Comparative effectiveness of Biobrane®, RECELL® Autologous skin Cell suspension and Silver dressings in partial thickness paediatric burns: BRACS randomised trial protocol.
Mixed partial thickness burns are the most common depth of burn injury managed at a large Australian paediatric hospital specialty burns unit. Prolonged time until re-epithelialisation is associated with increased burn depth and scar formation. Whilst current wound management approaches have benefits such as anti-microbial cover, these are not without inherent limitations including multiple dressing changes. The Biobrane® RECELL® Autologous skin Cell suspension and Silver dressings (BRACS) trial aims to identify the most effective wound management approach for mixed partial thickness injuries in children. All children presenting with an acute burn injury to the study site will be screened for eligibility. This is a single-centre, three-arm, parallel group, randomised trial. Children younger than 16 years, with burns ≥ 5% total body surface area involving any anatomical location, up to 48 h after the burn injury, and of a superficial partial to mid-dermal depth, will be included. A sample size of 84 participants will be randomised to standard silver dressing or a Regenerative Epithelial Suspension (RES™) with Biobrane® or Biobrane® alone. The first dressing will be applied under general anaesthesia and subsequent dressings will be changed every 3 to 5 days until the wound is ≥ 95% re-epithelialised, with re-epithelialisation time the primary outcome. Secondary outcomes of acute pain, acute itch, scar severity, health-related quality of life, treatment satisfaction, dressing application ease and healthcare resource use will be assessed at each dressing change and 3, 6 and 12 months post-burn injury. The findings of this study can potentially change the wound management approach for superficial partial to mid-dermal burns in children locally and worldwide. The Australian New Zealand Clinical Trials Registry (ACTRN12618000245291) approved prospective registration on 15 February 2018. Registration details can be viewed at https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=374272&isReview=true.


Quantitative expression analysis of Bodhesin genes in the buck (Capra hircus) reproductive tract by real-time polymerase chain reaction (qRT-PCR).
Knowledge of the different patterns of gene expression along the male reproductive tract can assist in understanding the physiological processes of species-specific reproduction in mammals. In the present work, expression profiles of buck spermadhesin (bodhesin) genes along the reproductive tract by qRT-PCR were investigated. Total RNA from the seminal vesicle, testis, epididymis, bulbourethral gland and ductus deferens were reverse transcribed and the cDNA produced was submitted to qRT-PCR. For each homologous bodhesin gene, namely Bdh-1, Bdh-2 and Bdh-3, sets of specific primers and recombinant plasmids were prepared for gene quantification. In buck seminal vesicles, Bdh-2 is the homologue predominantly expressed, with a copy number on the order of millions of times more than Bdh-1 and thousand times more than Bdh-3. The copy number of Bdh-3 mRNA is only 10-fold greater than that of Bdh-1. Bodhesin transcripts were detected in all tissues examined, except in ductus deferens. The quantitative analysis also demonstrated clearly the differential gene expression of spermadhesin in bulbourethral gland. The striking differences in bodhesin gene expression indicate that each isoform could have a specific biological function in the buck genital tract, which deserves further detailed studies.


[Auto-immune hemolytic anemia associated with Kaposi's sarcoma. Report of a new case (author's transl)].
The association of Kaposi angiosarcomatosis and an auto-immune haemolytic anaemia is reported in a 69-year-old woman. The direct Coombs test was "igG complement" type positive. This is the 5th reported case and the 2nd in which haemolysis developed during an acute malignant exacerbation of the disease. The patient died less than 4 months following the diagnosis of Kaposi's sarcoma, after treatment with prednisone and chlorambucil. Lymphoid and immunological abnormalities are not rare during the course of Kaposi's sarcoma. The reasons are discussed briefly.


Pallidal Deep Brain Stimulation for KMT2B Related Dystonia in An Indian Patient.
Outcomes of pallidal stimulation in KMT2B dystonia have been infrequently reported prospectively. We report the six-month outcomes of bilateral GPi DBS in an Asian Indian patient with early-onset generalized dystonia associated with a novel heterozygous variant in the KMT2B gene.


Analysis of Neutrophil Transmigration Through Epithelial Cell Monolayers.
Transmigration of neutrophils through an epithelial layer, such as in the intestine or lung, is a necessary response to a perceived attack at the mucosal surface of that tissue. This process is dynamically regulated by a number of interactive events between the neutrophil and other cell types and allows for an effective and localized neutrophil response. However, in certain inflammatory diseases, including inflammatory bowel disease and chronic obstructive pulmonary disease (COPD), persistent neutrophil accumulation can contribute to disease pathology. Elucidating the mechanisms of this aberrant neutrophil accumulation is crucial for understanding and ameliorating these disease processes. The method we describe here is a controlled model system that allows for the investigation of the interactive signals involved in neutrophil transmigration through epithelial barriers, and possible mechanisms of deregulation of this process.


A study of desmosomes in colorectal carcinoma.
Desmosomes are adhesive junctions of epithelial cells. Their expression may be altered or lost in carcinomas resulting in reduced cellular adhesiveness. The desmosomes of colorectal carcinomas have been studied by fluorescent antibody staining, immunoblotting and electromicroscopy. A series of 58 malignant specimens, comprised of primary tumours and metastases, were desmosome positive. There was no indication of a comparative reduction in desmosome expression that might give rise to reduced adhesiveness of tumour cells, although loss of polarised junctional distribution in poorly differentiated tumours might have such a consequence. Western blotting analysis of colorectal cancers and cultured carcinoma cells identified desmosomal polypeptides dp1 + 2, dg1 and dg2 + 3 with similar relative molecular weights to normal homologues. In addition, a polypeptide of 140,000 was recognised only in malignant epithelium by anti-dg2 + 3 antiserum. The significance of this polypeptide is not understood. Tumours and uninvolved epithelium were exposed to low extracellular [Ca2+] to test whether tumour desmosomes were of reduced stability. This caused much cellular degradation in tumours but some viable cell clumps possessed desmosomes resistant to disruption by low [Ca2+]. Desmosomes may thus have a positive role in metastasis by maintaining intercellular adhesion between metastasising cells.


Radiomics Outperforms Clinical and Radiologic Signs in Predicting Spontaneous Basal Ganglia Hematoma Expansion: A Pilot Study.
Prediction of the hematoma expansion (HE) of spontaneous basal ganglia hematoma (SBH) from the first non-contrast CT can result in better management, which has the potential of improving outcomes. This study has been designed to compare the performance of "Radiomics analysis," "radiology signs," and "clinical-laboratory data" for this task. We retrospectively reviewed the electronic medical records for clinical, demographic, and laboratory data in patients with SBH. CT images were reviewed for the presence of radiologic signs, including black-hole, blend, swirl, satellite, and island signs. Radiomic features from the SBH on the first brain CT were extracted, and the most predictive features were selected. Different machine learning models were developed based on clinical, laboratory, and radiology signs and selected Radiomic features to predict hematoma expansion (HE). The dataset used for this analysis included 116 patients with SBH. Among different models and different thresholds to define hematoma expansion (10%, 20%, 25%, 33%, 40%, and 50% volume enlargement thresholds), the Random Forest based on 10 selected Radiomic features achieved the best performance (for 25% hematoma enlargement) with an area under the curve (AUC) of 0.9 on the training dataset and 0.89 on the test dataset. The models based on clinical-laboratory and radiology signs had low performance (AUCs about 0.5-0.6).


Design and Fabrication of MR-Tracked Metallic Stylet for Gynecologic Brachytherapy.
Active magnetic resonance (MR) tracking for gynecologic brachytherapy was made possible by attaching the micro radiofrequency coils to the brachytherapy applicator. The rectangular planar micro coil was fabricated using flexible printed circuits with dimensions of 8mm×1.5mm. A 5-Fr (1.6mm) tungsten brachytherapy stylet was custom-machined to incorporate the micro coils. The finite element analysis and the phantom tissue studies show that the proposed device enables in situ, real-time guidance of access routes to the target anatomy safely and accurately. The setup was tested in a Siemens 3T MR scanner. The micro coils can be localized rapidly (up to 40 Hz) and precisely (resolution: 0.6×0.6×0.6mm3) using an MR-tracking sequence.


Intestinal Flora in Chemotherapy Resistance of Biliary Pancreatic Cancer.
Biliary pancreatic malignancy has an occultic onset, a high degree of malignancy, and a poor prognosis. Most clinical patients miss the opportunity for surgical resection of the tumor. Systemic chemotherapy is still one of the important methods for the treatment of biliary pancreatic malignancies. Many chemotherapy regimens are available, but their efficacy is not satisfactory, and the occurrence of chemotherapy resistance is a major reason leading to poor prognosis. With the advancement of studies on intestinal flora, it has been found that intestinal flora is correlated with and plays an important role in chemotherapy resistance. The application of probiotics and other ways to regulate intestinal flora can improve this problem. This paper aims to review and analyze the research progress of intestinal flora in the chemotherapy resistance of biliary pancreatic malignancies to provide new ideas for treatment.


Recurrent seasonal severe hypertriglyceridemia-induced acute pancreatitis; a case report.
Acute pancreatitis (AP) is a serious inflammatory condition of the pancreas. Hypertriglyceridemia (HTG) is considered an uncommon cause of AP. The current study aims to present a unique case of recurrent seasonal severe HTG-induced AP (HTG-AP); treated with insulin and heparin. A 36-year-old male presented with recurrent attacks of severe upper abdominal pain that was radiating to the back and associated with repeated vomiting. The condition has being occurring every autumn-winter for the last three years. He had thalassemia minor and had a history of HTG-AP. His TG levels were relatively normal from February to August; however, from September to February, his TG levels highly elevated which has resulted in HTG-AP every year for the past three years. The condition was confirmed via a contrast-enhanced computerized tomography scan of the abdomen. To prevent the next HTG-AP, his TG level was monitored monthly. When TG levels spiked again, the patient was put on an insulin infusion with heparin, glucose, and potassium to rapidly reduce TG level. After two days, serum TG was dramatically reduced (<500 mg/dL). Despite multiple theories being proposed, the pathogenesis of HTG-AP is yet to be understood. Usually, HTG-AP is a single episodic, and recurrent HTG-AP is considered uncommon finding. Previous reports are contradictory regarding TG level and seasonal variation. There is currently no standard management approach to treat HTG-AP cases. HTG-AP rarely reoccurs on an annual basis, and seasonal variation seems to play a major role in its onset. The condition can be managed with insulin, heparin, and glucose infusions.


