Inside outreach: a challenge for health sciences librarians.
Like medical and health sciences libraries throughout the country, the Lamar Soutter Library (LSL) at the University of Massachusetts Medical School is dealing with ever-increasing outreach needs in times of diminishing funding. With the goal of reshaping the library's outreach program to better serve our patron groups, the Outreach Study Group was formed to investigate existing models of outreach. The group initially examined the current literature and subsequently conducted a nationwide survey of medical and health sciences libraries to identify trends in outreach. This article details the methods used for the survey, including establishing criteria for selecting participants, determining the focus, and developing and conducting the survey. Of the 40 libraries invited to participate, 63% completed the survey. An analysis of the data revealed successes, problems, and trends. The group's conclusions led to recommendations for the LSL's future outreach efforts. Analysis of the data revealed key findings in the areas of strategic planning, funding, and evaluation. A thoughtful definition of outreach ensures that outreach activities are expressions of the library's mission. Funding shifts require flexible programs. Evaluation provides data necessary to create new programs, sustain successful ones, and avoid repeating mistakes.


Important Considerations in the Diagnosis and Management of Post-transplant Lymphoproliferative Disorder.
A relative lack of molecular and clinical studies compared to other lymphoid cancers has historically made it difficult to determine optimal management approaches in post-transplant lymphoproliferative disorder (PTLD). We sought to better define the "state of the science" in PTLD by examining recent advances in risk assessment, genomic profiling, and trials of PTLD-directed therapy. Several major clinical trials highlight risk-stratified sequential therapy incorporating rituximab with or without chemotherapy as a rational treatment strategy in patients with CD20+ PTLD who do not respond to reduction of immunosuppression alone. Epstein Barr virus (EBV)-targeted cytotoxic lymphocytes are a promising approach in patients with relapsed/refractory EBV+ PTLD, but dedicated clinical trials should determine how autologous chimeric antigen receptor T cell therapy (CAR-T) may be safely administered to PTLD patients. Sequencing studies underscore the important effect of EBV infection on PTLD pathogenesis, but comprehensive genomic and tumor microenvironment profiling are needed to identify biomarkers that predict response to treatment in this clinically heterogeneous disease.


Testicular and epididymal percutaneous sperm aspiration in men with either obstructive or nonobstructive azoospermia.
To investigate our experience with epididymal and testicular sperm obtained by percutaneous aspiration to determine the effectiveness of these procedures in patients with obstructive or nonobstructive azoospermia. We also report on the pooled outcome of intracytoplasmic sperm injection, performed at six in vitro fertilization centers, using sperm from these two patient populations. A method of percutaneous aspiration of sperm was developed to facilitate diagnostic biopsy and therapeutic aspiration. A total of 265 aspirations were performed for diagnostic and therapeutic purposes from August 1995 through July 2001. Mature sperm were found in 34 (47%) of 73 men with nonobstructive azoospermia, who underwent testicular sperm aspiration for diagnostic purposes. In 56 procedures for men with nonobstructive azoospermia who underwent testicular sperm aspiration for intracytoplasmic sperm injection, an adequate number of viable sperm was obtained from 46 (82%), with an oocyte fertilization and clinical pregnancy rate of 55% and 44%, respectively. In men with obstructive azoospermia who underwent percutaneous epididymal sperm aspiration, viable sperm were found in 91 (97%) of 94 procedures, with an oocyte fertilization and clinical pregnancy rate of 58% and 39%, respectively. Sperm were obtained in 18 (100%) of 18 procedures in men with obstructive azoospermia who underwent testicular sperm aspiration, with a corresponding fertilization and clinical pregnancy rate of 51% and 38%, respectively. A small (less than 1 cm in diameter) subcapsular hematoma was the only complication. Percutaneous aspiration of sperm is an effective, safe, and reproducible means of obtaining adequate sperm for diagnosis or intracytoplasmic sperm injection in patients with obstructive or nonobstructive azoospermia. Our experience indicates that similar results can be obtained in both patient groups.


Effect of foot rotation on knee kinetics and hamstring activation in older adults with and without signs of knee osteoarthritis.
To determine the effects of changing the natural foot progression angle during gait (internal and external foot rotation) on the knee's adduction moment, lateral-medial shear force, and the ratio of medial-lateral hamstring muscle activation in those with signs of knee osteoarthritis and a matched healthy control group. Twelve subjects with signs of knee osteoarthritis and 12 matched healthy control subjects were evaluated. A 3D gait analysis system calculated forces and moments at the knee while the subjects walked in three conditions: (1) normal foot position, (2) external foot rotation, (3) internal foot rotation. Medial and lateral hamstring EMG data was also collected simultaneously and used to calculate the medial-lateral hamstring activation ratio during the stance phase of the gait cycle. Repeated measures ANOVAs were used to compare foot rotation conditions within each group; while between group comparisons were performed in the normal rotation condition only using t-tests. Those with knee osteoarthritis (OA) had an increased late stance knee adduction moment and a decreased medial-lateral hamstring activation ratio as compared to the healthy control group. Also, external foot rotation decreased the late stance knee adduction moment, lateral-medial shear force, and hamstring activation ratio. However, internal foot rotation did not increase these measures. Changes in foot position during gait have the ability to alter both the external loading of the knee joint and hamstring muscle activation patterns during gait. This may have implication in helping to unload the knee's articular cartilage.


