To overcome the technical limitation in the coiling of wide-necked aneurysms, stent-assisted coil embolization may be a technically feasible and relatively safe method, even though longer periods of follow-up are required.


External root resorption: an experimental radiographic evaluation.
Radiographs of a human mandibular premolar, in which five holes (resorptive defects) of differing diameters were drilled before its replacement into a human mandible, were evaluated by 11 dental faculty members. The radiographs were made at various exposure times and angulations. The observers' results were evaluated statistically. It was found that small resorptive defects were significantly more difficult to identify than larger ones. Also, angulation, exposure time, and location of the defects as defined in this study had no significant effect on the ability of observers to accurately identify them.


Association of Shoulder Problems in Persons With Spinal Cord Injury at Discharge From Inpatient Rehabilitation With Activities and Participation 5 Years Later.
To examine whether musculoskeletal shoulder pain and limitations in shoulder range of motion (ROM) at discharge from first rehabilitation are associated with activities and participation restrictions 5 years later in persons with spinal cord injury (SCI). Prospective cohort study. Eight specialized SCI rehabilitation centers. Subjects (N=138) with an SCI admitted for first rehabilitation. Not applicable. Peak power output (POpeak), Wheelchair Skills Test (WST), FIM motor score, ability to transfer, Physical Activity Scale for Individuals with Physical Disabilities (PASIPD), mobility range and social behavior subscales of the Sickness Impact Profile 68 (SIPSOC), and employment status. Mean age of the subjects at discharge was 39 years, 72% were men, 32% had tetraplegia, and in 65% the SCI was motor complete. At discharge, 39% reported shoulder pain and 32% had a limited shoulder ROM. In the analyses of variance, shoulder ROM limitation, but not shoulder pain, was associated with all but 1 outcome at 5 years. In the regression analyses, ROM limitations of the shoulder were negatively associated with the ability to transfer (P=.004), FIM motor scores (P<.001), and return to work (P= .027) 5 years after discharge. No significant associations were found with POpeak, WST performance time, SIPSOC, and PASIPD. The presence of limitations in shoulder ROM, but not shoulder pain, at discharge is associated with limitations in activities and employment status 5 years later.


Rapid and portable, lab-on-chip, point-of-care genotyping for evaluating clopidogrel metabolism.
Dual antiplatelet therapy with aspirin and a platelet P2Y12 receptor inhibitors (clopidogrel, prasugrel, ticagrelor) is a cornerstone of antithrombotic treatment in patients with acute coronary syndromes (ACS). Clopidogrel has been the standard of care for nearly a decade; however, its clinical efficacy is influenced by a considerable inter-patient variability in response, clearly associated to cytochrome P (CYP) enzyme genetic variations. We used a novel point-of-care lab-on-chip instrument to genotype ACS patients in order to identify carriers of the ATB-binding cassette ABCB1 3435, CYP2C19*2 and CYPC2C19*17 alleles and adjust the pharmacological approach accordingly. Between October 2012 and January 2013, 160 ACS patients were enrolled at the Cardiology Unit of the Ospedale Niguarda Cà Granda and genotyped at the patients' point-of-care using the newly developed Q3 portable real-time PCR instrument, which remarkably scored the CYP2C19*2, CYP2C19*17, and ABCB1 3435 alleles in a time of 70 min from DNA extraction to final genotype calls; concordance with the other gold-standard genotyping techniques was 100%. The Q3 instrument proved to be as reliable as the current conventional techniques. As genotyping in the ACS setting cannot be delegated to centralised clinical laboratories for reasons of time, genotyping at the patients' bedside provides an opportunity to conduct large-scale randomised trials in order to assess whether adding genotype data to clinical variables improves clinical outcomes.


Implementation of zero or near-zero fluoroscopy catheter ablation for idiopathic ventricular arrhythmia originating from the aortic sinus cusp.
Complete elimination of fluoroscopy during radiofrequency ablation (RFA) of idiopathic ventricular arrhythmias (IVAs) originating from the aortic sinus cusp (ASC) is challenging. The aim was to assess the feasibility, safety and a learning curve for a zero-fluoroscopy (ZF) approach in centers using near-zero fluoroscopy (NOX) approach in IVA-ASC. Between 2012 and 2018, we retrospectively enrolled 104 IVA-ASC patients referred for ZF RFA or NOX using a 3-dimensional electroanatomic (3D-EAM) system (Ensite, Velocity, Abbott, USA). Acute, short and long-term outcomes and learning curve for the ZF were evaluated. ZF was completed in 62 of 75 cases (83%) and NOX in 32 of 32 cases (100%). In 13 cases ZF was changed to NOX. No significant differences were found in success rates between ZF and NOX, no major complications were noted. The median procedure and fluoroscopy times were 65.0 [45-81] and 0.0 [0-5] min respectively, being shorter for ZF than for NOX. With growing experience, the preference for ZF significantly increased-43% (23/54) in 2012-2016 vs 98% (52/53) in 2017-2018, with a simultaneous reduction in the procedure time. ZF ablation can be completed in almost all patients with IVA-ASC by operators with previous experience in the NOX approach, and after appropriate training, it was a preferred ablation technique. The ZF approach for IVA-ASC guided by 3D-EAM has a similar feasibility, safety, and effectiveness to the NOX approach.


