Functional consequences of an integration of motion and stereopsis in area MT of monkey extrastriate visual cortex.
Experimental evidence from neurophysiological recordings in the middle temporal (MT) area of the macaque monkey suggests that motion-selective cells can use disparity information to separate motion signals that originate from different depths. This finding of a cross-talk between different visual channels has implications for the understanding of the processing of motion in the primate visual system and especially for behavioral tasks requiring the determination of global motion. In this paper, the consequences for the analysis of optic flow fields are explored. A network model is presented that effectively uses the disparity sensitivity of MT-like neurons for the reduction of noise in optic flow fields. Simulations reproduce the recent psychophysical finding that the robustness of the human optic flow processing system is improved by stereoscopic depth information, but that the use of this information depends on the structure of the visual environment.


Induction of alkaline phosphatase activity in HeLa cells by sodium butyrate.
The induction of HeLa cell alkaline phosphatase activity by sodium butyrate could be inhibited by the coadministration of caffeine or theophylline. The inhibitions were dose dependent, and at any given concentration the potency was theophylline greater than caffeine. Although the induction by sodium butyrate was more sensitive to the inhibition by the xanthines than was that produced by 5-iodo-2'-deoxyuridine, the magnitudes of the increases in cyclic AMP concentrations after treatment with the xanthines were similar in the inhibition of both types of induction. The induction of alkaline phosphatase activity by sodium butyrate also produced a shift in the thermostability pattern of the enzyme, with a proportionately greater increase in the heat-labile, rather than heat-stable, form of the activity.


Study of an electroosmotic pump for liquid delivery and its application in capillary column liquid chromatography.
A packed-bed electroosmotic pump (EOP) was constructed and evaluated. The EOP consisted of three capillary columns packed in parallel, a gas-releasing device, Pt electrodes and a high-voltage power supply. The EOP could generate output pressure above 5.0 MPa and constant flow rate in the range of nl/min to a few microl/min for pure water, pure methanol, 2 mM potassium dihydrogenphosphate buffer, the buffer-methanol mixture and the pure water-methanol mixture at applied potentials less than 20 kV. The composition of solvent before/after pumping was quantitatively determined by using a gas chromatograph equipped with both flame ionization detector and thermal conductivity detector. It was found that there were no apparent changes in composition and relative concentrations after pumping process for a methanol-ethanol-acetonitrile mixture and a methanol-water mixture. Theoretical aspect of the EOP was discussed in detail. An capillary HPLC system consisting of the EOP, an injection valve, a 15 cm x 320 microm i.d., 5 microm Spherigel C18 stainless steel analytical column, and an on-column UV detector was connected to evaluate the performance of the EOP. A comparative study was also carried out with a mechanical capillary HPLC pump on the same system. The results demonstrated that the reproducibility of flow rate and the pulsation-free flow property of the EOP are superior to that of mechanical pump in capillary HPLC application.


Immunostimulatory effects of polysaccharides isolated from young barley leaves (Hordeum vulgare L.) with dual activation of Th1 and Th2 in splenic T cells and cyclophosphamide-induced immunosuppressed mice.
Botanical polysaccharides have been widely known to possess immunological activity. The objective of this study was to investigate the molecular mechanisms underlying the immunostimulatory properties of polysaccharides isolated from barley leaf (Hordeum vulgare L.) (BLE0) in splenocytes and cyclophosphamide (CYP)-induced immunosuppressed mice. BLE0 showed cell proliferative activity and markedly increased the secretion of both Th1-cytokines (IFN-γ and IL-2) and Th2-cytokines (IL-4 and IL-10) in CD3/CD28-activated splenocytes. Molecular data revealed that BLE0 up-regulated the expression of T-bet with enhanced phosphorylation of Janus kinase (JAK)-signal transducer and activator of transcription (STAT) 1 signaling pathway. BLE0 also increase the phosphorylation of GATA3 via toll-like receptor (TLR) 2-mediated signaling pathway with nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) and activator protein 1 (AP-1) activation. Oral administration of BLE0 effectively improved CYP-induced decrease of body weight, splenocyte proliferation, and natural killer (NK) cell cytotoxic activity and significantly increased Th1 and Th2 cytokines, T-bet, and GATA3 mRNA expression. Dietary intake of BLE0 improves the immunological manifestations by stimulating both Th1 and Th2 responses via JAK/STAT1/T-bet and TLR2/GATA3, respectively.


Stomatal responses to humidity in Opuntia inermis in relation to control of CO2 and H2O exchange patterns.
At constant cladode temperature the stomatal resistance of O. inermis increased when the cladode-air vapor pressure difference was increased and stomatal resistance decreased when the cladode-air vapor pressure difference was lowered. Net CO2 fixation in the dark was very responsive to these humidity dependent changes in stomatal resistance. Net CO2 fixation and stomatal resistance in the light did not respond to changes in cladode-air vapor pressure differences in the light under the conditions tested. When temperature response functions for dark CO2 fixation were examined at constant ambient humidity, the reduction in dark CO2 fixation at higher temperatures was largely due to stomatal closure in response to the increased vapor pressure difference. The water requirement for net CO2 fixation in the dark at typical nocturnal vapor pressure differences was about 10 times lower than that of net CO2 fixation in the light at vapor pressure differences typical of the late afternoon. The role of the stomatal responses to humidity in determining the patterns and rates of net CO2 exchange in the light or dark, and its possible ecological significance is discussed.


Comparing mini-open and arthroscopic acromioclavicular joint repair: functional results and return to sport.
Acromioclavicular joint (ACJ) dislocation is a common injury that can result from sports activities. The surgical technique for the treatment of Type III and Type IV injuries, according to the Rockwood classification, remains controversial. The purpose of the study was to determine the functional outcome after minimally invasive and arthroscopic surgery. The mini-open surgery was done with MINAR® system, whereas the arthroscopic technique was done with Dog BoneTM Button. Retrospective Cohort study. We reviewed 31 who were surgically treated for acute acromioclavicular dislocation Type III and Type IV (2012-2015). We excluded subjects with chronic dislocation or other injury. We selected 16 patients (average age 37). Half of the sample patients were treated with mini-open surgery with the MINAR® system, and the other half of the patients were treated with the Dog Bone arthroscopic technique. The Constant Shoulder Score, the Oxford Shoulder Score, the Simple Shoulder Test and the Subjective Patient Outcome for Return to Sports (SPORTS) score were used to assess functional outcome of the treated shoulder. Mean follow-up was 13 months (range 6-27 months). The mean Constant Shoulder Score was 91.10 (range 82.76-96.66), Oxford Shoulder Score was 46.19 (range 42.00-48.00), the Simple Shoulder Test was 10.50 (range 9.00-12.00), and the SPORTS score was 7.88 (range 3-10). There is a statistically significant difference between the sample operated with the mini-open surgery and the group operated with arthroscopic technique. The probability of return to their sport, according to the results of the SPORTS score, was significantly higher for patients treated with the MINAR® system (p < 0.001). However, the objective parameter of Constant scale is statistically better in patients operated by arthroscopic technique (p < 0.05; p < 0.001). Restoration of ACJ anatomy is the key to a successful therapy. The surgical technique should be personalized. The miny-open surgery and also the arthroscopic surgery are adequate with good clinical results. However, according to the SPORTS score, the patients treated with mini-open surgery returned to their sport with less pain and better performance than those belonging to the other group.


CTnDOT integrase performs ordered homology-dependent and homology-independent strand exchanges.
Although the integrase (IntDOT) of the Bacteroides conjugative transposon CTnDOT has been classified as a member of the tyrosine recombinase family, the reaction it catalyzes appears to differ in some features from reactions catalyzed by other tyrosine recombinases. We tested the ability of IntDOT to cleave and ligate activated attDOT substrates in the presence of mismatches. Unlike other tyrosine recombinases, the results revealed that IntDOT is able to perform ligation reactions even when all the bases within the crossover region are mispaired. We also show that there is a strong bias in the order of strand exchanges during integrative recombination. The top strands are exchanged first in reactions that appear to require 2 bp of homology between the partner sites adjacent to the sites of cleavage. The bottom strands are exchanged next in reactions that do not require homology between the partner sites. This mode of coordination of strand exchanges is unique among tyrosine recombinases.


CD4/CD8 lineage commitment: matching fate with competence.
The outcome of positive selection of T lymphocytes is that there is a close match between the lineage adopted by a particular cell (CD4+ or CD8+) and the specificity of the T-cell receptor for the class of Major Histocompatibility Complex molecule recognized. How this match is obtained has been a matter of debate. We review the evidence, from recent and older experiments, that indicates that the process follows a selective logic, rather than an instructive one.


Modeling and teaching techniques for conceptual and logical relational database design.
This paper proposes a series of techniques to be used in teaching database design. Common ERD notations are discussed. The authors developed an ERD notation, adapted from the Unified Modeling Language, which facilitates student learning of the database design process. The paper presents a specific step by step process for representing the ERD components as tables and for normalizing the resulting set of tables.


Management of asymptomatic carotid bruit.
One hundred forty-nine consecutive patients who had peripheral arterial disease (PAD) with clinically audible asymptomatic bruits were studied. Sixty-two of these patients were age- and sex-matched with 62 PAD patients in whom no bruits were detected. The PAD was demonstrated by angiography or by the 1-minute exercise test. Clinical assessment was performed every 6 months and oculoplethysmography and carotid phonoangiography (OPG/CPA) were performed every year. Angiography and reconstructive surgery were performed only if symptoms of transient ischemic attack (TIA) or stroke occurred. Life-table analysis revealed that over a 5.5-year follow-up, 32% of 211 PAD patients were expected to die. In the control study 45% of bruit patients and 32% of control patients were expected to die (no significant difference). Myocardial infarction accounted for 59% of deaths in the bruit group compared with 28% in the control group (no significant difference). TIA occurred more commonly in the bruit group (26.5%) than in the controls (6%) (p less than 0.02). However, stroke without warning occurred in 9% of bruit patients compared with 8% of controls (no significant difference). It is concluded that for asymptomatic carotid bruit it is safe to wait for the onset of symptoms before angiography and corrective reconstructive surgery.


How to Do It: Transbrachial Impella Placement to Facilitate Percutaneous Coronary Intervention.
A 64-year-old man with diffusely diseased iliofemoral vessels and an ejection fraction of 20% to 25% presented with a non-ST elevation myocardial infarction and proximal left anterior descending (LAD) and left circumflex (LCx) coronary artery disease, with a chronically occluded right coronary artery. The iliofemoral system was not suitable for Impella placement, and bilateral axillary arteries were heavily calcified. The proximal left brachial artery was chosen for placement of both an Impella CP (Abiomed, Danvers, MA, USA) and percutaneous coronary intervention (PCI) sheath through a graft sewn to the brachial artery in this single-access technique. A 6 mm graft was sewn to the brachial artery, through which the Impella CP was placed. The Impella CP sheath was then used to introduce a 7F sheath for PCI. Successful PCI with drug-eluting stents was carried out to the LAD and LCx arteries, the Impella was weaned and removed, and the graft was stapled. The patient was discharged without any access or PCI complications. This report demonstrates the feasibility of the single-access Impella technique through a brachial artery cutdown approach.