The Semisitting Retrosigmoid Technique for Removal of Large Vestibular Schwannoma: 2-Dimensional Operative Video.
The retrosigmoid approach in semisitting position (RS-SSP) is a powerful technique for removal of large vestibular schwannomas. 1 It improves extent of tumor resection and nerve preservation. This video shows the case of a 34-year-old man with a large vestibular schwannoma, treated with the RS-SSP technique. The patient consented to the procedure and to publication of his image. Preoperative MRI and bone window computed tomography are essential for optimal planning. Intraoperative monitoring throughout the surgery includes somatosensory evoked potential (SSEP) and motor evoked potential (MEP) of limbs, facial MEP and electromyography, and brainstem auditory evoked potention. Major steps are (1) positioning of patient in SSP under SSEP recordings, 2,3 (2) ipsilateral retrosigmoid craniotomy, (3) straight dura incision parallel to sigmoid sinus, (4) opening the basal cisterns and gently elevation of cerebellum, (5) identification of Tübingen line on posterior surface of petrous bone, (6) opening and emptying the internal auditory canal (IAC) under nerves preservation, (7) intracisternal tumor debulking, (8) bimanual nerve dissection of cochlear nerve inferiorly and facial nerve medially/ventrally, (9) endoscopic investigation of IAC fundus, 4 (10) plugging the IAC with bone wax and muscle, (11) jugular vein compression before dura closure, and (12) Closure of craniotomy and wound. Correct positioning in SSP is crucial to minimize the risk of air embolism. 3. Additional resection of suprameatal tubercle allows extension toward the middle fossa and removal of dumbbell-shaped trigeminal schwannomas and petroclival meningiomas. 4.


Occurrence of tuberculosis among people exposed to cattle in Bangladesh.
Tuberculosis (TB) has been an important public health concern in Bangladesh. The most common cause of human TB is Mycobacterium tuberculosis, while bovine TB is caused by Mycobacterium bovis. The objective of this study was to determine the frequency of TB in individuals with occupational exposure to cattle and to detect Mycobacterium bovis among cattle in slaughterhouses in Bangladesh. Between August 2014 and September 2015, an observational study was conducted in two government chest disease hospitals, one cattle market, and two slaughterhouses. [Correction added on 27 June 2023, after first online publication: In the preceding sentence, the year "2014" has been added after the word "August".] Sputum samples were collected from individuals who met the criteria for suspected TB and had been exposed to cattle. Tissue samples were collected from cattle that had low body condition score(s). Both humans and cattle samples were screened for acid-fast bacilli (AFB) by Ziehl-Neelsen (Z-N) staining and cultured for Mycobacterium tuberculosis complex (MTC). Region of difference (RD) 9-based polymerase chain reaction (PCR) was also performed to identify Mycobacterium spp. We also conducted Spoligotyping to identify the specific strain of Mycobacterium spp. Sputum was collected from a total of 412 humans. The median age of human participants was 35 (IQR: 25-50) years. Twenty-five (6%) human sputum specimens were positive for AFB, and 44 (11%) were positive for MTC by subsequent culture. All (N = 44) culture-positive isolates were confirmed as Mycobacterium tuberculosis by RD9 PCR. Besides, 10% of cattle workers were infected with Mycobacterium tuberculosis in the cattle market. Of all TB (caused by Mycobacterium tuberculosis) infected individuals, 6.8% of individuals were resistant to one or two anti-TB drugs. The majority of the sampled cattle (67%) were indigenous breeds. No Mycobacterium bovis was detected in cattle. We did not detect any TB cases caused by Mycobacterium bovis in humans during the study. However, we detected TB cases caused by Mycobacterium tuberculosis in all humans, including cattle market workers.


Screening for middle-ear disease in schools for hearing-impaired children.
The aim of the study was to determine the prevalence of middle-ear dysfunction in a group of hearing-impaired children attending schools for the deaf. Two groups of subjects between the ages of 4 and 16 years were selected. Group 1 consists of Caucasian and Group 2 of Negroid children. Otoscopic examinations, impedance and pure tone testing were performed on each child. The results indicated a prevalence of 43% failures on the impedance tests in the Caucasian group and 18% failures in the Negroid group. Chronic problems like perforations, otorrhoea, etc. were more common in Group 2. The results also suggest the existence of differences in the prevalence of middle-ear dysfunction between normal and hearing-impaired children.


Circulating tumor cells: a valuable marker of poor prognosis for advanced nasopharyngeal carcinoma.
To evaluate the prognostic value of circulating tumor cells (CTCs) in nasopharyngeal carcinoma (NPC). Cox's proportional hazards regression models were used to identify whether CTCs was a poor prognostic factor for NPC. Chi-square tests were used to analyze and compare the distribution characteristics of CTCs in NPC. ROC curve was used to estimate the cut-off point of CTCs. Kaplan-Meier survival analyses were used to observe the prognostic value of CTCs alone and in combined with Epstein-Barr Virus DNA (EBV-DNA). CTCs was confirmed to be an independent risk factor for poor prognosis of NPC by Cox's regression models that enrolled 370 NPC cases and took age, gender, EBV-DNA and CTCs as variables. The proportion of CTCs in stage IV NPC was statistically different from that in stage III; the cut-off point of CTCs between stage IV (288 cases) and stage III (70 cases) NPC estimated by ROC curve was 0.5. The prognosis of advanced NPC patients became worse with the increase of CTCs count. The combined detection of CTCs and EBV-DNA could better predict the prognosis of NPC compared with the single detection of EBV-DNA.


Correction to Report of the 2016-17 Academic Affairs Standing Committee: Entrustable Professional Activities Implementation RoadmapCorrection to Student Self-Assessment and Faculty Assessment of Performance in an Interprofessional Error Disclosure Simulation Training Program.
[This corrects the article DOI: 10.5688/ajpe815S4.][This corrects the article DOI: 10.5688/ajpe81354.].


The P72R Polymorphism of p53 Predisposes to Obesity and Metabolic Dysfunction.
p53 is well known for its tumor suppressor role, but this protein also has a poorly understood role in the regulation of metabolism. Human studies have implicated a common polymorphism at codon 72 of p53 in diabetic and pre-diabetic phenotypes. To understand this role, we utilized a humanized mouse model of the p53 codon 72 variants and monitored these mice following challenge with a high-fat diet (HFD). Mice with the arginine 72 (R72) variant of p53 developed more-severe obesity and glucose intolerance on a HFD, compared to mice with the proline 72 variant (P72). R72 mice developed insulin resistance, islet hypertrophy, increased infiltration of immune cells, and fatty liver disease. Gene expression analyses and studies with small-molecule inhibitors indicate that the p53 target genes Tnf and Npc1l1 underlie this phenotype. These results shed light on the role of p53 in obesity, metabolism, and inflammation.


Inhibitory effect of lignans from the rhizomes of Coptis japonica var. dissecta on tumor necrosis factor-alpha production in lipopolysaccharide-stimulated RAW264.7 cells.
The inhibitory effect of 10 lignan constituents isolated from the rhizomes of Coptis japonica var. dissecta on tumor necrosis factor (TNF)-alpha production in lipopolysaccharide (LPS)-stimulated macrophage cell line (RAW264.7 cells) has been studied. Among them, pinoresinol, woorenoside-V and lariciresinol glycoside showed significant inhibitory activities in the range from 37% to 55% at the concentration of 25 micrograms/ml. The results are first report that the lignans isolated from Coptis japonica inhibit TNF-alpha production, and suggest that the lignan components may partly participate in antiinflammatory and antiallergic effect of Coptis japonica through the inhibition of TNF-alpha production.


Applications of Vascular Imaging and Interventional Radiology Modalities in the Upper Extremity: A Review.
Hand and upper extremity (HUE) vascular disorders are encountered frequently by hand surgeons in clinical practice. A wide array of imaging and vascular interventional radiology modalities exists for the diagnosis and treatment of HUE vascular disorders, some of which may not be familiar to the HUE surgeons. In this review article, we summarize the vascular imaging and vascular interventional radiology modalities and their relative advantages, disadvantages, and indications with respect to HUE pathology. We aim to familiarize HUE surgeons with the available types of diagnostic and therapeutic options for HUE vascular pathologies and aid interdisciplinary communication with vascular interventional radiology specialists during the clinical decision-making process.


Tandem coarctations of thoracic and abdominal aorta with intervening hypoplastic thoracic aorta: treatment with unilateral axillofemoral graft.
Tandem coarctations of the thoracic and abdominal aorta with an intervening segment of hypoplastic thoracic aorta were discovered unexpectedly in a 14-year-old boy brought to the emergency room for a displaced fracture of the radius. After the fracture healed, the boy's potentially dangerous anomalies were treated successfully with a unilateral axillofemoral prosthetic graft. This has remained patent for 42 months, and the boy has done well.


Anti-oxidant and anti-apoptotic effects of luteolin on mice peritoneal macrophages stimulated by angiotensin II.
Luteolin, a plant flavonoid, can be found in a variety of plants and possesses anti-tumorigenic, anti-mutagenic, anti-oxidant and anti-inflammatory properties. However, the protective effects of luteolin on mice peritoneal macrophages stimulated by Angiotensin II (Ang II) have not been fully elucidated. Mice peritoneal macrophages were confirmed to be strongly positive for the macrophage marker CD68. Cell viability was tested after cells were pretreated with different concentrations of luteolin (6.25, 12.5 and 25μM) and stimulated by Ang II. Luteolin not only significantly increased the viability of macrophages in the presence of Ang II, but also decreased the apoptotic rate, up-regulated Bcl-2 expression, and down-regulated Bax expression, thereby raising the ratio of Bcl-2 to Bax. In addition, luteolin pretreatment significantly increased the activity of SOD and reduced the levels of malondialdehyde (MDA), which was up-regulated in the presence of Ang II. This protective effect was also seen with Vitamin E (VitE) pretreatment, which was used as a standard control in this study. These data clearly demonstrate that luteolin suppresses Ang II-directed oxidative stress and apoptosis on mice peritoneal macrophages.


Epidemiology of PAH in Korea: An Analysis of the National Health Insurance Data, 2002-2018.
Pulmonary arterial hypertension (PAH) is a rare but fatal disease. Recent advances in PAH-specific drugs have improved its outcomes, although the healthcare burden of novel therapeutics may lead to a discrepancy in outcomes between developing and developed countries. We analyzed how the epidemiology and clinical features of PAH has changed through the rapidly advancing healthcare infrastructure in South Korea. PAH was defined according to a newly devised 3-component algorithm. Using a nationwide health insurance claims database, we delineated annual trends in the prevalence, incidence, medication prescription pattern, and 5-year survival of PAH in Korea. Cumulative survival and potential predictors of mortality were also assessed among 2,151 incident PAH cases. Between 2002 or 2004 and 2018, the prevalence and incidence of PAH increased 75-fold (0.4 to 29.9 per million people) and 12-fold (0.5 to 6.3 per million person-years), respectively. The proportion of patients on combination PAH-specific drug therapy has also steadily increased up to 29.0% in 2018. Among 2,151 incident PAH cases (median [interquartile range] age, 50 [37-62] years; 67.2% female), the 5-year survival rate and median survival duration were 71.8% and 13.1 years, respectively. Independent predictors of mortality were age, sex, etiology of PAH, diabetes, dyslipidemia, and chronic kidney disease. This nationwide study delineated that the prevalence and incidence of PAH have grown rapidly in Korea since the early 2000s. The use of combination therapy has also increased, and the 5-year survival rate of PAH in Korea was similar to those in western countries.


