The interstitial cells in the renal medulla of rat, rabbit, and gerbil in different states of diuresis.
The inner zone of the renal medulla of rats, gerbils, and rabbits was investigated to determine whether or not there are any characteristic ultrastructural differences between the interstitial cells of these species. The effects on the interstitial cells of water deprivation and water loading were also investigated. In all three species, the Type 1 interstitial cells, the lipid containing cells, were abundant and their distribution and topographical relations as well as their general ultrastructure were similar. The previously reported significantly higher frequency in desert rats could not be confirmed. Although the lipid droplets of the interstitial cells were smaller in gerbils and rabbits when compared to rats, their fine structure was similar. Their electron dense outer zone was sometimes associated with a granular material and/or a lamellar material with a periodicity of about 40 A resembling phospholipid "myelin figures". Water-loaded rats showed a considerable increase in the number of lipid droplets when compared to dehydrated or untreated animals. In contrast, the interstitial cells of waterloaded gerbils and rabbits were depleted of lipid droplets.


Twenty Clinically Pertinent Factors/Observations for Percutaneous Absorption in Humans.
At least 20 clinically relevant factors affect percutaneous absorption of drugs and chemicals: relevant physico-chemical properties, vehicle/formulation, drug exposure conditions (dose, duration, surface area, exposure frequency), skin appendages (hair follicles, glands) as sub-anatomical pathways, skin application sites (regional variation in penetration), population variability (premature, infants, and aged), skin surface conditions (hydration, temperature, pH), skin health and integrity (trauma, skin diseases), substantivity and binding to different skin components, systemic distribution and systemic toxicity, stratum corneum exfoliation, washing-off and washing-in, rubbing/massaging, transfer to others (human to human and hard surface to human), volatility, metabolic biotransformation/cutaneous metabolism, photochemical transformation and photosensitivity, excretion pharmacokinetics, lateral spread, and chemical method of determining percutaneous absorption.


[Correlation between expression level of functional genes and tanshinones' accumulation in Salvia miltiorrhiza from different areas].
To study the relationship between functional gene expression in Salvia miltiorrhiza from different producing areas and active principles, which might provide scientific basis for the gene regulation of tanshinones. The quantitative determination of cryptotanshinone and tanshinone II A was carried out by using HPLC method, expression level of 3 functional genes of SmAACT, SmCMK and SmIPPI were investigated by real-time PCR method. The content of active principles together with expression level of SmAACT and SmCMK were higher in S. miltiorrhiza from genuine producing areas including Henan and Shanxi, but lower in samples from Beijing which was non-genuine producing area. Expression level of SmAACT and SmCMK had close relationships involving tanshinones' accumulation, but the SmIPPI gene had not.


Long-term trends in sunshine duration and its association with schizophrenia birth rates and age at first registration--data from Australia and the Netherlands.
Based on the well-described excess of schizophrenia births in winter and spring, we hypothesised that individuals with schizophrenia (a) would be more likely to be born during periods of decreased perinatal sunshine, and (b) those born during periods of less sunshine would have an earlier age of first registration. We undertook an ecological analysis of long-term trends in perinatal sunshine duration and schizophrenia birth rates based on two mental health registers (Queensland, Australia n=6630; The Netherlands n=24,474). For each of the 480 months between 1931 and 1970, the agreement between slopes of the trends in psychosis and long-term sunshine duration series were assessed. Age at first registration was assessed by quartiles of long-term trends in perinatal sunshine duration. Males and females were assessed separately. Both the Dutch and Australian data showed a statistically significant association between falling long-term trends in sunshine duration around the time of birth and rising schizophrenia birth rates for males only. In both the Dutch and Australian data there were significant associations between earlier age of first registration and reduced long-term trends in sunshine duration around the time of birth for both males and females. A measure of long-term trends in perinatal sunshine duration was associated with two epidemiological features of schizophrenia in two separate data sets. Exposures related to sunshine duration warrant further consideration in schizophrenia research.


Engagement of GPI-linked CD48 contributes to TCR signals and cytoskeletal reorganization: a role for lipid rafts in T cell activation.
GPI-linked proteins coassociate with intracellular tyrosine kinases in "lipid rafts" proposed to function as platforms for signal transduction and cytoskeletal reorganization. TCR activation requires both tyrosine kinase signals and cytoskeletal reorganization. How receptor engagement initiates cytoskeletal changes remains poorly understood. We investigated the consequences of recruiting GPI-linked CD48 and associated rafts to the site of T cell:APC contact by stimulating T cells with APCs that express the CD48 ligand CD2. We demonstrate that CD2:CD48 interactions enhance TCR-mediated functions. CD48/TCR coengagement qualitatively and quantitatively enhances lipid raft-dependent zeta association with the actin cytoskeleton and zeta tyrosine phosphorylation. This implicates lipid rafts as sites where receptor-induced signals and cytoskeletal reorganization are integrated and reveals a novel component of accessory molecule function.


Traditional and Latest Researches on Aspergillus oryzae and Related Koji Molds.
We would like to thank all the contributors to this Special Issue on Aspergillus oryzae and related Koji molds (https://www [...].


Photocatalytic degradation of aqueous propoxur solution using TiO2 and Hbeta zeolite-supported TiO2.
Photocatalytic activity of TiO2 and zeolites supported TiO2 were investigated using propoxur as a model pollutant. Hbeta, HY and H-ZSM-5 zeolites were examined as supports for TiO2. Hbeta was chosen as the TiO2 support based on the adsorption capacity of propoxur on these zeolites (Hbeta>HY=H-ZSM-5). TiO2/Hbeta photocatalysts with different wt.% were prepared and characterized by XRD, FT-IR and BET surface area. The progress of photocatalytic degradation of aqueous propoxur solution using TiO2 (Degussa P-25) and TiO2 supported on Hbeta zeolite was monitored using TOC analyzer, HPLC and UV-vis spectrophotometer. The degradation of propoxur was systematically studied by varying the experimental parameters in order to achieve maximum degradation efficiency. The initial rate of degradation with TiO2/Hbeta was higher than with bare TiO2. TOC results revealed that TiO2 requires 600min for complete mineralization of propoxur whereas TiO2/Hbeta requires only 480min. TiO2/Hbeta showed enhanced photodegradation due to its high adsorption capacity on which the pollutant molecules are pooled closely and hence degraded effectively.


Disruption of SMC-related genes promotes recombinant cholesterol esterase production in Burkholderia stabilis.
Burkholderia stabilis strain FERMP-21014 secretes cholesterol esterase (BsChe), which is used in clinical settings to determine serum cholesterol levels. Previously, we constructed an expression plasmid with an endogenous constitutive promoter to enable the production of recombinant BsChe. In this study, we obtained one mutant strain with 13.1-fold higher BsChe activity than the wild type, using N-methyl-N'-nitro-N-nitrosoguanidine as a mutagen. DNA-sequencing analysis revealed that the strain had lost chromosome 3 (∆Chr3), suggesting that the genes hindering BsChe production may be encoded on Chr3. We also identified common mutations in the functionally unknown BSFP_068720/30 genes in the top 10 active strains generated during transposon mutagenesis. As BSFP_068720/30/40 comprised an operon on Chr3, we created the BSFP_068720/30/40 disruption mutant and confirmed that each disruption mutant containing the expression plasmid exhibited ~ 16.1-fold higher BsChe activity than the wild type. Quantitative PCR showed that each disruption mutant and ΔChr3 had a ~ 9.4-fold higher plasmid copy number than the wild type. Structural prediction models indicate that BSFP_068730/40 is structurally homologous to the structural maintenance of chromosomes (SMC) protein MukBE, which is responsible for chromosome segregation during cell division. Conversely, BSFP_068720/30/40 disruption did not lead to a Chr3 drop-out. These results imply that BSFP_068720/30/40 is not a SMC protein but is involved in destabilizing foreign plasmids to prevent the influx of genetic information from the environment. In conclusion, the disruption of BSFP_068720/30/40 improved plasmid stability and copy number, resulting in exceptionally high BsChe production. KEY POINTS: • Disruption of BSFP_068720/30/40 enabled mass production of Burkholderia Che/Lip. • BSFP_068730/40 is an SMC protein homolog not involved in chromosome retention. • BSFP_068720/30/40 is likely responsible for the exclusion of exogenous plasmids.


