Long-Term Survival Analysis and Prognostic Factors of Arabic Patients with Differentiated Thyroid Carcinoma: A 20-Year Observational Study at the King Hussein Cancer Center (KHCC) Involving 528 Patients.
DTC accounts for the majority of endocrine tumors. While the incidence of thyroid cancer has been increasing globally over the past few decades, papillary thyroid carcinoma (PTC) generally shows an excellent prognosis, except in cases with aggressive clinicopathological features. This study aimed to assess the 5- and 10-year overall survival (OS) and progression-free survival (PFS) of 528 Arabic patients diagnosed with primary DTC from 1998 to 2021. Additionally, the study aimed to analyze the impact of various factors on both OS and PFS. An univariable survival analysis was conducted using Kaplan-Meier curves. The 5- and 10-year OS for patients with DTC have exceeded 95%. Additionally, PFS showed very good rates (ranging between 96.5 and 85% at 5 and 10 years, respectively). Age, male gender, risk of recurrence, and distant metastasis were identified as the main negative prognostic factors for both OS and PFS, while RAI treatment was found to be a significant factor in improving OS. Moreover, adherence to the King Hussein Cancer Center's (KHCC) CPG demonstrated significant improvement in PFS. These findings highlight common prognostic factors and favorable outcomes in Arabic patients with DTC treated at a tertiary cancer center using standard of care approaches.


Covalently attached sandwich structure from colloidal particles and diazoresin.
A covalently attached sandwich structure between layers and particles has been fabricated from z.sbnd;COOH-containing copolymer latex particles and z.sbnd;N(2)(+)-containing polymers by self-assembly combined with a UV irradiation technique. The ionic bonds involving the layers and particles change to covalent bonds under UV irradiation and the sandwich structure become very stable toward polar organic solvents and electrolyte aqueous solutions.


The natural elimination rate of procalcitonin in patients with normal and impaired renal function.
Procalcitonin (PCT) plasma concentrations and its kinetic can be used as a diagnostic tool in critically ill patients and patients with sepsis. Since renal dysfunction is a frequent complication in these patients, and PCT is a protein with a low molecular weight, we have measured the half-life time of PCT after peak concentrations in patients with normal and impaired renal function. We also have analyzed the influence of patients age and gender on PCT elimination kinetics. Prospective clinical study. Renal dysfunction was assessed by plasma creatinine. The half-life time of PCT was evaluated 24 and 48 h after acute induction of PCT, when the focus of PCT induction has rapidly been eliminated. Intensive care unit of our University hospital, a tertiary health care institution. 69 patients were included into the study. None. The half-life-time of PCT was not significantly altered during renal dysfunction (26.1-33.1 h, 25-50 percentiles, creatinine clearance < 30 ml/min) when compared with normal renal function (22.3-28.9 h). It neither correlated with creatinine clearance (p=0.14), nor age (p=0.99) or gender (p=0.90, Pearson product-moment correlation). The data of the present study demonstrate that assessment of PCT kinetic can also be used for diagnostic and prognostic reasons in patients with renal dysfunction. It may, however, exceed 24 h also in patients with normal renal function. As to the present knowledge, renal secretion does not contribute as a main pathway to PCT elimination.


Measuring postirradiation subcutaneous soft-tissue fibrosis: state-of-the-art and future directions.
Clinician-based rating scales and quantitative instruments used to quantify the severity of soft-tissue fibrosis were reviewed to determine if they were reliable and valid measures for clinical and research use. Existing clinician-based measures, the Medical Research Council (MRC) and European Organization for Research and Treatment of Cancer/Radiation Therapy Oncology Group (EORTC/RTOG), have preliminary testing of reliability and validity such that they provided a basis for the development of a revised measure. The revised measure, designed for use in National Cancer Institute-Common Toxicity Criteria for Adverse Events v3.0, evaluates subcutaneous and deep-tissue fibrosis separately and each is graded on a 5-point scale. The revised measure needs to be tested for reliability and validity, and it is recommended that it be used in concert with the MRC and/or EORTC/RTOG scales until such evidence is available and its utility can be determined. Quantitative measures, although attractive from a research perspective, will have limited clinical and multisite utility because of the apparatus required and the associated costs. Finally, a framework for evaluating fibrosis and the consequences of fibrosis is presented.


Identification of insulin-like growth factor-binding protein-2 (IGF-BP-2) and a low molecular weight IGF-BP in human seminal plasma.
Three distinct binding proteins for the insulin-like growth factors (IGF-BPs) have recently had their cDNAs cloned and sequenced. We have evaluated IGF-BP expression in normal, oligospermic and azospermic human seminal plasma (SP), and have identified IGF-BP-2 in all samples. Additionally, SP contains a non-glycosylated low molecular weight IGF-BP (24K), which does not appear to be structurally or immunologically related to IGF-BP-1, -2 or -3.


Effects of Ala-Gln feeding strategies on growth, metabolism, and crowding stress resistance of juvenile Cyprinus carpio var. Jian.
The present study was conducted to evaluate the effects of different L-alanyl-l-glutamine (Ala-Gln) feeding strategies on the growth performance, metabolism and crowding stress resistance related parameters in juvenile Jian carp (Cyprinus carpio var. Jian) under crowded condition (80 g/L). Juvenile Jian carp (initial weight 26.1 ± 0.6 g) were distributed into five groups which fed with graded concentrations (0% or 1.0%) of Ala-Gln for eight weeks. Control group (I, 0/0) fed with control diet (0% Ala-Gln) throughout the feeding trial. The other four groups employed different control and experimental diet feeding strategies ranging from two weeks control diet fed and two weeks experimental diet (1% Ala-Gln) fed (II, 0/2) to eight weeks experimental diet fed (V, 4/4). Results revealed that Mean weight gain (MEG) under all different feeding strategies of Ala-Gln were significantly higher than that of the control group (p < 0.05), and MEG of group II (201.90%) was even higher than that of group IV (184.70%). Liver glycogen and blood total protein of groups II, III and V were significantly higher than that in groups I and IV (p < 0.05). The highest level of serum thyroxine (10.07 ng/ml), insulin-like growth factor-I (52.40 ng/ml) and insulin (9.73 μ IU/mL) were observed in group V. However, diet supplemented with Ala-Gln did not affect the levels of serum glucose, cortisol and catecholamine in fish. The mRNA expression of GR1a, GR1b and GR2 were also significantly changed in Ala-Gln supplementation groups compared with control group (p < 0.05). After fish intraperitoneally injected with virulent Aeromonas hydrophila, the fish survival rates were significantly increased in all Ala-Gln supplementation groups compared with control group (p < 0.05). Results from the present experiment showed the importance of dietary supplementation of Ala-Gln in benefaction of the growth performance, metabolism and crowding stress resistance in Jian carp breeding. The optimal feeding strategy was alternatively fed with control diet and then experimental diet at an interval of two weeks for juvenile Jian carp under crowded condition.


Coordinating expectations through central bank projections.
Central banks are increasingly communicating their economic outlook in an effort to manage the public and financial market participants' expectations. We provide original causal evidence that the information communicated and the assumptions underlying a central bank's projection can matter for expectation formation and aggregate stability. Using a between-subject design, we systematically vary the central bank's projected forecasts in an experimental macroeconomy where subjects are incentivized to forecast the output gap and inflation. Without projections, subjects exhibit a wide range of heuristics, with the modal heuristic involving a significant backward-looking component. Ex-Ante Rational dual projections of the output gap and inflation significantly reduce the number of subjects' using backward-looking heuristics and nudge expectations in the direction of the rational expectations equilibrium. Ex-Ante Rational interest rate projections are cognitively challenging to employ and have limited effects on the distribution of heuristics. Adaptive dual projections generate unintended inflation volatility by inducing boundedly-rational forecasters to employ the projection and model-consistent forecasters to utilize the projection as a proxy for aggregate expectations. All projections reduce output gap disagreement but increase inflation disagreement. Central bank credibility is significantly diminished when the central bank makes larger forecast errors when communicating a relatively more complex projection. Our findings suggest that inflation-targeting central banks should strategically ignore agents' irrationalities when constructing their projections and communicate easy-to-process information.


Subject-level measurement of local cortical coupling.
The human cortex is highly folded to allow for a massive expansion of surface area. Notably, the thickness of the cortex strongly depends on cortical topology, with gyral cortex sometimes twice as thick as sulcal cortex. We recently demonstrated that global differences in thickness between gyral and sulcal cortex continue to evolve throughout adolescence. However, human cortical development is spatially heterogeneous, and global comparisons lack power to detect localized differences in development or psychopathology. Here we extend previous work by proposing a new measure - local cortical coupling - that is sensitive to differences in the localized topological relationship between cortical thickness and sulcal depth. After estimation, subject-level coupling maps can be analyzed using standard neuroimaging analysis tools. Capitalizing on a large cross-sectional sample (n=932) of youth imaged as part of the Philadelphia Neurodevelopmental Cohort, we demonstrate that local coupling is spatially heterogeneous and exhibits nonlinear development-related trajectories. Moreover, we uncover sex differences in coupling that indicate divergent patterns of cortical topology. Developmental changes and sex differences in coupling support its potential as a neuroimaging phenotype for investigating neuropsychiatric disorders that are increasingly conceptualized as disorders of brain development. R code to estimate subject-level coupling maps from any two cortical surfaces generated by FreeSurfer is made publicly available along with this manuscript.


Inhibition and affinity chromatography of chicken lung angiotensin I-converting enzyme with captopril.
1. Angiotensin I-converting enzyme (EC 220.127.116.11) has been purified to electrophoretic homogeneity from chicken lung by using a facile two-step protocol which included affinity chromatography on Sepharose-bound captopril. 2. Captopril was a potent inhibitor of chicken lung angiotensin I-converting enzyme with Ki values of 2.0 nmol/l and 1.6 nmol/l for detergent-extracted and trypsin-extracted angiotensin I-converting enzymes, respectively. 3. Molecular weight comparison of trypsin-extracted (M(r)270,000) and detergent-extracted (M(r)690,000) angiotensin I-converting enzyme indicated that membrane-binding sequence contributed to a large extent to the enzyme molecule. 4. Kinetic properties of both forms of the enzyme suggested that the membrane-bound sequence contributed to an increase of the enzyme-substrate affinity.


