Retrosternal gastric bypass for inoperable esophageal cancer: a report of 71 patients.
Palliative substernal gastric bypass was performed in 71 patients with unresectable cancer of the intrathoracic esophagus. Fifty-six patients (78.9%) left the hospital, 53 eating normally and 3 on a soft diet. There were 15 hospital deaths (21%), 8 due to respiratory failure and pulmonary sepsis with tracheoesophageal fistulization. The remaining 7 deaths were due to aspiration and respiratory failure in 2 patients, anastomotic leakage with sepsis in 2, subphrenic abscess and septicemia in 1, mediastinitis in 1, and intestinal obstruction in 1. Anastomotic leakage occurred in 17 patients (23.9%), 5 of whom died. Wound infections developed in 28 patients (39.4%), 3 with mediastinal esophagocutaneous fistulas. Reestablishment of unimpeded swallowing, relief of respiratory aspiration, isolation of cancerous tracheobronchial infiltration, and freedom from incident-prone endoesophageal tubes were achieved in all patients leaving the hospital. Information is presented on 25 patients who were available for follow-up.


The Association of Distinct Social Determinants of Health with Added Sweetener Knowledge and Consumption in a U.S. Sample of People Living with HIV.
Prior studies in people living with HIV (PLWH) suggest added sweetener intake exceeds recommendations and associates with cardiometabolic abnormalities. Little is known of factors that associate with increased sweetener consumption in PLWH. This cross-sectional study explored knowledge and consumption of added sweeteners and associations of social determinants of health (SDoH) among 900 PLWH residing in the United States. Demographics, SDoH, and added sweetener knowledge and consumption were assessed via an online survey, multivariable analyses were completed. Results demonstrate that sex, race, and low educational level associated with lower sweetener knowledge. Race, age, body mass index, income, limited access to fresh fruits/vegetables, and low sweetener knowledge associated with higher sweetener consumption. Findings highlight the need for consideration of specific demographics and inequitable social circumstances when developing nutrition lifestyle strategies, inclusive of added sweetener education, that are feasible and sustainable across diverse community settings of PLWH.


Electron-transfer processes in carboxy-cytochrome c oxidase after photodissociation of cytochrome a3 2+ . CO.
Under continuous illumination the CO binding curve of reduced carboxy-cytochrome c oxidase maintains the shape of the binding curve in the dark. The apparent dissociation constant calculated from the binding curves at various light intensities is a linear function of the light intensity. Marked differences are observed between the light-induced difference spectra of the fully reduced carboxy-cytochrome c oxidase and the mixed-valence carboxy-cytochrome c oxidase. These differences are enhanced in the presence of ferricyanide as an electron acceptor and are explained by partial oxidation of cytochrome a3 in the mixed-valence enzyme after photodissociation. Upon addition of CO to partially reduced formate cytochrome c oxidase (a2+a3 3+ . HCOOH) the cytochrome a3 2+. CO compound is formed completely with a concomitant oxidation of cytochrome a and the Cu associated with cytochrome a. During photodissociation of the CO compound the formate rebinds to cytochrome a3 and cytochrome a and its associated Cu are simultaneously reduced. These electron transfer processes are fully reversible since in the dark the a3 3+ . HCOOH compound is dissociated slowly with a concomitant formation of the a3 2+ . CO compound and oxidation of cytochrome a. When these experiments are carried out in the presence of cytochrome c, both cytochrome c and cytochrome a are reduced upon illumination of the mixed-valence carboxy-cytochrome c oxidase. In the dark both cytochrome c and cytochrome a are reoxidized when formate dissociates from cytochrome a3 and the a2+ 3 . CO compound is formed back. Thus, in this system we are able to reverse and to modulate the redox state of the different components of the final part of the respiratory chain by light.


Contemporary trends in HIV-associated neurocognitive disorders in Ghana.
Widespread introduction of early combination antiretroviral therapy (cART) for People Living with HIV (PLWH) will influence the burden, profile, and trajectory of HIV-associated neurocognitive disorders (HAND) in the 21st century. To assess the prevalence and trajectory of HAND among PLWH in a Ghanaian tertiary medical center. We analyzed the dataset of a study involving PLWH established on cART (n = 256) and PLWH not initially on cART (n = 244). HIV-negative individuals (n = 246) served as normative controls for neurocognitive assessments. HAND was defined according to the Frascati criteria into asymptomatic neurocognitive impairment (ANI), mild neurocognitive disorder (MND) and HIV-associated dementia (HAD) at enrollment and at month 12. Multivariate logistic regression models were fitted to identify factors associated with HAND. Among PLWH on cART, 21.5%, 3.5% and 0.0% had ANI, MND and HAD respectively compared with 20.1%, 9.8% and 2.0% among PLWH cART naïve, p < 0.0001. Overall, 71.6%, 20.8%, 6.6% and 1.0% had no cognitive impairment, ANI, MND and HAD at baseline. Among participants who completed month 12 follow-up, 55.2% had no cognitive impairment, 43.5%, 1.2%, 0.0% had ANI, MND and HAD respectively, p < 0.0001. Adjusted odds ratio (95% CI) of six independent predictors of HAND at month 12 were no education (3.29;1.81-6.00), stage 4 disease (4.64;1.37-15.69), hypertension (2.28;1.10-4.73), nevirapine use (2.05;1.04-4.05), baseline viral load (0.66;0.56-0.77), and cigarette use (0.10; 0.03-0.42). Most Ghanaian patients in the post-cART era with HAND had mild neurocognitive impairments. The impact of hypertension on progression of HAND warrants further evaluation in our settings.


Bilateral cleft lip. An unorthodox management.
Successful repair of bilateral cleft lip requires attention to the soft-tissue anomalies of the lip and nose and the hard-tissue defects of the maxilla. An algorithm for the management of the infant with bilateral cleft lip is presented. A multidisciplinary approach that uses lip adhesion and passive alveolar molding plates to set the stage for subsequent definitive lip and columellar reconstruction is discussed. This approach differs from most others because of reliance on the mucosal circulation of the prolabium.


Lumbar Discectomy With Bone-Anchored Annular Closure Device in Patients With Large Annular Defects: One-Year Results.
Reherniation rates following lumbar discectomy are low for most patients; however, patients with a large defect in the annulus fibrosis have a significantly higher risk of recurrence. Previous results from a randomized controlled trial (RCT) demonstrated that the implantation of a bone-anchored annular closure device (ACD) during discectomy surgery lowered the risk of symptomatic reherniation and reoperation over one year with fewer serious adverse events (SAEs) compared to discectomy alone. The objective of this prospective, post-market, historically controlled study was to evaluate the use of an ACD during discectomy, and to confirm the results of the RCT that was used to establish regulatory approval in the United States. In this post-market study, all patients (N = 55) received discectomy surgery with a bone-anchored ACD. The comparison population was patients enrolled in the RCT study who had discectomy with an ACD (N = 262) or discectomy alone (N = 272). All other eligibility criteria, surgical technique, device characteristics, and follow-up methodology were comparable between studies. Endpoints included rate of symptomatic reherniation or reoperation, SAEs, and patient-reported measures of disability, pain, and quality of life. Fifty-five patients received ACD implants at 12 sites between May 2020 and February 2021. In the previous RCT, 272 control patients had discectomy surgery alone (RCT-Control), and 262 patients had discectomy surgery with an ACD implant (RCT-ACD). Baseline characteristics across groups were typical of the overall population undergoing lumbar discectomy. The proportion of patients who experienced reherniation and/or reoperation was significantly lower in the ACD group compared to RCT-ACD and RCT-Control groups (p < 0.05). In the ACD study, the one-year rate of symptomatic reherniation was 3.7%, compared to 8.5% in the RCT-ACD group and 17.0% in the RCT-Control group. In the ACD group, the risk of reoperation was 5.5%, compared to 6.5% in the RCT-ACD group and 12.5% in the RCT-Control group. There were no device-related SAEs or device integrity failures in the ACD, and there were clinically meaningful improvements in patient-reported measures of disability, pain, and quality of life. In this post-market study of bone-anchored ACD in patients with large annular defects, rates of symptomatic reherniation, reoperation, and SAEs were all low. Compared to the RCT, the post-market ACD study demonstrated lower rates of reherniation and/or reoperation and measures of back pain one-year post-surgery.


Determination of the minor component bromhexine in cotrimoxazole-containing tablets by absorption spectrophotometry and partial least-squares (PLS-1) multivariate calibration.
The mucolitic bromhexine [N-(2-amino-3,5-dibromobenzyl)-N-methylcyclohexylamine] has been determined in cotrimoxazole-containing tablets by partial least-squares (PLS-1) multivariate of spectrophotometric calibration data in the spectral range 310-350 nm. In the studied commercial tablets, cotrimoxazole is present in large excess (ca. 100:1 in weight) with respect to bromhexine, and a high degree of spectral overlapping exists among bromhexine and cotrimoxazole components. However, the obtained recoveries are reasonably good with the presently discussed technique.


Endometrial ablation: postoperative complications.
Endometrial ablation as a treatment for abnormal uterine bleeding has evolved considerably over the past several decades. Postoperative complications include the following: (1) pregnancy after endometrial ablation; (2) pain-related obstructed menses (hematometra, postablation tubal sterilization syndrome); (3) failure to control menses (repeat ablation, hysterectomy); (4) risk from preexisting conditions (endometrial neoplasia, cesarean section); and (5) infection. Physicians performing endometrial ablation should be aware of postoperative complications and be able to diagnose and provide treatment for these conditions.


Comparative physicochemical and biocompatible properties of radiopaque dicalcium silicate cement and mineral trioxide aggregate.
The purpose of this study was to comparatively examine physicochemical and biocompatible properties of 20 wt% bismuth oxide (Bi(2)O(3))-containing dicalcium silicate cement and white-colored mineral trioxide aggregate (WMTA). The radiopacity, setting time, diametral tensile strength, pH value, morphology, and phase composition of the cements with and without Bi(2)O(3) were measured after mixing powders with water. Cement biocompatibility was evaluated by incubating the cement specimens with MG63 human osteoblast-like cells. The addition of Bi(2)O(3) to the cement led to a significant increase (p < .05) in the setting time of 24 minutes. It was accompanied by a small decrease in the pH value but without adversely affecting diametral tensile strength. The radiopacity value of the Bi(2)O(3)-containing cement was equivalent to 7.3 mm of aluminum, which was significantly higher (p < 0.05) than pure cement without Bi(2)O(3) (1.1 mm of aluminum) but lower (p < .05) than WMTA (9.3 mm of aluminum). However, it was greater than 3 mm of aluminum, which is the value recommended by ISO 6876/2001 standards. MG63 cell viability cultured on Bi(2)O(3)-containing cement was higher than that cultured on WMTA at all culture times. The dicalcium silicate cement with 20 wt% Bi(2)O(3) showed shortened setting time and good biocompatibility and thus may have the potential to be a root-end filling material alternative to MTA.