Cloning and expression of arylalkylamine N-acetyltranferase-2 during early development and metamorphosis in the sole Solea senegalensis.
The arylalkylamine N-acetyltransferase (AANAT) is a key enzyme in the rhythmic production of melatonin. Two Aanats are expressed in teleost fish, one retinal specific, Aanat1, and the other one pineal specific, Aanat2, being the latter the main enzyme responsible of the plasma nocturnal melatonin increase in fish. In anurans melatonin has been involved in metamorphosis through antagonizing thyroid hormone function; however, no available data reports a relationship between melatonin system and metamorphosis in fish. In this study, we have cloned the AANAT2 (SsAanat2) in a flatfish, Solea senegalensis, and studied its sites of expression and developmental expression pattern by in situ hybridization and Real Time PCR. These studies allowed us to demonstrate a specific signal in the pineal gland of sole larvae from 2 days post-fertilization (dpf), which was evident until post-metamorphosis. Immunohistochemical analysis on the hybridized slides showed that the sole pineal Aanat2 expressing cells corresponded to pineal photoreceptor cells. Real Time PCR was performed in animals kept under natural photoperiod and sampled at different stages from 0 to 21 dpf (including pre-, early-, middle- and late-metamorphic stages) and at midlight (ML) and middark (MD) daytimes. Sole Aanat2 expression was higher at MD than at ML from 2 dpf and at most developmental stages analyzed. The highest AANAT2 mRNA abundance was observed at 2 and 4 dpf. A significant 60-fold reduction in Aanat2 expression was seen just before metamorphosis demonstrating, for the first time in a vertebrate species, that the expression of pineal AANAT and thyroid hormones levels exhibit an inverse pattern during metamorphosis.


Patients' willingness to use a pharmacist-provided medication management service: the influence of outcome expectancies and communication efficacy.
Previous research has demonstrated that some patients who are at risk of experiencing medication-related problems express a lack of willingness to use pharmacist-provided medication management services. Little is known about the factors that influence willingness to use these services among patients who have not yet experienced the service. The aim of this study was to test a model of willingness to use the Australian Home Medicines Review (HMR) service. Specifically, this study aimed to determine the influence of positive and negative outcome expectancies and communication efficacy over willingness among patients who were eligible to receive the service but have not yet experienced it. A cross-sectional survey was conducted with patients who were recruited by 264 community pharmacists throughout Australia. Patients were included in the study if they had not yet experienced HMR but were taking more than 5 medicines daily or more than 12 doses daily. Measurement scales were developed using exploratory and confirmatory factor analyses. Structural equation modeling was used to test the model. Questionnaires received from 286 patients (15.6%) were analyzed. Multi-item measurement scales were observed to have acceptable construct reliabilities (range, 0.69-0.94). Importantly, respondents held overall neutral expectations about the personal benefits of HMR (positive outcome expectancies) but high communication efficacy. Structural equation modeling revealed that positive outcome expectancies (β=0.56, P<.001) and communication efficacy (β=0.25, P<.05) influenced willingness to use, whereas negative outcome expectancies had no significant effect. The extent to which patients believe that HMR would provide them with increased medicines knowledge, improve their medicines management capability, and reduce their medicine concerns had a significant influence over willingness to use the service. Because these expectancies are relatively low, there appears to be significant scope for increasing patient demand for these services. Patient-directed material about medication management services should highlight the provision of medication information.


Deep venous drainage variant rate and degree may be higher in patients with perimesencephalic than in non-perimesencephalic angiogram-negative subarachnoid hemorrhage.
The basal vein of Rosenthal (BVR) variant is a potential origin of bleeding in angiogram-negative subarachnoid hemorrhage (AN-SAH). We compared the rate and degree of BVR variants in patients with perimesencephalic AN-SAH (PAN-SAH) and non-perimesencephalic AN-SAH (NPAN-SAH). We retrospectively reviewed the records of AN-SAH patients admitted to our hospital between 2013 and 2018. The associations between variables (baseline characteristics, clinical and radiological data, and outcome) with bleeding patterns and degree of BVR variants were analyzed. Additionally, potential predictors of positive findings on repeated digital-subtracted angiogram (DSA), rebleeding, delayed cerebral infarction (DCI), and poor outcome were further studied. A total of 273 patients with AN-SAH were included. The incidence rate and degree of BVR variants were significantly higher in PAN-SAH patients compared with those in NPAN-SAH patients (p < 0.001). Patients with normal bilateral BVRs are more likely to have a severe prognosis and diffused blood distribution (p < 0.05). We found an increased rate of positive findings on repeated DSA, DCI, rebleeding, and poor outcome at 3 months and 1 year after discharge (all p < 0.05) in patients with bilateral normal BVRs. Bilateral normal BVRs were considered a risk factor (predictor) of positive findings on repeated DSA, rebleeding, and poor outcome (all p < 0.05). PAN-SAH patients have a higher rate and degree of BVR variants compared with patients with NPAN-SAH. Those AN-SAH patients with bilateral normal BVRs are more likely to be of arterial origin and are at risk of suffering from rebleeding and a poor outcome. • Patients with PAN-SAH have a higher rate and degree of BVR variants compared with patients with NPAN-SAH, which suggested that AN-SAH patients with normal BVRs are more likely to originate from arterial bleeding. • AN-SAH patients with normal BVRs are more likely to have positive findings on repeated DSA examinations, as well as an increased incidence of rebleeding and poor outcome, which may assist and guide neurologists in selecting treatment.


Exercise training-induced improvement in skeletal muscle PGC-1α-mediated fat metabolism is independent of dietary glycemic index.
This study hypothesized that a low-glycemic diet combined with exercise would increase expression of nuclear regulators of fat transport and oxidation in insulin-resistant skeletal muscle. Nineteen subjects (64 ± 1 y; 34 ± 1 kg/m2 ) were randomized to receive isocaloric high-glycemic-index (HiGIX; 80 ± 0.6 units, n = 10) or low-glycemic-index (LoGIX; 40 ± 0.3 units, n = 9) diets combined with supervised exercise (1 h/d, 5 d/wk at ∼85% HRmax ) for 12 weeks. Insulin sensitivity was determined by hyperinsulinemic-euglycemic clamp. Skeletal muscle biopsies were obtained before and after the intervention to assess fasting gene and protein expression. Weight loss was similar for both groups (9.5 ± 1.3 kg). Likewise, improvements in insulin sensitivity (P < 0.002) and PPARγ (P < 0.002), PGC-1α (P = 0.003), CD36 (P = 0.003), FABP3 (mRNA, P = 0.01 and protein, P = 0.02), and CPT1B (mRNA, P = 0.03 and protein, P = 0.008) expression were similar for both interventions. Increased insulin sensitivity correlated with increased PGC-1α expression (P = 0.04), and increased fasting fat oxidation correlated with increased FABP3 (P = 0.04) and CPT1B (P = 0.05) expression. An exercise/diet program resulting in 8% to 10% weight loss improved insulin sensitivity and key molecular mechanisms in skeletal muscle that are controlled by PGC-1α. These effects were independent of the glycemic index of the diets.