PTSD and post-traumatic stress spectrum in the Italian Navy Operational Divers Group and corps of Coast Guard Divers employed in search and rescue activities in the Mediterranean refugees emergences and Costa Concordia shipwreck.
Rescue personnel is at high risk for Post-traumatic Stress Disorder (PTSD) because of the possible repetitive exposition to "cruel details of traumatic events" (DSM-5). Literature reported PTSD rates in combat exposed veterans, although the Italian Navy military personnel has been frequently involved in no-war activities in most recent years, such as Search and Rescue (SAR) activities of civilians involved in catastrophic events. The study aimed at exploring the prevalence of PTSD and its impact on social and work functioning among divers of the Italian Navy employed in the SAR activities for the Costa Concordia shipwreck (2012), the collapsed control tower of the Genoa harbour (2013), and the "Mare Nostrum" and "Triton" immigrant emergency Operations in the Mediterranean Sea. The 85 Italian Navy and Coast Guard Divers on duty for these activities were involved in the study and forty fulfilled the assessments, including the: Impact Event Scale (IES-r), Trauma and Loss Spectrum Self-Report (TALS-SR) and Work and Social Adjustment Scale (WSAS). In the three years before enrollment 77.5% of the sample (n = 31) performed at least one rescue operation, with full and partial DSM-5 PTSD rates being 7.5% and 22.5%, respectively. A correlation emerged between WSAS domains or total scores and TALS-SR score domains for PTSD. Rescue Navy personnel resulted to be at risk for post-traumatic stress symptoms, and these subthreshold PTSD manifestations appear to impact on functioning. Further studies are needed to better investigate PTSD risk and resilience factors in this particular group of workers.


Escherichia coli primary aortitis presenting as sequelae of incompletely treated urinary tract infection.
We report a rare case of nonaneurysmal infectious aortitis (IA) with the causative microorganism being Escherichia coli. The patient was a 78-year-old man who presented with a 3-week history of abdominal pain, fevers, and anorexia after treatment for a urinary tract infection. The patient had positive blood cultures and a computed tomography scan that had signs of IA. He was treated with intravenous antibiotics and extra-anatomic revascularization with excision and debridement of the infected aortic segment with a good outcome. IA is an uncommon condition with a high mortality rate; however, if diagnosed early, it can be successfully treated.


Effects of chronic nicotine administration on RBC velocity in mesenteric capillaries of the rat.
The purpose of this study was to determine the effects of chronic administration of nicotine on red blood cell (RBC) velocity in single capillaries of the mesentery. Ten male rats consumed an average of 2.38 mg nicotine/kg/day, an approximate '2 pack' equivalent, in their drinking water for a period of 15-20 weeks. At the end of this time RBC velocity was measured in single capillaries of the mesentery. The data were compared to RBC velocities measured in a group of matched control rats. Red cell velocities in the control and nicotine groups averaged 1.22+/-0.23 and 0.59+/-0.10 mm/sec SEM, respectively. These values were significantly different (p less than or equal to 0.01). It is concluded that chronic administration of nicotine to rats in levels equivalent to tobacco smoking reduces resting capillary blood flow in the mesenteric circulation as indicated by differences in erythrocyte velocity.


In vivo hierarchy of individual T-cell epitope-specific helper T-cell subset against an intracellular bacterium.
Cellular immunity is indispensable for efficient protection against intracellular bacterial infection. CD4+ and CD8+ T cells specific for a variety of antigenic peptides derived from particular bacteria are induced after the infection. T cells recognizing different antigenic peptides have been speculated to have different functions in terms of the protective immunity. We here induced individual CD4+ T cells specific for each antigenic peptide derived from Listeria monocytogenes independently with DNA vaccines using gene gun bombardment and compared the CD4+ T-cell populations for their ability on the specific protective immunity against lethal listerial challenge and analyzed their characteristics.


Reverse atrial remodeling in patients who maintain sinus rhythm after electrical cardioversion: evidence derived from the measurement of total atrial conduction time assessed by PA-TDI interval.
A key mechanism of atrial fibrillation (AF) is atrial remodeling. Total atrial conduction time non-invasively assessed via tissue Doppler imaging (PA-TDI interval) may reflect the degree of electrical and structural atrial remodeling. The purpose of this study was to determine whether the PA-TDI interval is an independent predictor of recurrent AF after successful electrical cardioversion (eCV) and if it suggests reverse atrial remodeling. Fifty-one patients (mean ± SD 66 ± 10.6 years; 35 % women) with persistent AF and successful eCV were prospectively enrolled. The PA-TDI interval was measured 6 h and 90 days post-cardioversion. AF relapse was determined via 7-day Holter-ECG immediately after eCV and repeated after 90 days. Early recurrent AF (within 7 days) occurred in 21 patients (41.2 %), whereas after 90-day follow-up 26 patients (51 %) had AF recurrence. PA-TDI interval was longer in patients with AF recurrence within 90 days compared to patients who remained in sinus rhythm (SR) (149.1 ± 8.3 vs. 129.8 ± 10.9 ms, p < 0.0001). Optimal cut-off values for recurrent AF after 7 or 90 days from ROC analysis were 142 and 143 ms, respectively. Furthermore, the PA-TDI interval decreased significantly from baseline in those who remained in SR (129.8 ± 10.9 vs. 125.8 ± 10 ms, p < 0.0001), whereas the PA-TDI interval increased in patients who developed AF after 90 days (149.1 ± 8.3 vs. 152 ± 9 ms, p < 0.0001). The PA-TDI interval is an independent predictor of early and mid-term AF recurrence after eCV. Moreover, our data suggests reverse atrial remodeling in those patients who remained in stable SR.