Titanium clip placement to allow accurate tumour bed localisation following breast conserving surgery: audit on behalf of the IMPORT Trial Management Group.
Accurate tumour bed (TB) localisation is a key requirement for the UK IMPORT (Intensity Modulated Partial Organ Radiotherapy) trial. We audited the value of titanium clips for TB localisation following breast conserving surgery (BCS) in breast radiotherapy (RT) planning. At surgery, paired clips were positioned around the TB as follows: 1. Medial, lateral, superior and inferior: half-way between skin and fascia; 2. Posterior: at the pectoral fascia; 3. Anterior: close to the suture line. Thirty consecutive patients with clips inserted were audited at the time of RT planning. Audit standards were set as follows: (i) 5/6 pairs of clips identified on RT planning computed tomography (CT) scan - 100%; (ii) possible clip migration: <10%; (iii) TB localisation improved with clips: >50%. Inter- and intra-observer variability in clinician outlining of the TB was studied in a subset of 12 randomly selected patients to see if this impacted on positioning of radiotherapy field borders. Five or six pairs of clips were identified in all 30 cases. The TB could be successfully identified using CT seroma alone in only 8/30 (27%) patients. Clips were essential for the TB localisation of the other 22/30 (73%) patients. There was no evidence of clip migration. TB localisation led to modified RT field borders in 18/30 (60%) patients. Five of these patients had highly visible seromas, so the addition of clips modified field borders in 13/30 (43%) patients. Both inter- and intra-observer variability was reasonable and did not impact on positioning of radiotherapy field borders. Titanium clips provide an accurate and reliable method of TB localisation following BCS. We anticipate that the audit results will lead to clips being adopted as best practice by the Association of Breast Surgeons (ABS) at BASO (British Association of Surgical Oncology).


Thirteen-week oral toxicity study of methyl carbamate in rats and mice.
The purpose of this study was to identify the toxicologic effects produced by methyl carbamate in F344 rats and B6C3F1 mice. Administration of methyl carbamate by gavage five times a week for 13 weeks to male (50, 100, 200, 400, or 800 mg/kg) and female (62.5, 125, 250, 500, or 1000 mg/kg) rats resulted in dose-related lesions in the liver characterized by proliferative changes in hepatocytes consisting of foci of cellular alteration and frequent mitoses with atypical forms. Toxic alterations consisted of focal hepatocellular necrosis, pigmentation of Kupffer's cells, and the presence of basophilic inclusions resembling nucleoli in the cytoplasm of hepatocytes. Other toxic effects observed in rats were weight loss, testicular hypoplasia, bone marrow hyperplasia, and excessive pigmentation of the spleen. The survival of male and female rats was reduced following administration of the highest dose of methyl carbamate. In contrast to these findings, administration of the chemical to male (93.75, 187.5, 375, 750, or 1500 mg/kg) and female (125, 250, 500, 1000, or 2000 mg/kg) mice five times a week for 13 weeks resulted only in weight loss and inflammatory changes of the liver. The proliferative nature of the hepatic lesions observed in rats suggests that the compound is potentially hepatocarcinogenic.


Belief incongruence and the intention-behavior gap in persons with at-risk alcohol use.
When intentions are expressed, e.g., when filling in a health questionnaire, people may have unrealistic beliefs towards behavior change resulting in strong intentions to change. These may fail to correspond to reality when the behavior actually should be performed. Belief incongruence was tested as a possible source of the intention-behavior gap. The study sample consisted of 433 job agency clients with at-risk alcohol use (64% men, mean age=30.6 (SD=11.6) years). Behavioral, normative, and control beliefs, intention, and alcohol use were assessed at baseline and three months later. The influence of belief incongruence on the intention-behavior gap was examined using latent interaction models. The gap between stated intentions and at-risk alcohol use three months later was larger when the according normative beliefs were incongruent (total effect: b=-0.44, p<0.05 for persons with congruent beliefs vs. b=-0.06, p>0.10 for persons with incongruent beliefs). When controlling for the mediating effect of changes in intentions, the association between belief incongruence and intention-behavior gap was attenuated (direct effect: b=-0.56, p<0.01 for persons with congruent beliefs vs. b=-0.28, p<0.05 for persons with incongruent beliefs). Neither behavioral belief incongruence nor control belief incongruence was significantly associated with the intention-behavior gap. Normative belief incongruence may contribute to the gap between intentions to adhere to recommended drinking limits and subsequent at-risk alcohol use. Focusing on the reduction of misperceptions about drinking norms could help to increase the proportion of persons who succeed in translating their intentions into behavior.


Why is there plastic packaging in the natural environment? Understanding the roots of our individual plastic waste management behaviours.
Plastic waste is now a classic contaminant of the natural environment and the origins of the contamination need to be well understood. The transition from a useful object to a waste product is a fundamental moment that, from the point of view of the scientific literature, remains poorly understood. This review therefore aims to highlight some factors controlling this intentionality, but also those that influence individual waste management behaviours. For this purpose, an original approach involving the study of the amount of knowledge within different disciplinary fields of research has been employed. The results underline that the low direct impact of the consequences on their users of the discarding of plastic packaging seems to be an important reason for individual mismanagement. Furthermore, the modern individual behaviours of the discarding of plastics are often deeply rooted in the past of the populations. Policies to reduce waste disposal come up against strong individual behavioural constraints that limit the proper management of plastic waste. Thus, incivilities, difficulty in enforcing sanctions, or public opposition to changes in waste management are all factors that contribute to the maintenance waste discarding behaviour. The reuse behaviour of objects that have become useless is also historically attested, but has tended to disappear with the rise of the consumer society. This type of behaviour, whose valorisation is a way of reducing plastic waste abandonment behaviour, remains, however, less scientifically studied than other ways such as recycling.


Association of Raf with the CD3 delta and gamma chains of the T cell receptor-CD3 complex.
Protein kinases and phosphatases play an important role in signal transduction. In the T cell, activation via the T cell receptor-CD3 complex results in rapid tyrosine phosphorylation of proteins, as well as subsequent increases in serine/threonine phosphorylation. The Raf serine/threonine kinase has been implicated in many receptor signaling pathways, including those of platelet-derived growth factor, epidermal growth factor, insulin, and interleukin-2 receptors. We show here that Raf is associated with the T cell receptor-CD3 complex in unstimulated murine T cells. Using a COS cell expression system, we show that a hypophosphorylated form of Raf specifically associates with the CD3 gamma and delta chains but not with the CD3 epsilon or zeta chains. These results suggest that Raf mediates signal transduction from the gamma and delta chains of the T cell receptor-CD3 complex, analogous to the role played by ZAP-70 in signal transduction mediated by the zeta chain.


Myricetin exhibit selective anti-lymphoma activity by targeting BTK and is effective via oral administration in vivo.
Myricetin (MYR) is a polyhydroxy flavone originally isolated from Myrica rubra, and is widely distributed in a variety of medicinal plants and delicious food. MYR has been proven to have inhibitory effects against various types of cancer. However, the exact role of MYR in lymphoma development is still unclear. In vitro, the MTT assay was performed to evaluate the activity of human diffuse large B lymphoma cell TMD-8 and other tumor cells. Homogeneous time-resolved fluorescence (HTRF) and molecular docking were used to detect the target of MYR inhibiting TMD-8 cells. In addition, flow cytometry, Annexin V-FITC/PI assays, Hoechst 33258, and mondansylcadaverine (MDC) fluorescent standing were used to detect the cell cycle, apoptosis, and autophagy, respectively. Moreover, Western blot analysis was conducted to analyze related signaling pathways. In TMD-8 cell xenotransplanted mice, immunohistochemistry, histopathology, and blood biochemical tests were used to evaluate the effectiveness and safety of oral administration of MYR. Here, we found that MYR is more sensitive to TMD-8 cells than other tumor cells by targeting bruton tyrosine kinase (BTK). BTK is an attractive target for the treatment of B-cell malignancies. The HTRF assay showed that MYR inhibited BTK kinase with an IC50 of 1.82 μM. Furthermore, the HTRF assay and Western blot analysis demonstrated that MYR could bind to key residues (Ala478, Leu408, Thr474) in the BTK active pocket, inhibit the autophosphorylation on tyrosine 223, and block BTK/ERK and BTK/AKT signal transduction cascades (including downstream substrates GSK-3β, IKK, STAT3, and NF-κb). The results of cell cycle, apoptosis, and autophagy showed that MYR could induce G1/G0 cycle arrest by regulating cyclinB1/D1 expression, induce apoptosis by increasing the Bax/Bcl-2 ratio, and trigger autophagy by inhibiting mTOR activation. In vivo, oral administration of MYR significantly inhibited the growth of TMD-8 xenograft tumora without toxic side effects. Furthermore, Ki67 and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) analysis showed that MYR could inhibit proliferation and induce apoptosis of tissue lymphoma cells. Taken together, MYR is an oral available natural BTK inhibitor that effectively inhibits the growth of lymphoma TMD-8 cells both in vitro and in vivo. In addition, our findings support that the use of MYR is a novel and promising therapeutic strategy for the treatment of lymphoma.


Evolution of size distribution and transfer of mineral particles between flocs in activated sludges: an insight into floc exchange dynamics.
The aggregation behavior of activated sludge flocs was investigated by monitoring the size distribution of flocs and transfer of mineral particles between flocs, under various conditions of agitation and dilution. The results showed that (i) the shape of the floc size distribution can be fitted with a gamma function, (ii) a steady-state mean floc size is reached for a given stirring rate, (iii) this stable floc size is shifted towards floc growth as sludge concentration is increased, (iv) under cycled-shear conditions, microbial aggregates break up and re-form in an almost reversible manner, (v) blending of raw sludge and sludge spiked with Aquatal mineral particles results in particle exchange between flocs and (vi) the detailed study of exchange kinetics indicates that some flocs do not participate to the aggregation dynamics. These experimental results suggest that the activated sludge floc size is governed by a flocculation/deflocculation balance, implying an exchange of floc constituents between microbial aggregates.


