Heart Rate Variability Biofeedback for Mild Traumatic Brain Injury: A Randomized-Controlled Study.
To determine whether heart rate variability biofeedback (HRV-BF) training, compared to a psychoeducation control condition can strengthen the integration of the central and autonomic nervous systems as measured by neuropsychological measures in patients with mild traumatic brain injury (mTBI). Participants were recruited from two university hospitals in Taipei, Taiwan. A total of 49 participants with mTBI were recruited for this study. Forty-one participants completed the study, 21 in the psychoeducation group and 20 in the HRV-BF group. Randomized controlled study. The Taiwanese Frontal Assessment Battery, the Semantic Association of Verbal Fluency Test, the Taiwanese version of the Word Sequence Learning Test, the Paced Auditory Serial Addition Test-Revised, and the Trail Making Test were used as performance-based neuropsychological functioning measures. The Checklist of Post-concussion Symptoms, the Taiwanese version of the Dysexecutive Questionnaire, the Beck Anxiety Inventory, the Beck Depression Inventory, and the National Taiwan University Irritability Scale were used as self-report neuropsychological functioning measures. Furthermore, heart rate variability pre- vs. post-training was used to measure autonomic nervous system functioning. Executive, information processing, verbal memory, emotional neuropsychological functioning, and heart rate variability (HRV) were improved significantly in the HRV-BF group at the posttest whereas the psychoeducation group showed no change. HRV biofeedback is a feasible technique following mild TBI that can improve neuropsychological and autonomic nervous system functioning. HRV-BF may be clinically feasible for the rehabilitation of patients with mTBI.


Factors associated with the use of mind body therapies among United States adults with musculoskeletal pain.
To determine the prevalence of mind body therapy use and correlates of use among adults with prolonged musculoskeletal pain, a group for whom mind body therapies are recommended. The U.S. 1999 National Health Interview Survey. Prolonged musculoskeletal pain was defined as any soft tissue, joint, or bony pain for at least 1 month. Analyses used SUDAAN and reflect national estimates. Use of mind body medicine (relaxation techniques, imagery, biofeedback, and hypnosis) and prayer in the previous year. Respondents (n=6079) with musculoskeletal pain were almost twice as likely as those without (n=24,722) to use mind body medicine (9% versus 5%, respectively, p<.0001) and prayer (20% versus 12%, respectively, p<.0001). After adjustment, men were less likely than women to use mind body medicine (odds ratio 0.55 [0.43-0.71]) and prayer (odds ratio 0.56 [0.48-0.66]). Those who had a high school education were less likely than those with training beyond high school to use mind body medicine (odds ratio 0.36 [0.28-0.47]) and prayer (odds ratio 0.61 [0.52-0.71]). Mind body therapies are not used commonly by adults with prolonged musculoskeletal pain. Understanding barriers to their use may facilitate wider application in this population.


Electrocuted Hip: Late Consequences of Electrical Shock Injuries of Orthopaedic Relevance: A Case Report and Review of Literature.
A 43-year-old man suffered household electric shock from 220 V alternating current when he accidently touched a live wire with his left hand. Subsequently, he was diagnosed to have osteonecrosis of the left femoral head and underwent total hip arthroplasty. We suggest that the electric current could have thrombosed the terminal subsynovial vessels of the femoral head, leading to osteonecrosis. To the best of authors' knowledge, only 2 cases of osteonecrosis of the hip after electric shock have been reported in the literature. A literature review of the delayed consequences of electric shock injuries pertaining to orthopaedics is also presented.


Mediator studies in skin blister fluid from patients with dual skin reactions after intradermal allergen injection.
Skin blister fluid (SBF) samples obtained after allergen skin testing in a total of 26 patients with late cutaneous reactions (LCRs) were examined for the presence of various vasoactive mediators. Histamine was predominant during the early phase of the wheal and flare reaction(206 +/- 40 ng/ml) and decreased with the development of the LCR toward normal SBF levels (around 20 ng/ml). Kallikrein activity was measurable in low amounts (around 5 ng/ml) in three out of 13 SBF samples taken 30 min after skin testing and in five of 13 SBF samples taken 6 hr after allergen testing. The thromboxane B2 content of SBF showed an increase with the development of LCR (control skin 976 +/- 483 ng/ml; allergen-tested skin 30 min after allergen injection, 1465 +/- 1566 ng/ml; allergen-tested skin 6 hr after antigen injection, 1775 +/- 731 ng/ml). SBF obtained from normal skin as well as from allergen-tested skin showed significant platelet-activating property as measured in an in vitro serotonin-release assay from washed human platelets. It is concluded that during the development of late-phase reactions a complex interaction of various mediator systems takes place.


Quantitative Anatomical Comparison of Anterior, Anterolateral and Lateral, Microsurgical and Endoscopic Approaches to the Middle Cranial Fossa.
To quantitatively compare different microsurgical and endoscopic approaches to the middle cranial fossa in a preclinical setting with a novel, computer-based research method. Different approaches were performed bilaterally in 5 head and neck specimens that underwent high-resolution computed tomography scans: 5 transcranial anterolateral (supraorbital, mini-pterional, pterional, pterional-transzygomatic, fronto-temporal-orbito-zygomatic) without and with anterior clinoidectomy; 2 transcranial lateral (subtemporal and subtemporal-transzygomatic); 2 endoscopic transnasal (transpterygoid, transpterygoid to infratemporal fossa); 2 endoscopic transorbital (superior eyelid and inferolateral), and endoscopic transmaxillary. A dedicated navigation system was used to quantify surgical working volumes and exposure of different areas of the middle cranial fossa (ApproachViewer, part of GTx-Eyes II, University Health Network, Toronto, Canada). Statistical analysis was performed using a mixed linear model with bootstrap resampling. Endoscopic transnasal and fronto-temporal-orbito-zygomatic approaches with anterior clinoidectomy showed the largest surgical volumes. Endoscopic approaches allowed a wider exposure of medial anatomical surfaces (e.g., the petrous apex) compared with transcranial ones. Transcranial approaches with larger craniotomies allowed the widest exposure of superomedial anatomical structures (e.g., roof of cavernous sinus). The resection of the zygomatic arch allowed exposure of more medial surfaces with an inferior to superior trajectory. This study implemented a novel neuronavigation-based research method to quantitatively compare different approaches to the middle cranial fossa; its results might guide, after consideration of clinical implications, the choice of the neurosurgical approach to different areas of this complex skull base region.


Erratum to: Low dose of hydroxychloroquine reduces fatality of critically ill patients with COVID-19.
1. In the abstract, we missed a piece of information. The correct sentence should be "In this retrospective study, we included 550 critically ill COVID-19 patients who need mechanical ventilation (63.5%) and oxygen therapy (35.6%) in Tongji Hospital, Wuhan, from February 1, 2020 to April 4, 2020." 2. We mistakenly put an approval number from Tongji Hospital ethics committee in the paper (IRBID: TJ-C20200113). The correct number should be TJ-IRB20200229. 3. We mistakenly filled some data in Table 1 and the correct Table 1 (the corrected data are in boldface) should be as follows.


Methods for the generation of heritable germline mutations in the disease vector Culex quinquefasciatus using clustered regularly interspaced short palindrome repeats-associated protein 9.
Culex quinquefasciatus is a vector of many diseases that adversely impact human and animal health; however, compared to other mosquito vectors limited genome engineering technologies have been characterized for this vector. Clustered regularly interspaced short palindrome repeats-associated protein 9 (CRISPR-Cas9) based technologies are a powerful tool for genome engineering and functional genetics and consequently have transformed genetic studies in many organisms. Our objective was to improve upon the limited technologies available for genome editing in C. quinquefasciatus to create a reproducible and straightforward method for CRISPR-Cas9-targeted mutagenesis in this vector. Here we describe methods to achieve high embryo survival and mutagenesis rates and we provide details on the injection supplies and procedures, embryo handling and guide RNA (gRNA) target designs. Through these efforts, we achieved embryo survival rates and germline mutagenesis rates that greatly exceed previously reported rates in this vector. This work is also the first to characterize the white gene marker in this species, which is a valuable phenotypic marker for future transgenesis or mutagenesis of this vector. Overall, these tools provide the framework for future functional genetic studies in this important disease vector and may support the development of future gene drive and genetic technologies that can be used to control this vector.


Homology between phosphotyrosine acceptor site of human c-abl and viral oncogene products.
The human homologues of several independent viral oncogenes, each of which encodes tyrosine-specific protein kinases, have been identified. Of these, three (v-src, v-yes and v-fes/fps) are known to exhibit considerable sequence homology, particularly in the regions of their phosphorylation acceptor sites. In the present study, sequences encoding the tyrosine phosphorylation acceptor sites of the Abelson murine leukaemia virus oncogene, v-abl, and its human cellular homologue, c-abl, have been identified and their nucleic acid sequences determined. Our results establish extensive homology between this region of c-abl and acceptor domains of the v-src, v-yes and v-fes/fps family of viral oncogenes, as well as more distant relatedness to the catalytic chain of the mammalian cyclic AMP-dependent protein kinase. These findings suggest that, of the homologues of retroviral oncogenes with tyrosine protein kinase activity examined to date, all were probably derived from a common progenitor and may represent members of a diverse family of cellular protein kinases.


Onset timing of electromyographic activity in the vastus medialis oblique and vastus lateralis muscles in subjects with and without patellofemoral pain syndrome.
Inappropriate neural control of the quadriceps femoris muscle group has been implicated in patellofemoral pain syndrome (PFPS). This study investigated the timing of initial electromyographic (EMG) activity of the vastus medialis oblique muscle (VMO) and the vastus lateralis muscle (VL) in asymptomatic subjects and subjects with PFPS during reflex and voluntary muscle activity. Fifteen symptomatic subjects (SYMP group) (9 with bilateral symptoms) and 12 asymptomatic subjects (ASYMP group) participated. Both knees were tested in the ASYMP group and only the symptomatic knees were tested in the SYMP group, resulting in a total of 24 data sets from each group. Electromyographic data were recorded from the VMO and VL under three conditions: reflex knee extension (RFLX) elicited by a patellar tendon tap, and active knee extension in non-weight-bearing (NWB) and weight-bearing (WB) situations. For each condition, EMG activity onset times for the VMO and VL were determined from ensemble averages of four trials. There were no differences between the SYMP and ASYMP groups with respect to the relative timing of initial VMO and VL activity under any of the three conditions tested. Mean timing differences for both groups were less than 0.25 milliseconds under reflex conditions and less than 4 milliseconds for active knee extension under both WB and NWB conditions. These findings contradict a previous report of differences in reflex timing related to PFPS. Differences in the relative timing of onset of EMG activity of the VMO and VL during voluntary knee extension were not significant between SYMP and ASYMP groups, and were not related to the relative timing differences observed during reflex testing.


