Dentoskeletal changes due to rapid maxillary expansion in growing patients with tooth-borne and tooth-bone-borne expanders: A randomized clinical trial.
To compare, using cone-beam computed tomography, the dentoskeletal changes in rapid maxillary expansion with tooth-bone-borne (Hybrid Hyrax) and tooth-borne (Hyrax) appliances. Forty-two patients who met the eligibility criteria (aged 11-14 years; transverse maxillary deficiency, posterior crossbite, and presence of upper first premolars and molars) were screened and allocated into two groups: HHG (treatment with Hybrid Hyrax) and HG (treatment with Hyrax). The primary outcomes included nasomaxillary dimensional changes. CBCT was performed before and 3 months after the activation phase. Measurements were performed using Dolphin® . Baseline data were compared using one-way ANOVA. For intergroup comparison, ANCOVA was used to analyze the initial age, appliance activations (mm), and mid-palatal suture maturation data as covariates. Statistical significance was set at 5%. The premolar region in HHG showed increased skeletal changes than in HG, with the difference being 1.5 mm (0.5; 2.6) in the nasal cavity (P = .004), 1.4 mm (0.3; 2.5) in the nasal floor (P = .019), and 1.1 mm (0.2; 2.1) in the maxilla (P = .022). The molar region in HHG showed increased skeletal changes with the difference being 0.9 mm (0.2; 1.5) in the nasal cavity (P = .005), and 0.9 mm (0; 1.8) in the maxilla (P = .042) than in HG. Premolar inclination was higher in HG. Hybrid Hyrax showed more skeletal changes and fewer dental side effects, especially in the first premolar region. The amount of activation influenced the higher nasal skeletal changes in the Hybrid hyrax group.


[Ataralgesia with nalbuphine-midazolam instead of fentanyl-midazolam analgesia. Anesthesia and the postoperative control of pain. A preliminary report].
Nalbuphine-midazolam ataractanalgesia has been studied in anaesthesia and postoperative analgesia. Attention has been applied to the efficiency, pharmacological activity, side effects, adverse reactions of nalbuphine as a fentanyl substitute. Preliminary results show that nalbuphine could be used safely as anaesthesia component and as postoperative analgetic.


Protective effect of a synthetic peptide comprising the complete preS2 region of the hepatitis B virus surface protein.
A peptide was synthesized containing the entire 55 amino acid residue sequence of the hepatitis B virus (HBV) surface antigen preS2 region (ad subtype). The unconjugated peptide was inoculated into four chimpanzees. Following multiple injections, all of the animals developed specific antipeptide antibodies that reacted with intact surface antigen particles bearing the preS2 moiety. All four peptide-inoculated animals were found to be protected from infection after intravenous challenge with live HBV of either the ad or ay subtypes.


Garnet crystallization does not drive oxidation at arcs.
Arc magmas, the building blocks of continental crust, are depleted in total iron (Fe), have higher ratios of oxidized Fe to total Fe (Fe3+/∑Fe), and record higher oxygen fugacities (fO2's) compared with magmas erupted at mid-ocean ridges. Garnet crystallization could explain these observations if garnet removes substantial amounts of Fe2+, but not Fe3+, from magma, yet this model for continental crust generation has never been tested experimentally. Analysis of garnets and melts in laboratory experiments show that the compatibilities of Fe2+ and Fe3+ in garnet are of similar magnitudes. Our results indicate that fractional crystallization of garnet-bearing cumulates will remove 20% of total Fe from primary arc basalts but negligibly alter the Fe3+/∑Fe ratio and fO2 of the melt. Garnet crystallization is unlikely to be responsible for the relatively oxidized nature of basaltic arc magmas or the Fe-depletion trend observed in continental crust.


Co-liposomes having anisamide tagged lipid and cholesteryl tryptophan trigger enhanced gene transfection in sigma receptor positive cells.
Selective gene transfection could be strategy of interest for reducing off-target gene expression and toxicity. In this respect, sigma receptors are found to be over-expressed in many human tumors and liposomal formulations with ability to target these sigma receptors may improve the transfection efficiency to a significant level. To this direction, six novel lipids have been synthesized with different hydrophobic segments such as a long hydrophobic chain or a cholesteryl group and L-tryptophan as the head group. Three of them, Lipid 1, 3 and 5 possessed cationic Me3N(+) moiety at the distal end. In contrast each of the other three Lipid 2, 4 and 6 possessed sigma receptor targeting anisamide group with no cationic charge. Mixing of cationic and anisamide counterparts of the same lipid in a molar ratio of 1:1 produced co-liposomes L-M-1 (Lipid 1+2), L-M-2 (Lipid 3+4) and L-M-3 (Lipid 5+6). These co-liposomes, while keeping the sigma targeting anisamide tag intact, showed good DNA binding and release which were optimized from EB intercalation and gel electrophoresis assays. Inclusion of a zwitterionic, fusogenic natural lipid, DOPE, into the co-liposomes further improved the binding efficiencies of the lipid mixtures with DNA. These co-liposomes having cationic and anisamide lipids and DOPE were highly selective toward sigma positive HEK293 and HEK293T cells compared to the sigma negative HeLa cells. As evidenced from both FACS and luciferase assay, a lipid mixture comprising Lipid 3, 4 and DOPE in a molar ratio of 1:1:1 (L-M-2D1) was the best for transfection of reporter pEGFP-C3 and functional pCEP4-p53 gene plasmids. Anisamide mediated sigma receptor selectivity was further probed by pre-incubating the transfecting cells with lipids possessing anisamide and by quantification of the un-transfected plasmid DNA. Also each formulation was highly non-toxic in the cell lines examined.


Phosphatidylserine's role in Ebola's inflammatory cytokine storm and hemorrhagic consumptive coagulopathy and the therapeutic potential of annexin V.
The phosphatidylserine (PS) molecule is present in cell membranes where it is actively kept on their inner leaflets but when cells are damaged it moves to the surface and become a signal for their removal, the platform upon which the coagulation cascade takes place and a ligand that activates a feedback cycle of inflammatory cytokine secretion and initiates the wakeup call for the innate immune response. These are physiologic responses to PS but the Ebola virus displays PS molecules on its membrane's surface and the huge numbers of viruses cause a pathologic inflammatory cytokine storm and a hemorrhagic consumptive coagulopathy. Annexin V is an innate molecule that can cloak membrane displayed PS and prevents its Th1 cell's inflammatory cytokine generation and cascade thrombin generation. The hypothesis presented is that its administration will cloak PS and prevent Ebola's consumptive coagulopathy and its cytokine storm.


Synaptotagmin XI in Parkinson's disease: New evidence from an association study in Spain and Mexico.
The pathophysiology of PD (Parkinson's disease) has been related to the ubiquitin proteasome system and oxidative stress. Parkin acts as ubiquitin ligase on several substrates. Because genetic variants often have different frequencies across populations, population specific analyses are necessary to complement and validate results from genome-wide association studies. We carried out an association study with genes coding for parkin substrates and cellular stress components in the Galician population (Northern Spain). SNCA and MAPT SNPs were also analyzed. We studied 75 SNPs in a discovery sample of 268 PD patients and 265 controls from Galicia. A replication sample of 271 patients and 260 controls was recruited from Mexico City. We observed significant association between PD and SNPs in MAPT. Nominal p-values<0.05 were obtained in the Galician cohort for SNPs in SYT11, coding for synaptotagmin XI. These results were replicated in the Mexican sample. The associated markers lie within a ~140kb strong linkage disequilibrium segment that harbors several candidate genes, including SYT11. SNPs from the GBA-SYT11-RAB25 region have been previously associated with PD, however the functionally relevant variants remain unknown. Our data support a likely role of genetic factors within 1q22 in PD susceptibility.


Postoperative Outcomes, Weight Loss Predictors, and Late Gastrointestinal Symptoms Following Laparoscopic Sleeve Gastrectomy.
To evaluate the outcomes, weight loss predictors, and gastrointestinal symptoms of patients after laparoscopic sleeve gastrectomy (LSG). The postoperative medical status of the patients was obtained retrospectively using a questionnaire and was compared to existing medical data before the surgery. We included 201 candidates, 178 patients completed mean of 3 years of follow-up. Mean excess body weight loss (%EWL) was 65.14% ± 15.74 at 6 months, 78.53% ± 20.28 at 12 months, and 74.32% ± 23.92 at 3 years after LSG. Older age (P = 0.018), higher baseline BMI (P = 0.003), and higher number of medications (P < 0.001) were negative predictors for EWL%. Total weekly hours of physical activity was found to be a positive predictor for EWL% (P = 0.008). Remission rates of co-morbidities were 83.5% for dyslipidemia (P < 0.001), 65.8% for hypertension (P < 0.001), 62.1% for type 2 diabetes mellitus (T2DM) (P < 0.001), and 60.7% for gastroesophageal reflux (GERD) (P < 0.001). Late gastrointestinal symptoms were as follows: emesis in 25.9%, constipation in 24.7%, diarrhea in 4.5%, food intolerance in 22.5% and alopecia in 42.7% of the patients. Our study shows LSG as a potential tool in achieving almost 75% of EWL% with significant remission of co-morbidities, along with various late gastrointestinal symptoms.


Body-size differences in a colonizing amphipod-mollusc assemblage.
We examined body size patterns in a colonizing assemblage of marine amphipods and molluscs. We collected animals over a 25 day period from an archipelago of pits that were drilled in brick surfaces. The percent of pits occupied, abundance, species richness, and body size of colonists all increased significantly through time. We compared size ratios of coexisting species with two null models, one that randomized individuals and one that randomized species-populations. For both models, observed overlap ratios usually did not differ from randomness, although species richness was consistently lower than expected for later samples. Results were similar for a subset of the data, a guild of suspension/deposit feeding amphipod species. Some assemblages did show significant deviations from the null models, but the results were spotty and varied among replicates. Overall, the evidence for non-random overlap ratios in body sizes of colonizers was weak.


Effect of active fraction of cerebral on expression of caspase-3 and beta-amyloid precursor protein during therapy of hemorrhagic stroke in the acute and delayed periods.
Active anti-stroke fraction of Cerebral preparation (extract of water-soluble molecules from brain tissue of animals with hemorrhagic stroke) decreased caspase-3 expression and improved survival of experimental animals in the acute period after hemorrhagic stroke.