PD-L1 and EBV LMP1 expressions in classic Hodgkin lymphomas and its correlation with clinicopathological parameters and prognosis.
Programmed death pathway leads to T cell anergy. Wide range of malignancies take advantage of this pathway by programmed death-ligand 1 (PD-L1) expression either on neoplastic cells or on the nonneoplastic cells of tumour microenvironment. New therapeutic approaches have been directed against this pathway. We studied PD-L1 expression on both neoplastic Hodgkin and Reed-Sternberg (HRS) cells and cells of tumour microenvironment in classic Hodgkin lymphoma (CHL) patients and compared it with Ebstein-Barr virus (EBV) positivity, clinical data, and survival rates. Lymph node excision materials of 56 CHL patients diagnosed between 2007 and 2017 were included in this retrospective study. PD-L1 expression of HRS cells and tumour microenvironment cells were evaluated by immunohistochemical assay. Staining intensity and rate of the PD-L1 expressions were estimated. EBV was examined by immunohistochemistry for latent membrane protein 1 (LMP1) antibody. Clinical data of 39 patients and survival data of 34 patients were compared with PD-L1 expressions on tumour cells. PD-L1 expression was present in HRS cells in 89.2% of the cases. There was more than 20% of PD-L1 expression in cells of tumour microenvironment in all the cases. PD-L1 positivity did not show statistically significant difference according to EBV expression, clinical parameters, and prognosis. Previous studies showed inconsistent rates for PD-L1 prevalence (20%-95.7%) in CHL patients due to differences in the study methods. Although high prevalence of PD-L1 positivity was found in majority of them, there was no statistically significant difference between PD-L1 positivity on HRS cells and EBV expression, clinical parameters, and prognosis. This high prevalence in patients with various clinical properties makes PD-L1 a potential target for new emerging immunotherapies for CHL.


Very early and late form-to-meaning computations during visual word recognition as revealed by electrophysiology.
We used a large-scale data-driven approach to investigate the role of word form in accessing semantics. By using distributional semantic methods and taking advantage of an ERP lexical decision mega-study, we investigated the exact time dynamic of semantic access from printed words as driven by orthography-semantics consistency (OSC) and phonology-semantics consistency (PSC). Generalized Additive Models revealed very early and late OSC-by-PSC interactions, visible at 100 and 400 msec, respectively. This pattern suggests that, during visual word recognition: a) meaning is accessed by means of two distinct and interactive paths - the orthography-to-meaning and the orthography-to-phonology-to-meaning path -, which mutually contribute to recognition since early stages; b) the system may exploit a dual mechanism for semantic access, with early and late effects associated to a fast-coarse and a slow-fine grained semantic analysis, respectively. The results also highlight the high sensitivity of the visual word recognition system to arbitrary form-meaning relations.


Sequestration of bovine seminal plasma proteins by different assemblies of phosphatidylcholine: A new technical approach.
Binder of SPerm (BSP) proteins, the main proteins from bovine seminal plasma, are known to partially intercalate into the outer leaflet of the spermatozoa membrane and bind to choline-containing lipids being present therein. This insertion generates a negative effect on semen quality after cryopreservation by inducing an early-stage capacitation of spermatozoa. The assumption of surface properties exhibited by BSP proteins was checked by tensiometry measurements: BSP proteins are highly surface active. This suggests that BSP proteins can reach the interface covered by phospholipids not only by interactions between one and each other but also due to their own surface activity. The insertion of BSP proteins into the lipid domains outer leaflet of spermatozoa was reproduced on a biomimetic system such as Langmuir monolayers. The insertion of BSP proteins can be performed in the compressible fluid domains which contain choline-bearing lipids. Monolayer films were used as well to study the complexation of BSP proteins by two phospholipid assemblies: low density lipoprotein (LDLs) from egg yolk or liposomes produced from egg phospholipids. Irrespective of the phospholipid structure (lipoprotein or liposome), BSP was hindered to alter the structure of the membrane. Only the overall ratio BSP proteins:phosphatidylcholine was important. The difference between the two sequestering agents lies on their surface properties: LDL have a strong tendency to merge with the outer layer whereas liposomes mainly remain in the bulk on the same time scale.


Effect of sub-acute oral cyanide administration in rats: protective efficacy of alpha-ketoglutarate and sodium thiosulfate.
Chronic toxicity of cyanide in humans and animals has been previously described. Alpha-ketoglutarate (alpha-KG) and sodium thiosulfate (STS) are known to confer remarkable protection against acute cyanide poisoning in rodents. Their efficacy against sub-acute or chronic cyanide exposure is not known. The objective of the present study was to assess the sub-acute toxicity of potassium cyanide (KCN) in female rats following oral administration of 7.0 mg/kg (0.5 LD50) for 14 d. The effect of alpha-KG (oral; 1.0 g/kg) and/or STS (intraperitoneal, 1.0 g/kg) on cyanide toxicity was also evaluated. Various hematological and biochemical indices were determined after 7 d of treatment and additional parameters like organ-body weight index (OBI) and histology of brain, heart, lung, liver, kidney and spleen were performed after 14 and 21 d (recovery group) of cyanide exposure. Sub-acute exposure of KCN did not produce any significant change in body weight of the animals, OBI, hematology and the levels of blood urea, creatinine, aspartate aminotransferase, triiodothyronine (T3) and tetraiodothyronine (T4). The levels of temporal glutathione disulfide (GSSG) and hepatic malondialdehyde (MDA), reduced glutathione (GSH) and GSSG were unaffected. However, in KCN treated animals elevated levels of blood glucose and reduced levels of alanine aminotransferase were observed. Activities of cytochrome c oxidase in the brain and rhodanese in the liver were diminished. Reduced levels of GSH and enhanced levels of MDA in brain were observed. Increased levels of blood thiocyanate were observed in all the treatments of KCN. Additionally, KCN also produced various histological changes in the brain, heart, liver and kidney. Although, treatment of alpha-KG and STS alone significantly blunted the toxicity of KCN, concomitant use of both interventions afforded to maximum protection. This study indicates a promising role of alpha-KG and STS for the treatment of prolonged cyanide exposures.


Factor analysis scales of generalized amino acid information as applied in predicting interactions between the human amphiphysin-1 SH3 domains and their peptide ligands.
Factor analysis scales of generalized amino acid information (FASGAI) involving hydrophobicity, alpha-helix and beta-turn propensities, bulky properties, compositional characteristics, local flexibility, and electronic properties, was proposed to represent the structures of the decapeptides binding the human amphiphysin-1 SH3 domains. Parameters being responsible for the binding affinities were selected by genetic algorithm, and a quantitative structure-affinity relationship (QSAR) model by partial least square was established to predict the peptide-SH3 domain interactions. Diversified properties of the residues between P(2) and P(-3) (including P(2) and P(-3)) of the decapeptide (P(4)P(3)P(2)P(1)P(0)P(-1)P(-2)P(-3)P(-4)P(-5)) may contribute remarkable effect to the interactions between the SH3 domain and the decapeptide. Particularly, electronic properties of P(2) may provide relatively large positive contributions to the interactions, and reversely, hydrophobicity of P(2) may be largely negative to the interactions. These results showed that FASGAI vectors can well represent the structural characteristics of the decapeptides. Furthermore, the model obtained, which showed low computational complexity, correlated FASGAI descriptors with the binding affinities as well as that FASGAI vectors may also be applied in QSAR studies of peptides.


High temperature stability of anatase in titania-alumina semiconductors with enhanced photodegradation of 2, 4-dichlorophenoxyacetic acid.
The incorporation of aluminum acetylacetonate as alumina source during the gelation of titanium alkoxide reduces the nucleation sites for the formation of large rutile crystals on temperatures ranging from 400 to 800°C. As a result, the aggregation of anatase crystals is prevented at high temperature. A relationship among the specific surface area, pore size, energy band gap, crystalline structure and crystallite size as the most relevant parameters are evaluated and discussed. According to the results for the photocatalytic degradation of 2,4-dichlorophenoxyacetic acid, the specific surface area, pore size, Eg band gap are not determinant in the photocatalytic properties. It was found that the anatase crystallite size is the mores important parameter affecting the degradation efficiency.


[The QTc interval and its dispersion in hypertrophic myocardiopathy--its relation to complex ventricular arrhythmias and the effect of anti-arrhythmia agents].
The aim of the present study was to evaluate, in patients with hypertrophic cardiomyopathy (HCM): 1. The relation of rate corrected QT interval (QTc) and of QTc interlead variability (QTc dispersion) to complex ventricular arrhythmias (CVA); 2. The effects of amiodarone (Am), beta-blockers (beta B) and calcium antagonists (CA) on QTc and on QTc dispersion. Surface 12 leads ECG was analysed in 55 patients with HCM (39 +/- 12 years, 32 males). All patients were in sinus rhythm, without bundle branch block. Maximum (max), minimum (min) and mean QTc values were considered. QTc dispersion was calculated as: a) max QTc - min QTc (max-min); b) dispersion index (DI) = standard deviation of QTc/mean QTcx100. Patients groups were defined accordingly to: 1--the absence (group A1-35 patients) or the presence (group A2-20 patients) of CVA on 24 hours Holter monitoring; II--absence of cardioactive medication (group B1-20 patients) versus monotherapy with Am (group B3-10 patients), or beta B (group B4-15 patients), or CA (group B5-10 patients). Age, gender, type of HCM (asymmetric versus concentric) and echocardiographic fractional shortening were not different in the studied groups. [table: see text] 1. Maximum QTc interlead QTc dispersion are increased in patients with HCM that show CVA on Holter monitoring; 2. Amiodarone prolongs QTc but reduces QTc dispersion, while beta-blockers and calcium antagonists do not significantly change neither the duration nor the dispersion of ventricular repolarization.


Patterns of fetal breathing activity in the human fetus at 24 to 28 weeks of gestation.
Continuous 24-hour observations of fetal breathing were performed in 20 normal, pregnant women between 24 and 28 weeks' gestation by real-time ultrasound. Fetuses made breathing movements approximately 14% of the time. No change in breathing activity after a maternal meal was observed, but a significant increase in the incidence of fetal breathing activity was noted overnight. Fetuses at 24 to 28 weeks' gestation breathed at a rate of 44 breaths per minute, and the longest period of apnea noted was 14 minutes. These data suggest that the pattern and incidence of fetal breathing at 24 to 28 weeks' gestation are different from those of fetuses observed in the last 10 weeks of pregnancy. A maturational process in the control of fetal breathing may explain these observations.


