Crystal structure of MJ1247 protein from M. jannaschii at 2.0 A resolution infers a molecular function of 3-hexulose-6-phosphate isomerase.
The crystal structure of the hypothetical protein MJ1247 from Methanococccus jannaschii at 2 A resolution, a detailed sequence analysis, and biochemical assays infer its molecular function to be 3-hexulose-6-phosphate isomerase (PHI). In the dissimilatory ribulose monophosphate (RuMP) cycle, ribulose-5-phosphate is coupled to formaldehyde by the 3-hexulose-6-phosphate synthase (HPS), yielding hexulose-6-phosphate, which is then isomerized to fructose-6-phosphate by the enzyme 3-hexulose-6-phosphate isomerase. MJ1247 is an alpha/beta structure consisting of a five-stranded parallel beta sheet flanked on both sides by alpha helices, forming a three-layered alpha-beta-alpha sandwich. The fold represents the nucleotide binding motif of a flavodoxin type. MJ1247 is a tetramer in the crystal and in solution and each monomer has a folding similar to the isomerase domain of glucosamine-6-phosphate synthase (GlmS).


HENRYK - An endless source of metal coordination surprises.
The basic knowledge about biological inorganic chemistry, thermodynamics and metal binding sites of metalloproteins is crucial for the understanding of their metal binding-structure-function relationship. Metal-peptide complexes are useful and commonly used models of metal-enzyme active sites, among which copper and zinc models are one of the most extensively studied. HENRYK is a peptide sequence present in numerous proteins, and serves as a potentially tempting binding site for Cu2+ and Zn2+. Maybe more importantly, HENRYK also happens to be the first name of our group leader. The results of this work, which, at the first glance, might seem to be a 'chemical scrabble', went far beyond our expectations and surprised us with a novel, uncommon behavior of a Cu2+ complex with a peptide with a histidine in position one. At low pH, the binding is a typical histamine-like coordination, but with the increase of pH, the imidazole nitrogen is moved to the axial position and replaced with an amide; at basic pH, the binding mode is a {NH2, 3N-} one in the equatorial plane. It is important to note, that no dimeric species are formed in between. Such binding is thermodynamically much more stable than a simple complex with histamine, and quite comparable to complexes with several possible imidazole anchoring sites.


Novel step selection analyses on energy landscapes reveal how linear features alter migrations of soaring birds.
Human modification of landscapes includes extensive addition of linear features, such as roads and transmission lines. These can alter animal movement and space use and affect the intensity of interactions among species, including predation and competition. Effects of linear features on animal movement have seen relatively little research in avian systems, despite ample evidence of their effects in mammalian systems and that some types of linear features, including both roads and transmission lines, are substantial sources of mortality. Here, we used satellite telemetry combined with step selection functions designed to explicitly incorporate the energy landscape (el-SSFs) to investigate the effects of linear features and habitat on movements and space use of a large soaring bird, the golden eagle Aquila chrysaetos, during migration. Our sample consisted of 32 adult eagles tracked for 45 spring and 39 fall migrations from 2014 to 2017. Fitted el-SSFs indicated eagles had a strong general preference for south-facing slopes, where thermal uplift develops predictably, and that these areas are likely important aspects of migratory pathways. el-SSFs also provided evidence that roads and railroads affected movement during both spring and fall migrations, but eagles selected areas near roads to a greater degree in spring compared to fall and at higher latitudes compared to lower latitudes. During spring, time spent near linear features often occurred during slower-paced or stopover movements, perhaps in part to access carrion produced by vehicle collisions. Regardless of the behavioural mechanism of selection, use of these features could expose eagles and other soaring species to elevated risk via collision with vehicles and/or transmission lines. Linear features have previously been documented to affect the ecology of terrestrial species (e.g. large mammals) by modifying individuals' movement patterns; our work shows that these effects on movement extend to avian taxa.


Predictors of blood loss during orthognathic surgery: outcomes from a teaching institution.
The objective of the study was to correlate different orthognathic surgical procedures with operating time and blood loss, reported from an accredited resident training institution. Ninety-five patient records were evaluated retrospectively. Individual blood volume, percent blood volume lost (BVL), and estimated blood loss (EBL) for each patient were recorded and correlated with operating time (OT). Statistics included independent t tests, one-way analysis of variance, and linear regression. The mean OT for all procedures was 203 min with mean blood loss 556 ml. Mean EBL for males was 676 ml versus 468 ml for females. Overall BVL was 12.4 %, while for males, BVL was 13.3 % compared to 11.8 % for females. For a single orthognathic procedure (n = 45), mean OT 145 min., EBL 414 ml, and BVL 9.0 %; two procedures (n = 41), mean OT was 239 min., EBL 659 ml, and BVL 15 %; three procedures (n = 9), mean OT 328 min, EBL 793 ml, and BVL was 17 %. Examination of individual procedures suggests a shorter OT for Le Fort I procedures with slightly greater EBL. Concomitant orthognathic procedures are associated with greater OT and EBL. Blood volume should be calculated for male and female patients separately. Percent BVL can be predicted based on OT using a basic equation.


Minkowski functionals: An MRI texture analysis tool for determination of the aggressiveness of breast cancer.
This work aims to see whether Minkowski Functionals can be used to distinguish between cancer types before chemotherapy treatment has begun, and whether a response to treatment can be predicted by an initial scan alone. Fat-nulled T1w 3T DCE-MRI scans were taken of 100 cases of biopsy confirmed breast cancer and a series of binary images created on lesion containing slices. Minkowski Functionals were calculated for each binary image and the change in these values as the binary threshold was raised was described using 6(th) order polynomials. These polynomials were used to compare between patient subgroups, for triple negative breast cancer (TNBC) status, chemotherapy response, biopsy grade, nodal status, and lymphovascular invasion status. When using Minkowski Functionals statistically significant (P < 0.05) differences were found between TNBC status, biopsy grade, and lymphovascular invasion status subgroups for all methodologies. The analysis performance did not appear to be affected by the number of threshold steps used. Most notably, very strong differences (P ≤ 0.01) were found between TNBC and other intrinsic subtype patients. When analyzed with a binary logistic regression model, an area under the curve value of 0.917 (0.846-0.987, 95% confidence interval) for TNBC classification was found. The method of texture analysis presented here provides a novel way to characterize tumors, and demonstrates clear differences between cancer groups which are detectable before treatment begins, and can help with treatment planning as a valuable prognosis tool.


Estimation of potential carcinogenic effects related to waterborne environmental contaminants.
Described here is a computer program that provides estimates of theoretical cancer levels in a community following long-term exposure to contaminants found in domestic drinking water. The program employs one of three low-dose risk assessment models using dichotomous outcome data to derive a dose-response curve. Based on this curve, lifetime probabilities are determined, by dose, for acquiring selected types of cancer in a specified population. The program allows for sensitivity analyses of varying demographic, epidemiologic, and environmental factors, all of which could influence the occurrence of disease at the community level.


Interferon induction and suppression in swine testicle cells by porcine parvovirus and its proteins.
Porcine parvovirus (PPV) is a major causative agent of reproductive failure in swine, which currently affects the swine industry worldwide. Although PPV was identified several years ago, little is known about how it overcomes host innate immunity. In this study, we used quantitative real-time PCR and a luciferase reporter assay to determine whether PPV infection induces type I interferon (IFN-α and IFN-β) and whether PPV infection blocks dsRNA-induced IFN-β promoter activation in cell cultures. The results indicate that PPV does not induce type I interferon and that the NS2 protein of PPV could blocks dsRNA-induced IFN-β promoter activation.


Psychosocial and behavioral functioning among pediatric brain tumor survivors.
To describe the psychosocial and behavioral functioning, as described by patient, parent and teacher, of a cohort of adolescents who have been previously treated for a brain tumor. A cohort of 32 patients, 12-18 years old, were evaluated between 1 and 5 years post-treatment for brain tumor during the patient's regularly scheduled follow-up clinic appointment at the Dana-Farber Cancer Institute. The Self-Report questionnaire and the Parent-Report of the Behavioral Assessment System for Children (BASC) were administered to the patient and to one of the patient's parents, respectively. In addition, the BASC Teacher-Report was completed by the patient's teacher. Descriptive statistics were generated; binomial distribution analyses were carried out to assess whether the proportion of individuals with impaired performance on each measure exceeded normative expectations. Comparison of the proportion of patients with elevated scores to normative expectations indicated no excess of elevated scores on any of the BASC scales of the Self-Report. However, parents endorsed items in the areas of attention problems and leadership; teachers endorsed items concerning learning problems; and both parents and teachers endorsed items indicative of somatization behaviors. Parent and teacher feedback indicate some level of psychosocial and behavioral morbidity for adolescents treated for a brain tumor; this finding contrasts with adolescent Self-Report indicating no difficulties in behavioral and psychosocial functioning. The extent to which these vulnerabilities impact quality of life and the discrepancy between reporters should be assessed in follow-up studies with a larger cohort of patients.


CT characteristics of a hyperdense renal mass due to Richter syndrome.
A case of Richter syndrome (histiocytic lymphoma or Hodgkin disease complicating chronic lymphocytic leukemia) presented as a hyperdense renal mass on CT.


The hippocampus influences assimilation and accommodation of schemata that are not hippocampus-dependent.
Learning is facilitated when information can be incorporated into an already learned set of rules or 'mental schema'. The location of a new restaurant, for example, is learned more easily if the neighbourhood's general layout is already known. This type of information is processed by the hippocampus and stored as a schema in the cortex, but it is not known whether the hippocampus can also map new stimuli to cortical schemata that are hippocampus-independent, such as odour classification. Using a hippocampus-independent odour-rule task we found that animals without a functional hippocampus learnt which odours did not fit the rule faster than sham animals, which persistently applied the rule to all odours. Conversely, when non-fitting odours were linked to a new rule sham animals were faster to link these odours to the new rule. The hippocampus, thus, regulates the association of stimuli with existing schemata even when the schemata are hippocampus-independent. © 2016 Wiley Periodicals, Inc.