Thermomechanical behavior of collagen-cross-linked porcine cornea.
Collagen cross-linking using combined riboflavin/UVA treatment has been shown to increase the biomechanical rigidity of the cornea and has been used successfully for the treatment of progressive keratoconus. From morphological and biochemical investigations, a different degree of cross-linking for the anterior and posterior stroma by the treatment is suggested. The present study was undertaken to better evaluate this effect by testing the thermomechanical behavior. Ten 10 x 5 mm corneal strips from porcine cadaver eyes enucleated within 5 h post mortem were cross-linked using the photosensitizer riboflavin and UVA irradiation (370 nm, irradiance = 3 mW/cm(2)) for 30 min and compared to ten untreated corneal strips and ten corneal strips cross-linked with 0.1% glutaraldehyde. The temperature in a water bath was raised from 60 to 95 degrees C with temperature increments of 1 degrees C per minute. The hydrothermal shrinkage of the corneal strips was measured in 2.5 degrees C steps using a micrometer. In addition, six 10-mm whole corneal buttons were cross-linked with riboflavin/UVA and immersed into water at 70 or 75 degrees C. The maximal hydrothermal shrinkage for the untreated control specimens and the posterior portion of the riboflavin/UVA-treated corneas was at 70 degrees C, for the anterior portion of the cornea cross-linked by riboflavin/UVA at 75 degrees C and for glutaraldehyde-cross-linked cornea at 90 degrees C. In the cross-linked corneal buttons, a typical mushroom-like shape was observed at 70 degrees C and a cylinder shape at 75 degrees C. The different degree of collagen cross-linking in the corneal stroma after riboflavin/UVA treatment is reflected by the differences in the maximal shrinkage temperature of the anterior and posterior portion. Therefore, in the corneas cross-linked with riboflavin/UVA a higher shrinkage temperature was observed for the anterior portion of the cornea (75 degrees C) compared to the posterior stroma (70 degrees C) due to the higher degree of cross-linking of the anterior stroma. The anterior localization of the cross-linking effect is advantageous for the endothelium and for the preservation of the anterior corneal curvature.


Polycystic ovary syndrome: a new direction in treatment.
Polycystic ovary syndrome is a diagnosis made in 5%-10% of women between late adolescence and the menopause. Patients may present with oligomenorrhoea or amenorrhoea, anovulation or infertility, hirsutism or acne. Women with the syndrome have at least seven times the risk of myocardial infarction and ischaemic heart disease of other women, and by the age of 40 years up to 40% will have type 2 diabetes or impaired glucose tolerance. Polycystic ovary syndrome is associated with insulin resistance, with consequent hyperinsulinaemia and (frequently) hyperlipidaemia and obesity. Recent research has shown that the application of diabetes management techniques aimed at reducing insulin resistance and hyperinsulinaemia (such as weight reduction and the administration of oral hypoglycaemic agents) can not only reverse testosterone and luteinising hormone abnormalities and infertility, but can also improve glucose, insulin and lipid profiles. The management of polycystic ovary syndrome should now include patient education and attention to diabetes and cardiovascular risk factors such as hyperlipidaemia, obesity, physical exercise, glucose intolerance, hypertension and cigarette smoking.


A novel human estrogen receptor beta: identification and functional analysis of additional N-terminal amino acids.
A novel human estrogen receptor beta (hERbeta) was cloned from human testis mRNA, ovary and thymus cDNA utilizing PCR and 5' RACE methods. The 5' end of hERbeta contained an additional open reading frame, in-frame and upstream of the published clones. hERbeta encodes a protein of 530 amino acids with an approximate molecular weight of 63 kDa and is larger than the previously reported rat, mouse and human protein. To determine the functional role of additional N-terminal amino acids, we compared the transcription functions of receptor lacking (hERbetaT) and receptor containing (hERbetaL) this N-terminal extension. hERbetaL is more active than hERbetaT in transactivating ERE-based reporter genes. hERbetaL, but not hERbetaT, attenuated cytokine mediated NFkappaB activation. Taken together, the additional N-terminal amino acids appear to play a role in modulating estrogen responsive gene expression in vitro.


Recovery of cardiac autonomic responsiveness with low-intensity physical training in patients with chronic heart failure.
A gradual worsening of autonomic control of cardiovascular function accompanies the progression of heart failure. Exercise training modulates autonomic balance, and may affect the prognosis of the disease. The sympathovagal balance was studied after 3 months of low-intensity rehabilitation compared with conventional therapy in 45 patients with heart failure (52% ischemic, 48% idiopathic), of whom 30 underwent rehabilitation and 15 did not. In 11 rehabilitated patients we also studied the effects on autonomic profile of 6 additional months of home-based training. Rehabilitated and non-rehabilitated patients had similar NYHA class, ejection fraction, exercise pVO2; 50% assumed carvedilol (39+/-5 mg/day). Autoregressive power spectral density of RR intervals variability were assessed during 10 min of: (1) supine rest and free breathing; (2) supine rest and breathing at 20 acts/min (=vagal stimulus); (3) standing (=sympathetic stimulus). During each period, the ratio LF/HF of the individual autospectrum indicated the sympathovagal balance. After 3 months of rehabilitation, pVO2 increased (20%); LF/HF at rest was unchanged (8.7+/-1.2 vs. 9.2+/-1.2); it decreased with controlled breathing (-18%) and increased during standing (+79%) (P<0.05). These changes were more evident after 6 months of home-based training, when pVO2 was still high: LF/HF at rest was reduced (5.4+/-0.9 vs. 8.5+/-2.1), decreased during controlled breathing (-17%) and increased during standing (87%) (P<0.05). No changes in any variable were seen in non-rehabilitated patients. A low intensity rehabilitation program restores autonomic tone and reactivity to vagal and sympathetic stimuli. Some of these effects are already evident after the initial hospital-based phase.


Varenicline and related interventions on smoking cessation: A systematic review and network meta-analysis.
Based on randomized controlled trials, a network meta-analysis was conducted to compare treatment effects across varenicline and related smoking interventions. English databases were screened for randomized controlled trials reporting the effect of varenicline as treatment for smoking. The risk of bias in included trials was assessed using the Cochrane Handbook tool. Stata 15.1 software was used to perform network meta-analysis, and the GRADE approach was used to assess the evidence credibility on the tobacco treatment effects of different interventions. Thirty-four studies involving 26,130 smokers were included in the network meta-analysis. Varenicline and 11 other interventions were reported, yielding 66 pairs of comparisons. Network meta-analysis showed that varenicline monotherapy or its combination with other interventions were superior in achieving smoking cessation compared to bupropion, nicotine replacement therapy, counselling, and placebo. Furthermore, compared to the varenicline, evident abstinence superiority was found in varenicline + bupropion (odds ratio = 1.49, 95% confidence interval [1.02, 2.18]). Finally, the surface under the cumulative ranking curve value indicated that varenicline + bupropion has the highest probability to become the best intervention. Varenicline monotherapy increased the odds of smoking cessation further than bupropion monotherapy, nicotine replacement therapy, counselling, and placebo, while varenicline combined with other interventions may even achieve a better abstinence effect. More credible evidence has been reported indicating that the combination of varenicline and bupropion is a superior treatment for smoking.


Inducing factors and deformation mechanism of the Zhangjiacitang landslide in the Three Gorges Reservoir Area.
Landslides are the most widely distributed geological hazards in the Three Gorges Reservoir Area (TGRA). Understanding the deformation mechanism and evolution of landslides is of great significance for their prevention and control. In this study, we focused on the Zhangjiacitang landslide, a typical bank landslide in the TGRA. We analyzed the relationship between landslide deformation and water level fluctuations and rainfall, based on accumulated displacement monitoring data, to clarify their triggering factors and deformation mechanism. The results show that the Zhangjiacitang landslide is a large-scale accumulation landslide. Under the influence of cyclic water level fluctuations and periodic rainfall, the accumulated displacement-time curve shows a "stepped" characteristic. Heavy rainfall emerged as the primary factor influencing the deformation of the Zhangjiacitang landslide, leading to substantial deformation throughout different periods. The deformation of the landslide exhibited a positive correlation with the intensity of rainfall. In contrast, the impact of water level changes on the landslide deformation was more intricate. A rapid water level drop (> 0.3 m/d) tended to intensify the landslide deformation, while the slow water level drop period (< 0.3 m/d) did not exhibit such an effect. This study emphasizes the need for closely monitoring the landslide status during heavy rainfall periods and rapid water level decline periods. The findings of this study provide a certain reference for landslide monitoring, early warning, prevention and control in the TGRA.


Alternative approaches to cervical cancer screening for developing countries.
Cervical cancer remains the most common cancer among women living in developing countries, largely because of the failure either to initiate or sustain effective cervical-cancer screening programmes. This potentially preventable and curable cancer continues to cause high mortality among relatively young women residing in low-resource countries. Cytology as a screening test, linked with a robust healthcare infrastructure, has significantly affected cervical cancer prevention in countries that have had sufficient resources to establish and sustain well-conducted programmes. The failure to establish such programmes has stimulated a large body of research into alternative screening tests and approaches to cervical-cancer prevention. Two of the most recent research methods have been visual inspection with acetic acid and molecular testing for high-risk types of human papillomavirus deoxyribonucleic acid. Visual inspection with acetic acid has shown a great deal of promise in cross-sectional studies; however, in randomised-controlled trials, it has been shown to be significantly less effective in reducing cervical cancer or its precursors. The development of point-of-care human papillomavirus or other highly sensitive tests for the prevention of cervical cancer is imperative. It has also been clearly shown that linking testing or screening to treatment (so-called 'screen and treat') without the intervention of colposcopy or the need for sophisticated laboratories may potentially prevent cervical cancer in large numbers of women.


Seed predation in the legume Crotalaria : I. Intensity and variability of seed predation in native and introduced populations of C. pallida ait.
In order to evaluate the role of seed predators as selective agents within a population of conspecific plants, the intensity of predispersal seed predation by chewing insects and the variation in predation intensity with individual and season were measured for the legume shrub Crotalaria pallida. In a native, tropical (East African) population, predation intensity averaged 49% for late dry season-early wet season samples, but ranged from less than 20% to near 100% for different individuals. Average seedcrop loss varied markedly with season, and these seasonal shifts differed in two adjacent sites, probably due at least in part to transient predator satiation. However, individual plants differed significantly in intensity of seed predation sustained, and these individual differences were apparently maintained consistently in the face of the seasonal changes. For introduced, temperate-zone (North Carolina, USA) populations of the same species, predation averaged only 16-17%, but the proportionate variation among individuals was even greater than for the African population. These results support the hypothesis that predators inflict substantial differential seed mortality and discriminate consistently among individual plant seedcrops, thus exerting strong selection within plant populations.