Evaluation of the bioequivalence and pharmacokinetics of two formulations of rizatriptan after single oral administration in healthy volunteers.
The pharmacokinetic parameters of two oral formulations of rizatriptan (CAS 144034-80-0, a capsule preparation as test and rizatriptan tablet as reference), given at a single dose of 10 mg each, were compared in an open-label, randomized, single oral dose, two-period cross-over design in 20 healthy volunteers under fasting conditions. Plasma concentrations of rizatriptan were measured by a validated HPLC assay. The parametric 90% confidence intervals of the geometric mean values of the test/reference ratios were 91.9% to 101.9% (point estimate: 97.3%) for AUC(0-infinity), 93.0% to 102.2% (point estimate: 96.5%) for AUC(0-t), 90.1% to 100.0% (point estimate: 95.4%) for Cmax, being within the acceptance criteria for bioequivalence (80%-125%). Tmax values were analyzed by the nonparametric Wilcoxon test and the difference was not statistically significant. Therefore, it is concluded that the test and reference rizatriptan formulations are bioequivalent with regard to both the extent and the rate of absorption.


A possible role for progesterone in the preovulatory gonadotropin surge through modulation of LHRH degrading activity.
The preovulatory surge of gonadotropins is triggered by estradiol and enhanced to its full magnitude by progesterone. Progesterone may exert this effect through several mechanisms. One of the mechanisms is through the ability of progesterone to induce an increase in the hypothalamic content and release of LHRH. The purpose of this study was to determine if progesterone might not act through yet another mechanism and facilitate LHRH release of the proestrous gonadotropin surge through modulation of luteinizing hormone releasing hormone (LHRH) degrading activity. Sixty-day-old Sprague-Dawley rats were ovariectomized; 14 days later, the estradiol-progesterone milieu of proestrous was mimicked in these animals through the use of estradiol containing silastic implants and subcutaneous progesterone injections. The LHRH degrading activity of the hypothalamus, pituitary and serum were monitored subsequently at preselected time points. In the hypothalamus, estradiol alone was capable of inducing significant increase in degrading activity; progesterone alone had no effect; however, progesterone subsequent to estradiol priming suppressed the increase induced by estradiol alone. In the pituitary, neither estradiol alone nor progesterone alone nor progesterone subsequent to estradiol priming had any significant effect on degrading activity. In the serum, estradiol induced a rapid and significant increase in activity; progesterone alone suppressed activity; progesterone subsequent to estradiol priming induced a similar but more rapid suppression. Therefore, the overall tendency was for estradiol to stimulate and progesterone to suppress LHRH degrading activity in the tissues studied. The results of this study indicate that progesterone has the capacity to suppress LHRH degrading activity and may be one of the mechanisms capable of increasing the availability of LHRH to the anterior pituitary gland thereby facilitating the preovulatory gonadotropin surges.


Discoidin domain receptor inhibitors as anticancer agents: A systematic review on recent development of DDRs inhibitors, their resistance and structure activity relationship.
Discoidin domain receptors (DDRs) are one of the less explored targets for the treatment of cancer which belong to receptor tyrosine kinases family. Discoidin domain receptors (DDRs) are a collagen-activated receptor tyrosine kinase and essential for controlling cellular functions like proliferation, morphogenesis, adhesion, differentiation, invasion, matrix remodeling, and migration. Although there are many targets and their inhibitors are reported which treat cancer. But most of drugs were amalgamated with moderate to severe side effects. This results in untreated cancerous cells. One of the reasons that cancer is considered challenging to treat because the targets were mutating rapidly and the inhibitor become less potent. The target identification is a tedious task for the researchers from the early 1990 s till date. When it comes to cancer, there has not been any magical stick to treat it undisputedly. Therefore, need for discovery of new receptor may helpful to overcome these difficulties. The development of DDR inhibitors has received a lot of attention ever since the target was discovered. In this review we have reported the development of most promising DDR1 and DDR2 small molecule inhibitors from the perspective of medicinal chemistry. We have also discussed about the clinical trials, recent patents, selectivity biological activity, and structure-activity relationship (SAR) of DDR1 and DDR2 inhibitors.


Isolation and identification of an arabinogalactan extracted from pistachio external hull: Assessment of immunostimulatory activity.
This work studies the extraction and purification of a novel arabinogalactan from pistachio external hull. It was extracted with a simple method from pistachio hull which is considered as unexploited waste. Based on the results of sugar analysis by GC-FID, glycosidic linkage by GC-MS, NMR spectroscopy, and molecular weight by Size Exclusion Chromatography, pistachio hull water soluble polysaccharides (PHWSP) were identified as a type II arabinogalactan (AG), with characteristic terminally linked α-Araf, (α1 → 5)-Araf, (α1 → 3,5)-Araf, terminally linked β-Galp, (β1 → 6)-Galp, and (β1 → 3,6)-Galp. DEPT-135, HSQC, HMBC and COSY NMR data suggested the presence of (β1 → 3)-Galp mainly branched at O-6 with (β1 → 6)-Galp chains, α-Araf chains, and terminally linked α-Araf. These AG from pistachio external hulls showed in vitro stimulatory activity for B cells, suggesting their possible use as an immunological stimulant in nutraceutical and biomedical applications.


Mesh tube-calibrated varicose veins for coronary artery bypass grafting.
Complex arterial bypass grafting may be contraindicated for patients with multivessel disease and inadequate saphenous veins. In such cases varicose veins may be used as bypass conduits after calibration by insertion into mesh tubes. After in vitro and experimental testing, as well as gratifying results in infrainguinal arterial reconstructions, wrapped varicose vein grafts in addition to arterial bypass grafts were used in 6 patients undergoing coronary artery bypass grafting.


The interactive effect of the MAOA-VNTR genotype and childhood abuse on aggressive behaviors in Chinese male adolescents.
Gene-environment interactions that moderate aggressive behavior have been identified in association with the MAOA (monoamine oxidase A) gene. The present study examined the moderating effect of MAOA-VNTR (variable number of tandem repeats) on aggression behavior relating to child abuse among Chinese adolescents. A sample of 507 healthy Chinese male adolescents completed the Child Trauma Questionnaire-Short Form (CTQ-SF) and Youth Self-report of the Child Behavior Checklist. The participants' buccal cells were sampled and subjected to DNA analysis. The effects of childhood abuse (CTQ-SF scores), MAOA-VNTR [high-activity allele (H) versus low-activity allele (L)], and their interaction in aggressive behaviors were analyzed by linear regression. Child maltreatment was found to be a significant independent factor in the manifestation of aggressive behavior, whereas MAOA activity was not. There was a significant interaction between MAOA-VNTR and childhood maltreatment in the exhibition of aggressive behaviors. In the context of physical or emotional abuse, boys in the MAOA-L group showed a greater tendency toward aggression than those in the MAOA-H group. Aggressive behavior arising from childhood maltreatment is moderated by MAOA-VNTR, which may be differentially sensitive to the subtype of childhood maltreatment experienced, among Chinese adolescents.


A fatal case of Ludwig's angina and mediastinitis caused by an unusual microorganism, Gemella morbillorum.
We present a case of Ludwig's angina in a 48-y-old immunocompetent male caused by an unusual pathogen, Gemella morbillorum. The infection was complicated with mediastinitis and despite aggressive management of the disease the patient died after 12 d of hospitalization. This is the first reported case of Ludwig's angina caused by G. morbillorum and emphasizes that the disease remains a potentially lethal infection.


Low-tech vs. high-tech approaches in μPADs as a result of contrasting needs and capabilities of developed and developing countries focusing on diagnostics and point-of-care testing.
Paper-based analysis has captivated scientists' attention in the field of analytical chemistry and related areas for the last two decades. Arguably no other area of modern chemical analysis is so broad and diverse in its approaches spanning from simple 'low-tech' low-cost paper-based analytical devices (PADs) requiring no or simple instrumentation, to sophisticated PADs and microfluidic paper-based analytical devices (μPADs) featuring elements of modern material science and nanomaterials affording high selectivity and sensitivity. Correspondingly diverse is the applicability, covering resource-limited scenarios on the one hand and most advanced approaches on the other. Herein we offer a view reflecting this diversity in the approaches and types of devices. The core idea of this article rests in dividing μPADs according to their type into two groups: A) instrumentation-free μPADs for resource-limited scenarios or developing countries and B) instrumentation-based μPADs as futuristic POC devices for e-diagnostics mainly aimed at developed countries. Each of those two groups is presented and discussed with the view of the main requirements in the given area, the most common targets, sample types and suitable detection approaches either implementing high-tech elements or low-tech low-cost approaches. Finally, a socioeconomic perspective is offered in discussing the fabrication and operational costs of μPADs, and, future perspectives are offered.


Comparison of developmentally regulated lectins from three species of cellular slime mold.
Extracts of the cohesive forms of the cellular slime molds Dictyosteliym discoideum, Dictyostelium mucoroides and Dictyostelium purpureum contain lectin activity, assayed as hemagglutination activity. The lectin activity from each species binds quantitatively to Sepharose 4B and can be eluted with D-galactose. The resultant purified lectins are abundant proteins representing, in the case of D. purpureum, up to 5% of the total soluble protein of cohesive cells. The preparations from each species are similar but distinct in amino acid composition and other properties. Each purified preparation gives rise to two protein bands on sodium dodecyl sulfate-polyacrylamide gel electrophoresis with the major band representing as little at 77% (D. purpureum) and as much as 96% (D. mucoroides) of the total protein in the two bands. The molecular weights of the pair of bands were different for each species, ranging between about 23 000 and 26 000. The two bands are believed to represent subunits of lectins made up of either one or a combination of these two proteins. The apparent molecular weights of the purified lectin activities determined by sucrose density gradient centrifugation were all in the range of 100 000. N-Acetyl-D-galactosamine was a potent inhibitor of the hemagglutination activity of each perparation; but there were some differences in the relative inhibitory potency of a number of other saccharides. Antiserum raised against each preparation, as well as univalent antibody fragments derived from these antisera, reacted best with the antigens to which they were raised; but showed some cross reaction measured both by precipitin reactions and by inhibition of hemagglutination activity of the purified lectins. The differences between the lectins from the different species could be trivial; but they also could be important for defining specific properties of these three species which reliably segregate into colonies of a single species when grown in mixed culture.


Laryngopharyngeal Reflux and GERD: Correlation Between Reflux Symptom Index and Reflux Finding Score.
To study the relationship between laryngopharyngeal reflux (LPR) and gastroesophageal reflux disease (GERD) using clinical scoring and endoscopy. Data was collected from a sample of 100 patients with GERD symptoms who presented to ENT out-patient department, for a duration of 2 years. Patients were evaluated using Reflux Symptom Index (RSI) questionnaire and Reflux Finding Score (RFS). All patients underwent videolaryngoscopy and upper gastrointestinal endoscopy. Patient with positive findings underwent treatment with proton pump inhibitors and were followed up for 3 months. Out of 100 patients, 23 had LPR, 19 had GERD, 40 had LPR + GERD, 18 were normal. Among the LPR group, the predominant symptoms were hoarseness of voice, globus sensation and heartburn. Majority of GERD group had globus sensation, dysphagia and heartburn as their predominant symptoms. On laryngoscopy, in both LPR and LPR + GERD group, most common finding was interarytenoid erythema and vocal cord edema. On esophagogastroduodenoscopy, in both GERD and LPR + GERD group, esophagitis was the most common finding. RSI value was highest in patients with LPR + GERD. RFS value was high in LPR group followed by groups of LPR + GERD and GERD. RSI and RFS are easily administered, highly reproducible, low cost clinical scoring symptom questionnaire which can identify the patients with LPR. 82.6% of LPR patients had significant RFS scoring but with no significant findings in OGD. This study also illustrates the importance of PPI therapy in LPR patients with no evidence of GERD.