The Complexity of Multiple Contraceptive Method Use and the Anxiety That Informs It: Implications for Theory and Practice.
Despite clinical guidelines and national data describing the use of one contraceptive method as the best and most common way to prevent unintended pregnancy, limited evidence indicates a more complex picture of actual contraceptive practice. Face-to-face in-depth interviews were conducted in November of 2013 with a sample of women from two cities in the United States (n = 52). The interviews explored the ways participants used contraception to protect themselves from unintended pregnancy over the past 12 months. Most respondents reported using multiple methods, many of which are considered to be less-effective, within this timeframe. The practice of combining methods in order to increase one's level of protection from pregnancy was prevalent, and was mainly enacted in two ways: by backing up inconsistent method use with other methods and by "buttressing" methods. These practices were found to be more common, and more complex, than previously described in the literature. These behaviors were mainly informed by a deep anxiety about both the efficacy of contraceptive methods, and about respondents' own perceived ability to prevent pregnancy. These findings challenge prevailing assumptions about women's contraceptive method use and have implications for clinical contraceptive counseling practice.


Considerations for a phase-III trial to evaluate a group B Streptococcus polysaccharide-protein conjugate vaccine in pregnant women for the prevention of early- and late-onset invasive disease in young-infants.
In 2010, an estimated 393,000 infection-related neonatal deaths occurred worldwide with Group B streptococcus (GBS) being a leading cause. Prevention of early-onset disease (0-6 days; EOD) is currently focused on intra-partum antibiotic prophylaxis to mothers identified as being at risk; such strategies reduce EOD by 75-80% but are resource-intensive and logistically-difficult to implement in developing countries. Vaccination of pregnant women is an alternate strategy for preventing both EOD and late-onset disease (7-89 days; LOD). A trivalent GBS polysaccharide-protein conjugate vaccine (GBS-CV) composed of capsular epitopes from serotypes Ia, Ib and III is undergoing phase-II evaluation among pregnant women in Europe, North America and Africa. These serotypes cause 70-80% of all invasive GBS disease in early-infancy. Maternal anti-GBS antibodies are associated with protection from EOD, however, since a correlate of efficacy has not been defined, a phase III efficacy trial may be required for licensure. Criteria for selecting appropriate sites include sufficiently high GBS incidence in large birth cohorts, as well as adequate clinical and microbiological diagnostic skills and capacities. Alternate pathways to licensure should be explored, e.g. identification of serological correlates of protection with subsequent phase IV studies establishing vaccine-effectiveness against invasive GBS disease. Conducting a randomized, placebo-controlled efficacy trial, however, has the additional advantage of also being able to evaluate the role of GBS contributing to neonatal culture-negative sepsis, stillbirths, prematurity and low-birth weight.


Effect of neurotrophins on differentiation, calcification and proliferation in cultures of human pulp cells.
Neurotrophins (NTs) are expressed during tooth development. However, little is known about a role of NTs in differentiation of pulp cells into mineralizing cells. In this study, mRNA expressions of hard tissue-related proteins, calcification and proliferation are examined in cultures of human pulp (HP) cells. Nerve growth factor (NGF), brain derived neurotrophic factor (BDNF), neurotrophin (NT)-3 and NT-4/5 increased the mRNA levels of dentin sialophsphoprotein, alkaline phosphatase, osteopontin, type I collagen and bone morphogenetic protein-2 and mineral deposition in cultures of HP cells. The increased levels and manners varied, depending on the concentrations of NTs and hard-tissue related protein tested. On the other hand, only NGF significantly stimulated DNA synthesis in cultures of HP cells. These findings suggest that NTs characteristically regulate hard-tissue related protein expression, calcification and proliferation in pulp cells. NTs may accelerate pulp cell differentiation.


Abdominal obesity and the risk of recurrent deep vein thrombosis.
Abdominal obesity has been found to be associated with an increased risk of deep vein thrombosis (DVT). Whether patients with abdominal obesity have an increased risk of recurrence is currently unknown. Patients with objective diagnosis of DVT and a life expectancy of greater than 6 months underwent measurement of the circumference of the waist. A waist circumference of greater than 102 cm for men and greater than 88 cm for women defined abdominal obesity. Information on age, gender, and on the presence of risk factors for DVT was collected. At follow-up, all patients underwent serial compression ultrasound of the lower limbs and were clinically evaluated every 6 months. One hundred patients were enrolled, 58 with abdominal obesity and 42 without. Mean age was 64.5 and 57.3 years, respectively (p<0.05). Percentage of male patients was 32.8% and 81.0% (p<0.01). Unprovoked DVT and transient risk factors rates were similar in both groups. Overall, recurrent DVT was documented in 29 patients, 16 in patients with abdominal obesity (27.6%) and 13 in patients without (31.0%). At the multivariate regression analysis HR for VTE recurrence in abdominal obese patients was 1.26 (95% confidence interval=0.47-3.4). Abdominal obesity does not seem to modify the risk of recurrent DVT.


Acute morphine dependence in mice selectively-bred for high and low analgesia.
Acute morphine dependence was compared in mice selectively-bred for high (HA) and low (LA) swim stress-induced analgesia and high (HAR) and low (LAR) levorphanol analgesia by counting the number of naloxone-precipitated jumps. Whereas LAR mice displayed greater acute morphine dependence than HAR mice, HA and LA mice did not differ. No genotypic differences were observed in non-dependent mice, discounting possible differences in basal naloxone sensitivity and/or opioid peptide levels. Thus, the two selection projects, while both producing lines exhibiting highly divergent sensitivity to morphine analgesia, have not had analogous effects on all opioid measures, supporting the notion of independent genetic mediation of opioid analgesia and dependence. Further, these data suggest that analgesic sensitivity may not predict sensitivity to morphine dependence.


Weight change and mental health status in a behavioral weight loss trial.
Obesity, depression, and anxiety often co-occur, but research on weight change and mental health status is limited. This analysis examined how the mental component score (MCS-12) from the Short Form health survey changed over 24 months in weight loss trial participants with vs. without treatment seeking for affective symptoms (TxASx) and by weight change quintiles. Participants with complete data (n = 1163) were analyzed from enrollees in a cluster-randomized, behavioral weight loss trial in rural U.S. Midwestern primary care practices. Participants received a lifestyle intervention with different delivery models, including in-clinic individual, in-clinic group, or telephone group counseling visits. Participants were stratified by baseline TxASx status and 24-month weight change quintiles. Mixed models were used to estimate MCS-12 scores. There was a significant group-by-time interaction at the 24-month follow-up. The largest 0-24 month increase in MCS-12 scores (+5.3 points [12 %]) was observed in participants with TxASx who lost the most weight during the trial, while the largest decrease in MCS-12 scores (-1.8 points [-3 %]) was observed in participants without TxASx who gained the most weight (p < 0.001). Notable limitations included self-reported mental health, the observational analytical design, and a largely homogenous source population, as well as the possibility of reverse causation biasing some findings. Mental health status generally improved, particularly among participants with TxASx who experienced significant weight loss. Those without TxASx who gained weight, however, had a decline in mental health status over 24 months. Replication of these findings is warranted.