Sex differences in hippocampal cognition and neurogenesis.
Sex differences are reported in hippocampal plasticity, cognition, and in a number of disorders that target the integrity of the hippocampus. For example, meta-analyses reveal that males outperform females on hippocampus-dependent tasks in rodents and in humans, furthermore women are more likely to experience greater cognitive decline in Alzheimer's disease and depression, both diseases characterized by hippocampal dysfunction. The hippocampus is a highly plastic structure, important for processing higher order information and is sensitive to the environmental factors such as stress. The structure retains the ability to produce new neurons and this process plays an important role in pattern separation, proactive interference, and cognitive flexibility. Intriguingly, there are prominent sex differences in the level of neurogenesis and the activation of new neurons in response to hippocampus-dependent cognitive tasks in rodents. However, sex differences in spatial performance can be nuanced as animal studies have demonstrated that there are task, and strategy choice dependent sex differences in performance, as well as sex differences in the subregions of the hippocampus influenced by learning. This review discusses sex differences in pattern separation, pattern completion, spatial learning, and links between adult neurogenesis and these cognitive functions of the hippocampus. We emphasize the importance of including both sexes when studying genomic, cellular, and structural mechanisms of the hippocampal function.


A subclavian line complication: embolisation of an arteriovenous fistula.
We report a case illustrating the successful non-surgical management of an arteriovenous fistula resulting from central line placement. After diagnosis by angiography transcatheter embolotherapy of the internal mammary artery provided an alternative to thoracotomy in treating this unusual complication.


Yes and PI3K bind CD95 to signal invasion of glioblastoma.
Invasion of surrounding brain tissue by isolated tumor cells represents one of the main obstacles to a curative therapy of glioblastoma multiforme. Here we unravel a mechanism regulating glioma infiltration. Tumor interaction with the surrounding brain tissue induces CD95 Ligand expression. Binding of CD95 Ligand to CD95 on glioblastoma cells recruits the Src family member Yes and the p85 subunit of phosphatidylinositol 3-kinase to CD95, which signal invasion via the glycogen synthase kinase 3-beta pathway and subsequent expression of matrix metalloproteinases. In a murine syngeneic model of intracranial GBM, neutralization of CD95 activity dramatically reduced the number of invading cells. Our results uncover CD95 as an activator of PI3K and, most importantly, as a crucial trigger of basal invasion of glioblastoma in vivo.


Case report on recombinant coagulation factor VIIa in the treatment of three haemophilia A patients with inhibitors in Singapore.
We report the first experiences with use of recombinant coagulation Factor VIIa (rFVIIa) in the treatment of haemophilia A patients with inhibitors in Singapore and discuss observations in 3 patients. Case 1 bled on two separate occasions into his neck muscles and vocal cord. Case 2 had gross haematuria from bleeding in the renal calyxes. Case 3 bled into the parotid muscles. rFVIIa in doses, ranging from 50 ug/kg to 90 ug/kg, at different dosing intervals, were used. Excellent responses were seen in doses of 70 and 90 ug/kg. rFVIIa is highly effective, both clinically and cost-wise, in the treatment of these patients.


Involvement of metabolism-permeability in enhancing the oral bioavailability of curcumin in excipient-free solid dispersions co-formed with piperine.
Curcumin (CUR) has gained increasing interest worldwide due to multiple biological activities. However, the therapeutic application remains limited because of its low aqueous solubility, intestinal metabolism and poor membrane permeability. In present study, an excipient-free CUR solid dispersion co-formed with piperine (PIP), the absorption enhancer involving metabolism-permeability, was successfully prepared by melting and quench cooling (co-amorphous CUR-PIP). The co-amorphous CUR-PIP exhibited superior performance in non-sink dissolution compared with crystalline and amorphous CUR, and showed physically stable at least 3 months, attributing to the strong molecular interactions between CUR and PIP as evaluated by FTIR spectra. Furthermore, the combination of PIP with CUR in the co-amorphous formulation could inhibit the glucuronidation of CUR, as exhibited in the in vitro assay of rat intestinal microsomes. The co-amorphous CUR-PIP would also exhibit higher gastrointestinal membrane permeability of CUR, as confirmed by Papp of CUR in Caco-2 model. After administration of co-amorphous CUR-PIP, the AUC of CUR significantly increased by 2.16- and 1.92-fold those in crystalline and amorphous CUR, respectively. This study demonstrates that the developed co-amorphous CUR-PIP can enhance the bioavailability of CUR by increasing its dissolution, inhibiting metabolic processes, and facilitating membrane permeability.


4-Hydroxy-2-pyrone formation by chalcone and stilbene synthase with nonphysiological substrates.
Valerophenone synthase (VPS) is a polyketide synthase that catalyzes the formation of the phloroglucinol derivatives in the synthesis of the bitter acids in hop (Humulus lupulus). The reaction uses isovaleryl-CoA or isobutyryl-CoA, but otherwise it is identical to that of the chalcone synthase in flavonoid biosynthesis. Our study showed that chalcone synthase can perform the function of VPS, but not perfectly, because the majority of the reactions terminated after two condensation reactions (products: 4-hydroxy-2-pyrone derivatives). The same experiments with stilbene synthase yielded exclusively the 4-hydroxy-2-pyrone derivatives, not the products expected from three condensation reactions. The results are discussed in the context of the functional diversity and evolution in the family of CHS-related polyketide synthases.


A naphthalocyanine based near-infrared photosensitizer: synthesis and in vitro photodynamic activities.
A hydrophilic near-infrared (NIR) photosensitizer featuring a naphthalocyanine core and peripheral carboxylate acid groups was synthesized and characterized. Its photophysical and photochemical properties were studied and compared with phthalocyanine. Due to the extended π-conjugation, both the Q band and fluorescence emit of this naphthalocyanine bathochromically shift to NIR region. It also exhibits superior NIR photodynamic efficiency to phthalocyanine as evidenced by high efficiency in generating singlet oxygen (ΦΔ=0.66) and in vitro phototoxicity toward Hela human cervical cancer cells. Therefore, this novel naphthalocyanine could potentially be a NIR photosensitizer for photodynamic therapy.