Complex Re-Entrant Arrhythmias Involving the His-Purkinje System: A Structured Approach to Diagnosis and Management.
This study sought to characterize the presentations, electrophysiological features and diagnostic maneuvers for a series of unique arrhythmias involving the HPS. By virtue of its unique anatomy and ion channel composition, the His-Purkinje system (HPS) is prone to a variety of arrhythmic perturbations. The authors present a collaborative multicenter case series of 6 patients with HPS-related arrhythmias. All patients underwent electrophysiological studies using standard multipolar catheters. In 3 patients, both typical and reverse bundle branch re-entry were seen, with 1 patient demonstrating "figure of 8" re-entry likely involving the septal fascicle. One patient presented with systolic dysfunction associated with a high premature ventricular complex burden, with the mechanism being bundle-to-bundle re-entrant beats masquerading as dual response to a single sinus impulse. Two patients were diagnosed with interfascicular re-entry. Diagnosis was aided by careful assessment of HV interval in sinus rhythm and ventricular tachycardia, multipolar catheters to assess the activation sequence of the His-right bundle branch, and fascicles and entrainment of different components of the HPS. Cure of the arrhythmia was achieved by ablation of the right bundle branch block in 3 patients, the left septal fascicle in 2 patients, and the left posterior fascicle in 1 patient. Proper diagnosis of re-entrant arrhythmias involving the HPS may prove challenging. We emphasize a structured approach for diagnosis and effective therapy.


On the residual water content of dried but viable cells.
We have examined the residual water in dried cysts of the brine shrimp, Artemia salina, by gas-bombardment techniques at reduced pressures and temperatures. This treatment reduced, but did not remove all the residual water, the lower limit being about 0.0069 gH2O/g dried weight. The significance of such small amounts of water to cell hydration is assessed. The treatment did not appreciably reduce the viability of this cyst population.


Pigmented dermatofibrosarcoma protuberans (Bednár tumor). An autopsy case with systemic metastasis.
An autopsy case of pigmented dermatofibrosarcoma protuberans (Bednár tumor) with systemic metastasis is reported. No previous example of this tumor showing widespread metastasis has been reported in the literature. The patient, a 45-year-old man, developed a tumor on the right upper arm. The tumor recurred twice and metastasized to other parts of the skin, lungs and brain during the 8-year clinical course. The primary tumor contained melanin-laden tumor cells and showed a storiform growth pattern. Autopsy confirmed multiple metastatic lesions in the skin, lungs, brain, thyroid, pancreas, stomach, small intestine and thigh muscles. The recurrent and metastatic tumors lacked both melanin production and the storiform arrangement, and instead revealed "fibro-sarcomatous" change with a herring-bone or interlacing pattern of growth.


[Follow-up and evaluation of plans developed during pulmonary rehabilitation].
Pulmonary rehabilitation inevitably contains two essential components: therapeutic education and exercise training. The principal aim of this study was to evaluate the evolution over a year of the realization of plans determined during a pulmonary rehabilitation program (PRP). At the end of a PRP the patient made plans in accordance with his health condition. A telephone enquiry was undertaken at 3, 7 and 12 months to evaluate the progress of the plans, the motivation to perform them, dyspnoea and quality of life. The data of 65 patients were analyzed (87 inclusions). Fifty-seven percent of the plans continued for one year. Walking had an adherence rating of 71%. Loss of motivation appeared to be the main cause for stopping (20%). Quality of life remained stable (p=0.39) and an increase in dyspnoea, though statistically significant (p<0.01), was of no clinical relevance. The majority of plans were maintained but without clinical effect on the quality of life or the level of dyspnoea. Decreased motivation was the major limitation to realization or continuation of the plans. New studies will have to be implemented to analyze the factors which lead to this decrease.


Are solidified fillings of mesopores basically bulk-like except for the geometric confinement?
A short review of our thermodynamic and structural work on Ar, N(2), CO, O(2), and the n-alkane C(19)H(40) in mesoporous glasses is presented. The experimental information comes from X-ray diffraction, vapour pressure isotherms, optical transmission, heat capacity, and dielectric measurements. The filling in the pore centre formed by capillary condensation is distinguished from the adsorbed layers on the pore walls and is compared to the bulk state. Special attention is paid to metastable states and to the rearrangement of partial fillings that show up as a consequence of phase transitions.


Analysis of feeding suppression produced by perifornical hypothalamic injection of catecholamines, amphetamines and mazindol.
The effects on feeding of perifornical hypothalamic injection of catecholamines, amphetamines and mazindol were examined in hungry rats. In pargyline-pretreated subjects, both dopamine and epinephrine significantly suppressed food intake, at doses as low as 31 ng for dopamine and 150 ng for epinephrine (the latter injected with an alpha-adrenoceptor blocker). This effect was reliably strengthened by inhibiting catecholamine deamination or presynaptic catecholamine uptake. Perifornical injections of amphetamine, mazindol, methamphetamine, and phenmetrazine also suppressed feeding. The magnitude of this effect in individual animals was positively correlated with the effect produced by catecholamine agonists. Moreover, this effect of mazindol was partially antagonized by perifornical injection of dopaminergic and beta-adrenoceptor blockers. The effects of amphetamine and epinephrine were abolished by these drugs, while dopamine's effect was selectively inhibited by the dopaminergic antagonist. Serotonergic antagonists produced no change. These findings lend support to the hypothesis that perifornical hypothalamic catecholamine neurons, through dopaminergic receptors and beta-adrenoceptors, are involved in inhibiting feeding behavior, as well as in mediating the anorexic action of the amphetamines and mazindol.


Trophoblast debris modulates the expression of immune proteins in macrophages: a key to maternal tolerance of the fetal allograft?
Interactions between maternal immune cells and the placenta are of substantial interest since diseases of pregnancy, such as recurrent miscarriage, villitis of unknown etiology and preeclampsia may arise due to inadequate adaptation of the maternal immune system. During normal pregnancy trophoblast debris is shed from the placenta into the maternal blood in large quantities. This trophoblast debris is then rapidly cleared from the maternal circulation. In this study, we exposed trophoblast debris generated from an in vitro placental explant model to peripheral blood-derived macrophages and quantified a variety of molecules that are important in immune responses by ELISA or flow cytometry. Phagocytosis of trophoblast debris resulted in reduced cell-surface expression of MHC-II molecules, the costimulatory molecules (CD80, CD86, CD40 and B7H3), monocyte chemoattractant protein-1 (MCP-1), inter-cellular adhesion molecule 1 (ICAM-1) and IL-8 receptors in macrophages while the expression of programmed death-1 ligand 1 (PD-L1) was upregulated. In addition, phagocytosis of trophoblast debris induced the secretion of the anti-inflammatory cytokines IL-10, IL6 and IL1Ra and decreased the secretion of pro-inflammatory cytokines IL-1β, IL12p70 and IL-8 by macrophages. Phagocytosis of trophoblast debris also increased macrophage expression of the immunosuppressive enzyme indoleamine 2,3-dioxygenase (IDO). We have shown that phagocytosis of trophoblast debris from normal placentae alters the phenotype of macrophages such that they are likely to deviate maternal immune responses towards tolerance and away from inflammation. This may be one of the mechanisms that allow the human fetal allograft to survive in direct contact with the maternal immune system.


Optimization of gluten-free bread production with low aflatoxin level based on quinoa flour containing xanthan gum and laccase enzyme.
This study was aimed to develop a new cereal-based product using quinoa flour, xanthan gum, and laccase and also to evaluate their effects on the quality characteristics of gluten-free bread (GFB). Experimental design method was applied for optimization of gluten-free formulation. The effects of three variables of quinoa flour (0-50%), laccase activity (0-2 U/g flour), and xanthan gum (0-0.5%) on the contents of total aflatoxin (TAF) and aflatoxin B1 (AFB1), color indices (L*, a*, and b*), and texture properties (hardness, cohesiveness, and springiness) of GFB were evaluated. The results showed that quinoa flour and laccase enzyme significantly reduced TAF and AFB1 (p < 0.05). The lowest AFB1 level (3.67 ± 0.96 ng/g) in the GFB formulation containing quinoa flour (40%), laccase enzyme (2.0 U/g), and xanthan gum (0.46%) was very close to the predicted amount (3.66 ± 0.96 ng/g). Quinoa flour significantly reduced the L* and a* values and increased b* value and improved the texture parameters. Laccase enzyme also improved color indices and texture properties. Therefore, the use of laccase enzyme and quinoa flour is recommended based on the desired effect on the quality characteristics of GFB.


Retrospective study of malaria cases treated in Newcastle General Hospital between 1990 and 1996.
Malaria, in particular Falciparum malaria, continues to pose a substantial risk to travelers to endemic areas. In this study we examined 93 case notes of patients with malaria treated in our department between 1990 and 1996. Forty-seven (50.5%) patients had infection with Plasmodium falciparum, 41 (44.1%) had Plasmodium vivax and 5 (5.4%) had Plasmodium ovale. One of these patients had a dual infection with P. falciparum and P. vivax. None of our patients had Plasmodium malariae. Forty-four of the P. falciparum cases (93.6%) were imported from sub-Saharan Africa, 33 of the P. vivax cases (78.5%) were imported from the Indian subcontinent. All the P. ovale cases were imported from sub-Saharan Africa. Fifty-four of our patients (58.1%) did not take any form of chemoprophylaxis. Forty-two out of 93 (45.2%) of the "travelers" were settled immigrants in the UK. Seventy-eight percent of travelers of British caucasian origin took prophylaxis whereas only 13.5% of travelers of ethnic minorities origin took prophylaxis. Greater awareness of the risk of malaria by travelers and medical practitioners in UK must be encouraged and in particular appropriate chemoprophylaxis instituted for travelers to chloroquine-resistant areas.