Sexual and reproductive healthcare for women asylum seekers in Switzerland: a multi-method evaluation.
Forced migration significantly endangers health. Women face numerous health risks, including sexual violence, lack of contraception, sexually transmitted disease, and adverse perinatal outcomes. Therefore, sexual and reproductive healthcare is a significant aspect of women asylum seekers' health. Even when healthcare costs of asylum seekers are covered by the government, there may be strong barriers to healthcare access and specific needs may be addressed inadequately. The study's objectives were a) to assess the accommodation and healthcare services provided to women asylum seekers in standard and specialised health care, b) to assess the organisation of healthcare provision and how it addresses the sexual and reproductive healthcare needs of women asylum seekers. The study utilised a multi-method approach, comprising a less-dominant quantitative component and dominant qualitative component. The quantitative component assessed accommodation conditions for women in eight asylum centres using a survey. The qualitative component assessed healthcare provision on-site, using semi-structured interviews with health and social care professionals (n = 9). Asylum centres were selected to cover a wide range of characteristics. Interview analysis was guided by thematic analysis. The accommodation in the asylum centres provided gender-separate rooms and sanitary infrastructure. Two models of healthcare were identified, which differed in the services they provided and in their organisation: 1) a standard healthcare model characterised by a lack of coordination between healthcare providers, unavailability of essential services such as interpreters, and fragmented healthcare, and 2) a specialised healthcare model specifically tailored to the needs of asylum-seekers. Its organisation is characterised by a network of closely collaborating health professionals. It provided essential services not present in the standard model. We recommend the specialised healthcare model as a guideline for best practise. The standard, non-specialised healthcare model used in some regions in Switzerland does not fully meet the healthcare needs of women asylum seekers. Specialised healthcare services used in other regions, which include translation services as well as gender and culturally sensitive care, are better suited to address these needs. More widespread use of this model would contribute significantly toward protecting the sexual and reproductive integrity and health of women asylum seekers.


Engaging in pleasant events explains the relation between physical disability and mental health outcomes in older adults.
This study expands the body of research examining mediators of the association between physical disability and mental health outcomes. Based on the behavioral model of depression, frequency of pleasant events were examined as a mediator between physical disability and mental health outcomes including depressive symptoms, meaning in life, and positive affect. We predicted that physical disability would have a significant indirect effect on mental health outcomes through the lower frequency of pleasant events. Cross-sectional study of 82 community-dwelling adults, Mage = 77.6, SD = 8.0, 64.6% female, was conducted. Self-report instruments measured frequency of pleasant events, physical disability, and mental health outcomes (depression symptoms, positive affect, and meaning in life). Simple mediation analyses demonstrated a significant indirect effect of physical disability on depressive symptoms (unstandardized coefficient = 0.16, 95% bias-corrected CI 0.03, 0.41), positive affect (unstandardized coefficient = -2.65, 95% bias-corrected CI -5.38, -0.88), and meaning in life (unstandardized coefficient = -1.58, 95% bias-corrected CI -3.19, -0.47) through engagement in pleasant events. Physical disability was associated with greater depressive symptoms and lower positive affect and meaning in life through reduced frequency of pleasant events. These findings are consistent with the behavioral model of depression and support several applied recommendations for reducing the burden of physical disability on mental health outcomes.


Ring opening of nucleosidic 1',2'-epoxides with aluminum reagent: a new stereoselective entry to 1'-C-substituted ribonucleosides.
Dimethyldioxirane-mediated epoxidation of 3',5'-O-(di-t-butylsilylene)-1',2'-dehydro uridine (6) proceeded face-selectively to give 1',2'-alpha-epoxyuracil nucleoside (7). When 7 was treated with Me3Al, an anomeric mixture of the target 1'-C-alpha-methyluridine derivative 8 and its epimer 9 (86%, 8/9 = 5/1) was obtained. On the other hand, N3-protection improved the stereoselectivity in the ring-opening reaction. Thus, N3-benzyloxymethyl (BOM)-1',2'-epoxy nucleoside 11 obtained from 10 gave the target 12 as the sole product.


Angiographic follow-up after successful percutaneous coronary angioplasty for chronic total coronary occlusion: experience in 110 consecutive patients.
Percutaneous transluminal coronary angioplasty (PTCA) was performed in 110 consecutive patients (111 vessels) with chronically occluded coronary arteries and was successful in 69 patients (69 vessels). Successful initial PTCA was related to the extent of coronary artery disease, the morphology of the proximal surface of the occlusion site, and the clinical duration of occlusion. Repeat angiography was performed for 62 patients, with successful initial PTCA and demonstrated restenosis in 34 (55%) patients, of whom 11 had total occlusion. Repeat PTCA was performed in 30 patients and was successful in 80%. Follow-up angiography after repeat PTCA was carried out in all patients who underwent successful second PTCA, and, it demonstrated re-restenosis in 7 (29%) patients. In this study, among 111 total occlusions, 28 vessels undergoing successful initial PTCA and 17 undergoing successful repeat PTCA were free from restenosis or re-restenosis at the time of follow-up angiography.


The oxygen consumption/oxygen delivery curve in severe preeclampsia: evidence for a fixed oxygen extraction state.
Increased total body oxygen consumption requirements are usually met by increased oxygen delivery and increased oxygen extraction. In certain conditions (e.g., adult respiratory distress syndrome) the ability to increase oxygen extraction is lost, and any increase in oxygen consumption depends on increased oxygen delivery. The objective of this study was to investigate the oxygen delivery/oxygen consumption relationship in severe preeclampsia. Thirty-two patients with severe preeclampsia (blood pressure > 160/110 mm Hg; 3 to 4+ proteinuria) were monitored with a pulmonary artery catheter. Baseline oxygen consumption and delivery in a group without volume expansion or pharmacologic vasodilatation were compared with those in a group who had received a magnesium sulfate infusion. Oxygen consumption, oxygen delivery, arterial-venous-oxygen difference, and the oxygen extraction ratio were low when compared to that for normal 32 to 38 week pregnancy. The oxygen extraction ratio, defined as the ratio of oxygen consumption to oxygen delivery, was abnormally low for pregnancy, especially considering the low oxygen delivery levels in these patients. Oxygen consumption was dependent on oxygen delivery over the entire range of values seen. Severe preeclampsia is associated with an abnormality of tissue oxygen extraction, as evidenced by a low and unresponsive oxygen extraction ratio. Oxygen consumption increases proportionately with increases in oxygen delivery without reaching an oxygen delivery-independent state. Even at high oxygen delivery levels the oxygen consumption in preeclamptic patients is still abnormally low for pregnancy.


Intraperitoneal chromic phosphate therapy after second-look laparotomy for ovarian cancer.
Between 1973 and 1985, 118 patients in clinical remission after initial surgery and postoperative chemotherapy for epithelial ovarian carcinoma underwent second-look laparotomy at the University of North Carolina. No evidence of disease (NED) was found in 57 of these patients; 43 patients received 15 mCi of radioactive chromic phosphate (32P) suspension given intraperitoneally in the immediate postoperative period. In 29 other patients, only microscopic or minimal residual disease (nodules less than 2 cm in size) was found, seven received 32P alone, ten received 32P and further chemotherapy, and 12 received chemotherapy alone. The 4-year postsecond-look survival of the patients with NED at second-look was 89% for those receiving 32P and 67% for those who had not. The respective figures for patients with minimal residual disease at second-look are 59% versus 22%. Irrespective of treatment, a group at high risk for failure after negative second-look laparotomy has been identified; those with an initial International Federation of Gynecology and Obstetrics (FIGO) stage greater than I and histologic grade greater than 1. A comparison of our data with 18 previously published series, indicates that use of postsecond-look intraperitoneal 32P can improve the progression-free interval, and possibly overall survival, of patients with NED or minimal residual disease without adding significant complications.


PROtective Ventilation with a low versus high Inspiratory Oxygen fraction (PROVIO) and its effects on postoperative pulmonary complications: protocol for a randomized controlled trial.
Postoperative pulmonary complications (PPCs) are the most common perioperative complications following surgical site infection (SSI). They prolong the hospital stay and increase health care costs. A lung-protective ventilation strategy is considered better practice in abdominal surgery to prevent PPCs. However, the role of the inspiratory oxygen fraction (FiO2) in the strategy remains disputed. Previous trials have focused on reducing SSI by increasing the inhaled oxygen concentration but higher FiO2 (80%) was found to be associated with a greater incidence of atelectasis and mortality in recent research. The trial aims at evaluating the effect of different FiO2 added to the lung-protective ventilation strategy on the incidence of PPCs during general anesthesia for abdominal surgery. PROtective Ventilation with a low versus high Inspiratory Oxygen fraction trial (PROVIO) is a single-center, prospective, randomized controlled trial planning to recruit 252 patients undergoing abdominal surgery lasting for at least 2 h. The patients will be randomly assigned to (1) a low-FiO2 (30% FiO2) group and (2) a high-FiO2 (80% FiO2) group in the lung-protective ventilation strategy. The primary outcome of the study is the occurrence of PPCs within the postoperative 7 days. Secondary outcomes include the severity grade of PPCs, the occurrence of postoperative extrapulmonary complications and all-cause mortality within the postoperative 7 and 30 days. The PROVIO trial assesses the effect of low versus high FiO2 added to a lung-protective ventilation strategy on PPCs for abdominal surgery patients and the results should provide practical approaches to intraoperative oxygen management. www.ChiCTR.org.cn , identifier: ChiCTR18 00014901 . Registered on 13 February 2018.


[Development of software system of medical monitoring equipment in spacecraft].
To develop a software system that can gather, manage and transmit signals of electrocardiograms, respiration, body temperature and blood pressure at real time, in order to monitor physiological signals of astronauts. Based on single-chip microprocessor, software system completed the A/D conversion, real-time signal processing, storage and transmission. The software system realized data acquisition of electrocardiogram, respiration, body temperature and blood pressure, as well as heart rate extraction from electrocardiogram, storage of physiological data, and transmission of physiological parameters to spacecraft. The software system could meet the needs of medical monitoring during manned spaceflight.