Separation of image-distortion sources and magnetic-field measurement in scanning electron microscope (SEM).
The electron-microscope image distortion generated by electromagnetic interference (EMI) is an important problem for accurate imaging in scanning electron microscopy (SEM). Available commercial solutions to this problem utilize sophisticated hardware for EMI detection and compensation. Their efficiency depends on the complexity of distortions influence on SEM system. Selection of a proper method for reduction of the distortions is crucial. The current investigations allowed for a separation of the distortions impact on several components of SEM system. A sum of signals from distortion sources causes wavy deformations of specimen shapes in SEM images. The separation of various reasons of the distortion is based on measurements of the periodic deformations of the images for different electron beam energies and working distances between the microscope final aperture and the specimen. Using the SEM images, a direct influence of alternating magnetic field on the electron beam was distinguished. Distortions of electric signals in the scanning block of SEM were also separated. The presented method separates the direct magnetic field influence on the electron beam below the SEM final aperture (in the chamber) from its influence above this aperture (in the electron column). It also allows for the measurement of magnetic field present inside the SEM chamber. The current investigations gave practical guidelines for selecting the most efficient solution for reduction of the distortions.


Transitional type papilloma of the nasopharynx.
A case of transitional-type papilloma arising in the nasopharynx is reported. The various theories for the aetiology of the condition are considered in the light of this finding.


Access of metronidazole into the chronically inflamed middle ear with reference to anaerobic bacterial infections.
Strictly anaerobic bacteria were found in about one third of 138 consecutive cases of active chronic otitis media. These infections were always mixed involving aerobes as well. In 79 cases only aerobes were found and 16 cultures were sterile. To provide a basis for possible clinical trials, the penetration of metronidazole into the ear was studied after an oral dose of 2.4 g to patients with chronic otitis media. Significant amounts of biologically active metronidazole were found in 8 of 12 middle ear discharges at 2--4 h, the concentrations varying between 9.4 and 65.0 microgram/ml. Between 2 and 13 h after administration, significant drug concentrations all exceeding the highest reported bactericidal ones were found in the middle ear mucosa in 6 cases of the 8 in which the determinations were possible. Neither the mucosal nor the discharge concentrations correlated with the simultaneous serum levels of metronidazole, which were high in all 23 patients studied.


Duration of elastomeric separation and effect on interproximal contact point characteristics.
The common protocol of a week-long duration of elastomeric separators to facilitate band placement usually causes discomfort. In this study, we examined the minimum separation time required to create an interproximal space >0.16 mm (band thickness), the interproximal changes over 24 hours after separator removal, and the mechanical characteristics of various separators. Thirty subjects, ages 28.1 +/- 2.8 years, had an elastomeric separator placed between the mandibular second premolar and first molar (CP5-6) for 1, 4, 12, and 24 hours. After separator removal, CP5-6 was measured for space and tightness of dental contact point (TDCP) changes up to 24 hours after separator removal. The mechanical behaviors of 6 manufacturers' separators were compared. After 12 and 24 hours of separation, all patients demonstrated space >0.16 mm (P <.001). A significant negative correlation (R = -0.59 to -0.63; P = .001) was found between baseline TDCP and the space measured at separator removal. A biphasic viscoelastic recovery (82%-95%) to baseline tightness level occurred within 24 hours. Variation between manufacturers was low (9%). Separators should be placed a day before banding. The patient should arrive 3 to 4 hours before the appointment for separator replacement if the separator is lost. Rapid recovery after separation removal implies the biological soundness of elastomeric separation regardless of the manufacturer used.


UV-induced DNA damage initiates release of MMP-1 in human skin.
Destruction of collagen is a hallmark of photoaging. The major enzyme responsible for collagen 1 digestion, matrix metalloproteinase-1 (MMP-1), is induced by exposure to sunlight. To study the molecular trigger for this induction, human skin was ultraviolet-B (UVB)-irradiated and treated with liposome-encapsulated DNA repair enzymes. The photolyase-mediated DNA repair of epidermal UV damage was associated with a reduction of MMP-1 mRNA and protein expression in both the epidermal and dermal compartments of the skin. The role of the epidermal cells in MMP-1 induction in the fibroblasts was examined when human epidermal keratinocytes were irradiated with UVB and their media were transferred to unirradiated human dermal fibroblasts. Transfer of media from irradiated keratinocytes to unirradiated fibroblasts enhanced MMP-1 mRNA and protein. Thus, UV damage to keratinocytes of the epidermis may participate in the destruction of collagen in the dermis by release of soluble mediators that signal fibroblasts to release MMP-1. The MMP-1 induction was reduced when the keratinocytes were treated with DNA repair enzymes T4 endonuclease V or UV endonuclease prior to transfer of the media to fibroblasts. This implies that UVB, which deposits most of its energy on the chromatin of the epidermal keratinocytes and to a lesser extent in the upper dermis, has a significant role in photoaging. DNA damage in the keratinocytes initiates one of the signals for MMP-1 release, and enhancing DNA repair can reduce MMP-1 expression in human skin cells and tissue.


Topical Pharmacotherapy for Actinic Keratoses in Older Adults.
Actinic keratosis is caused by excessive lifetime sun exposure. It must be treated, regardless of thickness, because it is the biologic precursor of invasive squamous cell carcinoma, a potentially deadly malignancy. Physical ablative techniques such as cryotherapy, lasers, and curettage are the most used treatments for isolated lesions. Multiple lesions are treated with topical drugs, chemical peelings, and physical techniques. Drug preparations containing diclofenac plus hyaluronate, aminolevulinic acid, and methyl aminolevulinate and different concentrations of imiquimod and 5-fluorouracil are approved for this clinical indication. All treatments have a good profile of efficacy and tolerability although there are relevant differences in the clearance rate, tolerability, and type and frequency of adverse effects. In addition, they have very different mechanisms of action and treatment protocols. No differences in the efficacy and tolerability were found in older patients compared with younger patients, therefore no dose adjustments are needed. That said, older patients often need to be motivated to treat actinic keratoses and a careful attention to expectations, needs, and preferences should be used to obtain the maximal adherence and prevent treatment failure. This goal can be achieved with a careful evaluation not only of published efficacy, toxicity, and tolerability data but also of practical topics such as the frequency of daily applications, the overall duration of therapy, and the need for a caregiver. Finally, particular attention must be paid in the case of frail patients and immunosuppressed patients.


Was priority setting included in the Canadian COVID-19 pandemic planning and preparedness? A comparative analysis of COVID-19 pandemic plans from eight provinces and three territories.
Variation in priorities during pandemic planning among the federal, provincial and territorial jurisdictions are thought to have impacted Canada's ability to effectively control the spread of the COVID-19 virus, and protect the most vulnerable. The potential influence of diverse and divergent political, cultural, and behavioural factors, regarding inclusion of priority setting (PS) in pandemic preparedness planning across the country is not well understood. This study aimed to examine how the Canadian federal, provincial and territorial COVID-19 pandemic preparedness planning documents integrated PS. A documentary analysis of the federal, eight provincial, three territorial COVID-19 preparedness and response plans. We assessed the degree to which the documented PS processes fulfilled established quality requirements of effective PS using the Kapiriri & Martin framework. While the federal plan included most of the parameters of effective PS, the provinces and territories reflected few. The lack of obligation for the provinces and territories to emulate the federal plan is one of the possible reasons for the varying inclusion of these parameters. The parameters included did not vary systematically with the jurisdiction's context. Provinces could consider using the framework of the federal plan and the WHO guidelines to guide future pandemic planning. Regular evaluation of the instituted PS would provide a mechanism through which lessons can be harnessed and improvement strategies developed. Future studies should describe and evaluate what PS mechanisms were implemented.


Enhanced matrix degradation after withdrawal of TGF-beta1 triggers hepatocytes from apoptosis to proliferation and regeneration.
TGF-beta1 is a profibrogenic cytokine participating in deposition of extracellular matrix in fibrotic disorders. In liver, its anti-proliferative/apoptotic effect on hepatocytes promotes fibrosis. The tetracycline-controlled double-transgenic TA(LAP-2)/p(tet)TGF-beta1 mouse provides a model for reversible liver fibrosis. In livers of TGF-beta1-expressing mice, hepatocytes showed synchronous apoptosis detected by DNA laddering and active caspase-3 staining that disappeared when expression of transgenic TGF-beta1 was switched off. In these 'off' mice, perisinusoidal liver fibrosis resolved within 21 days accompanied by elevated proliferation of hepatocytes. Here, we have specified the intermediary stages (2-3 days off and 6 days off) in terms of (i) proliferation (by immunohistochemical staining of proliferating cell nuclear antigen and expression of cyclin D1 mRNA) and (ii) extracellular matrix remodelling processes (by measuring mRNA expression of matrix metalloproteinases-2 and -13 (mmp-2 and mmp-13) and tissue inhibitor of matrix metalloproteinases 1 (timp-1) and quantitative morphometric analysis. In summary, we show a rapidly declining timp-1 mRNA level together with lastingly high mmp-2 and mmp-13 mRNA levels after 2-3 days, suggesting that high matrix-degrading potential represents a prerequisite for the markedly enhanced proliferation of hepatocytes in the early stages after switching off transgenic TGF-beta1.


Atrial-Selective Potassium Channel Blockers.
Atrial fibrillation (AF) is associated with increased morbidity and mortality. Atrial-selective potassium (K(+)) channel blockers may represent a novel therapeutic target. The best validated atrial-specific ion currents are the acetylcholine-activated inward-rectifier K(+) current IK,ACh and ultrarapidly activating delayed-rectifier K(+) current IKur. Two-pore domain and small-conductance Ca(2+)-activated K(+) channels and Kv1.1 channels may also contribute to the atrial repolarization. We review the molecular and electrophysiologic characteristics of atrial-selective K(+) channels and their potential pathophysiologic role in AF. We summarize currently available K(+) channel blockers focusing on the most important compounds.