Left axis deviation in healthy infants and children.
In a series of 1036 routine electrocardiograms, 14 children, without clinical and echocardiographic evidence of heart disease, showed a left axis deviation in the standard electrocardiogram. Six children also had an incomplete right bundle branch block. Left axis deviation is defined as a mean frontal QRS complex axis being -30 degrees or less. The age varied from three months to 10 years, with a clear predominance of males (13/14). The unusual finding of left QRS axis deviation in normal children is emphasized.


Efficacy and safety of foam sclerotherapy with sodium tetradecyl sulfate as preferred sclerosant of venous malformations based on experience from a single specialist center.
We have assessed the efficacy and safety of interventional therapy for venous malformations (VMs), with foam sclerotherapy as the treatment of choice according to our experience at a single specialist center. All the patients with VMs who had undergone interventional therapy (ie, embolo-sclerotherapy and/or open surgery) from January 1, 2015 to December 31, 2019 were identified through a prospective database. The VM types were classified according to the Puig classification. The outcome measures assessed included the efficacy and complications. The former was divided into four groups: no response, mild response, moderate response, and complete response. The complications were defined as any tissue or functional damage, distal embolization, or tissue reaction. The continuous variables were compared using the analysis of variance F test, and discrete variables were analyzed using the χ2 tests. P values < .05 were considered statistically significant. A total of 207 patients were included. Puig type I lesions were significantly less likely to have received foam sclerotherapy using sodium tetradecyl sulfate (STS) 3% (P ≤ .001) and more likely to have been surgically excised (P ≤ .001). At the patient's first procedure during the study period, the volumes of foam STS 3% were significantly different across all types of VM (P ≤ .001). The patients with type I VMs had received a lower volume of STS 3% compared with those with type II and III VMs. The efficacy outcome categories were significantly different across all types of VMs (P ≤ .001). Overall, only 14 patients (6.8%) had reported no improvement in efficacy, and 38 patients (18%) had not attended follow-up. Therefore, 154 patients (74.8%) had experienced some form of efficacious outcome. Ten patients (4.8%) had developed complications such as hematoma, thrombophlebitis, and ulceration. The incidence of complications differed significantly across the categories (P = .030), with more complications reported for those with type I VMs. We found that intervention with foam sclerotherapy using STS 3% is clinically effective and safe for patients with VMs and was most successful for those with Puig type I and II VMs.


Training of CT-guided Periradicular Therapy in a Realistic Simulation Environment - Evaluation and Recommendations for a Training Curriculum.
To evaluate the training of computed tomography (CT)-guided periradicular therapy in a realistic simulation environment and to derive recommendations for a training curriculum. A novel simulation environment including the use of a 3D printed, patient-mimicking phantom was used to train medical students to perform CT-guided periradicular therapy of the lumbar spine. Seventeen participants underwent three training sessions (day 0, day 7, and after day 28) with six procedures per session. Procedure duration and the number of fluoroscopy image acquisitions were recorded. Participants' performance was assessed by an independent investigator using a six-point checklist scale (0 = lowest, 6 = highest). In addition, participants self-evaluated their skills and the simulation training in questionnaires. Procedure durations and image acquisitions decreased after one training session (p < 0.001) without further improvement thereafter (p > 0.6). They also decreased within training sessions and were lowest after five procedures in all sessions. Performance scores improved after the first session to nearly perfect scores in the second session (mean 5.7; 95%CI: 5.5-6.0; p < 0.001) and decreased again in the third session (mean 4.9; 95%CI: 4.6-5.3; p = 0.008). Participants were satisfied with their training progress and felt adequately prepared to perform CT-guided periradicular therapies on patients after the training. Simulation-based training of CT-guided periradicular therapy in a realistic environment is effective and should ideally be performed with one training session consisting of five procedures shortly before treating the first patient.


Behavioral "insomnia" in the child.
Most of the causes of sleeplessness in the young child after early infancy are behavioral in nature. These may be primary or they may complicate other disorders. Typical factors include inappropriate associations to the sleep transition process, absent and inconsistent limit setting by caretakers, and various scheduling abnormalities (including unnecessary nighttime feedings). Once proper diagnosis is made, rapid resolution can be expected through behavioral intervention. Even partial arousal symptomatology ("night terrors"), often misdiagnosed at this age, may reflect, and respond to correction of, inappropriate sleeping schedules.


[Main stem intervention-Is one stent better than two after all?]
The current European Society of Cardiology (ESC) guideline recommendations give equal consideration to percutaneous coronary interventions (PCI) and bypass surgery for the treatment of main stem stenosis. Because of the anatomical setting, interventional treatment of main stem stenosis represents a complex PCI procedure. For this reason, extensive planning of the PCI with the use of intravascular imaging is necessary to assess the extent of calcification in the main stem itself and also in the proximal vascular segment of the anterior interventricular branch (left anterior descending, LAD) and the circumflex branch (RCX). Furthermore, an assessment of the vessel diameter is necessary for planning the PCI as well as for stent selection. Especially in the case of severely calcified lesions, careful and routine dissection of the lesion to be treated is essential. For this purpose, so-called cutting balloons, scoring balloons or debulking devices (rotational atherectomy, orbital atherectomy) can be used. In the case of a main stem stenosis involving the bifurcation, the choice of stent strategy depends on the extent of calcification of the daughter vessels (LAD and RCX), as well as the complexity of the bifurcation stenosis. The superiority of the so-called double kissing (DK) crush technique over a single stent strategy could be confirmed in a randomized trial and should be used in main stem bifurcation stenoses with pronounced calcification of the proximal segments of the LAD and RCX (stenosis length > 10 mm, and > 70% diameter stenosis). The already established 2‑stent strategies for the treatment of bifurcation stenosis could be modified or further developed. In preliminary studies the advantage of the so-called DK nano-crush technique and the DK culotte technique could be shown, whereby these initial results still have to be confirmed by larger randomized studies.


Weather and the transmission of bacillary dysentery in Jinan, northern China: a time-series analysis.
This article aims to quantify the relationship between weather variations and bacillary dysentery in Jinan, a city in northern China with a temperate climate, to reach a better understanding of the effect of weather variations on enteric infections. The weather variables and number of cases of bacillary dysentery during the period 1987-2000 has been studied on a monthly basis. The Spearman correlation between each weather variable and dysentery cases was conducted. Seasonal autoregressive integrated moving average (SARIMA) models were used to perform the regression analyses. Maximum temperature (one-month lag), minimum temperature (one-month lag), rainfall (one-month lag), relative humidity (without lag), and air pressure (one-month lag) were all significantly correlated with the number of dysentery cases in Jinan. After controlling for the seasonality, lag time, and long-term trend, the SARIMA model suggested that a 1 degree C rise in maximum temperature might relate to more than 10% (95% confidence interval 10.19, 12.69) increase in the cases of bacillary dysentery in this city. Weather variations have already affected the transmission of bacillary dysentery in China. Temperatures could be used as a predictor of the number of dysentery cases in a temperate city in northern China. Public health interventions should be undertaken at this stage to adapt and mitigate the possible consequences of climate change in the future.


Culture media conditioned by wounded cells modify the fibronectin localization pattern of unwounded confluent PtK2 cells.
A confluent PtK2 cell sheet was incised in a serum-free culture medium, at 15 min, 2 hr and 24 hr after wounding. The culture media were collected in the same way and used as conditioned media. Unwounded confluent cells were cultured in the conditioned medium for 24 hr. They showed a modification of fibronectin localization similar to that which we had previously observed in wounded confluent PtK2 cells: cells lost their normal fibronectin fibrils and were surrounded by fibronectin lace. This finding suggested that during wound healing, the cells released soluble chemical factors which could modify the fibronectin localization pattern of unwounded confluent cells. Subconfluent cells did not respond to conditioned media, showing that confluent cells and subconfluent cells had different susceptibilities.


Optimal utilization of prevention of mother-to-child transmission of HIV services among adolescents under group versus focused antenatal care in Eastern Uganda.
Group antenatal care (G-ANC), an alternative to focused ANC (F-ANC), involves grouping mothers by gestational and maternal age. In high-income countries, G-ANC has been associated with improved utilization of health care services like Prevention of Mother to Child Transmission (PMTCT) of HIV services. Some low-resource countries with poor utilization of health care services have piloted G-ANC. However, there is limited evidence of its efficiency. We, therefore, compared G-ANC versus F-ANC with regards to optimal utilization of PMTCT of HIV services and assessed associated factors thereof among adolescent mothers in eastern Uganda. We defined optimal utilization of PMTCT of HIV services as the adolescent being up to date with HIV counseling and testing. If found HIV negative, subsequent timely re-testing. If found HIV positive, initiation of antiretroviral therapy (ART) under option B plus for the mother. While for the infant, it entailed safe delivery, testing, feeding, and appropriate HIV chemotherapy. From February to April 2020, we conducted a cross-sectional study among 528 adolescent mothers in four sites in eastern Uganda. We assessed the optimal utilization of PMTCT of HIV services among adolescent mothers that had attended G-ANC versus F-ANC at the post-natal care or immunization clinics. We also assessed the factors associated with optimal utilization of PMTCT of HIV services among these mothers. Optimal utilization of PMTCT was higher among those in G-ANC than in F-ANC (74.7% vs 41.2, p-0.0162). There was a statistically significant association between having attended G-ANC and optimal utilization of PMTCT [PR = 1.080, 95%CI (1.067-1.093)]. Other factors independently associated with optimal utilization were; having a partner that tested for HIV [PR = 1.075, 95%CI (1.048-1.103)], trimester of first ANC visit: second trimester [PR = 0.929, 95%CI (0.902-0.957)] and third trimester [PR = 0.725, 95%CI (0.616-0.853)], and the health facility attended: Bugembe HCIV [PR = 1.126, 95%CI (1.113-1.139)] and Jinja regional referral hospital [PR = 0.851, 95%CI (0.841-0.861]. Adolescent mothers under G-ANC had significantly higher optimal utilization of PMTCT of HIV services compared to those under F-ANC. We recommend that the Ministry of Health considers widely implementing G-ANC, especially for adolescent mothers.


Seronegative ocular toxoplasma panuveitis in an immunocompetent patient.
Toxoplasma gondii is the most common cause of infectious posterior uveitis worldwide in immunocompetent patients. Despite its prevalence, diagnosis can still be challenging and vision-threatening in cases with atypical presentations. This case exemplifies the importance of clinical exam and additional workup when required despite negative initial serology results. A 73-year-old immunocompetent woman presented with a 2-year history of recurrent panuveitis and retinal necrosis not responsive to systemic antiviral therapy. Toxoplasma serum antibodies (IgG and IgM) were not detected on systemic workup one year prior. The slit-lamp exam revealed mutton fat keratic precipitates, panuveitis, and necrotic retinal lesions adjacent to a retinal scar. Repeated Toxoplasma serum antibodies (IgG and IgM) were again negative. However, aqueous fluid testing by polymerase chain reaction (PCR) was highly positive for Toxoplasma gondii. The patient improved after starting systemic anti-toxoplasma therapy. To our knowledge, this is the first report in the literature of an immunocompetent patient with ocular toxoplasmosis and undetectable serum IgG and IgM. Aqueous fluid PCR testing is useful in suspected ocular toxoplasmosis in patients with vision-threatening lesions despite negative serology.