Implications for biomass/coal combustion emissions and secondary formation of carbonaceous aerosols in North China.
To understand the origins, secondary formation and seasonality of carbonaceous aerosols in North China, we collected PM2.5 samples on day- and night-time bases in summer and winter 2016 from a typical metropolis, Tianjin, and studied their carbonaceous components and stable carbon isotope ratios of total carbon (δ13CTC). PM2.5 ranged from 21.2 μg m-3 to 74.8 μg m-3 in summer and 25.3-816 μg m-3 in winter. On average, organic carbon (OC) elemental carbon (EC) and water-soluble OC were found to be higher (3-5 times) in winter than that in summer. Secondary organic carbon that estimated by EC-tracer method was enhanced by a factor of 7 in winter compared to that in summer. δ13CTC showed a small enrichment of 13C (average -25.41 ± 0.34‰) in summer compared to that (-24.42 ± 0.44‰) in winter. Linear relations and mass ratios of selected carbonaceous components and δ13CTC imply that the carbonaceous aerosols in Tianjin were mainly derived from biomass burning emissions and photochemical processing in summer. In winter, coal combustion emissions and in situ secondary formation of organics, including water-insoluble OC (WIOC), were dominant. This study warrants a need to understand the formation mechanisms of WIOC in the urban atmosphere and thus to reconcile the atmospheric models.


Rising hospitalization rates for inflammatory bowel disease in Poland.
The incidence and prevalence of inflammatory bowel disease (IBD) in Poland is unknown. We aimed to define the rates of hospitalization for IBD and time trends in the past 2 decades. Data were obtained from the database of the National Institute of Public Health (1991-1996 and 2003-2007). Data on hospitalizations for Crohn's disease (CD) and ulcerative colitis (UC) were extracted. Age-, sex-, and disease‑specific rates of hospitalization per 100,000 population were calculated. During the years 1991-1996 and 2003-2007, the rate of hospitalization for IBD increased each year, rising from 12.50 to 30.61 per 100,000 population. Rising time trends were observed in both sexes. The hospitalization rate increased from 3.53 to 9.35 per 100,000 population for CD and from 8.97 to 21.26 per 100,000 population for UC. A rising time trend was observed in hospitalizations for CD in men aged from 0 to 39 years. A rising time trend for CD in women was observed between the years 2003 and 2007. The hospitalization rate for UC was higher in men (9.18 to 23.29 per 100,000) than in women (8.77 to 19.37 per 100,000). Rising time trends for UC were observed in the years from 2003 to 2007 in all men and women except for those aged from 40 to 64 years. Hospitalization rates for IBD in Poland increased from 1991 to 1996 and from 2003 to 2007, with rising time trends in both sexes. For CD, the rising time trend in men was limited to younger age groups. The hospitalization rate for UC was significantly higher in men than in women.


Methodological aspects on drug receptor binding analysis.
Although drug receptors occur in relatively low concentrations, they can be visualized by the use of appropriate radioindicators. In most cases the procedure is rapid and can reach a high degree of accuracy. Specificity of the interaction is studied by competition analysis. The necessity of using several radioindicators to define a receptor population is emphasized. It may be possible to define isorecptors and drugs with selectivity for one isoreceptor.


Results of aortic valve-sparing and restoration with autologous pericardial leaflet extensions in congenital heart disease.
The purpose of this study is to evaluate the efficacy of aortic valve-sparing repair with glutaraldehyde-treated autologous pericardium in congenital valvular pathology. Sixty-two patients underwent reparative aortic valve surgery from January 1997 through December 2003. The mean age was 25 +/- 20 years (+/- standard deviation) (range, 10 days to 81 years). Fifty percent (31 of 62) were less than 19 years old at operation. The diagnoses included bicuspid aortic valve (39 patients), ventricular septal defect (14 patients), severe aortic stenosis (6 patients), subaortic stenosis (7 patients), bacterial endocarditis (7 patients), neonatal truncus arteriosus (2 patients), Shone's complex (2 patients), transposition complex (1 patient), double-chambered right ventricle (1 patient), and Marfan's syndrome (1 patient). Twelve patients (19 %) had prior sternotomy and cardiac operations. Valve-sparing techniques included pericardial leaflet extensions in 62 patients, creation of one or more pericardial neoaortic sinuses in 8, subcommissuroplasty in 8, pericardial patch of perforated leaflets in 9, Dacron mesh wrap (Boston Scientific, Wayne, NJ) of dilated ascending aorta in 12, and concomitant tricuspid and mitral valve repairs in 3 and 4 patients, respectively. There was one early death (1.6%). There were no late deaths at a mean follow-up of 25 +/- 16 (range, 0.1 to 72.5 months). Six patients required reoperation and prosthetic or homograft replacement for aortic valve incompetence. One out of 6 reoperations required re-repair. The remaining patients are well with a mean aortic regurgitation grade by echocardiography of 1.3 +/- 0.9 (scale, 0 to 4). Aortic valve repair with pericardial leaflet extension is a promising technique for the growing child.


Inclusion of nonrandomized studies in Cochrane systematic reviews was found to be in need of improvement.
Nonrandomized studies (NRSs) are considered to provide less reliable evidence for intervention effects. However, these are included in Cochrane reviews, despite discouragement. There has been no evaluation of when and how these designs are used. Therefore, we conducted an overview of current practice. We included all Cochrane reviews that considered NRS, conducting inclusions and data extraction in duplicate. Of the included 202 reviews, 114 (56%) did not cite a reason for including NRS. The reasons were divided into two major categories: NRS were included because randomized controlled trials (RCTs) are wanted (N = 81, 92%) but not feasible, lacking, or insufficient alone or because RCTs are not needed (N = 7, 8%). A range of designs were included with controlled before-after studies as the most common. Most interventions were nonpharmaceutical and the settings nonmedical. For risk of bias assessment, Cochrane Effective Practice and Organisation of Care Group's checklists were used by most reviewers (38%), whereas others used a variety of checklists and self-constructed tools. Most Cochrane reviews do not justify including NRS. When they do, most are not in line with Cochrane recommendations. Risk of bias assessment varies across reviews and needs improvement.


Prognostic value of MYCN and ID2 overexpression in neuroblastoma.
The molecular mechanisms driven by overexpression of the MYCN gene in neuroblastoma are not well known. Whether MYCN overexpression in the absence of genomic amplification, or ID2 overexpression has prognostic value remains controversial. Ninety-nine neuroblastic tumors from Memorial Sloan-Kettering Cancer Center and 12 neuroblastoma cell lines were analyzed by Affymetrix U95v2 Microarray System. The expression levels of the genes MYCN and ID2 were determined by RT-PCR and immunohistochemistry and the clinical value of the overexpression of both genes was determined. MYCN genomic amplification with overexpression was prognostic for survival (P = 0.0005). Stage 4 patients with MYCN amplification but without overexpression, had no increased likelihood of death, whereas cases with MYCN overexpression but no genomic amplification showed a low survival (P = 0.0096). ID2 did not correlate with MYCN expression (R = -0.23 for tumors and -0.27 for cell lines) or with survival (P = 0.8746). MYCN amplification was not related to clinical outcome in the absence of overexpression in neuroblastoma tumors. ID2 expression appears to be independent of MYCN expression and lacks prognostic value.


Ultrasound-mediated targeted drug delivery generated by multifocal beam patterns: an in vitro study.
Ultrasound-mediated targeted drug delivery has been a subject for a dedicated research activity for several decades. Nevertheless, in vitro studies in this field of research are characterized by their inconsistencies. To improve the repeatability of such experiments, a novel approach of multifocal spot generation was investigated. A multifocal pattern of 16 spots was utilized using an iterative Gerchberg-Saxton algorithm. The pattern was applied to insonate a 96-well Petri dish plate using a clinically available planar-phased array transducer with approximately 1000 elements with a central frequency of 0.55 MHz. The pattern was acoustically characterized and applied to a monolayer of human breast cancer cell line in the 96-well plate. With the help of ultrasonic contrast agents, the intracellular drug uptake was increased by an average factor of 3.5 compared with the control group.


Prevention of postoperative endophthalmitis.
Prevention of postoperative endophthalmitis (POE) requires (1) environmental control, (2) tissue control, and (3) anticipation of eyes at special risk of infection. Environmental control entails an adequate supply of finely filtered air and absolute sterility of solutions, medications, and objects and materials used during surgery. Tissue control involves degerming the skin of the operative field, inhibition of the flora of the lid margins by an antibiotic ointment use preoperatively, and pretreatment of the conjunctival tear film by soluble antibiotics possessing activity against Proteus and Pseudomonas as well as gram-positive species. Eyes at special risk of infection include those of diabetics, chronic alcoholics, and individuals who have been maintained for long periods of time on systemic or topical corticosteroids. Patients who have had multiple eye operations, recurrent uveitis, and who are scheduled for surgery on the second eye during a single hospital admission should receive special consideration preoperatively.


Post-mortem distribution of the synthetic cannabinoid MDMB-CHMICA and its metabolites in a case of combined drug intoxication.
This case report centres on the post-mortem distribution of the synthetic cannabinoid MDMB-CHMICA and its metabolites in the case of a 27-year-old man found dead after falling from the 24th floor of a high-rise building. Toxicological analysis of post-mortem samples confirmed, besides consumption of the synthetic cannabinoids MDMB-CHMICA (1.7 ng/mL femoral blood) and EG-018, the abuse of THC (9.3 ng/mL femoral blood), amphetamine (1050 ng/mL femoral blood), MDMA (275 ng/mL femoral blood), and cocaine. Regarding EG-018 and cocaine, only traces were detected in heart blood as well as in the brain (EG-018) and urine (cocaine), respectively, which is why no quantification was conducted in the femoral blood sample. It was concluded from femoral blood analysis that, at the time of death, the man was under the influence of the synthetic cannabinoid MDMB-CHMICA, THC, amphetamine and MDMA. Comprehensive screenings of all post-mortem specimens were conducted to elucidate the post-mortem distribution of MDMB-CHMICA and its metabolites. The MDMB-CHMICA concentrations ranged between 0.01 ng/mL (urine) and 5.5 ng/g (brain). Comparably low concentrations were detected in cardiac and femoral blood (2.1 ng/mL and 1.7 ng/mL, respectively) as well as in the psoas major muscle (1.2 ng/g). Higher concentrations were found in the lung (2.6 ng/g), liver (2.6 ng/g), and kidney (3.8 ng/g). Gastric content yielded a MDMB-CHMICA concentration of 2.4 ng/g (1.1 μg absolute). Screening for MDMB-CHMICA metabolites resulted in the detection of mainly monohydroxylated metabolites in the blood, kidney, and liver specimens. Results indicated that monohydroxylated metabolites of MDMB-CHMICA are appropriate target analytes for detecting MDMB-CHMICA intake.