Benign adenomatous multicystic kidney tumor (Perlmann's tumor) and renal cortical carcinoma with adenomatous multicystic features: 12 cases.
To re-examine clear cell cystic lesions of the kidney and to assess their potential clinicopathologic significance, as the long-forgotten diagnosis of benign adenomatous multicystic kidney tumor (Perlmann's tumor) has not been cited in the literature in more than 35 years. We identified 12 patients between 1959 and 1996 who underwent a radical nephrectomy at our institution and were diagnosed with either adenomatous multicystic clear cell kidney tumor (n = 4) or with renal cell carcinoma (RCC) associated with features of adenomatous clear cell multicystic kidney tumors (n = 8). All diagnoses were reviewed histologically by a single pathologist. Nine of 1 2 patients had Stage T2NOMO disease, and 3 patients had Stage T1 NOMO disease. There were 8 men and 4 women. The average age at the time of surgery was 60.5 years (range 25 to 74). Six patients are still alive with a mean follow-up of 4.7 years (range 1.5 to 16.3) and have no evidence of recurrent disease. Of the 6 patients who died, mean survival time was 8.8 years (range 0 to 15.7). One patient died in the perioperative period, and the other 5 patients died of other causes, unrelated to their kidney tumor. Adenomatous clear cell multicystic kidney disease may represent a histologically distinct benign neoplasm, and its presence in association with RCC may confer a more favorable prognosis. Its distinction from usual solid hemorrhagic or focally necrotic RCC is important.


Metal concentrations in plasma and cerebrospinal fluid in patients with Alzheimer's disease.
The homeostasis of essential metals such as copper, iron, selenium and zinc may be altered in the brain of subjects with Alzheimer's disease (AD). Concentrations of metals (magnesium, calcium, vanadium, manganese, iron, cobalt, nickel, copper, zinc, selenium, rubidium, strontium, molybdenum, cadmium, tin, antimony, cesium, mercury and lead) were determined in plasma and cerebrospinal fluid (CSF) by inductively coupled plasma mass spectrometry in 173 patients with AD and in 87 patients with the combination of AD and minor vascular components (AD + vasc). Comparison was made with 54 healthy controls. The plasma concentrations of manganese and total mercury were significantly higher in subjects with AD (p < 0.001) and AD + vasc (p <or= 0.013) than in controls. In CSF, however, the concentrations of vanadium, manganese, rubidium, antimony, cesium and lead were significantly lower among subjects with AD (p <or= 0.010) and AD + vasc (p <or= 0.047) than in controls. Strong positive correlations were noted between plasma Cs versus CSF Cs in subjects with AD (r(s) = 0.50; p < 0.001), and AD + vasc (r(s) = 0.68; p < 0.001). Besides the raised plasma mercury concentrations, no consistent metal pattern in plasma or CSF was observed in patients with AD.


Is exercise-induced U-wave inversion predictive of proximal left anterior descending coronary artery disease?
A 66-year-old patient with a recent history of chest pain was submitted to exercise test. The rest electrocardiogram was normal, but during effort, a striking U-wave inversion in the chest leads occurred, not associated with any ST-segment change. Coronary angiogram demonstrated a severe proximal narrowing of the left anterior descending coronary artery. Effort-induced U-wave inversion in the precordial leads has long been recognized as a marker of stenosis of the left anterior descending coronary artery, but this pattern is seldom taken into account.


Calcium and cancer.
For many years the calcium ion has repeatedly cropped up in research work concerning the transformation of the normal cell to the malignant state. When these results are collected together they indicate that calcium may hold the key to the solution of many of the problems concerning the cancer cell.


Relations among depressive symptoms, electrocardiographic hypertrophy, and cardiac events in non-ST elevation acute coronary syndrome patients.
Cardiac outcomes after acute coronary syndrome (ACS) are worse in patients with depression, but identifying which depressed patients are at increased risk, and by what means, remains difficult. We analyzed inpatient electrocardiograms (ECGs) from 955 patients admitted with non-ST elevation ACS (NSTE-ACS) in the Prescription Use, Lifestyle, and Stress Evaluation (PULSE) study. Patients with QRS duration ⩾120 ms or whose rhythm was not normal sinus were excluded (sample size=769). Depressive symptoms were measured by Beck Depression Inventory score ⩾10. ECG markers included Cornell product-left ventricular hypertrophy (CP-LVH) and strain pattern in the lateral leads. In multivariable logistic regression models, depressive symptoms were associated with increased odds of CP-LVH, ECG-strain, and the combination of the two (odds ratios 1.74-2.33, p values <0.01). The combination of both CP-LVH and ECG-strain was predictive of one-year risk of myocardial infarction (MI) or death among patients with depressive symptoms (hazard ratio 4.91, 95% CI 1.55-15.61, p=0.007), but not among those without depressive symptoms (p value for interaction 0.043). In our non-ST elevation (NSTE)-ACS cohort, ECG markers of hypertrophy were both more common, and more predictive of MI/mortality, among those with depressive symptoms. Cardiac hypertrophy is a potential target for therapy to improve outcomes among depressed NSTE-ACS patients.