An inner ear anomaly in golden hamsters.
A new mutation of the inner ear was discovered in golden hamsters raised in our laboratories. Although scanning electron microscopy showed a normal arrangement of individual stereocilia on the first row of outer hair cells, the entire bundle of stereocilia were irregular in orientation and scattered in several directions. Seventy per cent to 85% of the stereociliary bundles were found to be abnormal throughout the cochlea, with no apparent difference between the right and left sides. Transmission electron microscopy showed that the cuticles of the first row of the outer hair cells were dislocated, but no dislocation due to this mutation was apparent in the lower portions. This mutation of the inner ear was already present in the basal turn four days after birth. The kinocilium was located outside of the stereocilia in the first row of outer hair cells, but sensory hairs were scattered in every direction, as in the adult animals. A comparison of auditory brainstem response tests revealed no difference between the abnormal and normal hamsters.


Vaccinia virus lacking the deoxyuridine triphosphatase gene (F2L) replicates well in vitro and in vivo, but is hypersensitive to the antiviral drug (N)-methanocarbathymidine.
The vaccinia virus (VV) F2L gene encodes a functional deoxyuridine triphosphatase (dUTPase) that catalyzes the conversion of dUTP to dUMP and is thought to minimize the incorporation of deoxyuridine residues into the viral genome. Previous studies with with a complex, multigene deletion in this virus suggested that the gene was not required for viral replication, but the impact of deleting this gene alone has not been determined in vitro or in vivo. Although the crystal structure for this enzyme has been determined, its potential as a target for antiviral therapy is unclear. The F2L gene was replaced with GFP in the WR strain of VV to assess its effect on viral replication. The resulting virus replicated well in cell culture and its replication kinetics were almost indistinguishable from those of the wt virus and attained similar titers. The virus also appeared to be as pathogenic as the WR strain suggesting that it also replicated well in mice. Cells infected with the dUTPase mutant would be predicted to affect pyrimidine deoxynucleotide pools and might be expected to exhibit altered susceptibility to pyrimidine analogs. The antiviral activity of cidofovir and four thymidine analogs were evaluated both in the mutant and the parent strain of this virus. The dUTPase knockout remained fully susceptible to cidofovir and idoxuridine, but was hypersensitive to the drug (N)-methanocarbathymidine, suggesting that pyrimidine metabolism was altered in cells infected with the mutant virus. The absence of dUTPase should reduce cellular dUMP pools and may result in a reduced conversion to dTMP by thymidylate synthetase or an increased reliance on the salvage of thymidine by the viral thymidine kinase. We confirmed that F2L was not required for replication in cell culture and determined that it does not play a significant role on virulence of the virus in intranasally infected mice. The recombinant virus is hypersensitive to (N)-methanocarbathymidine and may reflect metabolic differences in the mutant virus.


Junctional transfer of small molecules in cultured bovine brain microvascular endothelial cells and pericytes.
We have utilized cultures of bovine brain microvascular endothelial cells (MEC) and pericytes to study two aspects of intercellular relations in the microvasculature. First, the apparent contradiction between the reported demonstration of dye transfer between endothelial cells in capillaries and venules in rat omentum and the lack of ultrastructurally demonstrable interendothelial gap junctions in the same vessels in omentum, brain, and other tissues led us to examine this problem in vitro. MEC showed extensive transfer of both fluorescent dye (Lucifer yellow CH, 96% transfer incidence in primary culture) and radiolabeled uridine nucleotides (97%). Freeze-fracture replicas of MEC revealed both gap and tight junctions. These results demonstrate that MEC are capable of producing gap junctions and engaging in junctional communication in vitro. Second, we have examined the interaction of pericytes with MEC. Cultured pericytes showed gap junctions in freeze-fracture replicas, variable dye transfer (cell density dependent, 19-91%), and extensive nucleotide transfer (94%). While the incidence of dye transfer between MEC and pericytes was low (10-31%), nucleotide transfer between these cells was extensive (86-96%). The demonstration of junctional transfer between MEC and pericytes in vitro may be particularly significant considering the high frequency of junctional contact between these cells in vivo. These cultured cell models should help us to better understand the complex interactions of vessel wall cells in microvascular physiology and pathophysiology.


Cochrane corner: bone morphogenetic protein (BMP) for fracture healing in adults.
Delay in fracture healing is a complex clinical and economic issue for patients and health services. To assess the incremental effectiveness and costs of bone morphogenetic protein on fracture healing in fractures and nonunions compared with standards of care. We searched The Cochrane Library (2008, Issue 4), MEDLINE, and other major health and health economics databases (to October 2008). Randomized controlled trials (RCTs) and full or partial economic evaluations of bone morphogenetic protein for fracture healing in skeletally mature adults. All clinical and economic data were extracted by one author and checked by another.


A flexible physical protection process for lignin extraction.
Research on lignin valorization has gained ground, driven by its potential to replace fossil-based phenolics in bio-based applications. Technical lignins are structurally complex and still poorly characterized, prompting the need for novel extraction processes for lignin of high analytical quality. In this context, a two-step cyclic extraction process for lignin was contrasted with a one-step cyclic extraction. The latter was shown to preserve the native structure of the spruce lignin product better and improved the yields of both the extracted lignin and residual fiber fraction. The application of the one-step cyclic extraction process to birchwood resulted in a similar protection of the lignin structure. Overall, a flexible physical protection (FPP) process for extraction of lignin with an abundance of native bonds is presented. The lignin product has a high abundance of ether bonds and hydroxyl functionalities, which are of interest in biochemical, polymer, and material applications.


Boron-doped diamond: Investigation of the stability of surface-doping versus bulk-doping using cyclic cluster model calculations.
Boron-doped bulk diamond and the boron-doped hydrogen terminated (001) surface of diamond were investigated using the cyclic cluster model. Structure and stability of the hydrogen-terminated (001) surface were calculated and compared with experimental and other theoretical results from the literature. Boron-doping was modeled by substitution of a carbon atom by a boron atom in different positions with increasing distance from the surface up to boron-doped bulk diamond. In agreement with experiments on nanoclusters, boron is most stable in the first surface layers. (c) 2008 Wiley Periodicals, Inc. J Comput Chem, 2008.


A comparison of treatment effects of total arch distalization using modified C-palatal plate vs buccal miniscrews.
The purpose of this study was to compare the treatment effects of palatally vs buccally placed temporary anchorage devices. Of 40 Class II division 1 malocclusion patients, 22 were treated with modified C-palatal plate (MCPP) appliances (age 21.9 ± 6.6 years), and 18 (age 24.2 ± 6.8 years) were treated with buccally placed miniscrews between the maxillary first molar and second premolar. A total of 26 linear and angular measurements were analyzed on pre- and posttreatment lateral cephalograms. Multivariate analysis of variance was performed to evaluate the treatment effects within each group and to compare the effects between groups. Overall, the MCPP appliances showed 4.2 mm of distalization, 1.6 mm of intrusion of the first molar with 2° tipping, and 0.8 mm extrusion of incisors. The miniscrew group resulted in 2.0 mm of distalization, 0.1 mm intrusion of the first molar with 7.2° tipping, and 0.3 mm of incisor extrusion. Regarding soft tissue change, in the MCPP group, the upper lip was significantly retracted ( P < .001). Comparing the treatment effects between MCPP appliances and buccal miniscrews, the MCPP appliances showed greater distalization and intrusion with less distal tipping of the first molar and less extrusion of the incisor compared to the buccal miniscrews.


Serum Homocysteine and Behavioral and Psychological Symptoms of Dementia: Is There Any Correlation in Alzheimer's Disease?
There are studies showing the relation between serum B12, folate and Behavioral and Psychological symptoms of Dementia (BPSD) in Alzheimer's disease (AD). Serum levels of these vitamins do not reflect actual disease status and therefore checking the serum Homocysteine level is considered a better test. Homocysteine has been found to be associated with cognitive impairment and various psychiatric disorders. This study was planned to identify the correlation between serum homocysteine levels and BPSD in AD patients. AD patients (n = 18) and healthy controls (n = 18) were included in the study. Diagnosis of AD was confirmed using International Classification Disease-10. AD patients were assessed using Mini Mental Status Examination (MMSE), Clinical Dementia Rating scale (CDR), Global Deterioration scale (GDS), and Neuropsychiatric inventory (NPI). Healthy controls were assessed on MMSE and Mini International Neuropsychiatric Interview. Serum homocysteine, vitamin B12, and folate levels were measured in all study subjects. Patients with AD had statistically significant higher serum levels of homocysteine as compared to the control group, while the levels of vitamin B12 and folate did not differ significantly. There was statistically significant positive correlation of serum homocysteine levels with total NPI score as well as with NPI sub-domains particularly delusion, agitation/aggression, and depression/dysphoria. Serum homocysteine levels did not correlate significantly with MMSE, CDR, and GDS scores. Correlation was observed between serum homocysteine levels and behavioral and psychological symptoms of AD. There is a possibility of etiological role, but the underlying pathophysiological mechanisms need to be elucidated. Whether patients will benefit or not with supplements of vitamin B12 and folate requires further research. This was a cross-sectional study and findings should not be generalized. Further prospective longitudinal studies with a large number of patients are needed.


Distribution of gelsolin and phosphoinositol 4,5-bisphosphate in lamellipodia during EGF-induced motility.
During induced cell motility the actin cytoskeleton at the leading edge must undergo constant reorganization. Recently, phosphoinositides have been shown to be central to cytoskeleton-membrane linkages and actin organization and turnover. Epidermal growth factor (EGF) receptor (EGFR)-mediated cell motility requires phospholipase C-gamma (PLCgamma), hydrolysis of phosphoinsotide 4,5-bisphosphate (PIP(2)) and subsequent release of gelsolin. We hypothesized this led to the mobilization of PIP(2)-binding proteins which modify the actin cytoskeleton and thus sought to determine whether the leading edge was a site of active PIP(2) hydrolysis and gelsolin redistribution to cytoskeleton. Herein, we report that during EGF-induced motility, the leading edge's submembranous region constitutes a distinct subcellular locale. The relevant phosphoinositide composition of this space was determined by probing with an antibody to PIP(2) and a green fluorescence protein (GFP)-tagged pleckstrin homology (PH) domain of PLCdelta (GFP-PH) that recognizes both PIP(2) and inositol 1,4,5-trisphosphate (IP(3)). PIP(2) was absent from leading lamellipodia despite an increase in IP(3) generation, suggesting an increase in PIP(2) hydrolysis at the leading edge. Visualized with immunofluorescence, gelsolin preferentially concentrated near the leading edge in a punctate fashion. Examining the Triton X-insoluble actin cytoskeleton fractions, we observe a PLCgamma-dependent increase of gelsolin incorporation upon EGF stimulation. At a molecular level, field emission scanning electron microscopy (FE-SEM) shows that gelsolin incorporates preferentially into the submembranous actin arcs at the leading edge of the lamellipodia. Together these data suggest a model of PIP(2) hydrolysis at the leading edge causing a localized release of PIP(2)-binding proteins-particularly gelsolin-that drives cytoskeletal rearrangement and protrusion.