Pericytes as mediators of infiltration of macrophages in multiple sclerosis.
Multiple sclerosis (MS) is a neurodegenerative condition of the central nervous system (CNS). It is associated with blood-brain barrier (BBB) breakdown and intravasation of leukocytes, particularly monocyte-derived macrophages, into the CNS. Pericytes are mural cells that are encased within the basement membrane of vasculature, and they contribute functionally to the neurovascular unit. These cells play an important role in maintaining BBB integrity and CNS homeostasis. However, the critical role of pericytes in mediating inflammation in MS or its models is unclear. Whether pericytes infiltrate into the CNS parenchyma in MS also needs clarification. CNS samples from the experimental autoimmune encephalomyelitis (EAE) mouse model of MS were collected at different time points for immunohistochemical analysis of pericytes along the inflamed vasculature. These findings were validated using MS brain specimens, and further analysis of pericyte involvement in inflammation was carried out by culturing primary pericytes and macrophages. Multiplex ELISA, transmigration assay and real-time PCR were used to study the inflammatory potential of pericytes in cultures. We found that pericytes exhibit a heterogenous morphology, with notable elongation in the inflamed perivascular cuffs of EAE. This was manifested by a decrease in pericyte density but an increase in the coverage by pericytes along the vasculature. Chondroitin sulfate proteoglycans (CSPGs), a family of extracellular matrix proteins enriched within inflamed perivascular cuffs, elevated levels of pro-inflammatory chemokines/cytokines in pericytes in culture. Importantly, pericytes stimulated with CSPGs enhanced macrophage migration. We did not detect pericytes in the CNS parenchyma during EAE, and this was corroborated in MS brain samples. Our data suggest that pericytes seek to restore the BBB through increased coverage, but that their exposure to CSPGs prompt their facilitation of macrophages to enter the CNS to elevate neuroinflammation in EAE and MS.


Transcriptome analysis of colorectal cancer liver metastasis: The importance of long non-coding RNAs and fusion transcripts in the disease pathogenesis.
Despite several attempts to define the many genomic aspects of colorectal cancer liver metastasis (CRC-LM), there is still a lack of a complete and accurate picture of the cancer transcriptome and its function in the generation of metastasis. Cancer Genome Atlas Sequence Read Archive (SRA) was used to get RNA sequencing data for CRC-LM and primary CRC. The CDseqR deconvolution method followed by the edgeR statistical approach was employed to accurately find differentially expressed genes (DEGs). Weighted gene co-expression network analysis (WGCNA) was used to determine the long non-coding RNA (lncRNA) and mRNA pairs in CRC-LM etiology. Three alternative methods were used to explore fusion transcripts to anticipate the potential driver chimeras. Multiple cancer-related pathways were enriched in the up-regulated genes, including cell cycle, DNA replication, and RNA transport. SPP1 was the most up-regulated gene important in the cellular proliferation and migration and CCDC152 was the most down-regulated gene known in the metastatic spread of CRC. There were seven distinct lncRNAs discovered, two of which were novel (LOC107984834 and LOC107985040) and associated with metastatic related pathways such as the extracellular matrix-receptor interaction. Overall survival analysis demonstrated that SPP1 and LOC107985040 were significantly associated with poor prognosis outcomes. Seven new fusion transcripts were found in seven CRC-LM patients (22.5%) anticipated to have potential driver functions in cancer. The newly discovered dysregulated genes and other transcriptome abnormalities could contribute to a better understanding of the CRC-LM underlying mechanism, leading to the development of new diagnostic, prognostic, and therapeutic molecular options for personalized medicine.


Angiogenesis and hypertension.
The formation of new blood vessels is an important process in embryonic development and in physiological repair processes. Abnormalities in blood vessel growth have been associated with various pathologies. The basic observation underlying the hypothesis that essential hypertension is based on an impaired capacity for vascular growth is the nature of the structural alterations of microvascular beds in essential hypertension. Recent advances in understanding the molecular and cellular mechanisms of vascular growth suggest that the remodeling of individual vessels and vascular networks in hypertension may be a pathological variant of the formation of mature networks. Genetic and fetal influences appear to have significant effects in determining impaired vascular development as an early cause of essential hypertension.


Taste development: differential growth rates of tongue regions in humans.
There is a paucity of information about the anatomical and functional development of the human gustatory system. Although the anatomical development of the taste-sensitive fungiform, circumvallate and foliate papillae in the respective anterior, posterior and latero-posterior regions of the dorsal surface of the tongue has been well documented in the fetus, there is limited information about how these regions grow and when they exhibit adult function. The present study is concerned with determining when the growth of one of these taste-sensitive regions becomes adult in size, namely, the anterior region, and how this growth compares with that of the remaining posterior region. Two-hundred and thirty-two living subjects aged between 4 and 32 years participated. Following the identification and marking of a series of landmarks on the dorsal surface of the tongue with blue food dye, five measurements of the width and length of various parts of the tongue allowed calculation of the growth of the anterior and posterior regions. The results indicate that the fungiform papillae-rich anterior region attains adult-size by 8-10 years of age whilst the posterior region continues to grow until 15-16 years. Interestingly, this early development is not matched by achievement of adult function [Dev. Brain Res. 82 (1994) 286] or adult size papillae or taste pores [Dev. Brain Res., submitted]. Finally, the findings of the present study will allow studies of the development of taste function in humans to be conducted using equivalent tongue areas in subjects of different ages.


Reliability of dynamic sentinel node biopsy combined with ultrasound-guided removal of sonographically suspicious lymph nodes as a diagnostic approach in patients with penile cancer with palpable inguinal lymph nodes.
Dynamic sentinel node biopsy (DSNB) is considered "unsuitable" in patients with penile cancer and palpable inguinal lymph nodes. The aim of this study was to determine the diagnostic reliability of DSNB combined with ultrasound (US)-guided removal of additional suspicious lymph nodes as a minimally invasive diagnostic approach in these patients. A total of 23 consecutive patients with penile cancer and unilaterally or bilaterally palpable inguinal lymph nodes underwent DSNB according to the 2-day protocol. Before the combined staging procedure, the patients underwent preoperative US of both groins. During surgery, sentinel nodes and additional suspicious lymph nodes as determined by the US examination were removed under US guidance. A complete inguinal lymph node dissection was only performed in patients who had tumor-positive nodes. Follow-up consisted of control visits according to the European Association of Urology guidelines, including US investigation of the groins. The primary tumors were staged as T1, T2, and T3 carcinomas in 12, 8, and 3 patients, respectively. Grading was good, moderate, and poor in 2, 16, and 4 cases, respectively. Tumor grading could not be determined in 1 patient who underwent surgery of the invasive part of the primary tumor elsewhere. Sentinel nodes or nonsentinel nodes or both were positive in 15 of 36 palpatory-positive groins. DSNB alone showed lymphatic spread in 10 inguinal regions. US-guided removal of suspicious nonsentinel nodes revealed 5 further inguinal basins with metastases, which would have been missed by DSNB owing to rerouting or complete blockage of the lymphotropic tracer. So far, no lymph node relapse has been observed in the 12 patients with node-negative disease by this combined diagnostic approach with a median follow-up of 42 (16-84) months. The morbidity (postoperative bleeding and prolonged lymphorrhea) associated with this procedure was minor (6%). The results of this study imply that DSNB combined with US-guided removal of suspicious lymph nodes is a reliable diagnostic approach in patients with penile cancer with palpable inguinal lymph nodes. DSNB alone in these patients leads to a significant false-negative rate. These early and promising results have to be confirmed in larger cohort studies.


Single leg landing kinematics in volleyball athletes: A comparison between athletes with and without active extension low back pain.
The purpose of this study was to compare kinematics of the lower extremity and lumbar spine during a single leg landing task between female volleyball athletes with and without persistent low back pain (LBP). In this cross sectional study, 36 volunteer female volleyball athletes with (n = 18) and without (n = 18) LBP were recruited. Two specifically trained physical therapists selected only athletes with a specific movement-based subgroup of LBP for inclusion. Three dimensional kinematic and ground reaction force data were recorded for each athlete across three single leg landing trials by utilizing a Vicon 6-camera motion capture system and one in-floor embedded Kistler force plate, respectively. Independent t-tests compared data between the two groups. Lumbar lordosis when standing (p = 0.046) as well as on initial contact (p = 0.025) and at the time which the maximal vertical ground reaction force occurred (p = 0.020) were significantly greater in the LBP group. There were no other significant differences. The tendency for this specific subgroup of athletes to consistently adopt more extended lumbar postures in both static and dynamic tasks may be worth considering by those involved in coaching, performance optimizing and injury prevention.


Repeated intracoronary injections of contrast media. Additive hemodynamic and electrophysiologic effects in a dog model.
Coronary arteriography in patients implies several selective injections into the coronary arteries. The authors investigate whether repeated injections cause additive cardiac hemodynamic and electrophysiologic effects in dogs. Five repeated injections of 5 mL iohexol (Omnipaque 350 mgI/mL, Nycomed Imaging AS, Oslo, Norway), ioxaglate (Hexabrix 320 mgI/mL, Laboratory Guerbet, Cedex, France), and sodium meglumine-diatrizoate (Renografin-76 370 mgI/mL, Squibb Diagnostics, Princeton, NJ) were given into the left coronary artery in 7 anesthetized dogs and were compared with the effects after a 5 mL single injection of the same medium. Left ventricular (LV) pressures, LV dP/dtmax (inotropy) and epicardial monophasic action potential were recorded, from which monophasic action potential duration (MAPD) was measured. Repeated injections of ioxaglate and sodium meglumine-diatrizoate did not potentiate initial decrease in LV pressures and inotropy, but the secondary increase in LV inotropy increased more after repeated injections than after a single injection. Repeated injections of iohexol increased LV inotropy more than a single injection. All contrast media prolonged MAPD more after repeated injections than after single injections. MAPD was prolonged 30 sec after the last injection. Repeated injections of contrast media cause greater cardiac hemodynamic and electrophysiologic effects than a single injection during selective coronary arteriography.


Synthesis of geopolymer using municipal solid waste incineration fly ash and steel slag: Hydration properties and immobilization of heavy metals.
In this study, a novel method for the disposal of municipal solid waste incineration fly ash (MSWIFA) was proposed. By applying geopolymer technology, steel slag (SS) and MSWIFA were used together as precursors to synthesize a cementitious material with sufficient strength that is useable in construction. The effects of the dosages of SS and alkaline activator on the properties of the geopolymer were investigated. Compressive testing was used to characterize the mechanical properties of the geopolymer. X-ray diffraction (XRD), thermogravimetric analysis (TGA), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and energy dispersive spectroscopy (EDS) were used for microscopic analysis. Leaching tests were performed to assess the immobilization effect of the geopolymer on heavy metals. The results showed that the compressive strength of the geopolymer reached 23.03 MPa at 56 d with 20% SS and 11% Na2O admixture. Highly polymerized hydration products, such as C-(A)-S-H gels and N-A-S-H gels, contributed to the compact microstructure, which provided mechanical strength and limited the migration and leaching of heavy metals in the geopolymer matrix. In terms of the results, this work is significant for the development of MSWIFA management.