Levonorgestrel 52 mg intrauterine system efficacy and safety through 8 years of use.
Extending hormonal intrauterine system duration will allow users to have less need for procedures to provide long-term contraception. This study aimed to evaluate the efficacy and safety of the levonorgestrel 52 mg intrauterine system during years 7 and 8 of use. A total of 1751 nulliparous and multiparous participants aged 16 to 45 years enrolled in a phase 3, multicenter trial to evaluate the efficacy and safety of the use of the Liletta levonorgestrel 52 mg intrauterine system for up to 10 years. Participants aged 36 to 45 years at enrollment underwent safety evaluation only. After the first year, we evaluated participants every 6 months for intrauterine system location confirmation and urine pregnancy testing at each visit. We assessed the Pearl Indices in years 7 and 8 and the life-table analysis for cumulative pregnancy rates through 8 years of use. For the primary efficacy analyses, all participants aged 16 to 35 years at enrollment were included through year 6; years 7 and 8 included only users aged ≤39 years at the start of each use year. Safety outcomes were assessed in all participants regardless of duration of use. We assessed amenorrhea rates, defined as no bleeding or spotting in the 90 days before the end of the year. After intrauterine system placement, we followed 1568 participants aged 16 to 35 years and 146 participants aged 36 to 45 years. The 16- to 35-year-old participants included 986 (57.5%) nulliparous and 433 (25.3%) obese users. Overall, 569 participants started year 7, 478 completed year 7 (380 aged ≤39 years at beginning of year) and 343 completed year 8 (257 aged ≤39 years at beginning of year); 77 completed 10 years of use. Eleven pregnancies occurred over 8 years, 7 (64%) of which were ectopic. Two pregnancies occurred in year 7 (Pearl Index, 0.49; 95% confidence interval, 0.06-1.78), 1 in a participant with implantation 4 days after a desired removal; no pregnancies occurred in year 8. The cumulative life-table pregnancy rate in the primary efficacy population through year 8 was 1.32 (95% confidence interval, 0.69-2.51); without the postremoval pregnancy, the rate was 1.09 (95% confidence interval, 0.56-2.13). Two perforations (0.1%) occurred, none noted after year 1. Expulsion occurred in 71 (4.1%) participants overall, with 3 in year 7 and 2 in year 8. Pelvic infection was diagnosed in 16 (0.9%) participants during intrauterine system use, 1 each in years 7 and 8. Only 44 (2.6%) participants overall discontinued because of bleeding complaints (4 total in years 7 and 8) with rates per year of 0.1% to 0.5% for years 3 to 8. Amenorrhea rates were 39% at both years 7 and 8. The levonorgestrel 52 mg intrauterine system is highly effective over 8 years of use and has an excellent extended safety profile. This report details the longest period of efficacy and safety data for continuous use of a levonorgestrel 52 mg intrauterine system for contraception.


Conjunctival malignant melanoma: A rare variant and review of important diagnostic and therapeutic considerations.
Malignant melanoma of the conjunctiva is a relatively infrequent neoplasm that can be associated with significant morbidity and cause diagnostic difficulty to both the ophthalmologist and pathologist. We herein describe the first reported case in North American and European databases of a rare variant-signet ring cell melanoma - arising in the background of primary acquired melanosis (PAM) and use this case as a review of important diagnostic and therapeutic considerations when faced with this condition.


Synthesis and cytotoxicity of new platinum(IV) complexes of mixed carboxylates.
In order to develop new antitumor platinum(IV) complexes with highly tuned lipophilicity, a series of (diamine)Pt(IV) complexes of the formula [Pt(IV)(dach)L(3)L'] or [Pt(IV)(dach)L(2)L"(2)] (dach=trans-(+/-)-1,2-diaminocyclohexane; L=acetato, propionato; L'=acetato, propionato, valerato or pivalato; L"=trifluoroacetato) have been synthesized by electrophilic substitution of the tris(carboxylato)hydroxoplatinum(IV) complexes, [Pt(IV)(dach)L(3)OH] (L=acetato, propionato), with various carboxylic anhydrides such as acetic, trifluoroacetic, pivalic and valeric anhydrides. The present platinum(IV) complexes were fully characterized by means of elemental analyses, 1H NMR, mass and IR spectroscopies. The complexes 8 and 10, satisfying the appropriate range of lipophilicity (logP=0.18-1.54), exhibited high activity (ED(50), 5.1 and 1.3 microM, respectively) compared with other complexes, which implies that the lipophilicity is an important factor for the antitumor activity of this series of complexes.


Special Issue: Diversity of Extremophiles in Time and Space.
Extreme environments are fascinating ecosystems that have allowed us to increase our knowledge about the evolutionary processes of life [...].


Quality control of imbalanced mass spectra from isotopic labeling experiments.
Mass spectra are usually acquired from the Liquid Chromatography-Mass Spectrometry (LC-MS) analysis for isotope labeled proteomics experiments. In such experiments, the mass profiles of labeled (heavy) and unlabeled (light) peptide pairs are represented by isotope clusters (2D or 3D) that provide valuable information about the studied biological samples in different conditions. The core task of quality control in quantitative LC-MS experiment is to filter out low-quality peptides with questionable profiles. The commonly used methods for this problem are the classification approaches. However, the data imbalance problems in previous control methods are often ignored or mishandled. In this study, we introduced a quality control framework based on the extreme gradient boosting machine (XGBoost), and carefully addressed the imbalanced data problem in this framework. In the XGBoost based framework, we suggest the application of the Synthetic minority over-sampling technique (SMOTE) to re-balance data and use the balanced data to train the boosted trees as the classifier. Then the classifier is applied to other data for the peptide quality assessment. Experimental results show that our proposed framework increases the reliability of peptide heavy-light ratio estimation significantly. Our results indicate that this framework is a powerful method for the peptide quality assessment. For the feature extraction part, the extracted ion chromatogram (XIC) based features contribute to the peptide quality assessment. To solve the imbalanced data problem, SMOTE brings a much better classification performance. Finally, the XGBoost is capable for the peptide quality control. Overall, our proposed framework provides reliable results for the further proteomics studies.


The use of growth factors, CD34(+) cells and fibrin for the management of chronic venous ulcers.
Chronic venous ulceration represents a very common event. Current standard treatment includes local wound care with the application of compression. We report the effects of platelet-rich plasma in patients with chronic venous ulcers, which is able to stimulate fibroblasts, macrophages and mesenchymal cells and growth factors in order to achieve re-epithelialisation and neovascularisation within the microenviroment of the wound. We also documented the efficacy of this method as the sole treatment without surgical procedures.


State-of-the-art review of the clinical research on menopause and hormone replacement therapy association with Parkinson's disease: What meta-analysis studies cannot tell us.
The menopause is a midlife endocrinological process that greatly affects women's central nervous system functions. Over the last 2 decades numerous clinical studies have addressed the influence of ovarian hormone decline on neurological disorders like Parkinson's disease and Alzheimer's disease. However, the findings in support of a role for age at menopause, type of menopause and hormone replacement therapy on Parkinson's disease onset and its core features show inconsistencies due to the heterogeneity in the study design. Here, we provide a unified overview of the clinical literature on the influence of menopause and ovarian hormones on Parkinson's disease. We highlight the possible sources of conflicting evidence and gather considerations for future observational clinical studies that aim to explore the neurological impact of menopause-related features in Parkinson's disease.


Development of a SYBR Green quantitative PCR assay for detection of Lates calcarifer herpesvirus (LCHV) in farmed barramundi.
Lates calcarifer herpes virus (LCHV) is a novel virus of farmed barramundi in Southeast Asia. However, a rapid detection method is yet to be available for LCHV. This study, therefore, aimed to develop a rapid quantitative PCR (qPCR) detection method for LCHV and made it timely available to public for disease diagnostics and surveillance in barramundi farming countries. A newly designed primer set targeting a 93-bp fragment of the LCHV putative major envelope protein encoding gene (MEP) was used for developing and optimizing a SYBR Green based qPCR assay. The established protocol could detect as low as 10 viral copies per μl of DNA template in a reaction containing spiked host DNA. No cross-amplification with genomic DNA extracted from host as well as common aquatic pathogens (12 bacteria and 4 viruses) were observed. Validation test of the method with clinical samples revealed that the virus was detected in multiple organs of the clinically sick fish but not in the healthy fish. We thus recommend that barramundi farming countries should promptly initiate active surveillance for LCHV in order to understand their circulation for preventing possibly negative impact to the industry.


MEF2D Mediates the Neuroprotective Effect of Methylene Blue Against Glutamate-Induced Oxidative Damage in HT22 Hippocampal Cells.
Methylene blue (MB) can ameliorate behavioral, neurochemical, and neuropathological impairments in animal models of acute and chronic neurodegenerative disorders, but the underlying mechanism remains unclear. Myocyte enhancer factor 2 (MEF2D) is known to promote neuronal survival in several models, and several survival and death signals converge on MEF2D and regulate its activity. Here, we investigated the role of MEF2D in the neuroprotective effect of MB against glutamate-induced toxicity in HT22 neuronal cells. Our results showed that MB, event at less than 100 nM, improved the viability of HT22 cells exposed to 2 mM glutamate. MB attenuated the mitochondrial impairment and quenches the reactive oxygen species (ROS) induced by glutamate. Surprisingly, MB at 50-200 nM did not affect the Nrf2/HO-1 pathway, an important endogenous anti-oxidative system. Further study showed that MB increased the transcription and translation of MEF2D. In addition, MB upregulated the expression of mitochondrial NADH dehydrogenase 6 (ND6) in a MEF2D-dependent manner. Knockdown of MEF2D abolished both MB-medicated increase of ND6 and MB-induced neuroprotection against glutamate-induced toxicity. Moreover, we showed that MB promoted Akt function activity, suppressed GSK-3β activity, and increased MEF2D level in hippocampus of mice and HT22 cells. These findings for the first time demonstrate that MB protects HT22 neuronal cells against glutamate-induced cell death partially via the regulation of MEF2D-associated survival pathway.


[A rupture of the dorsal pharyngeal wall following a blunt neck trauma: 4th case in the world literature? (author's transl)].
A report is given of a 22-year-old woman who suffered from an external non-penetrating injury to the ventral side of the neck resulting in a rupture of the dorsal pharyngeal wall. She was successfully treated with conservative therapy, i.e. intravenous fluids and conservative therapy, i.e. intravenous fluids and antibiotics. It is concluded that not all cases of pharyngeal rupture due to a blunt external trauma of the neck need surgical treatment.


Subnormal carnitine levels and their correction in artificially fed patients from a neurological intensive care unit: a pilot study.
Primary and secondary carnitine deficiency syndromes are characterized by myopathy, encephalopathy and hepatopathy. We measured plasma levels of free and esterified carnitine in 20 patients from our neurological intensive care unit who required intravenous or tube feeding. After 2-3 weeks 19 patients showed a 30%-60% decrease in the levels of serum free and total carnitine. As soon as oral feeding was recommenced, carnitine levels quickly returned to normal. These data suggest the need for new carnitine-enriched feeding fluids, which are presently under investigation.