MiR-204-5p-targeted AP1S2 is necessary for papillary thyroid carcinoma.
MiR-204-5p, as a tumour suppressor, has been found in several cancers. However, whether miR-204-5p is involved in papillary thyroid carcinoma (PTC) has not yet been investigated. In this study, we identified miR-204-5p as a down-regulated miRNA in PTC tissues, unveiling that the levels of miR-204-5p in serum of patients with PTC were linked to PTC risk, and that the expression in patients concomitant with both PTC and benign lesions was much lower than that in patients only with PTC. Furthermore, we documented that miR-204-5p inhibited proliferation, migration, invasion, and cell cycle progression and triggered apoptosis of PTC cells via cell biology experiments. Finally, we identified that AP1S2 was a target of miR-204-5p using RNA-seq, iTRAQ, and bioinformatics prediction. Overall, miR-204-5p functions as a suppressor for PTC pathogenesis via the miR-204-5p/AP1S2 axis.


Effector Molecules and Regulatory Proteins: Applications.
Bacteria respond to their external environment by modulating gene expression in the presence of certain effector molecules. The adaptive responses are mediated by transcriptional regulators that, after binding to the DNA, recognize these effector molecules and modify transcription. Some applications of regulatory proteins are reviewed here.


Sex differences in the association between PTSD symptoms with cardiac autonomic function and subclinical atherosclerotic risk.
Post-traumatic stress disorder (PTSD) is a public health concern that may elevate the risk for cardiovascular disease (CVD). There are established sex differences in both PTSD risk and CVD risk. To examine sex-specific associations between subclinical PTSD symptom severity and subclinical CVD risk in young men and women. A total of 61 young adults (women: n = 29, mean age: 26 ± 7 years) completed the post-traumatic stress disorder civilian checklist (PCL) and the Center for Epidemiologic Studies Depression Scale (CES-D). Aortic stiffness was measured as carotid-femoral pulse wave velocity (cfPWV). Peripheral vasomotor function was measured as flow-mediated slowing (FMS) of carotid-radial PWV following 5-min forearm occlusion. Heart rate variability was used to assess sympathovagal balance as LF/HF ratio. PCL score was positively correlated with CES-D score (r = 0.79, p < .001), cfPWV (r = 0.33, p = .03) and LF/HF ratio (r = 0.42, p = .009) in men. PCL score was positively correlated to CES-D score (r = 0.80, p < .001) in women, but was inversely correlated to cfPWV (r = -0.38, p = .02) and LF/HF ratio (r = -0.34, p = .04). PCL score was also inversely associated with FMS in women (r = -0.49, p = .01). There are sex differences in the association of PTSD symptoms and subclinical atherosclerosis. In men, increased PTSD symptoms may increase CVD risk by increasing sympathovagal balance and aortic stiffness. In women, increased PTSD symptoms may increase CVD risk via reducing vasomotor function.


Increased plasma levels of nerve growth factor in vernal keratoconjunctivitis and relationship to conjunctival mast cells.
To evaluate the nerve growth factor (NGF) plasma concentration in patients with vernal keratoconjunctivitis and to correlate it with the histopathology and immunopathology of the disease. An immunoenzymatic assay was performed to measure NGF plasma levels in patients with vernal keratoconjunctivitis and in healthy matched controls. A competitive radioimmunoassay was used to detect eosinophil cationic protein (ECP) and total specific immunoglobulin E (IgE) serum levels. Histologic evaluation was performed in tarsal and bulbar conjunctival biopsies. Plasma levels of NGF were significantly higher (P < 0.001) in patients with vernal keratoconjunctivitis (mean = 8224.47 +/- 7802.53 pg/ml; median = 121 pg/ml) than in controls (mean = 51.68 +/- 5.94 pg/ml; median 42.5 pg/ml). Conjunctival tissue showed a significant increase of mast cells, eosinophils, and lymphocytes in vernal keratoconjunctivitis. A significant correlation was observed between plasma levels of NGF and the number of mast cells in the tarsal conjunctiva (Cc = 0.81; P < 0.005) and bulbar conjunctiva (Cc = 0.77; P < 0.01) of patients with vernal keratoconjunctivitis. No correlation was found between NGF plasma levels and total IgE serum levels in patients with vernal keratoconjunctivitis; NGF plasma levels were inversely related to the number of circulating eosinophils (Cc = -0.61; P < 0.05) and to the increased serum levels of ECP (Cc = -0.71; P < 0.02). These data represent the first reported evidence of increased NGF plasma levels in an allergic human disease and suggest a possible relationship between this neurotrophic polypeptide and inflammatory cells in vernal keratoconjunctivitis.


Characterization of the transmembrane channel-like (TMC) gene family: functional clues from hearing loss and epidermodysplasia verruciformis.
Mutations of TMC1 cause deafness in humans and mice. TMC1 and a related gene, TMC2, are the founding members of a novel gene family. Here we describe six additional TMC paralogs (TMC3 to TMC8) in humans and mice, as well as homologs in other species. cDNAs spanning the full length of the predicted open reading frames of the mammalian genes were cloned and sequenced. All are strongly predicted to encode proteins with 6 to 10 transmembrane domains and a novel conserved 120-amino-acid sequence that we termed the TMC domain. TMC1, TMC2, and TMC3 comprise a distinct subfamily expressed at low levels, whereas TMC4 to TMC8 are expressed at higher levels in multiple tissues. TMC6 and TMC8 are identical to the EVER1 and EVER2 genes implicated in epidermodysplasia verruciformis, a recessive disorder comprising susceptibility to cutaneous human papilloma virus infections and associated nonmelanoma skin cancers, providing additional genetic and tissue systems in which to study the TMC gene family.


Venous air embolism and active lung inflation at high and low CVP: a study in "upright" anesthetized sheep.
To assess the safety and efficacy of the maneuver of active lung inflation (ALI) after venous air embolism, measurements were made of pulmonary artery occlusion pressure (PAOP), central venous pressure (CVP), and superior jugular bulb pressure (JbP) as an index of cerebral venous sinus pressure in eight sheep before and after a 2-ml/kg air embolus and before and in the release phase of an ALI to a pressure of 4 kPa (30 mm Hg). (PAOP-CVP) difference decreased significantly after the air embolus with a further decrease after ALI (P less than 0.01). An increase in JbP occurred with ALI only when the CVP was elevated before the injection of air. After air embolism in neurosurgery, ALI may increase the likelihood of paradoxical embolism in patients at risk and may also fail to help in identifying the site of air entry.


Preparation and activities of selenium polysaccharide from plant such as Grifola frondosa.
Selenium polysaccharide is an organic selenium compound formed by the combination of polysaccharide and selenium. The biological activity of selenium polysaccharide from plant such as Grifola frondosa is generally higher than that of selenium and polysaccharide, and it is more easily absorbed and utilized by human body. Therefore, selenium polysaccharide has a wide range of applications in immune regulation, anti-tumor, anti-oxidation, anti-aging and so on. Due to the unique pharmacological activity of selenium polysaccharide, the research of selenium polysaccharide has gradually become a hot spot. At present, there are few kinds of selenium polysaccharide, but its structure is very complex. The chemical structure and mechanism of selenium polysaccharide in vivo are not completely clear and need further study. Herein, the preparation and biological activities of selenium polysaccharides were introduced systematically, which provided theoretical basis for further research and application of selenium polysaccharides.


Analysis of phylogeny, distribution, and pathogenicity of Botryosphaeriaceae species associated with gummosis of Anacardium in Brazil, with a new species of Lasiodiplodia.
Netto, M. S. B., Lima, W. G., Correia, K. C., da Silva, C. F. B., Thon, M., Martins, R. B., Miller, R. N. G., Michereff, S. J., and Câmara, M. P. S. 2016. Analysis of phylogeny, distribution, and pathogenicity of Botryosphaeriaceae species associated with gummosis of Anacardium in Brazil, with a new species of Lasiodiplodia. We identified Botryosphaeriaceae species associated with gummosis on Anacardium in Brazil. Isolates were sampled and identified on the basis morphology and phylogeny, through analysis of a partial translation elongation factor 1-α sequence, ribosomal DNA internal transcribed spacers, and β-tubulin gene sequence. Ten taxa were identified, namely, Lasiodiplodia brasiliense, L. euphorbicola, L. gonubiensis, L. iraniensis, L. jatrophicola, L. gravistriata sp. nov., L. pseudotheobromae, L. theobromae, Neofusicoccum batangarum, and Pseudofusicoccum stromaticum. Lasiodiplodia theobromae has been previously reported in cashew and is the most prevalent species observed. All the other species are reported here for the first time on this host. All species of Botryosphaeriaceae were pathogenic on detached green cashew shoots. Differences in aggressiveness were observed among the species, with N. batangarum, L. iraniensis, L. jatrophicola, and L. gravistriata characterized as the most aggressive species, whilst L. euphorbicola and L. pseudotheobromae were identified as the least aggressive.


Dataset demonstrating physical properties of recycled wind turbine blade composites.
Wind turbine blades that face end-of-life recycled mechanically. The recycled material was first comminuted via a hammer-mill through a range of varying screen sizes, resinated and compressed to a final thickness to manufacture second generation composites fabricated using recycled wind turbine material and a polyurethane adhesive. Physical properties (water sorption (WA), Thickness swelling (TS)) dataset of composites made from recycled wind turbine blades presented. Dataset also presented the influence of resin level, moisture content, mill screen size and density on the physical properties of composites.


[Detection of rubella specific IgM on gel filtration through Sephadex G 200: use of dithiothreitol and limits with MnCl2-heparine pretreatment (author's transl)].
The detection of rubella haemagglutination inhibiting antibody, in the IgM fraction of the serum, on gel filtration through Sephadex G 200, needs precautions to exclude false results. Treatment with dithiothreitol is a satisfactory method for confirming the content of rubella IgM antibody. The failure of MnCl2-heparin pretreatment to remove non specific inhibitors of rubella hemagglutinin is unfrequent (7/108) and so do be repeated. Rarely (1/108) aggregated IgG fractionates with IgM and yield false positive results.


