Outcomes of sleeve lobectomy versus pneumonectomy: A propensity score-matched study.
To compare short- and long-term outcomes between sleeve lobectomy and pneumonectomy for lung cancer in a single center during a 15-year period. One thousand nine hundred eighty-one patients who underwent either a sleeve lobectomy (n = 964; 48.7%) or a pneumonectomy (n = 1017; 51.3%) from January 2003 to December 2017 at the Shanghai Pulmonary Hospital, were matched according to a propensity score to produce 2 groups of 665 patients each. The study period was divided into 3 5-year subperiods. Sleeve lobectomy was associated with a lower 30- and 90-day mortality (0.60% and 0.90% vs 1.5% and 3.91%; P = .177 and P = .001, respectively, after matching), lower morbidity (4.36% vs 8.16%; P = .005 before matching, 3.61% vs 8.72%; P < .001 after matching), improved 5-year survival (62.7% vs 43.1%; P < .001 before matching and 61% vs 44.7%; P < .001 after matching), and 5-year disease-free survival after matching (56.6% vs 46.2%; P < .001). The sleeve lobectomy to pneumonectomy ratio increased by 78%, whereas 90-day mortality decreased by 66.81% between the first and the last subperiods. Sleeve lobectomy is associated with improved short- and long-term outcomes and should be the resection of choice for centrally located lung cancers, when feasible.


Comparison of pregnancy-specific interventions to a traditional treatment program for cocaine-addicted pregnant women.
Alcohol and drug use in pregnancy is a significant concern. There is a paucity of treatment programs for substance-abusing pregnant women, especially if indigent. Furthermore, treatment retention is compromised when the drug of choice is crack-cocaine. This paper reports the results of a study comparing treatment retention of cocaine-abusing indigent pregnant women before and after incorporating pregnancy-specific interventions. Audits were performed on 603 charts of women enrolled between 1988 and 1994 in either a traditional treatment program (n = 114) or in the Pregnancy Substance Abuse Program (PSAP) (n = 489). Differences in treatment retention were found between the two treatment groups. Drop-out rates from the inpatient component of treatment were significantly lower in the PSAP group than in the control group (11.3% vs. 38.6%, p < .001). There was a higher rate of completion of outpatient treatment in the PSAP compared to the control group (34.4% vs. 13.5%, p < .005). These results were achieved with a 2-day decreased inpatient stay. Treatment retention improved when specialized interventions were provided, at minimal additional cost. These results have implications for other publicly funded treatment programs.


Comparative analysis of in vivo and in silico toxicity evaluation of the organoiodine compounds towards D.magna using multivariate chemometric approach: A study on the example of amiodarone phototransformation products.
In the present study the photochemical fate of organoiodine compound - amiodarone was performed. The drug turned out to be highly susceptible to UV-Vis irradiation, especially in the presence of humic substances and organic matrix. Qualitative LC-MS analysis revealed formation of twelve - mainly previously unreported - transformation products (TPs). Four major TPs were submitted to the toxicity analysis with the use of D. magna. All of the tested TPs presented higher toxic potential than the parent compound. The phenolic TPs were approximately 100 times more toxic than amiodarone. Toxic properties of the major TPs resulted in steadily increasing toxic potential of the photo-generated mixture over the time of irradiation. Moreover, the experimental toxicity data, concerning the TPs, were compared with results estimated by 6 in silico models with the use of a multivariate chemometric analysis. The results showed that the applied computational methods were able neither to correctly predict toxic properties of the studied compounds, nor the trends in change of their toxic parameters. Additional validation of in silico models ability to predict toxicity of iodinated organic compounds showed that the studied computational methods do not present sufficient prediction ability. Therefore their estimations concerning organoiodines should be verified using experimental tests.


Septic arthritis of the ankle: Do not forget Pasteurella pneumotropica.
Pasteurella pneumotropica is an important bacterial pathogen in both animals and humans. Most reported Pasteurella infections in humans involve skin and soft tissues, often after an animal bite, scratch, or lick to an open wound. We report a case of septic arthritis with Pasteurella pneumotropica in a diabetic and cardiopathic patient who was the victim of a rat bite in the street, with a good evolution after medical and surgical treatment.


Chiropteran influenza viruses: flu from bats or a relic from the past?
The identification of influenza A-like genomic sequences in bats suggests the existence of distinct lineages of chiropteran influenza viruses in South and Central America. These viruses share similarities with conventional influenza A viruses but lack the canonical receptor-binding property and neuraminidase function. The inability to isolate infectious bat influenza viruses impeded further studies, however, reverse genetic analysis provided new insights into the molecular biology of these viruses. In this review, we highlight the recent developments in the field of the newly discovered bat-derived influenza A-like viruses. We also discuss whether bats are a neglected natural reservoir of influenza viruses, the risk associated with bat influenza viruses for humans and whether these viruses originate from the pool of avian IAV or vice versa.


Processing of laser Doppler flowmetry signals from healthy subjects and patients with varicose veins: Information categorisation approach based on intrinsic mode functions and entropy computation.
The diagnosis of pathologies from signal processing approaches has shown to be of importance. This can provide noninvasive information at the earliest stage. In this work, the problem of categorising - in a quantifiable manner - information content of microvascular blood flow signals recorded in healthy participants and patients with varicose veins is addressed. For this purpose, laser Doppler flowmetry (LDF) signals - that reflect microvascular blood flow - recorded both at rest and after acetylcholine (ACh) stimulation (an endothelial-dependent vasodilator) are analyzed. Each signal is processed with the empirical mode decomposition (EMD) to obtain its intrinsic mode functions (IMFs). An entropy measure of each IMFs is then computed. The results show that IMFs of LDF signals have different complexity for different physiologic/pathological states. This is true both at rest and after ACh stimulation. Thus, the proposed framework (EMD + entropy computation) may be used to gain a noninvasive understanding of LDF signals in patients with microvascular dysfunctions.


The earliest experimental convulsions by Joseph Priestley in 1766 friendship with Benjamin Franklin.
In 1766, Joseph Priestley (1733-1804) was the first to systematically demonstrate the universal convulsive effect of an electrical discharge applied to the head of all the several species studied. We here republish his overlooked experiments, which often resulted in death, and which ante date the scientific studies of the electrical functions of the brain, the role of "discharges" in seizures, and experimental epilepsy by about a century. Priestley's studies of electricity were influenced by those of Benjamin Franklin (1706-1790), who became a good friend during Franklin's prolonged period in London between 1757 and 1775. Both were elected Fellows of the Royal Society and both were awarded the Copley Medal of that Society. Priestley's experiments are relevant to the history of epilepsy and neuropsychiatry, and to the modern study of sudden unexplained death in epilepsy (SUDEP).


Isolation from subcellular preparation of a mediator of hypoglycaemic hGH peptides.
This study demonstrated the release into the incubation medium of a cellular mediator from isolated fat adipocytes and hepatocytes after treatment with the hypoglycaemic fragment of human growth hormone, hGH 6-13. The activity of the putative mediator observed in the cell "ghosts" of both liver and rat cells suggests that the active component is likely to be derived from plasma membranes and has an ubiquitous cellular distribution. The hGH fragment-induced release of the mediator from plasma membranes depends upon the physiological status of the animals. Liver plasma membranes of starved rats yield significantly higher levels of the cellular mediator in response to treatment with hGH 6-13. The studies of the physiological factors influencing the release of the material from cellular systems clearly enhance the production of adequate amounts of the cellular mediator for molecular characterization. The precise chemical nature and the physiological role of the hGH cellular mediator are currently unknown.


Immunological relationship and binding capacity of prolactin receptors in cytosolic and membrane fractions of rabbit mammary gland.
We have recently identified and partially characterized a specific lactogen binding protein in rabbit mammary gland cytosol. In this report, studies using pregnant or lactating rabbits are described which further characterize the cytosolic lactogen binding protein in relation to the membrane-bound lactogen receptor. The data show that in pregnant or lactating rabbits the binding capacity (fmol/mg protein) of membranes is at least double that of the cytosol preparation although when expressed on a tissue content basis (fmol/g tissue) there was no membrane-cytosol difference in receptor number. Treatment of lactating rabbits with CB-154, however, caused a marked increase (100-150%) in the binding capacity of membrane-bound receptors with comparatively little effect (+20%) on the cytosolic lactogram binding protein. There was also a marked difference in the association constants for 125I-hGH, with the cytosolic lactogen binding protein exhibiting a 6-fold higher affinity than the membrane-bound receptor. Three anti-prolactin receptor monoclonal antibodies (M110, A82 (antagonists) and A917 (agonist) have also been used to assess the relative immunological characteristics of the cytosolic lactogen binding protein and the membrane lactogen receptor. Each monoclonal antibody was able to inhibit the specific binding of 125I-hGH to both membranes and cytosol in a dose-dependent manner. However, the order of potency was not identical being M110 greater than A917 greater than A82 in membranes and M110 greater than A82 greater than A917 in cytosol. A917 was at least 10 times more active in membranes than cytosol whereas A82 was at least 10 times more active in cytosol.(ABSTRACT TRUNCATED AT 250 WORDS)


Organization and efferent connections of transplanted suprachiasmatic nuclei.
The hypothalamic suprachiasmatic nucleus (SCh) is the principal brain structure involved in the generation of circadian rhythms. In the present study, we have employed immunohistochemical techniques to evaluate the development of the fetal SCh following its transplantation to the brain of adult host animals. Donor hypothalami were obtained from normal Long-Evans fetuses and transplanted to the lateral, third, or fourth ventricle of Brattleboro rats. Neuronal aggregations exhibiting the organotypic features of the SCh were present in over 90% of the grafts recovered at each transplantation site. Like the normal endogenous SCh, SCh-like cell groups identified within the transplants contained a prominent population of parvicellular (9-13 micron), neurophysin-containing neurons that were immunopositive for vasopressin (VP) but not oxytocin. These SCh-like cell groups also invariably contained similar small neurons that were immunoreactive for vasoactive intestinal polypeptide (VIP). Typically, VP and VIP immunoreactive perikarya were concentrated in contiguous, complementary parts of the grafted SCh, but fibers immunoreactive for either peptide were distributed throughout the extent of the nucleus. Because the brain of the Brattleboro rat is deficient in vasopressin, it was possible to evaluate the projection of the vasopressinergic component of the transplanted SCh to the host brain. Although SCh were identified in grafts recovered from each intraventricular transplantation site, an appreciable input to the host brain could be identified only when the fetal tissue was grafted to the third ventricle. Here, grafted SCh established efferent connections with periventricular diencephalic structures which ordinarily receive a projection from the in situ SCh. Specifically, VP immunoreactive fibers originating from transplanted SCh were identified in the medial preoptic area, the periventricular and dorsomedial hypothalamic nuclei, the paraventricular nuclei of the thalamus and hypothalamus, and in the retrochiasmatic area, arcuate nucleus, and suprachiasmatic nucleus of the host brain. These results demonstrate that the fetal SCh not only survives transplantation but also retains its distinguishing cytological features and the capacity to form an appropriately restricted set of efferent connections with the brain of adult host animals.