Effect of Japanese cedar specific immunotherapy on allergen-specific T(H)2 cells in peripheral blood.
The involvement of a shift from TH2 to TH1 responses in peripheral blood in pollen subcutaneous immunotherapy (SCIT) has been contentious, partly because of difficulties analyzing antigen-specific TH cells. To use recent technical advances to establish a more direct and simple method to analyze antigen-specific TH cells and to clarify the involvement of a TH2/TH1 shift in peripheral blood in pollen specific immunotherapy. After short-term (6-hour) antigen stimulation, antigen-specific TH cells in peripheral blood of Japanese children and young adults with Japanese cedar pollinosis undergoing SCIT were analyzed by multicolor flow cytometry for the presence of the activation marker CD154 and intracellular cytokines. Twenty-eight patients between 5 and 22 years of age were enrolled in the study; 22 had started SCIT after enrolling in the study (SCIT group), and the remaining 6 were planning to start SCIT in the next off-season (control group). The number of Japanese cedar-specific interleukin (IL) 5-, IL-4-, interferon γ-, IL-17A-, IL-10-, and tumor necrosis factor α-producing TH cells without antigen-driven cell proliferation was determined. The seasonal increase in the number of Japanese cedar-specific IL-5- and IL-4-producing TH cells seen in the control group was suppressed in the SCIT group (P < .005 and <.001, respectively). We report a powerful method for the analysis of antigen-specific TH cells in peripheral blood. This method will contribute to our understanding of immune mechanisms of immunotherapy and help us develop more sophisticated allergen specific immunotherapy.


Methane Production from Rice Straw Hydrolysate Treated with Dilute Acid by Anaerobic Granular Sludge.
The traditional anaerobic digestion process of straw to biogas faces bottlenecks of long anaerobic digestion time, low digestion rate, less gas production, etc., while straw hydrolysate has the potential to overcome these drawbacks. In this study, the dilute sulphuric acid-treated hydrolysate of rice straw (DSARSH) containing high sulfate was firstly proved to be a feasible substrate for methane production under mesophilic digestion by granular sludge within a short digestion time. Batch anaerobic digestion process was operated under different initial chemical oxygen demand (COD) values at temperature of 37 °C with the pH of 8.5. Among the initial COD values ranging from 3000 to 11,000 mg/L, 5000 mg/L was proved to be the most appropriate considering high COD removal efficiency (94.17 ± 1.67 %), CH4 content (65.52 ± 3.12 %), and CH4 yield (0.346 ± 0.008 LCH4/g COD removed) within 120 h. Furthermore, when the studied system operated at the initial COD of 5000 mg/L, the sulfate removal ratio could reach 56.28 %.


[5 years' experiences with the Gersthof polyethylene peg-anchored acetabulum].
The acetabular socket "Model Gersthof" is a spheric polyethylene component which can be anchored cement-free by means of three symmetrically arranged pegs at the outside. Between July 1979 and October 1986, 1316 implants of cement-free sockets were performed at our own department. The evaluation of the socket was based on the criterium of radiological instability (= aseptic loosening). After five years of observation, this design-oriented evaluation of success shows a survival of 92% +/- 2.9%.


[Anatomy of the wrist joint and carpus].
A systematic anatomical representation of the carpal area is not an adequate means to show its way of function. This paper describes the functional correlations between the distal radio-ulnar joint and the wrist joint. The proximal wrist joint is composed of two mechanically equivalent compartments. Within the ulnocarpal joint, the disk fulfills a most important function as a surface adapting and pressure transmitting element. Its perforation is a pre-arthrotic deformity. The column conception of the carpus is supported by cinematic studies as well as by analyses of the subchondral bone density and the spongy structure of the ossa carpi. This conception presumes a radial scaphoid column, a central lunate column, and an ulnar triquetrum column.


Percutaneous nephrolithotomy in the United kingdom: results of a prospective data registry.
Percutaneous nephrolithotomy (PCNL) is commonly used in the management of large upper renal tract stones. It is highly effective but carries a greater risk of significant morbidity than less invasive treatment options such as ureteroscopy or extracorporeal shock wave lithotripsy. Evaluate the current practice and outcomes of PCNL using a national prospective data registry. All surgeons undertaking PCNL in the United Kingdom were invited to submit data to an online registry. Effectiveness was assessed by stone-free rates and safety according to complications including blood transfusion, fever, and sepsis rates. Since January 2010, data on 987 patients who had 1028 PCNL procedures were collected. A total of 299 of 1012 procedures (30%) were for staghorn calculi, 299 (30%) for stones >2 cm, 329 (33%) for stones 1-2 cm, and 89 (9%) for stones <1cm. There were no significant differences in rates of failed access or complications according to whether a urologist or radiologist obtained renal access. There was a nonsignificant trend to a higher transfusion rate with balloon dilatation (7 of 222 [3.2%]) compared with serial dilatation (2 of 245 [0.8%]) of the renal tract (p = 0.093). Totally tubeless procedures were not associated with higher complication rates but did lead to a significant reduction in median length of stay (3 d vs 1.5 d; p<0.0001). Intraoperatively, 78% of patients were believed to be stone free, which was confirmed in 68% with postoperative imaging. Blood transfusion was required in 24 of 968 patients (2.5%). The incidence of postoperative fever was 16% and of sepsis was 2.4%. The PCNL data registry is a unique resource providing vital information on current practice and critical outcome data. Using the registry, endourologists can audit their practice against national outcome data for this benchmark procedure. It will help surgeons counsel patients during consent for this complex endourologic procedure about the possible outcome in their hands.


Evaluation of measurement strategies to increase the reliability of EMG indices to assess back muscle fatigue and recovery.
The purpose of this study was to assess different measurement strategies to increase the reliability of different electromyographic (EMG) indices developed for the assessment of back muscle impairments. Forty male volunteers (20 controls and 20 chronic low back pain patients) were assessed on three sessions at least 2 days apart within 2 weeks. Surface EMG signals were recorded from four pairs (bilaterally) of back muscles (multifidus at the L5 level, iliocostalis lumborum at L3, and longissimus at L1 and T10) while the subjects performed, in a static dynamometer, two static trunk extension tasks at 75% of the maximal voluntary contraction separated by a 60 s rest period: (1) a 30 s fatigue task and (2) a 5 s recovery task. Different EMG indices (based on individual muscles or averaged across bilateral homologous muscles or across all muscles) were computed to evaluate muscular fatigue and recovery. Intra-class correlation coefficient (ICC) and standard error of measurement (SEM) in percentage of the grand mean were calculated for each EMG variable. Reliable EMG indices are achieved for both healthy and chronic low back pain subjects when (1) electrodes are positioned on medial back muscles (multifidus at the L5 level and longissimus at L1) and (2) measures are averaged across bilateral muscles and/or across two fatigue tests performed within a session. The most reliable EMG indices were the bilateral average of medial back muscles (ICC range: 0.68-0.91; SEM range: 5-35%) and the average of all back muscles (ICC range: 0.77-0.91; SEM range: 5-30%). The averaging of measures across two fatigue tests is predicted to increase the reliability by about 13%. With regards to EMG indices of fatigue, the identification of the most fatigable muscle also lead to satisfactory results (ICC range: 0.74-0.79; SEM range: 21-26%). The assessment of back muscle impairments through EMG analysis necessitates the use of multiple electrodes to achieve reliable results.