RAFTK/Pyk2 mediates LPA-induced PC12 cell migration.
The phospholipid lysophosphatidic acid (LPA) is a normal constituent of serum that functions as a lipid growth factor and intracellular signaling molecule. In this report, we have investigated the signaling mechanism and function of the tyrosine kinase RAFTK/Pyk2 in LPA-induced cell migration. Analysis of tyrosine phosphorylation upon LPA stimulation in neuroendocrine PC12 cells revealed 6 major tyrosine-phosphorylated proteins with estimated sizes of 180, 120, 115, 68, 44, and 42 kDa. These proteins were identified as epidermal growth factor receptor (EGFR), focal adhesion kinase, RAFTK/Pyk2, paxillin, Erk 1, and Erk 2, respectively. Using specific pharmacological inhibitors, we found that the tyrosine phosphorylation of RAFTK/Pyk2 was intracellular Ca2+-dependent, but not EGFR-dependent, during LPA stimulation of these cells. Moreover, the cytoskeletal and signal scaffolding protein, paxillin, associated with and was regulated by RAFTK/Pyk2 in a Ca2+-dependent manner. Characterization of LPA receptors showed that LPA1 (Edg2) and LPA2 (Edg4) are major receptors for LPA, while LPA3 receptor (Edg7) expression was limited. Upon using the LPA1/LPA3 receptor-specific antagonist VPC 32179, we observed that inhibition of the LPA1/LPA3 receptors had no effect on the LPA-induced phosphorylation of RAFTK, strongly suggesting that the LPA2 receptor is a key mediator of RAFTK phosphorylation. Furthermore, LPA induced PC12 cell migration, which was subsequently blocked by the dominant-negative form of FAK, FRNK. Expression of a dominant-negative form of the small GTPase Ras also blocked LPA-induced cell migration and RAFTK phosphorylation. Taken together, these results indicate that RAFTK is a key signaling molecule that mediates LPA-induced PC12 cell migration in a Ras-dependent manner.


Advances in the enantioseparation of β-blocker drugs by capillary electromigration techniques.
β-Blocker drugs or β-adrenergic blocking agents are an important class of drugs, prescribed with great frequency. They are used for various diseases, particularly for the treatment of cardiac arrhythmias, cardioprotection after myocardial infarction (heart attack), and hypertension. Almost all β-blocker drugs possess one or more stereogenic centers; however; only some of them are administered as single enantiomers. Since both enantiomers can differ in their pharmacological and toxicological properties, enantioselective analytical methods are required not only for pharmacodynamic and pharmacokinetic studies but also for quality control of pharmaceutical preparations with the determination of enantiomeric purity. In addition to the chromatographic tools, in recent years, capillary electromigration techniques (CE, CEC, and MEKC) have been widely used for enantioselective purposes employing a variety of chiral selectors, e.g. CDs, polysaccharides, macrocyclic antibiotics, proteins, chiral ion-paring agents, etc. The high separation efficiency, rapid analysi,s and low consumption of reagents of electromigration methods make them a very attractive alternative to the conventional chromatographic methods. In this review, the development and applications of electrodriven methods for the enantioseparation of β-blocker drugs are reported. The papers concerning this topic, published from January 2000 until December 2010, are summarised here. Particular attention is given to the coupling of chiral CE and CEC methods to MS, as this detector provides high sensitivity and selectivity.


Cerium-polysulfide redox flow battery with possible high energy density enabled by MFI-Zeolite membrane working with acid-base electrolytes.
A pH change can enable high-energy-density RFB (redox flow battery) in an aqueous medium. Nevertheless, a membrane to prevent the ion crossover is needed. This study adopted cerium and polysulfide in an acid-base combined electrolyte with an MFI-Zeolite membrane as a separator. The increased potential with pH change is described by the OCP (open circuit potential) difference, which varies by 0.8 V for the combination of acid-acid and acid-base electrolyte. A decrease of 350 mV at the redox peak potential of Ce3+/Ce4+ and a 10 mV negative potential shift for S42-/2S22- highlights the pH effect between the combination of acid-acid and acid-base electrolyte indicates the influence of pH leading in half-cell of anodic than the opposite cathodic side. The UV-visible spectral analysis for Ce3+ and S42- ions displacement shows that cerium and sulfur ions do not migrate to each other half-cell through an MFI-Zeolite membrane. As a result, the current efficiency of 94%, voltage, and energy efficiency of 40%-43% were attained at a current density of 10 mA cm-2. Moreover, the acid-base composition of the Ce/S system showed an energy density of 378.3 Wh l -1.


Developments in the chemistry and biochemistry of pectic and hemicellulosic polymers.
Improved methods of isolation and analysis of cell walls from a range of plant tissues have shed new light on the structure of the constituent polymers, and have also helped to clarify some of the conflicting opinions on their mode of occurrence and association within the walls. The chemistry (and biochemistry) of pectic and hemicellulosic polymers in different types of plant organs is outlined, with particular emphasis on parenchymatous and immature tissues. The following aspects are discussed: the mode of occurrence of arabinans, galactans and arabinogalactans, and the possible association of some of them with proteins; the structural features of the esterified rhamnogalacturonans and associated neutral sugar residues in the pectic substances of middle lamellae and primary cell walls; the occurrence of acidic xylans, acidic arabinoxylans, and acidic arabinoxylans in association with other polymers in the cell walls of cambial, suspension-cultured and parenchymatous tissues of dicotyledons; evidence for the occurrence of small but significant amounts of xyloglucans in association with other polymers, and the occurrence of a range of xyloglucans in parenchymatous tissues; evidence for the occurrence of phenolic ester and phenolic cross-linkages between the cell wall polymers of parenchymatous tissues of both dicotyledons and monocotyledons, particularly the association of hydroxycinnamic acids with some pectic substances; the occurrence of proteoglycans and proteoglycan-polyphenol complexes and their relationship to the traditional hemicelluloses; and some aspects of the non-cellulosic polymers of non-endospermic and endospermic seeds.


Concomitant deletion of HRAS and NRAS leads to pulmonary immaturity, respiratory failure and neonatal death in mice.
We reported previously that adult (HRAS-/-; NRAS-/-) double knockout (DKO) mice showed no obvious external phenotype although lower-than-expected numbers of weaned DKO animals were consistently tallied after crossing NRAS-KO and HRAS-KO mice kept on mixed genetic backgrounds. Using mouse strains kept on pure C57Bl/6 background, here we performed an extensive analysis of the offspring from crosses between HRAS-KO and NRAS-KO mice and uncovered the occurrence of very high rates of perinatal mortality of the resulting DKO littermates due to respiratory failure during the first postnatal 24-48 h. The lungs of newborn DKO mice showed normal organ structure and branching but displayed marked defects of maturation including much-reduced alveolar space with thick separating septa and significant alterations of differentiation of alveolar (AT1, AT2 pneumocytes) and bronchiolar (ciliated, Clara cells) cell lineages. We also observed the retention of significantly increased numbers of undifferentiated progenitor precursor cells in distal lung epithelia and the presence of substantial accumulations of periodic acid-Schiff-positive (PAS+) material and ceramide in the lung airways of newborn DKO mice. Interestingly, antenatal dexamethasone treatment partially mitigated the defective lung maturation phenotypes and extended the lifespan of the DKO animals up to 6 days, but was not sufficient to abrogate lethality in these mice. RNA microarray hybridization analyses of the lungs of dexamethasone-treated and untreated mice uncovered transcriptional changes pointing to functional and metabolic alterations that may be mechanistically relevant for the defective lung phenotypes observed in DKO mice. Our data suggest that delayed alveolar differentiation, altered sphingolipid metabolism and ceramide accumulation are primary contributors to the respiratory stress and neonatal lethality shown by DKO mice and uncover specific, critical roles of HRAS and NRAS for correct lung differentiation that are essential for neonatal survival and cannot be substituted by the remaining KRAS function in this organ.


Characterising repetitive behaviours in young boys with fragile X syndrome.
Repetitive behaviours are frequently observed in individuals with intellectual disability (ID). The present study examined the profile, inter-correlations and predictive correlates of repetitive behaviours in boys with fragile X syndrome (FXS), the leading inherited cause of ID. Specific child characteristics examined as predictors included anxiety, nonverbal cognition and autism social-affective symptomatology. Participants were 39 boys with FXS (aged 6-10 years). Repetitive behaviours were measured using the Repetitive Behavior Scale - Revised (RBS-R) - a 43-item caregiver-report measure normed on individuals with ID. Restricted Interests and Sensory Motor behaviours were reported as most problematic for this sample of boys, whereas Self-injurious behaviours were less problematic. All subscales of the RBS-R were significantly inter-correlated. Nonverbal IQ was negatively related, whereas anxiety and social affective symptoms of autism spectrum disorder were positively related, to scores for Restricted Interests. Anxiety was also positively related to scores for Compulsive behaviours and Ritualistic Sameness behaviours. This study provides a preliminary description of repetitive behaviours in boys with FXS, which may form the groundwork for future research.


The influence of cell-matrix interactions on the development of quail chorioallantoic vascular system.
The extracellular matrix-component fibronectin (FN) was detected in close localisation to the vascular system (VS) of the quail chorioallantoic membrane (CAM). We have examined the role of cell-fibronectin interactions within the developing CAM. In two series of experiments the CAM was directly exposed to (1) an antibody against the cell-binding fragment of FN, and to (2) RGD-containing synthetic peptides which are recognized by the FN receptor. For controls an antibody against tubulin and a SHLVE-pentapeptide that does not interfere with the FN-receptor were applied. In the presence of anti-FN antibodies and RGD-sequences the CAM could not establish a normal vascular system. We observed hypo- and partially avascular regions; the resulting vascular pattern was atypically lacunar. None of the control substances affected the regular development of the chorioallantoic vascular system. These results demonstrate the essential role of FN in CAM angiogenesis.