Real-time PCR and Amplified MTD® for rapid detection of Mycobacterium tuberculosis in pulmonary specimens.
Patients with suspected pulmonary tuberculosis (PTB) in the First Affiliated Hospital, College of Medicine, Zhejiang University. To evaluate the 'Care TB®' real-time polymerase chain reaction (PCR) assay in comparison with the Amplified MTD® Test (AMTD) for the rapid diagnosis of TB. Self-expectorated sputum was collected for direct smear microscopy, culture, real-time PCR and AMTD assay. Performance of the 'Care TB' real-time PCR and AMTD assay were compared using a combination of culture and clinical diagnosis as a reference standard. Of the 178 sputum specimens, 83 were culture-positive; of these, 74 were Mycobacterium tuberculosis complex and 9 strains were non-tuberculous mycobacteria. The overall sensitivities and specificities were respectively 91.6% and 100% for real-time PCR, and 95.2% and 97.9% for AMTD. In the smear-positive specimens, the sensitivities and specificities were respectively 97% and 100% for real-time PCR, and 98.5% and 100% for AMTD. In the smear-negative specimens, the sensitivities and specificities were 70.6% and 100% for real-time PCR, and 82.4% and 97.7% for AMTD. Both real-time PCR and AMTD are rapid and specific tests for detecting M. tuberculosis complex; however, 'Care TB' real-time PCR is more convenient and economical.


Stop SIDS--sleeping solitary supine, sucking soother, stopping smoking substitutes.
The recognition of prone sleeping and maternal smoking as modifiable risk factors for sudden infant death syndrome (SIDS), has drastically decreased SIDS incidence. However, during the last years other factors have become necessary to consider to further reduce the risk of SIDS. Side sleeping implies a greater risk than supine sleeping but is still common. Bed sharing may increase the risk of SIDS, while use of a pacifier seems to be protective. Replacement of maternal smoking with nicotine substitutes is not harmless. To further reduce the risk of SIDS, exclusive supine sleeping should be encouraged and side sleeping discouraged. When the breast-feeding is established, a pacifier can very well be used at bedtime. Bed sharing can increase the risk of SIDS if the infant is below 2-3 months of age, especially if the mother is a smoker. Any nicotine use should be avoided during pregnancy and breast-feeding.


Unlocking Access to Broad Molecular Profiling: Benefits, Barriers, and Policy Solutions.
"Personalized healthcare" is generating new approaches to disease management by considering inter-individual variability in genes, environment, and lifestyle. Technologies such as comprehensive genomic profiling (CGP) are drivers of this shift. Here, we address the significant hurdles to the equitable implementation of CGP into routine clinical practice. This article draws on published evidence on the value of genomic profiling, as well as interviews with nine academic and clinical experts from six different countries to validate findings and test policy proposals for reforms. The potential benefits of CGP extend beyond direct patient outcomes, to healthcare systems with societal and economic impacts. Among key barriers impeding integration into routine clinical practice are the lack of infrastructure to ensure reliable clinical testing and the limited understanding of genomics among healthcare personnel. In addition, the absence of health economic evidence supporting broader use of CGP is creating concerns for payers regarding the systemic benefits and affordability of this technology. Policy proposals that aim to improve equitable patient access to CGP will need to consider new funding models, health technology assessment processes that capture both patient and systemic benefits, and appropriate regulatory standards to determine the quality of genomic profiling tests.


Etiologic Subtypes of Watershed Infarcts.
Two types of watershed infarcts (WI) are recognized. Internal WI are usually attributed to either severe stenosis in large arteries or acute hypotensive events, whereas external WI are thought to be caused by embolism. The aim of this study was to determine the etiologic background and prognosis of external and internal WI in our patients. We reviewed the medical records and diffusion-weighted images of the patients who were admitted to our stroke unit with acute ischemic stroke between January 2012 and November 2014. The demographics, clinical features, radiologic investigations, and other etiologic tests of the patients with internal or external WI were recorded. We determined etiologic stroke subtypes according to the automated Causative Classification System. Fifty-three patients with WI were detected in our registry. Twenty-two (41.5%) of them were women. The mean age was 69 ± 12.8 (33-98) years. Twenty-one (39.6%) patients had external WI: 7 (33.3%) of them had large-artery atherosclerosis (LAA), 8 (38.1%) patients had cardioembolism, 3 (14.3%) patients had stroke due to other causes (vasculitis; n = 3), and etiologic subtype was undetermined in 3 patients (14.3%). Thirty-two (60.4%) patients had internal WI: 21 (65.6.%) of them had LAA, 5 (15.6%) patients had cardioembolism, 3 (9.4%) patients had stroke due to other causes (aneurysm; n = 1, hypercoagulability due to chronic myeloid leukemia; n = 1, vasculitis; n = 1), and etiologic subtype of 3 (9.4%) patients remained cryptogenic. LAA was significantly associated with internal WI (P = .024). Hypertension was more common in patients with internal WI (P = .035). In this series, cardioembolism was the most common etiologic subtype in the patients with external WI, whereas internal WI were significantly associated with LAA. Uncommon causes should also be investigated in cryptogenic patients.