Gut-associated lymphoid tissue as source of an IgA immune response in respiratory tissues after oral immunization and intrabronchial challenge.
Most IgA plasma cells in the digestive tract are thought to derive from gut-associated lymphoid tissue, whereas IgA plasma cells in the respiratory mucosa are thought to originate largely in bronchus-associated lymphoid tissue. However, previous work has also shown that IgA antibodies to gut antigens can be detected in immunocytes of the bronchial mucosa and in bronchial secretions after appropriate stimulation via the gut. To analyze the cellular origin of such respiratory antibodies, mice were orally immunized with ferritin for 40 days and then segregated for intrabronchial challenge as follows: one group was given saline, another group Formalin-fixed Escherichia coli as a nonspecific challenge, and a third group ferritin. Lungs and intestines from these animals were then examined by immunofluorescence for the presence of plasma cells containing particular isotypes of antibody to ferritin. Animals fed ferritin and given saline or E. coli intrabronchially showed a greater than 6-fold increment in IgA antiferritin plasma cells in the bronchial mucosa, compared to animals which had not received ferritin, whereas orally immunized animals challenged intrabronchially with ferritin showed a greater than 15-fold increase. In other experiments, ferritin-naive animals transfused with mesenteric node cells that were obtained from donors that had been orally immunized with ferritin and were already committed to IgA production showed a 4-fold or greater increase in IgA antiferritin plasma cells in respiratory mucosa after intrabronchial challenge with ferritin when compared to recipients of peripheral node cells from the same donors or to recipients of mesenteric node cells that had not been specifically boosted intrabronchially. These results suggest that immunologically specific IgA immunocytes from gut-associated lymphoid tissue can migrate to the respiratory mucosa after oral immunization, and that migration and/or local cell division are enhanced by subsequent intrabronchial challenge. In providing further evidence for interrelations between gut-associated and bronchus-associated lymphoid tissue, the findings lend added support to the overall concept of a generalized secretory immune system.


Appropriate use of virtual touch quantification and FibroScan M and XL probes according to the skin capsular distance.
Appropriate utilization of different diagnostic modalities is essential for the accurate liver stiffness measurements (LSM) in patients with chronic liver diseases. The aim of this study was to evaluate the efficacy of Virtual Touch Quantification (VTQ) and the FibroScan M and XL probes in term of accurate LSM and to identify factors associated with inadequate measurements in obese and non-obese Japanese patients. A total of 664 consecutive patients with chronic liver disease were prospectively enrolled. LSM were evaluated concurrently with VTQ and the FibroScan M and XL probes. LSM quality was categorized as inadequate (success rate <60% and/or interquartile range/median value of ≥30%) or adequate. No significant differences in the rate of inadequate LSM were observed among the three diagnostic modalities. In multivariate analysis, skin capsule distance (SCD) was strongly associated with inadequate rates obtained with VTQ and the M probe [odds ratio (OR) 1.28, P < 0.0001 and OR 1.20, P < 0.0001, respectively]. Inadequate LSM rates with both VTQ and the M probe increased with longer SCD, with a significant difference between subgroups at an SCD of ≥22.5 mm (VTQ 54.0%; M probe 51.1%; XL probe 25.2%; P < 0.0001). The rates of inadequate LSM rates with VTQ were significantly lower than those with the XL probe at an SCD of <17.5 mm. A total of 15 liver biopsy specimens obtained from nonalcoholic fatty liver disease patients confirmed the diagnostic accuracy and high applicability of the XL probe. Long SCD reduced the diagnostic performance of the FibroScan® M probe and VTQ. LSM modalities should be selected according to SCD.


Significance of anterior commissure involvement in early glottic squamous cell carcinoma treated with trans-oral CO2 laser microsurgery.
To study and compare the outcome of trans-oral CO2 laser microsurgery for early glottic squamous cell cancer with and without the involvement of anterior commissure (AC). This is a retrospective analysis of 296 cases of early glottic squamous cancer treated by trans-oral CO2 laser microsurgery. The patients were divided into two groups depending on whether AC was involved or not. The impact of AC involvement on rates of local recurrence, laryngeal preservation, overall survival, and disease-specific survival was compared in both the groups. Out of the 296 cases, 61 cases had AC involvement, while in 235 cases AC was free of disease. Local recurrence rate was significantly higher at 29.51% in the group with AC involvement, while only 18.3% cases had local recurrence in the group without AC involvement with P value of 0.0001. On T stage-wise analysis, 34.8% cases of T2 lesions with AC involvement developed local recurrence, as compared to only 10.26% cases of T2 without AC involvement with significant P value of 0.007. Larynx preservation rate was 95.8% versus 93.26% in the AC-involved and AC not-involved cases, respectively, without any statistical significance (P=0.287). The overall survival was 90.16% versus 86.38% in the cases with and without AC involvement, respectively, without significant P value 0.642. Trans-oral laser surgery is an excellent treatment option in patients with early glottic cancer irrespective of whether or not the AC is involved. Trans-oral laser microsurgery for early glottic cancer involving AC requires adequate exposure, proper assessment, good experience, and advanced surgical skills.


Genetic epidemiology and heritability of AIS: A study of 415 Chinese female patients.
Recent familial segregation studies supported a multifactorial genetic model for the etiology of adolescent idiopathic scoliosis (AIS). However, the extent of quantitative genetic effects, such as heritability, have not been fully evaluated. This genetic epidemiology study examined the sibling recurrent risk and heritability of AIS in first-degree relatives of 415 Chinese female patients, which is up to now the largest cohort. They were first diagnosed by community screening program and compared to 203 age-matched normal controls. Out of the total 531 sibs of AIS cases, 94 sibs had scoliosis (sibling recurrence risk = 17.7%). The prevalence of AIS among male and female sibs of an index case were 11.5% (95% CI = 7.5-15.5) and 23.0% (95% CI = 18.1-27.9), respectively. Female sibs of an index case had an increased risk of 8.9-fold (95% CI = 3.2-34.4) for developing AIS. These recurrent risks were significantly higher than the risk in the control group (p < 0.0001). Overall, heritability was estimated to be 87.5 ± 11.1%. The results confirmed the prevailing impression of strong genetic influence on the risk of AIS. Here we provided a large-scale study for the genetic aggregation estimates in an Asian population for the first time. The finding also positioned AIS among other common disease or complex traits with a high heritability.


The measurement of deoxynucleotide (dNTP) pools by radioimmunoassay (RIA).
Radioimmunoassay provides an alternative, sensitive and reproducible high throughput method for the measurement of dNTP pools. The extent and duration of inhibition of TS can be investigated by determination of the TTP and "dUMP" pools and the effects of D1694 and ZD9331 have confirmed their biochemical profiles. The RIAs will be useful in providing information for the design of treatment protocols for TS inhibitors and with the specific assay of dUTP, on mechanisms of cell death in different cell lines.


Bacterial biofilm formation inside colonic crypts may accelerate colorectal carcinogenesis.
Research in the field of relation between microbes and colorectal carcinogenesis has gained increasing interest in past years. Recently, link between microbial biofilm and carcinogenesis in colon was demonstrated by several authors indicating that biofilm not only is a key player in carcinogenesis, but also may contribute to the understanding of side-specific colon cancer-right sided colon cancer versus left sided. In this article, we briefly highlight the major findings of the research of biofilm and carcinogenesis and demonstrate our findings of colonic cancer tissue and colonic polyp examined for biofilm. Colonic cancer tissue from a patient with a right-sided colon cancer, and an adenoma tubular polyp were examined for biofilm formation by flourescens in situ hybridization. In cancer tissue we found biofilm formation on the surface epithelium but surprisingly also deep into the crypts. No biofilms were found in tubular polyp tissue. To our knowledge, this is the first-time biofilm formation deep into colonic crypts are demonstrated in a patient with right-sided colon cancer. This may indicate that bacterial biofilm may have a key role in carcinogenesis.


Adapting Technological Interventions to Meet the Needs of Priority Populations.
Cardiovascular diseases (CVD) comprise the leading cause of mortality worldwide, accounting for 3 in 10 deaths. Individuals with certain risk factors, including tobacco use, obesity, low levels of physical activity, type 2 diabetes mellitus, racial/ethnic minority status and low socioeconomic status, experience higher rates of CVD and are, therefore, considered priority populations. Technological devices such as computers and smartphones are now routinely utilized in research studies aiming to prevent CVD and its risk factors, and they are also rampant in the public and private health sectors. Traditional health behavior interventions targeting these risk factors have been adapted for technology-based approaches. This review provides an overview of technology-based interventions conducted in these priority populations as well as the challenges and gaps to be addressed in future research. Researchers currently possess tremendous opportunities to engage in technology-based implementation and dissemination science to help spread evidence-based programs focusing on CVD risk factors in these and other priority populations.


Sex-steroid hormones and EGF signalling in breast and prostate cancer cells: targeting the association of Src with steroid receptors.
Sex-steroid hormones trigger association of their receptors with signalling effectors. Remarkably, various hormonal effects, such as DNA synthesis of different cell types are evoked by this association. In mammary and prostate cancer cells, EGF, androgen or estradiol trigger the assembly of AR/ER/Src complex. SH2-Src interacts with a phosphotyrosine residue of ER and SH3-Src interacts with a proline rich sequence of AR. This association stimulates Src-dependent signalling, DNA synthesis and cytoskeleton changes. We now report that in prostate or breast cancer cells stimulated by EGF or androgen or estradiol, small peptides (6-10 amino acids) derived from ER or AR sequences involved in the receptor interaction with Src, prevent AR/ER/Src association, Src/Erk pathway stimulation, cyclin D1 expression and DNA synthesis. The peptide action is restricted to cells expressing the steroid receptors and to signals mediated by these receptors. Remarkably, the peptides do not modify the steroid receptor-dependent transcriptional activity. Growth of prostate or mammary cancer cell xenografts is strongly inhibited by these novel receptor antagonists.