Translocation efficiency, susceptibility to proteasomal degradation, and lipid responsiveness of apolipoprotein B are determined by the presence of beta sheet domains.
Apolipoprotein (apo) B100 is an atypical secretory protein in that its translocation across the endoplasmic reticulum membrane is inefficient, resulting in the partial translocation and exposure of apoB100 on the cytoplasmic surface of the endoplasmic reticulum. Cytosolic exposure leads to the association of nascent apoB with heat shock protein 70 and to its predisposition to ubiquitination and proteasomal degradation. The basis for the inefficient translocation of apoB100 remains unclear and controversial. To test the hypothesis that beta sheet domains present in apoB100 contribute to its inefficient translocation, we created human apoB chimeric constructs apoB13,16 and apoB13,13,16, which contain amino-terminal alpha globular domains but no beta sheet domains, and apoB13,16,beta, which has an amphipathic beta sheet domain of apoB100 inserted into apoB13,16. These constructs, along with carboxyl-terminal truncations of apoB100, apoB34 and apoB42, were used to transfect HepG2 and Chinese hamster ovary cells. In contrast to the lack of effect of proteinase K on apoB13,16 and apoB13,13,16, the levels of apoB34, apoB42, and apoB13,16,beta were decreased by 70-85% after proteinase K-induced proteolysis in both HepG2 and Chinese hamster ovary cells. Either oleic acid or proteasomal inhibitors (N-acetyl-leucinyl-leucinyl-norleucinal and lactacystin) significantly increased the cell levels of apoB13,16,beta, apoB34, apoB42, and full-length apoB100 but had no effect on the cell levels of apoB13,16 and apoB13,13,16. When HepG2 cells were incubated with a microsomal triglyceride transfer protein inhibitor, the cellular levels of apoB13,16,beta, apoB34, and apoB42 were decreased by 70-80%, whereas the levels of apoB13,16 and apoB13,13,16 were unaffected. The effects of microsomal triglyceride transfer protein inhibition were reversed by lactacystin. Our results clearly demonstrate that the translocation efficiency, susceptibility to proteasomal degradation, and lipid responsiveness of apoB were determined by the presence of a lipid binding beta sheet domain. It is possible that beta sheet domains may at least transiently facilitate the interaction of apoB with the lipid bilayer surrounding the translocation channel.


Diterpenoid alkaloids from two species of Delphinium.
Four new compounds (1-4) were isolated from the whole plants of two species of Delphinium, including two C20-diterpenoid alkaloids, umbrodines A and B (1 and 2), and a dibenzoxazepinone, umbrolide A (3) from Delphinium umbrosum Hand.-Mazz. and a C20-diterpenoid alkaloid, kingiadine (4) from Delphinium kingianum Bruhl. ex Huth. Ten known diterpenoid alkaloids were also isolated. Their structures were elucidated via HR-ESIMS, IR, and NMR data. Lycoctonine (11) and delectinine (12) exhibited appreciable cardiac activity. Furthermore, 11 and 12 showed cardioprotective effects against doxorubicin-induced toxicity in H9c2 cells, with the maximum protection rates of 61.63% and 51.18%, respectively.


Interference in localizing tactile stimuli.
A series of experiments investigated the ability of subjects to localize a tactile stimulus in the presence of an additional, extraneous tactile stimulus. The subject's task was to localize a tactile stimulus (target) presented at one of several locations on his or her left index fingerpad. The target stimulus, generated on a 6 x 24 array of stimulators, was presented either by itself or in the presence of an extraneous stimulus (masker) that either preceded or followed the target. The localizability of the target was affected by the temporal separation between the target and masker in much the same way as previous studies have shown identification of tactile patterns to be affected. Unlike previous identification results, presenting the masking stimulus to the same location as the target interfered with localizability, although not as much as did presenting the masker to a different location. The results are discussed in terms of their implications for identification and discrimination of tactile patterns.


Validation of the Sonographic Measurement of Lateral Parapharyngeal Wall Thickness in Childhood Obstructive Sleep Apnea.
Lateral parapharyngeal wall (LPW) thickness is a potentially useful anatomical marker of childhood obstructive sleep apnea (OSA). Measuring LPW thickness by ultrasonography (USG) is technically feasible but its use in children has not been validated. Therefore, this study aimed to assess the intra- and inter-operator reliability of the sonographic measurements of LPW thickness in children and to assess its validity against magnetic resonance imaging (MRI) measurements. Prepubertal children aged 6-11 years suspected to suffer from OSA were recruited. Repeated measurements of LPW thickness by USG were conducted to evaluate the intra- and inter-operator reliability, examined by intraclass correlation coefficient (ICC). LPW thickness was measured as the distance between the internal carotid artery and the echogenic surface of the pharynx in an oblique coronal plane by USG. LPW thickness was measured by MRI at the retropalatal level. The agreement between the LPW thickness measured by USG and MRI was assessed by ICC and Bland-Altman plot. Thirty-four children (mean age: 8.66 ± 1.61, 26 male) were recruited. The intra- and inter-operator reliability of the LPW thickness by USG was good (ICC = 0.84 and 0.82, respectively). The agreement between the USG-measured and MRI-measured LPW thickness was moderate (ICC = 0.72). he Bland-Altman plot demonstrated a mean difference of 0.061 cm and a 95% limit of agreement from 0.91 to 1.12 cm. In this study, we demonstrated that ultrasonography is a valid and reliable method to assess LPW thickness in children. This study was supported by the Direct Grant for Research from the Research Committee of the Chinese University of Hong Kong (Project no. 2020.073).


Role of sphingolipids in the pathogenesis of intrahepatic cholestasis.
Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-related liver disorder that affects from 0.2% to 15.6% pregnant women. The disease is connected with increased risk of fetal morbidity and mortality, but is unfortunately detected quite late. The diagnosis of ICP is based on only one manifestation: pruritus which mainly affects soles and palms. Twenty intrahepatic cholestasis of pregnancy (ICP) women and twenty healthy pregnant women (control group) took part in the study. In the study group, blood sampling for baseline measurements was performed on the first day of hospital stay - before the commencement of treatment with ursodeoxycholic acid (UDCA) - and repeated after 7 days of 900 mg UDCA per day. An additional blood sample was collected on the second day after childbirth. In the control group, blood samples were collected directly after hospital admission. We compared plasma sphingolipids in samples of the subjects from ICP and ICP + UDCA-treated groups as well as the ICP group after delivery with the healthy controls. Of all sphingolipids, the median values of C16-Cer and C18-Cer were significantly higher in the plasma of cholestasis patients not treated with UDCA as compared to the control. Following 7 days of UDCA treatment, a considerable decrease in C16-Cer, C18-Cer and the total concentration of bile acids was noted as compared to the baseline. It is known that sphingolipids serve as modulators of liver regeneration. We assume these substances could be potential markers for detecting early onsets of intrahepatic cholestasis of pregnancy.


Comparative Study between Multi-slice Computed Tomographic Arthrography and Arthroscopy in the Evaluation of Rotator Cuff Tears.
Objective To compare the imaging findings of anatomical alterations using multi-slice computed tomographic arthrography in the evaluation of rotator cuff tears in the shoulder, correlating them with the arthroscopy (the gold standard diagnostic test) findings. Materials and Methods A longitudinal, prospective, comparative study of diagnostic accuracy performed in the period between June 2016 and June 2017 in patients of both sexes, aged between 40 and 70 years, with shoulder rotator cuff tendon tears and therapeutic need to undergo shoulder arthroscopy. Patients with contraindication to magnetic resonance imaging were included. After multi-slice computed tomographic arthrography, all patients underwent arthroscopy. Results To obtain the results, the following parameters were determined: sensitivity, specificity, accuracy, positive predictive value, negative predictive value, and Kappa coefficient, and contrast between the imaging method and arthroscopy. Conclusion In the impossibility of performing magnetic resonance imaging (the gold standard imaging technique), multi-slice computed tomographic arthrography is an imaging examination capable of evaluating/diagnosing rotator cuff tears.


Primary structure of a protease isoinhibitor from bovine spleen. A possible intermediate in the processing of the primary gene product.
Sequence studies on the protease isoinhibitor I isolated from bovine spleen have revealed that it consists of two molecular variants which differ only in the presence of an additional COOH-terminal residue, asparagine, in the less abundant form. The complete amino acid sequence shows that they are composed of 65 or 66 residues and predicts Mr of 7223 or 7338, respectively. The sequences correspond exactly to the 58-residue polypeptide chain of spleen isoinhibitor II plus NH2- and COOH-terminal extensions of 2 and 5 or 6 amino acid residues, respectively. Moreover the entire sequences are located within the 100-residue structure deduced from the mRNA and DNA sequences of the putative precursor. These data support the idea that the molecular variants of isoinhibitor I are either mature proteins with distinct functional roles, or intermediates in the multistage processing of the primary product of gene expression, which eventually leads to the mature protein, i.e. inhibitor II.


Sunbed use in Germany: trends, user histories and factors associated with cessation and readiness to change.
Sunbed use is considered carcinogenic in humans. Studies that examine behavioural patterns related to sunbed use over time are needed for developing skin cancer prevention strategies. To explore age-related trends in the initiation age, to investigate individual histories of sunbed use and to identify characteristics associated with cessation. We analysed cross-sectional data of 4851 sunbed users and nonusers from a representative sample of Germans, aged 14-45 years, interviewed in 2011/2012. Biographical data were reconstructed based on reported tanning frequency/duration and changes in sunbed use over time. We used survival analysis to model the initiation age and created birth cohorts to assess age-related trends. Characteristics associated with sunbed use cessation were identified using logistic regression. Among sunbed users, median sunbed exposure was 180 min per year. Annual exposure remained constant in 85·6% of this subgroup with no changes over time during periods of sunbed use. Age at initiation decreased significantly across birth cohorts from 25 to 19 years (25th percentile; cohorts 1966-75 to 1986-93). Characteristics associated with sunbed use cessation included educational level [odds ratios (OR) 1·53 and 1·71 for medium and high education, respectively], greater awareness of skin cancer risk (OR 2·41) and immigrant background (OR 0·54; all P < 0·01). Initiation of sunbed use at an increasingly younger age suggests the need for interventions targeted at young adults. Approaches that increase general skin cancer risk awareness and that are sensitive to participants' educational level and immigrant background may also be helpful.


Efficient algorithms for searching for exact repetition of nucleotide sequences.
There are several algorithms designed for searches for homologous sequences (Fitch 1966; Needleman and Wunsch 1970; Chva'tal and Sankoff 1975; Griggs 1977; Sannkoff 1972; Smith and Waterman 1981; Smith et al. 1981, Wagner and Fischer 1974; Waterman et al. 1976). This paper presents some very simple and useful high speed, "text editing" algorithms that search for exact nucleotide sequence repetition and genome duplication. The last algorithm suggested here is specifically adapted for the 4-letter alphabet of nucleotide sequences. Owing to the rapid accumulation of nucleotide sequences and the frequent need to search for sequence repetition or where a given set of nucleotides occurs in long sequences, efficient algorithms of this type are a necessity.