Possible effects of metallosis on spermatozoal apoptotic genes expression in individuals with intramedullary nailing prosthesis.
Seminal quality could be affected by metallosis caused by intramedullary nailing (IMN). Our objectives were to estimate metal ion levels in the seminal plasma of subjects with IMN, to determine their effects on semen parameters and on spermatozoal apoptotic gene expression, and to determine whether these expressed genes could be used as candidate biomarkers of seminal deterioration in individuals with IMN or not. Semen samples were collected from 60 subjects with IMN and 30 age-matched healthy controls. Seminal plasma contents of cobalt (Co), chromium (Cr), and molybdenum (Mo) were assayed. Spermatozoal Bcl-2 and Bax gene expressions were determined. Studied semen parameters were significantly lower in subjects with IMN for ≥5 years in relation to controls while the concentrations of Co, Cr, and Mo in the seminal plasma samples were significantly higher. There were significantly lower spermatozoal Bcl-2 expression, higher Bax expression, and lower Bcl-2/Bax ratio in subjects with IMN for ≥5 years than in controls. In subjects with IMN for ≥5 years, receiver operating characteristic (ROC) curve analysis of studied gene expressions and Bcl-2/Bax ratio were done showing priority of the ratio with 86.7 % sensitivity, 100 % specificity, 100 % positive predictive value, and 93.8 % negative predictive value at cutoff values ≤0.777. Co, Cr, and Mo metals are found at high concentrations in the seminal plasma of individuals with IMN leading to increased spermatozoal apoptotic activity. Spermatozoal Bcl-2/Bax ratio could be used as a candidate biomarker of reproductive disorders in individuals with intramedullary nailing.


Plasma Extracellular Vesicle Serpin G1 and CD14 Levels are Associated with Major Adverse Cardiovascular Events and Major Adverse Limb Events in Patients Undergoing Femoral Endarterectomy.
Plasma extracellular vesicles (EV) are an emerging source of biomarkers for diagnosis and prognosis of cardiovascular disease (CVD). Risk stratification for common adverse events such as major adverse limb events (MALE) and major adverse cardiovascular events (MACE) by an EV blood sample could improve healthcare management by individualising drug therapy or improving informed decision making regarding revascularisations in patients with peripheral artery disease (PAD). As such, this study investigated the associations between plasma EV proteins and prospectively registered MALE and MACE in consecutive patients undergoing femoral endarterectomy. Using the Athero-Express biobank study, four EV proteins (Cystatin C, CD14, Serpin C1, and Serpin G1) were measured in the high density lipoprotein subfraction isolated from plasma of 317 PAD patients undergoing arterial revascularisation. Multivariable Cox proportional hazard regression was used to investigate the association between plasma EV protein levels and MACE and MALE in the three year post-operative period. Most patients were treated for claudication (Fontaine II, 52.8%), although rest pain (Fontaine III, 30.1%) and ischaemic wounds (Fontaine IV, 17.1%) were common in this cohort. Within three years 51 patients died, amongst whom 25 deaths were due to CVD, 39 patients experienced a MACE, and 125 patients experienced a MALE. Multivariable regression models, based on statistically proven covariables and literature, showed a significant association of Serpin G1 (HR 1.49; 95% CI 1.08 - 2.06; p = .016) and CD14 (HR 1.40; 1.03 - 1.90; p = .029) with MACE, and of Serpin G1 (HR 1.29; 1.07 - 1.57; p = .009) with MALE. Serpin G1 and CD14 plasma EV protein levels are associated with future MACE and MALE in patients with severe PAD.


Phototoxicity of Dictamnus alba.
Phytophotodermatitis from Dictamnus alba was observed in three patients. Thin-layer chromatography and spectrophotometry disclosed the occurrence of 5-methoxypsoralen and 8-methoxypsoralen in the plant extracts which was also demonstrated by their phototoxic activity in vitro.


Dendritic cells in Barrett's esophagus carcinogenesis: an inadequate microenvironment for antitumor immunity?
Barrett's esophagus corresponds to the replacement of the normal esophageal squamous epithelium by a columnar epithelium through a metaplastic process. This tissue remodeling is associated with chronic gastroesophageal reflux and constitutes a premalignant lesion leading to a 30- to 60-fold increase in the risk to evolve into esophageal adenocarcinoma. The present study aimed to investigate a possible immune evasion in Barrett's esophagus favoring esophageal adenocarcinoma development. We demonstrated that myeloid and plasmacytoid dendritic cells are recruited during the esophageal metaplasia-dysplasia-carcinoma sequence, through the action of their chemoattractants, macrophage inflammatory protein 3α and chemerin. Next, we showed that, in contrast to plasmacytoid dendritic cells, myeloid dendritic cells, co-cultured with Barrett's esophagus and esophageal adenocarcinoma cell lines, display a tolerogenic phenotype. Accordingly, myeloid dendritic cells co-cultured with esophageal adenocarcinoma cell lines stimulated regulatory T cell differentiation from naïve CD4(+) T cells. In agreement with those results, we observed that both metaplastic areas and (pre)malignant lesions of the esophagus are infiltrated by regulatory T cells. In conclusion, soluble factors secreted by epithelial cells during the esophageal metaplasia-dysplasia-carcinoma sequence influence dendritic cell distribution and promote tumor progression by rendering them tolerogenic.