Thermal stratification effect on gravity driven transport of hybrid CNTs down a stretched surface through porous medium.
The purpose of the current article is to explore the impact of thermal stratification and medium porosity on gravity-coerced transport of hybrid carbon nanotubes down an upright extending sheet inspired by a constant applied magnetic field along with heat transfer investigation in existence of thermal radiation, viscous dispersal, and joule heating effect. Rectangular coordinates are chosen for the mathematical interpretation of the governing flow problem. Homothetic analysis is employed for the sake of simplification process. The reduced system of coupled nonlinear differential equations is dealt numerically by dint of computational software MATLAB inbuilt routine function Bvp4c. The numerical investigation is carried out for the distinct scenarios namely, ( i ) Presence of favorable buoyancy force, ( i i ) Case of purely forced convection and ( i i i ) Presence of opposing buoyancy force. Significant Findings: The key findings include that the presence of hybrid carbon nanotubes and medium porosity contributes significantly to upsurging surface shear stress magnitude whereas, external magnetic field and velocity slip effects in an altered manner. The present study may be a benchmark in study of fueling process in space vehicles and space technology.


CCR5 antagonists: bicyclic isoxazolidines as conformationally constrained N-1-substituted pyrrolidines.
A series of CCR5 antagonists containing bicyclic isoxazolidines was generated through a nitrone mediated cycloaddition with olefins bearing the preferred pharmacophores previously described. Potent antagonists (3 and 16) were generated with enhanced affinity for the CCR5 receptor while maintaining antiviral activity against HIV.


Aminothiazolylglycyl derivatives of carbacephem antibiotics. II. Synthesis and antibacterial activity of novel aminothiazolyl cephem compounds with hydroxypyridone moiety.
The synthesis and antimicrobial activity of novel carbacephem antibiotics which have amido moiety of (S)-aminothiazolylglycyl side chain are described. Among them, the compound having 5-hydroxy-4-pyridon-2-carboxyl group (KT-4697) showed exceptionally strong activity against Pseudomonas aeruginosa as well as Gram-negative bacteria. A cephalosporin with this acyl group namely KT-4788 with methylpyridiniumthiomethyl group at C-3 was found to be the most active against Gram-positive and Gram-negative strains including P. aeruginosa.


Canopy dynamics and carbon gain in response to soil water availability in Encelia frutescens gray, a drought-deciduous shrub.
The production and longevity of leaves of Encelia frutescens Gray, a drought-deciduous subshrub of the Mohave and Sonoran Deserts, were followed during the summer and fall of 1983 in an experimental field garden. The relationships between seasonally changing plant water status, extent of canopy development, and photosynthetic capacity per unit leaf area were determined. Maximum leaf life spans during a summer activity period were between 3 and 4 months, with the great majority living between 1 and 3 months. Leaf production occurred synchronously in well defined cohorts triggered by precipitation events. Extensive leaf turnover occurred during the summer period even though the plants remained in continuous leaf. Turnover was most pronounced when precipitation triggered the production of new leaf cohorts.Five weeks were required for plants to reach maximum canopy development when renewed soil-water availability followed a prolonged drought. Photosynthetic capacity per unit leaf area recovered much sooner than total leaf area, and submaximal leaf area development was the major factor limiting whole-plant carbon gain during a leaf-flushing period lasting several weeks. As the soil began to dry out, physiological capacity declined more rapidly than leaf area, and became the primary limiting factor to whole plant carbon gain.


The value of electroencephalographic recordings in dialysis encephalopathy: case-reports and review of literature.
The electroencephalographic abnormalities with dialysis dementia are described in five patients with this disorder. The tracings of all patients showed a mild to moderate slowing of the background rhythm, intermixed with paroxysmal and rhythmic waves, most prominent on the frontal areas. Epileptiform discharges were seen in only one record. Clinical features, hypotheses regarding pathogenesis, and treatment of this usually fatal encephalopathy are briefly discussed.


Distributions and sources of heavy metals in sediments of the Bohai Sea, China: a review.
This paper summarizes the recent research results from studies concerning heavy metals in the Bohai Sea in recent decades. The temporal and spatial variations and potential sources of the heavy metals in the surface sediments were analyzed. Based on these obtained data, the average concentrations in surface sediments collected in recent years (summarized 3171 samples) were 0.31, 87.0, 25.7, 25.8, 0.11, 16.9, 52.2, and 27.7 μg/g for Cd, Zn, Cu, Pb, Hg, As, Cr, and Ni, respectively. In the samples collected in the 1980s, the concentrations were 22.6, 21.3, 69.13, 0.26, and 57.5 μg/g (summarized 218 samples) for Cu, Pb, Zn, Cd, and Cr. The concentrations of Cu, Pb, Zn, and Cd increased slightly. Generally, higher concentrations were measured in the Bohai Bay and central Bohai Sea. The distribution patterns of heavy metals were significantly different between samples collected after the year of 2000 and those in the 1980s. In the 1980s and recent years, higher concentrations of Zn, Cd, and Pb were measured in the samples collected from Bohai Bay and Liaodong Bay, respectively. This indicated that the sources of heavy metals in Bohai Sea were changed significantly during the past decades.