Predictors of All-Cause Mortality after Endovascular Aneurysm Repair: Assessing the Role of Psoas Muscle Cross-Sectional Area.
To evaluate psoas muscle area (PMA) as a predictor of all-cause mortality after endovascular aneurysm repair (EVAR) and compare it with other predictor variables. Retrospective review of 407 patients who underwent EVAR over a 7-year period was performed. Demographics, comorbidity variables, and outcomes were collected. Preprocedure computed tomography scans were used to measure the PMA. Descriptive statistics summarized the demographic information and predictor variables. Kaplan-Meier analysis and univariate and multivariate Cox proportional regression analyses were performed. The main outcome measure was survival time. Median survival time for patients with PMA in the lowest quartile of the distribution (≤1442 mm2) was 65.5 months (95% confidence interval [95% CI] 37.7-78.9) vs 91.2 months (95% CI 77.9-110.0 when PMA >1442 mm2). Multivariate analysis revealed lower PMA was associated with decreased survival (adjusted hazard ratio [AHR] 1.68; 95% CI 1.15-2.40, P = .006). Similarly, the presence of coronary artery disease (AHR 1.54, 95% CI 1.01-2.35, P = .045) and statin use after EVAR were associated with decreased survival (AHR 2.36, 95% CI 1.24-4.49, P = .009). Hyperlipidemia was associated with increased survival after EVAR (AHR 0.51, 95% CI 0.33-0.81, P = .004). Compared with patients with low body mass index (BMI) (<18.5), a normal BMI was associated with increased survival (AHR 0.21, 95% CI 0.08-0.53, P = .001). Although PMA is a risk factor for decreased survival time, other factors such as patient hyperlipidemia, presence of coronary artery disease, post-EVAR statin use, and BMI are also predictive of postoperative mortality.


Solution structure of the DNA-binding domain of RPA from Saccharomyces cerevisiae and its interaction with single-stranded DNA and SV40 T antigen.
Replication protein A (RPA) is a three-subunit complex with multiple roles in DNA metabolism. DNA-binding domain A in the large subunit of human RPA (hRPA70A) binds to single-stranded DNA (ssDNA) and is responsible for the species-specific RPA-T antigen (T-ag) interaction required for Simian virus 40 replication. Although Saccharomyces cerevisiae RPA70A (scRPA70A) shares high sequence homology with hRPA70A, the two are not functionally equivalent. To elucidate the similarities and differences between these two homologous proteins, we determined the solution structure of scRPA70A, which closely resembled the structure of hRPA70A. The structure of ssDNA-bound scRPA70A, as simulated by residual dipolar coupling-based homology modeling, suggested that the positioning of the ssDNA is the same for scRPA70A and hRPA70A, although the conformational changes that occur in the two proteins upon ssDNA binding are not identical. NMR titrations of hRPA70A with T-ag showed that the T-ag binding surface is separate from the ssDNA-binding region and is more neutral than the corresponding part of scRPA70A. These differences might account for the species-specific nature of the hRPA70A-T-ag interaction. Our results provide insight into how these two homologous RPA proteins can exhibit functional differences, but still both retain their ability to bind ssDNA.


Prevalence of fatigue in adults with congenital heart disease.
The aim of this cross-sectional study was to examine the prevalence of the multidimensional phenomenon of fatigue in adults with congenital heart disease. Adults with congenital heart disease are a growing population, and patient-reported outcomes can provide valuable information about the patient's experience of living with CHD. Fatigue is a multidimensional phenomenon that can be described as an overwhelming feeling of exhaustion with a reduced capacity of mental and physical work. Fatigue can be observed clinically in adults with congenital heart disease, but the actual prevalence is unknown. Fatigue was assessed by the Multidimensional Fatigue Inventory which enables the respondent to report the presence of fatigue according to five dimensions: "general fatigue," "physical fatigue," "mental fatigue," "reduced motivation," and "reduced activity." The questionnaire was sent to 463 patients in Lund and Umeå. Four groups with complex CHD and two groups with moderately complex CHD were included. The reliability (internal consistency) of the Multidimensional Fatigue Inventory was tested for all dimensions and groups of diagnosis. The response rate was 56.6% (n= 262). In patients with complex CHD, 40.0-59.4% reported severe to very severe general fatigue, and patients with a single ventricle reported the highest prevalence (59.4%). Among patients with complex CHD, 29.2-40.0% reported severe to very severe mental fatigue. The Multidimensional Fatigue Inventory had a high reliability measured with Cronbach's alpha. The study findings show a relatively high prevalence of fatigue in adults with congenital heart disease, and general fatigue was the most prevalent. Further studies are needed regarding fatigue and its causes and consequences in adults with congenital heart disease. The Multidimensional Fatigue Inventory proved to be an instrument with high reliability and low internal loss, which suggests that the instrument may be suitable to use as a patient-reported outcome in the care of adults with congenital heart disease, preferably at repeated occasions.


Gene delivery by adenoviruses.
Adenoviruses have a number advantages as gene delivery vectors, including ability to transduce a wide variety of non-dividing and dividing cells with high efficiency, relative ease of construction, and ability to be purified as high-titer viral stocks. These characteristics make adenoviruses particularly attractive for over-expressing specific genes in vitro and for evaluating in vivo biological activity in animal models. In this chapter, procedures will be described for adenovirus construction and virus delivery to in vivo sites for measurement of osteogenic activity.


APOLLO I: Anticoagulation control in atrial fibrillation.
Anticoagulation control as assessed by time in therapeutic range (TTR) correlates positively with the safety and efficacy of thromboprophylaxis in atrial fibrillation. We set out to assess TTR in our unit and to investigate determinants of better control. This was a case series study of atrial fibrillation patients anticoagulated with warfarin or acenocoumarol at the Family Health Unit of Fânzeres. Sociodemographic and clinical data were collected and TTR was calculated by the Rosendaal method, based on international normalized ratio tests performed in external laboratories in the preceding six months. SPSS 21.0 was used for the statistical analysis, with descriptive statistics, Spearman's correlation, and the Mann-Whitney U and Kruskal-Wallis tests. Of the 106 eligible patients, 70% participated in the study. Median TTR was 65.3% (P25=48.3%, P75=86.8%). We found a positive association between this variable and duration of atrial fibrillation (ρ=0.477, p<0.001, r(2)=0.116) and with duration of anticoagulation (ρ=0.5, p<0.001, r(2)=0.087). No association was found with age, gender, educational level or existence of a caregiver (p>0.05). Median TTR in our unit is similar to that in southern European countries and close to the good control threshold (70%) proposed by the European Society of Cardiology. The duration of atrial fibrillation and of anticoagulation explains only a small part of the measure's variability. Other determinants of anticoagulation control must be investigated in future studies and comparative studies should be carried out in family health units monitoring anticoagulation on the premises.


Randomized, prospective comparison of four burst pacing algorithms for spontaneous ventricular tachycardia.
"Less aggressive" burst stimulation is more effective in terminating spontaneous monomorphic ventricular tachycardia with a lesser acceleration rate. Higher ventricular tachycardia cycle length and use of 91% coupling interval were independent predictors for pacing termination.


Metallic, magnetic and molecular nanocontacts.
Scanning tunnelling microscopy and break-junction experiments realize metallic and molecular nanocontacts that act as ideal one-dimensional channels between macroscopic electrodes. Emergent nanoscale phenomena typical of these systems encompass structural, mechanical, electronic, transport, and magnetic properties. This Review focuses on the theoretical explanation of some of these properties obtained with the help of first-principles methods. By tracing parallel theoretical and experimental developments from the discovery of nanowire formation and conductance quantization in gold nanowires to recent observations of emergent magnetism and Kondo correlations, we exemplify the main concepts and ingredients needed to bring together ab initio calculations and physical observations. It can be anticipated that diode, sensor, spin-valve and spin-filter functionalities relevant for spintronics and molecular electronics applications will benefit from the physical understanding thus obtained.


LncRNA HOXA11-AS regulates calcium oxalate crystal-induced renal inflammation via miR-124-3p/MCP-1.
Long noncoding RNA (lncRNA) has been suggested to play an important role in a variety of diseases over the past decade. In a previous study, we identified a novel lncRNA, termed HOXA11-AS, which was significantly up-regulated in calcium oxalate (CaOx) nephrolithiasis. However, the biological function of HOXA11-AS in CaOx nephrolithiasis remains poorly defined. Here, we demonstrated that HOXA11-AS was significantly up-regulated in CaOx nephrolithiasis both in vivo and in vitro. Gain-/loss-of-function studies revealed that HOXA11-AS inhibited proliferation, promoted apoptosis and aggravated cellular damage in HK-2 cells exposed to calcium oxalate monohydrate (COM). Further investigations showed that HOXA11-AS regulated monocyte chemotactic protein 1 (MCP-1) expression in HK-2 cell model of CaOx nephrolithiasis. In addition, online bioinformatics analysis and dual-luciferase reporter assay results showed that miR-124-3p directly bound to HOXA11-AS and the 3'UTR of MCP-1. Furthermore, rescue experiment results revealed that HOXA11-AS functioned as a competing endogenous RNA to regulate MCP-1 expression through sponging miR-124-3p and that overexpression of miR-124-3p restored the inhibitory effect of proliferation, promotion effects of apoptosis and cell damage induced by HOXA11-AS overexpression. Taken together, HOXA11-AS mediated CaOx crystal-induced renal inflammation via the miR-124-3p/MCP-1 axis, and this outcome may provide a good potential therapeutic target for nephrolithiasis.


Bioremediation efficiency in the removal of dissolved inorganic nutrients by the red seaweed, Porphyra yezoensis, cultivated in the open sea.
The bioremediation capability and efficiency of large-scale Porphyra cultivation in the removal of inorganic nitrogen and phosphorus from open sea area were studied. The study took place in 2002-2004, in a 300 ha nori farm along the Lusi coast, Qidong County, Jiangsu Province, China, where the valuable rhodophyte seaweed Porphyra yezoensis has been extensively cultivated. Nutrient concentrations were significantly reduced by the seaweed cultivation. During the non-cultivation period of P. yezoensis, the concentrations of NH4-N, NO2-N, NO3-N and PO4-P were 43-61, 1-3, 33-44 and 1-3 micromol L(-1), respectively. Within the Porphyra cultivation area, the average nutrient concentrations during the Porphyra cultivation season were 20.5, 1.1, 27.9 and 0.96 micromol L(-1) for NH4-N, NO2-N, NO3-N and PO4-P, respectively, significantly lower than in the non-cultivation season (p<0.05). Compared with the control area, Porphyra farming resulted in the reduction of NH4-N, NO2-N, NO3-N and PO4-P by 50-94%, 42-91%, 21-38% and 42-67%, respectively. Nitrogen and phosphorus contents in dry Porphyra thalli harvested from the Lusi coast averaged 6.3% and 1.0%, respectively. There were significant monthly variations in tissue nitrogen content (p<0.05) but not in tissue phosphorus content (p>0.05). The highest tissue nitrogen content, 7.65% in dry wt, was found in December and the lowest value, 4.85%, in dry wt, in April. The annual biomass production of P. yezoensis was about 800 kg dry wt ha(-1) at the Lusi Coast in 2003-2004. An average of 14708.5 kg of tissue nitrogen and 2373.5 kg of tissue phosphorus in P. yezoensis biomass were harvested annually from 300 ha of cultivation from Lusi coastal water. These results indicated that Porphyra efficiently removed excess nutrient from nearshore eutrophic coastal areas. Therefore, large-scale cultivation of P. yezoensis could alleviate eutrophication in coastal waters economically.