The human spermatozoa genome. Analysis by DNA reassociation kinetics.
The physicochemical characteristics of the human spermatozoa DNA have been analyzed by means of analytical ultracentrifugation and reassociation kinetics and compared with DNA from a somatic human cell, the leukocyte. Human spermatozoa DNA is composed of a major (86.7%) and a minor (13.3%) component with buoyant densities in neutral CsCl corresponding to 1.697 and 1.704 g/cm3, respectively. The DNA obtained from leukocytes contained only the first component. Reassociation kinetics of sheared DNA showed that the most rapidly-renatured repeated sequences consituted 12.1% of the sperm genome and only 9.2% of leukocyte genome. On the contrary single copy sequences were more abundant in leukocyte (64%) than in spermatozoa (59%) DNA. Reassociation kinetics with long DNA fragments (2000 nucleotides) were clearly different between sperm and leukocyte DNA, indicating the presence in sperm cells of a specific cluster of highly repetitive DNA. This entity may play a role in giving the spermatozoa nucleus its characteristic properties, involving supercoiling, quasi crystal structure, stability, lack of transcription, etc. and secondarily may function as an early pairing mechanism during syngamy.


In vivo crosslinking of nuclear proteins to DNA by cis-diamminedichloroplatinum (II) in differentiating rat myoblasts.
When cells are briefly exposed to cis-diamminedichloroplatinum (II) before lysis in high sodium dodecyl sulfate-urea solutions, the high molecular-weight nucleic acids pelleted by ultracentrifugation contain an increased level of bound proteins when compared to a similar fraction from untreated cells. Subsequent shearing of the pelleted DNA followed by treatment with DNase permits electrophoretic and immunoblot analysis of the crosslinked proteins. In the present study such experiments were carried out with reference to nuclear envelope pore complex proteins in the differentiating L8 rat skeletal muscle cells. The results show that (i) whereas the major lamin proteins crosslinked to DNA in both myoblast and myotubes, lamin B is crosslinked to a greater extent to DNA in myotubes; (ii) a 62-kDa lectin-binding glycoprotein is apparently situated differently with respect to DNA in myotube nuclei; and (iii) the crosslinking pattern of the nuclear matrix proteins to DNA is qualitatively similar in myoblast and myotubes. In addition, lamin C', a modified form of lamin C, not observed in intact nonmuscle cells previously [Glass et al. (1985) J. Biol. Chem. 260, 1895-1900], exists as a native component of the nuclear lamina in rat skeletal myotubes but not in myoblasts. These results point to significant structural alterations in the proteins of the nuclear lamina-pore complex during myogenesis.


Federal state differentials in the efficiency of health production in Germany: an artifact of spatial dependence?
Due to regional competition and patient migration, the efficiency of healthcare provision at the regional level is subject to spatial dependence. We address this issue by applying a spatial autoregressive model to longitudinal data from Germany at the district ('Kreis') level. The empirical model is specified to explain efficiency scores, which we derive through non-parametric order-m efficiency analysis of regional health production. The focus is on the role of health policy of federal states ('Bundesländer') for district efficiency. Regression results reveal significant spatial spillover effects. Notably, accounting for spatial dependence does not decrease but increases the estimated effect of federal states on district efficiency. It appears that genuinely more efficient states are less affected by positive efficiency spillovers, so that taking into account spatial dependence clarifies the importance of health policy at the state level.


A Shelf Stable Fmoc Hydrazine Resin for the Synthesis of Peptide Hydrazides.
C-terminal hydrazides are an important class of synthetic peptides with an ever expanding scope of applications, but their widespread application for chemical protein synthesis has been hampered due to the lack of stable resin linkers for synthesis of longer and more challenging peptide hydrazide fragments. We present a practical method for the regeneration, loading, and storage of trityl-chloride resins for the production of hydrazide containing peptides, leveraging 9-fluorenylmethyl carbazate. We show that these resins are extremely stable under several common resin storage conditions. The application of these resins to solid phase peptide synthesis (SPPS) is demonstrated through the synthesis of the 40-mer GLP-1R agonist peptide "P5". These studies support the broad utility of Fmoc-NHNH-Trt resins for SPPS of C-terminal hydrazide peptides.