Per anal suturing of a bleeding ulcer to achieve successful hemostasis of massive hemorrhage associated with ulcerative colitis: report of two cases.
We report herein the cases of two patients with ulcerative colitis complicated by massive hemorrhage who were successfully treated by per anal suturing of a bleeding ulcer. A 40-year-old woman and a 22-year-old man had suffered from extensive colitis for 8 and 2 years, respectively, and both followed a similar clinical course. They were admitted under emergency conditions and, despite treatment with intravenous high-dose prednisolone and thereafter with intraarterial injections of prednisolone, suffered several attacks of massive hemorrhage with hypovolemic shock. Emergency subtotal colectomy with ileostomy and rectal mucous fistula were performed, but recurrent massive hemorrhage occurred during the early postoperative period. Bleeding from a discrete ulcer in the rectum was subsequently located, and both patients underwent per anal suturing of the ulcer. No recurrent bleeding occurred thereafter, and an ileoanal anastomosis was performed several months later. Massive hemorrhage is a rare complication of ulcerative colitis which is most often resolved by subtotal colectomy without proctectomy. Although bleeding associated with ulcerative colitis usually occurs diffusely, these case reports serve to demonstrate that massive bleeding can also result from a discrete ulcer. We advocate that this condition be treated by an endoscopic or local hemostatic procedure.


Multimedia distributions, bioaccumulation, and trophic transfer of microcystins in the Geum River Estuary, Korea: Application of compound-specific isotope analysis of amino acids.
To determine distributions, bioaccumulation, and trophic transfer of freshwater cyanobacterial toxins such as microcystins (MCs), surface water, suspended solids, sediments, and coastal organisms were collected from seven stations in inner and outer regions of the estuary dam in the Geum River Estuary in June and July 2017. Concentrations of MC variants (MC-LR, -RR, and -YR) in the multimedia samples were analyzed using a HPLC-MS/MS. Trophic position (TP) of organisms (fish, bivalve, gastropod, decapod, and polychaete) was determined by nitrogen stable isotope analyses of both bulk tissues and amino acids. From July to August 2017, great concentrations of MCs were detected in discharged freshwater ranging from 0.4 to 75 μg L-1. Considerable amounts of MCs are delivered to the Geum River Estuary in summer season. MCs spread far away as dissolved phases (18.7-49.5 ng L-1) in July when large amount of freshwater was discharged during the rainy season. Concentrations of MCs in marine organisms varied among species, ranging from 40 to 870 ng g-1 dw. Bioaccumulated MCs tend to decrease with increasing TP of organisms, suggesting that MCs are biodiluted through the marine food web. Compound-specific isotope analysis (nitrogen of amino acids) provides more reliable TPs compared with those by bulk isotope analysis in a closed estuary (such as the Geum River Estuary) with large fluctuations in the isotope ratio of primary producers.


Construction of an immunostimulatory plasmid, pUCpGs10, and research on its immune adjuvant effect.
In order to overcome the instability of CpG ODN in vivo, sequence diversity, and individual differences, eleven CpG ODN fragments were meticulously selected and linked to form a Multi-CpG, which were repeatedly inserted into the cloning vector pUC19 for constructing the recombinant plasmid pUCpGs10 containing ten of Multi-CpG. Using the multi-genotype HCV E1 and multi-epitope complex HCV-T as immunogens, and plasmid pUCpGs10 as the immune adjuvant, Balb/c mice were immunized through nasal and subcutaneous immunization. Strong-specific humoral and cellular immune response were induced, which can obviously inhibit the growth of homograft expressing HCV antigen. The immune adjuvant effect of pUCpGs10 closely matched that of Freund's complete adjuvant. The plasmid pUCpGs10 can significantly improve IgA content in serum and different mucosal extract and systematical T-cell response via intranasal immunization. In conclusions, the newly constructed immunostimulatory plasmid pUCpGs10 is able to effectively activate the humoral and cellular immune activity, and possesses activation on mucosal immune response.


Description of three new species of the genus Myxobolus infecting carp fishes of India.
Myxobolus Bütschli, 1882 (Myxozoa, Myxosporea, Bivalvulida, Myxobolidae) is an important parasitic protozoan of freshwater fishes reported from almost all over the world. The severity of infection may lead to mortality of the host fish. The present paper deals with the description of three new species of Myxobolus Bütschli, 1882, Myxobolus sonarpurensis sp. nov., Myxobolus elongatum sp. nov. and Myxobolus petalum sp. nov. from a freshwater minor carp Labeo bata (Hamilton, 1822) and major carp Labeo rohita (Hamilton, 1822) respectively from West Bengal, India. Spores of Myxobolus sonarpurensis sp. nov. measures 12.16 µm × 6.74 µm, with two elongated unequal sized polar capsules measuring, 8.84 µm × 3.019 µm and 7.71 µm × 3.12 µm. Spores of Myxobolus elongatum sp. nov. are 16.23 µm × 7.9 µm with two equal polar capsules 8.896 µm × 3.468 µm and 6.51 µm × 3.46 µm. In comparison to aforementioned two new species, Myxoboluspetalum sp. nov. have two equal polar capsules, 7.905 µm × 2.975 µm (2.9 µm) in each spore, 12.07 µm × 5.95 µm.


Production of artificial fingermarks. Part II - The use of a modified inkjet printer for the deposition of synthetic secretions.
This study is the second part of a larger body of research dedicated to the production of synthetic secretions and the use of an inkjet printer to deposit realistic artificial fingermarks. An artificial emulsion combining eccrine and sebaceous compounds, which was described and tested in the first part of this research, was used as it showed a promising compatibility with common detection techniques. An inkjet printer was modified to print the emulsion on two different substrates: paper (porous) and acetate (non-porous). After optimisation of the printing parameters, multiple fingermarks were printed and processed with a range of standalone detection techniques: 1,2-indanedione-zinc, ninhydrin, Oil Red O, and physical developer on paper, and cyanoacrylate fuming, rhodamine 6G, gold/zinc vacuum metal deposition, and silver black powder on acetate. The detection techniques were also applied in sequence, which is considered one of the biggest advantages of the emulsion over simpler amino acid mixtures that are usable with amino acid reagents only. Natural fingermarks deposited by a single donor were processed with the same techniques for comparison. The effect of water immersion was also investigated, where fingermarks printed on paper were immersed in water for 15 min, before being processed with 1,2-indanedione-zinc and Oil Red O. The results showed that realistic-looking fingermarks could be printed on paper and that printing on acetate was also possible albeit of lower quality due to the nature of the substrate. The artificial fingermarks were successfully enhanced by all the detection techniques tested, at the notable exception of physical developer. The results obtained were very similar to what is generally observed with real fingermarks, and it was observed that the impact of water immersion on the artificial fingermarks was comparable as well. These findings open new perspectives for the development of multi-target quality control test strips or for the standardisation of proficiency testing and interlaboratory collaborative exercises where ground truth is crucial to guarantee comparable results and objective assessment.


SMURF1, a promoter of tumor cell progression?
Overexpression of HECT-type E3 ubiquitin ligase SMURF1 is correlated with poor prognosis in patients with various cancers, such as glioblastoma, colon cancer, and clear cell renal cell carcinoma. SMURF1 acts as a tumor promoter by ubiquitination modification and/or degradation of tumor-suppressing proteins. Combined treatment of Smurf1 knockdown with rapamycin showed collaborative antitumor effects in mice. This review described the role of HECT, WW, and C2 domains in regulating SMURF1 substrate selection. We summarized up to date SMURF1 substrates regulating different type cell signaling, thus, accelerating tumor progression, invasion, and metastasis. Furthermore, the downregulation of SMURF1 expression, inhibition of its E3 activity and regulation of its specificity to substrates prevent tumor progression. The potential application of SMURF1 regulators, specifically, wisely choose certain drugs by blocking SMURF1 selectivity in tumor suppressors, to develop novel anticancer treatments.


Evaluation of the appropriateness of nursing home residents' transfer to emergency departments.
France is experiencing a steady increase in the number of residents living in nursing homes (NHs). Each year, 25% of these residents are hospitalized, half of them through emergency departments (EDs). A part of these transfers to EDs are unjustified and not without consequences. The first aim of our study is to evaluate the proportion of avoidable NHs resident transfer to EDs. An observational, prospective and multicentric study was conducted between January and August 2019 in the 6 EDs of a French county during 3 inclusion periods. A multidisciplinary expert panel determined the appropriateness of each ED transfer. The results were expressed in gross values and %. Expert agreement was assessed by Fleiss' kappa statistical measure. Transfers were deemed avoidable in 12 to 35% of cases and appropriate in 53 to 81% of cases according to the experts. Fleiss' Kappa score on the concordance of the different experts' answers concerning the relevance of transfers was slight with k = 0.28 with a significant p-value (p < 0.0001). Infection could benefit of direct hospitalization whereas trauma/wound and acute heart/pulmonary failure are the most relevant reasons of presentation to the ED. Too many ED transfers of NH residents remain avoidable. There is a disparity of results among the experts reflecting a limitation of this study related to the subjective nature of relevance. In a society where demographic projections predict a continuing aging population anywhere EDs are regularly crowded, it would be interesting to identify and prevent factors predisposing to ED transfer and consider alternative managements with a better geriatric and emergency physicians collaboration for this specific population.


Is assessment of peripheral endothelial dysfunction useful tool for risk stratification of type 2 diabetic patients with manifested coronary artery disease?
Endothelial dysfunction, per se, in coronary arteries can stratify a risk in coronary artery disease patients. Selected studies evaluating endotheliopathy as predictor of events in patients with type 2 diabetes, but without coronary artery disease. We hypothesized that peripheral endothelial dysfunction could predict prognosis of type 2 diabetic patients who presented coronary artery disease. Our data presented endothelial dysfunction as prognostic marker of cardiovascular events in type 2 diabetic patients with manifested coronary artery disease, according univariate regression model.


Feeding status alters exploratory and anxiety-like behaviors in zebrafish larvae exposed to quinpirole.
The dysfunction of dopaminergic signaling is associated with several neurological disorders. The use of pharmacological agents that interact with this signaling system may be employed to understand mechanisms underlying such disorders. Nutritional status can impact dopamine reuptake, receptor affinity, transporter activity, and the effects of drugs that bind to dopamine receptors or interact with dopaminergic system. Here we evaluated the effects of quinpirole (a dopamine D2/D3 receptor agonist) exposure on fed and non-fed zebrafish larvae. Zebrafish larvae (6 days post-fertilization, dpf) were exposed to quinpirole (5.5, 16.7, and 50.0 μM) or water (control group) for one hour. To evaluate the effect of feeding status on quinpirole exposure, the experiments were performed on fed and non-fed animals, a between subject experimental design. Both fed and non-fed quinpirole treated larvae exhibited increased erratic movements compared to controls in an open tank exploration task. No alterations were observed on the main parameters of exploratory behavior and swim activity for non-fed larvae treated with quinpirole compared to controls. However, fed animals exposed to quinpirole exhibited increased locomotor activity, anxiety-like behavior, and repetitive circular movements when compared to controls and non-fed exposed animals. In addition, we observed quinpirole exposure to have no effects on morphological parameters and heartbeat, but to impair optomotor responses in both fed and non-fed larvae compared to control. We also found quinpirole effects to interact with feeding status, as quinpirole-treated fed larvae improved while quinpirole treated non-fed larvae impaired their avoidance reaction towards an aversive stimulus. These results indicate that the behavioral effects of quinpirole exposure depended upon feeding status. They showed that consumption of food, a naturally rewarding stimulus known to engage the dopaminergic system, made this neurotransmitter system more susceptible to quinpirole's effects.