Fatal and non-fatal food injuries among children (aged 0-14 years).
To identify and characterize food items with high risk of airway obstruction in children younger than 15 years. This retrospective study collected injury data from 1989 to 1998 for 26 pediatric hospitals in the United States and Canada. Aspiration, choking, ingestion, and insertion injuries due to food items were analyzed. The data included 1429 infants and children. Results were compared with fatality data published by the American Association of Pediatrics in 1984. The 10 food objects with the highest frequency for both injuries and fatalities were identified. Peanuts caused the highest frequency of injury, and hot dogs were most often associated with fatal outcomes. The severity of respiratory distress prior to hospital evaluation varied for different foods. Age younger than 3 years was the highest-risk factor. Key characteristics such as bite size, shape, and texture were analyzed and found to demonstrate relationships with severity of clinical outcomes. Children younger than 3 years remain at greatest risk of food injury and death. We found that hard, round foods with high elasticity or lubricity properties, or both, pose a significant level of risk. Consideration of the key characteristics of the most hazardous foods may greatly decrease airway obstruction injuries. Food safety education can help pediatricians and parents select, process, and supervise appropriate foods for children younger than 3 years to make them safer for this highest-risk population.


Enhancing biofeedback-driven self-guided virtual reality exposure therapy through arousal detection from multimodal data using machine learning.
Virtual reality exposure therapy (VRET) is a novel intervention technique that allows individuals to experience anxiety-evoking stimuli in a safe environment, recognise specific triggers and gradually increase their exposure to perceived threats. Public-speaking anxiety (PSA) is a prevalent form of social anxiety, characterised by stressful arousal and anxiety generated when presenting to an audience. In self-guided VRET, participants can gradually increase their tolerance to exposure and reduce anxiety-induced arousal and PSA over time. However, creating such a VR environment and determining physiological indices of anxiety-induced arousal or distress is an open challenge. Environment modelling, character creation and animation, psychological state determination and the use of machine learning (ML) models for anxiety or stress detection are equally important, and multi-disciplinary expertise is required. In this work, we have explored a series of ML models with publicly available data sets (using electroencephalogram and heart rate variability) to predict arousal states. If we can detect anxiety-induced arousal, we can trigger calming activities to allow individuals to cope with and overcome distress. Here, we discuss the means of effective selection of ML models and parameters in arousal detection. We propose a pipeline to overcome the model selection problem with different parameter settings in the context of virtual reality exposure therapy. This pipeline can be extended to other domains of interest where arousal detection is crucial. Finally, we have implemented a biofeedback framework for VRET where we successfully provided feedback as a form of heart rate and brain laterality index from our acquired multimodal data for psychological intervention to overcome anxiety.


Malignant endocrine tumor of the pancreas associated with von Recklinghausen's disease.
We describe a case of malignant endocrine tumor of the pancreas associated with von Recklinghausen's disease. A 66-year-old woman with familial von Recklinghausen's disease was admitted to our hospital with weight loss and lower abdominal pain. Endoscopy revealed a submucosal tumor in the second part of the duodenum. Contrast-enhanced computed tomography showed a heterogeneous low-density tumor, measuring 20 x 15 mm, in the head of the pancreas, and metastatic lymphadenopathy. Angiography showed faint tumor staining without encasement or apparent increase in vascularity. Pancreatoduodenectomy was performed. Macroscopically, there was a solid tumor, measuring 20 x 18 mm, in the head of the pancreas. Histologically, a malignant endocrine tumor was shown, with direct invasion to the duodenum, and lymph node metastases. This is the thirteenth case of pancreatic malignant tumor and the fourth case of pancreatic endocrine tumor associated with von Recklinghausen's disease reported in the world literature.


A four-proton-families model for pH-dependent enzyme activation: application to intestinal brush border sucrase.
Current concepts of pH-dependent enzyme function are expanded to consider enzymes with up to four key proton families. In an earlier paper the authors extended classical theory to explain the existence, in the acid ionization reaction, of two functionally distinct, V and K, proton families, exemplified by the 1988 sucrase three-proton-families model of Vasseur et al. They now propose that enzymes having two distinguishable proton families at each side of the pH-activity curves exist in nature although there is no previously published evidence of their existence. The resulting, more general, four-proton-families model is treated as a useful framework from which submodels can be derived by simplification, the simplest being the 1911 linear model of Michaelis and Davidsohn, which took into account two proton families out of the theoretical maximum of four proposed here. It is shown that whether a three-proton-families or a four-proton-families model can explain sucrase better is not merely a question of theory but also involves the practical question of having enough data, at each side of the pH spectrum, to permit making an unequivocal choice between the two alternatives. The paper concludes with a discussion of substrate-induced pK shifts according to both models.


Sympathetic neuroaxonal dystrophy in the aged rat pineal gland.
Dysfunction of circadian melatonin production by the pineal gland in aged humans and rats is thought to reflect the functional loss of its sympathetic innervation. Our ultrastructural neuropathologic studies of the sympathetic innervation of the pineal gland of aged (24 months old) Fischer-344 and Sprague-Dawley rats showed loss of nerve terminals as well as the development of neuroaxonal dystrophy (NAD), an ultrastructurally distinctive distal axonopathy, far in excess of that in young control rats. Immunolocalization of tyrosine hydroxylase confirmed the age-related loss of normal noradrenergic innervation and development of NAD. NAD was more frequent in aged female rats compared to males and was particularly severe in aged female Sprague-Dawley rats compared to Fischer-344 rats. Pineal NGF content was significantly increased or unchanged in female and male aged Fischer-344 rats, respectively, compared to young controls. The rat pineal is a sensitive experimental model for the quantitative ultrastructural examination of age-related neuropathological changes in nerve terminals of postganglionic noradrenergic sympathetic axons, changes which may reflect similar changes in the diffusely distributed sympathetic innervation of other targeted endorgans.


Bronchiectases at early chest computed tomography in children with cystic fibrosis are associated with increased risk of subsequent pulmonary exacerbations and chronic pseudomonas infection.
Children with cystic fibrosis (CF) are often Pseudomonas aeruginosa (PsA) free and exhibit normal spirometry between the ages of 5 and 7. It is reported that computed tomography (CT) is more sensitive than FEV1 as an instrument in the identification of pulmonary disease. It is not known whether CF-CT scores in childhood may be used to highlight children at risk of developing severe disease. 1 - To assess the number of respiratory exacerbations (RTEs) during a follow-up period of 6 years and their correlation with the CF-CT scores in young CF children. 2 - To assess whether PsA-negative CF children with high chest CF-CT scores are more likely to develop chronic PsA lung infection. 68 chest CT performed in patients without chronic PsA infection were scored. All patients (median age 7.8 years) had at least 4 clinical, functional and microbiologic assessments/year in the subsequent 6 years. RTE was defined as hospitalization and IV antibiotic treatment for respiratory symptoms. 86.8% patients had <3 RTEs in the 6 year follow-up period. The number of RTEs in the 6 years subsequent to the CT scan was correlated to the bronchiectasis CT score (BCTS) (r = 0.612; p < 0.001) and to FEV1 at baseline (r = -0.495, p<0.001). A BCTS ≥ 17.5 identified patients with >3 RTEs during follow-up (sensitivity: 100%, specificity: 85%), while FEV1 did not. Only BCTS was significant in a logistic multivariate model (RR 1.15). BCTS was significantly lower and FEV1 higher in patients who did not develop chronic PsA infection by the end of the study. In CF children free from chronic PsA, both CT scores and FEV1 values demonstrate significant correlation with disease severity in the subsequent 6 years but CT score has higher predictive value in the identification of patients at risk.