An interval-valued carbon price forecasting method based on web search data and social media sentiment.
Accurate carbon price prediction is a crucial task for the carbon trading market. Previous studies have ignored the impact of online data and are limited to point predictions, which brings challenges to the accurate forecasting of carbon prices. To address those issues, this paper proposes an interval-valued carbon price forecasting method based on web search data and social media sentiment. First, we collect web search data and social media sentiment to improve prediction performance by synthesizing multiple types of data information. Second, we employ principal component analysis (PCA) to preprocess high-dimensional web search data, and utilize BosonNLP for quantifying social media information, thereby enhancing the predictability of the dataset. Subsequently, a variational mode decomposition (VMD) is applied to the carbon price and online data, followed by utilizing particle swarm optimization support vector regression (PSO-SVR) to predict each sub-modes and summing them up to obtain the ultimate forecasting outcome. Finally, using carbon prices in Guangdong and Hubei provinces as case studies, the experimental results demonstrate that web search data and social media sentiment significantly enhance the predictive accuracy of interval-valued carbon prices. Furthermore, the proposed VMD-PSO-SVR outperforms other comparative models in the accuracy and reliability of interval-valued forecasting.


Strain variation of lymphokine production and specific antibody secretion in mice infected with Mycobacterium lepraemurium.
Mice from strains showing either phenotypical expression of Bcg gene (C57BL/6, BALB/c, DBA/1, and (C57BL/6 X DBA/2)/F1, CBA, A/J, DBA/2) were infected intravenously with 10(7) Mycobacterium lepraemurium (MLM). The number of acid-fast bacilli (AFB) within the spleens, the ability of spleen cells to produce in vitro interleukin 1 and 2, and the serum levels of specific anti-MLM antibodies were assessed 3 months later. The number of AFB recovered from the spleens of various strains followed the strain distribution of genetically controlled innate resistance established for Mycobacterium bovis infection. A decrease of interleukin 2 production by spleen cells could be detected in C57BL/6, DBA/1, DBA/2 and (C57BL/6 X DBA/2)F1 mice only. The level of anti-MLM antibodies was found to be higher in C57BL/6, BALB/c and A/J mice than in the other strains tested. Thus no evidence appeared of a direct influence of the Bcg gene on lymphokine production and antibody secretion.


Cancer caregivers at the end-of-life: How much me vs. how much we?
This study explored cancer caregivers' individual and communal coping through their use of personal and communal pronouns during naturally occurring conversations. Nurse-home hospice visits involving cancer patients and their partner caregivers were audio recorded and then transcribed. Pronoun use was analyzed using Linguistic Inquiry Word Count (LIWC) software and descriptive statistics compared patient and partner caregivers' pronoun use. Personal and communal pronoun use was examined within six identified topics of caregiver speech: patient medical care, daily life, emotion, criticism/disagreement, relationships with family/friends, and asserting needs. Dyads (N = 76) had an average of 35.8 years in their relationship. Caregivers used proportionately more first-person singular (I-talk) than first-person plural (we-talk). However, they used significantly less I-talk than patients and less I-talk than LIWC measures in naturally occurring speech. Caregivers were most likely to discuss patient medical care (41.9%) and least likely to discuss their own needs (3.8%). Partner caregivers may find it easier to express emotions related to communal stressors, rather than their individual ability to cope with end-of-life caregiving. Examining personal and communal pronoun use by partner caregivers during nurse-home hospice visits may provide a more objective measure of caregiver coping than standard self-report measures.


Electrochemotherapy with cisplatin: potentiation of local cisplatin antitumour effectiveness by application of electric pulses in cancer patients.
This study was aimed at assessing the response to electrochemotherapy with cisplatin of cutaneous tumour nodules in patients with malignant melanoma, squamous cell carcinoma and basal cell carcinoma. In 4 patients, 30 tumour nodules of different sizes were treated; five without treatment, one with electric pulses, five with cisplatin injected intratumorally and 19 with electrochemotherapy, i.e. intratumoral administration of cisplatin followed by delivery of electric pulses to the tumour nodule. After 4 weeks, a complete response (CR) in all 19 electrochemotherapy treated nodules was obtained. All electrochemotherapy treated nodules remained in CR (range 7-11 months), regardless of histological type, except for the metastasis of a squamous cell carcinoma that progressed after 9 months. CR was also obtained in two of five tumour nodules treated with cisplatin intratumorally, but the other three nodules progressed within 3-7 months. Exposure of the tumour nodule to electric pulses without cisplatin treatment had no effect on tumour growth. Electrochemotherapy was well tolerated by all patients and a good cosmetic effect was obtained, with only minimal scarring and a slight depigmentation of the skin. Electrochemotherapy with cisplatin has proved to be effective in patients with cutaneous tumour nodules. Furthermore, electrochemotherapy is easy to perform and can be carried out on an out-patient basis.


Utility of magnetic resonance contrast agents in routine cranial imaging. Case study of an evaluative method.
Scientific studies that document the utility and value of MR imaging in routine clinical practice must differ from double-blind, randomized clinical trials. The case study in this article represents an effort to create pragmatic methods for these clinical environments. An independent, judicial panel reviewed blinded readings of unenhanced and enhanced MR images. This panel determined that Gd-DTPA enhancement improved the readings that were close enough for clinical purposes--called Diagnostic Merit. More importantly, clinical care was not disrupted, and statistically significant benefits were shown in routine practice. Such studies could lead to earlier reimbursement for useful imaging technologies.


Metallothionein-3 is expressed in the brain and various peripheral organs of the rat.
Metallothionein-3 (MT-3), also known as growth inhibitory factor (GIF), was originally identified in the brain. An essential step in elucidating the potential roles of MT-3 is to evaluate its expression levels in organs other than the brain. In this present study, we carried out RT-PCR, Western blot and immunohistochemical analyses to quantify MT-3 mRNA and its protein in the cerebrum, eye, heart, kidney, liver, prostate, testis, tongue, and muscle in male Wistar rats. MT-3 mRNA was detected in the cerebrum, the dorsolateral lobe of the prostate, testis, and tongue. Using a monoclonal anti-MT-3 antibody, we detected MT-3 in the cerebrum, the dorsolateral lobe of the prostate, testis, and tongue as a single band on an immunoblot. Immunohistochemical staining showed MT-3 in some astrocytes in the deep cortex, ependymal cells, and choroidal cells in the cerebrum. MT-3 was also detected in some cells of the glomerulus and the collective tubules in the kidney, some cells in the glandular epithelium of the dorsolateral lobe of the prostate, some Sertoli cells and Lydig cells in the testis, and taste bud cells in the tongue. Although MT-3 immunopositivity was obviously demonstrated in the kidney by the immnunohistochemical method, the expression of MT-3 was not fully detectable by RT-PCR and Western blot analyses. Interestingly, only a subset of cells showed positivity for MT-3, not all cells in all tissues. The localization of MT-3 in peripheral organs outside the brain suggests that MT-3 has roles in these tissues besides its role in growth inhibition of neurites.


Pd@l-asparagine-EDTA-chitosan: a highly effective and reusable bio-based and biodegradable catalyst for the Heck cross-coupling reaction under mild conditions.
In this research, a novel supramolecular Pd(ii) catalyst supported on chitosan grafted by l-asparagine and an EDTA linker, named Pd@ASP-EDTA-CS, was prepared for the first time. The structure of the obtained multifunctional Pd@ASP-EDTA-CS nanocomposite was appropriately characterized by various spectroscopic, microscopic, and analytical techniques, including FTIR, EDX, XRD, FESEM, TGA, DRS, and BET. The Pd@ASP-EDTA-CS nanomaterial was successfully employed, as a heterogeneous catalytic system, in the Heck cross-coupling reaction (HCR) to afford various valuable biologically-active cinnamic acid derivatives in good to excellent yields. Different aryl halides containing I, Br and even Cl were used in HCR with various acrylates for the synthesis of corresponding cinnamic acid ester derivatives. The catalyst shows a variety of advantages including high catalytic activity, excellent thermal stability, easy recovery by simple filtration, more than five cycles of reusability with no significant decrease in its efficacy, biodegradability, and excellent results in the HCR using low-loaded Pd on the support. In addition, no leaching of Pd into the reaction medium and the final products was observed.


[Pathogenesis of acute destructive lung processes of staphylococcal etiology].
Destructive processes in the lungs caused by staphylococci (SDL) were found to result in changes to the lipid metabolism in the lung parenchyma and organism of the patient which seemed to bring about disturbances in the pulmonary surfactant. Complex therapy made it possible to decrease the mortality rate in a group of 200 patients with SDL from 24% to 7%.


Meconium ileus in Cystic Fibrosis.
Meconium ileus (MI) is often the first manifestation of cystic fibrosis (CF) and occurs in approximately 20% of patients diagnosed with CF. This article reviews the pathophysiology of MI and its clinical presentation. It focuses on the medical and surgical management emphasizing the importance of nutrition and a multidisciplinary approach to improve both short-term and long-term outcomes for CF patients with MI.


Serum alkaline phosphatase in oral squamous cell carcinoma and its association with clinicopathological characteristics.
Biochemical changes occur in biological fluids and tissues of different types of malignancies. Tumor markers in serum, tissue, and other body fluids during neoplastic process are of clinical value in the management of patients with cancers. Serum alkaline phosphatase (ALP) activity is potentially a useful indicator for detection of malignancies, but its status in oral squamous cell carcinoma (OSCC) is less explored. The aim of this study is to evaluate the serum level of ALP in OSCC patients and assess its relation with the clinicopathological features. A total of 175 participants (145 OSCC patients and 30 healthy controls) were included in the study. One hundred and forty-five patients with OSCC who underwent treatment at our institution were included to obtain the clinicopathological data. Fasting blood ALP activity was evaluated using ALP assessment kit and biochemistry analyzer. The data were analyzed by SPSS-21 software (SPSS Statistics for Windows, Version 21.0, Armonk, NY, USA), using t-test, Mann-Whitney U, and Kruskal-Wallis tests. Raised ALP was seen in 24% of OSCC patients. The mean ALP in OSCC was significantly higher than the control. ALP level in patients with advanced stage was significantly higher than with early stage. The serum ALP level in OSCC patients with bone involvement (BI) by local extension of tumor was significantly higher than without BI. ALP showed statistically significant differences in relation to tumor stages and BI. Hence, ALP could be useful in advanced stage disease for expressing the endurance of patient and tumor expansion. Elevated ALP in OSCC patients may indicate BI.