A new and rapid system for the determination of enzymatic activity of bacterial collagenases.
Collagenase activity is assayed using N-CBZ-Gly-Pro-Gly-Pro-Ala as substrate in an autoanalyzer II system. The liberation of the tripeptide is monitored after the reaction with trinitrobenzenesulfonic acid. The new system shows a considerably improved precision when compared to existing methods and allows about ten times as many samples to be analyzed per day. This is of importance for laboratories where large amounts of activity determinations have to be performed.


Psychosocial and behavioral pre-treatment predictors of weight loss outcomes.
This study tested whether baseline behavioral and psychological variables predict weight and fat loss among overweight, non-obese individuals participating in a six-month calorie restriction trial. Participants (N=48) were randomly assigned to four groups, three of which included a calorie restriction program and one of which served as a healthy diet weight maintenance control. For the purposes of this study, data were analyzed only for participants assigned to the three calorie restriction groups (n=36). Ten psychological and behavioral measures were investigated through principal components factor analysis to examine whether these measures were assessing similar or distinct psychological and behavioral constructs. Based on the obtained six-factor solution, one measure from each domain was selected for inclusion in hierarchical regression analyses, which was used to test the relative importance of psychosocial and behavioral variables in predicting percent weight and fat loss over six months. After controlling for demographic and treatment variables, the behavioral and psychological measures of negative mood states, poor psychosocial functioning, and somatic symptoms were associated with less weight loss (R2=0.68, p<0.001) and fat loss (R2=0.65, p<0.001) over six months. Among overweight individuals, poor psychological adjustment, somatic symptoms, and negative mood states appear to form a psychosocial profile that is predictive of less weight and fat loss in calorie restriction programs.


A small molecule targeting myoferlin exerts promising anti-tumor effects on breast cancer.
Breast cancer is one of the most lethal cancers in women when it reaches the metastatic stage. Here, we screen a library of small molecules for inhibitors of breast cancer cell invasion, and use structure/activity relationship studies to develop a series of small molecules with improved activity. We find WJ460 as one of the lead compounds exerting anti-metastatic activity in the nanomolar range in breast cancer cells. Proteomic and biochemical studies identify myoferlin (MYOF) as the direct target of WJ460. In parallel, loss of MYOF or pharmacological inhibition of MYOF by WJ460 reduces breast cancer extravasation into the lung parenchyma in an experimental metastasis mouse model, which reveals an essential role of MYOF in breast cancer progression. Our findings suggest that MYOF can be explored as a molecular target in breast cancer metastasis and that targeting MYOF by WJ460 may be a promising therapeutic strategy in MYOF-driven cancers.


Interactive effects of Louisiana Sweet Crude (LSC) thin oil sheens and ultraviolet light on mortality and swimming behavior of the larval Eastern oyster, Crassostrea virginica.
The Eastern oyster (Crassostrea virginica) is an important commercial bivalve species which also has numerous ecological roles including biogeochemical cycling, providing habitat for larval fish and crustaceans, and reducing the impacts of coastal storms. Oil may pose a threat to oyster larvae swimming in the water column, leading to potential negative effects on survival, growth, and development. Oil toxicity may be further enhanced by chemical changes in the presence of sunlight. This study determined the toxicity of thin oil sheens with and without ultraviolet (UV) light, then examined the latent effects of the short term exposure on longer term survival and swimming ability. Larval C. virginica were exposed to four different oil sheen thicknesses for 24 h with either no UV light or 2-h UV light. Following the exposure, larvae were transferred to clean seawater and no UV light for 96 h. The presence of a 2-h UV light exposure significantly increased oyster mortality, indicating photo-enhanced toxicity. The LC50 for a 24-h oil sheen exposure without UV was 7.26 µm (23 µg/L PAH50) while a 2 h-UV exposure lowered the sheen toxicity threshold to 2.67 µm (10 µg/L PAH50). A previous 24-h oil sheen exposure (≥0.5 µm) led to latent effects on larval oyster survival, regardless of previous UV exposure. Sublethal impacts to larval oyster swimming behavior were also observed from the previous oil sheen exposure combined with UV exposure. This study provides new data for the toxicity of thin oil sheens to a sensitive early life stage of estuarine bivalve.


Repair of massive inguinal hernia: with pneumoperitoneum and without using prosthetic mesh.
There was an unusual need for preoperative induction of an artificial pneumoperitoneum in two cases of inguinal hernia. Both hernias were very large and associated with extensive intertrigo. Daily insufflations of air were performed for 13 and 11 days, with the patients compensating for this increased intraabdominal pressure over this time. Operation with removal of the ipsilateral testicle, cord, and scrotum was then straightforward and convalescence uneventful. The pneumoperitoneum allowed a repair to be effected without using a prosthetic mesh.


Distinct different sensitivity of Treg and Th17 cells to Fas-mediated apoptosis signaling in patients with acute coronary syndrome.
An imbalance in CD4(+)CD25(+) regulatory T (Treg) cells and Th17 cells has been found to correlate to occurrence of acute coronary syndrome [ACS, including unstable angina (UA) and acute myocardial infarction (AMI)]. However, the mechanisms of Th17/Treg imbalance in ACS patients are still unclear. The purpose of this study is to investigate the possibility of differences in sensitivity of Th17 and Tregs to Fas-mediated apoptosis which could lead to Th17/Treg imbalance in ACS patients. We examined the apoptosis of Th17 and Treg cells, apoptosis-related Fas/Fas ligand(FasL) pathway, and inflammatory markers in patients with AMI, UA, stable angina (SA) and controls by Flow cytometry and ELISA. Then we analysed the correlation of inflammatory markers and sFasL to Treg apoptosis, and the effect of anti-FasL antibody on Treg apoptois in vitro. Our study demonstrated that apoptotic Tregs, Fas and FasL expression, Caspase-3 activity of Tregs were significantly higher in ACS patients than those in NCA and SA patients (all P < 0.05). The percentage of apoptotic Tregs is positively correlated with the levels of inflammatory markers and sFasL. In vitro incubation of peripheral blood mononuclear cells from ACS patients with anti-FasL antibody resulted in a markedly reduction of apoptotic Treg cells. However, there were no significant differences in apoptotic Th17 cells and in Fas and FasL expression for Th17 cells between the four groups (all P >0.05). Tregs, but not Th17 cells, become apoptotic through Fas/FasL pathway, which contributed to reduction of Tregs leading to an imbalance between Th17 and Treg cells. This could be the mechanism underlying Th17/Treg imbalance and occurrence of ACS.


The Brain Trauma Foundation. The American Association of Neurological Surgeons. The Joint Section on Neurotrauma and Critical Care. Role of steroids.
The majority of available evidence indicates that steroids do not improve outcome or lower ICP in severely head-injured patients. The routine use of steroids is not recommended for these purposes.


The time course of serotonin 2C receptor expression after spinal transection of rats: an immunohistochemical study.
In the spinal cord serotonin (5-HT) systems modulate the spinal network via various 5-HT receptors. Serotonin 2A receptor and serotonin 2C receptor (5-HT2A and 2C receptors) are likely the most important 5-HT receptors for enhancing the motoneuron excitability by facilitating the persistent inward current (PIC), and thus play an important role for the pathogenesis of spasticity after spinal cord injury. In conjunction with our 5-HT2A receptor study, using a same sacral spinal transection rat model we have in this study examined 5-HT2C receptor immunoreactivity (5-HT2CR-IR) changes at seven different time intervals after spinal injury. We found that 5-HT2CR-IR was widely distributed in different regions of the spinal gray matter and was predominantly located in the neuronal somata and their dendrites although it seemed also present in axonal fibers in the superficial dorsal horn. 5-HT2CR-IR in different regions of the spinal gray matter was seen to be increased at 14days after transection (with an average ∼1.3-fold higher than in sham-operated group) but did not reach a significant level until at 21days (∼1.4-fold). The increase sustained thereafter and a plateau level was reached at 45days (∼1.7-fold higher), a value similar as that at 60days. When 5-HT2CR-IR analysis was confined to the ventral horn motoneuron somata (including a proportion of proximal dendrites) a significant increase was not detected until 45days post-operation. 5-HT2CR upregulation in the spinal gray matter is confirmed with Western blot in the rats 60days post-operation. The time course of 5-HT2CR upregulation in the spinal gray matter and motoneurons was positively correlated with the development of tail spasticity (clinical scores). This indicates that 5-HT2CR is probably an important factor underlying this pathophysiological development by increasing the excitability of both motoneurons and interneurons.


[Induced variability in Acremonium chrysogenum, a producer of neutral-alkaline proteases and peptidases].
Lethal and mutagenic effects of N-nitrosomethyl biuret on the organism producing a complex of proteolytic enzymes i. e. Acremonium chrysogenum were studied. It was shown that methionine inhibited production of the protease complex in the induced prototrophic mutants. The selected mutants were classified according to the level of enzyme biosynthesis induction by methionine.


Active sodium transport and the electrophysiology of rabbit colon.
The electrophysiologic properties of rabbit colonic epithelial cells were investigated employing microelectrode techniques. Under open-circuit conditions, the transepithelial electrical potential difference (PD) averaged 20 mV, serosa positive, and the intracellular electrical potential (psimc) averaged -32 mV, cell interior negative with respect to the mucosal solution; under short-circuit conditions, psimc averaged -46 mV. The addition of amiloride to the mucosal solution abolishes the transepithelial PD and active Na transport, and psimc is hyperpolarized to an average value of -53 mV. These results indicate that Na entry into the mucosal cell is a conductive process which, normally, depolarized psimc. The data obtained were interpreted using a double-membrane equivalent electrical circuit model of the "active Na transport pathway" involving two voltage-independent electromotive forces (emf's) and two voltage-independent resistances arrayed in series. Our observations are consistent with the notions that: (a) The emf's and resistances across the mucosal and baso-lateral membranes are determined predominantly by the emf (64 mV) and resistance of the Na entry process and the emf (53 mV) and resistance of the process responsible for active Na extrusion across the baso-lateral membranes: that is, the electrophysiological properties of the cell appear to be determined solely by the properties and processes responsible for transcellular active Na transport. The emf of the Na entry process is consistent with the notion that the Na activity in the intracellular transport pool is approximately one-tenth that in the mucosal solution or about 14 mM. (b) In the presence of amiloride, the transcellular conductance is essentially abolished and the total tissue conductance is the result of ionic diffusion through paracellular pathways. (c) The negative intracellular potential (with respect to the mucosal solution) is due primarily to the presence of a low resistance paracellular "shunt" pathway which permits electrical coupling between the emf at the baso-lateral membrane and the potential difference across the mucosal membrane; in the absence of this shunt, the "well-type" electrical potential profile characteristic of rabbit colonic cells would be 'converted' into a "staircase-type" profile similar to those reported for frog skin and toad urinary bladder by some investigators.