Medical teleconference about thoracic surgery using free Internet software.
Surgical teleconferences using advanced academic networks are becoming common; however, reports regarding Internet teleconferencing using free software packages such as Skype, USTREAM, and Dropbox are very rare. Teleconferences concerning mainly surgical techniques were held five times between Fukuoka University Hospital and other institutions from April to September 2010. These teleconferences used Skype and USTREAM as videophones to establish communication. Both PowerPoint presentations and surgical videos were made. These presentation files were previously sent to all stations via mail, e-mail, or Dropbox, and shared. A slide-show was simultaneously performed following the presenter's cue in each station. All teleconferences were successfully completed, even though there were minor instances of the Skype link being broken for unknown reasons during the telecommunication. Internet surgical teleconferences using ordinary software are therefore considered to be sufficiently feasible. This method will become more convenient and common as the Internet environments advance.


Single-step reverse transcription-polymerase chain reaction for hepatitis C virus RNA with DNA enzyme immunoassay hybridization.
A single reverse transcription-polymerase chain reaction (SRT-PCR) for HCV RNA detection, confirmed by hybridization of amplified products with biotinylated probes using DNA enzyme immunoassay (DEIA), was compared to nested-PCR (N-PCR) on 20 sera from patients with chronic (n = 18) or acute (n = 2) hepatitis. Results obtained by SRT-PCR confirmed by DEIA and by N-PCR identical. All but one of the patients with chronic hepatitis and positive HCV serology as well as the patients with acute hepatitis had detectable HCV RNA in serum; all patients with chronic hepatitis and indeterminate HCV serology and all controls (n = 5) were negative by the two PCR methods. Both SRT-PCR and N-PCR remained positive after 7 x 10(-2) and 5 x 10(-4) dilutions of two HCV RNA-positive sera. The threshold of detection for SRT-PCR was 15 RNA copies per assay, as assessed by testing serial dilutions of an in vitro synthesized 5'-NCR HCV RNA transcript. SRT-PCR confirmed by DEIA for HCV RNA appears to be as sensitive and specific as N-PCR. Furthermore, it is easier to perform, with less of contamination, is less time-consuming, requires fewer enzymes, and it permits semi-quantification of PCR products.


Potential ablation of accessory atrioventricular pathways: injection of alcohol into the atrioventricular groove.
Accessory atrioventricular (AV) pathways responsible for the Wolff-Parkinson-White syndrome have been treated successfully by surgical and radiofrequency catheter ablation techniques. In this study, we explored the feasibility of permanent chemical ablation of accessory pathways by direct injection of 100% ethanol into the canine AV groove. Right coronary artery blood flow and AV compartment pressure were measured in 5 adult mongrel dogs (part I) during injection of saline solution (10 to 15 mL) into the right AV groove. Atrioventricular groove compartment pressure increased from 1 +/- 1 to 31 +/- 12 mm Hg (p < 0.0001) and right coronary artery blood flow increased slightly from 117 +/- 17 to 138 +/- 44 mL/min (p = not significant). In 8 additional dogs (part II), 100% ethanol (10 mL) was injected into the left AV groove. After 6 weeks (n = 6) or 12 weeks (n = 2), histologic examination of the left AV groove demonstrated localized fibrous replacement of injured epicardial muscle, with only scant inflammatory infiltrate. Mild intimal fibrosis and intimal proliferation were present in the circumflex artery and its larger branches, but no significant luminal narrowing was evident. Angiograms at 12 weeks (n = 2) demonstrated no significant narrowing of the circumflex artery. In summary, injection of 100% ethanol into the AV groove is capable of locally ablating myocardial tissue, presumably including conductive tissues, while sparing the coronary arteries.


Magnetic resonance comparison of left-right heart volumetric and functional parameters in thalassemia major and thalassemia intermedia patients.
To evaluate a population of asymptomatic thalassemia major (TM) and thalassemia intermedia (TI) patients using cardiovascular magnetic resonance (CMR). We supposed that TI group could be differentiated from the TM group based on T2(∗) and that the TI group could demonstrate higher cardiac output. A retrospective analysis of 242 patients with TM and TI was performed (132 males, 110 females; mean age 39.6 ± 8 years; 186 TM, 56 TI). Iron load was assessed by T2(∗) measurements; volumetric functions were analyzed using steady-state-free precession sequences. Significant difference in left-right heart performance was observed between TM with iron overload and TI patients and between TM with iron overload and TM without iron overload (P < 0.05); no significant differences were observed between TM without iron overload and TI patients. A significant correlation was observed between T2(∗) and ejection fraction of right ventricle- (RV-) ejection fraction of left ventricle (LV); an inverse correlation was present among T2(∗) values and end-diastolic volume of LV, end-systolic volume of LV, stroke volume of LV, end-diastolic volume of RV, end-systolic volume of RV, and stroke volume of RV. CMR is a leading approach for cardiac risk evaluation of TM and TI patients.


Seed-mediated atomic-scale reconstruction of silver manganate nanoplates for oxygen reduction towards high-energy aluminum-air flow batteries.
Aluminum-air batteries are promising candidates for next-generation high-energy-density storage, but the inherent limitations hinder their practical use. Here, we show that silver nanoparticle-mediated silver manganate nanoplates are a highly active and chemically stable catalyst for oxygen reduction in alkaline media. By means of atomic-resolved transmission electron microscopy, we find that the formation of stripe patterns on the surface of a silver manganate nanoplate originates from the zigzag atomic arrangement of silver and manganese, creating a high concentration of dislocations in the crystal lattice. This structure can provide high electrical conductivity with low electrode resistance and abundant active sites for ion adsorption. The catalyst exhibits outstanding performance in a flow-based aluminum-air battery, demonstrating high gravimetric and volumetric energy densities of ~2552 Wh kgAl-1 and ~6890 Wh lAl-1 at 100 mA cm-2, as well as high stability during a mechanical recharging process.


[BIOLOGICAL PROPERTIES OF SALMONELLA, ISOLATED FROM CLINICAL MATERIAL AND AQUATIC ENVIRONMENT IN ROSTOV REGION].
Study biological properties of salmonella, isolated from clinical materials and water of Don river. Salmonella strains of various serovars were used in the study. Biochemical characteristics were studied by generally accepted methods, antigenic properties were evaluated in agglutination reactions, virulence was determined by Dlm for laboratory animals, antibiotics sensitivity was verified by disc-diffusion method. The presence of pathogenicity factors in isolated strains was shown: hemolytic activity--in 64 and 36.8% of cases, DNAse activity--in 28 and 26%, respectively in clinical and wild strains. Microorganism dose, resulting in death of all the animals (LD100) did not depend on serovar of salmonella and varied from 10(3) to 10(10) PFU/ml. Clinical strains were established to possess higher virulence and resistance to antibiotics compared with strains isolated from the aquatic envionment.


Former poliomyelitis as a health and socioeconomic factor. A paired sibling study.
Eighty former poliomyelitis patients and the sibling nearest in age and of same sex were examined with matched-pair analysis to evaluate the effect of previous poliomyelitis (polio) on social factors and general health. Fifty-four pairs with women (68 %), and 26 pairs with men (32 %) with a mean age 60.4 years were included. Data were collected by questionnaire. There was no significant difference in length of education between patients and siblings (categories < 8 years, 8-12 years, and > 12 years). Employment rate at age 40 years was 78 % for patients and 88 % for siblings (full-time or part-time); this difference was not significant. Educational options were considered to have been excellent by 38 % of the patients and 26 % of the siblings (not significant), with a fair agreement within the pairs (kappa=0.31). There was no significant difference regarding professional options; rated as excellent by 33 % of patients, and 28 % of siblings, with a fair agreement (kappa=0.25) also for this issue. Perception of general health today expressed on a horizontal VAS-scale (0-10) was significantly lower among the patients than the siblings, mean values of 5.8 and 6.8 (P < 0.001) respectively. Patients also reported a lower quality of life (P=0.03), and less energy for leisure activities (P=0.008). Post polio symptoms like muscular and articular pain, and abnormal tiredness were more common among patients than siblings, whereas there was no difference regarding coexisting illness. In conclusion, polio patients and their siblings reckoned their educational and professional options to have been at the same level. The patients were well educated and employed to the same degree up to the age of 40 years, but now at a higher age reported reduced general health.


Assessing causality from multivariate time series.
In this work we propose a general nonparametric test of causality for weakly dependent time series. More precisely, we study the problem of attribution, i.e., the proper comparison of the relative influence that two or more external dynamics trigger on a given system of interest. We illustrate the possible applications of the proposed methodology in very different fields like physiology and climate science.


Metabolic fingerprinting of must obtained from sun-dried grapes of two indigenous Cypriot cultivars destined for the production of 'Commandaria': A protected destignation of origin product.
Grapes's sun-dried process is one of the most critical steps in the production of 'Commandaria', a dessert wine product that is exclusively produced in Cyprus and derived from must obtained from two indigenous grape cultivars, namely 'Mavro' and 'Xynisteri'. Despite its significant economic importance, no data regarding the primary and secondary metabolites of the aforementioned cultivars exist. Thus, in the current study, the effect of sun drying process on the qualitative attributes and phenolic profile of 'Mavro' and 'Xynisteri' musts was dissected. Musts were analyzed at harvest and at the end of the sun-drying process that corresponds to ca. 30-40% water loss. Results highlighted significant differences in chemical composition of the must before and after the sun-drying process. Except for the increase of soluble solids content, a significant increment in glucose, fructose, total acidity, total phenols and total flavonoids contents was monitored. Subsequently, forty-two phenolic compounds were identified by LC-DAD-qTOF-MS revealing the polyphenolic fingerprint of the two cultivars. Results also indicated that changes in the phenolic composition of the obtained must are not only correlated with the dehydration effect, but both synthesis or degradation reactions occurred. In particular, the increases in the concentration of hydroxybenzoic acids were higher than the concentration effect for both cultivars. Regarding to hydroxycinnamates, dehydration caused a six-fold increase of hydroxycinnamic acid content in both cultivars. Intriguingly, the concentration of some hydroxycinnamic acids such as caffeic acid dihexoside and fertaric acid isomer went descending. Although the degradation of the internal side of the skin facilitate improved extractability from the skins to the grape pulp and therefore to the grape must, the sun-drying process may also induced stilbene and lignans synthesis production. A significant effect of dehydration on the postharvest biosynthesis of three groups of flavonoids (flavonols, flavan-3-ols, flavanonols), was also observed. This study sheds some light in the substantial changes that occur in specific metabolites during the sun drying process; such metabolites can be considered as potential factors that may determine organoleptic characteristics and biological properties of the end-product.