Interfacial and rheological properties of long-lived foams stabilized by rice proteins complexed to transition metal ions in the presence of alkyl polyglycoside.
Transition-metal coordination complexes are hopeful to make advanced structural materials, since the metal-coordination bonds, unlike typical covalent bonds, can regenerate after rupture, allowing for dynamic, tunable, and reversible mechanical characteristics. Integration of metal-coordinate crosslinking in foam material has rarely been reported. We developed the hydrolyzed rice proteins (HRP) as the building block for amphiphilic transition-metal coordination complexes that could be used to make long-lived foams with high yield stress. Surface properties of the foaming solution were determined using equilibrium and dynamic tensiometers. Structural information of aggregates in the foaming solution was detected by small-angle X-ray scattering (SAXS) and Cryo-Tem. Visualization of liquid flow in the interfacial liquid film was studied by the reflective optical interference technique. Rheological response of liquid foam was characterized by a rheometer with amplitude-sweep and frequency-sweep modes. In the presence of transition metal ions, HRP formed a mechanically strong rigid film. In the absence of transition metal ions or the addition of alkyl polyglycoside (APG), HRP was desorbed to produce a mobile film with a detergent state. The two interfacial states could be actively switched based on facile changes in bulk solution composition (metal ions or alkyl glycoside or chelating agent), and the switching between the two states led to the formation of extremely stable foam with high yield stress or the collapse of foam with a significant decrease in yield limit. The transition-metal coordination complexes adsorbed on the surface of the liquid film could increase the elastic modulus of liquid foam by more than an order of magnitude without increasing the viscosity of the foaming solution. We further revealed the origin of foam stability/instability and used other well-characterized proteins to prepare transition-metal coordination complexes to make long-lived foams. The cases described in this work illustrate the universal nature of the strategy, which in principle can be extended to many types of protein.


The distribution of polypeptide YY (PYY) - and pancreatic polypeptide (PP) - immunoreactive cells in the domestic fowl.
The distribution of the polypeptide which has an N-terminal tyrosine and a C-terminal tyrosine (PYY) - and pancreatic polypeptide (PP) - immunoreactive cells were investigated in the gut of the domestic fowl. PPY-immunoreactive cells were observed in the duodenum and jejunum. PP-immunoreactive cells were seen in the duodenum, jejunum, ileum and colon. Both PYY- and PP-immunoreactive cells were extended from the basal lamina to the gut lumen i.e. of open type. PYY-immunoreactive cells occurred mainly in the basal and middle portion of the villi. On the other hand, PP-immunoreactive cells were located mostly in the crepts. The occurrence of PYY-immunoreactive cells in the upper part of the small intestine is rather similar to that of amphibians and reptiles, than to that of mammals, where PYY-immunoreactive cells are located in the distal part of the small intestine and in the large intestine.


Changes in ventricular geometry early after Fontan operation.
Acute removal of a ventricular volume overload, in the face of relatively unchanging ventricular mass, results in geometric alterations that can impair diastolic ventricular performance after Fontan operation. We investigated whether geometric alterations were (1) more severe after Fontan operation than after hemi-Fontan operation, (2) more severe in infants than in children, and (3) more severe in the morphologic right ventricle than in the morphologic left ventricle. We studied 22 patients, 11 with hypoplastic left heart syndrome and 11 with a functionally single morphologic left ventricle. After Fontan operation, right ventricular end-diastolic volume declined by 52% from 36.6 +/- 12.2 to 17.5 +/- 9.3 mL. Right ventricular wall thickness increased from 6.8 +/- 1.3 to 7.5 +/- 1.8 mm. Left ventricular end-diastolic volume diminished by 40% from 57.6 +/- 23.3 to 34.8 +/- 17.6 mL. Left ventricular wall thickness increased from 7.0 +/- 2.1 to 8.7 +/- 1.9 mm. The alterations in right ventricular geometry are more marked early after Fontan operation than early after the hemi-Fontan procedure. Geometric alterations in the left ventricle appear to be more severe in infants than in children. Finally, alterations in the morphologic right ventricle appear to be of similar magnitude to those in the morphologic left ventricle.


Global, regional, and national endometriosis trends from 1990 to 2017.
Endometriosis is a chronic inflammatory disease defined as the presence of endometrial tissue outside the uterus that causes pelvic pain and infertility. We used the Global Burden of Disease Study (GBD) 2017 to comprehensively analyze the burden of endometriosis between 1990 and 2017. DisMod-MR 2.1 was used to estimate the incidence and prevalence in some countries/territories with sparse or absent data. Annual percent changes were calculated to quantify endometriosis burden estimate trends. Furthermore, the sociodemographic index (SDI) was used to assess the relationship between endometriosis burden estimates and development level. Between 1990 and 2017, endometriosis age-standardized incidence and prevalence and years of life lived with disability (YLDs) decreased globally by 0.21% (95% confidence interval (CI): -0.23% to -0.20%), 0.29% (95% CI: -0.31% to -0.28%), and 0.28% (95% CI: -0.30% to -0.27%) per year, respectively. Apart from the high SDI quintiles with increasing trends of endometriosis incidence rate, prevalence rate, and YLDs, decreasing trends were observed in all SDI quintiles for all burden estimates. In conclusion, it appears that all endometriosis burden estimates have decreased globally between 1990 and 2017. However, these results are based on limited data and highlight the need for increased data collection on the incidence and prevalence of endometriosis.


Treatment of Crigler-Najjar type 1 disease: relevance of early liver transplantation.
Crigler-Najjar syndrome type 1 (CNS1) is characterized by severe unconjugated hyperbilirubinemia from birth, caused by total failure of UDP-glucuronyltransferase activity. Only orthotopic liver transplantation (OLT) offers the prospect of cure. However, because the onset of neurologic deficits is unpredictable, timing of OLT remains difficult. In our transplant center, 3 patients underwent early OLT for CNS1. Two of them (7 yr, 12 yr) showed mild to moderate neurologic deficits only few weeks before OLT, another patient (4 yr) had no signs of bilirubin encephalopathy. All patients required extensive phototherapy to control bilirubin levels. Thus, OLT was performed shortly after the onset of neurologic symptoms or as a prophylactic procedure, respectively. OLT was uneventful in all recipients. One of the symptomatic patients (7 yr) completely recovered from neurologic deficits at 36 months on OLT, whereas the other patient (12 yr) significantly improved symptoms at 27 months of OLT. These patients, including the 4-year-old boy, attend school at appropriate grades now. Irreversible brain damage (kernicterus) may occur in the course of CNS1 disease. Because no alternative treatment options are available at this time, OLT should be performed as a preventive procedure to counteract severe CNS-related complications.


Characterization of antibiotic resistance in Listeria spp. isolated from slaughterhouse environments, pork and human infections.
Listeria species are susceptible to most antibiotics. However, over the last decade, increasing reports of multidrug-resistant Listeria spp. from various sources have prompted public health concerns. The objective of this study was to characterize the antibiotic susceptibility of Listeria spp. and the genetic mechanisms that confer resistance. Forty-six Listeria spp. isolates were studied, and their minimal inhibitory concentrations of antibiotics were determined by microdilution using Sensititre standard susceptibility MIC plates. The isolates were screened for the presence of gyrA, parC, lde, lsa(A), lnu(A), and mprF by PCR, and the amplified genes were sequenced. All isolates were susceptible to penicillin, ampicillin, tetracycline, erythromycin, and carbapenems. Resistance to clindamycin, daptomycin, and oxacillin was found among L. monocytogenes and L. innocua, and all species possessed at least intermediate resistance to fluoroquinolones. GyrA, parC, and mprF were detected in all isolates; however, mutations were found only in gyrA sequences. A high daptomycin MIC, as reported previously, was observed, suggesting an intrinsic resistance of Listeria spp. to daptomycin. These results are consistent with reports of emerging resistance in Listeria spp. and emphasize the need for further genotypic characterization of antibiotic resistance in this genus.


Simple Diagnostic Tools May Guide Transcatheter Closure of Superior Sinus Venosus Defects Without Advanced Imaging Techniques.
There is a recent interest in nonsurgical correction of superior sinus venosus defects. Patient selection is currently based on advanced imaging and printing technologies. Simple clinical tools to select patients will expand its applicability in developing countries. Defects caudally extending toward the oval fossa and right upper pulmonary veins draining beyond the cavoatrial junction on transesophageal echocardiography were excluded. Balloon interrogation of cavoatrial junction confirmed complete occlusion of the defect with unobstructed pulmonary venous drainage to left atrium. Single long covered stents or overlapping covered stents were used to exclude sinus venosus defects. Closure of left-to-right interatrial shunt without causing pulmonary vein occlusion was confirmed on follow-up imaging. Forty-four patients selected after transesophageal echocardiography underwent balloon interrogation with monitoring of right upper pulmonary vein. Eighteen out of 44 patients were ineligible. Twenty-four eligible patients with closure of left-to-right interatrial shunt without pulmonary vein occlusion underwent covered stent exclusion using single long stents in 15 and overlapping stents in the rest, while 2 patients are awaiting the procedure. Four patients aged 6 to 16 years received stents that were 18 mm or larger. Three patients had stent embolization that required surgical correction in 2 but in the last patient was managed nonsurgically with an overlapping covered stent with good final outcomes. Procedure was successful in 22 patients. At a median follow-up of 20 months (range, 3-54 months), there were no adverse events. Follow-up imaging showed trivial left-to-right shunt in 4 and unobstructed pulmonary veins in all patients. Transesophageal echocardiography and balloon interrogation identified 60% of the patients with sinus venosus defects to be eligible for catheter closure. Overlapping stents are an alternative to custom-made long stents. Transesophageal echocardiography confirms procedural success on follow-up. Advanced imaging and printing technologies are not essential for successful outcomes and thus simple tests increase the feasibility in developing countries.


Clinical practice guidelines for the diagnosis and management of acute otitis media in children-2018 update.
"Clinical Practice Guidelines for the Diagnosis and Management of Acute Otitis Media in Children-2018 update (2018 Guidelines)" aim to provide appropriate recommendations about the diagnosis and management of children with acute otitis media (AOM), including recurrent acute otitis media (recurrent AOM), in children under 15 years of age. These evidence-based recommendations were created with the consensus of the subcommittee members, taking into consideration unique characteristics of bacteriology and antimicrobial susceptibilities of AOM pathogens in Japan, as well as global advances in vaccines. The subcommittee re-evaluated key clinical issues based on SCOPE (a master plan of the guidelines) and created clinical questions (CQ) about the diagnosis and management of AOM patients. A literature search of the publications from 2013 to 2016 were added to the Guidelines 2013, not only to assess the evidence on the effectiveness of vaccines, but also to provide up to date information of the bacteriology and antimicrobial susceptibilities of AOM causative pathogens in Japan. We have proposed guidelines for disease severity-based management of AOM patients, after classifying AOM severity into mild, moderate, and severe, based on age, clinical manifestations, and otoscopic findings. Precise otoscopic findings are essential for judging AOM severity, which can lead to appropriate management of AOM patients.