Factors affecting length of hospitalization of infants and children for recurrent gastroenteritis in Western Australia.
Aboriginal infants in Western Australia (WA) have much higher rates of hospitalization for gastroenteritis than do their non-Aboriginal peers. The aim of this 7-y retrospective study was to investigate the factors affecting the duration of hospitalizations due to recurrent gastroenteritis in WA. All infants born in WA in 1995 and 1996 who had indexed gastroenteritis admissions during their first year of life (n = 1009) were followed until 31 May 2002. Linked hospitalization and birth records were retrieved to derive the outcome measures, associated co-morbidities and other demographic variables. A proportional hazards frailty model was then used to determine factors influencing discharge from hospital for the study cohort. Aboriginal patients were readmitted to hospital more frequently and stayed in hospital more than twice as long as non-Aborigines. Factors that slowed the rate of discharge from hospital included Indigenous status and the presence of coexisting conditions such as dehydration, sugar intolerance, failure to thrive and iron-deficiency anaemia. Gastrointestinal infections are common illnesses in infants and children, particularly for those who live in overcrowded and unhygienic conditions. Coexisting morbidities including undernutrition, nutrient deficiencies, other infections and gastrointestinal carbohydrate intolerance contribute to prolonged and recurrent hospitalization. Multifaceted clinical, disease prevention and health/hygiene promotion are needed to lessen the burden of these infections.


Role of aging and striatal nitric oxide synthase activity in an animal model of tardive dyskinesia.
The risk of tardive dyskinesia (TD) increases with advancing age. Haloperidol increases striatal oxidative stress and inhibits nitric oxide (NO) synthase (NOS) in vitro. Biological aging is associated with increased oxidative stress and reduced brain NOS activity. This paper has explored aging and striatal NOS activity ex vivo as co-morbid factors in an animal model of TD. Young adult, mature adult and aged rats were treated with water or haloperidol (1.5 mg/kg per day) for 12 weeks. Vacous chewing movements (VCM) were monitored, as was striatal NOS activity. Aging significantly increased spontaneous VCM in mature and aged animals and progressively attenuated NOS activity in both mature adult and aged rats compared to young animals, and numerically lower in aged versus mature adult animals. Haloperidol significantly increased VCM in all age groups, while significantly reducing NOS activity in young and mature adults but not aged. Reduced NOS activity after haloperidol treatment was significantly lower in mature compared to young rats, but only numerically lower in aged rats receiving the drug, with a slight increase noted in the latter. In the current model, aging did not markedly alter haloperidol-induced VCM. Abrogated striatal nitrergic activity, therefore, underlies aging and haloperidol-induced VCM. Compensatory nitrergic mechanisms may preclude progressive NOS suppression and dyskinesia under conditions of advanced age and NOS inhibition.


Water and aging.
Having evolved from the sea and developed from an embryo, the species and the individual lose water--the medium and solvent wherein these processes occur--continually as they age. From an embryo, which is about 90% water, to a senescent individual in the tenth decade, there is a decline in body water to 60% or below. This loss in body water has profound effects on pathophysiology, making older persons susceptible to both under- and overhydration because they have a smaller volume of distribution for exogenous water. A colloid osmotic macromolecular aggregation model has been hypothesized to explain water loss in aging individuals.


Discussion: 'Surgical staging in early ovarian carcinoma' by Garcia-Soto et al.
In the roundtable that follows, clinicians discuss a study published in this issue of the Journal in light of its methodology, relevance to practice, and implications for future research.


Community during the Pandemic and Civil Unrest.
Beginning with the concept of community, this editorial describes the essence of community as connectedness, sharing and caring. The notion of cultural trauma helps clarify the meaning and impact of the pandemic and concurrent racial unrest. Evidence is offered of sharp decline in community wellbeing from these traumas. As in other major disasters, communities of support have arisen to help neighbors and others who need urgent assistance repairing their lives and their torn social fabric.


How Many Participants? How Many Trials? Maximizing the Power of Reaction Time Studies.
Due to limitations in the resources available for carrying out reaction time (RT) experiments, researchers often have to choose between testing relatively few participants with relatively many trials each or testing relatively many participants with relatively few trials each. To compare the experimental power that would be obtained under each of these options, I simulated virtual experiments using subsets of participants and trials from eight large real RT datasets examining 19 experimental effects. The simulations compared designs using the first [Formula: see text] trials from [Formula: see text] randomly selected participants, holding constant the total number of trials across all participants, [Formula: see text]. The [Formula: see text] combination maximizing the power to detect each effect depended on how the mean and variability of that effect changed with practice. For most effects, power was greater in designs having many participants with few trials each rather than the reverse, suggesting that researchers should usually try to recruit large numbers of participants for short experimental sessions. In some cases, power for a fixed total number of trials across all participants was maximized by having as few as two trials per participant in each condition. Where researchers can make plausible predictions about how their effects will change over the course of a session, they can use those predictions to increase their experimental power.


The synthesis of ethacrynic acid thiazole derivatives as glutathione S-transferase pi inhibitors.
Glutathione S-transferase pi (GSTpi) is a phase II enzyme which protects cells from death and detoxifies chemotherapeutic agents in cancer cells. Ethacrynic acid (EA) is a weak GSTpi inhibitor. Structure modifications were done to improve the ability of EA to inhibit GSTpi activity. Eighteen EA thiazole derivatives were designed and synthesized. Compounds 9a, 9b and 9c with a replacement of carboxyl group of EA by a heterocyclic thiazole exhibited improvement over EA to inhibit GSTpi activity.


[Identification and genetic control of the Ld1-allotype of mink low-density serum lipoprotein].
Ld1, an antigen of serum low density lipoprotein, was identified by means of mink alloimmunization. No genetic relation was established between Ld1 and the Ipm-system of very high density lipoprotein. Based on the analysis of breeding data, the existence of an autosomal dominant gene, Ld1+, is postulated. This gene codes for the new alloantigenic marker. The existence of at least one other allotype of the Ld-system is suggested.


Ammonia-assisted synthesis of low-crystalline FeCo hydroxides for efficient electrochemical overall water splitting.
Low-crystalline FeCo hydroxides were synthesized on a gram scale with the aid of ammonia, and they exhibited impressive catalytic activity for both the HER and OER. We utilized these catalysts to assemble a water splitting cell, which functions efficiently. The electrolytic cell can produce a consistent current density of 200 mA cm-2 for over 20 hours while operating at a voltage of 1.95 V.


Periurethral abscess.
From 1963 to 1985, 63 periurethral abscesses were treated in 47 men. The records were reviewed to characterize the natural course of the disease. The most common predisposing factors were a history of gonorrhea, previous periurethral abscess and urethral stricture disease. Treatment consisted of abscess drainage, suprapubic urinary diversion and intravenous antibiotic therapy, consisting of an aminoglycoside and a cephalosporin. Mortality was 1 of 63 patient hospitalizations (1.6 per cent). Improved survival over historical cohorts is attributed to the availability of better antibiotics and medical support.


Human herpesviruses 6 and 7 in salivary glands and shedding in saliva of healthy and human immunodeficiency virus positive individuals.
The presence of human herpesvirus 6 (HHV-6) and human herpesvirus 7 (HHV-7) was investigated by the polymerase chain reaction in saliva specimens from healthy persons, donors affected by common cold or recurrent aphthous ulceration (RAU), and human immunodeficiency virus (HIV) positive patients, and in salivary gland biopsies. The sensitivity of the technique made it possible to detect as few as 5-10 target molecules in 15 microliters of saliva. HHV-6 was present in 63% of salivary gland biopsies and in 3% of salivas from healthy persons. No significant difference in the presence of HHV-6 was detected in specimens from donors with common cold, RAU, or HIV-infected patients. HHV-7 was present in 75% of salivary glands and in 55% of salivas from healthy persons. HHV-7 was detected with similar frequency in salivas from donors with common cold or RAU. Salivas from HIV-infected patients harbored HHV-7 with higher frequency (81%) and increased viral load. These results show that salivary glands are a site of persistent infection for both HHV-6 and HHV-7. However, the two viruses seem to differ in their biological properties: 1) HHV-6 is rarely present in saliva in detectable amounts, while HHV-7 is frequently detected; and 2) immunosuppression by acquired immunodeficiency syndrome (AIDS) increases the frequency of detection and the viral load of HHV-7, but does not have a significant effect on HHV-6 shedding in saliva.


The effect of cholesterol on the morphology and reactivity of the mixture of lipids used in syphilis serology.
The effect of increasing amounts of cholesterol on the morphology of the liposomes constituting the VDRL-antigen was studied. The morphological parameters examined were the shape of the lipoidal particles and especially the number of lamellae on each particle in the various mixtures of lipids studied. Cholesterol in the presence of cardiolipin and lecithin is observed as rhomboid crystals, indicating that the majority of the cholesterol is located exterior to the lamellar membranes of lecithin and cardiolipin. It is shown that the effect of cholesterol is to reduce the number of individual lamellae per liposome, mainly by mechanically dispersing the cardiolipin and lecithin on the surface of the cholesterol crystals. It is suggested that cholesterol has no effect on the structure of the epitopes which react with antibodies in sera from patients with syphilis, but that, as a result of the mechanical dispersion of cardiolipin and lecithin, it creates liposomes with more accessible epitopes.


The Effects of Dementia Care Co-Management on Acute Care, Hospice, and Long-Term Care Utilization.
Although nurse practitioner dementia care co-management has been shown to reduce total cost of care for fee-for-service (FFS) Medicare beneficiaries, the reasons for cost savings are unknown. To further understand the impact of dementia co-management on costs, we examined acute care utilization, long-term care admissions, and hospice use of program enrollees as compared with persons with dementia not in the program using FFS and managed Medicare claims data. Quasi-experimental controlled before-and-after comparison. Urban academic medical center. A total of 856 University of California, Los Angeles (UCLA) Alzheimer's and Dementia Care program patients were enrolled between July 1, 2012, and December 31, 2015, and 3,139 similar UCLA patients with dementia not in the program. Comparison patients were identified as having dementia using International Classification of Diseases-9 codes and natural language processing of clinical notes. Coarsened exact matching was used to reduce covariate imbalance between intervention and comparison patients. Dementia co-management model using nurse practitioners partnered with primary care providers and community organizations. Average difference-in-differences per quarter over the 2.5-year intervention period for all-cause hospitalization, emergency department (ED) visits, intensive care unit (ICU) stays, and number of inpatient hospitalization days; admissions to long-term care facilities; and hospice use in the last 6 months of life. Intervention patients had fewer ED visits (odds ratio [OR] = .80; 95% confidence interval [CI] = .66-.97) and shorter hospital length of stay (incident rate ratio = .74; 95% CI = .55-.99). There were no significant differences between groups for hospitalizations or ICU stays. Program participants were less likely to be admitted to a long-term care facility (hazard ratio = .65; 95% CI = .47-.89) and more likely to receive hospice services in the last 6 months of life (adjusted OR = 1.64; 95% CI = 1.13-2.37). Comprehensive nurse practitioner dementia care co-management reduced ED visits, shortened hospital length of stay, increased hospice use, and delayed admission to long-term care.