Extent of prophylactic lymph node dissection in the central neck area of the patients with papillary thyroid carcinoma: comparison of limited versus comprehensive lymph node dissection in a 2-year safety study.
To compare the "comprehensive" (including bilateral paratracheal, pretracheal, prelaryngeal lymph nodes) (CCND) with "limited" (saving contralateral paratracheal lymph nodes) central node dissection (LCND) for postoperative complications and disease recurrence rate in sonographically node-negative papillary thyroid carcinomas. From 2003 to 2005, 114 consecutive patients, diagnosed as sonographically node-negative thyroid papillary carcinomas, were included retrospectively. Among them, the LCND was performed in 56 patients and CCND in 58 patients, in combination with total thyroidectomy, based on the operator-dependent decision. We compared the complication rates and the recurrence rates between these two groups with a mean follow-up duration of 2 years. Transient hypocalcemia was more frequent in the CCND group than in the LCND group (48.3% vs 26.8%, P = .02, odds ratio [OR] = 2.55). However, the other complication rates were similar in the two groups. In addition, the immediate postoperative reduction of parathyroid hormone (PTH) was more evident in the CCND group. The postoperative PTH levels increased up to a similar level (12.4 vs 11.8 pg/mL) over 6 months. The incidence of permanent hypocalcemia did not differ significantly between the two groups. Four (7.1%) and five recurrences (8.6%) were found in two groups, respectively, implying similar oncological safety during the 2-year follow-up. The LCND with total thyroidectomy could be an alternative treatment option for node-negative papillary thyroid carcinomas, because LCND had fewer short-term hypocalcemia and similar oncological outcomes during the 2-year follow-up. Further study enrolling a large number of patients with long-term follow-up is needed.


Recurrent acute otitis media in infants: analysis of risk factors.
Recurrence acute otitis media (RAOM) may cause a considerable morbidity and a great parental concern. The aim of this study was to analyze the risk factors that are likely to be responsible for RAOM in infants, and their impact on treatment failure. A retrospective study on 340 infants with RAOM was conducted. Data were collected from hospital charts. A 10 days course of amoxicillin/clavulanate was used for treatment of recurrence, while surgical management in the form of adenoidectomy and/or myringotomy was reserved for patients with persistent disease. We analyzed various risk factors that may affect the prognosis of RAOM, including: age, prematurity, upper respiratory tract infections (URTI), duration of breastfeeding, use of pacifiers, parental smoking, seasonality, the presence of siblings (family size), gender, adenoid hypertrophy, allergy, and craniofacial abnormalities. Use of pacifiers, short duration of breastfeeding, older infantile age, winter season, URTI and presence of adenoid hypertrophy were identified as risk factors for RAOM. Treatment failure may be due to adenoid hypertrophy, short duration of breastfeeding and it is more common in older age infants. We did not find a significant association between RAOM and gender, prematurity, exposure to passive smoking, the presence of siblings, allergy, craniofacial abnormalities. Factors that may cause recurrence of the disease in infant population are use of pacifiers, short duration of breastfeeding, older infantile age, winter season, upper respiratory tract infections and adenoid hypertrophy. Also, treatment failure may be caused by adenoid hypertrophy and short duration of breastfeeding. Good understanding of these factors may help to decrease the recurrence rate and to improve the treatment of the disease.


Myosin crossbridge configurations in equilibrium states of vertebrate skeletal muscle. Heads swing axially or turn upside-down between resting and rigor.
The positions and orientations of the myosin heads in relaxed, active, rigor and S1-labelled fish muscle are being determined by analysis both of electron micrographs and of low-angle X-ray diffraction patterns. The X-ray analysis of resting muscle makes use of the head shape defined from the study of S1 crystals, with variable head configurational parameters being used on each of the three different 3-fold symmetric 14.3 nm-spaced 'crowns' of myosin heads within the 42.9 nm axial repeat of the myosin filaments. Diffraction patterns were stripped using CCP13 fibre diffraction software. Searches and optimisation were carried out using simulated annealing and local refinement procedures to give a 'best fit' relaxed structure with a crystallographic R-factor of about 4%. It had heads oriented all the same way up (i.e. with similar rotations around their own long axes) on the myosin filament, but with a small range of axial tilts. Head configuration in rigor fish muscle is being determined by X-ray diffraction and electron microscopy of normal rigor muscle and of skinned muscle soaked with extrinsic myosin S1. Computed 3-D reconstructions of acto-S1 using X-ray amplitudes and phases from electron microscopy are informative and help to analyse the X-ray diffraction data that extend axially to about 1 nm resolution. An ambiguity is the axial direction of the observed resting myosin head array relative to the known polarity of the actin filaments. One polarity would give little axial displacement (2-3 nm) between opposite ends of the resting and rigor heads, and in this case the heads would need to rotate around their own long axes by about 115 degrees to make a rigor attachment. The other (preferred) filament polarity would provide considerable axial swinging (14-15 nm) between the two states. We are attempting to define the absolute polarity of the resting muscle myosin head array using electron microscopy and image processing either of cryo-sections or of replicas from shadowed, freeze-fractured, rapidly frozen fish muscle fibres.


Differential expression and 5' end mapping of actin genes in Dictyostelium.
Using a modification of the Berk and Sharp S1 nuclease mapping procedure and by analyzing actin cDNA clones, we have examined the expression of several members of the 17-member multigene family encoding actin in Dictyostelium. The mapping procedure, which takes advantage of the fact that the actin genes are homologous in the protein-coding region but are very divergent in the proposed 5' untranslated region has enabled us to quantitate the relative expression of several genes during the Dictyostelium life cycle. We have shown that at least six of the 17 potential actin-coding sequences are expressed. One is not expressed at levels of more than 0.5--1% of total actin mRNA at the developmental times examined and appears to be a pseudogene. By quantitating the amount of actin mRNA in mRNA populations isolated from cells at various times in development, we have shown that four of the actin genes show different patterns of expression. Interestingly, three of the four genes appear to encode the same protein. We have also taken advantage of the S1 mapping procedure to identify the 5' ends of the actin mRNAs from four genes and have compared the sequences outside the 5' ends on these genes with the nucleotide sequences of seven other actin genes. We have identified homologous sequences in most of these genes that may be involved in initiation of transcription.


Influence of chemical modification of cysteine and histidine side chains upon subunit reassembly of alpha crystallin.
Alpha crystallin, the important multimeric structural protein of mammalian eye lens, is an assembly composed of 30 alpha-A and 10 alpha-B subunits. The influence of either partial or complete chemical modification of two important amino acid side chains, cysteine and histidine, upon the integrity of native alpha crystallin assembly and also upon the mode of subunit reassembly has been investigated. It has been found that chemical modification of surface-exposed cysteine and histidine side chains does not affect the subunit-subunit interactions stabilizing the native aggregate. Cysteine modifications, either partial or complete, unlike histidine modifications, do not seem to affect the backbone conformation of the subunits refolded after denaturation. Both cysteine and histidine modifications, however, affect the packing of the refolded structural elements forming the tertiary structure of the subunits and also the mode of oligomeric reorganization. The most striking effect of histidine modification is the considerable increase in size of the aggregates upon reassociation of the modified subunits. The chaperone activity, however, has been found to remain almost unaffected in spite of these chemical modifications.


Institutional Pediatric Convulsive Status Epilepticus Protocol Decreases Time to First and Second Line Anti-Seizure Medication Administration.
Convulsive status epilepticus (CSE) is a medical emergency associated with high rates of morbidity and mortality. Although guidelines for CSE management recommend rapid treatment of seizures, prior studies show that compliance with these guidelines is low. In this study, we assessed if implementation of a paper-based clinical pathway for the treatment of CSE improves the timeliness and appropriate dosing of first and second line anti-seizure medications (ASM). A non-digital CSE treatment protocol was implemented as part of a quality improvement initiative in 2016. A retrospective analysis was subsequently conducted on cases of CSE originating in the pediatric emergency department (ED) from 2012-2019. Standard descriptive statistics were used to assess patient demographics as well as the timing and dosing of the first and second line ASMs used in our protocol (lorazepam [LZP] and fosphenytoin [FOS]). Statistical process control charts (XmR charts) were used to assess the variation in time to drug administration before and after implementation of the protocol. 153 cases of CSE were identified (72 prior to and 81 after protocol implementation). Among patients who were actively having seizures on arrival to the ED (n = 44), the median time from arrival to ASM administration decreased from 15 to 11 minutes for the first LZP dose (p = 0.23), 23 to 10 minutes for the second LZP dose (p = 0.06), and 40 to 25 minutes for the PHE dose (p = 0.04). There was no improvement in time to LZP administration after seizure onset among those with seizure onset after hospital arrival (5 minutes before/after implementation for the first LZP dose and 15 to 14 minutes for second LZP dose); however, the time to FOS decreased from 42 to 22 minutes (p = 0.86). Statistical process control charts showed a universal decrease in variation for time to each drug administration after protocol implementation. Whereas FOS dosing was largely appropriate before and after protocol implementation, appropriate dosing of LZP did not improve, with only about half of patients receiving the recommended dose. The implementation of a paper-based treatment protocol for CSE was associated with a decreased time to ASM administration among patients who arrived to the ED, particularly for the second-line ASM. Approaches for improving appropriate benzodiazepine dosing are needed.


Black carbon in Xiamen, China: Temporal variations, transport pathways and impacts of synoptic circulation.
Black carbon (BC) plays a vital role in atmospheric environment and climate change. Temporal variations and transport pathways of BC in Xiamen, China with the impacts of synoptic circulation were investigated in 2014 with Aethalometer. Annual mean BC concentration was 4270 ng m-3. BC exhibited clear diurnal (seasonal) variations, with the maximum of 6182 (4755) ng m-3 at 6:00 (in spring) and minimum of 2847 (3774) ng m-3 at 13:00 (in summer). Conditional probability function analysis indicated that high BC concentrations were associated with northwesterly winds with low wind speed. Air masses originating from the East China Sea and passing along with East China Coast had the highest BC concentrations. Potential source contribution function and concentration weighted trajectory analysis suggested that major sources for BC included the surrounding region, southwestern Fujian and eastern Guangdong to the southwest, Hubei, Hunan and Jiangxi to the northwest, the East China Sea and the South China Sea. Of the nine synoptic circulation patterns, three cyclone-related patterns were associated with low BC concentrations and small biomass burning (BCbb) contributions. Of the six anticyclone-related patterns, the three cold-high circulations around winter were associated with moderate BC concentrations and large BCbb contributions. The two cold-high patterns in spring and autumn were associated with high BC concentrations and small BCbb contributions, while the warm-high pattern was associated with moderate BC concentration and small BCbb contribution. The findings provide insights into the transport mechanisms of BC with the impacts of synoptic pattern in China.