Identification and physicochemical characterization of caffeine-citric acid co-crystal polymorphs.
The purpose of the present study was to identify a new caffeine-citric acid co-crystal (CA-CI) polymorph and characterize three CA-CI polymorphs. The stability order among the three CA-CI polymorphs was also determined. One new and two known CA-CI polymorphs were prepared by the liquid-assisted grinding method or the slurry methods. The three CA-CIs were then identified and characterized by powder X-ray diffraction (PXRD), thermal analysis, IR spectroscopy, Raman spectroscopy, and dynamic vapor sorption (DVS). The stability order of the CA-CIs was determined by the slurry conversion method. Each CA-CI showed distinct PXRD, IR, Raman, and DVS data. The melting points of CA-CIs were 131°C (a new form, Form III), 141°C (Form I), and 160°C (Form II). The order of thermodynamic stability was CA-CI Form II>CA-CI Form I>CA-CI Form III. CA-CI Forms I and II were relatively stable against humidity compared to CA, CI and CA-CI Form III.


Discovery of a series of potent, orally active α,α-disubstituted piperidine NK(1) antagonists.
Modification of prototype NK(1) antagonist 2 resulted in the synthesis of a series of simple amides 6 and retroamides 9. These compounds were shown to be potent and orally active NK(1) antagonists.


Multicompartment mesoporous silica nanoparticles with branched shapes: an epitaxial growth mechanism.
Mesoporous nanomaterials have attracted widespread interest because of their structural versatility for applications including catalysis, separation, and nanomedicine. We report a one-pot synthesis method for a class of mesoporous silica nanoparticles (MSNs) containing both cubic and hexagonally structured compartments within one particle. These multicompartment MSNs (mc-MSNs) consist of a core with cage-like cubic mesoporous morphology and up to four branches with hexagonally packed cylindrical mesopores epitaxially growing out of the cubic core vertices. The extent of cylindrical mesostructure growth can be controlled via a single additive in the synthesis. Results suggest a path toward high levels of architectural complexity in locally amorphous, mesostructured nanoparticles, which could enable tuning of different pore environments of the same particle for specific chemistries in catalysis or drug delivery.


Histopathological comparison of biodegradable polymer and permanent polymer based sirolimus eluting stents in a porcine model of coronary stent implantation.
Biodegradable stent coatings were recently introduced as a potential solution to overcome sustained inflammatory responses observed with permanent polymer-based drug-eluting stents. In a preliminary study, selected biodegradable or permanent polymer-based sirolimus-eluting stent (SES) formulations were screened for effectiveness in comparison to bare metal stents (BMS) at 28 days. Subsequently, the most favourable SES formulation was compared to commercially available SES (Cypher™) at 28, 90 and 180 days to investigate the histopathologic response as well as tissue, blood and organ pharmacokinetics. Overlapping SES implantation was conducted to evaluate vascular healing at 28 days in this particular setting. SES with biodegradable poly (L-lactide) polymer (PLLA) or poly(lactide-co-glycolide) showed the most favourable outcome with regards to reductions in neointimal area in comparison to BMS at 28 days. The PLLA SES showed a similar reduction in neointimal area compared to Cypher™ at 28 days, with significant greater reductions at 90 and 180 days (1.7 ± 0.7 mm² vs. 3.1 ± 1.5 mm², p=0.03 and 1.8 ± 1.2 mm² vs. 3.0 ± 1.5 mm², p=0.01, respectively). Sirolimus vascular tissue concentrations were detectable up to 90 days following implantation. Overlapping stented segments showed favourable histopathologic results with respect to fibrin deposition and endothelialisation at 28 days. In conclusion, the use of PLLA as drug-eluting matrix resulted in mild inflammatory responses in the presence of effective sirolimus tissue concentrations. The greater efficacy observed at long-term follow-up in PLLA SES compared to Cypher™ may be a multifactorial result of stent design, polymer biocompatibility and improved release kinetics.


The effect of ethanol on survival time in hemorrhagic shock in an unanesthetized swine model.
Controversy exists as to whether ethanol intoxication causes exaggerated hypotension or increased mortality during hemorrhagic shock. Previous studies have used anesthetized animals. This limits data interpretation as anesthetic agents, particularly pentobarbital, have well-documented effects on hemodynamics and the response to hemorrhage. We studied the effects of moderate ethanol intoxication on blood pressure and survival time during fatal hemorrhagic shock in unanesthetized swine. Immature female swine weighing 15 to 20 kg were splenectomized and instrumented with chronic indwelling aortic catheters, right atrial catheters, and gastrostomy tubes. Four to seven days later the unanesthetized animals underwent hemorrhagic shock. Thirty minutes prior to the start of hemorrhage, the experimental group (n = 8) received 3 mL/kg of 100% ethanol mixed as a 1:3 solution with water through a gastrostomy tube. The control group (n = 8) received an equal amount of water. The distal aortic catheter was connected to a roller pump and blood was removed at a rate of 1 mL/kg/min until the animal died. Arterial pressure, heart rate, lactate ethanol and glucose levels, hematocrit, and arterial blood gases were measured in both groups at baseline and every 15 minutes thereafter. A mean ethanol level of 1,500 to 1,700 micrograms/mL was produced in the experimental group from baseline through 60 minutes. Data were analyzed using Student's two-tailed t test, and analysis of variance for repeated measures. There was no significant difference in survival time between the control (63.1 +/- 2.8 min) and ethanol (59.9 +/- 5.9 min) groups. Systolic blood pressure was significantly lower in the ethanol group after 15 minutes of hemorrhage (81 +/- 22 to 59 +/- 14 mm Hg, P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)


The impact of an innovative reform to the South Carolina dental medicaid system.
To evaluate the effectiveness of an innovative reform in 2000 to the Dental Medicaid program in South Carolina. South Carolina Medicaid enrollment data and dental services utilization data from 1998, 1999, and 2000. The study was observational and retrospective in nature. Quarterly data were used in general linear regression models to examine time trends in the percent of Medicaid enrollees ages 21 and younger who received dental services. Trends in the total number of dental procedures provided per Medicaid enrollee were also analyzed, with sub-analyses performed on the four most frequent categories of procedures. Data were provided by the state's Quality Improvement Organization. From 1998 to 1999, there was a downward trend in the number and percent of Medicaid enrollees ages 21 and younger receiving dental services and in the total number of services provided. This trend was dramatically reversed in 2000. The January 2000 dental Medicaid reform in South Carolina had marked impact on Medicaid enrollees' access to dental services.


Differences in treatment strategies in the management of acute appendicitis in a county hospital in Guatemala and an academic teaching institution in the United States.
Laparoscopy and antibiotic-first (NOM) strategies have been introduced in the management of acute appendicitis in industrialised countries. Data regarding the feasibility of these strategies in low-income nations are sparse. A retrospective analysis of adult patients undergoing appendicectomy at a county non-teaching hospital in San Benito, Guatemala (Hospital Nacional (HNSB)) was compared to an academic, teaching institution in Dallas, USA (Veterans Medical Centre). Most patients at the VA (92%) underwent computed tomography prior to being operated upon while none did so at HNSB. Whilst all patients at HNSB underwent an open approach, 95% of VA patients underwent a laparoscopic appendicectomy with a 4.7% conversion rate. General anaesthesia was universally used at Veterans Medical Centre, whilst spinal anaesthesia was utilised in 88% of cases at HNSB. NOM of acute appendicitis was undertaken only rarely at the Veterans Medical Centre and never at HNSB, where it was not thought expedient.


A comprehensive approach to determine the probiotic potential of human-derived Lactobacillus for industrial use.
Specific strains should only be regarded as probiotics if they fulfill certain safety, technological and functional criteria. The aim of this work was to study, from a comprehensive point of view (in vitro and in vivo tests), three Lactobacillus strains (Lactobacillus paracasei JP1, Lactobacillus rhamnosus 64 and Lactobacillus gasseri 37) isolated from feces of local newborns, determining some parameters of technological, biological and functional relevance. All strains were able to adequately grow in different economic culture media (cheese whey, buttermilk and milk), which were also suitable as cryoprotectants. As selective media, LP-MRS was more effective than B-MRS for the enumeration of all strains. The strains were resistant to different technological (frozen storage, high salt content) and biological (simulated gastrointestinal digestion after refrigerated storage in acidified milk, bile exposure) challenges. L. rhamnosus 64 and L. gasseri 37, in particular, were sensible to chloramphenicol, erythromycin, streptomycin, tetracycline and vancomycin, increased the phagocytic activity of peritoneal macrophage and induced the proliferation of IgA producing cells in small intestine when administered to mice. Even when clinical trails are still needed, both strains fulfilled the main criteria proposed by FAO/WHO to consider them as potential probiotics for the formulation of new foods.


Transcriptome analysis of anorexic and preferred silkworms (Bombyx mori) on artificial diet.
The silkworm, Bombyx mori, is an important oligophagous economic insect and feeding habits of different silkworm varieties to artificial diet are different. Research on the mechanisms of feeding habits on artificial diet, and breeding of silkworm varieties adapted on artificial diet, which is a necessary condition for industrial silkworm rearing, is currently lacking. For an artificial diet, Xin was anorexic, whereas Haoyue A showed a strong appetite. When the two varieties were crossed, the F1 generation showed a poor appetite for the artificial diet and had a setae dispersion rate of <50 %. However, the F2 generation, self-bred progeny of F1, had a good appetite for the artificial diet, with a setae dispersion rate of 70 %. Herein, transcriptome analysis was conducted on the F2 generation, comparing individuals with anorexic and preferred feeding habits, and 2188 differential genes were identified, with 1524 genes up-regulated and 934 genes down-regulated. Several genes were identified to contribute to feeding habits, such as genes involved olfactory system, energy supply, and cell proliferation and differentiation. GO enrichment revealed a large number of DEGs related to behavior, growth, signaling, developmental process, response to stimulation, and other pathways. Furthermore, proteins closely related to feeding were expressed differently. Some DEGs were selected for qRT-PCR, and results indicated the reliability of the DEG results. The DEGs between individuals with anorexic and preferred feeding habits were screened by RNA-Seq technology, which provides a reliable reference to study molecule mechanisms of feeding habits on artificial diet.