Impact of arsenic(V) on testicular oxidative stress and sperm functional attributes in Swiss albino mice.
The arsenic (As) is a multi system effector including reproduction. The present study examined the association of graded doses of As(V) on testicular microenvironment and sperm function in mice. Thirty-six adult male mice were randomly assigned to six groups (n = 6). Group A served as control without test chemical. The groups B, C, D, E, and F were administered graded doses of 10, 25, 50, 100, and 200 ppm As(V), respectively, through drinking water for 40 days. A dose-dependant significant (P < 0.05) decrements were observed in epididymal sperm kinematic attributes (progressive motility, rapid, fast progressive, VCL, VSL, VAP, LIN, STR, WOB and TYPE A (STR >80 %, ALH 2.5 μm) by CASA), viability, plasma membrane functional integrity, and mitochondrial membrane potential which were associated with insignificant decrease in serum testosterone levels. The histoarchitectural studies of testes showed progressive loss of spermatozoa concentration in the seminiferous tubules as the As(V) dose increased. The mice exposed to As(V) had an increase in the As accumulation, protein carbonylation, and lipid peroxidation levels associated with alterations in SOD, CAT, and GST activities in the testes. In conclusion, higher doses of As(V) (more than 50 ppm) were found to be testicular toxicants which impaired semen quality by inducing oxidative stress in the testicular microenvironment.


Health goal cognition and adjustment in women with fibromyalgia.
The purpose of this study was to identify individual differences in symptom-specific goal for persons diagnosed with fibromyalgia syndrome (FMS) and to determine whether those differences are related to adjustment outcomes. Women with FMS (N=71) rank ordered 12 FMS-specific goals and completed a packet of psychosocial outcome measures. Cluster analysis suggested that there were three relatively homogeneous subgroups defined. Cluster 1 ranked goals related to seeking professional care higher than all other groups. Cluster 2 ranked self-sufficiency goals higher than the other two groups. Cluster 3 ranked social-validation goals higher than the other two clusters. Multivariate analyses of variance (MANOVAs) and post-hoc tests showed that goal profiles covaried with differences in pain, negative affect, goal-specific social support, general social support, goal-related interference, and negative life events. Differences between groups are discussed in the context of proposed relations between goals and environmental support.


Transport of anthracene and benz(a)anthracene through iron-quartz and three aquifer materials in laboratory columns.
In groundwater systems, dissolved natural organic matter (NOM) can influence the mobility of organic contaminants by altering the contaminant behavior in water and solid phases. The transport of anthracene and benz(a)anthracene (B(a)A) was studied in the presence and absence of NOM and/or soil organic matter (SOM) in column experiments. The results show that sorption are related to the properties of polycyclic aromatic hydrocarbons (PAHs), NOM and SOM. In the Fe-quartz media, the amount of NOM (20 mg/l) in solution had a little effect on increasing the apparent solubility of anthracene and countering increased anthracene sorption. In the natural (Bemidji) soil, Suwannee river fulvic acid (SRFA, 20 mg/l) and Suwannee river humic acid (SRHA) in water did not compete with SOM for anthracene, indicating that SOM has higher partition efficiency for anthracene. It was also observed that slow diffusion through an organic phase apparently caused most of the observed tailing in column breakthrough curves (BTCs). Even though the fOC of washed Bemidji sediment was very low, the transport of B(a)A was retarded significantly, however, and the transport of B(a)A was shown to be facilitated by dissolved NOM.


Is there a role for capsule endoscopy in the staging work-up of patients with gastric marginal zone B-cell lymphoma of MALT?
In earlier studies, involvement of the small intestine was reported in patients with gastrointestinal lymphoma. Prospective data on the involvement of the small intestine in patients suffering from gastric extranodal MZBCL of MALT do not exist so far. In this study, we investigated the frequency of the involvement of the small intestine and the role of capsule endoscopy in patients with gastrointestinal extranodal MZBCL of MALT and of follicular lymphoma. 40 consecutive patients with gastrointestinal extranodal MZBCL of MALT (26 men, 14 women, aged 27 - 80 years), and 7 patients with known follicular lymphoma of the small intestine (5 men, 2 women, aged 34 - 63 years) underwent capsule endoscopy. Involvement of the small intestine was identified by capsule endoscopy in all 7 patients with known follicular lymphoma of the small intestine. In 6 of 40 patients with gastric extranodal MZBCL of MALT abnormal findings could be observed, three of these findings indicative for lymphoma involvement of the small intestine. However, in each of these 3 cases, intestinal involvement had been already diagnosed by conventional GI endoscopy before capsule endoscopy. Capsule endoscopy is able to detect involvement of the small intestine in patients with gastrointestinal lymphoma. However, involvement of the small intestine seems to be rare in patients with gastric extranodal MZBCL of MALT. In summary, routine diagnostic work-up of the small intestine, e. g. by capsule endoscopy seems unnecessary because of the rare involvement of the small intestine and an excellent long-term outcome irrespective of a possible intestinal manifestation.


Chagas disease in pregnancy.
Chagas disease is a tropical disease now making its appearance in the United States as more immigration from Latin America occurs. Pregnant women with chronic infection with Trypanosoma cruzi may present with cardiac or gastrointestinal symptoms and transmit the infection to their fetuses. A 32-year-old Mexican woman presented with cardiac symptoms at 16 weeks' gestation. She was found to have a left anterior hemiblock on her electrocardiogram. Her indirect immunofluorescent antibody titer for T cruzi was positive at greater than 1:2048. Subsequently, she had a normal pregnancy and delivery. The infant's T cruzi immunofluorescent antibody titer was 1:256 at birth and had not declined at his 6-week follow-up. Obstetric care providers in the United States need to be familiar with American trypanosomiasis because it may present during pregnancy. Serious maternal disease is possible, and perinatal transmission may be seen in 2-10% of cases.


Drug related vasculitis. Clinicopathologic correlations in 30 patients.
Drug related vasculitis has variously been described as necrotizing hypersensitivity or allergic angiitis or microscopic panarteritis nodosa. We reviewed tissue sections from 30 patients with validated drug hypersensitivity and vasculitis in order to precisely define this entity. No evidence of necrotizing vascular lesions or of fibrinoid associated with necrosis was found. The vascular lesions in all 30 patients involved small arteries, arterioles, capillaries, and venules. The inflammatory infiltrate consisted primarily of mononuclear cells and prominent numbers of eosinophils and was present in all three layers of the involved vessel walls. Clinically the patients developed either localized or systemic vasculitis, which could not be predicted on the basis of the associated drug. The findings of a skin rash, fever, or eosinophilia and the development of symptoms consistent with a hypersensitivity reaction while medication was being taken were all suggestive of the diagnosis of drug related vasculitis.


Three-dimensional structure of cat tibialis anterior motor units.
The motor unit is the basic unit for force production in a muscle. However, the position and shape of the territory of a motor unit within the muscle have not been defined precisely. The territories of five motor units in the cat tibialis anterior muscle were reconstructed three-dimensionally (3-D) from tracings of the glycogen-depleted fibers belonging to each unit. The motor unit territories did not span the entire length of the muscle and their cross-sectional areas tapered along the proximodistal axis producing a conical shape. In addition, the position of the territory of each unit shifted in an anterior-posterior plane along the longitudinal axis of the muscle, presumably as a consequence of the pinnation of the fibers. The area of the motor unit territory at any given level along the proximodistal axis was highly correlated with the number of fibers within the territory at that level. Connective tissue boundaries (outlining fascicles) appeared to have a strong influence on the shape of the territory, territories showed abrupt changes at connective tissue boundaries as groups of motor unit fibers within a fascicle often terminated together while motor unit fibers in neighboring fascicles did not terminate. It is likely that the mechanical impact of the recruitment of a motor unit is affected by the location and shape of motor units within the same muscle area.(ABSTRACT TRUNCATED AT 250 WORDS)


Developing conceptually sound items for a clinical courage questionnaire.
Clinical courage can be described as a rural doctor's adaptability and willingness to undertake clinical work at the limits of their training and experience to meet the needs of their patients. This article describes the in-house development of survey items to include in a quantitative measure of clinical courage. The questionnaire development involved two key concepts: a second-order latent factor model structure and a nominal group technique, used to develop consensus among the research team members. The steps taken to develop a sound clinical courage questionnaire are described in detail. The resulting initial questionnaire is presented, ready for testing with rural clinicians and refinement. This article outlines the psychometric process of questionnaire design and presents the resultant clinical courage questionnaire.


Perillyl alcohol mediated radiosensitization via augmentation of the Fas pathway in prostate cancer cells.
The management of hormone-insensitive locally advanced prostate cancer is difficult and complex and there is an urgent need for the development of effective chemotherapeutic agents intended for combination with currently available treatment modalities. The present paper demonstrates the effectiveness of the monoterpene perillyl alcohol (POH) as potent radiosensitizer on DU145 and PC3 cell lines by performing clonogenic survival assays, cycle analysis, and assays to detect viability, apoptosis, and Fas receptor/ligand by flow cytometry. POH pretreatment resulted in a dose dependent sensitization to kill cell by radiation. Furthermore, POH treatment induced a transient G(2)/M arrest, enhanced the expression of the membrane bound form of the Fas ligand and sensitized the cells to Fas mediated apoptosis. The unique manner of radiosensitization in addition to its low toxicity profile makes POH a promising new agent for preclinical evaluation as a potential radiosensitizer in the treatment of prostate cancer.


Morphology of the rat carotid sinus nerve. II. Number and size of axons.
Ten carotid sinus nerves from five rats were examined by electron microscopy at a level of 0.5 mm from the glossopharyngeal nerve (nerve IX). The sinus nerves were found to contain from 455 to 757 (mean 625) axons per nerve, of which an average of 86.3% were unmyelinated. The unmyelinated axons had a size distribution that fitted a Gaussian distribution with a mean diameter of 0.78 micron and a variance of 0.013 micron. Such axons ranged in size from 0.17 to 1.7 microns. The myelinated axons had a unimodal size distribution skewed to the right, with a median total fibre diameter of 2.49 microns. Although total diameter of myelinated fibres ranged from 1.5 to 5.3 microns, 96% of such fibres were smaller than 4 microns. Axon diameter of myelinated fibres averaged 64% of the total diameter, but this proportion tended to increase with the size of the axon. Some 68% of myelinated fibres had axons with a diameter within the range of sizes of unmyelinated axons. The number of axons varied along the length of the sinus nerve, but no consistent pattern of change was found among different rats. The two nerves examined at 0.1 and 0.5 mm from nerve IX had 8-10 more myelinated axons at the more distal level, and the number of unmyelinated axons increased by four in one nerve but decreased by 26 in the other nerve. In three nerves examined at 0.5 and 2.0 mm from nerve IX, the number of unmyelinated axons increased from proximal to distal by 11 (2%) to 220 (43%), whereas the number of myelinated axons increased by 20 (48%) in one nerve but decreased by 7-10 (13-21%) in the others. One day after nerve IX was cut distal to the petrosal ganglion, most myelinated axons in the sinus nerve were degenerating and only 109 unmyelinated axons were still present. By four days all but two myelinated axons were gone and the normal complement of unmyelinated axons was replaced by more than 1800 rounded profiles, most of which probably were pseudopodia of reactive Schwann cells. Transection of nerve IX central to the petrosal ganglion did not produce such ultrastructural changes in Schwann cells, nor did it reduce the number of axons in the sinus nerve to a degree sufficient to be detected by the counting procedure. Although these results indicate that most axons in the sinus nerve are sensory, some nonsensory axons undoubtedly are present too. The sensory and nonsensory axons in the nerve apparently are closely associated with one another and in some cases might be enveloped by the same Schwann cells.