Persistent truncus arteriosus on dual source CT.
Persistent truncus arteriosus is a rare congenital cardiac disease with variable presentation. The exact preoperative diagnosis and delineation of anatomy are very important because the optimal timing and procedure for truncus arteriosus repair are decided on the basis of the morphological characteristics. Moreover, the presence of associated anomalies influences the surgical outcome and mortality in these patients. Dual-source computed tomographic evaluation with three-dimensional post-processing is highly valuable for delineating its precise morphology and to identify and characterize the associated anomalies. Also depiction of the precise aortic arch morphology and simultaneous evaluation of the airway are very useful in treatment planning. This pictorial review provides an overview of the imaging spectrum of truncus arteriosus and various associated anomalies as seen on dual-source computed tomography.


The role of cryosurgery in the treatment of hepatic cancer: a report of 113 cases.
From November 1973 to June 1992, cryosurgery with liquid nitrogen (-196 degrees C) was performed on 113 patients with hepatic cancer, including 107 patients with primary liver cancer (PLC) and 6 patients with secondary liver cancer (SLC). Of the 107 PLC patients, the subclinical stage constituted 30.8% (33/107), the moderate stage 61.7% (66/107), and the late stage 7.5% (8/107). There were 32 cases with small PLC (up to 5 cm). Liver cirrhosis was observed in 86.0% (92/107). We designed flat cryoprobes for freezing tumors deep within the hepatic parenchyma. Intraoperative ultrasound was used for monitoring hepatic cryolesions. There were no operative mortalities and complications, such as rupture of a tumor, delayed bleeding, or bile leakage. The 5-year and 10-year survival rates were 22.0% and 8.2%, respectively, for the 107 PLC patients and 48.8% and 17.1%, respectively, for the 32 patients with small PLC. Of the 6 SLC patients, survival ranged from 2 months to 90 months (average, 23.2 months). One SLC patient has been well for 7 years and 6 months after cryosurgery. These results indicate that cryosurgery, the in situ freezing of cancer, is a safe and effective treatment for unresectable hepatic cancer.


Average conformations determined from PRE data provide high-resolution maps of transient tertiary interactions in disordered proteins.
In the last decade it has become evident that disordered states of proteins play important physiological and pathological roles and that the transient tertiary interactions often present in these systems can play a role in their biological activity. The structural characterization of such states has so far largely relied on ensemble representations, which in principle account for both their local and global structural features. However, these approaches are inherently of low resolution due to the large number of degrees of freedom of conformational ensembles and to the sparse nature of the experimental data used to determine them. Here, we overcome these limitations by showing that tertiary interactions in disordered states can be mapped at high resolution by fitting paramagnetic relaxation enhancement data to a small number of conformations, which can be as low as one. This result opens up the possibility of determining the topology of cooperatively collapsed and hidden folded states when these are present in the vast conformational landscape accessible to disordered states of proteins. As a first application, we study the long-range tertiary interactions of acid-unfolded apomyoglobin from experimentally measured paramagnetic relaxation enhancement data.


Oxygen-transport fluid based on perfluorochemicals: effects on liver biochemistry.
The effects of (1) i.v. injection of various perfluorochemical (PFC) emulsions, (2) different fractions of the non-ionic poloxamer surfactant, Pluronic F-68, or (3) i.p. injection of component PFC oils have been studied separately in male and female rats. Injection of 10 ml/kg body wt of either Fluosol-DA 20% (F-DA) or a novel perfluorodecalin emulsion containing a C-16 oil additive in male rats increased liver weight up to 7 days later; no corresponding effect occurred in response to injection of Oxypherol (FC-43). Liver weight was also increased in female rats at 72 hr after injection of the novel emulsion but this was less pronounced than in males; liver weight in female rats was unchanged in response to injection of either F-DA or FC-43 but was 12% greater at 72 hr after injection of FDC oil. Mean liver microsomal cytochromes P-450 concentrations in male rats were increased 2-3 fold at 72 hr after injection of either FDC, F-DA or the novel emulsion; a less pronounced increase was also seen at 7 days in animals receiving the novel emulsion. No significant alterations in cytochromes activity occurred in response to injection of FTPA, FTBA, the C-16 oil, FC-43 or either commercial grade or purified pluronic solution. Liver cytochromes P-450 concentrations in female rats were unaffected by any of the experimental treatments.


Corneal sensitivity in nephropathic cystinosis.
We measured corneal sensitivity in 14 patients with infantile nephropathic cystinosis and in 13 age-matched controls. All patients with cystinosis had the pathognomonic anterior segment findings of crystal deposition within conjunctiva and cornea. Transcutaneous stimulation of the supraorbital nerve and surface electromyographic recording of the orbicularis oculi muscle performed on four patients showed a normal afferent limb to the blink reflex. The corneal sensitivity in patients with cystinosis was 3.18 g/mm2; in the control subjects it was 0.43 g/mm2. This difference was statistically significant (P less than .001).


[Study on the situation regarding endoscope cleaning and disinfection in the department of otolaryngology in Hunan hospitals].
To investigate the situation regarding the cleaning and sterilization of endonasal endoscopes in department of otolaryngology in Hunan Province, and to provide strategy for improving the level of sterilization and management of endonasal endoscopes. A total of 100 medical institutions were investigated by spot assessment, check and sampling. Data was analyzed by multivariate analysis. The qualified rate of rules and regulations for endoscopy was 28.8% in the second-class hospitals and 45% in the top-class hospitals. The qualified rate of environment for endoscopy cleaning and sterilization was 36.3% in the second-class hospitals and 85% in the top-class hospitals. The main problems include lack of independent disinfection room, the space not large enough, and/or lack of ventilation system. The qualified rate of bacterial detection for post-sterilized endoscopes and biopsy forceps was 93.8% in the second-class hospitals and 95.0% in the top-class hospitals, and the main pathogenic bacteria was gram-positive cocci and gram-negative bacilli. The multivariate analysis showed that the influencial factors for endoscope cleaning and disinfection are as follows: staffs responsible for the cleaning and sterilization of otolaryngology endoscopes, the standard for cleaning and disinfection process, and the frequency of endoscope use. The present situation of cleaning and sterilization for otolaryngology endoscopes is better in the top-class hospitals than that in the second-class hospitals. The sterilization and management of otolaryngology endoscopy are needed to be improved, and the staff training is needed, especially in the primary hospitals.


Management of the helpless patient after radioiodine ablation therapy - are we being too strict?
A helpless patient was administered 1 GBq of I to ablate thyroid remnants post-thyroidectomy. The patient was quadriplegic, doubly incontinent and unable to swallow. Published data suggest that nursing staff may receive a total effective dose of 3400 microSv when dealing with such a patient for one 8 h shift per day for 7 days post-treatment. To quantify the effective doses received by nursing staff on dealing with a helpless patient undergoing radioiodine ablation therapy. After intravenous administration of 131I, the whole-body doses received by nursing staff were measured using electronic personal dosemeters for 7 days. The nursing staff recorded the times spent in contact with the patient and the activities performed during these times. The total effective dose received by nursing staff over 7 days was 148 microSv. A nurse working alone for one 8 h shift per day for 7 days could receive an effective dose of 91 microSv. The nursing staff spent an average of 23 min (standard deviation, 15 min) per 8 h shift dealing with the patient. Nursing duties were performed at a contact distance of approximately 0.5 m from the patient. The nursing contact times required for the management of a helpless patient post-radioiodine therapy are lower than previously estimated. It is possible to successfully treat such a patient whilst keeping the effective doses to nursing staff within appropriate constraints. The measured nursing contact times provide an up-to-date summary of current nursing practice and will be a useful aid in the planning of future treatments.


Phosphorylation of troponin I by protein kinase C: mechanism of inhibition by calmodulin and troponin C.
The mechanism by which calmodulin and troponin C influence phosphorylation of troponin I (TnI) by protein kinase C was investigated. The phosphorylation of TnI by protein kinase C requires the presence of acidic phospholipid, calcium and diacylglycerol. Light scattering intensity and fluorescence intensity experiments showed that TnI associated with the phospholipid membranes and caused extensive aggregation. In the presence of Ca2+, TnI-phospholipid interactions were prevented by approximately stoichiometric amounts of either troponin C or calmodulin. Troponin C was shown to completely inhibit phosphorylation of TnI by either protein kinase C or by phosphorylase b kinase. In contrast, calmodulin completely inhibited phosphorylation of TnI by protein kinase C, but had only little effect on TnI phosphorylation by phosphorylase b kinase. Inhibition by calmodulin did not appear to be due to interaction with PKC, since calmodulin mildly increased protein kinase C phosphorylation of histone III-S. The ratio of phosphoserine to phosphothreonine in protein kinase C-phosphorylated TnI remained approximately constant for reactions inhibited by up to 90% by calmodulin. TnI interactions with phospholipid and phosphorylation of TnI by PKC were also prevented by high salt concentrations. However, salt concentrations adequate to inhibit phosphorylation were sufficient to dissociate only TnI, but not protein kinase C from the membrane. These results suggest that the binding of TnI to phospholipid is required for phosphorylation by protein kinase C and that prevention of this binding by any means completely inhibited phosphorylation of TnI by protein kinase C.


Expression of capsaicin receptor (VR1) by myelinated primary afferent neurons in rats.
The expression of capsaicin (VR1) receptor by A-fiber primary afferent neurons has been investigated by double immunohistochemical staining with VR1 and 200 kD neurofilament (NF200; an A-fiber marker) antibodies, and by VR1 immunohistochemical staining in combination with cholera toxin B subunit (CTB; also an A-fiber marker) retrograde tracing. Approximately 30% of the VR1-positive dorsal root ganglion (DRG) neurons were NF200-positive. Intra-sciatic nerve injection of CTB labeled over 30% of the VR1-positive neurons in the L5 DRG. Size frequency distribution analysis revealed that these VR1 and NF200, or VR1 and CTB, double-labeled neurons were predominantly small and medium sized. These results suggest that capsaicin receptors are likely to be expressed by Adelta-fiber neurons as well as C-fiber neurons.