A review of studies on gut microbiota and levodopa metabolism.
Parkinson's disease (PD) is the second most common neurodegenerative disease globally. Levodopa (L-dopa) has been the cornerstone for treating Parkinson's since the 1960s. However, complications such as "wearing-off" and dyskinesia inevitably appear with disease progression. With the further development of microbiomics in recent years, It has been recognized that gut microbiota plays a crucial role in Parkinson's disease pathogenesis. However, Little is known about the impact of gut microbiota in PD treatment, especially in levodopa metabolism. This review examines the possible mechanisms of gut microbiota, such as Helicobacter pylori, Enterobacter faecalis, and Clostridium sporogenes, affecting L-dopa absorption. Furthermore, we review the current status of gut microbiota intervention strategies, providing new insights into the treatment of PD.


Controlling Tunneling Characteristics via Bias Voltage in Bilayer Graphene/WS2/Metal Heterojunctions.
Van der Waals heterojunctions, formed by stacking two-dimensional materials with various structural and electronic properties, opens a new way to design new functional devices for future applications and provides an ideal research platform for exploring novel physical phenomena. In this work, bilayer graphene/WS2/metal heterojunctions (GWMHs) with vertical architecture were designed and fabricated. The tunneling current-bias voltage (It - Vb) properties of GWMHs can be tuned by 5 × 106 times in magnitude for current increasing from 0.2 nA to 1 mA with applied bias voltage increasing from 10 mV to 2 V. Moreover, the transfer properties of GWMHs exhibit n-type conduction at Vb = 0.1 V and bipolar conduction at Vb = 2 V; these findings are explained well by direct tunneling (DT) and Fowler-Nordheim tunneling (FNT), respectively. The results show the great potential of GWMHs for high-power field-effect transistors (FETs) and next-generation logic electronic devices.


The effect of ligand density on in vivo tumor targeting of nanographene oxide.
Recently, the application of nanographene oxide (nGO) as a drug delivery system has significantly increased. But, the rational engineering of nGO surface to improve its in vivo targeting and biodistribution remains mostly unexplored. In this study, we have prepared folic acid conjugated Pluronic for non-covalent functionalization of nanographene oxide (nGO) sheets and active tumor targeting. To modulate the ligand density on the nGO surface, different ratios of folate conjugated Pluronic and unmodified Pluronic were combined and used for coating nGO sheets. The surface density of targeting ligand linearly increased as the relative amount of folate conjugated Pluronic was increased. The association of functionalized nGOs with folate receptor overexpressing human epithelial mouth carcinoma cells (KB cells) was evaluated by flow cytometry. Cellular uptake of nGO by KB cells increased steadily with the increase in ligand density. In contrast, the in vivo experiment in mouse xenograft model did not show the steady increase in tumor targeting by increasing ligand density. Upon intravenous administration into KB tumor-bearing mice, tumor accumulation of nGO did not show a significant targeting effect up to 25% of ligand coating density. However, a strong and similar tumor accumulation of nGO was observed for both 50% and 100% folate coatings. Thus, a significant difference in tumor accumulation of nGO was observed between the low folate density groups and high folate density groups, suggesting the existence of a critical ligand density for tumor targeting. The significant difference of tumor targeting of nGO depending on ligand density also resulted in the dramatic change in photothermal tumor ablation by the irradiation of NIR laser.


[Radicular artery thrombosis after cervical anterior approach for cervico-brachial neuralgia (author's transl)].
An anterior cervical approach completed by a bone graft is performed on a man suffering from cervico brachial neuralgia which did not improve by medical treatment and rest. During four months, the post operative course is excellent, with complete disappearance of pain and regression of the pre-existing neurological deficit. At the end of this period, the appearance of a major deficit within the field of the concerned root led to a selective brachial angiogram which revealed the existence of a radicular artery thrombosis.


On the use of Monte Carlo simulations to model transport of positrons in gases and liquids.
In this paper we make a parallel between the swarm method in physics of ionized gases and modeling of positrons in radiation therapy and diagnostics. The basic idea is to take advantage of the experience gained in the past with electron swarms and to use it in establishing procedures of modeling positron diagnostics and therapy based on the well-established experimental binary collision data. In doing so we discuss the application of Monte Carlo technique for positrons in the same manner as used previously for electron swarms, we discuss the role of complete cross section sets (complete in terms of number, momentum and energy balance and tested against measured swarm parameters), we discuss the role of benchmarks and how to choose benchmarks for electrons that may perhaps be a subject to experimental verification. Finally we show some samples of positron trajectories together with secondary electrons that were established solely on the basis of accurate binary cross sections and also how those may be used in modeling of both gas filled traps and living organisms.


Duplication of male urethra.
Male urethral duplication is an unusal anomaly with many variants including complete duplication from the bladder to the glans penis as well as incomplete and abortive forms. Two cases are presented of duplication of the male urethra of the epispadiac incomplete type. A chart has been constructed to facilitate categorization of the various forms of urethral duplication in the male.


Bloodletting ameliorates insulin sensitivity and secretion in parallel to reducing liver iron in carriers of HFE gene mutations.
To clarify the pathogenesis of diabetes associated with mutations of the hemochromatosis (HFE) gene, 17 carriers, 9 normal glucose tolerant (NGT) and 8 diabetic, were evaluated in an interventional trial. At enrollment and after a 2-year bloodletting period, euglycemic-hyperinsulinemic clamp, oral glucose tolerance test (OGTT), liver histology (nonalcoholic fatty liver disease activity score [NAS]), and liver iron content (LIC) were assessed. NGT subjects had significantly higher baseline insulin sensitivity (P <or= 0.001), secretion, and insulinogenic index (calculated from the OGTT) (P <or= 0.0001 for both) and lower LIC (P = 0.004) and NAS (P = 0.02) than diabetic patients. Baseline LIC correlated negatively with insulin secretion (NGT r(0) = -0.676, P <or= 0.0001; diabetes r(0) = -0.589, P = 0.02) and insulin sensitivity (M value) (NGT r(0) = -0.597, P = 0.009; diabetes r(0) = -0.535, P = 0.03) and positively with NAS (diabetes r(0) = 0.649, P = 0.007) and triglycerides (NGT r(0) = 0.563, P = 0.015). At month 24, circulating iron was reduced by 179 +/- 26% in NGT and 284 +/- 54% in diabetic subjects. Insulin secretion (NGT 20 +/- 4%; diabetes 33 +/- 7%) and insulin sensitivity (NGT 25 +/- 5%; diabetes 18 +/- 3%) increased. LIC decreased in both groups (NGT 126 +/- 42%; diabetes 61 +/- 13%), and NAS ameliorated (NGT 65.1 +/- 6.5 vs. 38.1 +/- 6.83; P <or= 0.0001; diabetes 2.1 +/- 10.7 vs. 69.9 +/- 10; P <or= 0.0001). Iron depletion ameliorates insulin secretion and sensitivity in NGT and diabetic carriers of HFE gene mutations. This amelioration occurs in parallel with decreased LIC and improved NAS. These results justify glucose tolerance testing and prophylactic iron depletion in asymptomatic carriers as well.


A novel puncture approach via point "O" for percutaneous kyphoplasty in patients with L4 or L5 osteoporotic vertebral compression fracture.
This study introduced a novel point "O" puncture approach for percutaneous kyphoplasty (PKP) in patients with L4 or L5 osteoporotic vertebral compression fracture (OVCF) and evaluated its clinical and radiographic outcomes. Between September 2019 and December 2020, we compared the clinical and radiographic outcomes in 31 cases (36 vertebrae) using the "O" entry point PKP intervention (O-PKP) and 31 cases (37 vertebrae) using transverse the process-pedicle approach PKP intervention (T-PKP). No serious postoperative complications were observed in any of the participants. Only two T-PKP patients experienced intervertebral disc space leakage. Compared with the T-PKP patients, the O-PKP patients showed shorter operative time and fluoroscopy times (P < 0.05), comparable blood loss and cement volume (P > 0.05), improved VAS and ODI scores at the final follow-up (P < 0.05), better increases in the vertebral compression ratio (P < 0.05), comparable Cobb angle (P > 0.05), comparable anteroposterior bone cement distribution, enhanced bilateral bone cement distribution (P < 0.05), and larger sagittal and transverse angles (P < 0.05). Herein, O-PKP was indicated for patients with L4 or L5 OVCF. This puncture approach showed significant advantages over T-PKP not only in terms of pain relief, surgery and fluoroscopy times but also in the puncture angle, vertebral reconstruction, and symmetrical cement distribution.


The biosynthesis of retinoic acid from retinol by rat tissues in vitro.
This report shows that a spectrum of vitamin A-dependent tissues can produce retinoic acid by synthesis in situ, indicates that cellular retinol and retinoic acid binding proteins are not obligatory to retinoic acid synthesis, and provides initial characterization of retinoic acid synthesis by rat tissues. Retinoic acid synthesis from retinol was detected in homogenates of rat testes, liver, lung, kidney, and small intestinal mucosa, but not spleen. Zinc did not stimulate the conversion of retinol into retinoic acid by liver homogenates. Retinoic acid synthesis was localized in cytosol of liver and kidney, where its rate of synthesis from retinol was fourfold (liver) and sevenfold (kidney) slower than from retinal. The synthesis of retinoic acid from retinol required NAD and was not supported by NADP. NADH (0.5 mM) reduced retinoic acid synthesis from retinol, supported by NAD (2 mM), by 50-70%, but was fivefold less potent in reducing retinoic acid synthesis from retinal. Dithiothreitol enhanced the conversion of retinol, but not retinal, into retinoic acid. EDTA inhibited the conversion of retinol into retinoic acid slightly (13%, liver; 29%, kidney). A high ethanol concentration (100 mM), relative to retinoid substrate (10 microM), inhibited retinoic acid synthesis from retinol (liver, 54%; kidney, 30%) and from retinal (30%, liver; 9%, kidney). 4'-(9-Acridinylamino)methansulfon-m-anisidine, an inhibitor of aldehyde oxidase, and disulfiram, a sulfhydryl-group crosslinking agent, were potent inhibitors of retinoic acid synthesis at 10 microM or less, and seemed equipotent in liver and kidney. 4-Methylpyrazole, an inhibitor of ethanol metabolism, also inhibited retinoic acid synthesis from retinol, but was less potent than the former two inhibitors, and affected liver to a greater extent than kidney, particularly with retinal as substrate.