New chloride-activated aminopeptidase from human erythrocytes.
A new Cl- -activated aminopeptidase was purified from the cytosol of human erythrocytes as a single chain protein of an approx. Mr of 70,000 and pI of 5.1. The enzyme hydrolysed 2-naphthylamides of aliphatic, aromatic and basic L-amino acids, with a preference for the alanyl residue. It also hydrolysed di-, tri-, and some hydrophobic tetrapeptides. The inhibitors were bestatin, amastatin, Co2+, Zn2+, Mn2+, 4-hydroxymercuribenzoate and 1,10-phenanthroline. The activity of the enzyme, inhibited by 4-hydroxymercuribenzoate, was partially restored by the addition of sulfhydryl compounds. The presence of 0.2 M Cl- (Br-,F-) caused a several-fold increase in the isolated aminopeptidase activity.


Irritability and its relationship with psychosocial symptoms and quality of life in adolescents with epilepsy receiving levetiracetam therapy: A case-control study.
Levetiracetam, a widely used anticonvulsant drug in children and adolescents, has been associated with irritability, psychosocial symptoms, and low quality of life, which are also influenced by other epilepsy variables. The objective of this study was to investigate the level of treatment-related irritability in adolescents receiving levetiracetam, and to evaluate the relationship between irritability levels and psychosocial symptoms, and quality of life. A cross-sectional, case-control study was conducted. Consecutive adolescent patients with epilepsy aged 11-17 years with partial or generalized seizures, treated with either levetiracetam or valproic acid for at least 6 months, and healthy controls were recruited. The Affective Reactivity Index parent report and self-report, Strengths and Difficulties Questionnaire, and Pediatric Quality of Life Inventory-Psychosocial subscale were utilized to assess irritability, psychosocial symptoms, and functioning. A total of 120 participants were analyzed; 33 patients in the LEV group, 45 patients in the VPA group, and 42 healthy controls. Both self and parent report irritability levels of the LEV group were found to be significantly higher than those of healthy controls. The irritability levels of the LEV and VPA groups were not statistically different, but still the LEV group had higher irritability levels on both scales. In the LEV group, irritability was positively correlated with behavioral, emotional, and attention/hyperactivity problems, and also negatively correlated with psychosocial quality of life. Adolescents with epilepsy using LEV have a high level of irritability and this is associated with some psychosocial symptoms and poor quality of life.


D-Lyxose as a substrate for Streptomyces D-xylose isomerase.
Results are presented which show that the D-xylose isomerases present in Streptomyces olivaceus and Streptomyces phaeochromogenes NRRL B-3559 are incapable of utilizing D-lyxose as a substrate. The implications of these findings as related to the use of D-lyxose in the selection of constitutive mutants are discussed.


Protein-protein interaction and functionTRPC channels.
Since their identification in the concluding years of the last century, the mammalian transient receptor potential (canonical) (TRPC) channels have remained in the limelight as the primary candidates for the Ca(2+) entry pathway activated by the hormones, growth factors, and neurotransmitters that exert their effect through activation of PLC. Although TRPC channels have been shown clearly to mediate, at least in part, receptor-activated Ca(2+) entry in literally all cell types, several of their central characteristics, as recorded in expression systems using recombinant channels, differ from those of the native receptor-dependent Ca(2+) influx channels. The present review attempts to highlight the interaction of TRPC channels with other proteins, which may explain the variability of TRPC channel activation and regulatory mechanisms observed with the native and recombinant channels. These include the homologous and heterotopous interactions of TRPC channel isoforms, the interaction of TRPC channels with calmodulin, PLCgamma, IP(3) receptors, and with scaffolding proteins like InaD, EBP50/NEHRF, caveolin, Janctate and Homers.


Targeting alpha-synuclein or tau for treating neurodegenerative movement disorders.
The two commonest groups of neurodegenerative disorders causing movement disorders are synucleinopathies and tauopathies. These disorders are characterised by the accumulation of abnormally misfolded forms of α-synuclein and tau proteins. Our current understanding of their pathogenesis suggests that extracellular forms of these proteins are of major relevance to the mechanism of pathology propagation throughout the brain and disease progression. The most novel approaches to find disease-modifying therapies aim to reduce or block these forms of tau and α-synuclein. This article reviews therapeutic strategies targeting α-synuclein and tau protein which have entered clinical development.


Stress, antioxidant defence and mucosal immune responses of the large yellow croaker Pseudosciaena crocea challenged with Cryptocaryon irritans.
To clarify the effects of a Cryptocaryon irritans infection on the stress, antioxidant and mucosal immune response of the large yellow croaker Pseudosciaena crocea, this study utilized C. irritans at dose of 12,000 (group I); 24,000 (group II); and 36,000 (group III) theronts/fish to infect large yellow croaker weighing 100 ± 10 g. The food intake, survival and relative infection intensity (RII); levels of reactive oxygen species (ROS), malondialdehyde (MDA) and vitamin C (VC), activities of super oxide dismutase (SOD) and catalase (CAT) in liver; variation patterns of lysozyme (LZM), alkaline phosphatase (AKP), complement component 3 (C3) and immunoglobulin M (IgM) levels in the body surface mucus at different time points after infection were compared. These results showed that with the increase of the infection dose and the passage of time, the food intake and survival of the fish gradually decreased. The final survival of the control group (0 theronts/fish), group I, group II, and group III was 100, 100, 96.67 ± 5.77, and 48.33 ± 7.64. Group I, II, and III stopped feeding respectively on the third, third and second days after infection. RII increased significantly with increased infection dose. The RII of the control group, group I, group II, and group III was 0, 0.73 ± 0.06, 1.30 ± 0.26, and 1.84 ± 0.02. With the infection dose increased, ROS contents showed an overall upward trend; MDA contents of the group I, group II and group III did not show significant changes at any timepoint compared with the control group; Activities of SOD and CAT and the overall VC levels in the liver of P. crocea dropped; LZM activity showed an overall upward trend; AKP activity increased first then dropped at each timepoint with its highest level appearing at group II; Complement C3 and IgM levels in body surface mucus were significantly increased. In conclusion, P. crocea has a strong ability to resist oxidative stress caused by the infection of C. irritans. The body surface mucus of P. crocea contains high levels of immune factors, which presented a rapid and significant response to the infection of C. irritans.


A guide to entry into specialist training.
Dental graduates have a number of career pathways to choose from, one of which is to train as a specialist. It is sometimes difficult to obtain good advice on entering the specialist training process. This paper, aimed at recent dental graduates, gives an overview of what is required of applicants who wish to obtain a specialty registrar (StR) position in one of the 13 dental specialties recognised by the General Dental Council. The potential financial implications of specialist training are outlined, along with information on dental foundation training, MFDS and MJDF examinations and postgraduate degrees. The importance of gaining experience in clinical governance and research is outlined. Advice regarding the application process and interview technique is also included. It is the authors' intention that, having read this paper, recent dental graduates will have increased knowledge of the various career paths that lead to specialisation and those interested in specialising will have improved knowledge of how to begin their journey.


Transfection in perfused microfluidic cell culture devices: A case study.
Automated microfluidic devices are a promising route towards a point-of-care autologous cell therapy. The initial steps of induced pluripotent stem cell (iPSC) derivation involve transfection and long term cell culture. Integration of these steps would help reduce the cost and footprint of micro-scale devices with applications in cell reprogramming or gene correction. Current examples of transfection integration focus on maximising efficiency rather than viable long-term culture. Here we look for whole process compatibility by integrating automated transfection with a perfused microfluidic device designed for homogeneous culture conditions. The injection process was characterised using fluorescein to establish a LabVIEW-based routine for user-defined automation. Proof-of-concept is demonstrated by chemically transfecting a GFP plasmid into mouse embryonic stem cells (mESCs). Cells transfected in the device showed an improvement in efficiency (34%, n = 3) compared with standard protocols (17.2%, n = 3). This represents a first step towards microfluidic processing systems for cell reprogramming or gene therapy.


Enhanced Thermal Conductivity and Dielectric Properties of Epoxy Composites with Fluorinated Graphene Nanofillers.
The demand for high-performance dielectrics has increased due to the rapid development of modern electric power and electronic technology. Composite dielectrics, which can overcome the limitations of traditional single polymers in thermal conductivity, dielectric properties and mechanical performance, have received considerable attention. In this study, we report a multifunctional nanocomposite material fabricated by blending fluorinated graphene (F-graphene) with epoxy resin. The F-graphene/epoxy composite exhibited a high thermal conductivity of 0.3304 W·m-1·K-1 at a low filler loading of 1.0 wt.%, which was 67.63% higher than that of pure epoxy. The composite dielectric also showed high breakdown strength (78.60 kV/mm), high dielectric constant (8.23), low dielectric loss (<0.015) and low AC conductivity (<10-11 S·m-1). Moreover, the composite demonstrated high thermal stability and strong mechanical strength. It is believed that the F-graphene/epoxy composite has outstanding performance in various aspects and can enable the development and manufacturing of advanced electric power and electronic equipment devices.


The roles and mechanism of m6A RNA methylation regulators in cancer immunity.
N6-methyladenosine (m6A), the most common internal modification in RNA, can be regulated by three types of regulators, including methyltransferases (writers), demethylases (erasers), and m6A binding proteins (readers). Recently, immunotherapy represented by immune checkpoint blocking has increasingly become an effective cancer treatment, and increasing shreds of evidence show that m6A RNA methylation affects cancer immunity in various cancers. Until now, there have been few reviews about the role and mechanism of m6A modification in cancer immunity. Here, we first summarized the regulation of m6A regulators on the expression of target messenger RNAs (mRNA) and their corresponding roles in inflammation, immunity response, immune process and immunotherapy in various cancer cells. Meanwhile, we described the roles and mechanisms of m6A RNA modification in tumor microenvironment and immune response by affecting the stability of non-coding RNA (ncRNA). Moreover, we also discussed the m6A regulators or its target RNAs which might be used as predictor of cancer diagnosis and prognosis, and shed light on the potentiality of m6A methylation regulators as therapeutic targets in cancer immunity.