Intracranial arachnoid cysts: What is the appropriate surgical technique? A retrospective comparative study with 61 pediatric patients.
Symptomatic intracranial arachnoid cysts (ACs) should be treated either through microsurgical (MS) or endoscopic surgical (ES) fenestration. Implantation of cysto-peritoneal shunt (CPS) system is another treatment option with decreasing indication. In our study, we compared the complication and revision rates between the three operative techniques in pediatric patients. We included patients below 18 years with symptomatic intracranial ACs operated between 2004 and 2021. Initial symptoms, location, complication rate, clinical and radiological improvement, postoperative events and revision rate were compared retrospectively. Sixty-one patients; 33 (54.1%) MS operated (mean age 7.6 years), 18 (29.5%) ES operated (mean age 6.2 years) and 10 (16.4%) with CPS (mean age 3.0 years) were collected. The most common initial symptom was headache in 45.9%. 20 (32.8%) postoperative events were documented. The highest revision rate (60%) was seen in the CPS group compared to 33.3% in MS group and 16.7% in ES group. 31 patients harbored perisylvian ACs, 89% remained event-free after ES, 71% after MS and 20% after CPS. Clinical improvement immediately after surgery was observed in 58 patients (96.9% in MS, 88.9% in ES and 100% in CPS). A radiological volume reduction could be proven postoperative in 51 patients (78.8% MS, 88.9% ES and 90% CPS). Endoscopic fenestration of AC is a safe and efficient technique which is being widely used nowadays with the highest event free survival compared to microsurgical fenestration especially in perisylvian arachnoid cysts. CPS shows on long terms the highest revision rate but carries the least surgical risks.


Public awareness in Egypt about COVID-19 spread in the early phase of the pandemic.
This study aimed to evaluate public awareness in Egypt related to the coronavirus. An online structured survey was conducted during March and April 2020 to assess coronavirus knowledge. The questionnaire was divided into 6 parts consisting of 39 questions for a total possible score of 0 to 39; to assess the participants' general knowledge [10 items]; symptoms knowledge [2 items]; transmission knowledge [6 items]; preventive knowledge [4 items]; treatment knowledge [6 items], and public knowledge of governmental and international efforts [10 items]. A total of 726 participants participated, 97.5% of them knew the main clinical symptoms of coronaviruses. 99% believed that following the etiquette of coughing, sneezing, or wearing a medical mask is important to reduce infection transmission. 80.5% of the participants believed that there is no effective treatment or vaccine available for the coronavirus. The important role of the international organizations to overcome the coronavirus was known by (92.3%). 65.2% believed that the Ministry of Health provided reliable data on the number of infections or death. 27.9% of the participants consider coronavirus infection as a stigma. The average score of this survey was 31.75/39 (81.4%) regarding the knowledge about the disease. Overall, the study participants' had good knowledge of coronavirus and the international efforts to confront the coronavirus. Further study is required to evaluate the effect of such good knowledge on decreasing the infection rate.


A synergistic bacterial pool decomposes tebuthiuron in soil.
This study aimed to propose an eco-compatible strategy to mitigate the possible environmental contamination caused by tebuthiuron. Therefore, we screened potential tebuthiuron-degrading microorganisms from conventional (CS) and no-till (NTS) systems producing sugarcane. Then, they were bioprospected for their ability of decomposing the target-molecule at 2.48 mmol g-1 and 4.96 mmol g-1 into CO2 via respirometry. Integrating microbiota from CS and NTS into an advantageously synergistic bacterial pool produced the highest specific-growth rate of CO2 of 89.60 mg day-1, so outstripped the other inoculum. The bacterial CN-NTS framework notably stabilized the sigmoidal Gompertz curve on microbial degradation earliest and enabled the seeds of Lactuca sativa to germinate healthiest throughout ecotoxicological bioassay for cross-validation. Our study is preliminary, but timely to provide knowledge of particular relevance to progress in the field's prominence in remediating terrestrial ecosystems where residual tebuthiuron can persist and contaminate. The analytical insights will act as an opening of solutions to develop high-throughput biotechnological strategies for environmental decontamination.


The long-term outcome of patients with glycogen storage diseases.
In this retrospective study from five centres, 139 patients over 10 years of age with glycogen storage disease types I, III, VI and IX are described. Almost half of the patients with glycogen storage disease type Ia had retarded growth and most had hyperlipidaemia. One-third of the patients had adenomas, although none of these showed malignant transformations. With increasing age the growth, liver size and hyperlipidaemia of patients with glycogen storage disease type III improve. However, there was a high incidence of myopathy and cardiomyopathy. Patients with glycogen storage disease types VI and IX had a normal growth pattern after childhood. Hepatomegaly and hypercholesterolaemia, however, were still present in half of the patients.