Cholinergic modulation of sensory responses in rat primary somatic sensory cortex.
Responses evoked in single neurons of the primary somatic sensory cortex following tactile stimulation were examined before, during and after local iontophoretic application of acetylcholine (ACh) in urethane-anesthetized rats. The most common effect of ACh was an enhancement of the discharge evoked by sensory stimuli. Some cells responded to sensory input only in the presence of ACh. Response enhancement was observed in both supra- and infragranular layers, whereas response suppression was the most common effect in layer IV. These studies suggest that cholinergic systems modify sensory processing in cerebral neocortex by modulating the effectiveness of afferent inputs to cortical neurons in all layers.


[Traumatic carotid aneurysm in the region of the base of the skull with life-threatening hemorrhage into the nasopharyngeal space].
The author reports on a typical case of a traumatic aneurysm of the internal carotid artery with life-threatening bleeding which could be cured. Picture of the disease, diagnosis, and possibilities of treatment are discussed.


[Heterochromatic regions of chromosomes 1, 9, 16 and Y in children with signs of embryonic development disorder].
Some reduction of the length of C segments and their variability in chromosomes 1, 9, 16 and Y was exhibited by children having disturbances at an early stage of embryogenesis. The data obtained might suggest a certain activity of the heterochromatic regions during the embryo development. Based on these data, one may also suppose that reduction of the heterochromatin amount may affect the normal morphogenetic processes.


Microarray analysis identifies apoptosis regulatory gene expression in HCT116 cells infected with thermostable direct hemolysin-deletion mutant of Vibrio parahaemolyticus.
The thermostable direct hemolysin (TDH) is considered as a major virulence factor of Vibrio parahaemolyticus. We observed this potential in several human cancer cell lines by using the TDH-producing wild-type (RIMD2210633) as well as tdh-deletion mutant of V. parahaemolyticus and found that the deletion of tdh did not affect cytotoxicity to any of the cell lines tested. DNA fragmentation and annexin V staining showed that both wild-type and tdh-mutant trigger apoptosis in these cells. To understand the molecular basis of cell death in the absence of TDH, gene expression profile of human colon cancer cell line HCT116 infected with tdh-deletion mutant was carried out using human cDNA microarrays consisting of 33,000 known genes. In infected cells, differentially expressed genes including genes for early growth response, growth arrest and DNA damage, and activating transcription factor that affect programmed cell death pathways were detected. Interestingly, mutant strains having a deletion in type III secretion system 1 (TTSS1) failed to elicit DNA fragmentation in HCT116 cells. Our results strongly suggest that apoptosis requires functional TTSS1 and TTSS1-dependent translocation factor(s) to be associated with the host cell death, and thus pathogenesis of V. parahaemolyticus.


Residential exposure to natural outdoor environments and general health among older adults in Shanghai, China.
Exposure to natural outdoor environments (NOE) has been shown to be beneficial to older adults' health and functioning, yet this assertion has rarely been tested in China. We investigated the relationships between exposure to NOE and older adults' self-rated health in Shanghai, China and examined whether these relationships varied by sex, age, education and hukou status. This cross-sectional study used micro-data sample of the 2010 Shanghai population census, including 7962 older adults nested within 3345 neighbourhoods. Self-rated health was the outcome variable. Four NOE exposure indicators were calculated for each neighbourhood: the amount of surrounding greenness/blueness and proximity to large green/blue spaces. Multilevel logistic regression was employed to explore the association between natural outdoor environment exposure and self-rated health, adjusting for individual-level and neighbourhood-level covariates. Stratified analyses were used to examine variations by sex, age, education and hukou status. Older adults living in neighbourhoods with higher surrounding greenness and higher proximity to both green spaces and blue spaces were more likely to report good health. Residential surrounding blueness was not significantly related to self-rated health. Females, those aged 60-69 years, those who had elementary school or junior high school education and those with non-local hukou benefit more from residential surrounding greenness, and those aged 70-79 years and who had elementary school or junior high school education benefit more from residential proximity to blue spaces. Higher residential greenness and proximity to both green spaces and blue spaces were associated with better self-rated health, particularly for females, younger older adults, the low educated and non-local hukou holders. Our findings suggest that urban green spaces and urban blue spaces have different effects on health among Chinese older adults and that the assessment of exposure matters to the investigation of NOE-health relationships.


Luteinizing hormone releasing hormone agonists: the US experience.
In a large multicentre trial, 1 mg/day leuprorelin given subcutaneously was as effective as diethylstilboestrol in the treatment of prostatic cancer but with a lower incidence of side-effects, although leuprorelin could induce tumour flare-up. Total androgen ablation using a combination of leuprorelin and the non-steroidal anti-androgen flutamide in the treatment of prostatic cancer was more effective than either orchidectomy or diethylstilboestrol. The efficacy of 1 mg/day leuprorelin given subcutaneously plus 250 mg flutamide three times a day compared with leuprorelin plus placebo was confirmed in a randomized, double-blind study of 603 patients. Progression-free and overall survival were prolonged, and tumour flare-up and other side-effects were reduced in patients with untreated advanced prostatic cancer and in those with minimal disease.


The effectiveness of initial therapy contact: A systematic review.
'Initial therapy contacts', defined as (the first) 3 h or less of face-to-face psychological treatment, encompassing both the early phase of a longer therapy and one-off single session therapies, are seen as a critical phase of treatment. However, little is known about the direct effect of initial therapy contacts on change in common symptoms typically presented by patients in psychological therapy services. Our systematic literature search resulted in 35 identified empirical studies on the effect of initial therapy contacts. These studies were analyzed in three stages: 1) A systematic comparison of study characteristics using the preferred reporting items for systematic reviews and meta-analyses; 2) A domain-based evaluation of methodological rigor of the studies, in line with Cochrane's guidelines on assessing risk of bias; 3) A narrative synthesis of reported findings. The considerable variability in therapy format (a stand-alone single session, 2 + 1 format, or initial session of multisession therapy) and study design (post/pre-post measurement, with/without control) limited comparability of studies. The quality assessment indicated that the majority of studies had relatively weak methodologies overall. Qualitative synthesis of the effectiveness results suggests that a significant proportion of patients reported benefits, including symptom change. This positive effect is especially clear when compared to no-treatment controls, and appears to be maintained at follow-up. The findings suggest that a broad range of initial therapy formats, could in itself be beneficial to patients in primary care treatment settings, and that further research is warranted.


Influence of root canal instrumentation and obturation techniques on intra-operative pain during endodontic therapy.
To analyse the influence of root canal instrumentation and obturation techniques on intra-operative pain experienced by patients during endodontic therapy. A descriptive cross-sectional study was carried out in Ponferrada and Sevilla, Spain, including 80 patients (46 men and 34 women), with ages ranged from 10 to 74 years, randomly recruited. Patient gender and age, affected tooth, pulpal diagnosis, periapical status, previous NSAID or antibiotic (AB) treatment, and root canal instrumentation and obturation techniques were recorded. After root canal treatment (RCT), patients completed a 10-cm visual analogue scale (VAS) that ranked the level of pain. Results were analysed statistically using the Chi-square and ANOVA tests and logistic regression analysis. The mean pain level during root canal treatment was 2.9±3.0 (median=2) in a VAS between 0 and 10. Forty percent of patients experienced no pain. Gender, age, arch, previous NSAIDs or AB treatment and anaesthetic type did not influence significantly the pain level (p>0.05). Pain during root canal treatment was significantly greater in molar teeth (OR=10.1; 95% C.I.=1.6-63.5; p=0.013). Root canal instrumentation and obturation techniques did not affect significantly patients' pain during root canal treatment (p>0.05). Patients feel more pain when RCT is carried out on molar teeth. The root canal instrumentation and obturation techniques do not affect significantly the patients' pain during RCT.


De novo large-cell neuroendocrine carcinoma of the prostate: A case report and literature review.
Prostatic large-cell neuroendocrine carcinoma is poorly studied. Although several case reports are available, information on the clinicopathological characteristics of this disease is limited, particularly for the de novo (hormone-naive) type. Herein, we report an extremely rare de novo case of this disease with a good prognosis despite a multi-metastatic status. An 83-year-old male patient presented with a high serum prostate-specific antigen level and was found to have de novo prostatic large-cell neuroendocrine carcinoma with an adenocarcinoma component upon pathological examination. Diagnosed with stage pT4cN1cM1c, he underwent chemo-hormonal therapy using a luteinizing hormone-releasing hormone antagonist and combined etoposide and cisplatin, which achieved a partial response. The patient has survived for 20 months without progression. Although prostatic large-cell neuroendocrine carcinoma is known for its aggressive clinical behavior, the de novo type with an adenocarcinoma component may be sensitive to hormonal therapy and achieve a good prognosis.


Formation-stimulating regimens other than sodium fluoride.
Although no bone formation-stimulating regimen has been approved for treatment of established osteoporosis, there are a number of potentially effective drugs that are in various stages of preclinical and clinical testing. The two that show the greatest potential and the ones most likely to become available initially for clinical treatment are a parathyroid hormone fragment, PTH(1-34), and insulin-like growth factor-I. A promising approach for the future is to discover orally active agents that enhance the local production of growth factors by bone cells. It is likely that effective formation-stimulating regimens will become available for treating established osteoporosis within the next 5 years.


Distribution and ultrastructure of ventral root afferents to lamina I of the cat sacral spinal cord.
Following ventral root injury-filling with horseradish peroxidase at sacral spinal levels S1, S2, and S3, small fascicles of axons can be observed to enter the ventral portion of lamina I and arborize primarily in the dorsolateral region just medial to the tract of Lissauer (TL). Some axons enter the TL and turn in a rostrocaudal direction. Labeled axons studied by electron microscopy are both myelinated and unmyelinated, and terminals in lamina I contain round clear, and dense cored vesicles and contact smaller diameter dendrites and vesicle-containing elements. The concentration of these putative ventral root afferents appears to be largest in the S2 segment, with smaller numbers found within S1 and S3.