Steady-state plasma and bronchopulmonary characteristics of clarithromycin extended-release tablets in normal healthy adult subjects.
The steady-state concentrations of clarithromycin in plasma were compared with concomitant concentrations in epithelial lining fluid (ELF) and alveolar macrophages (AM) obtained from intrapulmonary samples during bronchoscopy and bronchoalveolar lavage (BAL). Concentrations of the major metabolite, 14-hydroxyclarithromycin, were also determined in plasma and AM. Forty-two healthy, non-smoking adult subjects (age: 18-54 years; 19 females, 23 males) received oral clarithromycin extended-release formulation (1000 mg once daily for five consecutive days). Bronchoscopy and BAL were carried out once in each subject at either 3, 6, 9, 12, 24 or 48 h after the last administered dose of clarithromycin. In addition, three subjects who did not take clarithromycin served as controls and underwent bronchoscopy at 0 h. Drug concentrations in plasma, ELF, and AM were determined by high-performance liquid chromatography. Clarithromycin was extensively concentrated in ELF [range of mean (+/-s.d.) concentrations: 6.38 +/- 3.92 to 11.50 +/- 6.65 mg/L] and AM (127.0 +/- 61.5 to 573.8 +/- 309.3 mg/L) than simultaneous plasma concentration (0.75 +/- 0.31 to 2.22 +/- 0.72 mg/L). The ranges of mean (+/-s.d.) concentrations of 14-hydroxyclarithromycin in plasma and AM were 0.52 +/- 0.29 to 0.80 +/- 0.31 mg/L and 22.1 +/- 13.5 to 49.5 +/- 16.2 mg/L, respectively. Once-daily dosing of extended-release formulation clarithromycin 1000 mg produced significantly (P < 0.05) higher steady-state concentrations of clarithromycin in ELF (2-14 times) and AM (50-700 times) compared to simultaneous plasma concentrations throughout the 24 h period after drug administration. The 14-hydroxy metabolite of clarithromycin achieved significantly (P < 0.05) higher steady-state concentrations in AM (18-180 times) compared with concurrent plasma concentrations.


Clinical significance of psychiatric comorbidity in children and adolescents with obsessive-compulsive disorder: subtyping a complex disorder.
A promising approach in relation to reducing phenotypic heterogeneity involves the identification of homogeneous subtypes of OCD based on age of onset, gender, clinical course and comorbidity. This study aims to assess the sociodemographic characteristics and clinical features of OCD patients in relation to gender and the presence or absence of another comorbid disorder. The sample comprised 112 children and adolescents of both sexes and aged 8-18 years, all of whom had a diagnosis of OCD. Overall, 67 % of OCD patients had one comorbid diagnosis, 20.5 % had two such diagnoses and 2.6 % had three comorbid diagnoses. The group of OCD patients with a comorbid neurodevelopmental disorder had significantly more family history of OCD in parents (p = .049), as compared with the no comorbidity group and the group with a comorbid internalizing disorder, and they also showed a greater predominance of males (p = .013) than did the group with a comorbid internalizing disorder. The group of OCD patients with internalizing comorbidity had a later age of onset of OCD (p = .001) compared with both the other groups. Although the initial severity was similar in all three groups, the need for pharmacological treatment and for hospitalization due to OCD symptomatology was greater in the groups with a comorbid neurodevelopmental disorder (p = .038 and p = .009, respectively) and a comorbid internalizing disorder (p = .008 and p = .004, respectively) than in the group without comorbidity. Our findings suggest that two subtypes of OCD can be defined on the basis of the comorbid pathology presented. The identification of different subtypes according to comorbidity is potentially useful in terms of understanding clinical variations, as well as in relation to treatment management and the use of therapeutic resources.


Effect of a cholesterol-lowering diet on maternal, cord, and neonatal lipids, and pregnancy outcome: a randomized clinical trial.
We assessed the effect of a cholesterol-lowering diet on maternal, cord, and neonatal plasma lipids and pregnancy outcome. Nonsmoking white women with singleton pregnancies (n = 290), aged 21 to 38 years, and with no previous pregnancy-related complications, were randomized to either continue their usual diet or to adopt a diet that promoted fish, low-fat meats and dairy products, oils, whole grains, fruits, vegetables, and legumes from gestational week 17 to 20 to birth. Maternal total and low-density lipoprotein cholesterol levels were lowered in the intervention compared with the control group (P < .01). Lipid levels in cord blood and in neonates born to mothers in the intervention versus the control groups did not differ. In the intention-to-treat cohort 1 (0.7%) of 141 women in the intervention group versus 11 (7.4%) of 149 women in the control group delivered before 37 weeks (RR 0.10; 95% CI 0.01-0.77). The incidence of other pregnancy complications and birth weight was similar in both groups. A cholesterol-lowering diet may modify maternal lipid levels but not cord and neonatal lipids. The marked observed effect of this diet on the reduction of preterm delivery in low-risk pregnancies should encourage future larger studies to clarify the role of such a diet in the prevention of preterm birth.


A double patch sandwich technique for surgical repair of acute aortic dissection type A.
This study compares two groups of patients with acute aortic dissection type A in whom two different techniques of anastomotic reinforcement were used, and evaluates the impact of these two techniques on perioperative blood loss and surgical outcome. One hundred eighty-five consecutive patients with acute aortic dissection type A between 1998 and 2002 were grouped according to the technique utilized for reinforcing the aortic anastomotic site. Group A consisted of 21 patients in whom a novel double patch sandwich technique was used, whereas in group B (164 patients) conventional Teflon felt strips served as reinforcement. Preoperative profiles were comparable for both groups. Deep hypothermia and circulatory arrest were used in 180 patients (97%). Retrograde cerebral perfusion and retrograde cardioplegia were used in 70 patients (38%). Hospital mortality for the two groups was 4.7% (1 of 21) and 18% (29 out of 164), p < 0.30, respectively. On average 2 versus 6 U of PRBC (p < 0.21), and 3 versus 5 U of FFP (p < 0.004) were given during operation in groups A and B, respectively, and indicates reduced suture line bleeding in group A. Modifications in the surgical technique for repair of acute aortic dissection type A, and in anastomotic reinforcement in particular, may lead to substantial reduction of suture line bleeding and diminished blood loss and transfusion requirements, and favorably affects patient outcome. Nevertheless, continued effort is mandatory to further enhance surgical outcome in this patient population.


Surgical injury of the common bile duct.
Review of our experience with twenty-two bile duct injuries and the literature leads us to the following conclusions: (1) Most biliary strictures follow surgery and can be avoided by adequate exposure, accurate dissection, use of hemostatic clips rather than clamps and ties, and the liberal use of operative cholangiography. (2) Injuries diagnosed at the time of surgery should be repaired by end-to-end anastomosis over a T tube if length is adequate or by Roux-en-Y choledochojejunostomy if length is inadequate. (3) The diagnosis of biliary injury should be suspected when jaundice, biliary fistula, or cholangitis occur in the postoperative period. (4) IVC, PTC, ERCP, or fistulography should be used when possible to delineate the site of injury or stricture and assist in planning the operative repair. (5) Surgery should be performed as soon as the diagnosis is made and the patient is in satisfactory condition for operation. (6) Early reoperation may be necessary to establish drainage and prepare for a later definitive procedure. In some cases, definitive repair can be performed this time. (7) Most late strictures should be repaired with a choledochojejunostomy to a defunctionalized limb of jejunum when resection and primary end-to-end repair cannot be accomplished.


Evaluation of a Rapid Immunochromatographic Diagnostic Test for the detection of rabies from brain material of European mammals.
The surveillance of rabies relies on investigations conducted on dead suspected animals or animals showing clinical signs suggestive of rabies. An immunochromatographic method based on lateral flow principle has been evaluated against a collection of brain samples mainly of European mammals including bats. The performance of this new test has been compared to the conventional gold standard methods: the fluorescent Antibody Test (FAT) and the Rapid Tissue Culture Infection Test (RTCIT). This test enabled the detection of various rabies strains belonging to rabies species 1, 5, 6 and 7 and demonstrated an overall specificity of 100% and a sensitivity of more than 88% when compared to FAT and RTCIT. A total agreement between the Rapid Immunochromatographic Diagnostic Test and conventional technique results have been obtained for European bat samples.


The utility of indocyanine green (ICG) for the identification and assessment of viability of the parathyroid glands during thyroidectomy.
We conducted this study to evaluate the ability of indocyanine green (ICG) and near infra-red fluorescence (NIRF) camera to aid in the identification and assessment of viability of parathyroid glands during thyroid surgery. A prospective observational study was conducted between May and October 2020 among 50 consecutive patients who underwent total thyroidectomy at a single institution. Parathyroid glands were identified under white light during thyroidectomy following which reconstituted ICG was injected through a peripheral vein and the location of parathyroid glands was confirmed. The perfusion to the parathyroid gland was assessed by documenting the fluorescence intensity score (FIS) and the parathyroid angiogram score (PAS). There was no difference in the number of parathyroid glands seen on visual inspection 147 (73.5%) when compared to under NIRF camera, 146 (73%). Though the rate of postoperative hypoparathyroidism was lower in the cohort with FIS 3 (14.2%) compared to score 2 and 1 (28.5% and 100%, respectively), this was not significant (p = 0.35). A significant correlation was noted between a delayed flow on PAS and the development of post-thyroidectomy hypoparathyroidism (p = 0.01). PAS had a sensitivity of 100%, specificity of 88.6%, NPV of 100% and PPV of 55.6% to predict the development of post-thyroidectomy hypoparathyroidism. In this study, there was no additional benefit of ICG and NIRF camera in the identification of parathyroid glands. However, ICG angiogram seems to be a good adjunct for the intraoperative assessment of the viability of the parathyroid glands and accurately predicts the development of postoperative hypoparathyroidism.


Quadruple therapy containing amoxicillin and tetracycline is an effective regimen to rescue failed triple therapy by overcoming the antimicrobial resistance of Helicobacter pylori.
To identify optimal antibiotics for second-line quadruple therapy of Helicobacter pylori after failed 1-week triple therapy. One hundred patients were enrolled in this study after the failure of 1-week triple therapy. They were randomized to receive 1-week quadruple therapy consisting of amoxicillin, omeprazole and bismuth salts, plus either metronidazole or tetracycline. Before quadruple therapy, the H. pylori culture of each patient was tested for metronidazole resistance or clarithromycin resistance by E-test. Six weeks later, an endoscopy or 13C-urea breath test was used to define the success of H. pylori eradication. The H. pylori eradication rates by intention-to-treat and per protocol analysis were higher in the tetracycline group than in the metronidazole group (intention-to-treat: 78% vs. 58%, P < 0.05; per protocol: 89% vs. 67%, P < 0.05). In the metronidazole group, but not in the tetracycline group, the per protocol eradication rate of quadruple therapy was lower for the infected isolates with metronidazole resistance than for those without metronidazole resistance (77% vs. 33%, P < 0.05). Quadruple therapy, including tetracycline and amoxicillin, improves the H. pylori eradication rate after failed triple therapy.