[The rare malformation of nasal aplasia].
After presenting two sisters with the rare form of congenital arrhinia, this syndrome is reviewed, an explanation of the pathogenesis is offered and the therapeutic options of the functional and aesthetic reconstruction are discussed. In cases of congenital arrhinia different degrees of respiratory distress, cyanotic episodes, and impaired food intake are described. Therefore after birth respiration and food intake need to be monitored to alleviate the situation through intubation or tracheotomy. The following conclusions could be made based on the literature overview. Little is known about the pathophysiology and a great variety of therapeutic interventions and reconstruction solutions with a wide spectrum of complications are described. Due to the numerous forms of complications, which need to be compared with the reconstructive results, indications for surgical reconstruction of the airway and plastic reconstruction of the nose during childhood must be defined very stringently. One method to achieve a satisfactory plastic result is with an osseointegrated prosthesis. This facial prosthesis can be inserted without complications and can guarantee an adequate result, whereas no impairment of maxillofacial development was noted.


The relations between reading and spelling: an examination of subtypes of reading disability.
Three groups of reading-disabled children were found in studies of English, German, and French: a group with a double deficit in reading and spelling, a group with a single spelling deficit, and a more rarely reported group presenting a single reading deficit. This study set out to examine whether these groups can be found in adults, readers and spellers of Hebrew, which differs from the previously studied orthographies in many aspects. To this end, Hebrew-speaking adults with or without reading disability were administered various literacy and literacy-related tests. Results confirm the existence of the same three groups. While all shared a phonological deficit, subtle differences in phonological decoding ability and in speed of processing distinguished between the groups. The study therefore suggests that the previously reported associations and dissociations between reading and spelling are not restricted to English, German, or French and may not be only developmental in nature.


Efficient high resolution sLORETA in brain source localization.
Objective.Estimation of the source location within the brain from electroencephalography (EEG) and magnetoencephalography measures is a challenging task. Among the existing techniques in the field, which are known as brain imaging methods, standardized low-resolution brain electromagnetic tomography (sLORETA) is the most popular method due to its simplicity and high accuracy. However, in this work we illustrate that sLORETA is still noisy and the additive noise is causing the blurry image. The existing pre-fixed/manual thresholding process after sLORETA can partially take care of denoising. However, this ad-hoc theresholding can either remove so much of the desired data or leave much of the noise in the process. Manual correction to avoid such extreme cases can be time-consuming. The objective of this paper is to automate the denoising process in the form of adaptive thresholding.Approach.The proposed method, denoted by efficient high-resolution sLORETA (EHR-sLORETA), is based on minimizing the error between the desired denoised source and the source estimates.Main results.The approach is evaluated using synthetic EEG and real EEG data. spatial dispersion (SD), and mean square error (MSE) are used as metrics to provide the quantitative performance of the method. In addition, qualitative analysis of the method is provided for real EEG data. This proposed model demonstrates advantages over the existing methods in sense of accuracy and robustness with SD and MSE comparison.Significance.EHR-sLORETA could have a significant impact on clinical studies with source estimation task, as it improves the accuracy of source estimation and eliminates the need for manual thresholding.


Conformational stability of globular proteins.
The conformational stability of ribonuclease T1 has been measured as a function of the variables of most interest to biochemists: temperature, pH, salt concentration, disulfide-bond content and amino acid sequence. The results provide insight into the forces that stabilize globular proteins.


The WE SENSE study protocol: A controlled, longitudinal clinical trial on the use of wearable sensors for early detection and tracking of viral respiratory tract infections.
Viral respiratory tract infections (VRTI) are extremely common. Considering the profound social and economic impact of COVID-19, it is imperative to identify novel mechanisms for early detection and prevention of VRTIs, to prevent future pandemics. Wearable biosensor technology may facilitate this. Early asymptomatic detection of VRTIs could reduce stress on the healthcare system by reducing transmission and decreasing the overall number of cases. The aim of the current study is to define a sensitive set of physiological and immunological signature patterns of VRTI through machine learning (ML) to analyze physiological data collected continuously using wearable vital signs sensors. A controlled, prospective longitudinal study with an induced low grade viral challenge, coupled with 12 days of continuous wearable biosensors monitoring surrounding viral induction. We aim to recruit and simulate a low grade VRTI in 60 healthy adults aged 18-59 years via administration of live attenuated influenza vaccine (LAIV). Continuous monitoring with wearable biosensors will include 7 days pre (baseline) and 5 days post LAIV administration, during which vital signs and activity-monitoring biosensors (embedded in a shirt, wristwatch and ring) will continuously monitor physiological and activity parameters. Novel infection detection techniques will be developed based on inflammatory biomarker mapping, PCR testing, and app-based VRTI symptom tracking. Subtle patterns of change will be assessed via ML algorithms developed to analyze large datasets and generate a predictive algorithm. This study presents an infrastructure to test wearables for the detection of asymptomatic VRTI using multimodal biosensors, based on immune host response signature. CliniclTrials.govregistration:NCT05290792.


Laparoscopic adjustable gastric banding: surgical and radiological approach.
The laparoscopically-placed adjustable gastric band (LAGB) is a minimally invasive, adjustable and completely reversible operation. We report 3 years experience. Between May 1998 and January 2001, we operated on a consecutive series of 50 patients (8 male/42 female). Mean age of patients was 37 years (30-48). Mean preoperative BMI was 43 kg/m2 (range 38-55). Mean operative time was 130 minutes (range 75-150), and the conversion rate was 6%. Mean hospital stay was 2.8 days (range 2-10). Postoperatively 7/50 (14%) of patients had dysphagia and subsequently 2 (4%) developed gastric pouch dilatation. 2/50 (4%) had non-fatal pulmonary embolism and 2/50 (4%) developed gastroesophageal reflux. Overall morbidity was 32%. There has been no mortality. 6 weeks postoperatively, patients had adjustment of the band by the radiologists. Follow-up has been up to 30 months. Mean excess weight loss at 6 months was 30% (range 26-35%, N = 50), at 12 months 52% (range 44-55%, N = 42), at 24 months 60% (range 55-65%, N = 14) and at 30 months 62% (range 58-64%, N = 8). 5 patients have reached their ideal body weight. LAGB is safe and effective, even early in the learning curve. The radiologist plays a distinct role. A multi-disciplinary team approach is essential for optimal results. Long-term results are pending.


Forgiveness as a moderator of the association between victimization and suicidal ideation.
The present study examined the relationships between victimization, suicidal ideation and forgiveness. 962 Chinese middle school students were evaluated using the Chinese versions of the Olweus Bully/Victim Questionnaire (OBVQ), the Positive and Negative Suicide Ideation scale (PANSI) and the Forgiveness Questionnaire (FQ). High victimization and low forgiveness were found to predict increased suicidal ideation. Victimized students with high level of forgiveness reported less suicidal ideation than students with low level of forgiveness. Forgiveness was found to moderate the association between victimization and suicidal ideation and could be a protective factor against suicidal ideation in victimized students.


Bioavailability of imipramine tablets relative to a stable isotope-labeled internal standard: increasing the power of bioavailability tests.
A new methodology for comparative bioavailability testing is described in which each drug formulation is compared with a stable isotope-labeled variant of the drug that is consumed orally in solution at the same time the tested formulation is ingested. The methodology is used to determine the comparative bioavailabilities of two commercially available brands of imipramine hydrochloride. The power of the new methodology to detect differences between drug formulations, when, in fact, such differences exist, is shown to be superior to that of conventional bioavailability tests.


Are buccal cancers in India and Canada any different?
To compare the treatment outcomes of squamous cell carcinoma (SCC) of buccal mucosa in India and Canada. We compared the outcome of 169 patients with SCC of buccal mucosa treated at Tata Memorial Hospital (TMH), India with 64 matched patients from Cancer Care Manitoba (CCMB), Canada. Overall and cause specific survivals for the two geographical groups were calculated by Kaplan-Meir method and compared using log rank test. Cox regression analysis was used to see impact of independent variables. At 5 years, CCMB patients had lower over all survival (57.4% vs. 67.1%; P = 0.002) than TMH ones but similar cause specific survival (76.4% vs. 74.2%; P = 0.690). Age had an independent influence on both over all and cause specific survival. After adjusting for the age confounding in the Cox proportional hazard model there was no difference in the overall survival of the two groups (HR = 0.84; 95% CI = 0.51, 1.40; P = 0.509). Radiated patients had three times higher risk of dying of disease than surgically treated ones (HR = 3.03; 95% CI = 1.64, 5.60; P < 0.001). There was no difference in the cause specific survival between the two groups. Apparent difference in the overall survival was due to the difference in the age of presentation.


Improving internet-delivered cognitive behaviour therapy for alcohol misuse: Patient perspectives following program completion.
Although Internet-delivered cognitive behaviour therapy (ICBT) for alcohol misuse is efficacious in research trials, it is not routinely available in practice. Moreover, there is considerable variability in engagement and outcomes of ICBT for alcohol misuse across studies. The Alcohol Change Course (ACC) is an ICBT program that is offered free of charge by an online clinic in Saskatchewan, Canada, which seeks to fill this service gap, while also conducting research to direct future improvements of ICBT. As there is limited qualitative patient-oriented research designed to improve ICBT for alcohol misuse, in this study, we describe patient perceptions of the ACC post-treatment. Specifically, post-treatment feedback was obtained from 191 of 312 patients who enrolled in the ACC. Qualitative thematic analysis was used to examine post-treatment written comments related to what patients liked and disliked about the course, which skills were most helpful for them, and their suggestions for future patients. The majority of patients endorsed being very satisfied or satisfied with the course (n = 133, 69.6%) and 94.2% (n = 180) perceived the course as being worth their time. Worksheets (n = 61, 31.9%) and reflections of others (n = 40, 20.9%) received the most praise. Coping with cravings (n = 63, 33.0%), and identifying and managing risky situations (n = 46, 24.1%) were reported as the most helpful skills. Several suggestions for refining the course were provided with the most frequent recommendation being a desire for increased personal interaction (n = 24, 12.6%) followed by a desire for wanting more information (n = 22, 11.5%). Many patients offered advice for future ACC patients, including suggestions to make a commitment (n = 47, 24.6%), do all of the work (n = 29, 15.2%), and keep a consistent approach to the course (n = 24, 12.6%). The results provide valuable patient-oriented directions for improving ICBT for alcohol misuse.