The Relationships of Demographic Characteristics with Diabetes Biomarkers and Physical Activity Adherence in African American Adults.
The objective of this study was to examine the relationships of demographic characteristics with diabetes biomarkers and physical activity adherence in African American adults with type 2 diabetes mellitus. Data for this secondary analysis were collected in a controlled trial conducted at an ambulatory internal medicine clinic located in a mid-sized metropolitan area in the southeastern USA. Demographic information was obtained at baseline for all participants receiving a motivational interviewing intervention. Diabetes biomarkers and physical activity adherence were measured at baseline and 3-month follow-up. Being female, older, and having a higher education significantly predicted a decrease in serum glucose over time. Being female and older significantly predicted a slower decrease in body mass index over time. Being younger and more educated significantly predicted probability of improved physical activity adherence. Although older African American women had a significant decrease in serum glucose over time, they experienced a slower decrease in their body mass indices and were less likely to adhere to physical activity recommendations. Specific attention should be paid to the demographic characteristics of African Americans with type 2 diabetes mellitus in order to promote optimal clinical outcomes in this vulnerable population. This approach to treatment planning opens a window into the micro-level processes by which social determinants lead to a better response to treatment.


The Canadian Index of Wellbeing: key findings from the healthy populations domain.
The Canadian Index of Wellbeing (CIW) is an ambitious undertaking that aims to measure and track Canadians' overall "wellbeing". The Healthy Populations, one of eight CIW domains, brings together both population health outcomes and important influences on health. Indicators from eight subdomains (personal wellbeing, life expectancy/mortality, physical health conditions, functional health, mental health, lifestyle and behaviour, health care, and public health) make up the Healthy Populations domain. Following a review of worldwide literature on health and wellbeing indicators, application of a prespecified set of selection criteria, and expert external validation, ten core indicators and six secondary indicators were selected. The data sources include several national population data systems (CCHS, NPHS) and databases kept at the Canadian Institute for Health Information. Indicators were examined for trends over time, and were stratified by age, sex, income and education. A single summary measure, health domain index, was calculated and reported annually from 1994 to 2008. Analysis of data over a 15-year time period found that Canadians are living longer, but with fewer years in optimal health. Diabetes rates have risen, along with obesity rates, while smoking rates are on the decline and regular physical activity is becoming more common. There were notable income and education gradients for virtually all indicators measured, and gender disparities evident for life expectancy, health-adjusted life expectancy, diabetes, and depression. A worrisome downward trend in health outcomes for Canada's youth (12-19 years) was observed. The overall health index score showed a modest rise of 6.6% from 1994 to 2008. The Healthy Populations domain, and its ongoing use and refinement, can be an important resource for understanding and monitoring the health of Canadians. Knowledge about the status of Canadians' wellbeing will benefit from the contextualization of these findings through evidence generated from the other CIW domains.


Formation of modified DNA bases in cells exposed either to gamma radiation or to high-LET particles.
The aim of the present study was to measure the formation of eight base modifications in the DNA of cells exposed to either low-LET ((60)Co gamma rays) or high-LET ((12)C(6+) particles) radiation. For this purpose, a recently optimized HPLC-MS/MS method was used subsequent to DNA extraction and hydrolysis. The background level of the measured modified bases and nucleosides was shown to vary between 0.2 and 2 lesions/10(6) bases. Interestingly, thymidine glycols constitute the main radiation-induced base modifications, with an overall yield of 0.097 and 0.062 lesion/10(6) bases per gray for gamma rays and carbon heavy ions, respectively. Both types of radiations generate four other major degradation products, in the following order of decreasing importance: FapyGua > 5-HmdUrd > 5-FordUrd > 8-oxodGuo. The yields of formation of FapyAde and 8-oxoAde are one order of magnitude lower than those of the related guanine modifications, whereas the radiation-induced generation of 5-OHdUrd was below the limit of detection of the assay. The efficiency for both types of radiation to generate base damage in cellular DNA is low because the highest yield per gray was 0.097 thymine glycols per 10(6) DNA bases. As a striking observation, the yield of formation of the measured DNA lesions was found to be, on average, twofold lower after exposure to high-LET radiation ((12)C(6+)) than after exposure to low-LET gamma radiation. These studies show that the HPLC-MS/MS assay provides an accurate, reliable and sensitive method for measuring cellular DNA base damage.


mRNA loading into ATP-responsive polyplex micelles with optimal density of phenylboronate ester crosslinking to balance robustness in the biological milieu and intracellular translational efficiency.
Carriers for messenger RNA (mRNA) delivery require propensities to protect the mRNA from enzymatic degradation and to selectively release mRNA in the cytosol for smooth mRNA translation. To meet these requirements, we designed mRNA-loaded polyplex micelles (PMs) with ATP-responsive crosslinking in the inner core by complexing mRNA with poly(ethylene glycol)-polycation block copolymers derivatized with phenylboronic acid and polyol groups, which form crosslinking structures via spontaneous phenylboronate ester formation. PMs thus prepared are tolerable against enzymatic attack and, in turn, disintegrate in the cytosol to release mRNA when triggered by the cleavage of phenylboronate ester linkages in response to elevated ATP concentration. Two structural factors of the PM, including (i) the introduction ratios of phenylboronate ester crosslinkers and (ii) the structure and protonation degree of amino groups in the polycation segment, are critical for maximizing protein expression in cultured cells due to the optimized balance between the robustness in the biological milieu and the ATP-responsive mRNA release in the cytosol. The optimal PM formulation was further stabilized by installing cholesterol moieties into both the mRNA and ω-end of the block copolymer to elicit longevity in blood circulation after intravenous injection.


Immunohistochemical identification of prostatic acid phosphatase and prostate specific antigen in female periurethral glands.
Periurethral glands were found in 7 of 10 female urethras harvested at autopsy. In all 7 cases, immunoperoxidase staining showed the presence of prostatic acid phosphatase in glandular acini. By similar techniques, prostate specific antigen was demonstrated in acini of 4 of 7 urethras with periurethral glands. The findings support a female homologue of the male prostate.


Sildenafil activates antioxidant and antiapoptotic genes and inhibits proinflammatory cytokine genes in a rat model of renal ischemia/reperfusion injury.
To study the possible renoprotective effect of sildenafil against renal ischemia/reperfusion (I/R) injury and its effect on the expression of some antioxidant, antiapoptotic gene and proinflammatory cytokine genes in rat model of renal I/R injury. One hundred and twenty male Sprague Dawley rats were subdivided into three equal groups: sham (underwent right nephrectomy without ischemia), control (underwent right nephrectomy and left ischemia for 45 min) and study [as control with 1 mg/kg sildenafil (per oral) 60 min before anesthesia]. Serum creatinine and BUN were measured at the baseline and the study endpoints (2, 24, 48 h and 7 days), and the left kidney was harvested at study endpoints for histopathological examination as well as for assessment of the expression of antioxidant genes (Nrf-2, HO-1 and NQO-1), antiapoptotic gene (Bcl-2) and inflammatory cytokines, e.g., TNF-a, IL-1β and ICAM-1. I/R caused significant increase in serum creatinine, BUN, histopathological damage score (p < 0.001) and significant reduction in antioxidant genes (nrf2, HO-1 and NQO-1) and antiapoptotic gene (Bcl2) with significant increase in TNF-a, IL-1β and ICAM-1 genes in kidney tissues. Pretreatment with sildenafil caused significant attenuation of serum creatinine and BUN as well as significant increase in the expression of antioxidant genes and Bcl-2 genes with significant reduction in the expression of proinflammatory cytokine genes (p value < 0.001). The renoprotective effect of sildenafil against renal I/R might be due to the activation of antioxidant genes (Nrf2, HO-1 and NQO-1) and antiapoptotic gene (Bcl2) and attenuation of proinflammatory cytokines (TNF-a, IL-1β and ICAM-1).


Comparison of Magnetic Resonance Enterography Global Score (MEGS) with indices of Crohn's disease activity in South Asian population.
Assessment of disease activity in Crohn's helps predict important clinical outcomes. Among the various modalities available to assess disease activity, magnetic resonance enterography (MRE) is considered a safe and reliable imaging option. Various MRE-based scoring systems have been developed to measure disease activity, one of which being the MRE global score (MEGS). We aimed to correlate MEGS with some of the important indices of Crohn's disease activity. Crohn's disease patients referred for MRE were included in the study. Along with demographic profile and relevant investigations, MRE parameters related to MEGS were also assessed. A total of 47 patients were recruited for the study. Their median age was 34 years (range 18-68 years), and male:female ratio was 16:31. There was modest positive correlation between MEGS and faecal calprotectin (r = 0.3, p = 0.04), CRP level (r = 0.34, p = 0.02) and Harvey Bradshaw index (r = 0.3, p = 0.043), respectively. However, there was strong correlation between segmental MEGS and Simple Endoscopic Score in those with terminal ileal disease (r = 0.81, p < 0.001). Mural thickness was the only MRE parameter that correlated with active disease (OR - 1.35, 95% CI 1.01, 1.81, p = 0.041) on multivariate analysis. There was moderate inter-observer agreement (Lin's r = 0.78, p < 0.001). MEGS showed modest correlation with indices of Crohn's disease activity which corroborates the complementary role of MRE in management of such patients.


Effects of chronic cigarette smoking on myocardial deformation parameters by two-dimensional speckle tracking echocardiography.
Cigarette smoking causes myocardial damage with several mechanisms such as sympathetic nervous system activation, oxidative stress, and endothelial dysfunction. Chronic smokers have an increased risk of morbidity and mortality associated with cardiac events. We aimed to compare the myocardial deformation parameters between chronic smokers and nonsmoker healthy population. Forty-two healthy participants (mean age 33.48 ± 10.00 years) without smoking history, 40 participants (mean age 33.98 ± 9.27 years) who had been smoking were prospectively included. In addition to conventional echocardiographic measurements, global longitudinal strain (GLS) of left ventricle (LV), GLS of right ventricle (RV), left atrial strain, and strain rate were analyzed. Smokers had lower peak early diastolic velocity (E) and E/a (early diastolic velocity/late diastolic velocity) ratio in mitral inflow (70.0 ± 13.9 cm/sec vs 77.1 ± 13.3 cm/sec, P = .023; 1.4 ± 0.4 vs 1.7 ± 0.4, P = .011; respectively). Peak early diastolic velocity of mitral valve septal annulus (Em) and Em/Am ratio (peak early diastolic velocity of mitral valve/late diastolic velocity of mitral valve) (11.0 ± 2.1 cm/sec vs 12.1 ± 2.4 cm/sec, P = .023; 1.2 ± 0.3 vs 1.4 ± 0.4, P = .039; respectively) were lower in smokers. LV GLS and RV GLS were significantly lower in smokers (-17.6% ± 3.01 vs -19.2% ± 2.5; P = .013, -18.9% ± 4.4 vs -21.0% ± 4.5; P = .039; respectively). Impaired LV and RV deformation were found in chronic smokers in our study. Although there was no statistically significant difference with left ventricular ejection fraction, LV GLS which is the early indicator of LV systolic dysfunction was lower in chronic smokers. The assessment of early harmful effects of smoking on left and right ventricle might be evaluated with speckle tracking echocardiography.