Personalized 3D-printed guide in malignant bone tumor resection and following reconstruction - 17 cases in pelvic and extremities.
Customized accurate tumor resection and individualized reconstruction is a challenging in treatment of malignant bone tumor. Three-dimensional (3D)-printing technique is now widely used in the resection and following reconstruction of malignant bone tumor, which included but not limited to tumor model, osteotomy guide and customized implant. We retrospectively reviewed 17 patients, who underwent limb salvage surgery by using 3D-printed guide at a single center between August 2014 and October 2019. The median duration of follow-up was 26.5 months. Osteosarcoma (41.2%) were the predominant diagnoses. The functional outcomes were assessed by Musculoskeletal Tumor Society (MSTS) functional score. We also analyzed survival status, intraoperative data (blood loss, operation time and resection length), reconstruction method, margin outcomes and complications. We totally performed 93 guided osteotomies on affected bone and allograft bone in 17 patients. Reconstruction in 12 cases was performed with biological technique: allograft combined with autograft was used in 7 cases. 11 of 12 (91.7%) cases showed a good bone healing in both allograft and autograft. 1 of 12 (8.3%) cases had allograft necrosis. Additional intra-operative extracorporeal radiation was performed in 3 pelvic cases for reconstruction. 63 of 64 (98%) osteotomies achieved wide resection and negative margin. All the cases had successful limb salvage result without amputation. At the latest follow up, the mean MSTS Score was 24 (range: 13-30), 12 patients alive with no evidence of disease, 1 patient alive with disease, 5 patients had died of disease and 5 years overall survival is 73.3%. The most common complications are wound healing disorder in 4 cases (23.5%) and infection in 3 cases (17.6%). The 3D-printed resection guide was easy to use and showed promise in the field of orthopedic oncology. It can not only used in primary malignant bone tumor personalized resection but also in shaping structural bone allograft in biological reconstruction, which can achieve a safety surgical margin and individualized resection at the same time.


[Combined cataract and glaucoma surgery. Current options].
Trabeculectomy is no longer the gold standard for combined cataract glaucoma surgery considering the successful results following cataract surgery combined with trabeculotomy, viscocanalostomy and canaloplasty. The main disadvantage of these mostly non-penetrating procedures is the induction of conjunctival scarring which jeopardizes subsequent filtering surgery. Ab interno glaucoma surgery, including trabecular surgery and endocyclophotocoagulation, does not interfere with the conjunctival situation. These surgical options have a relatively minor risk profile for combined cataract glaucoma surgery compared to traditional filtering surgery; however, the pressure reducing efficacy of these ab interno approaches is limited with respect to the absolute reduction of intraocular pressure (IOP) and the achievable level of IOP. This has to be kept in mind when planning surgery.


[Studies on extraction process optimization of patrinia scabra Bunge saponins].
To optimize the conditions for the extraction of Patrinia scabra Bunge saponins. Orthogonal experimental design and ultrasonic method were employed to examine the conditions for the extraction by determination of saponins. The optimun condition for the extraction of Patrinia scabra Bunge saponins was as follows: 65% ethanol for 40 minutes, 55 degrees C and 210 watt of ultrasonic efficinecy. The extraction method of Patrinia scabra Bunge sponins is simple and efficient.


Retransplantation for end-stage liver disease: a single-center Asian experience.
Liver retransplantation carries a significantly higher morbidity and mortality compared with patients after single transplantations. The aim of this study was to review our outcomes in liver retransplantations. From February 1984 to February 2007, 409 liver transplantations were performed on 396 patients, including 13 retransplantations (3.2%) in 12 patients. The mean follow-up was 1.6 +/- 0.4 years (range, 0.1-5.2). The mean duration between the first and the second transplantation was 2.8 +/- 1.0 years (range, 15 days-11.6 years). The indications for the first liver transplantation included biliary atresia (n = 3), hepatitis B virus (HBV)-related cirrhosis with hepatoma (n = 3), fulminant hepatic failure (n = 2), HBV-related end-stage liver disease (n = 1), hepatitis C virus (HCV)-related end-stage liver disease (n = 1), neonatal hepatitis (n = 1), and glycogen storage disease (n = 1). The indications for retransplantations were secondary biliary cirrhosis (n = 3), veno-occlusive disease-related liver failure (n = 2), hepatic arterial occlusion and graft failure (n = 2), chronic rejection with hepatic graft failure (n = 2), recurrent HBV (n = 1) and de novo HBV-related decompensated cirrhosis (n = 1), and idiopathic graft failure (n = 1). There were 4 living donor and 9 deceased donor liver retransplantations. The cumulative survival rate was 71.4 +/- 14.4%, with an estimated mean survival time of 3.9 +/- 0.7 years. Our results showed that minimizing the rate of retransplantation was critical to enhance overall patient survival. Moreover, living donor liver retransplantation is another option within the short, yet critical, waiting period, after failure of the first graft. Provided that a suitable living donor is available, we recommend early retransplantation to minimize the risk of morbidity and mortality.


Cerebral candidiasis. Computed tomography appearance.
A three year old child who had been suffering from oral candidiasis since the age of 1 year presented with osteitis of the clavicle, 2 cerebral frontal abscesses and an occipital abscess which extended across the calvaria and was associated with osteolysis. Histological and microbiological studies following surgery confirmed the diagnosis of candidiasis in this girl who was found to have IgA immunodeficiency. The authors report the computed tomographic appearance of the cerebral lesions and review the literature.


Effect of Motivational Interviewing on depression scale scores of adolescents with obesity and overweight.
The aim of this study was to compare the effect of motivational interview (MI) with conventional care on the depression scale scores of adolescents with obesity/overweight. It was a controlled cluster randomized trial with parallel design, including two groups: intervention group [Motivational Interview Group (MIG)], control group [Conventional Intervention Group (CIG)]. three face-to-face 30min' interviews three months apart (only MIG interviews were based on MI principles). change in Children Depression Inventory (CDI) scores. We used a mixed repeated-measures ANOVAs analysis to assess the group vs time interaction. Effect size was calculated for ANOVA with difference of means of the total score (DOMTS). CDI scores were compared by a paired t-test. Eighty-three (84%) adolescents finished the intervention. There was a significant time vs group interaction both groups. While in the CIG scores significantly increased, in the MIG the scores significantly decreased. The DOMTS was significantly different between the two groups. We concluded that MI showed a positive effect on depression scale scores over time relatively to conventional intervention.