Identification and characterization of an endogenous P2X7 (P2Z) receptor in CHO-K1 cells.
CHO-K1 cells were examined for their cellular responses to the P2 receptor agonist, 2'- and 3'-O-(4-benzoylbenzoyl)-ATP (DbATP), and for the presence of mRNA for P2X receptors. Reverse transcriptase-polymerase chain reactions, using primers directed against the rat P2X subunits, detected the presence of P2X7 but not P2X1-P2X6 subunits. DbATP (EC50 approximately equal to 100 microM) evoked non-desensitizing inward currents which reversed at approximately equal to 0 mV, suggesting activation of a non-selective cation channel. ATP also evoked inward currents but was less potent than DbATP. DbATP also stimulated the accumulation of 45calcium (45Ca2+) and the DNA binding dye, YO-PRO-1, in CHO-KI cells. Both responses were inhibited by NaCl and MgCl2. In 280 mM sucrose buffer, 45Ca2+ accumulation was measurable within 10-20 s of agonist addition, whereas YO-PRO-1 accumulation was only detectable after 8 min. ATP and ATPgammaS were also agonists but were less potent than DbATP, while UTP, 2-methylthio ATP, ADP and (alphabeta)methylene ATP were inactive at concentrations up to 100 microM. DbATP increased lactate dehydrogenase release from CHO-K1 cells, suggesting cell lysis, although this effect was only pronounced after 60-90 min. These data suggest that CHO-K1 cells express an endogenous P2X7 receptor which can be activated by DbATP to cause a rapid inward current and accumulation of 45Ca2+. Prolonged receptor activation results in a delayed, increased permeability to larger molecules such as YO-PRO-1 and ultimately leads to cell lysis. Importantly, the presence of an endogenous P2X7 receptor should be considered when these cells are used to study recombinant P2X receptors.


Genetic associations and serum paraoxonase levels with atherosclerosis in western Iranian patients.
The oxidative modification of low-density lipoprotein (LDL) in the arterial wall plays a pivotal role in the initiation and progression of atherosclerosis which is a complex and progressive disorder. Paraoxonase1 (PON1), which is required for lipid metabolism, is believed to protect LDL from oxidation. The relationship between PON1 gene Leusin55Methionin (L55M) and Glutamine192Arginine (Q192R) polymorphisms in western Iranians with atherosclerosis and its association with enzyme activity and oxidized low-density lipoprotein (oxLDL) were examined in the present study. In this study, blood specimens were collected from 145 healthy individuals and 154 patients with atherosclerosis proven by angiography referred to Shahid Madani Hospital, Khorramabad, Iran. Genomic deoxy ribonucleic acid (DNA) was extracted from whole blood. For all the subjects, restriction fragment length polymorphism-polymerase chain reaction (RFLP-PCR) was carried out for the detection of L55M and Q192R polymorphisms. PON1 enzyme activity and the level of oxLDL were also evaluated. There was a 3.114-fold increase in the risk of developing atherosclerosis in the subjects presenting the PON1L55M, MM genotype compared to those with the LL genotype (OR 3.114; 95% CI 1.412-6.870). PON1Q192R polymorphism in the PON1 gene was not associated with atherosclerosis. Patients with atherosclerosis had significantly higher oxLDL and reduced PON1 enzyme activity (P < 0.05) compared to the controls. There was no association between the type of genotype, enzyme activity, and oxLDL level. It has been concluded that PON1L55M polymorphism and MM genotype are associated with an increased risk of coronary artery disease (CAD) in Iranian patients with atherosclerosis. We did not find any relationship between PON1Q192R polymorphism and atherosclerosis.


Non-Expert Markings of Active Chronic Graft-Versus-Host Disease Photographs: Optimal Metrics of Training Effects.
Lack of reliable measures of cutaneous chronic graft-versus-host disease (cGVHD) remains a significant challenge. Non-expert assistance in marking photographs of active disease could aid the development of automated segmentation algorithms, but validated metrics to evaluate training effects are lacking. We studied absolute and relative error of marked body surface area (BSA), redness, and the Dice index as potential metrics of non-expert improvement. Three non-experts underwent an extensive training program led by a board-certified dermatologist to mark cGVHD in photographs. At the end of the 4-month training, the dermatologist confirmed that each trainee had learned to accurately mark cGVHD. The trainees' inter- and intra-rater intraclass correlation coefficient estimates were "substantial" to "almost perfect" for both BSA and total redness. For fifteen 3D photos of patients with cGVHD, the trainees' median absolute (relative) BSA error compared to expert marking dropped from 20 cm2 (29%) pre-training to 14 cm2 (24%) post-training. Total redness error decreased from 122 a*·cm2 (26%) to 95 a*·cm2 (21%). By contrast, median Dice index did not reflect improvement (0.76 to 0.75). Both absolute and relative BSA and redness errors similarly and stably reflected improvements from this training program, which the Dice index failed to capture.


[Comparisons of pharmacological effect and LD50 among four kinds of Hawthorn fruit].
Four kinds of Hawthorn Fruit, namely Large Chinese Hawthorn, Chinese Hawthorn, Nippon Hawthorn and Yunnan Hawthorn, were compared in animal experiments. Their effects on small intestine motion, myocardial ischemia and hypercholesterolemia have been found different from each other.


On A.J. Underwood's model for a random pattern.
Three different "random" spatial models, incorrectly treated as identical by Underwood (1978), are described and their distinctness noted.


The DNA labelling index: a prognostic factor in node-negative breast cancer.
The DNA labelling index (LI), representing the fraction of S-phase cells, was studied in 76 patients operated on for breast cancer from 1975 to 1979. No patient had lymph node involvement following axillary dissection (N-), and no adjuvant medical treatment was given. Patients were classified in one of two groups according to the median LI. Patient distribution by age, tumour size, and receptor status was identical in both groups. A higher frequency of grade 3 tumours was noted in the group with an LI above the median value. The cell proliferation rate was an important discriminative factor for metastatic potential. The probability of survival at 8 years for patients with a high LI was significantly lower than that of patients with low LI (36% versus 100%; p less than 0.001). Relapse-free survival at 8 years was respectively 56% and 83% (p less than 0.02). At 2 years, these values were 75% and 100%, indicating the early occurrence of metastases. By contrast, the LI had no prognostic value concerning loco-regional disease recurrence or survival after the appearance of metastasis. No relationship was found in this study between survival and other prognostic factors, namely tumour size, histological grade, or hormone receptor level. The LI currently appears to be the best prognostic factor for N- breast cancer. High risk patients identified by this method could thus be offered adjuvant medical treatment.


Nucleotide sequences of cDNAs encoding precursors of human insulin-like growth factor II (IGF-II) and an IGF-II variant.
We have isolated 3 cDNA clones encoding human IGF-II and a variant of IGF-II. The amino acid sequence encoded by the IGF-II cDNA is identical to the sequence previously described [(1978) FEBS Lett. 89, 283-286]. In the amino acid sequence predicted by the IGF-II variant cDNA, the Ser residue 29 in the B-domain has been replaced by an Arg-Leu-Pro-Gly sequence. The corresponding mRNAs probably arise by alternative splicing of a common RNA precursor. The IGF coding region of the cDNA inserts is flanked by sequences encoding a signal peptide and a carboxy-terminal peptide indicating that both human IGF-II and its variant are synthesized as precursors.


Influence of diet, vitamins and chemotherapeutic agents on gastrointestinal cancer.
Dietary influences play a major role in the pathogenesis of most gastrointestinal malignancies. However, it has been difficult to define which dietary components will be most significant for any given individual. In this article we discuss the methodological challenges to research in this field as well as recent observations that have been made on the role of dietary factors in specific digestive tract neoplasms.