Aspartic acid and glutamic acid levels in the cochlear nucleus after auditory nerve lesion.
Aspartic acid, glutamic acid and alanine were measured in the cochlear nucleus after lesioning the auditory nerve by cochlear ablation. Ultrastructural analysis of the cochlear nucleus showed that most primary auditory terminals were degenerating one day after cochlear ablation; the terminals were enlarged and the number of synaptic vesicles was reduced. Primary auditory terminals were virtually gone three days after cochlear ablation. Aspartic acid decreased after cochlear ablation in parallel with the morphological degeneration of the primary auditory terminals. The level of total aspartic acid in the cochlear nucleus had decreased more than 8% one day after cochlear ablation and more than 30% after two days, and remained at this level up to 28 days. Glutamic acid also decreased in the cochlear nucleus after cochlear ablation but not in parallel with the morphological degeneration of the primary auditory terminals. Following a slight increase one day after cochlear ablation, total glutamic acid decreased about 10% after two days and continued to decrease slowly through to day 28. Alanine dropped slowly after cochlear ablation and not in parallel with the degeneration of the primary terminals. Levels of other amino acids measured were unchanged or had increased two days after cochlear ablation. Aspartic acid and glutamic acid did not decrease in the superficial layers of the dorsal cochlear nucleus, an area receiving little or no primary innervation.


Addition of ascorbic acid to the extracellular environment activates lipoplexes of a ferrocenyl lipid and promotes cell transfection.
The level of cell transfection mediated by lipoplexes formed using the ferrocenyl lipid bis(11-ferrocenylundecyl)dimethylammonium bromide (BFDMA) depends strongly on the oxidation state of the two ferrocenyl groups of the lipid (reduced BFDMA generally mediates high levels of transfection, but oxidized BFDMA mediates very low levels of transfection). Here, we report that it is possible to chemically transform inactive lipoplexes (formed using oxidized BFMDA) to "active" lipoplexes that mediate high levels of transfection by treatment with the small-molecule reducing agent ascorbic acid (vitamin C). Our results demonstrate that this transformation can be conducted in cell culture media and in the presence of cells by addition of ascorbic acid to lipoplex-containing media in which cells are growing. Treatment of lipoplexes of oxidized BFDMA with ascorbic acid resulted in lipoplexes composed of reduced BFDMA, as characterized by UV/vis spectrophotometry, and lead to activated lipoplexes that mediated high levels of transgene expression in the COS-7, HEK 293T/17, HeLa, and NIH 3T3 cell lines. Characterization of internalization of DNA by confocal microscopy and measurements of the zeta potentials of lipoplexes suggested that these large differences in cell transfection result from (i) differences in the extents to which these lipoplexes are internalized by cells and (ii) changes in the oxidation state of BFDMA that occur in the extracellular environment (i.e., prior to internalization of lipoplexes by cells). Characterization of lipoplexes by small-angle neutron scattering (SANS) and by cryogenic transmission electron microscopy (cryo-TEM) revealed changes in the nanostructures of lipoplexes upon the addition of ascorbic acid, from aggregates that were generally amorphous, to aggregates with a more extensive multilamellar nanostructure. The results of this study provide guidance for the design of redox-active lipids that could lead to methods that enable spatial and/or temporal control of cell transfection.


Highly active G-quadruplex/hemin DNAzyme for sensitive colorimetric determination of lead(II).
A UV-vis, CD, and differential pulse voltammetric study was performed on the deactivation of the activity of parallel G-quadruplex/hemin DNAzymes (G4 DNAzymes) by Pb(II). The G4 DNAzyme carries a d[TC] sequence at its 3' end and is stabilized by potassium(I). On addition of Pb(II), the K(I) ions in the parallel G4 are replaced by Pb(II) to keep the parallel topology. Intruded Pb(II) decrease the affinity between the topology and hemin, this leads to a decrease of DNAzyme activity for catalyzing the oxidation of 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) by hydrogen peroxide to form a green dye with an absorption maximum at 420 nm. The assay does not use any amplification, and has a linear response in the 0.01 to 10 μM Pb(II) concentration range and a 7.1 nM limit of detection. The method was successfully applied to the analysis of spiked water samples. Graphical abstractSchematic diagram of the colorimetric lead(II) assay based on the competition between K+ and Pb2+ stabilized G-quadruplex/hemin DNAzymes (G4 DNAzymes).


The nucleotide sequence of the Akv murine leukemia virus genome.
The nucleotide sequence of an infectious molecular clone of the Akv murine leukemia virus has been determined by the dideoxy chain termination method after subcloning in bacteriophage M13 vectors. The sequence predicts an RNA genome of 8371 nucleotides containing three large open reading frames corresponding to the gag, pol, and env genes. Signal sequences for transcription, splicing, and translation have been identified. The positions of 95 major RNase T1 resistant oligonucleotides of the Akv RNA genome have been located.


Hand-mirror (HM) cells in acute lymphoblastic leukaemia (A.L.L.). An attempt at cellular classification by morphometric analytical parameters using the S.A.M. (Shape Analytical Morphometry) system.
A morphometric study of the nuclear and cytoplasmic shape of a blastic population in a case of HM-A.L.L. was performed by comparing the two differently shaped populations with and without HM configuration. The results obtained using analytical size-independent parameters created by the S.A.M. work-station enable us to characterize the shape of both blastic cell populations quantitatively, and strongly suggest the existence of shape modulation from one cellular type toward the other. Thus a possible sequence from blastic cells (having regular, rather round nuclei) to HM cells (characterized by high distortion of both nucleus and cytoplasm) was proposed.


Comparison of three in-house multiplex PCR assays for the detection of Neisseria gonorrhoeae and Chlamydia trachomatis using real-time and conventional detection methodologies.
To develop and evaluate multiplex PCR assays for Chlamydia trachomatis and Neisseria gonorrhoeae, using real-time and conventional PCR detection methodologies. Two real-time multiplex PCR assays, using nuclease (TaqMan-ABI7500) and hybridisation (LightCycler) probe formats, and a third assay using conventional PCR with solid-phase hybridisation and colour detection, were developed. The porA pseudogene was targeted for N. gonorrhoeae, and the major outer membrane protein gene for C. trachomatis. A total of 145 urogenital specimens were tested in all assays, and the results were compared with the Roche Cobas Amplicor assay. There was little difference in clinical sensitivity and specificity, result discrimination and test cost for the three in-house assays. Our results showed that competitive inhibition of the PCR occurred in some samples that were positive for both organisms. These results highlight the suitability and versatility of three multiplex PCR methods for the detection of C. trachomatis and N. gonorrhoeae.


Differential expression of leaf proteome of tolerant and susceptible maize (Zea mays L.) genotypes in response to multiple abiotic stresses.
In the present work, tropical maize genotypes were evaluated for multiple stresses (drought × low-N and waterlogging × low-N) applied simultaneously to 30-day-old maize seedlings. Two-dimensional gel electrophoresis was used to examine the protein changes induced by combined stress, in leaves, of tolerant and susceptible genotypes. Moreover, physiological and biochemical parameters were assessed to understand the physiological status of tolerant and susceptible genotypes under combined stress. The results show that up-regulated proteins of the tolerant genotype have a significant role in activating defense response, restoration of plant growth, and to maintain metabolic homeostasis under stressful conditions. Therefore, they contribute to improve and maintain the state of acclimation of the genotype under stress. Alternatively in the susceptible genotype, the up-regulated proteins are representative biomarkers of stress or are involved in the defense against pathogens and efforts to maintain energy metabolism. Thus, protecting the survival of the genotype under multiple stress conditions. We conclude that depending on the given stress treatment, tolerant and susceptible genotypes differed in stress-enduring approaches. Therefore, the study provides insight to comprehend the response of tolerant and susceptible genotypes under combined stress conditions, which could be valuable for further research and will demonstrate that it is advantageous to select combined stress-tolerant genotypes.


Colocutaneous fistula--a rare complication of percutaneous endoscopic gastrostomy.
Although the percutaneous endoscopic gastrostomy technique for feeding is a fairly common procedure now, we have not come across a complication such as described below, a probable migration of the tube from the stomach to the colon, without any objective proof for this.


Chronic exposure to alcohol during development alters the calcium currents of cultured cerebellar Purkinje neurons.
The effect of chronic exposure to alcohol during development on the calcium currents of rat cerebellar Purkinje neurons was studied in a culture model system using voltage clamp techniques. The neurons were exposed to 30 mM alcohol (ethanol) during the main period of morphological and physiological development. The calcium currents were measured at the end of the treatment period, which lasted for 8-10 days. The currents were evoked by a series of depolarizing test commands from holding potentials of -62 mV and -90 mV. The evoked currents were qualitatively similar in control and alcohol-treated neurons and were comprised of a high threshold slowly inactivating calcium current and a low threshold rapidly inactivating calcium current. The low threshold current could be observed in isolation at test potentials ranging from -50 to -30 mV. The mean peak amplitude of this current was significantly smaller in the alcohol-treated neurons compared to controls. At more depolarized test potentials, the high threshold current dominated the current response, which was characterized by an initial peak that slowly declined to a smaller relatively sustained level. The mean amplitude of the high threshold current at both peak and sustained levels was significantly larger in the alcohol-treated neurons compared to controls. Measurement of cell size indicated that alcohol-treated neurons were approximately 25% smaller than control neurons, a difference that could contribute to the smaller low threshold current observed in these neurons. These data show that chronic exposure to alcohol during the development can significantly influence the amplitude of calcium currents of the cultured Purkinje neurons.(ABSTRACT TRUNCATED AT 250 WORDS)


The synthesis and biological activity of a novel series of diazepine MMP inhibitors.
A novel series of diazepine-based hydroxamic acid inhibitors of MMP-1, MMP-9, and MMP-13 were prepared and evaluated both in vitro and in vivo.


Chromium uptake by rice and accumulation in soil amended with municipal solid waste compost.
Effect of addition of municipal solid waste compost (MSWC) on chromium (Cr) content of submerged rice paddies was studied. Experiments were conducted during the three consecutive wet seasons from 1997 to 1999 on rice grown under submergence, at the Experimental Farm of Calcutta University, India. A sequential extraction method was used to determine the various chromium fractions in MSWC and cow dung manure (CDM). Chromium was significantly bound to the organic matter and Fe and Mn oxides in MSWC and CDM. Chromium content in rice straw was higher than in rice grain. Chromium bound with organic matter in MSWC best correlated with straw Cr (r=0.99**) followed by Fe and Mn oxides (r=0.97*) and water soluble as well as exchangeable fractions (r=0.96*). The water soluble and the exchangeable fractions in MSWC best correlated with grain Cr (r=0.98*). The Cr content of rice grain had the highest correlation with water soluble and exchangeable Cr (r=0.99**) while the straw Cr best correlated with the Fe and Mn oxides (r=0.98*). Both the carbonate bound and residual fractions in MSWC and CDM did not significantly correlate with rice straw and grain Cr. MSWC would be a valuable resource for agriculture if it can be used safely, but long-term use may require the cessation of the dumping by the leather tanneries and other major contributors of pollutants.