Body dysmorphic disorder in female Swedish dermatology patients.
Individuals with body dysmorphic disorder (BDD) are highly distressed and impaired owing to perceived defects in their physical appearance that are not noticeable to others. They are frequently concerned about their skin and often present to dermatologists rather than psychiatrists. However, BDD patients attending dermatology clinics may be at risk of not receiving an appropriate assessment and beneficial treatment. The aims of this study were to estimate the BDD prevalence rate among Swedish female dermatology patients and to assess the psychological condition of BDD patients compared to that of other dermatology patients. The occurrence of BDD was estimated using the Body Dysmorphic Disorder Questionnaire (BDDQ), a validated self-report measure for BDD. Symptoms of depression and anxiety were measured by the Hospital Anxiety and Depression Scale (HADS), and quality of life was assessed using the Dermatology Life Quality Index (DLQI). The prevalence rate of BDD among female Swedish dermatology patients was 4.9% (95% CI 3.2-7.4). Anxiety (HADS A ≥ 11) was 4-fold more commonly reported by patients with positive BDD screening (48% vs. 11%), and depression (HADS D ≥ 11) was over 10-fold more common in patients with positive BDD screening (19% vs. 1.8%) (P < 0.001). The median DLQI score was 18 in the BDD group, compared to a score of 4 in the non-BDD group (P < 0.001). Our results indicate that BDD is fairly common among female Swedish dermatology patients (4.9%) and that BDD patients have high levels of depression and anxiety and severely impaired quality of life.


[Possibilities and limitations of immunotherapy in the treatment of malignant neoplasms].
The goal of cancer immunotherapy is to achieve cure when the more usual means of treatment fail to do so. This can be achieved in some animal models where tumor rejection antigens have been demonstrated. In man, the contribution of immunotherapy to the treatment of minimal residual but disseminated disease has been exceedingly poor. This discrepancy should be analyzed, in an effort to detect and define in vitro putative tumor rejection antigens in human tumors.


Aliphatic and aromatic hydrocarbons in marine biota and coastal sediments from the Gulf and the Gulf of Oman.
The composition and spatial distribution of aliphatic and polycyclic aromatic hydrocarbons (PAHs) were investigated in biota and coastal sediments from four countries surrounding the Gulf (Bahrain, Qatar, United Arab Emirates and Oman). The levels of total petroleum hydrocarbons (TPH), aliphatic unresolved mixture and PAHs in sediments and biota were relatively low compared to world-wide locations reported to be chronically contaminated by oil. Only in the case of the sediments collected near the BAPCO oil refinery in Bahrain, having concentrations of 779 microg g(-1) total petroleum hydrocarbon equivalents and 6.6 microg g(-1) Sigma PAHs, can they be categorized as chronically contaminated. Some evidence of oil contamination was also apparent in sediments and bivalves around Akkah Head and Abu Dhabi in the UAE, and near Mirbat in Oman. Contaminant patterns in sediments and biota indicated that the PAHs were mainly from fossil sources, with the exception of the high PAH concentrations in sediments near the BAPCO refinery that contained substantial concentrations of carcinogenic PAH combustion products.


Cost-effectiveness of magnetic resonance-guided focused ultrasound surgery for treatment of uterine fibroids.
To estimate the cost-effectiveness of a treatment strategy for symptomatic uterine fibroids, which starts with Magnetic Resonance-guided Focused Ultrasound Surgery (MRgFUS) as compared with current practice comprising uterine artery embolisation, myomectomy and hysterectomy. Cost-utility analysis based on a Markov model. National Health Service (NHS) Trusts in England and Wales. Women for whom surgical treatment for uterine fibroids is being considered. The parameters of the Markov model of the treatment of uterine fibroids are drawn from a series of clinical studies of MRgFUS, and from the clinical effectiveness literature. Health-related quality of life is measured using the 6D. Costs are estimated from the perspective of the NHS. The impact of uncertainty is examined using deterministic and probabilistic sensitivity analysis. Incremental cost-effectiveness measured by cost per quality-adjusted life-year (QALY) gained. The base-case results imply a cost saving and a small QALY gain per woman as a result of an MRgFUS treatment strategy. The cost per QALY gained is sensitive to cost of MRgFUS relative to other treatments, the age of the woman and the nonperfused volume relative to the total fibroids volume. A treatment strategy for symptomatic uterine fibroids starting with MRgFUS is likely to be cost-effective.


Local Renin-Angiotensin System Signaling Mediates Cellular Function of Aortic Valves.
The renin-angiotensin system (RAS) is activated in aortic valve disease, yet little is understood about how it affects the acute functional response of valve interstitial cells (VICs). Herein, we developed a gelatin-based valve thin film (vTF) platform to investigate whether the contractile response of VICs can be regulated via RAS mediators and inhibitors. First, the impact of culture medium (quiescent, activated, and osteogenic medium) on VIC phenotype and function was assessed. Contractility of VICs was measured upon treatment with angiotensin I (Ang I), angiotensin II (Ang II), angiotensin-converting enzyme (ACE) inhibitor, and Angiotensin II type 1 receptor (AT1R) inhibitor. Anisotropic cell alignment on gelatin vTF was achieved independent of culture conditions. Cells cultured in activated and osteogenic conditions were found to be more elongated than in quiescent medium. Increased α-SMA expression was observed in activated medium and no RUNX2 expression were observed in cells. VIC contractile stress increased with increasing concentrations (from 10-10 to 10-6 M) of Ang I and Ang II. Moreover, cell contraction was significantly reduced in all ACE and AT1R inhibitor-treated groups. Together, these findings suggest that local RAS is active in VICs, and our vTF may provide a powerful platform for valve drug screening and development.


Dispirotripiperazine-core compounds, their biological activity with a focus on broad antiviral property, and perspectives in drug design (mini-review).
Viruses are obligate intracellular parasites and have evolved to enter the host cell. To gain access they come into contact with the host cell through an initial adhesion, and some viruses from different genus may use heparan sulfate proteoglycans for it. The successful inhibition of this early event of the infection by synthetic molecules has always been an attractive target for medicinal chemists. Numerous reports have yielded insights into the function of compounds based on the dispirotripiperazine scaffold. Analysis suggests that this is a structural requirement for inhibiting the interactions between viruses and cell-surface heparan sulfate proteoglycans, thus preventing virus entry and replication. This review summarizes our current knowledge about the early history of development, synthesis, structure-activity relationships and antiviral evaluation of dispirotripiperazine-based compounds and where they are going in the future.


Epstein-Barr virus infection in polytransfused patients with homozygous beta-thalassaemia.
The frequency of Epstein-Barr virus (EBV) and hepatitis B virus (HBV) infection has been studied in 149 polytransfused thalassaemic patients and in healthy controls. Evidence for EBV infection was based on the detection of antibodies to viral capsid antigen (anti-VCA) and for HBV infection on the detection of either hepatitis B surface antigen (HBsAg) or hepatitis B surface antibody (anti-HBs). The frequency of anti-VCA was not significantly higher in the patients (16.4%) compared to the controls (69.8%) whereas HBV infection was more frequently observed in the patients (91.3%) than in the controls (17.3%). There was also no evidence of repeated infection or recent infection with EBV in the polytransfused patients. These data suggest that transfusion of stored blood does not represent a significant factor of spread for EBV.


[Construction of adeno-associated virus vector containing human papilloma virus 16 E7 gene and its expression in eukaryotic cells].
To construct recombinant adeno-associated virus vector containing human papilloma virus (HPV) 16E7 gene and identify its effectiveness of expression in eukaryotic cell. Recombinant adeno-associated virus particles containing HPV16E7 gene were generated by co-transfection of plasmids pAAV-MCS-E7, pAAV-RC and pAAV-helper into HEK293 cells. The viral particles were collected and purified. The vector titer was measured by southern blot. After the eukaryotic cells were transfected by virus particles, RT-PCR and western blot analysis were performed to identify rAAV expression. The recombinant adeno-associated virus vector containing HPV16E7 gene was correctly constructed. The vector titer measured by southern blot was approximately 1 x 10(11)/ml. After the eukaryotic cells were transfected by the recombinant adeno-associated virus vector, the expression of HPV16E7 gene was identified by RT-PCR and western blot. Recombinant adeno-associated virus HPV16E7 vector is successfully constructed and can stably express in eukaryotic cells.


Selection of Automated Platelet Counting Methods Based on Mean Platelet Volume (MPV).
Impedance-based detection and optic detection with fluorescence are common platelet counting methods used by modern hematology analyzers. There are few studies to compare the accuracy of platelet counts using these methods in case of increased MPV. Sixty patients with immune-related thrombocytopenia (IRTP) and 60 healthy controls were included. Platelet counts were obtained by BC-6900 analyzer using impedance detection (PLT-I) and optic detection with fluorescence (PLT-O). Flow cytometry was used as the reference (FCM-ref). The platelet counts in patients using PLT-I were significantly lower than those using PLT-O or FCM-ref by an average of 13.3%. The platelet counts by PLT-O compared to FCM-ref were not statistically significant. MPV inversely affected the platelet counts. When MPV was < 13 fL, platelet counts by all three methods were not statistically different. When MPV was ≥ 13 fL, platelet counts by PLT-I were significantly lower (-15.8%) than those by PLT-O or FCM-ref. Furthermore, when MPV was ≥ 15 fL, platelet counts using PLT-I were further decreased (-23.6%) compared to the counts obtained by PLT-O or FCM-ref. The platelet counts by PLT-O in patients with IRTP is as accurate as by FCM-ref. When MPV is < 13 fL, platelet counts by all three methods are comparable. However, when MPV is ≥ 13 fL, platelet counts by PLT-I can erroneously decrease by as many as 23.6%. Therefore, in case of IRTP, or any cases when MPV ≥ 13 fL, platelet counts obtained by PLT-I method should be carefully checked by other methods, such as PLT-O to ensure a more accurate platelet count.