Effect of Pyridine on the Mesophase of Teraryl Liquid Crystals: A New Series of Nematic Liquid Crystals Named 2-(4-Alkoxybiphen-4'-yl)-5-methylpyridines.
A new series of teraryl 2-(4-alkoxybiphen-4'-yl)-5-methylpyridines (nO-PPPyMe, n = 3-8) nematic liquid crystal compounds, bearing a biphenylene core and a picoline terminus, were synthesized using a short two-step reaction, and overall yields between 34% and 38% were obtained. Spectral analysis results were in accordance with the expected structures. The thermotropic behavior of the teraryl liquid crystal compounds was investigated through polarized optical microscopy and differential scanning calorimetry. All compounds exhibited a solely enantiotropic nematic phase at the medium-high temperature range of 162.4-234.2 °C. Furthermore, the results for the nO-PPPyMe series were analyzed relative to three other compound series, mO-PPPyCN (m = 2-8), iO-PPQMe (i = 3-8) and xO-PPyPMe (x = 1-10). Consequently, the effect of pyridine on the mesophase of teraryl liquid crystals was demonstrated.


The skin autofluorescence reflects the posttranslational glycation grade of the matrix protein collagen.
Advanced glycation end products (AGEs) seem to be involved in ageing as well as in the development of cardiovascular diseases. Accumulation of AGEs contribute to tissue stiffness and organ dysfunction by crosslinking extracellular matrix proteins like collagen. We aimed to assess whether AGE-modified cardiac tissue collagen and AGE related skin autofluorescence may reflect the cardiac function and have a prognostic value for the outcome of coronary artery bypass surgery patients. Therefore, AGE-modifications in collagen from 72 male patients undergoing isolated coronary artery bypass graft (CABG) surgery were analyzed. Collagen fractions were isolated from the right atrial auricle and the residual bypass graft material (saphenous vein) of these patients and quantified by 4-hydroxyproline assay. AGE modifications were determined by the AGE intrinsic fluorescence (excitation 360nm/emission 440nm). The skin autofluorescence (sAF) as a non-invasive parameter was measured using the AGE reader. The non-extractable collagen contained the highest amounts of AGEs and positively correlates with the patients age (p=0.0001), blood glucose level (p=0.002), HbA1c level (p=0.01) and sAF (p=0.008). The right atrial auricle collagen showed significantly more modifications compared to vein graft material of the same patient (p=0,001). Skin autofluorescence positively correlates with AGE content in cardiac tissue (p=0.01) and therefore could be used as a predictor of tissue stiffness in patients with coronary heart disease.


Evidence for the bilobal nature of diferric rabbit plasma transferrin.
Plasma transferrin is involved in iron transport within the circulatory system of vertebrates, and provides an iron source for haemoglobin synthesis and other metabolic requirements. However, despite extensive studies by spectroscopic, biochemical and physiological techniques, the nature of iron binding and the mechanisms of uptake and release of iron are not fully understood. Plasma transferrins are monomeric glycoproteins with a molecular weight of approximately 80,000 (ref. 2); they have two similar and very strong binding sites for Fe(III), together with two associated anion binding sites. Fragmentation studies on various transferrins have shown that the polypeptide chain is composed of two domains formed from the N-terminal and C-terminal halves of the polypeptide chain. Each domain contains one metal binding site. The marked sequence similarities which exist between the two halves may reflect a doubling of an ancestral structural gene during the phylogenetic development of the protein. Preliminary crystallographic investigations of diferric rabbit plasma transferrin have been reported from this laboratory. We now report initial studies of the X-ray structure determination of dife-ric rabbit plasma transferrin which have led to a 6-A resolution electron density map.


The context and influences of safety: An exploration of social networks, actions, and behaviour.
Safety systems are socio-cultural in nature, characterized by people, their relationships to one another and to the whole. This study aimed to (i) map the social networks of New Zealand's quality improvement and safety leaders, (ii) illuminate influential characteristics and behaviours of key network players and (iii) make recommendations regarding how networks might be optimized. Instrumental case study was done using mixed methods. Purposeful sampling was applied to collect survey data from delegates at two national safety and quality forums (n = 85). Social network questions asked respondents who influenced their safety work. Key network players were identified and invited to participate in a semi-structured interview (n = 7). Key players described safety systems in humanistic terms. Safety influence was determined to be a responsive relational process. Adaptive leaders broker relationships between multiple perspectives and contexts, which is essential for safe healthcare. Influential safety approaches appreciate the human contribution to safety. Designing the health system to adapt and respond to the needs of people, teams and communities, rather than the unilateral needs of the system, is essential. Adaptive leadership will assist in achieving these aims and will likely be embraced by New Zealand health professionals.


Allogeneic cultured epidermal grafts heal chronic ulcers although they do not remain as proved by DNA analysis.
To investigate whether allogeneic cultured keratinocytes are rejected or not, and to find out how beneficial their effect on wound healing could be, patients with chronic ulcers were grafted with allogeneic cultured human keratinocytes. In order to examine the epidermal origin of the healed wound, DNA analysis was performed and compared to donor and recipient blood-cell DNA. Healing was observed in 84% of the grafted ulcers by granulation tissue stimulation and would edge effect. In little time 60% of the grafted chronic ulcers healed completely. Although no rejection was observed, DNA analysis revealed that the grafted allogeneic keratinocytes were finally replaced by the patient's own epidermis. This study confirmed that cultured allogeneic keratinocytes that have been grafted on ulcers, play an important role in the wound healing process.


Balloon coarctation angioplasty with non-compliant balloon in low-birth-weight premature infants.
Although surgery is the standard treatment for native coarctation in neonates, it carries a high risk of complications. Percutaneous balloon angioplasty may be considered as an alternative treatment. The materials used in the intervention should be selected carefully to reduce complications. We recommended the use of non-compliant balloons in risky babies. They are more effective in the treatment of strick stenosis than compliant balloons.


Infectious complications in patients randomized to receive allogeneic bone marrow or peripheral blood transplantation.
Very few data are available on the comparison of infectious complications in peripheral blood stem cell transplantation (PBSCT) and bone marrow transplant (BMT). The objective of this study was to evaluate the severity and frequency of infectious complications in patients randomized to receive PBSCT or BMT. We retrospectively reviewed the charts of all patients included in a randomized clinical trial comparing PBSCT (27 patients) and BMT (29 patients). We analyzed two periods: pre-engraftment and post-engraftment. In the pre-engraftment period, we compared the two groups with respect to the duration of neutropenia, antibiotic use and hospitalization, and documentation of infection. In the post-engraftment period, we analyzed the occurrence and severity of graft-versus-host disease (GVHD), duration of cyclosporine, corticosteroids, antibiotic, antiviral and antifungal prophylaxis, number of episodes of infection, and death rates. Patients receiving PBSCT had shorter duration of neutropenia, but there were no differences in the incidence of infections or duration of antibiotic therapy. Patients receiving PBSCT had a higher incidence of extensive chronic GVHD (65% vs. 39%, P=0.08), longer duration of cyclosporine use (risk ratio [RR] 1.97), corticosteroids (RR 1.66), antibacterial (RR 2.60), antifungal (RR 2.50), anti-Pneumocystis carinii (RR 2.06) and anti-cytomegalovirus (RR 1.44) prophylaxis, and more infectious episodes (3.65 vs. 2.32 per 1000 days at risk, RR 1.57). There were no differences in death rates. Multivariate analysis identified the use of steroids as the most significant variable associated with infectious episodes. PBSCT was associated with more infections in the post-engraftment period.