Kinetics of fatty acid binding ability of glycated human serum albumin.
Kinetics of fatty acid binding ability of glycated human serum albumin (HSA) were investigated by fluorescent displacement technique with 1-anilino-8-naphtharene sulphonic acid (ANS method), and photometric detection of nonesterified-fatty-acid (NEFA method). Changing of binding affinities of glycated HSA toward oleic acid, linoleic acid, lauric acid, and caproic acid, were not observed by the ANS method. However, decreases of bind-ing capacities after 55 days glycation were confirmed by the NEFA method in comparison to control HSA. The decrease in binding affinities was: oleic acid (84%), linoleic acid (84%), lauric acid (87%), and caproic acid (90%), respectively. The decreases were consistent with decrease of the intact lysine residues in glycated HSA. The present observation indicates that HSA promptly loses its binding ability to fatty acid as soon as the lysine residues at fatty acid binding sites are glycated.


Efficient biotransformation of ginsenoside Rb1 to Rd by isolated Aspergillus versicolor, excreting β-glucosidase in the spore production phase of solid culture.
Ginsenosides are the major pharmacological components in ginseng. Microorganisms from a ginseng field were isolated to identify transformation of ginsenosides. Based on HPLC and LC-MS analysis, strain LFJ1403 showed strong activities to transform ginsenoside Rb1 to Rd as the sole product. Phylogenetic analysis of 18S rDNA indicated that LFJ1403 belonged to Aspergillus versicolor. Through comparing four systems of transforming Rb1 to Rd, strain LFJ1403 was found to secrete ginsenoside-converting enzymes in the spore production phase of plate culture. This result suggested that the enzyme could be directly obtained from the plate. The spore suspension, which contained the exocrine enzyme, was easy to prepare and efficient for biotransformation of ginsenoside Rb1 to Rd. Further study showed that the maximum bioconversion rate was 96% (w/w) in shake flasks when a spore suspension system was used with optimized biotransformation conditions. Scale-up of this system to 2L resulted in an 85% conversion rate. The ginsenoside Rb1 converting enzyme was separated by gradient HPLC with Q-Sepharose column, and its β-glucosidase activity and Rb1-converting ability was assayed by the 4-Nitrophenyl-β-D-glucopyranoside (PNPG) method and HPLC with C18 column, respectively. We obtained 130 U ml(-1) enzymatic activity with the purified β-glucosidase. This is the first report on efficiently converting ginsenoside using extracellular enzyme directly from the fungus spore production phase of solid culture.


Atypical presentation of COVID-19; an observational retrospective study.
COVID-19 infection may present with atypical signs and symptoms and false negative polymerase chain reaction (PCR) tests predisposing healthy people and health care workers to infection. The aim of the current study is to evaluate the features of atypical presentations in COVID-19 infection in a referral center in Tehran, Iran. Hospital database of inpatients admitted to Loghman Hakim hospital between February 20th and May 11th, 2020 was reviewed and all patients with final diagnosis of COVID-19 infection were evaluated for their presenting symptoms. Patients with chief complaints of "fever", "dyspnea", and/or "cough" as typical presentations of COVID-19 were excluded and those with other clinical presentations were included. Nineteen patients were included with a mean age of 51 ± 19 years, of whom, 17 were males (89%). Median [IQR] Glasgow coma scale (GCS) was 14 [13, 15]. Almost 10 had referred with chief complaint of methanol poisoning and overdose on substances of abuse. Only 8 cases (42%) had positive COVID-19 test. Nine (47%) needed invasive mechanical ventilation, of whom, two had positive COVID-19 test results (p = ns). Eight patients (42%) died with three of them having positive PCRs. In patients referring to emergency departments with chief complaint of poisoning (especially poisonings that can result in dyspnea including substances of abuse and toxic alcohols), gastrointestinal, and constitutional respiratory symptoms, attention should be given not to miss possible cases of COVID-19.


[Neonatal scrotal hemorrhage caused by post-traumatic hemoperitoneum].
The Authors describe a case of neonatal scrotal hematoma due to post-traumatic intra-abdominal hemorrhage. Differential diagnosis with testicular torsion and other causes of neonatal acute scrotum is considered and discussed.


Transient anomalies in genital appearance in some extremely preterm female infants may be the result of foetal programming causing a surge in LH and the over activation of the pituitary-gonadal axis.
Animal studies have linked foetal programming with the development of the polycystic ovarian syndrome, and metabolic syndrome, in adulthood. The objective is to describe the investigation of four extreme-premature female infants born between 25 and 29 weeks' gestation with apparent genital abnormalities in association with unusually high androgens and gonadotrophins, to postulate a cause and to raise awareness of pitfalls in assessment of these infants. Clinical examination and biochemical evaluation of four infants referred for apparent congenital ambiguity. Female gender was assigned at birth. Chromosome analysis confirmed 46XX, urine steroid profiles demonstrated no evidence of congenital adrenal hyperplasia and only the expected levels of foetal adrenal steroids. Elevated LH (up to 162 IU/l), testosterone (up to 2.6 nmol/l), Delta(4 )androstenedione (up to > 35 nmol/l) and dehydro-epiandrosterone sulphate (DHEAS) (up to 26.6 micromol/l) were seen in all four infants. These decreased over time but were significantly different from a control population of premature infants of similar gestational age. We postulate that the clinical pattern of apparent clitoral enlargement in some extremely premature infants may reflect true temporary virilization due to an unusually high (or excessive) LH surge, in turn causing high foetal androgens. Foetal programming of gonadotrophin excess is probably the primary cause of androgen increase, in turn causing virilization, in some extreme-premature infants. These may potentially be a group at future risk of polycystic ovary or metabolic syndrome, however, further work needs to be conducted to substantiate this hypothesis.


Genetic diversity and population structure of Saccharomyces cerevisiae isolated from Turkish sourdough by iPBS-retrotransposons markers.
Molecular DNA markers are valuable tools for analyzing genetic variation among yeast from different populations to reveal the genetically different autochthonous strains. In this study, we employed inter-primer binding site (iPBS) retrotransposon polymorphism to assess the genetic variation and population structure of 96 Saccharomyces cerevisiae isolates from four different regions in Turkey. The nine selected iPBS primers amplified 102 reproducible and scorable bands, of which 95.10% were polymorphic with an average of 10.78 polymorphic fragments per primer. The average polymorphism information content and the resolving power were 0.26-3.58, respectively. Analysis of molecular variance (AMOVA) revealed significant (P < 0.001) genetic differences within populations (88%) and between populations (12%). The unweighted pair group mean with arithmetic (UPGMA) dendrogram grouped 96 S. cerevisiae strains into two main clusters, where the highest probability of the data elucidating the population structure was obtained at ΔK = 2. There was not an obvious genetic discrimination of the populations according to geographical regions on UPGMA, supported by principal coordinate analysis. However, the individuals of the closer provinces in each population were more likely to group together or closely. The results indicate that iPBS polymorphism is a useful tool to reveal the genetically diverse autochthonous S. cerevisiae strains that may be important for the production of sourdough or baked goods.


Why the larch bud-moth cycle collapsed in the subalpine larch-cembran pine forests in the year 1990 for the first time since 1850.
The larch bud-moth cycle has been observed in the sub-alpine larch-cembran pine forests 16 times since 1850. Infestation is easily recognized by the characteristic red-brown discoloration of the larch crowns due to the wasteful feeding of the bud moth larvae. The heaviest defoliation recurs at intervals of 8.47±0.27 (SE) years, and the larval density per kilogram of larch branches varies more than 10000-fold over four or five generations. The basic regulatory mechanism for this cycle is the induced change in food quality for the two or more subsequent larval generations. Defoliation functions as a negative feedback mechanism acting on larval density. In 1989 local discoloration in the Upper Engadine valley was observed in the usual first focus. In 1990 and 1991, however, instead of the expected widespread defoliation damage, larval densities decreased drastically. Based on extensive field data collected from 1961 to 1991 on the development and the survival of the bud moth (Zeiraphera diniana Gn.) and the phenology of the host, Larix decidua L., this paper shows the effect of weather on survival in the egg stage and on the coincidence of larval hatching with the sprouting of the larch. It is shown that the winter and spring weather conditions in 1989-1991 were conducive to unusually high egg mortality. Since these conditions occurred in three successive generations, population growth was effectively reduced and the cycle collapsed prematurely. Thus the rather persistent cyclicity of the larch-larch bud-moth system was disturbed by weather conditions with a very low probability of occurrence, but due to the inherent high resilience of the system, the next population peak with visible defoliation is expected to occur 1996/1997, provided that the weather conditions return to the climatic standard.


An evaluation of Feulgen-acriflavine-SO2 and Hoechst 33258 for DNA cytofluorometry in tumour pathology.
The performance of Feulgen-acriflavine-SO2 and Hoechst 33258 for cytofluorometric ploidy determination is evaluated and compared. The fast initial fading of acriflavine-SO2 stained nuclei, with substantial reduction in fluorescence intensity within about 10 ms, is shown to be related to changes in DNA-ratios between cell types when measurements are performed using different excitation light intensities. Although low intensity excitation-, without such fading-, was used, the acriflavine-SO2 staining procedure showed large specimen to specimen variability regarding both mean fluorescence intensities and coefficients of variation (CV). The cells in such specimens could be shown to contain the same amount of chromophore using scanning absorbance measurements and the differing fluorescence values therefore probably represent variability in fluorescence yield. Specimens stained with Hoechst 33258 after RNase treatment showed very small deviations in mean fluorescence value between slides, and also much lower CV's than in acriflavine-SO2 stained specimens. The results indicate that with proper internal standards this procedure would allow the detection of deviations in DNA content in the order of 2%.


Quantitative Analysis and Comparison of Four Major Flavonol Glycosides in the Leaves of Toona sinensis (A. Juss.) Roemer (Chinese Toon) from Various Origins by High-Performance Liquid Chromatography-Diode Array Detector and Hierarchical Clustering Analysis.
Toona sinensis (A. Juss.) Roemer is an endemic species of Toona genus native to Asian area. Its dried leaves are applied in the treatment of many diseases; however, few investigations have been reported for the quantitative analysis and comparison of major bioactive flavonol glycosides in the leaves harvested from various origins. To quantitatively analyze four major flavonol glycosides including rutinoside, quercetin-3-O-β-D-glucoside, quercetin-3-O-α-L-rhamnoside, and kaempferol-3-O-α-L-rhamnoside in the leaves from different production sites and classify them according to the content of these glycosides. A high-performance liquid chromatography-diode array detector (HPLC-DAD) method for their simultaneous determination was developed and validated for linearity, precision, accuracy, stability, and repeatability. Moreover, the method established was then employed to explore the difference in the content of these four glycosides in raw materials. Finally, a hierarchical clustering analysis was performed to classify 11 voucher specimens. The separation was performed on a Waters XBridge Shield RP18 column (150 mm × 4.6 mm, 3.5 μm) kept at 35°C, and acetonitrile and H2O containing 0.30% trifluoroacetic acid as mobile phase was driven at 1.0 mL/min during the analysis. Ten microliters of solution were injected and 254 nm was selected to monitor the separation. A strong linear relationship between the peak area and concentration of four analytes was observed. And, the method was also validated to be repeatable, stable, precise, and accurate. An efficient and reliable HPLC-DAD method was established and applied in the assays for the samples from 11 origins successfully. Moreover, the content of those flavonol glycosides varied much among different batches, and the flavonoids could be considered as biomarkers to control the quality of Chinese Toon. Four major flavonol glycosides in the leaves of Toona sinensis were determined by HPLC-DAD and their contents were compared among various origins by HCA. Abbreviations used: HPLC-DAD: High-performance liquid chromatography-diode array detector, HCA: Hierarchical clustering analysis, MS: Mass spectrometry, RSD: Relative standard deviation.