Resolution and reconstitution of Rhodospirillum rubrum pyridine dinucleotide transhydrogenase. Proteolytic and thermal inactivation of the membrane component.
Pyridine dinucleotide transhydrogenase of the Rhodospirillum rubrum chromatophore membrane was readily resolved by a washing procedure into two inactive components, a soluble transhydrogenase factor protein and an insoluble membrane-bound factor. Transhydrogenation was reconstituted on reassociation of these components. The capacity of the membrane factor to reconstitute enzymatic activity was lost after proteolysis of soluble transhydrogenase factor-depleted membranes with trypsin. NADP+ or NADPH, but neither NAD+ nor NADH, stimulated by several fold the rate of trypsin-dependent inactivation of the membrane factor. Substantial protection of the membrane factor from proteolytic inactivation was observed in the presence of Mg2+ ions, an inhibitor of transhydrogenation, or when the soluble transhydrogenase factor was bound to the membrane. Coincident with the loss of enzymatic reconstitutive capacity of the membrane factor was a loss in the ability of the membranes to bind the soluble transhydrogenase factor in a stable complex. The membrane component was inactivated by preincubating soluble transhydrogenase factor-depleted membranes at temperatures above 45 degrees. NADP+, NADPH, or Mg2+ ions, but neither NAD+ nor NADH, protected against inactivation. These studies indicate that (a) the binding of NADP+ or NADPH to the membrane factor promotes a conformational alteration in the protein such that its themostability and susceptibility to proteolysis are increased, and (b) the inhibitory Mg2+ ion-binding site resides in the membrane component.


Evidence for serotonin binding in vitro by platelet factor 4 and beta-thromboglobulin.
Evidence is presented for in vitro high affinity binding of serotonin (5-HT) by beta-thromboglobulin (beta TG) and platelet factor 4 (PF4) from human blood. Results include: 1) identification by radioimmunoassay of PF4 in specifically bound material obtained by 5-HT affinity chromatography of human platelet extracts; 2) binding of 72% and 6% of radiolabelled PF4 on 5-HT and control affinity columns, respectively; and 3) binding of approximately 8 moles of 5-HT per mole of purified beta TG in the presence of ferrous ion and heparin in ultrafiltration studies, with Scatchard analysis indicating a dissociation constant of about 4 X 10(-8) M.


Mass spectrometry determination of endonuclear phospholipid composition and dynamics.
Mammalian cell lipid analyses using tandem electrospray ionization mass spectrometry, in conjunction with stable isotope labeling, permit unparalleled access to membrane phospholipid molecular species compositions and turnover. Lipidomic data from isolable compartments of lipid second messenger generation, such as membrane-free nuclei, can provide dynamic insights into the topology of phospholipid turnover. For example, ESI-MS/MS precursor scans of characteristic phosphocholine m/z 184(+) fragments reveal a highly saturated endonuclear phosphatidylcholine pool with homeostatic maintenance properties. A spatially distinct CDPcholine pathway yields, within minutes of choline-d(9) labeling, unsaturated endonuclear phosphatidylcholines progressively remodeled to more saturated species evidenced by tracking the deuteriated headgroup through precursor scans of phosphocholine-d(9) (m/z 193(+) fragment). Among the other endonuclear phospholipids, diacyl phosphatidylethanolamines (neutral loss of m/z 141(+)) are also highly saturated compared with those of whole cell whereas, phophatidylinositols (precursor scans of m/z 241(-) fragment) are essentially identical in nuclei and whole cells. Moreover, the pattern of myo-inositol-d(6) acquisition into endonuclear phosphatidylinositol (precursor scans of m/z 247(-) fragment) is inconsistent with compartment-specific synthesis. Endonuclear sphingomyelins (seen in precursor scans of m/z 184(+) and confirmed from precursor scans of m/z 168(-) fragments) are enriched but similar in composition to whole cell species whereas endonuclear phosphatidylserines (neutral loss of m/z 87(-)) are more saturated than their whole cell counterparts. The focus of described methodologies emphasize their value in probing the compositions and dynamics of endonuclear phospholipids, but in principle may be extended to exploration of other isolable compartments including ER or plasma membranes.


A temperature-induced absorption band centered in the region of 666 nm related to the configuration of the active site in frozen cytochrome oxidase.
The existence of a temperature-induced absorption band centred in the region of 666 nm is demonstrated for both membrane-bound and soluble cytochrome oxidase in the frozen state. The 666 nm band is generated solely by an increase in temperature of both fully reduced and mixed valence state cytochrome oxidase in the presence of CO or O2 within the 'pocket' containing the active site; it is not formed in the absence of both CO and O2 from the sample. The formation of the 666 nm band is entirely reversible when the temperature is decreased again and its formation is not dependent on the presence of liganded CO at the sixth coordination site of haem a3 in the low temperature range (below --120 degrees C) prior to photolysis. The shape and intensity of the 666 nm band are not affected by the extent of CO recombination following flash and photolysis and temperature increase and are not affected by changes in the valence states of the four metal centres when the O2 reaction is in progress.


Clinical features of thin basement membrane disease and associated glomerulopathies.
Thin basement membrane disease (TBMD) occurs in 5-11% of renal biopsy series, and can be associated with other glomerulopathies (GNs). Data on the prevalence, clinical features, and prognosis of TBMD with other GNs are limited. From June 1990 to May 2001, findings from 658 native kidney biopsies were retrospectively studied. The overall prevalence of TBMD was 7.9% (52 of 658). The mean glomerular basement membrane (GBM) thickness was 206 +/- 30 nm. Clinicopathological features were compared for patients with TBMD only (n = 14) and in those with TBMD and GN (n = 38). Focal segmental glomerulosclerosis, mesangial proliferative GN, and minimal change disease were the most common GNs associated with TBMD. After a mean follow-up period of 44.9 +/- 42.5 months, the group who only had TBMD revealed a relatively benign disease with microscopic haematuria and trivial proteinuria, a low prevalence of hypertension, and no renal progression. In the group who had both TBMD and GN, heavy proteinuria (6.1 +/- 5.2 g/day), hypoalbuminaemia (26 +/- 12 g/L) and renal insufficiency (76 +/- 25 mL/min) might develop. We suggested that the TBMD is a developmental abnormality of little or no significance and that it is the underlying associated GN rather than TBMD, which has the relevance to the outcome of renal disease.


Effects of VO2 nanoparticles on human liver HepG2 cells: Cytotoxicity, genotoxicity, and glucose and lipid metabolism disorders.
The rapid development of smart materials stimulates the production of vanadium dioxide (VO2) nanomaterials. This significantly increases the population exposure to VO2 nanomaterials via different pathways, and thus urges us to pay more attentions to their biosafety. Liver is the primary accumulation organ of nanomaterials in vivo, but the knowledge of effects of VO2 nanomaterials on the liver is extremely lacking. In this work, we comprehensively evaluated the effects of a commercial VO2 nanoparticle, S-VO2, in a liver cell line HepG2 to illuminate the potential hepatic toxicity of VO2 nanomaterials. The results indicated that S-VO2 was cytotoxic and genotoxic to HepG2 cells, mainly by inhibiting the cell proliferation. Apoptosis was observed at higher dose of S-VO2, while DNA damage was detected at all tested concentrations. S-VO2 particles were internalized by HepG2 cells and kept almost intact inside cells. Both the particle and dissolved species of S-VO2 contributed to the observed toxicities. They induced the overproduction of ROS, and then caused the mitochondrial dysfunction, ATP synthesis interruption, and DNA damages, consequently arrested the cell cycle in G2/M phase and inhibited the proliferation of HepG2 cells. The S-VO2 exposure also resulted in the upregulations of glucose uptake and lipid content in HepG2 cells, which were attributed to the ROS production and autophagy flux block, respectively. Our findings offer valuable insights into the liver toxicity of VO2 nanomaterials, benefiting their safely practical applications.


Doxorubicin loaded pH responsive biodegradable ABA-type Amphiphilic PEG-b-aliphatic Polyketal-b-PEG block copolymer for therapy against aggressive murine lymphoma.
A novel ABA-type polyethylene glycol (PEG)-b-polyketal (PK)-b-PEG block copolymer was synthesized via click reactions between the monoazido-monomethoxy-PEG and dialkyne terminated aliphatic polyketal with no carboxylic/amide linkages. Formation of the novel block copolymer was confirmed by 1H NMR, GPC, TGA, and DSC studies. The formed copolymer has shown faster degradation at acidic pH. Self-assembly of this block copolymer (average size 6.2 nm) was assessed by fluorescence study using pyrene as a probe. Doxorubicin loaded block copolymeric micelles (69.9 nm) have shown pH dependent elevated drug release at pH 6.4, indicating its potential as a pH responsive nano-carrier for anticancer therapy. The nano-sized copolymer demonstrated tumoricidal activities against the lymphoma of murine and human origin with significant levels of growth inhibition and apoptosis. Therapy with doxorubicin loaded copolymer reduced the tumor size and augmented the life span of the tumor bearing animals with improved histopathological parameters, compared with the untreated control.


Depression of hepatic drug-metabolizing enzyme activity by B. pertussis vaccination.
In vitro measurements are described on N-demethylation of aminopyrine and ethylmorphine, the hydroxylation of aniline as well as the level and activity of the electron transport system in hepatic microsomal fractions from pertussis vaccinated mice. Results indicate that pertussis vaccination of mice markedly decreases the level and activity of the hepatic drug-metabolizing system.


Centrifugal organization of direction preferences in the cat's lateral suprasylvian visual cortex and its relation to flow field processing.
The cerebral cortex of the cat contains between 1 and 2 dozen representations of the visual field with different functional specializations. Six visual field maps lie along both banks of the suprasylvian sulcus, lateral and anterior to the visual areas in the occipital cortex. We have studied single-unit receptive field properties and their global organization across the visual field in 2 of these lateral suprasylvian areas, PMLS (essentially the Clare-Bishop area) and PLLS. Most neurons in PMLS and PLLS display selectivity for the direction of a light stimulus moving across their receptive fields with various degrees of directional tuning. We have used light spots of different size and velocity projected on a tangent screen in order to determine the direction preference of cells in these 2 areas. A strong tendency was found for neurons to respond best to centrifugal directions, i.e., to movement away from the area centralis. Thus, for these cells direction preference depends on the location of their receptive fields within the visual field. Velocity preference and binocular interaction in these neurons is also globally organized: Velocity preference increases with eccentricity, binocular synergism is strongest in the center of the visual field. Cluster analysis of recording tracks with respect to "radial" and "circular" cell categories reveals a grouping of cells with like properties in the lateral suprasylvian cortex. These new categories are formed by combining "centrifugal" and "centripetal" cells on the one hand and cells with direction preferences orthogonal to these on the other. The radial or centrifugal organization of direction preferences in conjunction with the global arrangement of velocity preference and binocular interaction suggests that PMLS and PLLS are involved in the processing of expanding visual flow fields of motion. Such flow fields are commonly encountered when a visual object moves towards an observer or during forward locomotion.