An in vitro evaluation of the accuracy of Dentaport ZX apex locator in enlarged root canals.
The aim of this study was to examine the effects of root canal irrigants on the accuracy of Dentaport ZX electronic apex locator (EAL) in enlarged root canals. Our previous study revealed that as the diameter of the root canal increased, the electronically measured length with small size files became shorter in the presence of blood. It is not known whether different canal irrigants would interfere with the reading accuracy of an EAL in enlarged root canals. A total of 45 extracted single-rooted human teeth were used. In Stage 1, canals were instrumented using #10-40 K-files with a #40 K-file as the master apical file (MAF). The teeth were randomly divided into five groups and mounted in an experimental apparatus. The following irrigants were used during electronic canal measurements: Group A = 0.5% NaOCl; Group B = 2.5% NaOCl; Group C = 15% EDTA; Group D = 0.8% chlorhexidine (CHX); and Group E = RC Prep. In Stage 2, the canals were enlarged using a #60 K-file as the MAF. In Stages 1 and 2, the apical portion of the canals was instrumented using the step-back sequence (up to a #80 K-file). In Stage 3, the canals were enlarged again using a #80 K-file as the MAF. In each stage, the canal length was measured with a Dentaport ZX using #10 and #40, #10 and #60, and #10 and #80 K-files for Stages 1, 2 and 3, respectively. Data were analysed by two-way ANOVA and Fisher's PLSD test. Statistical analysis showed significant differences among all groups (p < 0.01). There was no significant difference between Group A and B at each stage and between Group D and E at Stage 2. A statistical significant difference was observed between #10 K-file and other files (#40, #60 and #80) at each stage (p < 0.01). In Groups A and B, there was no significant difference between #10 and #40 K-files (Stage 1) and between #10 and #60 K-files (Stage 2). The Dentaport ZX was accurate and not adversely affected by the presence of 0.5% or 2.5% NaOCl and EDTA in the enlarged canals, and the measured lengths obtained with small and large size files were comparable. However, it was accurate in the presence of CHX and RC Prep only when large size files were used, and the length measured with small size files was greater than the actual length.


Effect of body position on arterial oxygen tension in the elderly.
It is well known that body position can have an effect on gas exchange though the magnitude of this effect has not been studied thoroughly in the elderly. This study analyzes the effect body position change has on arterial oxygen tension (PaO(2)) and arterial carbon dioxide tension (PaCO(2)) in healthy elderly. We tested 46 "lung-healthy" elderly, including 30 women and 16 men, 67-88 years of age. Blood was drawn from the radial artery first in the sitting position and subsequently in the supine position. Spirometry was performed. Mean (SD) sitting PaO(2) was 10.53 kPa (1.22), whereas mean supine PaO(2) was 9.85 kPa (1.33). The difference between sitting and supine PaO(2) was 0.68 kPa (0.86) and was statistically significant. Sitting PaCO(2) was 5.06 kPa (0.47) and supine PaCO(2) was 5.05 kPa (0.54). The difference between sitting and supine PaO(2) correlated positively with FEV(1)/FVC %, negatively with the corresponding difference between sitting and supine PaCO(2), and negatively with BMI. We conclude that the significant difference in PaO(2) in sitting and supine positions clearly shows that the position needs to be considered both when attempting to establish reference values and when evaluating gas exchange in elderly persons. The positional changes in oxygenation are related to the corresponding change in PaCO(2), and to FEV(1)/FVC % and BMI.


Performing research in pregnancy: Challenges and perspectives.
There are numerous barriers to conducting clinical research in pregnancy, including ethical considerations, logistical difficulties, and federal regulations. Due to these challenges, there is a paucity of data on the safe and appropriate use of dermatologic therapies in pregnancy, even for easily accessed over-the-counter topical products, as well as for commonly prescribed medications. Given the lack of human safety data, the Food and Drug Administration pregnancy labeling system previously placed a high priority on animal data but was recently revised to highlight human data and pregnancy registries. The latter can provide prospective observational data on medication use in pregnant women, while avoiding many of the pitfalls of conducting clinical trials in this population; nevertheless, registry enrollment for dermatologic drugs remains low. Dermatologists must increase awareness of pregnancy registries and encourage patient enrollment to close this knowledge gap.


Anisomycin impairs long-term working memory in a delayed alternation task.
A long-term temporal component of working memory of rats trained on the radial maze has been shown to be susceptible to disruption by the protein synthesis inhibitor, anisomycin. It is not clear whether protein synthesis played a role in working memory because accurate performance on the radial maze required the storage of a large amount of information, or because the information was to be held in store for relatively long periods of time. This experiment tested these hypotheses by assessing the effect of anisomycin on choice accuracy in a comparatively simple spatial delayed alternation task. Results indicate that under the present training conditions, protein involvement in working memory is related more to the length of the retention interval than to the amount of information retained.


Expression of 87A, 87C and 93D heat shock puffs in trisomic (2L and 3L) strains of Drosophila melanogaster: evidence for a functional relation between 93D and 87C.
Chromosomal RNA synthesis of the three heat shock puffs 87A, 87C and 93D examined in trisomic 3L (T3L) and trisomic 2L (T2L) strains of Drosophila melanogaster and compared with that of Oregon R+ and compound stocks of the 3rd [C(3L)VGI ru st; F(3R)VDI es/F(3R)VDI es] and 2nd [C(2L)SHI+; F(2R) bw] chromosomes. The activity at two different temperatures (22 degrees and 37 degrees C) was monitored by [3H]uridine autoradiography. The results that while in the control T3L and T2L nuclei (22 degrees C), the 93D puff shows a higher level of transcriptional activity than in the Oregon R+ or compound stocks used as controls, in T3L and T2L nuclei from heat-shocked sets (37 degrees C), 93D does not show further induction compared with heat-shocked controls, and the 87C puff is 2.8 times more active than the 87A puff. These results suggest that there may be a direct functional and/or regulatory relationship between the activity of 93D and certain sequence specific activity of 87C, and that an optimum level of activity delimits the activity of the heat shock puff 93D in D. melanogaster.


Genetic testing and breach of patient confidentiality: law, ethics, and pragmatics.
Medical uses of genetic information have multiplied over the last several years. When an individual is a carrier of a clinically important allele, their kindred are at increased risk of carrying the same allele and of sharing the consequent risk of disease. If there were an intervention that could modify the risk of progression to disease, then there would be a clear advantage to kindred to be so informed. However, some probands may resist divulging that information to kindred for any of a variety of reasons, including the potential for discrimination. In this article we will review the manner in which the courts and professional organizations have viewed the conflict between 1 individual's right to privacy and another's right to information that could potentially be life saving or life prolonging. We will then consider the ethics of this issue and suggest an approach that physicians should take when confronting it.


Surgical Outcomes of Implant versus Autologous Breast Reconstruction in Patients with Previous Breast-Conserving Surgery and Radiotherapy.
Postmastectomy breast reconstruction in patients with a history of breast-conserving surgery (BCS) and radiotherapy is challenging, with a paucity of literature on the outcomes of different breast reconstructive techniques. The authors hypothesized that implant-based breast reconstruction (IBR) would be associated with higher complication rates compared to either IBR combined with latissimus dorsi (LD) or free flap breast reconstruction (FFBR). The authors conducted a retrospective review of patients who underwent mastectomy with a history of BCS and radiotherapy between January of 2000 and March of 2016. Surgical and patient-reported outcomes (BREAST-Q) were compared between IBR versus IBR/LD versus FFBR. The authors identified 9473 patients who underwent BCS and radiotherapy. Ninety-nine patients (105 reconstructions) met the authors' inclusion criteria, 29% ( n = 30) of whom underwent IBR, 26% ( n = 27) of whom underwent IBR/LD, and 46% ( n = 48) of whom underwent FFBR. The overall complication rate was not significantly different between the three groups (50% in IBR versus 41% in IBR/LD versus 44% in FFBR; P = 0.77), whereas reconstruction failures were significantly lower in the FFBR group (33% in IBR versus 19% in IBR/LD versus 0% in FFBR; P < 0.0001). The time between the receipt of radiotherapy and reconstruction was not a significant predictor of overall complications and reconstruction failure. No significant differences were identified between the three study cohorts in any of the three studied BREAST-Q domains. In patients with prior BCS and radiotherapy, FFBR was associated with lower probability of reconstruction failure compared to IBR but no significant difference in overall and major complication rates. The addition of LD flap to IBR did not translate into lower complication rates but may result in decreased reconstruction failures. Therapeutic, III.


A case of lymphoblastoid natural killer (NK)-cell lymphoma: association with the NK-cell receptor complex CD94/NKG2 and TP53 intragenic deletion.
The clinical, histological, phenotypic and genotypic features of a lymphoblastoid natural killer (NK)-cell lymphoma presenting in the skin in a young caucasian woman are described. The disease behaved aggressively, but long-lasting remission was obtained by combination chemotherapy followed by autologous bone marrow transplantation. The blastoid cells were positive for terminal deoxynucleotidyl transferase, CD34, CD56 and CD4. Furthermore, the NK-cell receptor complex CD94/NKG2 was strongly expressed, as shown by examination with reverse transcription-polymerase chain reaction. The T-cell receptor (TCR)-gamma genes were in germline, and with the exception of CD4 all T-cell antigens were negative, including CD3, TCR-beta, TCR-delta, TIA-1, granzyme B and perforin. Epstein-Barr virus was negative, and no expression was seen of myeloid cell-associated markers. Molecular analysis showed no abnormalities of the CDKN2A (p16), CDKN2B (p15) or TNFRSF6 (Fas) genes. By contrast, a 34-bp deletion in exon 7 of the TP53 (p53) gene was detected. It is suggested that lymphoblastoid NK-cell lymphoma, which is a rare but distinctive disease, originates from NK cell precursors and may be associated with and possibly caused by alterations in the TP53 gene. Experience is too limited to warrant therapeutic suggestions. However, stem cell transplantation may be a useful option in younger patients.


A Pair-Electrosynthesis for Formate at Ultra-Low Voltage Via Coupling of CO2 Reduction and Formaldehyde Oxidation.
Formate can be synthesized electrochemically by CO2 reduction reaction (CO2RR) or formaldehyde oxidation reaction (FOR). The CO2RR approach suffers from kinetic-sluggish oxygen evolution reaction at the anode. To this end, an electrochemical system combining cathodic CO2RR with anodic FOR was developed, which enables the formate electrosynthesis at ultra-low voltage. Cathodic CO2RR employing the BiOCl electrode in H-cell exhibited formate Faradaic efficiency (FE) higher than 90% within a wide potential range from - 0.48 to - 1.32 VRHE. In flow cell, the current density of 100 mA cm-2 was achieved at - 0.67 VRHE. The anodic FOR using the Cu2O electrode displayed a low onset potential of - 0.13 VRHE and nearly 100% formate and H2 selectivity from 0.05 to 0.35 VRHE. The CO2RR and FOR were constructed in a flow cell through membrane electrode assembly for the electrosynthesis of formate, where the CO2RR//FOR delivered an enhanced current density of 100 mA cm-2 at 0.86 V. This work provides a promising pair-electrosynthesis of value-added chemicals with high FE and low energy consumption.