Managed retreat for climate change adaptation in coastal megacities: A comparison of policy and practice in Manila and Vancouver.
'Managed retreat' is gaining considerable attention as part of megacities' climate change adaptation and resilience enhancement toolkits, and as a policy option for disaster risk reduction in coastal regions. The overarching objective of managed retreat is to reduce the exposure of people and assets to flooding, storm surges and sea level rise by retreating from these threats in a planned fashion. Managed retreat is one of four main options covered in the 'PARA' (protect/accommodate/retreat/avoid) framework explained in this paper, which can be used to enhance resilience in coastal megacities. In this paper, qualitative research methods were used to collect primary data on the feasibility of using managed retreat for two case study coastal megacities: Manila, Philippines, and Vancouver, Canada. Both case studies review the risk context of each city, local climate change adaptation/disaster risk reduction (CCA/DRR) policies linked to managed retreat, examples of managed retreat practice, and barriers to managed retreat identified through primary or secondary data analysis. Comparisons between the two cases are then carried out, and similarities and differences are highlighted. The paper concludes by suggesting possible means by which barriers to managed retreat might be overcome.


Phonological patterns in the conversational speech of children with cochlear implants.
In this descriptive, longitudinal study, phonological patterns (i.e., natural phonological processes) were examined in a set of conversational speech samples obtained from six young children fitted with cochlear implants. Both developmental and non-developmental patterns were observed. This is consistent with findings from previous studies of the speech of children with hearing loss who wear hearing aids. Several of the patterns found were also the same as those reported in previous studies of children with cochlear implants. One developmental pattern and two non-developmental patterns were significantly correlated with age demonstrating a decrease over time. Trends were evident in several other patterns suggesting possible directions for future investigations. The reader will be able to (1) differentiate developmental from non-developmental phonological patterns, (2) identify the patterns that can be seen in the speech of children fitted with cochlear implants, and (3) understand the direction of pattern occurrence over time in this population.


Comparison of Clinical Outcomes of Different Connection Modes of Extracorporeal Membrane Oxygenation Combine with Continuous Renal Replacement Therapy.
To evaluate the effect of different connection modes of ECMO and CRRT on patients with acute kidney injury (AKI). Twenty-one patients received ECMO with AKI. These patients were admitted to our center from December 2018 to February 2021, selected, and treated with both ECMO and CRRT. They were divided into A connection mode (pre-membrane-pre-pump connection) and B connection mode (post-membrane-post-pump connection). We compared clinical indicators and outcomes between two connection modes. There were eight cases (38.91%) in A connection mode and 13 cases (61.09%) in B connection mode, with median durations of ECMO assistance of 5 days and 7 days, respectively. Median flow rates of ECMO of 3.0 L/min and 2.5 L/min, respectively; CRRT flow rates of 200 mL/min and 180 mL/min, respectively. CRRT filter lifetime was over 48h in both connection modes. Except for NT-pro BNP, no significant differences in clinical indicators were observed between the two groups before or after the treatment (P > .05). Both connection modes could achieve the therapeutic purpose and need no higher level of anticoagulation for patients simultaneously treated with ECMO and CRRT. Two modes had no impact on treatment effect and clinical indicators in patients. It had no effect on length of ICU stay and prognostic.


Atrazine degradation by encapsulated Rhodococcus erythropolis NI86/21.
To develop an encapsulation procedure for Rhodococcus erythropolis NI86/21 and demonstrate its use as a slow-release inoculant for reducing atrazine levels in aquatic and terrestrial environments. Alginate encapsulation procedures were developed for the atrazine-degrading bacteria R. erythropolis NI86/21. Several bead amendments, including bentonite, powdered activated carbon (PAC) and skimmed milk (SM), were evaluated for slow release of R. erythropolis NI86/21 and efficacy of atrazine degradation. All bead types demonstrated a capacity to degrade atrazine in basal minimal nutrient buffer whilst continually releasing viable bacterial cells. We found that the addition of bentonite hastened cell release whilst SM sustained cell viability in bead formulations. Reducing the percentage of SM to 1% (w/v) resulted in faster rates of atrazine degradation in both liquid and soil, and was found to prolong cell survival upon bead storage. Limited oxygen transfer affects the capacity of the encapsulated R. erythropolis cells to degrade atrazine. Degradation studies have demonstrated the efficacy of R. erythropolis encapsulated cells to degrade atrazine in amended liquid and soil. However, in their current formulation, the wet alginate-based beads are impractical for field application because of their poor cell viability during storage. R. erythropolis NI86/21-encapsulated cells have the potential to reduce atrazine residues in a number of soil and water environments, possibly ensuring the continued registration and use of atrazine in agriculture by minimizing or eliminating nontarget effects.


[Controlled cell cultivation. 2. Cultivation of mammalian cells and tissues in the perfusion chamber].
The results of biological testing of a perfusion chamber are presented. The chamber can be used for a prolonged cultivation of cells and tissues of different types on controlling the composition of nutrient medium and gas phase. The possibility is shown to apply the chamber for a prolonged cultivation and the observation of the behavior of live cells under different influences.


Soluble polymer traceless linker investigations: solvent effects on the desulfonylation of polyethylene glycol (PEG) substituted aryl alkyl sulfones with sodium amalgam.
The soluble polymer polyethylene glycol containing a traceless aryl alkyl sulfone linker was found to be resistant to reductive cleavage with sodium amalgam (Na/Hg). Detailed investigations revealed that the solvent plays an important role in the desulfonylation reaction; subsequently it was determined that MeOH/DMF (1/8) is an ideal solvent system for the cleavage of this traceless linker.


High incidence of 3-thalassemia, hemoglobin E, and glucose-6-phosphate dehydrogenase deficiency in populations of malaria-endemic southern Shan State, Myanmar.
Samples from 916 members of various ethnic groups from malaria-endemic southern Shan State, Myanmar, were analyzed for 3-thalassemia (3-thal), 3-thalassemia (3-thal), abnormal hemoglobin variants, and glucose-6-phosphate dehydrogenase (G6PD) deficiency. Of these subjects, 530 (57.9%) were found to have at least one of these red cell genetic disorders. The overall frequencies for the various red cell genetic disorders were as follows: 3-thal, 37.5% (343/916); hemoglobin E (Hb-E), 20.3% (186/916); G6PD-Mahidol, 17.5% (160/916); and 3-thal, 0.3% (3/916). The frequencies of combined disorders were 6.9% (63/ 916) for 3-thal/Hb-E, 5.7% (52/916) for 3-thal/G6PD-Mahidol, 2.8% (26/916) for Hb-E/G6PD-Mahidol, 1.1% (10/916) for 3-thal/Hb-E/G6PD-Mahidol, and 0.1% (1/916) for 3-thal/3-thal/G6PD-Mahidol. Of the various ethnic and non-ethnic groups, the Bamar population showed the highest frequencies of 3-thal (56.9%, 177/311), Hb-E (28.3%, 88/311), and G6PD-Mahidol (21.2%, 66/311) (all duplicated and triplicated cases were included). In addition, 2 new mutations, an 3 gene triplication (/333(anti3.7); 0.2%, 2/916) and Hb-Neapolis (0.1%, 1/916), were detected. Our results showed that race was the dominant factor affecting the frequencies of red cell genetic disorders in malaria-endemic areas of Myanmar.


Fluorescence activated cell sorting: a reliable method in tissue engineering of a bioprosthetic heart valve.
Techniques of tissue engineering are used to seed human autologous cells in vitro on degradable mesh to create new functional tissue like a bioprosthetic heart valve. A precondition is subsequent seeding of native-valve-analogous pure endothelial and myofibroblast cell lines. The aim of this study is to find a safe method of isolating viable cell lines out of tissues from the operating room. Mixed cells from ascending aorta obtained from the operating room were incubated with an endothelial-specific fluorescent marker. The labeled cells were activated and sorted by flow cytometry. Isolated cell lines were cultured and thereafter square sheets of polymeric scaffold were seeded with myofibroblasts, followed by endothelial cells. The created tissue was stained with hematoxylin and eosin, van Gieson stain, and stains for factor VIII and CD34. Control culture samples (n = 25) revealed vital uncontaminated endothelial and myofibroblast cell lines. Microscopy of the seeded meshes (n = 16) demonstrated a tissue-like structure. Van Gieson stain showed production of collagen. Endothelial cells formed a superficial monolayer, demonstrated by factor VIII and CD34; no invasive formation of capillaries was detectable. These results demonstrate that fluorescence activated cell sorting is a reliable and safe method to gain pure vital autologous cell lines out of human mixed cells for subsequent seeding on degradable mesh and that those cells are active to form new tissue.


Mucus protectors: Promising therapeutic strategies for inflammatory bowel disease.
Inflammatory bowel disease (IBD) is a group of intestinal non-specific inflammatory diseases with unclear pathogenesis, characterized with the impaired intestinal mucosal barriers and the activated immune system. Mucus layer is the vital protector over the intestinal epithelia cells (IECs). Mucus layer with impaired function could not provide isolated protection for IECs and thus proteases and pathogens from the gut lumen attacked and damaged the epithelial layer. Clinical manifestation and histopathology suggest that IBD might be a self-digestive inflammatory disease caused by digestive enzymes. In this review, we specifically focus on the role of intestinal mucosal barriers and aim to summarize the relationship among mucus layer, self-digestion and inflammation in IBD. We also propose a "Two Hits" Self-Digestion theory to explain the role of self-digestion in IBD and assess the application of mucus protectors to treat IBD.


Effect of high-flow nasal cannula oxygen therapy on exercise tolerance in patients with idiopathic pulmonary fibrosis: A randomized crossover trial.
Exercise capacity in idiopathic pulmonary fibrosis (IPF) is limited by exercise-induced hypoxaemia. This study aimed to examine the effect of high-flow nasal cannula oxygen therapy (HFNC) on exercise tolerance in patients with IPF. We conducted a single-centre, open-label, randomized crossover trial to compare HFNC and Venturi mask (VM) therapy in terms of exercise tolerance. Patients underwent constant-load symptom-limited exercise testing at 80% peak work rate with HFNC or a VM in a randomized order. The settings were 60 L/min and a 50% fraction of inspired oxygen (FiO2 ) for HFNC and 12 L/min and 50% FiO2 for VM. The primary outcome was endurance time, and the secondary outcomes were heart rate (HR), percutaneous oxygen saturation (SpO2 ), dyspnoea and leg fatigue, as determined by the modified Borg Scale at the isotime and endpoint, and the level of comfort while using the devices. Twenty-four participants (75.0% men; age, median [interquartile range]: 77.5 [68.8-83.0] years) were enrolled. Compared with VM, HFNC significantly improved the endurance time (647.5 s [454.0-1014.8] vs. 577.5 s [338.0-861.5]), minimum SpO2 (96.0% [95.0-98.0] vs. 94.0% [92.8-96.0]) and leg fatigue at the isotime (3.0 [1.6-4.0] vs. 5.0 [3.0-6.3]) and endpoint (4.0 [2.8-5.0] vs. 5.0 [3.8-6.3]). Differences in maximum HR, dyspnoea at the isotime and endpoint and comfort were non-significant between HFNC and VM therapy. HFNC increased exercise tolerance in patients with stable IPF experiencing exercise-induced hypoxaemia.