Editorial for the Special Issue on Miniaturized Silicon Photodetectors: New Perspectives and Applications.
Silicon (Si) technologies provide an excellent platform for monolithically integrating both photonic [...].


Urinary levels of phthalate metabolites in women associated with risk of premature ovarian failure and reproductive hormones.
Phthalates, a class of high production-volume chemicals widely used as plasticizers, have been shown to impair ovarian functions in female animals, but epidemiological evidence is very limited. In this case-control study, the associations between phthalate exposure and premature ovarian failure (POF) in women were assessed. A total of 173 POF cases and 246 control women were recruited in Zhejiang, China. The urinary concentrations of 8 phthalate metabolites and the serum levels of ovary-related hormones were determined. Mono-isobutyl phthalate (MiBP) was the metabolite with the highest median concentration of 27.23 μg/g of creatinine in the whole group. Compared with the lowest quartile, higher urinary concentrations of MiBP were significantly associated with increased odds of POF (OR = 1.38, 95% CI: 0.73-2.61 for the fourth quartile; p for trend = 0.01). The estradiol/FSH ratio, a marker of ovarian function, in control women was significantly negatively associated with the urinary concentrations of most tested phthalate metabolites. Our results suggest that exposure to some phthalates may impair ovarian function and increase the odds of POF in women.


True fungal mycotic aneurysm of the basilar artery: a clinical and surgical dilemma.
Mycotic aneurysms of the intracranial circulation of true fungal etiology are extremely rare and are associated with a very high mortality. We report a case of a fatal aneurysm of the basilar artery secondary to Scedosporium apiospermum infection. The medical and surgical treatments are presented to demonstrate the difficulties associated with these lesions.


Morphological characters and feeding habits of insectivorous Kuhl's pipistrelle bat Pipistrellus kuhlii Cretzschmar, 1830, in different riverine habitats.
This study revises the morphological characters of both sexes of Kuhl's pipistrelle, including external, cranial and dental characters. This study also establishes a baseline for the diet of this insectivorous bat species across a variety of habitats in the Nile Valley, where diets have never before been investigated. Our findings of the stomach contentswere not significantly affected despite the different habitats from which the samples were collected. The three most common insect taxa recovered were Hymenoptera, Lepidoptera and Coleoptera. The percentage volume of insect orders in the diet of Kuhl's bat (63 stomachs) consisted of 29% of Hymenoptera, 9% of Coleoptera, 27% of Lepidoptera, 32% unknown materials and unexpected thing of these insectivorous bats was the presences of 3% fruits. A single order did not dominate the diet of this specie because Hymenoptera was the most fed insect orders by frequency of occurrence 87.3%, Lepidoptera by 74.6%, Coleoptera 36.5% and fruits in 4.8% of samples. Also, they may also be fed by other insect orders, as unknown materials were found in all samples.


Non enzymatic fluorometric determination of glucose by using quenchable g-C3N4 quantum dots.
A non-enzymatic fluorometric assay is described for the determination of glucose. The method is based on the use of g-C3N4 quantum dots (QDs) that have good water solubility. The QDs were synthesized by a one-step solvothermal process using formamide as precursor. The QDs possess an average size of ~5 nm, a band gap of 3.0~3.5 eV, and strong blue fluorescence (with excitation/emission maxima at 400/447 nm). Fluorescence is quenched by glucose (which acts as the electron acceptor) via an electron transfer mechanism. Comprehensive spectroscopy and density functional theory calculations show that the selectivity of the fluorescent probe can be attributed to the presence of N-H bonds that are formed between the QDs (mainly at plane edges) and glucose. The interaction forces lead to the formation of localized states for capturing hot electrons. This results in a decrease in the band gap and a reduction in fluorescence intensity. The probe is selective over some typical interfering species (such as cysteine and albumin) which often are present in the urine of diabetics. The method has a linear response in the 0.2 to 5.0 mM glucose concentration range and a 0.2 mM detection limit. Graphical abstractSchematic representation of the synthesis of g-C3N4 quantum dots (QDs) as a fluorescent nanoprobe for selective detection of glucose.


Comparison of nifedipine with a new calcium channel blocker, flordipine, in exercise-induced asthma.
Four patients with documented exercise-induced asthma (EIA) were pretreated orally in random, double-blind fashion with the calcium channel blockers nifedipine 20 mg and flordipine 25 and 50 mg and placebo, then subjected to exercise challenge on a cycloergometer. Each patient served as his own control, undergoing exercise challenge with the different pretreatments on 4 separate days. No statistically significant protection from EIA was found with either nifedipine or flordipine.


A dynamical analysis of oscillatory responses in the optic tectum.
Multi-unit recordings from the optic tectum of an awake pigeon displaying oscillatory behavior evoked by visual stimulus are highly non-stationary and contain a broad band of frequencies under a time-window analysis. Here we extend these observations by a non-linear dynamical analysis of these oscillatory signals (local fields potentials) in successive epochs during background activity and visual responses. Two numerical estimates have been obtained from the original data every 200 ms: (1) correlation dimension and (2) non-linear forecasting of the trajectories. Results from eight different recording sites analyzed are consistent and indicate, in the average, an increase in complexity of the signal during the oscillatory periods.


Enhanced prediction of Src homology 2 (SH2) domain binding potentials using a fluorescence polarization-derived c-Met, c-Kit, ErbB, and androgen receptor interactome.
Many human diseases are associated with aberrant regulation of phosphoprotein signaling networks. Src homology 2 (SH2) domains represent the major class of protein domains in metazoans that interact with proteins phosphorylated on the amino acid residue tyrosine. Although current SH2 domain prediction algorithms perform well at predicting the sequences of phosphorylated peptides that are likely to result in the highest possible interaction affinity in the context of random peptide library screens, these algorithms do poorly at predicting the interaction potential of SH2 domains with physiologically derived protein sequences. We employed a high throughput interaction assay system to empirically determine the affinity between 93 human SH2 domains and phosphopeptides abstracted from several receptor tyrosine kinases and signaling proteins. The resulting interaction experiments revealed over 1000 novel peptide-protein interactions and provided a glimpse into the common and specific interaction potentials of c-Met, c-Kit, GAB1, and the human androgen receptor. We used these data to build a permutation-based logistic regression classifier that performed considerably better than existing algorithms for predicting the interaction potential of several SH2 domains.


Imaging of Brain Slices with a Genetically Encoded Voltage Indicator.
Functional fluorescence microscopy of brain slices using voltage sensitive fluorescent proteins (VSFPs) allows large scale electrophysiological monitoring of neuronal excitation and inhibition. We describe the equipment and techniques needed to successfully record functional responses optical voltage signals from cells expressing a voltage indicator such as VSFP Butterfly 1.2. We also discuss the advantages of voltage imaging and the challenges it presents.


8 USPSTF recommendations FPs need to know about.
Treat high blood pressure only if measurements taken outside of the office confirm an initial high BP reading · Screen blood-glucose levels in overweight/obese individuals 40 to 70 years old · and more.


Purification and substrate specificity of an endopeptidase from the human oral spirochete Treponema denticola ATCC 35405, active on furylacryloyl-Leu-Gly-Pro-Ala and bradykinin.
An endopeptidase was purified to homogeneity from the cell extracts of Treponema denticola ATCC 35405 (a human oral spirochete) by a procedure that comprised dialysis, anion exchange fast protein liquid chromatography (FPLC), hydroxylapatite FPLC, immobilized metal affinity FPLC, FPLC chromatofocusing, and two consecutive gel permeation FPLC steps. The enzyme is a 62-kDa protein with an isoelectric point of 6.5-7.0. Experiments with enzyme inhibitors suggest that this enzyme is a metallopeptidase and that its activity is not dependent on sulfhydryl or serine residues. The enzyme is active on furylacryloyl-Leu-Gly-Pro-Ala (FALGPA; pH optimum near 6.25), bradykinin (Bk), and several Bk-related peptides. In FALGPA, the cleavage site is the Leu-Gly bond. An imino acid is absolutely necessary in position P'2. The shortest hydrolyzed peptide was FALGPA, the hydrolysis of which is strongly and competitively inhibited by Bk (Ki = 5.0 microM). The pyrophosphate ion and phosphoramidon also inhibited the hydrolysis of FALGPA. The enzyme does not hydrolyze all typical synthetic collagenase substrates, Azocoll, Azocasein, or Type I and Type IV collagens, or any other proteins tested. In Bk-related peptides, the hydrolyzed bond was Phe5-Ser6. Since a Bk antagonist and a Bk-potentiating pentapeptide also were good substrates, it is possible that the enzyme hydrolyzes Bks and related peptides only because of the coincidental, specific amino acid sequence of those substrates. A proposal is made that since a substantial portion of the amino acid sequence of FALGPA is present in collagen (and additionally acknowledging that the furylacryloyl residue structurally resembles that of proline), the natural substrates of this enzyme may be small, soluble collagen fragments produced by other enzymes from periodontal connective tissue, and that such peptides are important for the nutrition and pathogenicity of T. denticola.


Health care for osteoporosis in inflammatory bowel disease: unmet needs in care of male patients?
Osteoporosis is a frequent complication of inflammatory bowel disease (IBD). It may be related to IBD itself or to its therapy. In this study, the quality of care regarding diagnosis and treatment of osteoporosis was examined. In this retrospective, monocentric study 293 consecutive patients with IBD (98 ulcerative colitis, 195 Crohn's disease) were included. Information on age, gender, weight, nicotine abuse, course, disease pattern and medication was assessed, results of dual X-ray absorptiometry (DEXA-scan) were evaluated. DEXA-scan was performed in 174 patients (59 male, 115 female). Bone mineral density (BMD) was impaired in 38.5% of these patients. Male patients were diagnosed more often with osteopenia or osteoporosis than females (55.9% vs. 29.6%, p=0.03) and had a risk of bone disease comparable to postmenopausal women. Additionally, duration of corticosteroid treatment and IBD were identified as risk factors for osteoporosis. Follow up DEXA-scan demonstrated an overall deterioration of BMD in patients with normal baseline results. While in general, women are considered at higher risk for osteoporosis, male patients had a higher risk of impaired BMD, especially when under treatment with corticosteroids. The high incidence of reduced BMD supports the recommendation to screen patients with IBD at an early stage of disease, although a possible bias has to be considered for patients at a tertial referral centre for IBD. Patients with normal baseline DEXA-scan were still at risk to develop bone disease and it seems advisable to monitor patients with IBD for reduced BMD continually.