Abnormal changes in voltage-gated sodium channels Na(V)1.1, Na(V)1.2, Na(V)1.3, Na(V)1.6 and in calmodulin/calmodulin-dependent protein kinase II, within the brains of spontaneously epileptic rats and tremor rats.
Voltage-gated sodium channels (VGSCs) play a crucial role in epilepsy. The expressions of different VGSCs subtypes are varied in diverse animal models of epilepsy that may reflect their multiple phenotypes or the complexity of the mechanisms of epilepsy. In a previous study, we reported that NaV1.1 and NaV1.3 were up-regulated in the hippocampus of the spontaneously epileptic rat (SER). In this study, we further analyzed both the expression and distribution of the typical VGSC subtypes NaV1.1, NaV1.2, NaV1.3 and NaV1.6 in the hippocampus and in the cortex of the temporal lobe of two genetic epileptic animal models: the SER and the tremor rat (TRM). The expressions of calmodulin (CaM) and calmodulin-dependent protein kinase II (CaMKII) were also analyzed with the purpose of assessing the effect of the CaM/CaMKII pathway in these two models of epilepsy. Increased expression of the four VGSC subtypes and CaM, accompanied by a decrease in CaMKII was observed in the hippocampus of both the SERs and the TRM rats. However, the changes observed in the expression of VGSC subtypes and CaM were decreased with an elevated CaMKII in the cortex of their temporal lobes. Double-labeled immunofluorescence data suggested that in SERs and TRM rats, the four subtypes of the VGSC proteins were present throughout the CA1, CA3 and dentate gyrus regions of the hippocampus and temporal lobe cortex and these were co-localized in neurons with CaM. These data represent the first evidence of abnormal changes in expression of four VGSC subtypes (NaV1.1, NaV1.2, NaV1.3 and NaV1.6) and CaM/CaMKII in the hippocampus and temporal lobe cortex of SERs and TRM rats. These changes may be involved in the generation of epileptiform activity and underlie the observed seizure phenotype in these rat models of genetic epilepsy.


Effect of ovariectomy followed by administration of ovarian steroid hormones on the pig pinealocyte ultrastructure.
The ultrastructure of female pig pinealocytes was studied after ovariectomy alone and ovariectomy followed by administration of estradiol, progesterone, or both. Administration of estradiol as well as a combination of estradiol and progesterone induced qualitative ultrastructural changes in pinealocytes relative to Golgi apparatus and cytoplasmic dense bodies as well as quantitative ones, such as a decrease in relative volume of cytoplasmic dense bodies and lysosomes. Administration of progesterone caused the formation of dense bodies and a decrease in the relative volume of lysosomes. The results point to a relationship between the pineal gland and gonads in the pig and suggest that gonadal steroids, particularly estradiol, could be involved in a feedback mechanism of the hypothalamic-hypophyseal-gonadal system to the pineal gland.


Steroid therapy for male infertility associated with antisperm antibodies. Results of a small randomized clinical trial.
Ten infertile men with significant titres of antisperm antibodies were entered into a randomized double-blind study to test the efficacy of corticosteroid therapy compared to a placebo. Prednisolone was given orally at a dose of 1 mg/kg/day for 9 days repeated over 3 cycles (their wives' menstrual cycles). This treatment had no significant effect, when compared to placebo, on fertility, serum antibody levels or semen characteristics. A slight decrease in the titre of seminal antibodies was, however, observed in patients receiving prednisolone. In individuals, there were important fluctuations in antibody levels which were independent of drug administration.


Exome and regulatory element sequencing of neuromyelitis optica patients.
Neuromyelitis optica (NMO) is rare in Finland. To identify rare genetic variants contributing to NMO risk we performed whole exome, HLA and regulatory region sequencing in all ascertained cases during 2005-2013 (n=5) in a Southern Finnish population of 1.6 million. There were no rare variant shared by all patients. Four missense variants were shared by two patients in C3ORF20, PDZD2, C5ORF47 and ZNF606. Another PDZD2 variant was found in a third patient. In the non-coding sequence two predictably functional rare variants were shared by two patients. Our results do not support a homogeneous genetic etiology of NMO in Finland.


[Large cell calcifying Sertoli cell tumour: A case report].
A 19-year-old male Caucasian, without prior medical history, noticed a painless right testicular mass. Physical examination revealed neither gynecomastia nor abnormal skin pigmentation. Serum alpha-fetoprotein, β-HCG and testosterone levels were normal. Sonography depicted an intratesticular diffusely hyperechoic lesion with acoustic shadowing. The patient underwent right orchiectomy. Histology revealed a benign large cell calcifying Sertoli cell tumour. This tumour is rare and may be associated with genetic abnormalities.


Risk factors associated with anal sphincter tear difference among midwife, private obstetrician, and resident deliveries.
To identify risk factors that account for the difference in anal sphincter tear (AST) among midwife, private obstetrician, and resident deliveries. We performed a retrospective review of our obstetrical database and used logistic regression analysis to identify risk factors for AST. The relationship between delivery technique and AST was evaluated by comparing AST increase between vaginal deliveries without and with an episiotomy among the three categories of providers. After adjusting for risk factors, private obstetricians (OR: 1.81, 95% CI: 1.27-2.56) and residents (OR: 1.60, 95% CI: 1.20-2.15) had a higher rate of AST during vaginal delivery than midwives. Episiotomy increased the odds of AST by four-fold for midwives, two-fold for private obstetricians, and eight-fold for residents. Although midwife and resident's delivery methods were associated with more AST, neither experienced this complication more frequently than private obstetricians. This suggests that midwives and residents probably misdiagnosed some AST.


Prenatal ultrasound diagnosis of Klippel-Trenaunay-Weber syndrome associated with umbilical cord hemangioma.
We describe a case of prenatal diagnosed Klippel-Trenaunay-Weber syndrome, which mainly manifested as hypertrophy of the left thigh, and was associated with umbilical cord hemangioma and loss of heterozygosity (LOH) for 1q21.2 q44. This case report describes the second reported case associated with umbilical cord hemangioma and the first reported case with LOH for 1q21.2 q44.