Cytogenetic monitoring of hospital workers exposed to low-level ionizing radiation.
In the present study the cytogenetic effects in hospital workers exposed to low-level radiation were evaluated. Samples of peripheral blood were collected from 63 subjects working in radiodiagnostics and from 30 subjects, working in the same hospitals, who were used as controls. A higher number of cells with chromosome-type aberrations (CA) was observed in the exposed workers vs. the controls and the difference was statistically significant (p less than 0.05). No correlation was, on the contrary, found between CA and years of exposure. A significant difference was observed in the incidence of cells with CA between smokers and non-smokers, but in the control group only. In contrast, in the workers exposed to ionizing radiation, the frequency of cells with CA was very similar in smokers and non-smokers.


Elderly peoples' experiences of nursing homes in Bam city: A qualitative study.
With the increasing number of elderly, especially in recent decades, transfer to nursing homes and the number of centers has also increased but experiences and problems of elders in these centers is less considered. So, the goal of this study is to explore the Elderly peoples' experiences of nursing homes. The current research was performed using a phenomenological approach in 2016. Participation in the study is comprised of the elderly residents in a nursing home in Bam city who were selected based on an objective-oriented approach. The sampling was done until data saturation. Data collection methods were observation and an unstructured and in-depth interview. Data were analyzed using seven-stage Colaizzi process. In total, fifteen 68 - 82 years old people participated in our study and 52 primary and conceptual codes that were eventually categorized in five main themes (sense of rejection, sense of daily routine, impaired of communications, sense of hardship and mental obsession) and ten sub-themes emerged. Overall, most of the elders were not satisfied with the conditions. It seems that helpful, community and family education to acculturate respect for the elderly in the community, teach proper coping strategies, use the elderly's experiences, and consultation with them could be a way to maintain a sense of usefulness, independence and to prevent them from sensing monotonous and routine rhythm of life.


Primary mediastinal large B-cell lymphoma.
Primary mediastinal large B-cell lymphoma (PMLBCL) is a distinct clinical and biological disease from other types of DLBCL. It is more frequent in young female and constitutes 6%-10% of all DLBCL. PMLBCL is characterized by a diffuse proliferation of medium to large B-cells associated with sclerosis. Molecular analysis shows it to be a distinct entity from other DLBCL. Rituximab CHOP/MACOP-B-like regimens followed by mediastinal radiotherapy (RT) were associated with a 5-years PFS of 75%-85%. More intensive regimens, as DA-EPOCH-R without mediastinal RT, have shown very promising results, but this therapeutic advance needs to be confirmed in further prospective trials. The role of consolidative mediastinal RT should be still better assess in prospective comparative studies. PET-CT scan is a powerful tool to define the real quality of response and it is hoped that future prospective trials may allow its role in the de-escalation of mediastinal RT.


Epitaxially Integrated Hierarchical ZnO/Au/SrTiO3 and ZnO/Ag/Al2O3 Heterostructures: Three-Dimensional Plasmo-Photonic Nanoarchitecturing.
In this study, we fabricated three-dimensional (3D) hierarchical plasmo-photonic nanoarchitectures by epitaxially integrating semiconducting zinc oxide (ZnO) nanowires with vertically oriented plasmonic gold (Au) and silver (Ag) nanoplatforms and investigated their growth mechanisms in detail. We synthesized 3D hierarchical Au-ZnO nanostructures via a vapor-solid mechanism leading to the epitaxial growth of ZnO nanowires on vertically oriented single-crystalline Au nanowires on a strontium titanate (SrTiO3) substrate. The elongated half-octahedral Au nanowires with a rhombus cross-section were transformed into thermodynamically stable elongated cuboctahedral Au nanowires with a hexagonal cross-section during the reaction. After the transformation, ZnO thin films with six twinned domains were formed on the side planes of the elongated cuboctahedral Au nanowire trunks, and six ZnO nanowire branches were grown on the ZnO thin films. Further, 3D hierarchical Ag-ZnO nanostructures were obtained via the same vapor-solid mechanism leading to the epitaxial growth of ZnO nanowires on vertically oriented Ag nanoplates on an aluminum oxide (Al2O3) substrate. Therefore, the growth mechanism developed herein can be generally employed to fabricate 3D hierarchical plasmo-photonic nanoarchitectures.


Challenging Assumptions of Outcomes and Costs Comparing Peritoneal and Hemodialysis.
Policy makers have suggested increasing peritoneal dialysis (PD) would improve end-stage kidney disease (ESKD) outcomes and reduce Medicare spending compared with hemodialysis (HD). We compared mortality, hospitalizations, and Medicare spending between PD and HD among uninsured adults with incident ESKD. Using an instrumental variable design, we exploited a natural experiment encouraging PD among the uninsured. Uninsured patients usually receive Medicare at dialysis month 4. For those initiating PD, Medicare covers the first 3 dialysis months, including predialysis services in the calendar month when dialysis started. Starting dialysis later in a calendar month increases predialysis coverage that is essential for PD catheter placements. The policy encourages PD incrementally when ESKD develops later in the month. Dialysis start day appears to be unrelated to patient characteristics and effectively "randomizes patients" to dialysis modality, mitigating selection bias. Starting dialysis later in the month was associated with an increased PD uptake: every week later in the month was associated with an absolute increase of 0.8% (95% confidence interval [CI] 0.6%-0.9%) at dialysis day 1 and 0.5% (95% CI 0.3%-0.7%) at dialysis month 12. We observed no significant absolute difference between PD and HD for 12-month mortality (-0.9%, 95% CI -3.3% to 0.8%), hospitalizations during months 7 to 12 (-0.05, 95% CI -0.20 to 0.07), and Medicare spending during months 7 to 12 (-$702, 95% CI -$4004 to $2909). In an instrumental variable analysis, PD did not result in improved outcomes or lower costs than HD.


The association of serum uric acid with metabolic syndrome and its components-From a single-clinical centre in China.
Increasing evidence suggests that uric acid (UA) levels may play a role in the MetS. The purpose of this study was the association of serum uric acid with metabolic syndrome and its components from a single-clinical centre in China. We retrospectively analysed the physical examination information of patients at the Health Checkup Centre of the Beijing Friendship Hospital, Capital Medical University in 2018. MetS was defined as ≥3 of the risk factors according to the revised Harmonised criteria. Statistical analyses were performed using the SPSS statistical software package, version 22.0 (IBM Corporation, Armonk, NY, USA). A total of 36 663 subjects were retrospectively analysed. The incidence of MetS was 23.6% amongst the study participants and 38.9% in subjects with HUA. The incidence of HUA was 33.3% in the MetS group. Higher SUA levels were correlated with an increased risk of having full MetS, hypertriglyceridemia and low HDL-C after adjustment (all P < .001 for the trend). Only in males higher SUA levels correlated with an increased risk of being overweight. Individuals with the highest quartile of SUA had no significant association with having HP in males, and a significant association between SUA levels and hypertension was only seen in the highest quartile of females. Males with the highest quartile of SUA (Q4) and females with the higher quartiles of SUA (Q3 and Q4) had no significant association with having hyperglycemia. The incidence of HUA was increased in the MetS group consisting of Chinese patient subjects living in Beijing. SUA is strongly associated with full MetS as well as hypertriglyceridemia and low HDL-C. The relationship between HUA and an overweight BMI, HP and hyperglycemia varied by gender.


Hybridization of nucleic acids directly in agarose gels.
Nucleic acids, both DNA and RNA, separated on agarose gels can be visualized by direct hybridization of the dried gel with appropriate radioactive probes. This method does not involve the transfer of the nucleic acid from the gel. The method requires less manipulation than other procedures; it is extremely rapid, sensitive, and inexpensive. These attributes make this procedure a valuable alternative or supplement to the commonly used methods for visualization by hybridization of nucleic acids separated on agarose gels.


Mapping antibody binding sites on protein antigens.
The large surfaces of protein antigens that interact with antibody-combining sites can be determined using deuterium-exchange labelling and two-dimensional 1H nuclear magnetic resonance (NMR). This technique may also be applied to other protein-protein interactions to identify key residues that contribute to the affinity.


Vascular endothelial growth factor-regulated ovarian cancer invasion and migration involves expression and activation of matrix metalloproteinases.
Vascular endothelial growth factor (VEGF) expression is elevated in primary ovarian tumors and metastases. We examined the effect of VEGF on epithelial ovarian cancer (EOC) in vitro invasion and migration and underlying mechanisms. Using the Matrigel invasion assay and colloidal gold phagokinetic track assay, we found that VEGF induced EOC DOV13 invasion and migration in a matrix metalloproteinase (MMP)-dependent manner. Using Western blotting, we show that VEGF, at 20-80 ng/ml, induced secretion of pro-MMP-7 and pro-MMP-9 and activation of pro-MMP-2 in DOV13 conditioned medium in a concentration-dependent manner. However, gelatinolytic activity and total MMP-7 protein in DOV13 conditioned medium reached the maximum upon VEGF treatment at 20-40 ng/ml and decreased at higher-concentration VEGF treatment (80 ng/ml), as shown by DQ-gelatin degradation assay and ELISA. In addition to the effect on MMP secretion/activation, VEGF stimulated secretion of TIMP-2; and blocking TIMP-2 activity by an anti-TIMP-2 MAb significantly increased VEGF (80 ng/ml)-induced DOV13 invasion (p < 0.05), suggesting that VEGF may regulate MMP-2 activity in DOV13 conditioned medium through TIMP-2. Using real-time PCR, we found that VEGF, at 20 ng/ml, significantly increased the expression of VEGFR-1 and VEGFR-2 by approximately 4-fold and 31-fold, respectively, compared to untreated control (p < 0.05). However, the inducing effect of VEGF on VEGFR-2 expression and the internal expression of VEGF121 in DOV13 cells decreased with increasing of VEGF concentration, suggesting the existence of a negative feedback regulatory mechanism. In summary, our results indicate that VEGF may regulate EOC invasion and migration through VEGFR-mediated secretion and activation of MMPs.