Pulmonary excretion of H2 in calves with Cryptosporidium-induced malabsorption.
Pulmonary hydrogen gas (H2) concentrations were used to assess the malabsorption of dietary nutrients in preruminating calves inoculated with Cryptosporidium sp. Normal values were established in five control calves and seven calves (principals) were inoculated with 1.0 x 10(8) Cryptosporidium sp. oocysts. Hydrogen concentrations and wet fecal weights were measured at three stages: before Cryptosporidium sp. inoculation (stage 1), three days after the onset of diarrhea (stage 2), and after the resolution of diarrhea (stage 3). Mean end-breath and total-breath H2 concentrations in the principal calves were higher (P less than 0.025 and P less than 0.05) for stage 2, when compared to control values. Both end-breath and total-breath H2 concentrations were increased (P less than 0.001 and P less than 0.025, respectively) in the principal calves during stage 2 when compared to values obtained for stages 1 and 3. Concurrently, Cryptosporidium sp. infection was associated with increased (P = 0.06) fecal output during stage 2, only. The increased H2 concentrations and cumulative fecal output show that Cryptosporidium sp. caused malabsorption of fermentable nutrients.


Four naturally occurring mutations in the human GnRH receptor affect ligand binding and receptor function.
In the present study, we performed functional analyses of four mutations in the human GnRH receptor (GnRHR) gene, identified in patients with idiopathic hypogonadotropic hypogonadism. These mutations result in amino acid substitutions in the extracellular N-terminal domain (Thr32Ile), second extracellular loop (Cys200Tyr), third intracellular loop (Leu266Arg) and sixth transmembrane helix (Cys279Tyr). Immunocytochemical analysis of cells transfected with HA-tagged GnRHR constructs revealed that all four mutant receptors were present on the cell surface. However, all four mutant receptors failed to exhibit measurable specific GnRH binding and, except for Thr32Ile, any significant inositol phosphate accumulation after GnRH stimulation. In addition, Leu266Arg and Cys279Tyr receptors were unable to stimulate gonadotropin subunit or GnRHR gene promoter activity in response to GnRH. Interestingly, the Cys200Tyr mutant was able to stimulate gonadotropin subunit and GnRHR promoter activity, albeit with a higher EC(50) and a markedly reduced maximal response compared to wild type receptor. The Thr32Ile mutant was also able to stimulate gonadotropin subunit and GnRHR promoters, but with a further significant increase in EC(50). Similarly, this mutant partially retained the ability to activate extracellular signal-regulated kinase 1 and stimulate CRE-luciferase activity with an identical shift in EC(50). Taken together, the studies suggest that the Thr32Ile mutation reduces hGnRHR function primarily by reducing ligand binding affinity, and the Cys200Tyr mutation reduces cell surface receptor expression. All four amino acid substitutions interfered with ligand binding, and affected signal transduction and stimulation of gonadotropin and GnRHR gene expression in response to GnRH.


Teriparatide rapidly improves pain-like behavior in ovariectomized mice in association with the downregulation of inflammatory cytokine expression.
Recent studies have indicated that teriparatide, an anti-osteoporosis agent, significantly improves back pain regardless of the presence of vertebral fracture in osteoporosis patients. The aims of this study were to examine whether teriparatide improves pain-like behavior in an ovariectomized (OVX) mouse model, and to evaluate changes in osteoclast marker levels and inflammatory cytokine expression levels induced by teriparatide treatment in bone tissue in association with improvements in pain-like behavior. OVX and sham operations were performed in 8-week-old mice, followed by teriparatide treatment for 2 weeks. Pain-like behavior tests (von Frey, paw flick and spontaneous pain test), and the measurement of serum tartrate-resistant acid phosphatase 5b (TRAP5b) level and inflammatory cytokine (interleukin [IL]-1β, IL-6 and tumor necrosis factor [TNF]-α) expression levels in the bone tissue were conducted after teriparatide treatment in OVX mice. Pain-like behavior in the von Frey test was significantly improved by teriparatide treatment in OVX mice. With regard to the early phase (within the first 7 days of treatment), teriparatide significantly improved pain-like behavior in the von Frey test, the paw flick test and the spontaneous pain test. Teriparatide significantly inhibited the expression of IL-1β, IL-6 and TNF-α in OVX mice in the early phase of the treatment, while the TRAP5b level in OVX mice was not significantly affected. We demonstrated that the teriparatide-induced rapid improvement effect on pain-like behavior in OVX mice was associated with the downregulation of inflammatory cytokine expression, including IL-1β, IL-6 and TNF-α.


Early cellular responses to diverse growth stimuli independent of protein and RNA synthesis.
Serum, elevated pH, excess Zn++, 9,10 dimethyl-1,2 dibenzanthracene (DMBA) and insulin accelerate the progress of growth-inhibited chick embryo cells into the S-period of DNA synthesis. A comparative study was made of their capacity to elicit other cellular responses within two hours after their application. All the agents studied stimulated the uptake of the glucose analogue 2-deoxy-D-glucose (2-dGlc). Elevated pH elicited a more striking increase than the other agents in the uptake of the amino acid analogue alpha-amino isobutyric acid (AIB). The application of subtoxic concentrations of Zn++ or DMBA did not stimulate the uptake of uridine by cells nor its incorporation into RNA when tested at 2 hours. However, it was found that the stimulation of uridine utilization did occur but was delayed several hours. Similarly, the accelerated onset of DNA synthesis was also delayed for several hours by these agents. Insulin acted like serum in stimulating the utilization of 2-dGlc, AIB and uridine. Serum and DMBA were particularly effective in stimulating the utilization of choline. It was concluded that the utilization of 2-dGlc, uridine and thymidine are affected similarly by all the agents, but that there may be differential effects in the utilization of AIB and choline. The inhibition of RNA synthesis by actinomycin D did not prevent the relative stimulation of 2-dGlc, AIB and choline utilization by serum and pH treatment. The inhibition of protein synthesis by cycloheximide did not prevent the relative stimulation of 2-dGlc and choline utilization by serum and pH treatment. It partially blocked the increased uptake of AIB and had erratic effects on the utilization of uridine. It was concluded that neither RNA nor protein synthesis is required for some, if not all, the early responses to growth stimuli measured here. The inhibited cell appears to be a poised system which carries out a programmed array of reactions characteristic of the cell type following perturbation by a variety of unrelated agents. In vivo specificity is provided by the physiological reagents available (i.e., hormones) and their capacity to interact with different cell types.


The effect of cyclosporine on mortality and renal function in living related pediatric kidney transplant recipients.
The outcome, incidence of acute rejection episodes, complications and cyclosporine (CyA) induced nephrotoxicity were studied in 10 pediatric kidney transplant recipients who were grafted from one-haplotype indentical parent with immunosuppression of CyA and prednisolone (Pred). Excellent patient and graft survival could be achieved in this population with low incidences of acute rejection or serious complications as when compared with the results of azathioprine (AZ) treated pediatric patients. With a mean follow-up of 12.9 months (range 1 to 50 months), the patient survival rate was 100 per cent and the graft survival rate was 100, 84, 84 and 84 per cent at 1, 2, 3 and 4 years post transplantation, respectively. Serum creatinine levels in the group were 0.97, 1.17, 1.14 and 1.2 mg/dl at 3, 6, 12 and 24 months post transplantation, respectively. The incidence of treated acute rejection episodes was 20 per cent (2 out of 10) in the CyA-treated children, whereas it was 53 per cent (9 of 17) in the Az-treated children. Five children who had undergone transplant surgery before they were 11 years old displayed linear growth in height after their transplantation. There have been no opportunistic infections, aseptic necrosis or peptic ulcers in this group and cyclosporine nephrotoxicity has not been a serious problem in the pediatric recipients. Only 10 per cent (1 out of 10) of the recipients displayed acute nephrotoxicity and only one recipient has converted from CyA + Pred to CyA + AZ + Pred (Three drug therapy) due to persistent nephrotoxicity.(ABSTRACT TRUNCATED AT 250 WORDS)


The influence of aldose reductase on the oxidative burst in diabetic neutrophils.
Lucigenin-enhanced chemiluminescence was examined as an index of neutrophil superoxide production in four groups of 20 subjects: controls with/without infection and type 1 diabetics with/without infection. At 5 mM glucose there was no significant difference in chemiluminescence output between neutrophils from the four groups (P greater than 0.01). Increasing the in vitro glucose concentration from 5 to 20 mM produced an 8.75% reduction in superoxide in the combined control groups, compared with a 21.45% reduction in the diabetic subjects (P less than 0.01). With the addition of an aldose reductase inhibitor (Statil, ICI) to neutrophils from diabetic subjects, the suppression caused by an increase in glucose concentration to 20 mM was reduced to 4.5%. This value was similar to the controls (P greater than 0.01). Neutrophil aldose reductase activity, measured in 28 diabetic subjects was 0.024 +/- 0.003 U/10(8) cells (mean +/- SE). There was a significant correlation between aldose reductase activity and superoxide suppression (P less than 0.01, r = 0.64). These results suggest that aldose reductase is responsible for reduced superoxide production in diabetic patients and the addition of an aldose reductase inhibitor to the diabetic neutrophil restores superoxide output to control values.


The effect of "Pyriform Turbinoplasty" on nasal airflow using a virtual model.
A new procedure, pyriform turbinoplasty, is described and nasal airflow is measured before and after this procedure in a virtual model. Pyriform turbinoplasty is the submucosal reduction of the bone of the frontal process of the maxilla and the lacrimal bone. It opens part of the lateral margin of the nasal valve area with minimal damage to nasal mucosa. The resection of bone in this area can be extended by "nasal wall lateralization" when the lacrimal bone that joins the uncinate process behind the lacrimal duct as well as the base of the inferior turbinate and the edge of the maxilla at the rim of the pyriform aperture are removed. Nasal airflow was simulated using computational fluid dynamics and ANSYS Fluent solver. Analysis using fluid dynamics showed that these procedures help ventilation in the main airflow areas without substantially altering the normal pattern of airflow. The changes after performing a pyriform turbinoplasty seem to be an improvement when compared to the changes after inferior turbinate surgery that can misdirect the airflow largely through the inferior meatus.