Synthesis, analytical characterization and initial capillary electrophoretic use in acidic background electrolytes of a new, single-isomer chiral resolving agent: hexakis(2,3-di-O-acetyl-6-O-sulfo)-alpha-cyclodextrin.
The sodium salt of hexakis(2,3-di-O-acetyl-6-O-sulfo)-alpha-CD (HxDAS), the first member of the family of single-isomer, fully sulfated alpha-CDs, has been synthesized and used for the initial capillary electrophoretic separation of the enantiomers of nonionic, weak acid, weak base, and ampholytic analytes. HxDAS complexes less strongly with many of the analytes tested than the analogous beta- and gamma-cyclodextrin derivatives, namely, heptakis(2,3-di-O-acetyl-6-O-sulfo)-beta-cyclodextrin (HDAS) and octakis(2,3-di-O-acetyl-6-O-sulfo)-gamma-cyclodextrin (ODAS). Nevertheless, it facilitated the separation of the enantiomers of a large number of weak electrolyte and nonelectrolyte analytes in acidic aqueous background electrolytes. For all analytes, the effective mobilities and separation selectivities as a function of the background electrolyte concentration of HxDAS followed the trends that were found for HDAS and ODAS.


Malingering detection in a Spanish population with a known-groups design.
Malingering detection has become a topic of increased interest in the US over the last years. However, this development has not been matched in Europe. For example, in Spain there is insufficient evidence to support the use of reliable and valid malingering tests. In this study, we tested the applicability of two malingering detection tests (Test of Memory Malingering (TOMM) and Dot Counting Test) in a Spanish sample. The sample included three groups of patients (30 non-compensation seeking, 14 compensation seeking non-suspected of malingering, and 10 suspected of malingering) and a group of analog students (n=54). Tests' results were able to discriminate between the groups of malingerers (both patients and analogs) and non-malingerers (both compensation seeking and non-compensation seeking). However, the TOMM achieved a higher overall classification rate than the Dot Counting Test. Our results encourage the use of the TOMM as an indicator of malingering with Spanish population.


Lung cancer alters the hydrolysis of nucleotides and nucleosides in platelets.
The nucleotides and nucleosides of adenine are signaling molecules related to thromboregulation and modulation of immune responses in patients with malignancies. Thus, this study aims to determine NTPDase, 5'-nucleotidase, ectonucleotide pyrophosphatase/phosphodiesterase (E-NPP) and adenosine deaminase (ADA) activities in the platelets of patients with lung cancer. We collected blood samples from patients (n=33) previously treated for lung cancer with chemotherapy. Patients were classified as stage IIIb and IV according to the Union for International Cancer Control (UICC). Patients showed a significant decrease in the hydrolysis of adenosine diphosphate (ADP) and adenosine, whereas the adenosine monophosphate (AMP) hydrolysis and platelet aggregation were significantly increased in this group. Adenosine triphosphate (ATP) hydrolysis did not show significant results between the group of patients and the control group. We may suggest that ectonucleotidases as well as ADA are enzymes involved in thromboembolic events but especially here we may see that they are also directly involved in the generation of adenosine formation in the cancer patient circulation.


Does every patient need to be discussed at a multidisciplinary team meeting?
To evaluate the clinical impact and cost-effectiveness of a multidisciplinary team (MDT) meeting in a large hospital in the UK. A management plan for colorectal cancer patients was recorded by the supervising surgical consultant prior to the MDT meeting using the available clinical information and the available reports for imaging and histopathology. The recorded outcomes were then compared with the outcomes documented at the subsequent MDT meeting. The cost of the MDT meeting was calculated based on the salaries of individuals involved plus relevant overheads. A range of opportunity costs were considered, the most significant of which was the expenditure required to re-provide direct clinical care displaced by the MDT. Over a 3 month period a sample of 47 random cases were reviewed from the colorectal MDT. In three patients, there were significant differences between the preliminary consultant decision and the MDT recommendation: in one case management was changed based on further information about patient co-morbidity and performance status. In only one case was there a material alteration to a CT report, which altered management. The annual costs of running this colorectal local MDT alone were estimated at £162,734+ per annum with opportunity costs of at least twice that. The costs of MDT meetings are very high producing a small clinical impact. At a time of increasing financial and capacity pressure in healthcare systems, the use of scarce resources may be better deployed elsewhere.


Interaction of glucocorticoid receptor from rat liver with protamine and arginine.
The nontransformed glucocorticoid receptor (GR) from rat liver was found to bind to protamine-Sepharose and could be recovered by a salt gradient without a change in molecular configuration. The nontransformed GR also bound to arginine-Sepharose, but the transformed GR did not bind to either resin. Ligand-free GR interacted with both resins and was eluted without loss of its steroid binding ability. The bindings of GR to protamine- and arginine-Sepharose were saturable. The apparent dissociation constants of GR on protamine-Sepharose varied from 0.34 nM (-molybdate) to 0.68 nM (+ 10 mM molybdate) and those on arginine-Sepharose were 1.99 nM (-molybdate) and 0.65 nM (+ 10mM molybdate), respectively. The maximum binding capacity was achieved by arginine-Sepharose in the absence of molybdate. Higher salt concentrations (0.5 M NaCl) were required to elute GR from protamine-Sepharose than from arginine-Sepharose (approx 0.03 M NaCl). However, the effectiveness of several salts for the elution of GR was consistent in both resins as follows; MgCl2 = CaCl2 = Na2WO4 greater than (NH4)2SO4 = Na2MoO4 greater than arginine-HCl greater than lysine-HCl greater than KCI = NaCl. These results suggest that GR interacts with arginine residues in protamine. Chromatography using these resins resulted in 7-10-fold purification of occupied and unoccupied nontransformed GRs.


μ-Opioid agonists for preventing emergence agitation under sevoflurane anesthesia in children: a meta-analysis of randomized controlled trials.
Emergence agitation (EA) is an adverse effect after sevoflurane anesthesia in pediatric patients. The effectiveness of prophylactic μ-opioid agonists fentanyl, remifentanil, sufentanil, and alfentanil in preventing EA is debatable. A literature search was conducted to identify clinical trials that observed the effect of μ-opioid agonists fentanyl, remifentanil, sufentanil, and alfentanil on preventing EA in pediatric patients under sevoflurane anesthesia. The statistical software RevMan 5.3 was used for meta-analysis. Data from each study were combined using the relative ratio (RR), weighted mean differences, and their associated 95% confidence intervals. I(2) was used to evaluate heterogeneity. Subgroup analysis was conducted to investigate the possible influences of patient age, adenotonsillectomy, premedication, N2 O, propofol, and regional block/local anesthetics on preventing EA with prophylactic administration of μ-opioid agonists. Publication bias was checked using funnel plots and Begg's test. This meta-analysis showed the inclusion of 19 randomized controlled trials with 1528 patients (857 patients received μ-opioid agonists therapy and 671 patients had placebo). The pooled data indicated that prophylactic μ-opioid agonists fentanyl, remifentanil, sufentanil, and alfentanil significantly decreased the incidence of EA [RR = 0.49 (0.38, 0.64), I(2) = 42%, P = 0.04; RR = 0.57 (0.33, 0.99), I(2) = 37%, P = 0.19; RR = 0.18 (0.08, 0.39), I(2) = 0%, P = 0.98; and RR = 0.56 (0.40, 0.78), I(2) = 6%, P = 0.34, respectively]. All subgroup analyses strengthened the proof for lower incidence of EA under sevoflurane anesthesia after fentanyl administration. A possibility of publication bias was detected in the fentanyl group. This meta-analysis suggested that prophylactic μ-opioid agonists fentanyl, remifentanil, sufentanil, and alfentanil could significantly decrease the incidence of EA under sevoflurane anesthesia in children compared to placebo. Considering the limitations of the included studies, more clinical studies are required.


[Cholecystolithotomy with cholecystojejunostomy as surgical solution for cholelithiasis in portal hypertension caused by hepatic cirrhosis].
Cholecystolithotomy and cholecystojejunostomy has been carried out on 11 patients with severe hypertension from cirrhosis. The indications were frequently recurring attacks of biliary cholic or acute cholecystitis at onset. There was 1 postoperative death from cardiac infarction and only minor in-hospital morbidity. None of the remaining patients has to date developed post-cholecystojejunostomy sequelae. Except the case of extensive inflammation on gangrena, this procedure appears to be a safe and definitive operation, alternative to subtotal cholecystectomy.


Dietary squalene supplementation decreases triglyceride species and modifies phospholipid lipidomic profile in the liver of a porcine model of non-alcoholic steatohepatitis.
Squalene is a key minor component of virgin olive oil, the main source of fat in the Mediterranean diet, and had shown to improve the liver metabolism in rabbits and mice. The present research was carried out to find out whether this effect was conserved in a porcine model of hepatic steatohepatitis and to search for the lipidomic changes involved. The current study revealed that a 0.5% squalene supplementation to a steatotic diet for a month led to hepatic accumulation of squalene and decreased triglyceride content as well as area of hepatic lipid droplets without influencing cholesterol content or fiber areas. However, ballooning score was increased and associated with the hepatic squalene content. Of forty hepatic transcripts related to lipid metabolism and hepatic steatosis, only citrate synthase and a non-coding RNA showed decreased expressions. The hepatic lipidome, assessed by liquid chromatography-mass spectrometry in a platform able to analyze 467 lipids, revealed that squalene supplementation increased ceramide, Cer(36:2), and phosphatidylcholine (PC[32:0], PC[33:0] and PC[34:0]) species and decreased cardiolipin, CL(69:5), and triglyceride (TG[54:2], TG[55:0] and TG[55:2]) species. Plasma levels of interleukin 12p40 increased in pigs receiving the squalene diet. The latter also modified plasma lipidome by increasing TG(58:12) and decreasing non-esterified fatty acid (FA 14:0, FA 16:1 and FA 18:0) species without changes in total NEFA levels. Together this shows that squalene-induced changes in hepatic and plasma lipidomic profiles, non-coding RNA and anti-inflammatory interleukin are suggestive of an alleviation of the disease despite the increase in the ballooning score.