Contribution of hepatic lipase, lipoprotein lipase, and cholesteryl ester transfer protein to LDL and HDL heterogeneity in healthy women.
Hepatic lipase (HL) and cholesteryl ester transfer protein (CETP) have been independently associated with low density lipoprotein (LDL) and high density lipoprotein (HDL) size in different cohorts. These studies have been conducted mainly in men and in subjects with dyslipidemia. Ours is a comprehensive study of the proposed biochemical determinants (lipoprotein lipase, HL, CETP, and triglycerides) and genetic determinants (HL gene [LIPC] and Taq1B) of small dense LDL (sdLDL) and HDL subspecies in a large cohort of 120 normolipidemic, nondiabetic, premenopausal women. HL (P<0.001) and lipoprotein lipase activities (P=0.006) were independently associated with LDL buoyancy, whereas CETP (P=0.76) and triglycerides (P=0.06) were not. The women with more sdLDL had higher HL activity (P=0.007), lower HDL2 cholesterol (P<0.001), and lower frequency of the HL (LIPC) T allele (P=0.034) than did the women with buoyant LDL. The LIPC variant was associated with HL activity (P<0.001), HDL2 cholesterol (P=0.034), and LDL buoyancy (P=0.03), whereas the Taq1B polymorphism in the CETP gene was associated with CETP mass (P=0.002) and HDL3 cholesterol (P=0.039). These results suggest that HL activity and HL gene promoter polymorphism play a significant role in determining LDL and HDL heterogeneity in healthy women without hypertriglyceridemia. Thus, HL is an important determinant of sdLDL and HDL2 cholesterol in normal physiological states as well as in the pathogenesis of various disease processes.


Cell-Based Optimization of Covalent Reversible Ketoamide Inhibitors Bridging the Unprimed to the Primed Site of the Proteasome β5 Subunit.
The ubiquitin-proteasome system (UPS) is an established therapeutic target for approved drugs to treat selected hematologic malignancies. While drug discovery targeting the UPS focuses on irreversibly binding epoxyketones and slowly-reversibly binding boronates, optimization of novel covalent-reversibly binding warheads remains largely unattended. We previously reported α-ketoamides to be a promising reversible lead motif, yet the cytotoxic activity required further optimization. This work focuses on the lead optimization of phenoxy-substituted α-ketoamides combining the structure-activity relationships from the primed and the non-primed site of the proteasome β5 subunit. Our optimization strategy is accompanied by molecular modeling, suggesting occupation of P1' by a 3-phenoxy group to increase β5 inhibition and cytotoxic activity in leukemia cell lines. Key compounds were further profiled for time-dependent inhibition of cellular substrate conversion. Furthermore, the α-ketoamide lead structure 27 does not affect escape response behavior in Danio rerio embryos, in contrast to bortezomib, which suggests increased target specificity.


Plasma renin-angiotensin system-regulating aminopeptidase activities are modified in early stage Alzheimer's disease and show gender differences but are not related to apolipoprotein E genotype.
Alterations in blood pressure and components of the renin-angiotensin system (RAS) contribute to the development and progression of Alzheimer's disease (AD), resulting in changes that can lead or contribute to cognitive decline. Aspartyl aminopeptidase (ASAP), aminopeptidase A (APA), aminopeptidase N (APN) and aminopeptidase B (APB) catabolise circulating angiotensins, whereas insulin-regulated aminopeptidase (IRAP) has been described as the AT4 receptor. We have found in AD patients a significant decrease of APA activity in men but not in women, and of APN, APB and IRAP in both genders, when compared with control subjects. No changes were found in ASAP activity. Also, APN, APB and IRAP but not APA correlated with the Mini-Mental test, but no relationship with APOE genotype was found. We conclude that several components of the RAS are modified in AD patients, with gender differences. Furthermore, ROC analysis indicates that APN, APB and IRAP activities could be useful non-invasive biomarkers of AD from the earliest stages.


River toxicity assessment using molecular biosensors: Heavy metal contamination in the Turag-Balu-Buriganga river systems, Dhaka, Bangladesh.
Pollution in rapidly urbanising cities and in delta systems is a serious problem that blights the lives and livelihoods of millions of people, damaging and restricting potable water supply and supplies to industry (Whitehead et al, 2015, 2018). Employing new technology based on luminescent molecular biosensors, the toxicity in the rivers around Dhaka in Bangladesh, namely the Turag, Tongi, Balu and Buriganga, has been assessed. Samples taken at 36 sites during medium and low flow conditions and during the Bishwa Ijtema Festival revealed high levels of cell toxicity, as well as high concentrations of metals, particularly aluminium, cadmium, chromium, iron, zinc, lithium, selenium and nickel. Chemical analysis also revealed low dissolved oxygen levels and anoxic conditions in the rivers at certain sites. The bacterial molecular biosensors were demonstrated to be fast, with results in 30 min, robust and a highly sensitive method for the assessment of water toxicity in the field. Furthermore, the biosensor toxicity analysis correlated with the metals data, and a multivariate regression relationship was developed relating toxicity to key metals, such a selenium, zinc and chromium. The resulting model has been validated against split samples and the Bishwa Ijtema Festival data. The combination of modelling and the molecular biosensor technology provides a new approach to detecting and managing pollution in urban river systems.


The efficacy of passiflora incarnata linnaeus in reducing dental anxiety in patients undergoing periodontal treatment.
Oral premedication used to reduce the anxiety in patients undergoing dental treatment. Passion flower has been used as a sedative that can control the dental anxiety. This study determines the efficacy of Passion flower, in reducing anxiety during the dental procedures. In this randomized- one sided blind clinical trial, 63 patients, with moderate, high and severe anxiety(according to VAS score) in need of periodontal treatment were randomly divided into 3 groups of 21.The first group was given the drop Passion flower drop and the second group were given the drop of placebo and the third group; neither drug nor placebo were given (negative control group). RESULTS were analyzed by Chi Square, Variance Analysis, Tucky and Paired-T using SPSS software. Mean anxiety level prior to the drug administration was 12.09±2.42 for the Passion flower group, 12.00±2.66 for the placebo group and 11.66±2.39 for the negative control group. After premedication, these values were: 8.47±2.58 for the Passion flower group, 10.52±2.11 for the placebo group and 11.23±2.34 for the negative control group. These results demonstrated a significant difference (p< 0.0001) in the anxiety levels before and after the Passion flower administration in the Passion flower group and also between the Passion flower group and the other two groups. RESULTS indicated that administration of Passion flower, as a premedication, is significantly effective in reducing the anxiety. Since this study is a pioneer on the subject, further trials with greater number of subjects are required to confirm our results.


Mechanisms of heavy metal sorption on alkaline clays from Tundulu in Malawi as determined by EXAFS.
Chromium(III), copper(II), zinc(II), cadmium(II), mercury(II) and lead(II) cations are among the most common heavy metal pollutants in industrial waste waters. In our continued work on cost effective wastewater heavy metal removal agents and methods using local material, this study examines the interactions of chromium(III), copper(II), zinc(II), cadmium(II), mercury(II) and lead(II) cations with natural mixed clay minerals from Tundulu in Malawi using extended X-ray absorption fine structure (EXAFS) spectroscopy. The mixed clays were previously characterised and found to contain illite, low ordered kaolinite, mixed layer minerals and the non-clay mineral carbonate fluoroapatite with a mean pH(PZC) of 9.63. The EXAFS analyses provided qualitative evidence that oxygen atoms occupy the first coordination shells in all the studied central atoms. The metal species on the clay mineral surfaces seem to be adsorbates and/or precipitates of hydrolysis products. Chromium(III) forms a polynuclear hydrolysis complex on the mineral surface with Cr-O bond and Cr...Cr distances of 2.00 and 3.03 A, respectively, which is indicative of a chain structure with edge sharing CrO(6) octahedra. Copper(II) is bound to phosphate groups on the surface at low pH and has a first shell of coordinated oxygen atoms with Jahn-Teller distortion as revealed by different Cu-O bonds of 1.96 A for the equatorial ones, at 2.30 and 2.65 A for the axial oxygens, and a Cu-P distance at 3.29 A is distinguished as well. Upon treatment at neutral pH copper(I) oxide seems to be the main precipitation product on the clay surface. At neutral pH zinc(II) forms also polynuclear hydrolysis complexes with Zn-O bond and Zn...Zn distances of 2.01 and 3.11A, respectively, which shows the presence of edge sharing ZnO(4) tetrahedra. Cadmium(II) is adsorbed to the clay surfaces as a six-coordinated CdO(6) complex in octahedral fashion, but it is not possible to distinguish if cadmium is hydrated or partly hydrolysed. Mercury(II) is present as linear O-Hg-O units but without any observable Hg...Hg distance at high pH showing that mercury(II) is hydrolysed but not present as mercury(II) oxide. At low pH, linear O-Hg-Hg-O units are present showing that mercury(II) is reduced to mercury(I). No precise chemical environment around the lead(II) could be obtained for the lead(II) treated clays due to formation of different hydrolysis structures with multiple coordination numbers by lead(II) salts on the mixed clays.


Attenuated alpha oscillation and hyperresponsiveness reveals impaired perceptual learning in migraineurs.
Anomalous phantom visual perceptions coupled to an aversion and discomfort to some visual patterns (especially grating in mid-range spatial frequency) have been associated with the hyperresponsiveness in migraine patients. Previous literature has found fluctuations of alpha oscillation (8-14 Hz) over the visual cortex to be associated with the gating of the visual stream. In the current study, we examined whether alpha activity was differentially modulated in migraineurs in anticipation of an upcoming stimulus as well as post-stimulus periods. We used EEG to examine the brain activity in a group of 28 migraineurs (17 with aura /11 without) and 29 non-migraineurs and compared their alpha power in the pre/post-stimulus period relative to the onset of stripped gratings. Overall, we found that migraineurs had significantly less alpha power prior to the onset of the stimulus relative to controls. Moreover, migraineurs had significantly greater post-stimulus alpha suppression (i.e event-related desynchronization) induced by the grating in 3 cycles per degree at the 2nd half of the experiment. These findings, taken together, provide strong support for the presence of the hyperresponsiveness of the visual cortex of migraine sufferers. We speculate that it could be the consequence of impaired perceptual learning driven by the dysfunction of GABAergic inhibitory mechanism.


Hydrophobic modifications at 1-phosphate of inositol 1,4,5-trisphosphate analogues enhance receptor binding.
Inositol 1,4,5-trisphosphate (IP(3)) analogues were synthesized in order to investigate the importance of the environment of 1-phosphate of IP(3) for strong binding to the IP(3) receptor. Our results show that hydrophobic modifications of the 1-phosphate moiety enhance the binding affinity, with considerable latitude of substituent structure.