The chicken progesterone receptor A and B isoforms are products of an alternate translation initiation event.
The chicken progesterone receptor A and B proteins differ by an additional 128 amino acids located at the N terminus of the B protein. Using site-directed mutagenesis, we demonstrate that these two proteins arise by alternate initiation of translation from two in-phase AUG codons located on a single mRNA transcript. Both proteins are transcriptionally active in terms of their ability to activate a progesterone-responsive target gene. These results suggest a functional significance for evolutionary conservation of two forms of this steroid receptor.


Overexpression of fibulin-3 in tumor tissue predicts poor survival of malignant mesothelioma patients from hand-spinning asbestos exposed area in eastern China.
Fibulin-3 is an extracellular matrix glycoprotein widely expressed in various tissues. Tissue fibulin-3 expression have never been reported in association with prognosis of mesothelioma. Hence, we sought to determine the association between fibulin-3 expression and mesothelioma survival. We made a tissue microarray, which was comprised of cancer and normal tissue from mesothelioma patients (n = 82) during the period 1998-2017 in China. Fibulin-3 and HGMB1 expression were analyzed by immunohistochemistry method. Kaplan-Meier method and Cox proportional hazard models were used for analyzing survival data. Overall, 61 cases (74.4%) were female; 90.2% were of epithelioid type; the median overall survival time was 12.5 months. Fibulin-3 and HMGB1 were highly expressed in tumor tissue rather than adjacent tissue. The expression of fibulin-3 in tissue was correlated with that of HMGB1 (r = 0.32, P = 0.003). High expression of fibulin-3 in tumor tissue could predict poor survival in patients with mesothelioma (P = 0.02). This remained true in a multivariate model, with a significant hazard ratio of 1.91. We demonstrated that fibulin-3 in tumor tissue was a novel biomarker of poor survival of mesothelioma, suggesting it may be a relevant target for therapeutic intervention.


Modified Skoog Method for Hump Reduction.
Dorsal hump reduction is a key component of rhinoplasty. Spreader grafts are the most frequently used technique; however, dorsal irregularities may result. The modified Skoog method involves removal of the osseocartilaginous dorsal hump, its modification, further reduction of the nasal dorsum, replacement of the modified dorsal segment, and suspension of the upper lateral cartilages. The dorsal segment acts as an onlay spreader graft, preserves the middle vault, closes the open roof deformity, and creates a smooth dorsal contour from radix to anterior septal angle. The modified Skoog method produces optimal functional and aesthetic outcomes in appropriately selected patients.


Remediation program with automatized naming and reading for students with dyslexia: elaboration and clinical significance.
Elaborate a remediation program with rapid automatized naming and reading, as well as to verify the clinical significance of the elaborated program for students with dyslexia. The study involved five students from 3rd to the 5th grade of elementary school, aged 8 to 12 years, of both genders, with an interdisciplinary diagnosis of dyslexia. All students were submitted to pre- and post-test application of metalinguistic skills and reading test, reading comprehension and rapid automatized naming test. The analysis was performed using the JT method that allowed to verify positive or negative change and clinical significance in the post-testing. The results showed clinical significance in the tests of identification, syllable addition and combination, final and medial phoneme; in addition to nonwords repetition, real words and pseudowords reading, reading comprehension and rapid automatized naming test when comparing the pre- and post-testing. The elaborated program was efficient and applicable as an intervention instrument based on scientific evidence for students with dyslexia since it showed clinical significance for reading performance.


Misdiagnoses of 11C-choline combined with 18F-FDG PET imaging in brain tumours.
The widely applied F-FDG is known for its disadvantage in brain tumour PET imaging because of its high background uptake. C-choline can achieve high contrast of brain tumour imaging and was expected to have higher sensitivity and specificity. We analysed the misdiagnoses in C-choline PET imaging in brain tumours with the aim of improving the accuracy of diagnosis with C-choline PET imaging. We selected 10 patients proven to have been misdiagnosed on the basis of histopathological correlation and clinical follow-up among 94 patients (110 studies) who underwent C-choline PET/CT for diagnosed or suspected brain tumour between 23 March 2005 and 8 February 2007. C-choline PET imaging were performed on a Biograph Sensation 16 PET/CT scanner (Siemens Medical Systems), F-FDG imaging was also performed as reference. Of all 10 misdiagnosed patients, five were false positive (one abscess, one tuberculosis, one benign gliocyte proliferation, one inflammatory granuloma and one demyelination), four were false negative (two metastases from lung cancer, one lymphoma, one grade II glioma) and one was misdiagnosed by wrong interpretation due to lack of experience. The rate of false positives was (5/110) 4.55%; the rate of false negatives was (4/110) 3.64%; the accuracy of C-choline alone was (93/110) 84.5%; by comparison, the accuracy of F-FDG alone was (78/110) 70.9%. C-choline imaging has a certain rate of false positivity and false negativity. With proper application, C-choline might have greater potential than F-FDG for brain tumour PET imaging.


Structure of the cell-puncturing device of bacteriophage T4.
Bacteriophage T4 has a very efficient mechanism for infecting cells. The key component of this process is the baseplate, located at the end of the phage tail, which regulates the interaction of the tail fibres and the DNA ejection machine. A complex of gene product (gp) 5 (63K) and gp27 (44K), the central part of the baseplate, is required to penetrate the outer cell membrane of Escherichia coli and to disrupt the intermembrane peptidoglycan layer, promoting subsequent entry of phage DNA into the host. We present here a crystal structure of the (gp5-gp27)3 321K complex, determined to 2.9 A resolution and fitted into a cryo-electron microscopy map at 17 A resolution of the baseplate-tail tube assembly. The carboxy-terminal domain of gp5 is a triple-stranded beta-helix that forms an equilateral triangular prism, which acts as a membrane-puncturing needle. The middle lysozyme domain of gp5, situated on the periphery of the prism, serves to digest the peptidoglycan layer. The amino-terminal, antiparallel beta-barrel domain of gp5 is inserted into a cylinder formed by three gp27 monomers, which may serve as a channel for DNA ejection.


Rapid marked response of severe hyperemesis gravidarum to oral erythromycin.
A recent report has noted an association between Helicobacter pylori and hyperemesis gravidarum. We present two cases in which first-trimester patients with severe hyperemesis gravidarum requiring intravenous fluid replacement were placed on oral erythromycin therapy for other nonrelated conditions. Surprisingly, marked rapid improvement of the hyperemesis gravidarum was observed with complete resolution of all symptomatology. Both these patients tested seropositive for Helicobacter pylori. These unexpected, marked therapeutic responses are consistent with the recently reported association between hyperemesis gravidarum and Helicobacter pylori and possibly suggest a new therapeutic modality for similar patients.


Epidemiological assessment of levodopa use in Cuba: 1993-1998.
The purpose of this study is to describe and evaluate the use of levodopa in Cuba in order to provide a basis for intervention aimed at improving pharmacological treatment of individuals presenting with Parkinson's disease (PD). We studied the amount of levodopa, both plain and combined, distributed by the central laboratory to hospital and community pharmacies in Cuba in the period 1993-1998. An internationally established drug-classification system and a reported method for epidemiological assessment of levodopa sales were applied. Sweden in 1994 served as the reference population. National crude rates of levodopa use basically remained stable since 1994, and in 1998 stood at 0.11 defined daily dose (DDD) per 1000 inhabitants/day, approximately 15 times lower than the corresponding figure for the reference population. Annual provincial use of levodopa showed considerable geographical variation, with the lowest rates in the eastern provinces and the highest rates in Havana City (Ciudad de La Habana). Adjustment for age reduced such differences by approximately 50%. Levodopa use in Cuba is low and consistent with the reported low prevalence of the diagnosis of PD. Results suggest that the diagnosis and treatment of PD can be improved, with emphasis on better detection of PD.


Full reconstruction of simplicial complexes from binary contagion and Ising data.
Previous efforts on data-based reconstruction focused on complex networks with pairwise or two-body interactions. There is a growing interest in networks with higher-order or many-body interactions, raising the need to reconstruct such networks based on observational data. We develop a general framework combining statistical inference and expectation maximization to fully reconstruct 2-simplicial complexes with two- and three-body interactions based on binary time-series data from two types of discrete-state dynamics. We further articulate a two-step scheme to improve the reconstruction accuracy while significantly reducing the computational load. Through synthetic and real-world 2-simplicial complexes, we validate the framework by showing that all the connections can be faithfully identified and the full topology of the 2-simplicial complexes can be inferred. The effects of noisy data or stochastic disturbance are studied, demonstrating the robustness of the proposed framework.


Crystal structure and solvent-dependent behaviours of 3-amino-1,6-diethyl-2,5,7-trimethyl-4,4-di-phenyl-3a,4a-di-aza-4-bora-s-indacene.
In the title compound (3-amino-4,4-diphenyl-BODIPY), C28H32BN3, the central six-membered ring has a flattened sofa conformation, with one of the N atoms deviating by 0.142 (4) Å from the mean plane of the other five atoms, which have an r.m.s. deviation of 0.015 Å. The dihedral angle between the two essentially planar outer five-membered rings is 8.0 (2)°. In the crystal, mol-ecules are linked via weak N-H⋯π inter-actions, forming chains along [010]. The com-pound displays solvent-dependent behaviours in both NMR and fluorescence spectroscopy. In the 1H NMR spectra, the aliphatic resonance signals virtually coalesce in solvents such as chloro-form, di-chloro-methane and di-bromo-ethane; however, they are fully resolved in solvents such as dimethyl sulfoxide (DMSO), methanol and toluene. The excitation and fluorescence intensities in chloro-form decreased significantly over time, while in DMSO the decrease is not so profound. In toluene, the excitation and fluorescent intensities are not time-dependent. This behaviour is presumably attributed to the assembly of 3-amino-4,4-diphenyl-BODIPY in solution that leads to the formation of noncovalent structures, while in polar or aromatic solvents, the formation of these assemblies is disrupted, leading to resolution of signals in the NMR spectra.


Slow excitatory transmission in rat dorsal horn: possible mediation by peptides.
Repetitive stimulation of a dorsal root elicited a slow depolarization in about half of the dorsal horn neurons examined in the rat spinal cord slice preparation. The response was markedly depressed or abolished in the presence of substance P, substance P antagonists and capsaicin. In some dorsal horn neurons a slow hyperpolarization was also observed.