A novel adenosine analog, thio-Cl-IB-MECA, induces G0/G1 cell cycle arrest and apoptosis in human promyelocytic leukemia HL-60 cells.
Human A3 adenosine receptor (A3AR) agonists have been shown to play important roles in several physiological and pathological processes, including growth inhibition of human cancer cells. On this line, we recently found that a novel adenosine analog, 2-chloro-N6-(3-iodobenzyl)-4'-thioadenosine-5'-N-methyluronamide (thio-Cl-IB-MECA) was a potent human A3AR agonist, and is superior to a known agonist Cl-IB-MECA [Jeong LS, Jin DZ, Kim HO, Shin DH, Moon HR, Gunaga P, et al. J Med Chem 2003;46:3775]. Here, we report that a novel A3AR agonist, thio-Cl-IB-MECA inhibited the growth of human promyelocytic leukemia HL-60 cells by arresting cell cycle and induction of apoptosis. Thio-Cl-IB-MECA induced the cell cycle arrest of G0/G1 in the early time and at lower concentration (up to 25 microM). At higher concentration (50 microM), the apoptotic cell deaths were manifested by observation of the increase of sub-G0 phase of cell cycle distribution, DNA fragmentation and poly(ADP-ribose) polymerase (PARP) cleavage. In addition, the down-regulation of checkpoint protein cyclin D1 and c-myc by thio-Cl-IB-MECA was well correlated with the arrest of cell cycle transition of G1 to S phase. Further study revealed that the growth inhibitory activity of thio-Cl-IB-MECA is also related with the modulation of Wnt signaling pathway. The levels of beta-catenin, phosphorylated forms of GSK-beta and Akt were down-regulated by the treatment of thio-Cl-IB-MECA (10 nM) in a time-dependent manner, providing one of plausible mechanistic evidence for the involvement of the Wnt signaling pathway in the HL-60 cell growth inhibitory effects by thio-Cl-IB-MECA. These results suggest that a novel A3AR agonist, thio-Cl-IB-MECA can down-regulate Wnt signaling, inhibit proliferation and induce apoptosis in HL-60 leukemia cells, and thus provide the possibility of this compound in the potential therapeutic value of the treatment of leukemia.


Comparison of epirubicin hydrochloride and miriplatin hydrate as anticancer agents for transcatheter arterial chemoembolization of hepatocellular carcinoma.
The aim of this retrospective study was to compare the local control effects of transcatheter arterial chemoembolization (TACE) using epirubicin (EPIR) and that using miriplatin (MPT) for hepatocellular carcinoma (HCC). Between January 2010 and July 2011, 218 HCC cases were treated with TACE, including 69 cases using EPIR or MPT as initial treatment. All 69 patients were treated with iodized oil and gelatin sponge particles. The local control rate (modified Response Evaluation Criteria in Solid Tumors [RECIST] ver. 1.0), time to treatment failure (Kaplan-Meier and log-rank test) and adverse events were evaluated. Forty-two cases were treated using EPIR, and 27 cases were treated using MPT. All 69 patients had no previous treatment with TACE or hepatic arterial infusion. No serious adverse events were observed in either group. The response rates, including complete response (CR) and partial response (PR), of the EPIR group and the MPT group were 85.7% and 81.5%, respectively, with a time to treatment failure of 5.1 and 7.5 months, respectively. Excluding whole liver TACE cases, time to treatment failure was 5.4 months for the EPIR group and 10.1 months for the MPT group. In TACE naïve cases, there was no significant difference in local control between EPIR and MPT.


"Hot" spleen on Tc-99m sulfur colloid images.
In routine Tc-99m sulfur colloid (SC) liver-spleen imaging, relatively increased splenic uptake when compared with liver uptake is frequently seen. Commonly this is due to decreased hepatic uptake secondary to liver disease, but often it is because of increased uptake in the hyperfunctioning spleen. Reported is a case of lymphoma of the tonsil, with a "hot" spleen which was free of tumor. Possible etiology of the "hot" spleen is discussed and the known causes listed according to their prevalence.


Carbohydrate composition of purified serum glycoproteins in mucolipidosis II and mucolipidosis III.
Mucolipidosis II (I-cell disease) and Mucolipidosis III (ML III) are inherited disorders in which the molecular defect may involve an abnormality in a common post-translational modification step (possibly glycosylation) shared by lysosomal hydrolases. We tested whether such an alteration might be a generalized defect in glycoprotein biosynthesis and, thus, be reflected in an abnormal carbohydrate composition of non-lysosomal glycoproteins. The apoprotein of low density lipoprotein (apo-LDL) and immunoglobulin G (IgG) were purified to apparent homogeneity. Gas liquid chromatographic (glc) analysis of the carbohydrate content of these glycoproteins from ML II, ML III and normal sera revealed no differences in the relative ratios and total amounts of mannose, galactose, N-acetylglucosamine and sialic acid. These results suggest that if the postulated post-translational defect in these disorders involves changes in carbohydrate composition, it is not a general defect in glycosylation and may be specific for lysosomal hydrolases.


Stem cell niche structure as an inherent cause of undulating epithelial morphologies.
The spatial organization of stem cells into a niche is a key factor for growth and continual tissue renewal during development, sustenance, and regeneration. Stratified epithelia serve as a great context to study the spatial aspects of the stem cell niche and cell lineages by organizing into layers of different cell types. Several types of stratified epithelia develop morphologies with advantageous, protruding structures where stem cells reside, such as rete pegs and palisades of Vogt. Here, multistage, spatial cell lineage models for epithelial stratification are used to study how the stem cell niche influences epithelial morphologies. When the stem cell niche forms along a rigid basal lamina, relatively regular morphologies are maintained. In contrast, stem cell niche formation along a free-moving basal lamina may prompt distorted epithelial morphologies with stem cells accumulating at the tips of fingerlike structures that form. The correspondence between our simulated morphologies and developmental stages of the human epidermis is also explored. Overall, our work provides an understanding of how stratified epithelia may attain distorted morphologies and sheds light on the importance of the spatial aspects of the stem cell niche.


Mitochondrial function influences expression of methamphetamine-induced behavioral sensitization.
Repeated methamphetamine use leads to long lasting brain and behavioral changes in humans and laboratory rats. These changes have high energy requirements, implicating a role for mitochondria. We explored whether mitochondrial function underpins behaviors that occur in rats months after stopping methamphetamine self-administration. Accordingly, rats self-administered intravenous methamphetamine for 3 h/day for 14 days. The mitochondrial toxin rotenone was administered as (1 mg/kg/day for 6 days) via an osmotic minipump starting at 0, 14 or 28 days of abstinence abstinence. On abstinence day 61, expression of methamphetamine-induced behavioral sensitization was obtained with an acute methamphetamine challenge in rotenone-free rats. Rotenone impeded the expression of sensitization, with the most robust effects obtained with later abstinence exposure. These findings verified that self-titration of moderate methamphetamine doses results in behavioral (and thus brain) changes that can be revealed months after exposure termination, and that the meth-initiated processes progressed during abstinence so that longer abstinence periods were more susceptible to the consequences of exposure to a mitochondrial toxin.


Novel 4-(2-arylidenehydrazineyl)thienopyrimidine derivatives as anticancer EGFR inhibitors: Design, synthesis, biological evaluation, kinome selectivity and in silico insights.
The current study discovered fifteen new thieno[2,3-d]pyrimidine derivatives with potential anticancer action, including 5a-l, 6, and 7a-b. Results from the NCI screening revealed that compounds 5f-i and 7a significantly inhibited the proliferation of MDA-MB-468 cells at mean GI% and GI50 levels. Compared to staurosporine, these compounds (5f-i and 7a) demonstrated better safety towards typical WI-38 cells. Compounds 5g and 7a demonstrated the highest inhibition (two-digit nanomolar) when compared to erlotinib when their potency was tested on EGFR kinase. Considering the outcomes above, 5g was examined for its ability to disrupt the cell cycle with trigger apoptosis in breast cancer MDA-MB-468 cell lines. The apoptosis markers Bax, Bcl-2, Caspase-8, and Caspase-9, were detected. In silico molecular docking and dynamic simulation were used to explainthe biological activities of the most potent compound.


Evolution of synovitis in osteoarthritic knees and its association with clinical features.
To investigate the course of synovitis on contrast-enhanced magnetic resonance images (CE-MRI) in osteoarthritic knees over 2 years, and its association with pain and cartilage deterioration. Consecutive patients (n = 39, mean age 61 years, 79% woman, median (range) body mass index (BMI) 29 (24-48) kg/mm2) with clinical osteoarthritis (OA) were included. Baseline and follow-up CE-MRI (3 T) were scored paired in chronological order for synovitis (semi-quantitatively at 11 sites (range 0-22)), cartilage deterioration and bone marrow lesions (BMLs) (semi-quantitatively according to Knee Osteoarthritis Scoring System (KOSS)). Changes in sum scores were calculated. Cartilage deterioration was defined as change of ≥2 above the smallest detectable change (SDC). Pain was assessed by standardized questionnaires. Analysis of covariance (ANCOVA) and linear regression models were used to investigate association between synovitis change and cartilage deterioration and between synovitis change or cartilage deterioration and change in pain. The total synovitis score did not change over 2 years (mean change 0.2 (standard deviation (SD) 3.2)), although changes in individual patients were observed. Cartilage deterioration was observed in 51% of patients. Synovitis change score was lower in patients without compared to patients with cartilage deterioration, taking BML change in account (mean difference -2.1 (-4.1 to -0.1)). Change in synovitis was not associated with change in pain, whereas cartilage deterioration was associated with change in Intermittent and Constant OsteoArthritis Pain (ICOAP) constant pain in adjusted models (unstandardised coefficient (B) (95% confidence interval (CI)) 2.8 (0.4-5.3)). In individual patients synovitis fluctuates during disease course. Synovitis change was not associated with change in pain. Increase in synovitis is associated with cartilage deterioration, suggesting a role for synovitis as a target for disease-modifying treatment.


On Satnoianu-Wu's inequality.
By applying techniques in the theory of convex functions and Schur-geometrically convex functions, the author investigates a conjecture of Satnoianu on an algebraic inequality and generalizes some known results in recent years.


Minimally invasive transhiatal esophagectomy after thoracotomy.
Patients with end-stage achalasia may not be candidates for a transhiatal minimally invasive esophageal resection because of anatomic challenges and adhesions from previous interventions, namely, thoracotomy. Given the tactile feedback provided through a GelPort laparoscopic system (Applied Medical, Rancho Margarita, CA) we proposed that a minimally invasive transhiatal esophagectomy would be feasible in this patient cohort. The procedure was successful in 4 patients; seven complications occurred in 3 of the patients. At follow-up all patients demonstrated that they were meeting their nutritional needs with an oral diet.