Prehospital use of neuromuscular blocking agents in a helicopter ambulance program.
We prospectively studied the use of succinylcholine chloride and pancuronium bromide by the physician/nurse flight team of our hospital-based helicopter ambulance service. Patients who received these agents at the scene of an accident (prehospital group, n = 39) were compared with patients who were paralyzed by the flight team in the emergency department of transferring hospitals (control group, n = 35). By protocol, succinylcholine was used primarily for endotracheal intubation and pancuronium for prolonged paralysis after endotracheal intubation. Seventy-four patients received one or both agents. Overall, 61 of 74 patients had intracranial pathology as their primary diagnosis (82%). Endotracheal intubation was the primary indication for paralysis in the majority of patients (67 of 74), although intracranial pressure control, ventilation, agitation control, and seizure control were frequent secondary indications. Prior intubation attempts had failed in 40 of 74 patients (54%). After paralysis, intubation was successful in 68 of 71 patients (96%). Serious complications (ie, dysrhythmia requiring drug therapy) occurred in three patients but resolved with appropriate therapy in each case. Minor complications (ie, dysrhythmia not requiring drug therapy, histamine flush, infiltrated IV line) occurred in 18 patients. There was no significant difference in successful intubation or complication rate between the prehospital and control group. Paralysis allowed airway stabilization in a significant number of critically ill patients who could not otherwise be endotracheally intubated, with a lower incidence of complications than has been previously reported for ED patients. These results suggest that neuromuscular blocking agents can be used safely and effectively at accident scenes by a physician/nurse team.


Functional Recovery After Wharton's Jelly-Derived Mesenchymal Stem Cell Administration in a Patient with Traumatic Brain Injury: A Pilot Study.
To introduce a traumatic brain injury (TBI) patient who underwent stem cell transplantation (SCT) in order to minimize the remaining injury deficiencies. This study included a 29 years old male who had TBI resulting from a vehicle accident which took place one and a half years ago. The participant received six doses of intrathecal, intramuscular, and intravenous transplantation of Wharton?s jellv-derived mesenchymal stem cells (WJ-MSCs) at a goal dose of 1xl0 < sup > 6 < /sup > / kg respectively for each route of administration for six months. No important negative effects were reported. The patients? speech, cognitive, memory and fine motor skills were improved. The efficacy of treatment with SCT was assessed with cranial magnetic resonance imaging (MRI), computed tomography (CT) screening, and electroencephalography (EEG). SCT can have a promising future as a medical approach in recurrent TBI.


Preparation of capsules containing rejuvenators for their use in asphalt concrete.
Every year, there is a demand of more than 110 million metric tons of asphalt all around the world. This represents a huge amount of money and energy, from which a good part is for the preservation and renovation of the existing pavements. The problem of asphalt is that it oxidizes with time and therefore its beneficial properties disappear. Traditionally, rejuvenators spread in the road surface, are used to restore the original properties of the pavement. The problem is that, for a rejuvenator to be successful, it must penetrate the pavement surface. Furthermore, application of a rejuvenator will reduce the skid resistance of the pavement and, besides, rejuvenators have many aromatic compounds that can be harmful for the environment. To solve these problems this paper introduces a new concept in road construction: encapsulated rejuvenators. The basic principle is that when the stress in capsules embedded in the asphalt reaches a certain threshold value, the capsules break and some rejuvenator is released, restoring the original properties of the pavement. This paper will show how to prepare such capsules and how to determine their characteristics. This is one of the first steps towards intelligent pavements.


Ionomycin releases calcium from the sarcoplasmic reticulum and activates Na+/Ca2+ exchange in vascular smooth muscle cells.
Ionomycin (1 microM) produced a large spike in cytosolic free Ca2+ [( Ca2+]i). The ionophore had no effect on [Ca2+]i if the sarcoplasmic reticulum had previously been Ca2+ depleted by stimulating neurohormone receptors. Ionomycin markedly increased 45Ca2+ efflux and decreased total cell Ca2+ by 60 to 70% in 1 min. Replacing extracellular Na+ [( Na+]o) with choline or N-methyl-D-glucamine strongly inhibited the effects of ionomycin on 45Ca2+ efflux and total Ca2+. Ionomycin caused similar peak increases in [Ca2+]i in the presence and absence of [Na+]o, but the exponential fall from the peak was faster in the presence of [Na+]o. Dimethylbenzamil, a potent blocker of Na+/Ca2+ exchange in these cells, strongly inhibited the effects of ionomycin on 45Ca2+ efflux and total cell Ca2+. We conclude that the increase in cytosolic free Ca2+ produced by ionomycin may be sufficient to activate the plasma membrane Na+/Ca2+ exchanger which removes Ca2+ from the cytosol and helps restore basal [Ca2+]i.


Potato E3 ubiquitin ligase PUB27 negatively regulates drought tolerance by mediating stomatal movement.
The ubiquitin-proteasome system (UPS) is one of the main ways of eukaryotic protein degradation and post-translational modification. It has proven as an essential process for plants to respond to abiotic stresses. Plant U-box (PUB) protein acts as a ubiquitin ligase, which recognizes and ubiquitinates the target proteins. Many PUBs have been involved in water stress in Arabidopsis and rice, but similar comprehensive studies in potato remained limited. In this study, the overexpressed and interfered transgenic potato plants of StPUB27 were obtained and their performances were evaluated under osmotic stress. The result showed that overexpression of StPUB27 accelerated the dehydration of detached leaves companied with greater stomatal conductance, while the down-regulated StPUB27 expression by RNA interference (RNAi) showed a smaller stomatal conductance and a lower rate of water loss in detached leaves, thus showing higher tolerance to osmotic stress. In addition, no significant changes in the proline content were observed between StPUB27 overexpressed and RNAi potato plants. The result demonstrated that potato E3 ubiquitin ligase PUB27 may negatively regulate drought tolerance by mediating stomatal conductance.


Selenium binding protein 1 inhibits tumor angiogenesis in colorectal cancers by blocking the Delta-like ligand 4/Notch1 signaling pathway.
Selenium binding protein 1 (SELENBP1) is frequently downregulated in malignancies such as colorectal cancer (CRC), however, whether it is involved in tumor angiogenesis is still unknown. We analyzed the expression and localization of SELENBP1 in vessels from CRC and neighboring tissues. We investigated the in vitro and in vivo activity of SELENBP1 in angiogenesis and explored the underlying mechanism. SELENBP1 was localized to endothelial cells in addition to glandular cells, while its vascular expression was decreased in tumor vessels compared to that in vessels from neighboring non-tumor tissues. Gain-of-function and loss-of-function experiments demonstrated that SELENBP1 inhibited angiogenesis in vitro, and blocked communications between HUVECs and CRC cells. Overexpression of SELENBP1 in CRC cells inhibited tumor growth and angiogenesis, and enhanced bevacizumab-sensitivity in a mouse subcutaneous xenograft model. Mechanic analyses revealed that SELENBP1 may suppress tumor angiogenesis by binding with Delta-like ligand 4 (DLL4) and antagonizing the DLL4/Notch1 signaling pathway. The inhibitory effects of SELENBP1 on in vitro angiogenesis could largely be rescued by DLL4. These results revealed a novel role of SELENBP1 as a potential tumor suppressor that antagonizes tumor angiogenesis in CRC by intervening the DLL4/Notch1 signaling pathway.


Reliability of scapular kinematics estimated with three-dimensional motion analysis during shoulder elevation and flexion.
Knowing the reliability of three-dimensional motion analysis to evaluate scapular kinematics during upper limb movements is essential to plan further research dedicated to understanding scapulothoracic joint movements relative to the global shoulder motion. The aim of this study was to assess the intra-subject as well as intra- and interrater reliability of scapulothoracic joint angles during shoulder elevation in scapular plane and shoulder flexion. Twenty healthy participants (26.6 ± 3.5 years) were asked to perform maximum shoulder elevation in scapular plane as well as shoulder flexion. Reliability was assessed using the intraclass correlation coefficient (ICC) and its 95% confidence interval of scapular kinematics (rotation, tilting, pro-retraction) at each degree of global motion (shoulder elevation or shoulder flexion) between 0° to 150°. ICCs above 0.60 were accepted as good indicators for reliability. Intra-subject reliability was found to be very high (>0.9 for most part) for all scapulothoracic joint angles during both movements. Intra- and interrater reliability also showed good reliability being above 0.60 for the most part (except scapula tilting during shoulder elevation). Scapular kinematics showed low reliability during the respective first 10° and 20° of shoulder elevation and shoulder flexion. Furthermore, decreasing reliability was found above 120° of shoulder elevation or flexion. This study generally showed good to high levels of reliability in the range of interest (20-120°) in evaluating scapula kinematics in healthy adults during shoulder elevation and flexion; these results are important for future research providing a better understanding of scapular kinematics.


Kinetics of pyrophosphate-driven proton uptake by acidocalcisomes of Leptomonas wallacei.
In this work, we show the kinetics of pyrophosphate-driven H+ uptake by acidocalcisomes in digitonin-permeabilized promastigotes of Leptomonas wallacei. The vacuolar proton pyrophosphatase activity was optimal in the pH range of 7.5-8.0, was inhibited by imidiodiphosphate, and was completely dependent on K+ and PPi. H+ was released with the addition of Ca2+, suggesting the presence of a Ca2+/H+ antiport. In addition, X-ray elemental mapping associated with energy-filtering transmission electron microscopy showed that most of the Ca, Na, Mg, P, K, Fe, and Zn were located in acidocalcisomes. L. wallacei immunolabeled with antibodies against Trypanosoma cruzi pyrophosphatase show intense fluorescence in cytoplasmatic organelles of size and distribution similar to the acidocalcisomes. Altogether, the results show that L. wallacei acidocalcisomes possess a H+-pyrophosphatase with characteristics of type I V-H+-PPase. However, we did not find any evidence, either for the presence of H+-ATPases or for Na+/H+ exchangers in these acidocalcisomes.


Incorporating Crisis Intervention Team (CIT) knowledge and skills into the daily work of police officers: a focus group study.
This qualitative focus group study was conducted to evaluate the effectiveness of Crisis Intervention Team (CIT) training for police officers. Thematic analysis of transcripts of focus group discussions revealed that officers report increased knowledge of mental illnesses (which manifests as an improved ability to recognize and respond, reduced stereotyping/stigmatization, greater empathy toward consumers and their caregivers, more patience when dealing with consumers, and fewer arrests/more redirection toward treatment), as well as practical application of learned skills (evidenced by an ability to put individuals with mental illnesses at ease, reduced unpredictability of the crisis situation, and reduced risk of injury). Results highlight the potential for collaboration between law enforcement (and other public safety/criminal justice professions) and the mental health professions in the expanding CIT collaborative model.


On schizophrenia prognosis based on data of a clinicogenetical study.
Peculiarities of the clinical picture of schizophrenia were studied in a group of patients in which less than a half (785) patients had the aggravating fact and in two hereditary-aggravated groups: siblings (109 patients) and parents--children (118 pairs). Prognostic significance of the genetic factor, sex and age was studied as related to peculiarities of the clinical picture of schizophrenia. Hereditary aggravation is shown to be of a decisive importance for schizophrenia prognosis.