Uvulopalatopharyngoplasty as a treatment for snoring.
Uvulopalatopharyngoplaty was performed in 18 consecutive patients (15 men and three women; mean +/- standard deviation [SD] age, 46.3 +/- 7.5 years) who presented for the treatment of heavy habitual snoring. No attempt was made to select patients who were ideal anatomically for palatal modification. The loudness of snoring was measured during sleep by integrating the output of a calibrated microphone. An assessment before operation showed that nine patients had obstructive sleep apnoea; four patients had an apnoea index of greater than or equal to 25 apnoeas per hour. The patients were overweight and consumed, on average, 38 g of alcohol per day, but these variables did not change after the operation. The postoperative assessment was performed 138 +/- 44 days after uvulopalatopharyngoplasty. Fourteen patients showed a reduction in the loudness of their snoring, although snoring was abolished in one patient only (average snoring loudness in arbitrary units/min of sleep, 2.8 +/- 2.1 before operation compared with 1.4 +/- 1.5 units/min of sleep after the operation; P less than 0.05. The loudest snore in arbitrary units measured 7.1 +/- 3.3 units compared with 4.8 +/- 3.3 units, respectively; P less than 0.05). The percentage of the sleep time that was spent at an arterial oxygen saturation of less than 90% was reduced after uvulopalatopharyngoplasty (28% +/- 32% of total sleep time compared with 17% +/- 24% of total sleep time, respectively; P less than 0.05). There was no change in the apnoea index. The diastolic blood pressure was lower at the postoperative assessment (94 +/- 11 mmHg compared with 87 +/- 8 mmHg; P less than 0.05); six of 10 subjects whose diastolic blood pressures were greater than or equal to 95 mmHg before the operation had a diastolic blood pressure of less than 95 mmHg after uvulopalatopharyngoplasty (P less than 0.02). Computed tomographic scans showed an increase in the upper airway cross-sectional area at 3 cm and 4 cm above the hyoid bone after uvulopalatopharyngoplasty (P less than 0.05). We conclude that uvulopalatopharyngoplasty is an effective treatment for habitual, heavy snoring in many patients, but it is not the treatment of choice for patients with clinically-significant obstructive sleep apnoea.


Effects of Tongue-Strengthening Self-Exercises in Healthy Older Adults: A Non-Randomized Controlled Trial.
Tongue-strengthening exercises (TSE) using a device have been proposed as an intervention for improving tongue strength and endurance. However, devices for TSE have been expensive and difficult to manipulate and are not commonly used in home or clinical settings. This study therefore aimed to investigate whether tongue-strengthening self-exercises (TSsE) using a tongue-strengthening self-exercise tool at home can improve tongue strength in healthy older adults. This study included 27 participants (exercise group, η = 16, 7 men, 9 women, median age 84.5 years; control group, n = 11, 2 men, 9 women, median age 79.0 years). Exercises in the exercise group consisted of pushing the anterior tongue against the hard palate 30 times, 3 times a day, 5 days a week, for 8 weeks using a tongue-strengthening self-exercise tool. This tool is available in five levels of hardness. The most suitable hardness of the tool for each participant was calculated based on 60% of maximum tongue pressure (MTP) during the first 2 weeks of the training period and 80% of MTP for the remainder of the training period, as assessed using a tongue pressure-measuring device. The exercise group showed a significant improvement of 4.1 kPa in MTP (an 11.53% increase) and 4.53 s in endurance of tongue pressure (ETP) (a 99.86% increase). Furthermore, adherence in the exercise group was 99.2%. In conclusion, performing TSsE for 8 weeks was effective for increasing MTP and ETP in healthy older adults. This indicates that TSsE may be useful in older individuals at home to prevent age-related tongue muscle weakness.


Prediction of poor neurological outcome in comatose survivors of cardiac arrest: a systematic review.
To assess the ability of clinical examination, blood biomarkers, electrophysiology, or neuroimaging assessed within 7 days from return of spontaneous circulation (ROSC) to predict poor neurological outcome, defined as death, vegetative state, or severe disability (CPC 3-5) at hospital discharge/1 month or later, in comatose adult survivors from cardiac arrest (CA). PubMed, EMBASE, Web of Science, and the Cochrane Database of Systematic Reviews (January 2013-April 2020) were searched. Sensitivity and false-positive rate (FPR) for each predictor were calculated. Due to heterogeneities in recording times, predictor thresholds, and definition of some predictors, meta-analysis was not performed. Ninety-four studies (30,200 patients) were included. Bilaterally absent pupillary or corneal reflexes after day 4 from ROSC, high blood values of neuron-specific enolase from 24 h after ROSC, absent N20 waves of short-latency somatosensory-evoked potentials (SSEPs) or unequivocal seizures on electroencephalogram (EEG) from the day of ROSC, EEG background suppression or burst-suppression from 24 h after ROSC, diffuse cerebral oedema on brain CT from 2 h after ROSC, or reduced diffusion on brain MRI at 2-5 days after ROSC had 0% FPR for poor outcome in most studies. Risk of bias assessed using the QUIPS tool was high for all predictors. In comatose resuscitated patients, clinical, biochemical, neurophysiological, and radiological tests have a potential to predict poor neurological outcome with no false-positive predictions within the first week after CA. Guidelines should consider the methodological concerns and limited sensitivity for individual modalities. (PROSPERO CRD42019141169).


Changes in malocclusion over time in New Zealand adolescents.
The Dental Aesthetic Index (DAI) has been used in many cross-sectional studies of population samples, but its use in assessing changes in malocclusion is less common. The aim of the present study was to describe the natural history of malocclusion and investigate the utility of the DAI as a measure for describing changes in malocclusion in a population-based sample of adolescents. A repeat examination was conducted of a sample of 430 children first assessed in 2003 at age 13 and re-examined at age 16 (255 or 59.3 per cent of the baseline sample) with their DAI and orthodontic history recorded at each age. Of the adolescents re-assessed, 28 were in active orthodontic treatment, 30 had completed treatment and 197 had not received any treatment. There were substantial changes in the DAI items from age 13 to 16, with the greatest improvement in maxillary anterior irregularity. Overall, almost one-quarter of participants showed an improvement in their DAI treatment need category which was considerably higher among those who had either received treatment or were in treatment. The DAI is a valid and responsive tool for measuring change in malocclusion over time. Anterior mandibular irregularity shows the greatest change with age, and orthodontic treatment is effective in treating malocclusion, at least in the short-term.


Characterization of cholinergic muscarinic receptors in the rabbit iris.
The sphincter smooth muscle of the iris is innervated by excitatory parasympathetic nerve fibers, and the activation of these fibers results in the breakdown of phosphatidylinositol 4,5-bisphosphate into its derived second messengers, myosin light chain phosphorylation and muscle contraction. The present study characterizes the muscarinic acetylcholine receptors (mAChRs) of the rabbit iris employing [3H]N-methylscopolamine ([3H]NMS) and L-[3H]quinuclidinyl benzilate ([3H]QNB) as probes. Binding studies indicated that [3H]NMS and [3H]QNB bound to homogeneous populations of mAChRs with apparent Bmax values of 0.67 and 1.09 pmol/mg protein respectively. Binding of radioligands was rapid, saturable, stereospecific, reversible, and inhibited by specific muscarinic agonists and antagonists in a competitive manner. [3H]NMS displayed a lower amount of nonspecific binding and a faster association and dissociation rate than [3H]QNB. The relative potencies for displacement of both radioligands, based on their Ki values, were (-)QNB greater than atropine greater than (+)QNB greater than pirenzepine greater than pilocarpine. Antagonist displacement of the radioligands appeared to obey the law of mass action, indicating interaction with a single binding site. However, displacement of the radioligands by the agonists carbamylcholine and methacholine indicated interaction with both high and low affinity binding sites. Comparison of the displacement of [3H]NMS and [3H]QNB by pirenzepine in microsomal fractions from rabbit iris, ileal muscle and cerebral cortex revealed the presence of a single subtype of mAChR in the iris which had an affinity for PZ that was slightly higher than that of ileal M2 receptors, but lower than that of brain M1 receptors. This suggests that the mAChRs in the iris may represent a subclass of receptors within the M2 subtype, or they may constitute an entirely different subtype of mAChRs.


[Current types of ceramics available or in use].
For years, dental profession tried, to find an ideal material and technique, for improving esthetic and functions. The use of porcelain fused to metal crowns, offered the opportunity to build up esthetic crowns on anterior and posterior teeth; however the metal substructure of porcelain fused to metal crown prevent us in many cases to achieve an ideal esthetic, as far as translucency is concerned. The ceramic built up on an alumina core, and the new castable ceramics seam to eliminate this problem, but the laboratory procedures are time consuming and complex, and their mechanical strength are still questionnable.


Gel high-performance liquid chromatographic studies on the elution behavior of chemically deglycosylated human chorionic gonadotropin and its subunits.
The elution behavior of human chorionic gonadotropin and its subunits, and their desialylated and deglycosylated derivatives was studied on gel high-performance liquid chromatography. Using three TSK G-SW columns, excellent separations were achieved for eleven human chorionic gonadotropin derivatives. In a comparison of the native (30% carbohydrate content), asialo (24%) and HF-deglycosylated (8%) subunits, the estimated values of molecular weights on the basis of a series of reference globular proteins deviated in various degrees from the actual molecular weight. The extent of deviation depended on the carbohydrate content and possibly the location of carbohydrate chains. The data from recombination studies suggest that the beta-subunit is the dominant determinant for their expanded molecular size.


Ascending fractional pulse pressure closely relating to large artery function.
It is not known whether ascending fractional pulse pressure (PPf) is related to large artery function. This study was to evaluate whether PPf is associated with large artery function by augmentation index. A total of 190 subjects were enrolled (age range: 50 to 78 years) who had normal contractions, no local asynergy, and no history of myocardial infarction. The ascending aortic pressure was measured using a fluid-filled system. To quantify the relative magnitude of the pulsatile to mean artery pressure, we normalised the pulse pressure to the mean pressure and referred to this value as PPf and the association between the PPf and the augmentation index was investigated. Augmentation index showed significant associations with PPf by univariate analysis (R = 0.690, P < 0.001). The associations between PPf and the factors influencing large artery function were examined by multivariate analysis, and PPf revealed significant associations with age, mean aortic pressure, heart rate and type 2 diabetes (R(2) = 0.477, P < 0.001). The results were that ascending aortic PPf is closely associated with large artery function detected by augmentation index.