The human placenta project: Funded studies, imaging technologies, and future directions.
The placenta plays a critical role in fetal development. It serves as a multi-functional organ that protects and nurtures the fetus during pregnancy. However, despite its importance, the intricacies of placental structure and function in normal and diseased states have remained largely unexplored. Thus, in 2014, the National Institute of Child Health and Human Development launched the Human Placenta Project (HPP). As of May 2023, the HPP has awarded over $101 million in research funds, resulting in 41 funded studies and 459 publications. We conducted a comprehensive review of these studies and publications to identify areas of funded research, advances in those areas, limitations of current research, and continued areas of need. This paper will specifically review the funded studies by the HPP, followed by an in-depth discussion on advances and gaps within placental-focused imaging. We highlight the progress within magnetic reasonance imaging and ultrasound, including development of tools for the assessment of placental function and structure.


Lithium carbonate and methyldopa: apparent interaction in man.
An experimental subject with a stable serum level of lithium experienced symptoms of lithium toxicity when he ingested methyldopa. Physicians prescribing either or both of these drugs should be aware of this apparent interaction between lithium and methyldopa.


Obstetric consequences of postmaturity.
The obstetric management of 340 pregnancies delivered 2 or more weeks postterm and 1408 pregnancies delivered at 41 weeks is compared with that of 5915 pregnancies delivered at 39 to 40 weeks. In all patients menstrual dating was confirmed by early ultrasonographic examination. Postterm labor in primiparas resulted in a high cesarean section rate because of failure to progress; this increased rate was observed even after controlling for induction of labor and the size of the infant. We suggest that primiparas who go postterm often have increased uterine dysfunction. Uterine dysfunction accounts for the increase in the cesarean section rate and is a partial explanation for "failed" inductions.


Increased risk of group B streptococcal sepsis and meningitis in HIV-exposed uninfected infants in a high-income country.
The purpose of this study is to compare group B Streptococcus (GBS) infection incidence in HIV-exposed uninfected (HEU) and HIV-unexposed (HU) infants in a Spanish cohort. We conducted a retrospective study in 5 hospitals in Madrid (Spain). Infants ≤ 90 days of life with a GBS infection were included from January 2008 to December 2017. Incidence of GBS infection in HEU and HU children was compared. HEU infants presented a sevenfold greater risk of GBS infection and a 29-fold greater risk of GBS meningitis compared to HU, with statistical significance. Early-onset infection was tenfold more frequent in HEU children, with statistical significance, and late-onset infection was almost fivefold more frequent in the HUE infants' group, without statistical significance. HEU infants presented an increased risk of GBS sepsis and meningitis. One in each 500 HEU infants of our cohort had a central nervous system infection and 1 in each 200, a GBS infection. Although etiological causes are not well understood, this should be taken into account by physicians when attending this population. • HIV-exposed uninfected infants are at higher risk of severe infections. • An increased susceptibility of these infants to group B Streptococcus infections has been described in low- and high-income countries, including a higher risk of meningitis in a South African cohort. • Group B Streptococcal meningitis is more frequent in HIV-exposed uninfected infants also in high-income countries. • Physicians should be aware of this increased risk when attending these infants.


Assessment of the interrelation between photooxidation and biodegradation of selected polyesters after artificial weathering.
Three commercially available biodegradable polymers, two different aromatic-aliphatic copolyesters and polylactic acid, intended for the fabrication of agricultural mulching films, in addition to other applications, were subjected to a series of tests with the aim of studying the relationship between their photooxidation and biodegradation. Photooxidation resulted in the rearrangement of polymeric chains, in the case of both copolyesters the events led to polymeric chain crosslinking and the formation of insoluble polymeric gel. The tendency was significantly more pronounced for the copolyester with the higher content of the aromatic constituent. As regards polylactic acid photochemical reactions were not accompanied by crosslinking but instead provoked chain scissions. A biodegradation experiment showed that, despite marked structural changes, the extent of photooxidation was not the decisive factor, which significantly modified the rate of biodegradation in all three materials investigated. The specific surface area of the sample specimens was shown to be more important.


The Scandinavian Total Ankle Replacement and the ideal biomechanical requirements of ankle replacements.
The complex anatomy of the articular bone surfaces, ligaments, tendon attachments and muscles makes the ankle joint difficult to replicate in prosthetic replacements. Ever since the early 1970s, which saw the dawn of the first total ankle replacements, there have been numerous other attempts at replicating the joint, often with poor clinical outcomes. The anatomy of the ankle is discussed, followed by evidence of the normal ankle biomechanics and the ideal requirements of an ankle replacement. We focus on the Scandinavian Total Ankle Replacement and evaluate whether these requirements have been met.


Part-of relations in anatomy ontologies: a proposal for RDFS and OWL formalisations.
Part-of relations are central to anatomy. However, the definition, formalisation and use of part-of in anatomy ontologies is problematic. This paper surveys existing formal approaches, as well as the use of part-of in the Open Biological Ontologies (OBO) anatomies of model species. Based on this analysis, we propose a minimal ontology for anatomy which is expressed in the Semantic Web languages RDFS and OWL-Full. The paper concludes with a description of the context of this work in capturing cross-species tissue homologies and analogies.