Pharmacokinetic and tissue distribution study of six saponins in the rat after oral administration of Ilex pubescens extract using a validated simultaneous UPLC-qTOF-MS/MS assay.
Ilex pubescens Hook. et Arn is a medicinal plant of the Ilex family that is mainly used for the treatment of cardiovascular diseases. Its main medicinal ingredients are total triterpenoid saponins (IPTS). However, the pharmacokinetics and tissue distribution of the main multi-triterpenoid saponins are lacking. This is the first report that demonstrates a sensitive ultra-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry (UPLC-qTOF-MS/MS) method for the quantification of ilexgenin A (C1), ilexsaponin A1 (C2), ilexsaponin B1 (C3), ilexsaponin B2 (C4), ilexsaponin B3 (DC1) and ilexoside O (DC2) in rat plasma and various tissues of the heart, liver, spleen, lungs, kidney, brain, stomach, duodenum, jejunum, ileum, colon and thoracic aorta. The chromatographic separation was carried out on an Acquity HSS T3 UPLC column (2.1 × 100 mm, 1.8 µm, Waters, USA) with a mobile phase consisting of 0.1% (v/v) formic acid (A) and acetonitrile containing 0.1% (v/v) formic acid (B) at a flow rate of 0.25 mL/min. The MS/MS detection was performed by electrospray ionization (ESI) using selected ion monitoring (SIM) in negative scan mode. The developed quantification method showed good linearity over the concentration range of 10-2000 ng/mL for plasma and 25-5000 ng/mL for tissue homogenates with R2 ≥ 0.990. Lower limits of quantification (LLOQ) was 10 ng/mL in plasma and 25 ng/mL in tissue homogenates. The intra- and inter-day precision were less than 10.39%, and the accuracy was between - 1.03% and 9.13%. The extract recoveries, dilution integrity and matrix effect were well within satisfactory limits. Using the validated method, the pharmacokinetic parameters, including half-life, AUC, Cmax, CL, and MRT, of six triterpenoid saponins in rats after oral administration were provided by establishing their plasma concentration-time curves, while their absolute quantification in various tissues after oral administration was also determined at first, which provides a scientific basis for their clinical application.


Improved occupational performance of young adults with a physical disability after a vocational rehabilitation intervention.
The purpose of this study was to investigate into more detail how occupational performance of participants of a 1-year multidisciplinary vocational rehabilitation intervention changed over time, using a broad focus on three areas of occupational performance, addressing work, as well as self-care and leisure. In addition, we explored differences between employed and unemployed persons. In a pre-post-intervention design, changes in occupational performance, addressing work, self-care and leisure, were evaluated using the Canadian Occupational Performance Measure (COPM) and the Occupational Performance History Interview (OPHI-II). Eleven young adults (median 22 years) with physical disabilities participated. Post-intervention, participants experienced fewer problems and showed improved occupational performance in work, as well as self-care and leisure, and improved satisfaction with performance. Participants also showed improved occupational identity and occupational competence, and total scores on OPHI-II. Participants who did not achieve employment did not differ in demographic characteristics. They experienced problems in all three areas of occupational performance at pre-intervention, and more difficulty in interacting in occupational settings (environment). Post-intervention, their levels of occupational identity, competence and settings were similar to those of employed persons. Participants showed improved occupational performance after the intervention. The goal of employment and the broad integrated approach of the intervention seemed to motivate participants to resolve problems in work, as well as self-care and leisure. Unemployed persons faced problems in all three areas of occupational performance at start. Although they seemed to catch up during the intervention, they did not achieve employment within 1 year.


Production of fumonisin B1 and B 2 byFusarium moniliforme isolated from Korean corn kerneis for feed.
The natural occurrence of fumonisin B1 (FB1) and B2 (FB2), a promoter for hepatocarcinogenesis, was investigated in Korean corn kernels for feed by HPLC with fluorescence detection. From the 12 corn kernel samples, FB1 was detected in 5 samples at levels ranging from 53 to 1327ng/g, while FB2 was found in 4 samples from 69 to 680ng/g. In the positive samples, the average concentrations of FB1 and FB2 were 506 and 288ng/g, respectively. One sample (No. K3) showed the highest FB1 and FB2 contents as 1327 and 680ng/g, respectively.In the micrological survey on 5 positive samples for FB1 and FB2, 6 strains ofFusarium monlliforme were isolated, and all these isolates had a producibility of FB1 and FB1, with maximum levels of 80.7 to 180.9 g/g.Thisis the first report on the natural co-contamination of FB1 and FB2 in Korean corn kernels for feed, and on the ability ofF. moniliforme isolated from corn kernels for feed in Korea to produce FB1 and FB2.


Isolated frontal sinus aspergillosis treated by endoscopic modified Lothrop procedure.
Aspergillosis is a common fungal infection of the paranasal sinuses. Isolated frontal sinus aspergillosis is extremely rare, with only three cases reported in the literature. We report a case of isolated frontal sinus aspergillosis that was accompanied by a contralateral frontal sinus cyst enclosed osseously. The patient was treated successfully by an endoscopic modified Lothrop procedure that permitted complete removal of the fungus ball and wide opening of the frontal sinus. The patient is without evidence of disease 18 months after surgery.


Identification of two new members of the CSMD gene family.
CSMD1 is a putative suppressor of squamous cell carcinomas mapping to human chromosomal region 8p23. We have cloned two new members of this gene family, CSMD2 and CSMD3. The three CSMD proteins have very similar structures, each consisting of 14 CUB domains separated from one another by a sushi domain, an additional uninterrupted array of sushi domains, a single transmembrane domain, and a short cytoplasmic tail. CUB and sushi domains are thought to be sites of protein-protein or protein-ligand interactions, suggesting that CSMD proteins are either transmembrane receptors or adhesion proteins. The cytoplasmic tail sequences are highly conserved within the vertebrate lineage. CSMD2 maps to a chromosomal region that may contain a suppressor of oligodendrogliomas, yet its expression is elevated in some head and neck cancer cell lines. Functional overlap between the CSMD1 and the CSMD2 proteins may modify the phenotype resulting from the loss of either protein in tumors.