Stress Hyperglycemia During Surgery and Anesthesia: Pathogenesis and Clinical Implications.
Numerous studies have demonstrated an association between hyperglycemia in the perioperative period and adverse clinical outcomes. Many patients who experience hyperglycemia while hospitalized do not have a known history of diabetes and experience a transient phenomenon often described as "stress hyperglycemia" (SH). We discuss the epidemiology and pathogenesis of SH as well as evidence to date regarding predisposing factors and outcomes. Further research is needed to identify the long-term sequelae of SH as well as perioperative measures that may modulate glucose elevations and optimal treatment strategies.


Characteristics and function of an extracellular polysaccharide from a green alga Parachlorella.
The green alga Parachlorella sp. BX1.5 is a new strain that can significantly coproduce lipids and polysaccharides, inside and outside the cells, respectively. This study aimed to investigate the characteristics and functional properties of the extracellular polysaccharide (EPS). Ethanol-extracted EPS from the cells grown in N-starved BG11 medium was found to be a novel acidic rhamnan of straight-chain type, with a high molecular mass of > 1.75 × 106 daltons. The water-soluble EPS exhibited high viscosity as sol, even at low concentrations, with 0.5 % EPS showing almost constant viscosity at 10-40 °C. Its addition to mayonnaise resulted in improved oil-off, suggesting its possible application as a thickener or food additive. Cells with added EPS were found to exhibit resistance to environmental stress conditions, such as heat, dryness, and decompression, and ultraviolet rays. Based on these rheological and biological effects, its unique properties with respect to biorefinery have been discussed here.


Change in estimated glomerular filtration rate and fracture risk in the Action to Control Cardiovascular Risk in Diabetes Trial.
Patients with type 2 diabetes (T2DM) are at increased risk of fracture. High prevalence of chronic kidney disease (CKD) in T2DM may contribute to bone fragility, but whether dynamic change in kidney function is associated with fracture risk is unclear. To evaluate the association of pre-randomization baseline estimated glomerular filtration (eGFR) and its change over time with subsequent fracture risk in the Bone substudy of Action to Control Cardiovascular Risk in Diabetes (ACCORD) Trial, we conducted an observational study of 2262 women and 4737 men with T2DM and with at least 2 eGFR values. During a mean follow-up of 4.40±1.54 years, 235 women and 223 men sustained a new non-vertebral fracture. In multivariable adjusted sex-specific models, pre-randomization baseline eGFR was not a significant predictor of fracture risk in either men or women. However, a steeper decline in eGFR was associated with greater risk of fracture in women (hazard ratio [HR] per standard deviation [SD] decrement in eGFR slope, 1.30; 95% CI 1.17-1.44) but not men (HR per SD decrement in eGFR slope, 0.97; 95%CI 0.82-1.13). Accounting for competing risk of death modestly attenuated the association in women (HR per SD decrement in eGFR slope, 1.19; 95% CI 1.04-1.37), with the relationship in men remaining non-significant (HR per SD decrement in eGFR slope, 0.96; 95% CI 0.77-1.18). Declining kidney function predicts fracture risk in women but not in men with T2DM. Future studies should investigate the mechanisms for these associations.


Outcome of primary empyema thoracis: therapeutic and microbiologic aspects.
This study was undertaken to determine whether all adult patients with primary empyema thoracis need decortication. A management algorithm was developed and analyzed in a prospective, longitudinal, nonblinded study of 179 consecutive adult patients. The treatment options included thoracentesis, closed (tube) thoracostomy, image-guided catheter drainage, and decortication. We reviewed the outcomes of these procedures as they related to the pleural fluid cultures isolated and the antibiotic regimens used. Of the 179 patients, 20 had thoracentesis as the primary procedure, and 18 (90%) were cured. Ninety patients underwent closed thoracostomy as the primary procedure with a cure rate of 62% (56 patients) and a mortality rate of 11% (10 patients), and 24 patients required a secondary procedure. Seventy-six patients underwent decortication as either the primary or the secondary procedure with a cure rate of 88% (67 patients) and a mortality rate of 1.3% (1 patient); 8 patients required conversion to open thoracostomy. Hospital stay for decortication was 14+/-1 days and for closed thoracostomy, 17+/-1 days (p < 0.05). Decortication was necessary in 55% of patients with anaerobic infections and in 50% with aerobic infections. Clindamycin in combination with gentamicin sulfate was the most efficacious regimen with a success rate of 82% (51 of 62 patients); only 33% (17 of 52) were cured with penicillin. The overall mortality rate in this study was 6.7% (12 of 179 patients). Forty-two percent of patients with primary empyema thoracis ultimately require decortication. Decortication is more frequently necessary for anaerobic, tuberculous, staphylococcal, and pneumococcal infections. Although the overall mortality in this study was low, mortality remains high in elderly patients and patients with comorbid disease.


Role of interchain interactions in the stabilization of the right-handed twist of beta-sheets.
Conformational energy computations have been carried out for parallel and antiparallel beta-sheets composed of poly-L-Val and poly-L-Ile peptide chains, each consisting of four and of six residues, respectively, with CH3CO- and-NHCH3 end groups. The beta-sheets considered contained three and five equivalent chains, respectively. All computed minimum-energy beta-sheets were found to have a large right-handed twist of a magnitude that corresponds to the mean twist of beta-sheets observed in globular proteins. The twist has the same sign but is much larger than in beta-sheets of poly-L-Ala, because of intra- and interchain interactions between the bulky beta-branched side-chains. While the right-handed twist is a result of intrachain interactions between side-chains in the case of poly-L-Val, these interactions would favor a left-handed twist in poly-L-Ile, and the right-handed twist in the latter is a result of interchain interactions. Parallel beta-sheets are more stable than antiparallel sheets for both poly-L-Val and poly-L-Ile, in contrast to poly-L-Ala. This result agrees with observations on the preferred orientation of the chains in oligopeptides that form beta-structures. It also explains the observed high relative frequencies of occurrence of Val and Ile residues in parallel beta-sheets, as compared with antiparallel sheets, in globular proteins.


The effect of fructose-1, 6-diphosphate and HTK solution on protecting primary cardiac muscle cells of rat with cold preservation.
In this study we tried to investigate the effect of fructose-1,6-diphosphate and HTK solution on protecting primary cardiac muscle cells of rat with cold preservation. The primary cardiac muscle cells of rat were cultured in vitro with four preservation solutions respectively: 0.9% sodium chloride solution (group A), FDP (group B), HTK solution (group C) and a mixture of FDP and HTK solution (group D). The cells were preserved for 6, 8 and 10 h at 0-4 degrees C. The values of AST and LDH-L and the Na+-K+ ATPase activity in cardiac muscle cells were detected, and the survival rate of cardiac muscle cells was detected with trypan blue staining. The values of AST and LDH-L in group C and group D were remarkable lower those in group A and group B (P<0.001), while the Na+-K+ ATPase activity and the survival rate of cells in group C and group D were much higher than those in group A and group B (P<0.001). The values of AST and LDH-L after 6 hours in group D decreased much more than those in group C (P<0.01), while the Na+-K4 ATPase activity and the survival rate of cells in group D improved more than those in group C (P<0. 01). Both of the HTK solution and the mixture of HTK and FDP solution have an evident effect on protecting the primary cardiac muscle cells of rat in vitro with cold preservation, Compared with the HTK solution, the mixture solution has a better short-term protective effect.


Pancreatitis in children on chronic dialysis treated with valproic acid.
Four children treated with maintenance dialysis, three peritoneal and one hemodialysis, developed pancreatitis while receiving valproic acid (VPA) for chronic seizure disorders. Two patients recovered, eventually resuming VPA therapy after successful cadaveric renal transplantation. Two children died after complications of pancreatitis. No episodes of pancreatitis occurred in the other 74 children in this maintenance dialysis population; none of whom received VPA. Although pancreatitis is a known complication of VPA treatment or end-stage renal disease (ESRD), this is the first reported series specifically relating pancreatitis to VPA administration in children treated with maintenance dialysis. The literature related to the association of pancreatitis with VPA administration and ESRD therapy is briefly reviewed and the clinical implications are discussed.


Tyrosinase inhibitory cycloartane type triterpenoids from the methanol extract of the whole plant of Amberboa ramosa Jafri and their structure-activity relationship.
New tyrosinase inhibitory cycloartane triterpenoids have been discovered from the methanol extract of the whole plant of Amberboa ramosa (Roxb.) Jafri, which is a member from the Compositae family. Utilizing the conventional spectroscopic techniques, including 1D and 2D NMR analysis, and also by comparing the experimental with literature data, the isolated compounds proved to be cycloartane type triterpenoids. These cycloartanes are: (22R)-cycloart-20, 25-dien-2alpha3beta22alpha triol (1), (22R)-cycloart-23-ene-3beta, 22alpha, 25-triol (2), cycloartenol (3), cycloart-23-ene-3beta, 25-diol (4), cycloart-20-ene-3beta, 25-diol (5), cycloart-25-ene-3beta, (22R) 22-diol (6), 3beta, 21, 22, 23-tetrahydroxy-cycloart-24 (31), 25 (26)-diene (7), and (23R)-5alpha-cycloart-24-ene-3beta, 21, 23-triol (8). Out of these eight compounds, compound 3 did not show any activity against the enzyme tyrosinase. Among them compound 7 was found to be the most potent (1.32 microM) when compared with the standard tyrosinase inhibitors kojic acid (16.67 microM) and L-mimosine (3.68 microM). Finally in this paper, we have discussed the structure-activity relationships of these molecules.


Prevalence of childhood allergy in a subtropical environment: data from Dade County, Florida.
Other prevalence studies of allergy in school children have been limited to temperate zones only. The aims of this computerized investigation were wholly focused on South Florida, located in a subtropical climate. The occurrence of allergy in relation to marked geographic variations was surveyed to evaluate the prevalence of allergy in connection with these topographic differences.