A new approach for fat removal in a discontinuous autotransfusion device-concept and evaluation.
Fat present during blood salvage in orthopaedic or cardiac surgery can pose a risk of fat embolism and should be eliminated before transfusion. Based on observations of central fat accumulation at the bottom of Latham bowls, a fat reduction program was developed using two volume displacements, where blood temporarily is removed and respun in the bowl to force the fat through the RBC sediment. Pooled ABO-matched RBC and FFP were adjusted to a haematocrit of 10%, and human fat tissue added to a concentration of 1·25 vol%. In six experiments, blood was processed with the new-generation cell salvage device CS Elite in a newly developed fat reduction program in bowls of three sizes. Volumetric quantification of fat was performed after centrifugation of blood samples in Pasteur pipettes. From volumes, haematocrits and the concentrations of fat, RBC recovery and fat elimination rates were calculated. Fat removal rates of 93·2 ± 2·8, 97·0 ± 2·1 and 99·6 ± 0·3% were observed with a 70-ml, 125-ml and 225-ml bowl, respectively, and even higher rates when removal rates were calculated one cycle. At the same time, high RBC recovery and plasma elimination rates were maintained, not significantly different to the default program mode. Modifications in process parameters and sequence led to a fat reduction program that significantly improves fat removal with the Cell Saver Elite from 77·4 ± 5·1% in the default mode to an average of 98·6 ± 1·1%, yielding results equivalent to the continuous cell salvage system (C.A.T.S).


The role of cysteine conjugation in the detoxification of microcystin-LR in liver of bighead carp (Aristichthys nobilis): a field and laboratory study.
The role of glutathione (GSH) and cysteine (Cys) conjugates in the detoxification of microcystin-LR (MC-LR) in bighead carp (Aristichthys nobilis) was examined under laboratory and field conditions. Wild individuals of bighead carp were collected from 5 eutrophic lakes along the Yangtze River, while in laboratory experiment, bighead carp were injected intraperitoneally with 500 μg purified MC-LR/kg body weight (bw). Contents of MC-LR and its glutathione (MC-LR-GSH) and cysteine conjugates (MC-LR-Cys) in the liver of bighead carp were determined by liquid chromatography electrospray ionization mass spectrum (LC-ESI-MS). In laboratory experiment, low concentrations of MC-LR-GSH (mean: 0.042 μg/g dry weight (DW)) were always detectable, and the mean ratio of MC-LR-Cys to MC-LR-GSH was 6.55. While, in field study, relatively high MC-LR-Cys concentration (mean: 0.22 μg/g DW) was detected, whereas MC-LR-GSH was occasionally detectable, and the average ratio of MC-LR-Cys to MC-LR-GSH was as high as 71.49. A positive correlation was found between MC-LR-Cys concentration in the liver of bighead carp and MC-LR content in seston from the five lakes (r = 0.85). These results suggest that MC-LR-Cys might be much more important than MC-LR-GSH in the detoxification of MC-LR in fish liver, and that cysteine conjugation of MC-LR might be a physiological mechanism for the phytoplanktivorous bighead carp to counteract toxic cyanobacteria.


Aroma enhancement of blueberry wine by postharvest partial dehydration of blueberries.
Blueberries with 20%, 30%, and 40% weight loss were used for winemaking, aiming to explore the feasibility of applying postharvest dehydration for improving blueberry wine aroma. Postharvest dehydration decreased the titratable acidity of blueberries and their resultant wines. Total anthocyanins and phenols in blueberries with 30% weight loss were increased by 25.9% and 16.1%, respectively, due to concentration effects, while further dehydration resulted in a decline. Similar trends were observed in blueberry wines. Moderate postharvest dehydration increased total terpenes, benzeneacetaldehyde and phenylethyl alcohol, ethyl butanoate, methyl salicylate, 1-hexanol, and γ-nonalactone content in blueberries and wines, which could enhance the floral, fruity, and sweet notes of blueberry wines. Wines made from blueberries under severe dehydration (40% weight loss) had the lowest overall aroma score, which was related to the higher content of 4-ethyl-phenol and 4-ethylguaiacol. In conclusion, moderate postharvest dehydration benefited the aroma enhancement of blueberry wine.


Side effects of non-narcotic analgesics as a determinant of prescribing.
In the prescription of non-narcotic analgesics the physician's main responsibility is to make sure that the quality-of-life improvement expected from the drug's use justifies the associated risk, low though it is, of fatal side effects. The range of acceptable risk depends, naturally, on the dosage and duration of the treatment and on those characteristics of the patient which bear on the drug's efficacy and safety. In the treatment of acute pain an additional, very important, factor is the patient's remaining life expectancy. Quantification of maximal acceptable risks is aided by formal decision-analytic considerations. Such analyses indicate that maximal acceptable risks vary by several orders of magnitude among various clinical situations and that they are more liberal than intuition might generally suggest.


Role of JAK2 in the pathogenesis and therapy of myeloproliferative disorders.
The myeloproliferative disorders polycythaemia vera (PV), essential thombocythaemia (ET), and primary myelofibrosis (PMF) are clonal disorders of multipotent haematopoietic progenitors. The genetic cause of these diseases was not known until 2005, when several independent groups demonstrated that most patients with PV, ET and PMF acquire a single point mutation in the cytoplasmic tyrosine kinase JAK2 (JAK2V617F). These discoveries have changed the landscape for diagnosis and classification of PV, ET and PMF, and show the ability of genomic technologies to identify new molecular targets in human malignancies with pathogenetic, diagnostic and therapeutic significance.


Measurements of nonvolatile size distribution and its link to traffic soot in urban Shanghai.
Measurements of particle size distribution and size-resolved particle volatility were conducted using a volatility tandem differential mobility analyzers (V-TDMA) in the urban area of Shanghai during wintertime in January 2014. The nonvolatile mode particles with VSF exceeding 0.85 were always externally mixed with more-volatile mode particles. The average VSF ranged from 0.58 to 0.65 for 100-400nm particles, increasing with the increase of particle size. On average, the nonvolatile mode contributed 15-20% of number fraction for 50-400nm particles. Due to their hydrophobic nature, the nonvolatile particles were not easily removed by wet deposition. The concentrations of the nonvolatile mode particles and NOx were well correlated, indicating that the nonvolatile mode particles were mostly attributed to be fresh traffic soot. The diurnal variations in ensemble VSF and number fraction of nonvolatile mode particles exhibited two peaks in clean days, corresponding to morning and evening rush hours. The VSF distributions of 50nm particles were similar during a transition between haze to clean periods whereas in the accumulation mode range, the number fraction of more-volatile mode and the amount of volatile materials in the more-volatile mode particles during haze periods are considerably larger than those in clean periods, indicating different contribution from transported sources.


Hypoxia induces netrin-1 and Unc5b in atherosclerotic plaques: mechanism for macrophage retention and survival.
Hypoxia is intimately linked to atherosclerosis and has become recognized as a primary impetus of inflammation. We recently demonstrated that the neuroimmune guidance cue netrin-1 (Ntn1) inhibits macrophage emigration from atherosclerotic plaques, thereby fostering chronic inflammation. However, the mechanisms governing netrin-1 expression in atherosclerosis are not well understood. In this study, we investigate the role of hypoxia in regulating expression of netrin-1 and its receptor uncoordinated-5-B receptor (Unc5b) in plaque macrophages and its functional consequences on these immune cells. We show by immunostaining that netrin-1 and Unc5b are expressed in macrophages in hypoxia-rich regions of human and mouse plaques. In vitro, Ntn1 and Unc5b mRNA are upregulated in macrophages treated with oxidized low-density lipoprotein or inducers of oxidative stress (CoCl2, dimethyloxalylglycine, 1% O2). These responses are abrogated by inhibiting hypoxia-inducible transcription factor (HIF)-1α, indicating a causal role for this transcription factor in regulating Ntn1 and Unc5b expression in macrophages. Indeed, using promoter-luciferase reporter genes, we show that Ntn1- and Unc5b-promoter activities are induced by oxidized low-density lipoprotein and require HIF-1α. Correspondingly, J774 macrophages overexpressing active HIF-1α show increased netrin-1 and Unc5b expression and reduced migratory capacity compared with control cells, which was restored by blocking the effects of netrin-1. Finally, we show that netrin-1 protects macrophages from apoptosis under hypoxic conditions in a HIF-1α-dependent manner. These findings provide a molecular mechanism by which netrin-1 and its receptor Unc5b are expressed in atherosclerotic plaques and implicate hypoxia and HIF-1α-induced netrin-1/Unc5b in sustaining inflammation by inhibiting the emigration and promoting the survival of lesional macrophages.


Surfactant substitution in the newborn by application of artificial surfactant.
A protein-free artificial surfactant (ALEC) composed of two phospholipids when given as a prophylactic treatment at birth to very premature babies in randomized controlled trials. It was shown to reduce the severity of RDS, the ventilator pressure, the inspired oxygen requirements, the compliance of the respiratory system, the neonatal mortality and the incidence of ventricular hemorrhage. There are no apparent side effects from this treatment.


Decontamination of ubiquitous harmful microbial lineages in water using an innovative Zn2Ti0.8Fe0.2O4 nanostructure: dielectric and terahertz properties.
Many ubiquitous dangerous microbial lines could originate in different sources of polluted water and be distributed to tap water, which could cause multiple types of illnesses to humans and livestock. Despite enormous attempts to guarantee safety of potable water, these species are still regarded to be threated prevalent health issues and concerns. However, these species need a powerful disinfectant to be removed from contaminated water for receiving clean and healthy water. This study was therefore conducted to produce magnificent magnetic iron titanate zinc nano-particles (Zn2Ti0.8Fe0.2O4 MNPs) as a sophisticated approach for drinking water (DW) and wastewater purification. The identification of crystalline phase, dielectric and terahertz spectroscopy of iron zinc titanate nanostructure prepared via acidic sol-gel process and calcined at 800 °C. Results show that the formation of cubic structure for Zn2TiO4 phase, and the dielectric constant (ε') decreased with the higher frequency, tan (δ) has higher values at lower frequency and the conductivity increases relatively with frequency that attributes to the high resistive grain boundaries. Absorption coefficient, refractive index and dielectric properties of iron zinc titanate nano-particles was estimated via time domain-terahertz spectrometer and adjusted via the applied electric field. In particular, the Gram-negative bacteria were more prone than other microbes tested to the Magnetic Nano-Particles (MNPs). Results also was ascertained that the minimum inhibitory concentration (MIC) was 25 ppm at 30 min for E. coli and Salmonella enterica, 45 min for Listeria monocyteogens, Staphylococcus aureus, and Candida albicans and 60 min for Aspergillus niger with a noticeable bactericidal impact. Results exhibit that the MNPs explored are non-toxic and protected for individuals and the environment. MNPs can, therefore, be proposed as an expedient and impressive nano-scale applicant for inactivation during the drinking water and wastewater conservation of the prevailing dangerous microbes.