Evaluation of subsidence, chondrocyte survival and graft incorporation following autologous osteochondral transplantation.
The aim of this study was to evaluate subsidence tendency, surface congruency, chondrocyte survival and plug incorporation after osteochondral transplantation in an animal model. The potential benefit of precise seating of the transplanted osteochondral plug on the recipient subchondral host bone ('bottoming') on these parameters was assessed in particular. In 18 goats, two osteochondral autografts were harvested from the trochlea of the ipsilateral knee joint and inserted press-fit in a standardized articular cartilage defect in the medial femoral condyle. In half of the goats, the transplanted plugs were matched exactly to the depth of the recipient hole (bottomed plugs; n = 9), whereas in the other half of the goats, a gap of 2 mm was left between the plugs and the recipient bottom (unbottomed plugs; n = 9). After 6 weeks, all transplants were evaluated on gross morphology, subsidence, histology, and chondrocyte vitality. The macroscopic morphology scored significantly higher for surface congruency in bottomed plugs as compared to unbottomed reconstructions (P = 0.04). However, no differences in histological subsidence scoring between bottomed and unbottomed plugs were found. The transplanted articular cartilage of both bottomed and unbottomed plugs was vital. Only at the edges some matrix destaining, chondrocyte death and cluster formation was observed. At the subchondral bone level, active remodeling occurred, whereas integration at the cartilaginous surface of the osteochondral plugs failed to occur. Subchondral cysts were found in both groups. In this animal model, subsidence tendency was significantly lower after 'bottomed' versus 'unbottomed' osteochondral transplants on gross appearance, whereas for histological scoring no significant differences were encountered. Since the clinical outcome may be negatively influenced by subsidence, the use of 'bottomed' grafts is recommended for osteochondral transplantation in patients.


Aortic regurgitation in coronary artery bypass grafting: implications for cardioplegia administration.
Echocardiography can detect aortic regurgitation (AR) that may interfere with the adequate delivery of cardioplegia solution to the myocardium during cardiac operation. When aware of this lesion, the surgeon can modify the operative technique accordingly. We sought to evaluate the ability of intraoperative transesophageal echocardiography to detect AR and to correlate the severity of the lesion with the need for retrograde cardioplegia administration. Eighty-four consecutive patients undergoing coronary artery bypass grafting were evaluated. When AR was noted by intraoperative transesophageal echocardiography, a cannula was placed in the coronary sinus for possible retrograde cardioplegia administration. The surgeon was unaware of the severity of AR. After operation, the severity of AR was quantitated using the ratio of the regurgitation jet width to the left ventricular outflow tract diameter. The AR patients who required retrograde cardioplegia had a significantly higher ratio of regurgitation jet width to left ventricular outflow tract diameter than those AR patients who did not (0.36 +/- 0.06 versus 0.19 +/- 0.06, p < 0.005). Transesophageal echocardiography can provide accurate information regarding the presence and severity of AR. The calculated severity of AR on transesophageal echocardiography is associated with the need for retrograde cardioplegia administration.


Simulating failure times when the event of interest is unobservable with emphasis on animal carcinogenicity studies.
This paper discusses and summarizes the methods which can be used to simulate failure times when an intermediate event of interest is unobservable. Data from animal carcinogenicity experiments are typically of this form. The simulation of time-to-event data where cause of failure is known and the case where cause of failure is unknown are discussed. The methods proposed for simulating failure times use identifiable hazard functions and allow for random sampling of functioning experimental units at fixed times. Some useful design and programming tools are also given.


Rhamnolipid-biosurfactant permeabilizing effects on gram-positive and gram-negative bacterial strains.
The potential of biosurfactant PS to permeabilize bacterial cells of Pseudomonas aeruginosa, Escherichia coli, and Bacillus subtilis on growing (in vivo) and resting (in vitro) cells was studied. Biosurfactant was shown to have a neutral or detrimental effect on the growth of Gram-positive strains, and this was dependent on the surfactant concentration. The growth of Gram-negative strains was not influenced by the presence of biosurfactant in the media. Cell permeabilization with biosurfactant PS was shown to be more effective with B. subtilis resting cells than with Pseudomonas aeruginosa. Scanning-electron microscopy observations showed that the biosurfactant PS did not exert a disruptive action on resting cells such that it was detrimental to the effect on growing cells of B. subtilis. Low critical micelle concentrations, tender action on nongrowing cells, and neutral effects on the growth of microbial strains at low surfactant concentrations make biosurfactant PS a potential candidate for application in different industrial fields, in environmental bioremediation, and in biomedicine.


Synthesis and binding properties to GABA receptors of 3-hydroxypyridinyl- and 3-hydroxypiperidinyl-analogues of baclofen.
The synthesis of 3-(3-hydroxy-2-pyridinyl)propanoic acid, 3-(3-hydroxy-2-pyridinyl)-4-aminobutanoic acid, their corresponding piperidine compounds, and of some cyclized derivatives is described. In in vitro assays none of the new compounds shows any noteworthy affinity for GABAA or GABAB receptors; only (R,S)-3-(3-hydroxy-2-pyridinyl)-4-aminobutanoic acid and its lactam inhibited in some degree [3H]GABA binding, at 10(-4) M concentration, with low specificity as regards the two receptors.