The prince and the pauper. A tale of anticancer targeted agents.
Cancer rates are set to increase at an alarming rate, from 10 million new cases globally in 2000 to 15 million in 2020. Regarding the pharmacological treatment of cancer, we currently are in the interphase of two treatment eras. The so-called pregenomic therapy which names the traditional cancer drugs, mainly cytotoxic drug types, and post-genomic era-type drugs referring to rationally-based designed. Although there are successful examples of this newer drug discovery approach, most target-specific agents only provide small gains in symptom control and/or survival, whereas others have consistently failed in the clinical testing. There is however, a characteristic shared by these agents: -their high cost-. This is expected as drug discovery and development is generally carried out within the commercial rather than the academic realm. Given the extraordinarily high therapeutic drug discovery-associated costs and risks, it is highly unlikely that any single public-sector research group will see a novel chemical "probe" become a "drug". An alternative drug development strategy is the exploitation of established drugs that have already been approved for treatment of non-cancerous diseases and whose cancer target has already been discovered. This strategy is also denominated drug repositioning, drug repurposing, or indication switch. Although traditionally development of these drugs was unlikely to be pursued by Big Pharma due to their limited commercial value, biopharmaceutical companies attempting to increase productivity at present are pursuing drug repositioning. More and more companies are scanning the existing pharmacopoeia for repositioning candidates, and the number of repositioning success stories is increasing. Here we provide noteworthy examples of known drugs whose potential anticancer activities have been highlighted, to encourage further research on these known drugs as a means to foster their translation into clinical trials utilizing the more limited public-sector resources. If these drug types eventually result in being effective, it follows that they could be much more affordable for patients with cancer; therefore, their contribution in terms of reducing cancer mortality at the global level would be greater.


[Comparison of curative effect for colon flat lesion between mucosa resection and fulguration with high frequency current after mucosa staining under magnifying endoscope].
To observe the relationship between the pit patterns and pathology and compare the curative effect for colon flat lesion between endoscopic mucosa resection (EMR) and fulguration with high frequency current (FHFC). They were divided to two groups. There were 37 cases for FHFC in group A, and 34 cases for EMR in Group B. The two groups were comparabal. Examining patients suffering with colon flat lesions with magnifying endoscope and observing the pit patterns of mucosa after staining with indicarmine. The pit patterns of inflammatory or hyperplastic lesions were mainly pit II, adenoma pit III and pit IV, and carcinomatous lesions pit IV and pit V. The worse the differentiation degree of lesions was, the higher the pit patterns were. There were no difference (P > 0.05) between group A and B in complication and quantity, classification and distribution of lesions. No canceration was detected in 21 cases with adenoma in group A, while 4 cases of canceration (all were adenocacinoma) was found in 20 cases whith adenoma in group B. There was significance in canceration between two groups (P < 0.05). The worse the differentiation degree of lesions was, the higher pit patterns were. EMR and FHFC share the same validity and security when treating the flat lesions, but by EMR, doctors could judge whether the lesions were resected completely, once the remained lesions were found, they could be resected immediately again lesion in case of omission of canceration.


Complex host/symbiont integration of a multi-partner symbiotic system in the eusocial aphid Ceratovacuna japonica.
Some hemipteran insects rely on multiple endosymbionts for essential nutrients. However, the evolution of multi-partner symbiotic systems is not well-established. Here, we report a co-obligate symbiosis in the eusocial aphid, Ceratovacuna japonica. 16S rRNA amplicon sequencing unveiled co-infection with a novel Arsenophonus sp. symbiont and Buchnera aphidicola, a common obligate endosymbiont in aphids. Both symbionts were housed within distinct bacteriocytes and were maternally transmitted. The Buchnera and Arsenophonus symbionts had streamlined genomes of 432,286 bp and 853,149 bp, respectively, and exhibited metabolic complementarity in riboflavin and peptidoglycan synthesis pathways. These anatomical and genomic properties were similar to those of independently evolved multi-partner symbiotic systems, such as Buchnera-Serratia in Lachninae and Periphyllus aphids, representing remarkable parallelism. Furthermore, symbiont populations and bacteriome morphology differed between reproductive and soldier castes. Our study provides the first example of co-obligate symbiosis in Hormaphidinae and gives insight into the evolutionary genetics of this complex system.


The NLRP3 Inflammasome and Its Role in Sepsis Development.
The pathophysiology of sepsis is extremely complex. During this disease, the exacerbation of the inflammatory response causes oxidative stress, alterations in mitochondrial energy dynamics, and multiple organ failure. Some studies have highlighted the important role of the NLRP3 inflammasome in sepsis. This inflammasome is a macromolecular protein complex that finely regulates the activation of caspase-1 and the production and secretion of potent pro-inflammatory cytokines such as IL-1β and IL-18. In this review, we elucidate evidences to understand the connection between sepsis development and the NLRP3 inflammasome, the most widely investigated member of this class of receptor.


Parcellation of Human Amygdala Subfields Using Orientation Distribution Function and Spectral K-means Clustering.
Amygdala plays an important role in fear and emotional learning, which are critical for human survival. Despite the functional relevance and unique circuitry of each human amygdaloid subnuclei, there has yet to be an efficient imaging method for identifying these regions in vivo. A data-driven approach without prior knowledge provides advantages of efficient and objective assessments. The present study uses high angular and high spatial resolution diffusion magnetic resonance imaging to generate orientation distribution function, which bears distinctive microstructural features. The features were extracted using spherical harmonic decomposition to assess microstructural similarity within amygdala subfields are identified via similarity matrices using spectral k-mean clustering. The approach was tested on 32 healthy volunteers and three distinct amygdala subfields were identified including medial, posterior-superior lateral, and anterior-inferior lateral.


[Kala-azar with marked ferritinemia in a German school child].
We report on a case of visceral leishmaniasis acquired during a summer holiday in Spain. Apart from therapeutic aspects some mechanisms for the development of anaemia are discussed with regard to changes of the red blood cell counts, serum iron and ferritin concentrations measured before, during and after therapy.


Interrelationship between splenic and superior mesenteric venous circulation manifested by transient splenic arterial occlusion using a balloon catheter.
We examined the hemodynamic changes induced by transient splenic arterial occlusion using a balloon catheter to investigate the hemodynamic effect of transcatheter splenic arterial embolization--a procedure that has been used since its introduction in 1973 as therapy for hypersplenism and more recently for portal hypertension. The blood flow volume was measured in 20 patients with liver disease using an ultrasonic duplex system (Toshiba SAL50A/SDL-01A). The portal venous pressure was also measured via a 3F catheter using a transducer. The catheter was placed in position by substituting it for a 25-gauge needle that had been inserted into the portal vein under ultrasonic guidance percutaneously and transhepatically. Splenic arterial occlusion caused a drop in splenic venous blood flow from 708 +/- 487 to 241 +/- 155 ml per min, in portal venous blood flow from 993 +/- 439 to 807 +/- 419 ml per min and in portal venous pressure from 17.4 +/- 7.2 to 14.4 +/- 6.1 mm Hg. The latter two reductions were less than expected from the decrease in the splenic venous blood flow volume. This phenomenon was caused by an increase in the mesenteric venous blood flow from 475 +/- 126 to 630 +/- 270 mm per min. This increase may be due to a compensatory mechanism under the control of a regulatory loop in the liver or portal vein, and there seems to be a relationship between splenic and intestinal circulation in portal hypertension that maintains hepatic circulation.


Changes in levels of glutathione and related compounds and activities of glutathione-related enzymes during rat liver regeneration.
The levels of glutathione and glutathione disulfide increased during the regeneration process of rat liver, reaching a maximum (about twice the control value) on day 2 and reverting to the normal level within 5 days. During this regeneration process, changes in the hepatic level of cysteine, glycine and glutamate, the substrates for glutathione synthesis, were determined. The cysteine level in liver increased, reaching a maximum on day 2 and returned to the normal level after 5 days. The levels of glycine and glutamate did not change. The enzyme activities of cystathionine-beta synthase and gamma-cystathionase for cysteine synthesis, and of gamma-glutamylcysteine synthetase, which is a limiting enzyme for glutathione synthesis, were clearly increased in regenerating liver. The increase of glutathione level could be clearly accounted for by the elevation of these enzyme activities.


Chronic hyperglycemia with elevated glycated hemoglobin level and its association with postoperative acute kidney injury after a major laparoscopic abdominal surgery in diabetes patients.
The relationship between preoperative hyperglycemia and postoperative acute kidney injury (AKI) occurrence in non-cardiac surgery including laparoscopic surgery remains unclear. This study aimed to assess the relationship between preoperative chronic hyperglycemia and postoperative AKI occurrence after a major laparoscopic abdominal surgery. We retrospectively reviewed medical records of diabetic patients (≥ 20 years old) who underwent elective major laparoscopic abdominal surgery procedures between 2010 and 2016. Patients were divided into two groups based on a cut-off value of hemoglobin A1c (HbA1c) at 6%. Serum creatinine value was used for the diagnosis of AKI, and all assessments and diagnoses of postoperative AKI were performed on 0-3 postoperative days (POD) using the criteria of Kidney Disease: Improving Global Outcomes. In all, 1885 patients were included in the final analysis, and patients were divided into the following groups: < 6.0% group with 1257 patients (66.7%), and ≥ 6.0% group with 628 patients (33.3%). Sixty-nine patients (3.7%) were diagnosed with postoperative AKI within 3 POD. Multivariable logistic regression analysis showed no significant difference in the incidence rate of postoperative AKI between the HbA1c ≥ 6.0% group and the < 6.0% group (odds ratio 1.10, 95% confidence interval 0.57-2.15; P = 0.770). In addition, there was no significant interaction between preoperative HbA1c group and exposure to acute hyperglycemia (serum glucose > 200 mg/dL) for incidence of AKI on POD 0-3 (P = 0.181). In diabetic patients, preoperative chronic hyperglycemia is not associated with postoperative AKI occurrence within 3 POD after a major laparoscopic abdominal surgery.


Stromal-type Nephroblastoma with or without Anaplasia in Two Hedgehogs (Atelerix albiventris).
We describe the clinical and histological characteristics of stromal-type nephroblastomas that developed in two hedgehogs (Atelerix albiventris). In case 1, the tumour was composed of a proliferation of anaplastic stromal cells with ductal structures resembling the epithelium of nephroblastoma. In case 2, spindle-shaped cells that were somewhat larger than nephroblasts were frequently seen surrounding the cell cluster, and there was proliferation of stromal cells with collagen fibres at the periphery. Immunohistochemically, the tumour cells labelled weakly to strongly for the nephroblast marker Wilms' tumour-1 and were positive for Ki67 with rates of 5% and 10% for cases 1 and 2, respectively. Based on the above, the diagnosis was of stromal-type nephroblastoma with anaplasia in case 1 and without anaplasia in case 2. Our findings suggest that stromal-type nephroblastomas arise in adult hedgehogs and are clinically benign, and that histological anaplasia does not affect the prognosis.