Substituent distribution changes the pasting and emulsion properties of octenylsuccinate starch.
An improved preparation method of octenylsuccinate (OS) starch under high shear condition was described in this study. The distribution of OS substituents at the granular and molecular levels was assessed by confocal laser scanning microscopy (CLSM), β-amylase hydrolysis, chromatographic and (1)H NMR techniques. We found that the OS group distribution could change the pasting and emulsion properties of OS starches. Specifically, more uniform OS group distribution was identified in the central region of OS starch granules prepared under high shear condition (H-OS-starch), and OS groups were located both near the branching points and the non-reducing ends. More OS groups exposed outside of non-reducing ends would access the interface between oil and water and give more stabilized emulsion.


Phosphorus sources, speciation and dynamics in the lowland eutrophic River Kennet, UK.
This paper examines the behaviour of phosphorus (P) in a lowland chalk (Cretaceous-age) stream, the upper River Kennet in southern England, which has been subject to P remediation by tertiary treatment at the major sewage treatment works in the area. The effects of treatment are examined in relation to boron, a conservative tracer of sewage effluent and in terms of the relative contributions of soluble reactive phosphorus (SRP) loads from point and diffuse sources, and in-stream SRP loads. These results indicate a baseline reduction in in-stream SRP concentrations immediately following P-treatment of approximately 72%. Subsequent high flows result in a greater contribution of diffuse inputs and increases in SRP levels relative to the initial post-treatment period. The dynamics of SRP and particulate phosphorus (PP) are examined under a wide range of river flow conditions. Given the flashy nature of near-surface runoff in the River Kennet, sub-weekly (daily automated) sampling was used to examine the dynamics in SRP and PP concentrations in response to storm events. Simple empirical models linking weekly SRP concentrations with flow were developed. The empirical models were successfully applied to the daily data, to partition TP measurements and provide an estimate of daily SRP and PP concentrations. Mass balance studies were used to examine net gains and losses along the experimental river reach and indicate large net losses (up to 60%) during the extreme low flows and high SRP concentrations prior to P-treatment, which may be linked to extensive epiphytic growth. Phosphorus dynamics and response to P-treatment are discussed in relation to hydrological controls in permeable chalk catchments and wider implications for eutrophication management are examined.


What is your empathy scale not measuring? The convergent, discriminant, and predictive validity of five empathy scales.
Recent reviews of the emapthy literature have revealed that nearly half of the published studies on empathy employed an empathy measure that did not align precisely with the theoretical definition the author provided. This may occur because researchers might not know what each published empathy scale actually measures. The present research begins to address this problem by reporting a large set of correlates for five different empathy scales to enable researchers to review the interpersonal traits and abilities each scale predicted. Participants (N = 182) completed the Davis IRI and the empirically derived Hogan Empathy Scale (HES). Each empathy scale produced its own unique pattern of correlates with empathy related traits that more or less supported each scale's description. However, none of the five scales reliably predicted empathy related abilities. We discuss the importance of examining a scale's predictive validity over its reliability, face-validity, popularity, or name.


[Sulfide ooze mud and sodium chloride baths in treating osteoarthrosis patients].
Humoral immunity initially affected in patients with osteoarthrosis returns to normal under the influence of a multiple-modality treatment involving application of sulphide moor in combination with sodium chloride baths.


[Results of surgical treatment for acromioclavicular joint dislocation using the carbon fiber prosthesis].
The method, algorithm and results of treatment for acromioclavicular dislocation with carbon fiber prosthesis in 12 male patients has been presented. Excellent results have been achieved in all cases.


Occlusive clothing and ultraviolet radiation in hip surgery.
In a randomized study of 20 total hip arthroplasties, the staff wore shirts and trousers of a fabric impervious to bacteria underneath operating gowns of a non-woven material. Volumetric air sampling demonstrated a low number of colony-forming units with this clothing, further reduced by ultraviolet radiation to below 10 colony-forming units/m3, the upper limit of "ultraclean air," in all the cases (median 2.6, range 1.1-7.1).


P-glycoprotein and cancer: what do we currently know?
Acquired resistance during cancer treatment is unfortunately a frequent event. There are several reasons for this, including the ability of the ATP-binding cassette transporters (ABC transporters), which are integral membrane proteins, to export chemotherapeutic molecules from the interior of the tumor cells. One important member of this family is the protein known as Permeability Glycoprotein (P-Glycoprotein, P-gp or ABCB1). Its clinical relevance relies mainly on the fact that the inhibition of P-gp and other ABC transporters could result in the reversal of the multidrug resistance (MDR) phenotype in some patients. Recently, other roles apart from being a key player in MDR, have emerged for P-gp. Therefore, this review discusses the relationship between P-gp and MDR, in addition to the possible role of this protein as a biomarker in cancer.


Induction of recipient cell-specific donor T-cell anergy by UV-C-irradiated recipient immature monocyte-derived dendritic cells.
The induction of donor T-cell anergy to recipient cells for reducing GVHD could be one way of expanding donor candidates for HLA-mismatched hematopoietic SCT. The present study was designed to clarify whether recipient cell-specific T-cell anergy could be induced by priming donor lymphocytes with recipient monocyte-derived DCs (mo-DCs) irradiated with ultraviolet-C (UV-C). By irradiation of mo-DCs with UV-C, the expression of DC-associated surface phenotypes such as CD83, CD80, CD86 and CD40 was reduced and the antigen-presenting ability of UV-C-irradiated mo-DCs was clearly decreased. By co-culturing normal donor 1 lymphocytes with UV-C-irradiated donor 2 immature mo-DCs, the response of the lymphocytes to donor 2 mature mo-DCs was markedly reduced as compared with that of the lymphocytes prestimulated with non-irradiated donor 2 immature mo-DCs or UV-C-irradiated mo-DCs derived from a different individual donor 3. The present study demonstrated that recipient cell-specific T-cell anergy could be induced by priming donor lymphocytes with UV-C-irradiated recipient immature mo-DCs in hematopoietic SCT. These data suggest the applicability of donor graft cells, which have been prestimulated with UV-C-irradiated recipient immature mo-DCs, for expanding donor candidates in HLA-mismatched hematopoietic SCT.


Selective hydrogenation of 1,3-butadiene on platinum-copper alloys at the single-atom limit.
Platinum is ubiquitous in the production sectors of chemicals and fuels; however, its scarcity in nature and high price will limit future proliferation of platinum-catalysed reactions. One promising approach to conserve platinum involves understanding the smallest number of platinum atoms needed to catalyse a reaction, then designing catalysts with the minimal platinum ensembles. Here we design and test a new generation of platinum-copper nanoparticle catalysts for the selective hydrogenation of 1,3-butadiene,, an industrially important reaction. Isolated platinum atom geometries enable hydrogen activation and spillover but are incapable of C-C bond scission that leads to loss of selectivity and catalyst deactivation. γ-Alumina-supported single-atom alloy nanoparticle catalysts with <1 platinum atom per 100 copper atoms are found to exhibit high activity and selectivity for butadiene hydrogenation to butenes under mild conditions, demonstrating transferability from the model study to the catalytic reaction under practical conditions.


[Analysis of misdiagnosis of calcifying epithelioma in oral and maxillofacial-head and neck region].
Eight patients misdiagnosed as calcifying epithelioma during 2003-2008 at Department of Oral and Maxillofacial Surgery of Cangzhou Central Hospital were retrospectively analyzed. The pertinent literatures were reviewed and the pathogenesis, clinical manifestations, imaging performance and differential diagnosis of calcifying epithelioma were discussed.


Neural network of bipolar disorder: Toward integration of neuroimaging and neurocircuit-based treatment strategies.
Bipolar disorder (BD) is a complex psychiatric disorder characterized by dysfunctions in three domains including emotional processing, cognitive processing, and psychomotor dimensions. However, the neural underpinnings underlying these clinical profiles are not well understood. Based on the reported data, we hypothesized that (i) the core neuropathology in BD is damage in fronto-limbic network, which is associated with emotional dysfunction; (ii) changes in intrinsic brain network, such as sensorimotor network, salience network, default-mode network, central executive network are associated with impaired cognition function; and (iii) beyond the dopaminergic-driven basal ganglia-thalamo-cortical motor circuit modulated by other neurotransmitter systems, such as serotonin (subcortical-cortical modulation), the sensorimotor network and related motor function modulated by other non-motor networks such as the default-mode network are involved in psychomotor function. In this review, we propose a neurocircuit-based clinical characteristics and taxonomy to guide the treatment of BD. We draw on findings from neuropsychological and neuroimaging studies in BD and link variations in these clinical profiles to underlying neurocircuit dysfunctions. We consider pharmacological, psychotherapy, and neuromodulatory treatments that could target those specific neurocircuit dysfunctions in BD. Finally, it is suggested that the methods of testing the neurocircuit-based taxonomy and important limitations to this approach should be considered in future.


Scrotal reconstruction following an avulsion injury.
Scrotal reconstruction following avulsion of the scrotal skin often is a time-consuming, multistage repair. We present an alternative method of repair using a subcutaneous soft tissue expander.


Ketamine-Midazolam Anesthesia Induces Total Inhibition of Cortical Activity in the Brain of Newborn Rats.
The effects of general anesthetics ketamine and midazolam, the drugs that cause neuroapoptosis at the early stages of CNS development, on electrical activity of the somatosensory cortex in newborn rats were studied using extracellular recording of local field potentials and action potentials of cortical neurons. Combined administration of ketamine (40 mg/kg) and midazolam (9 mg/kg) induced surgical coma and almost completely suppressed early oscillatory patterns and neuronal firing. These effects persisted over 3 h after injection of the anesthetics. We concluded that general anesthesia induced by combined administration of ketamine and midazolam profoundly suppressed cortical activity in newborn rats, which can trigger neuroapoptosis in the developing brain.


Neuropathology in patients with multiple surgeries for medically intractable epilepsy.
Outcomes following surgery for chronic epilepsy are generally good; however, seizures persist/recur following initial surgery in some patients. We hypothesize that in patients who require multiple surgeries for intractable epilepsy, an identifiable pathologic substrate can be found in the subsequent surgical specimen, which accounts for the recurrent seizures. We retrospectively studied 102 patients (56 females) with medically intractable epilepsy who have had at least 2 surgeries more than 60 days apart from 1990-2010. Patient age at time of 1st surgery ranged from 3 months-60 years (mean 18.1 years). Mean duration of seizures prior to 1st surgery was 9.7 years. Time between the 1st and 2nd surgeries ranged from 0.28-15.3 years (mean 4.3 years). The most common pathologies at initial resection included focal cortical dysplasia (45%), tumor (19%), hippocampal sclerosis (16%), and non-specific changes (13%); 10% of patients had multiple significant pathologies. Of the 89 patients that had a significant initial surgical finding, 74 (83.1%) had a significant pathology at 2nd surgery; the same pathology was identified in 49 (66.2%) of these cases. The most commonly identified pathologies at 2nd surgery included remote infarcts (likely postoperative) (N=51) and focal cortical dysplasia (N=29). Three out of the 13 patients with initially non-specific findings had a significant finding at 2nd surgery, excluding postoperative infarct. Follow-up after last surgery ranged from 0.5-190 months (mean 48 months); 83% of patients were on anti-convulsive medication and 57% were seizure-free at last known follow-up. In the majority of cases of recurrent epilepsy with at least 2 surgeries (84%), pathologic findings accounting for seizures were found at the 2nd surgery. In most cases with significant initial pathology, a similar pathology was present at 2nd surgery (55%). Post-operative contusional damage may account for persistent seizures following initial surgery in a subset of patients.