Perfluorooctanoic acid (PFOA) exposure induces splenic atrophy via overactivation of macrophages in male mice.
Perfluorooctanoic acid (PFOA), a synthetic and widely used chemical, has aroused wide public concern due to its persistence, bioaccumulation, and potential toxicity. To investigate splenic atrophy induced by PFOA, male mice were exposed to 0, 0.4, 2, or 10 mg/kg/d PFOA for 28 d. Results demonstrated that spleen weight and relative spleen weight (RSW) decreased in the 2 and 10 mg/kg/d PFOA exposure groups. Iron levels in the spleen and serum were also reduced in all PFOA exposure groups. Weighted gene co-expression network analysis (WGCNA) of 7 043 genes highlighted enrichment in cell cycle, autoimmunity, and anemia in the spleen. In addition, changes in the levels of hemoglobin, platelets, bilirubin, and heme oxygenase-1 were consistent with anemia. The ratio of total macrophages to M1 macrophages in the spleen, phagocytic ability of macrophages, and levels of cytokines such as TNF-α, IL-1β, and IL-6 all increased, thus suggesting the occurrence of autoimmune disorder. Therefore, we concluded that overactivation of macrophages may be an important reason for splenic atrophy induced by PFOA exposure.


Activation of boron nitride nanotubes and their polymer composites for improving mechanical performance.
Boron nitride nanotubes (BNNTs) are inappropriate for further chemical derivatization because of their chemical inertness. We demonstrate covalent activation of chemically inert BNNTs by isophorone diisocyanate (IPDI) to form isocyanate group (NCO)-terminated BNNT precursors with an 'NCO anchor' ready for further functionalization. As identified by Fourier transform infrared spectroscopy, a number of molecules or polymers with -COOH, -OH or -NH₂ groups are readily attached to the activated IPDI-BNNTs. The IPDI-BNNT-involving polymer composites have shown mechanical properties are considerably improved due to the good dispersibility of IPDI-BNNTs in the polymer matrix and the strong interfacial interactions between BNNTs and polymers. The methodology reported here provides a promising method to promote the chemical reactivity of BNNTs and covalently modify polymer nanocomposites with improved mechanical performance.


Effects of multiplication stimulating activity (MSA) on AIB transport into myoblast and myotube cultures.
The effects of a somatomedian analog, Temin's multiplication stimulating activity (MSA), on amino acid transport into muscle cells have been characterized in a series of experiments on myoblasts and myotubes in culture. Addition of MSA to serum-starved L6 myoblasts increased the rate of aminoisobutyrate (AIB) uptake 50-150% within five hours. This early effect on transport was followed by increases in cell number, protein content and 3H-thymidine incorporation. Kinetic analyses indicated that MSA increased the maximal velocity of AIB uptake but had no effect on the KM for AIB. When myoblasts were allowed to fuse (and dividing cells eliminated by addition of 10(-4) M cytosine arabinoside) the AIB transport system(s) remained similarly responsive to MSA. In myoblasts and in myotubes, both the basal and MSA-stimulated rate of AIB uptake were sodium-dependent processes; little stimrulation occurred if sodium was absent from the labeling medium. Further suggesting the involvement of cations in response to hormone, MSA stimulated uptake of the potassium analog, 86Rb+, and increase net intracellular potassium in both myoblasts and myotubes. MSA was active at concentrations equivalent to in vivo levels of somatomedins; neither insulin nor growth hormone had any effect at or near physiological concentrations.


miR-663a inhibits hepatocellular carcinoma cell proliferation and invasion by targeting HMGA2.
Hepatocellular carcinoma (HCC) is a highly aggressive solid malignancy throughout the world. Dysregulation of miRNAs play essential roles in HCC progression via aberrant regulation of cell proliferation, apoptosis, as well as metastasis. miR-663a is a poorly investigated miRNA. Whether miR-663a regulates HCC development remains unknown. The aim of the study was to explore the role of miR-663a in HCC development. To determine the expression level of miR-663a in HCC, we analyzed the data from GSE21362 and TCGA. The results showed that miR-663a was significantly down-regulated in HCC tissue compared with adjacent non-tumor tissue. Gain of function and loss of function assays revealed that miR-663a distinctly inhibited cell proliferation, migration and invasion. Mechanistic investigations demonstrated that miR-663a modulated cell functions through targeting and suppressing high mobility group A2 (HMGA2). In addition, overexpression of HMGA2 remarkably attenuated the tumor repressive effect of miR-663a. Taken together, miR-663a inhibits HCC cell proliferation and motility by targeting HMGA2.


Theoretical study of electronic properties of organic photovoltaic materials.
It has been proved that fullerene derivatives, in which an oligophenylenevinylene (OPV) group is attached to C(60), present an interesting photophysical phenomenon and can be incorporated into photovoltaic cells. In these systems, the OPV acts as electron donor upon excitation, and then fullerene absorbs photoexcited electrons. These new organic semiconductor materials offer the prospect of lower manufacturing costs and they present several advantages: easy fabrication, large area, flexible and light weight devices when compared with inorganic counter parts. In the present theoretical study, oligomeric chains of p-phenylenevinylene (n-PPV, n = 3-8 units) and C(60)-OPV hybrids have been studied by density functional theory (DFT). Electronic properties such as electronic absorption and emission spectra were calculated in order to determinate how the increment of spectroscopic units affects their electronic behavior. These properties were carried out with time dependent-density functional theory (TD-DFT) and ZINDO semiempirical method. The theoretical calculations of the structural properties of n-PPV and fullerene-OPV hybrids were obtained using PBE1PBE/6-31G and ONIOM two-layered version, respectively. All calculations were done with Gaussian 03W program package.