Human placental sialidase: partial purification and characterization.
A sialidase [EC 126.96.36.199] has been partially purified from human placenta by means of procedures comprising Con A-Sepharose adsorption, ammonium sulfate precipitation, sucrose density gradient centrifugation, and high-pressure liquid chromatography on a Shim pack Diol 300 column. On high-pressure liquid chromatography, most of the beta-galactosidase that comigrated with the sialidase on sucrose density gradient centrifugation was removed. The sialidase was purified 3,600-fold from the preparation obtained by Con A-Sepharose adsorption. The enzyme liberated the sialic acid residues from (alpha 2-3) and (alpha 2-6) sialyllactose, colomic acid, fetuin, and transferrin, but not from bovine submaxillary mucin. The enzyme also hydrolyzed gangliosides GM3, GD1a, and GD1b in the presence of sodium cholate as a detergent, but GM1 and GM2 were less susceptible to the enzyme. The optimum pHs for 4-methylumbelliferyl-N-acetylneuraminate, sialyllactose, fetuin, and GM3 lay between 4.0 and 5.0.


Mycobacterium avium subsp. hominissuis Infection in a captive-bred kiang (Equus kiang).
Equids are considered highly resistant to mycobacterial infections and clinical cases have been described in domestic horses only. Mycobacterium bovis is the most common species reported, although a single report exists of disease due to definitively diagnosed infection with Mycobacterium avium subsp. hominissuis in two domestic horses. This is the first report of a mycobacterial infection in a kiang (Equus kiang), or indeed any wild equid. The animal had chronic loss of condition and serum biochemical changes suggestive of liver disease and chronic infection. Further investigation showed a chronic granulomatous enteritis, lymphadenitis and hepatitis with focal granulomatous pneumonia due to systemic infection with M. avium subsp. hominissuis. The distribution and severity of the lesions suggested that the route of infection was alimentary.


Synthesis of environmental-friendly ion-imprinted magnetic nanocomposite bentonite for selective recovery of aqueous Sc(III).
A novel reusable ion imprinted nanocomposite magnetic bentonite(IIPNMB) was prepared for selective recovery of aqueous scandium. Based on the fact that oxyphosphorus functional groups in sodium tripolyphosphate have good affinity to Sc(III) and chitosan is rich in hydroxy and amino active sites, they were chosen to build ion imprinted layers. Mesoporous IIPNMB showed good adsorption performance. The pseudo second-order kinetic model and Langmuir model fit the experimental data. According to XPS features, the amino, hydroxyl, PO and PO bonds of the adsorbents had electrostatic interaction and complexation with Sc(III), leading to the good selectivity of IIPNMB for Sc(III). In addition, the material atomic structure was proposed based on the chemical structure of IIPNMB for DFT calculation of ion imprinting adsorption, which clearly proved that the adsorption process of Sc(III) was stable, and it gave another proof for the mechanism of the selective extraction.


Surgeons changing the approach for total hip arthroplasty from posterior to direct anterior with fluoroscopy should consider potential excessive cup anteversion and flexion implantation of the stem in their early experience.
Many reports outline the benefits derived from using the direct anterior approach (DAA) in primary total hip arthroplasty (THA); however, the learning curve for the DAA has not been well documented, and the complications associated with the DAA during this learning curve seem relatively high. The aim of this study was to investigate implant positioning in primary THA, when the surgeon was a novice at the DAA, and had previously used the standard posterior approach (PA). We investigated implant positioning in the first 80 consecutive THA cases performed by two senior surgeons using the DAA (with fluoroscopic assistance), and compared them to the same two surgeons' previous 80 respective THA cases performed using their previous standard posterior approach. Cup positioning accuracy was higher for the DAA (p < 0.001) but greater cup anteversion (19.3° ± 11.0 using the PA vs 27.6° ± 6.3 using DAA, p < 0.0001) was also demonstrated. A total of 69.3 % of cups in the DAA group were positioned with an anteversion angle greater than their target angle. In the DAA group the stem was more frequently positioned in flexion and less frequently in neutral than for the PA group. Although fluoroscopic assistance seemed to decrease complications such as femoral fracture, surgeons changing from PA to DAA for THA should consider potential excessive cup anteversion and flexion implantation of the stem in their early experience with DAA.


Head-kidney thyroid in some Indian teleosts.
Six species of fishes, with different habits and belonging to different habitats and families, have been investigated. Only four, namely Discognathus lamta, Carassius auratus, Glossogobius giuris and Polynemus sexfilis have shown the presence of heterotopic thyroid follicles in their head-kidneys. The heterotopic thyroid follicles of Discognathus lamta appear to be functional while those of the rest of fishes are in non-functional state.


Pediatric inflammatory bowel disease: Fecal calprotectin response to Anti-tumor necrosis factor alpha.
Fecal calprotectin (FC) is a marker of mucosal inflammation in inflammatory bowel disease (IBD). We aimed to assess the effect of anti-tumor necrosis factor alpha (TNFα) therapy on FC levels in children with IBD. The medical records of pediatric patients treated with anti-TNFα agents (2015-2020) were reviewed retrospectively. 63 patients had FC levels measured prior to anti TNFα induction with sequential measurements during follow-up. The main outcome measures were time to FC response according to cutoffs of 250, 150, 100 and 50 µgr/gr. Mean age was 13.6 ± 3 years [females 28 (44.4%), Crohn's 55 (87%)]. Outcomes of < 250, < 150, < 100 and < 50 µgr/gr were achieved by 52 (82%), 51 (81%), 44 (70%) and 32 (50%), respectively. The median time for achieving these cutoffs was 4.8 (1.8-15.6), 7.9 (2.6-16.4), 10.0 (3.5-20.5) and 18.5 (7.0-64.7) months, respectively. Shorter time from diagnosis to treatment was associated with achievement of FC < 50 µgr/gr (p = 0.03). There was no association between age, disease type, anti-TNFα type, inflammatory markers, disease activity indices at baseline and induction anti-TNFα trough concentration and FC response. FC response was achieved by the majority of patients treated with anti-TNFα within a short period of time. FC normalization in responders required almost one year. Fecal calprotectin response was achieved by the majority of pediatric patients within a relatively short period of time after anti-TNFα induction and maintenance therapy. Fecal calprotectin normalization required an average period of approximately one year in responders. The faster response of fecal calprotectin is associated with shorter time from diagnosis to anti-TNFα treatment. Inflammatory bowel disease treating physicians should be aware of the relatively prolonged time to fecal calprotectin normalization and to allow enough time for anti-TNFα therapy to express its full potential prior to significant interventions.


'The best CPD I have done in a while'.
The BVA IN PRACTICE: CPD offering is going from strength to strength, says Tim Keen, BVA marketing manager, and the programme for July to December 2016 is now available.


Size variability of the human anterior cruciate ligament insertion sites.
Current trends in anterior cruciate ligament reconstruction (ACLR) have been toward anatomical reconstruction that restores the normal size and location of the anterior cruciate ligament insertions and its 2 bundles, the posterolateral (PL) and anteromedial (AM) bundles. This has resulted in a more individualized approach to ACLR. Several studies have shown that the size of the anterior cruciate ligament insertion sites is variable; however, these studies are limited by use of relatively small sample sizes and cadaveric specimens. This study was undertaken to evaluate the in vivo size variability of the anterior cruciate ligament insertion sites and its AM and PL bundles during arthroscopy in a large series of patients and to correlate these findings with individuals' physical characteristics (height, weight, and body mass index). Cross-sectional study; Level of evidence, 3. In 137 patients undergoing ACLR during the first 6 months after injury, the femoral and tibial anterior cruciate ligament insertion sites and the 2 bundles were identified, marked with electrocautery, and measured with an arthroscopic ruler. Additionally, physical characteristics of the patients, including self-reported height, weight, and body mass index, were recorded. The tibial anterior cruciate ligament insertion site had a mean length of 17.0 ± 2.0 mm. The tibial AM bundle length was 9.1 ± 1.2 mm and the width was 9.2 ± 1.1 mm. The tibial PL bundle insertion site length averaged 7.4 ± 1.0 mm and the width averaged 7.0 ± 1.0 mm. The femoral insertion sites had a mean length of 16.5 ± 2.0 mm. The length of the femoral AM bundle insertion site averaged 9.2 ± 1.2 mm and the width averaged 8.9 ± 0.9 mm. The femoral PL bundle insertion site length averaged 7.1 ± 1.1 mm and the width averaged 6.9 ± 1.0 mm. There were significant positive correlations between patient height and weight (P < .05) with femoral and tibial anterior cruciate ligament insertion site length, tibial PL bundle insertion site length, femoral AM bundle insertion site length, and tibial AM bundle and PL bundle insertion site areas. However, the coefficients of determination values were low (1.0% to 19.4%). There is a large variation in size of the anterior cruciate ligament insertion sites and the AM and PL bundles. Additionally, there are significant but weak correlations between the size of the insertions and height, weight, and body mass index of the individual patient.


Oral contraceptives, tubal sterilization, and functional ovarian cyst risk.
To determine whether current contraceptive method affects functional ovarian cyst risk, with emphasis on oral contraceptives (OCs) and tubal sterilization. We conducted a case-control study of 18-39-year-old health maintenance organization enrollees with a functional ovarian cyst diagnosed between January 1, and June 30, 1994, and age-matched female controls randomly selected from enrollment files. In-person interviews as well as medical and pharmacy records were obtained for 78% of cases and 82% of controls; these analyses were based on 392 cases and 623 controls. Odds ratios (ORs) calculated with unconditional logistic regression were used to estimate the risk of a functional ovarian cyst diagnosis associated with current contraceptive method. In multivariable analyses adjusting for age, education, number of live births, and reference year, the overall OR was 0.72 (95% confidence interval [CI] 0.53, 0.99) for current OC use, compared with use of nonsurgical nonhormonal contraception or no contraception. The risk associated with use of 35 microg ethinyl estradiol monophasic OCs (OR 0.69; 95% CI 0.44, 1.10) was slightly lower than that associated with less than 35 microg ethinyl estradiol monophasic (OR 0.79; 95% CI 0.43, 1.47) or multiphasic OCs (OR 0.76; 95% CI 0.49, 1.19). Women with tubal sterilization had a substantially increased risk of a functional ovarian cyst diagnosis (OR 1.70; 95% CI 1.05, 2.75) compared with women using nonhormonal or no contraception. Our findings suggest that low-dose OC use has little or no effect on functional ovarian cyst likelihood. The increased risks we found associated with tubal sterilization merit further investigation.