Shade adaptation and shade tolerance in saplings of three Acer species from eastern North America.
Saplings of three, co-occurring maple species in a mature maple-beech forest differed in a suite of structural and physiological characters that separated the canopy species, Acer, saccharum, from the two subcanopy species, A. pensylvanicum and A. spicatum. Acer saccharum had both more dense wood and tougher and heavier but thinner leaves than the subcanopy species. Acer pensylvanicum had the largest, lightest leaves with high stomatal density and its canopy architecture was the most effective in terms of leaf display for light interception. Acer spicatum had weaker wood similar to that of A. pensylvanicum but also small, soft and relatively poorly displayed leaves. Both subcanopy species maintained marginally higher average rates of photosynthesis over the growing season in the understory environment. We consider juvenile A. saccharum only shade-tolerant, capable of persisting through long periods in the closed canopy until a gap occurs but not specifically adapted to the understory environment. Juvenile A. sacchrum appears to be constrained functionally by the requirements set by the canopy environment that adults will occupy. Characters such as high wood density are already expressed in the understory sapling; this investment in denser wood slows the growth of saplings, but is necessary for structural reasons in the adult. Juvenile A. saccaharum have morphological and photosynthetic characters better suited to gas exchange and extension growth under the increased photon flux densities in large forest gaps, characteristics that will also be advantageous in the sunlit canopy environment of adults.Both subcanopy maples appear to be more truly shade-adapted, although in somewhat different ways. Acer pensylvanicum has characteristics that enhance the potential for capture and utilization of sunflecks and is able to sustain higher growth rates than A. saccharum in the shaded subcanopy environment. Acer spicatum shares some shade-adapted features with A. pensylvanicum, and its habit of lateral spread through stem layering may confer an additional advantage in foraging for small light gaps.


Free radical effects on membrane protein in myocardial ischemia/reperfusion injury.
Free radical generation may be the principal pathogenic factor responsible for the initiation of ischemia/reperfusion myocardial cell damage. Circumstantial evidence is in favour of the view that impaired function of the membraneous components of ischemic cells is associated with oxygen radical-induced alterations in proteins and lipids. Thus, lipid antioxidants and free radical scavengers as well as antagonists of protein modification may all be required for therapeutic intervention of this aspect of ischemia/reperfusion injury.


Poorly cohesive adenocarcinoma of the ampulla of Vater: a case report.
A 47-year-old Japanese male was submitted to pancreaticoduodenectomy for an ampullary cancer. Pathologically, the ampullary cancer was poorly cohesive adenocarcinoma without tubular structure. Moreover, locoregional lymph nodes were swollen with hypervascularity, plasmacytes infiltration, and hemorrhage. Our case seems to be different from usual poorly differentiated adenocarcinoma.


Assessment and determinants of aesthetic discomfort in hand osteoarthritis.
Dissatisfaction with hand appearance is frequently the presenting complaint of patients with hand osteoarthritis (HOA), yet no tool exists for its measurement and few studies have examined aesthetic discomfort. The aims of this study were to measure the extent and to explore the associations of aesthetic concerns in HOA. 172 patients with HOA were assessed with tender joint and node count, global and pain scores, Functional Index for Hand Osteoarthritis, Short Form-12, Hospital Anxiety and Depression Scale and posterior-anterior hand radiographs. Patients scored the aesthetic impact of the disease on a Visual Analogue Scale of 0-100 mm and were classified into low, intermediate and high aesthetic concern (HAC) based on this score. Of 172 patients (155 women), the majority (92%) had nodes and 46% had erosive disease. The mean aesthetic score was 44.8 mm (SD 35.9), and 59 (34.3%) patients scored their aesthetic discomfort ≥ 66 mm. Factors associated with HAC were female gender, a high number of tender joints and nodes, high global and pain scores, high radiological damage scores, the presence of erosions and high depression and anxiety levels. The multivariate analysis identified two independent factors associated with HAC: patient's global assessment (p=0.0005) and radiographic erosions (p=0.03). Aesthetic discomfort is a major concern for a significant number of patients with HOA, particularly women, those with a high burden of HOA disease and those with erosive osteoarthritis, and is also associated with depression, anxiety and poor health-related quality of life.


A Randomized, Placebo-Controlled Clinical Trial of Famciclovir in Shelter Cats with Naturally Occurring Upper Respiratory Tract Disease.
Upper respiratory tract disease (URTD) is a clinically relevant infectious disease in shelter cats, with individual and population-level welfare implications. The purpose of this study was to evaluate the effectiveness of famciclovir in reducing clinical signs of URTD in shelter cats during a therapeutic period of up to 21 days. Cats at two Northeastern United States animal shelters with URTD clinical signs were enrolled in a pragmatic, prospective, randomized, placebo-controlled clinical trial. Cats received either famciclovir (n = 11, target dose range 40-90 mg/kg) or placebo (n = 11), administered orally twice daily for up to 21 days with once-daily clinical scoring. At enrollment, conjunctival and oropharyngeal samples were collected for respiratory pathogen identification by RT-PCR. Zero-inflated Poisson regression was used to evaluate the treatment group effects and changes in clinical scoring over time. With each day of treatment, cats in both groups were less likely to experience worsening clinical scores; however, the risk of worsening scores with each day of treatment was significantly less in the famciclovir group compared to placebo (p = 0.006). Feline herpesvirus (FHV-1) DNA was detected in 11/21 cats. The findings justify further pragmatic studies to determine whether famciclovir treatment can contribute to a clinically relevant reduction in URTD morbidity in shelter cats.


[Photodynamic therapy in age-related macular degeneration: one-year results].
To evaluate the efficacy of photodynamic therapy (PDT) for subfoveal choroidal neovascularization(CNV) secondary to age-related macular degeneration(AMD) one year after PDT. 106 eyes of 106 AMD patients with subfoveal CNV detected by fluorescein angiography (FA). Best-corrected visual acuity, color fundus photography, FA and indocyanine green angiography were performed before and 1 year after treatment. Visual acuity and CNV size before PDT were compared with those 1 year after treatment. Pre-PDT factors predicting a visual acuity of 0.4 or more 1 year after this treatment were evaluated. Visual acuity improved or was maintained in 84 of the 106 eyes. The size of CNV decreased significantly (p < 0.001). A visual acuity of 0.4 or more 1 year after PDT was predicted by an acuity of 0.4 or more (p = 0.01) and occult with no classic CNV (p = 0.04) prior to PDT. PDT is effective for maintaining or improving visual acuity and obliteration of CNV for 1 year or longer. Factors predicting a visual acuity of 0.4 or more 1 year after PDT were an acuity of 0.4 or more and occult with no classic CNV prior to PDT.


Spatial dependence of alveolar angiogenesis in post-pneumonectomy lung growth.
Growth of the remaining lung after pneumonectomy has been observed in many mammalian species; nonetheless, the pattern and morphology of alveolar angiogenesis during compensatory growth is unknown. Here, we investigated alveolar angiogenesis in a murine model of post-pneumonectomy lung growth. As expected, the volume and weight of the remaining lung returned to near-baseline levels within 21 days of pneumonectomy. The percentage increase in lobar weight was greatest in the cardiac lobe (P < 0.001). Cell cycle flow cytometry demonstrated a peak of lung cell proliferation (12.02 ± 1.48%) 6 days after pneumonectomy. Spatial autocorrelation analysis of the cardiac lobe demonstrated clustering of similar vascular densities (positive autocorrelation) that consistently mapped to subpleural regions of the cardiac lobe. Immunohistochemical staining demonstrated increased cell density and enhanced expression of angiogenesis-related factors VEGFA, and GLUT1 in these subpleural regions. Corrosion casting and scanning electron microscopy 3-6 days after pneumonectomy demonstrated subpleural vessels with angiogenic sprouts. The monopodial sprouts appeared to be randomly oriented along the vessel axis with interbranch distances of 11.4 ± 4.8 μm in the regions of active angiogenesis. Also present within the regions of increased vascular density were frequent "holes" or "pillars" consistent with active intussusceptive angiogenesis. The mean pillar diameter was 4.2 ± 3.8 μm, and the pillars were observed in all regions of active angiogenesis. These findings indicate that the process of alveolar construction involves discrete regions of regenerative growth, particularly in the subpleural regions of the cardiac lobe, characterized by both sprouting and intussusceptive angiogenesis.


Is selective attention the basis for selective imitation in infants? An eye-tracking study of deferred imitation with 12-month-olds.
Infants and children do not blindly copy every action they observe during imitation tasks. Research demonstrated that infants are efficient selective imitators. The impact of selective perceptual processes (selective attention) for selective deferred imitation, however, is still poorly described. The current study, therefore, analyzed 12-month-old infants' looking behavior during demonstration of two types of target actions: arbitrary versus functional actions. A fully automated remote eye tracker was used to assess infants' looking behavior during action demonstration. After a 30-min delay, infants' deferred imitation performance was assessed. Next to replicating a memory effect, results demonstrate that infants do imitate significantly more functional actions than arbitrary actions (functionality effect). Eye-tracking data show that whereas infants do not fixate significantly longer on functional actions than on arbitrary actions, amount of fixations and amount of saccades differ between functional and arbitrary actions, indicating different encoding mechanisms. In addition, item-level findings differ from overall findings, indicating that perceptual and conceptual item features influence looking behavior. Looking behavior on both the overall and item levels, however, does not relate to deferred imitation performance. Taken together, the findings demonstrate that, on the one hand, selective imitation is not explainable merely by selective attention processes. On the other hand, notwithstanding this reasoning, attention processes on the item level are important for encoding processes during target action demonstration. Limitations and future studies are discussed.