Malarial parasitism and male competition for mates in the western fence lizard, Sceloporus occidentalis.
The effect of malarial parasitism on the ability of male western fence lizards, Sceloporus occidentalis, to compete for access to females was assessed experimentally. Pairs of male lizards, one infected with the malarial parasite, Plasmodium mexicanum, and the other not infected, were matched by size and color and placed in large seminatural outdoor enclosures along with an adult female lizard. Infected males displayed to females and to other males less often than did noninfected male lizards. Noninfected lizards were dominant in social interactions more often than malarious animals, based on duration and intensity of agonistic encounters toward the other male, and time spent with the female. Thus, malarial infection hinders the ability of male fence lizards to compete for mates.


[Painful cervical mass revealing an aneurysm of the internal jugular vein].
Internal jugular vein aneurysms or phlebectasia of the internal jugular vein are considered a benign pathology. They are more and more diagnosed with the evolution of imaging techniques : ultrasonography, angioscanner and MRI. Clinically they are often by chance, however accompanying clinical signs can be seen such as pain, hoarseness or vocal cord paralysis. Several differential diagnoses can be mentioned such as laryngocoele, gill cyst, paraganglioma and hemangioma. They are of unknown etiology with several hypotheses on the etiopathogenesis and on the frequent localization on the right. Conservative treatment can be chosen for small aneurysms and in children. Surgical treatment finds its indication especially in the event of a complication such as thrombosis or for an aesthetic interest; other treatments such as endovascular treatment are being evaluated. We report the case of a 67-year-old woman admitted for a painful latero-cervical mass, and in whom the diagnosis of an aneurysm of the internal jugular vein was suspected and confirmed by ultrasound and CTscan. The patient received successful surgical treatment.


Tissue culture loading test with storage granules from animal models of neuronal ceroid-lipofuscinosis (Batten disease): testing their lysosomal degradability by normal and Batten cells.
Storage granules (SGs) from ovine and canine models of Batten disease were found to be easily phagocytosed by four cell types studied. The cell types tested were human fibroblasts and peripheral monocytes (control and from a late infantile Batten disease patient), rat C6 cell line, and neonatal cardiomyocytes. The phagocytosed SGs elicited an increase in acid phosphatase activity which was localized in the phagolysosome. After phagocytosis SGs were followed for various times ranging from 7 to 21 days and were found to be of unchanged density (phase contrast), autofluorescence, and ultrastructural appearance. These findings point to their undergradability, or very low degree of degradability, in phagolysosomes in both normal or Batten cultured cells. The Batten disease SGs are not toxic and did not cause any adverse affect on the host cells. Either the normal clearance rate from lysosomes is too slow to be measured by this technique or subunit c accumulation in lysosomes need not result from a primary lysosomal protease defect. Subunit c may aggregate, because of the lack of some normally preventive factor, resulting in a physical barrier to the degradation of this highly apolar molecule.


Swiss GPs' preferences for antidepressant treatment in mild depression: vignette-based quantitative analysis.
GPs frequently prescribe antidepressants in mild depression. The aim of this study was to examine, how often Swiss GPs recommend antidepressants in various clinical presentations of mild depression and which factors contribute to antidepressant treatment recommendations. We conducted an online survey among Swiss GPs with within-subject effect analysis. Alternating case vignettes described a typical female case of mild depression according to International Classification of Diseases, 10th edition criteria, with and without anxiety symptoms and sleep problems. GPs indicated for each vignette their preferred treatments (several recommendations were possible). Additionally, we assessed GP characteristics, attitudes towards depression treatments, and elements of clinical decision-making. Altogether 178 GPs completed the survey. In the initial description of a case with mild depression, 11% (95%-CI: 7%-17%) of GPs recommended antidepressants. If anxiety symptoms were added to the same case, 29% (23%-36%) recommended antidepressants. If sleep problems were mentioned, 47% (40%-55%) recommended antidepressants, and if both sleep problems and anxiety symptoms were mentioned, 63% (56%-70%) recommended antidepressants. Several factors were independently associated with increased odds of recommending antidepressants, specifically more years of practical experience, an advanced training in psychosomatic and psychosocial medicine, self-dispensation, and a higher perceived effectiveness of antidepressants. By contrast, a higher perceived influence of patient characteristics and the use of clinical practice guidelines were associated with reduced odds of recommending antidepressants. Consistent with depression practice guidelines, Swiss GPs rarely recommended antidepressants in mild depression if no co-indications (i.e., sleep problems and anxiety symptoms) were depicted. However, presence of sleep problems and anxiety symptoms, many years of practical experience, overestimation of antidepressants' effectiveness, self-dispensation, an advanced training in psychosomatic and psychosocial medicine, and non-use of clinical practice guidelines may independently lead to antidepressant over-prescribing.


Students' Readiness and Perception of Interprofessional Learning in an Undergraduate Swiss Healthcare Student Context: A Cross Sectional Study.
The objective of this study was to assess attitudes toward interprofessional education (IPE) among undergraduate health students in Switzerland after 2 weeks of IPE training during the first year of their bachelor's curriculum. A cross-sectional study using a convenience sample of first-year undergraduate healthcare students assessed using the RIPLS scale. A total of 140 students participated in this study. Physiotherapist students achieved the highest mean scores for the total RIPLS. However, the total mean score for RIPLS for nurse students was statistically lower (p<0.001) in comparison to the other departments. The findings are inspiring in that students demonstrated positive attitudes, perceptions, and attributes toward IPE activities. This study contributes to the development of innovative IPE activities.


Symptomatic diffuse esophageal spasm. Manometric follow-up and response to cholinergic stimulation and cholinesterase inhibition.
Uniform criteria for defining symptomatic diffuse esophageal spasm (SDES) are lacking. Records of patients undergoing esophageal motility studies over a 3-year period were reviewed. Those patients who fulfilled a predefined set of arbitrary criteria for SDES returned for repeat motility study. Manometric abnormalities seen on initial examination remained unchanged on follow-up evaluation. In addition, response in SDES to two pharmacological agents--a cholinergic agonist and cholinesterase inhibitor--was evaluated and compared to that seen in normal subjects and in subjects with heartburn. Patients with SDES responded similarly to both agents, and their responses were significantly greater than those seen in controls or in subjects with heartburn. The results suggest that SDES is a relatively homogenous entity, with respect to both maintaining stability of manometric abnormalities and response to two different pharmacological agents. The future evaluation of similarly defined patients may lead to ascertaining more clearly the underlying pathophysiology of this "syndrome".


The clinical availability of facial nerve enhancement in temporal bone MRI for the patients of idiopathic acute peripheral facial palsy.
This study is to evaluate the duration of facial nerve enhancement in gadolinium-enhanced temporal bone MRI after the onset of acute facial palsy. Gd-enhanced MRI imagines were examined in 13 patients with idiopathic acute facial palsy within 14 days after the onset. The degree of facial nerve function was measured according to the House-Brackmann (H-B) grading system at their first visit at outpatient clinic. The follow-up MRI was taken about 16.5 months (7-24 months) after onset of disease. The degree of facial nerve enhancement was measured with signal intensity (SI) which was quantitatively analyzed using the region-of-interest (ROI) measurements for each segment of the facial nerve. SI was statistically analyzed by comparing SI values of contralateral site and ipsilateral site using the paired t test with SPSS program. The gadolinium enhancement was statistically increased at labyrinthine segment and geniculate ganglion area of facial nerve at initial temporal bone MRI. The gadolinium enhancement was statistically decreased at all the segments of facial nerve except tympanic segment (p < 0.05) at follow-up MRI. The facial nerve enhancement in Gd-enhanced MRI images prolonged more than 21 months of the onset. The newly developed pathologic lesions of acute facial palsy especially occur at the site of labyrinthine and geniculate ganglion.


Substrate binding to fluorescent labeled wild type, Lys213Arg, and HIS233Gln Saccharomyces cerevisiae phosphoenolpyruvate carboxykinases.
Saccharomyces cerevisiae phosphoenolpyruvate (PEP) carboxykinase is a key enzyme of the gluconeogenic pathway and catalyzes the decarboxylation of oxaloacetate and transfer of the gamma-phosphoryl group of ATP to yield PEP, ADP, and CO(2) in the presence of a divalent metal ion. Previous experiments have shown that mutation of amino acid residues at metal site 1 decrease the steady-state affinity of the enzyme for PEP, suggesting interaction of PEP with the metal ion [Biochemistry 41 (2002) 12763]. To more completely understand this enzyme interactions with substrate ligands, we have prepared the phosphopyridoxyl (P-pyridoxyl)-derivatives of wild type, Lys213Arg, and His233Gln S. cerevisiae PEP carboxykinase and used the changes in the fluorescence probe to determine the dissociation equilibrium constants of PEP, ATPMn(2-), and ADPMn(1-) from the corresponding derivatized enzyme-Mn(2+) complexes. Homology modeling of P-pyridoxyl-PEP carboxykinase and P-pyridoxyl-PEP carboxykinase-substrate complexes agree with experimental evidence indicating that the P-pyridoxyl group does not interfere with substrate binding. ATPMn(2-) binding is 0.8kcalmol(-1) more favorable than ADPMn(1-) binding to wild type P-pyridoxyl-enzyme. The thermodynamic data obtained in this work indicate that PEP binding is 2.3kcalmol(-1) and 3.2kcalmol(-1) less favorable for the Lys213Arg and His233Gln mutant P-pyridoxyl-PEP carboxykinases than for the wild type P-pyridoxyl-enzyme, respectively. The possible relevance of N and O ligands for Mn(2+) in relation to PEP binding and catalysis is discussed.


Effect of a tyrosine kinase inhibitor STI571 in a patient with hepatic metastases from a duodenal gastrointestinal stromal tumor.
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors. The molecular etiology is the result of mutations in the c-Kit gene. The mutant c-Kit proteins, which are activated without a stem cell factor, contribute to the tumor development. STI571 selectively inhibits c-Kit, BCR-ABL, and PDGFR tyrosine kinases. Based on this potential to inhibit critical c-Kit function in GISTs, case studies have reported effective outcomes following treatment with STI571. This case report describes a highly effective use of STI571 in a 54-year-old woman with multiple liver metastases from a GIST originating in the duodenum.