Prevalence and correlates of binge eating in white and African American adolescents.
This study examined the prevalence and correlates of binge eating in a biracial sample of adolescent males and females. White and African American students in Grades 6-12 (N=822) completed measures of social economic status (SES), body mass index (BMI), depression, current-ideal body image discrepancy, eating attitudes, dieting frequency, dietary intake, and activity level. Binge eating prevalence was highest among African American boys relative to the other demographic groups: 26% African American boys, 17% African American girls, 19% white boys, 18% white girls. Binge eating rates increased with age for white participants and decreased with age for African American participants. Depressive symptoms and consumption of high-fat foods predicted binge status among adolescents, whereas SES, BMI, eating attitudes, body image discrepancy, dieting, and low activity level failed to add predictive value. The observation of developmental differences in binging between whites and African Americans corresponds to their physical maturational divergence. These findings underscore the need for population-based surveys that sample binge eating across age, gender, and ethnicity.


[How does the employment status influence the effects of residential insecurity on health?]
This study aims to analyze the effects of housing insecurity on health and if those are modified by employment status of people belonging to "Treball als Barris" program in Barcelona between 2015 and 2016. We conducted a longitudinal study using a survey which included sociodemographic, employment and housing status information. This was administered to 469 individuals attended by "Treball als Barris" at baseline and after one year of follow-up. Then, we carried out a descriptive analysis and fitted regression models to estimate the effects of housing insecurity and employment status on health, and the interaction between them. Among women, we found negative effects of housing insecurity on health (PR of poor self-reported health among women who stayed under housing insecurity was 2.29 [IC95%: 1.36-3.84] compared to those who stayed secured), while, among men, main effects on health were due to employment status (PR of poor self-reported health among men who were unemployed without subsidy was 3.16 [IC95%: 1.02-6.15] compared to those who were employed after follow-up). In addition, results suggest an interaction between housing and employment status on mental health among. Housing insecurity rates have increased in last years. It produces negatives effects on health and can interact with other social determinants such as employment, mainly on men's mental health.


MicroRNA target-based network predicts androgen receptor-linked mycotoxin stress.
Stress-responsive microRNAs (miRNAs) contribute to the regulation of cellular homeostasis or pathological processes, including carcinogenesis, by reprogramming target gene expression following human exposure to environmental or dietary xenobiotics. Herein, we predicted the targets of carcinogenic mycotoxin-responsive miRNAs and analyzed their association with disease and functionality. miRNA target-derived prediction indicated potent associations of oncogenic mycotoxin exposure with metabolism- or hormone-related diseases, including sex hormone-linked cancers. Mechanistically, the signaling network evaluation suggested androgen receptor (AR)-linked signaling as a common pivotal cluster associated with metabolism- or hormone-related tumorigenesis in response to aflatoxin B1 and ochratoxin A co-exposure. Particularly, high levels of AR and AR-linked genes for the retinol and xenobiotic metabolic enzymes were positively associated with attenuated disease biomarkers and good prognosis in patients with liver or kidney cancers. Moreover, AR-linked signaling was protective against OTA-induced genetic insults in human hepatocytes whereas it was positively involved in AFB1-induced genotoxic actions. Collectively, miRNA target network-based predictions provide novel clinical insights into the progression or intervention against malignant adverse outcomes of human exposure to environmental oncogenic insults.


Mitogenic stimulation of human B lymphocytes via the inositol phospholipid 'dual pathway' of signalling requires persistent activation of both second messenger arms.
Highly purified resting tonsillar B lymphocytes mount an efficient mitogenic response on exposure to appropriate combinations of tumour-promoting phorbol esters and calcium ionophores, agents that mimic the biochemical second messengers generated through the cross-linking of surface immunoglobulins. By using agents that bind reversibly we show here that both signals need to be applied continuously in order for cells to proceed optimally to DNA synthesis. The data are consistent with the notion that, in the absence of 'help' from T lymphocytes or antigen-presenting cells, a chronic, persistent stimulation through antigen receptors is necessary to elicit a significant B-cell response.


[Inpatient and outpatient treatment in a crisis service: who uses what?].
The aim of our study was to identify person related factors for the utilization of inpatient and outpatient treatment in a crisis intervention unit. Data from the central psychiatric patient record (PSYREC) of the canton of Zurich have been analyzed. Different factors are associated with the treatment modalities. The decisive factor for the choice of an outpatient treatment is employment. The facilitation of employment should be of major interest for treatment in social psychiatry, e. g. by supported employment methods.


Evaluation is the key to success. A nurse-led tuberculosis contact tracing service.
1. It is important that health staff increase their knowledge of TB. 2. The development of nursing standards is essential to the efficient running of a contact tracing service. 3. Patient information is offered using the health belief model.


Influence of antigens and adjuvants on the production of gamma-interferon and antibody by ovine lymphocytes.
The production of gamma-interferon (gamma-IFN) and antigen-specific immunoglobulin isotypes was monitored in sheep given primary and secondary inocula of protein and polysaccharide antigens with or without adjuvants. In efferent lymph from prefemoral nodes draining the site of inoculation, gamma-IFN levels increased within 24 h after injection of adjuvants Quill A, dextran sulfate (DXS) and 6 days after oil adjuvants in saline. The increased synthesis of gamma-IFN was prolonged by 1-2 days by the presence of adjuvanted antigen, but the major stimulus to gamma-IFN production was provided by the adjuvant. Alhydrogel (AH) did not initiate gamma-IFN synthesis. Following a second inocula of antigen in saline, increased levels of gamma-IFN were detected in efferent lymph after 3-4 h, and persisted for at least 2 days. Following cultivation of leucocytes from immunized sheep with specific antigen in vitro, strong positive correlations between levels of interleukin (IL) IL-2, gamma-IFN, proliferative responses and antibody titres were observed. However, after analysis of the antigen-specific isotypes of immunoglobulin (Ig) there was no correlation between the production of gamma-IFN and particular Ig isotypes. Together with findings that AH did not preferentially induce IgG1 or IgG2, these results suggest that the specific subpopulations of helper T lymphocytes which regulate the production of antibody isotypes by differential secretion of gamma-IFN or IL-4, are not as clearly defined in sheep as in mice.


Sequence from the assembly nucleation region of TMV RNA.
In an effort to isolate RNA sequences containing the assembly nucleation region, uniformly 32P-labeled tobacco mosaic virus RNA was partially digested with pancreatic ribonuclease, and the mixture of fragments was incubated with limited amounts of tobacco mosaic virus protein disks in conditions favorable for reconstitution. The RNA fragments which became encapsidated were purified and sequenced by conventional techniques. The sequence of the first 139 nucleotides of P1, the principal encapsidated fragment, is AGGUUUGAGAGAGAAGAUUACAAGCGUGAGAGACGGAGGGCCCAUGGAACUUACAGAAGAAGUUGUUGAUGAGUUCAUGGAAGAUGUCCCUAUGUCAAUCAGACUUGCAAAGUUUCGAUCUCGAACCGGAAAAAAGAGU. Residues 1--110 of P1 overlap the assembly origin isolated and characterized in the accompanying papers by Zimmern (1977) and Zimmern and Butler (1977). Our results, taken in conjunction with the two accompanying papers, define the sequence of much of the nucleation region as well as sequences flanking it on both sides. The features of the P1 sequence which may have role in the nucleation reaction are discussed in detail in the text.


Copper bioavailability in Steilacoom Lake sediments.
Sediments were collected from Steilacoom Lake, Pierce County, in Washington State, and amended with copper sulfate (nominal concentrations of 800, 1,000, 1,500, and 2,000 mg Cu/kg dry weight) to assess copper bioavailability to Hyalella azteca, Chironomus tentans, or Ceriodaphnia dubia. H. azteca survival and C. tentans survival and growth were not significantly affected, with 10-day no observed effects concentrations (NOEC) and lowest observed effects concentrations (LOEC) of 2,010 and >2,010 mg Cu/kg, respectively. C. dubia was the most sensitive organism tested with 10-day NOEC and LOECs for survival and reproduction of 906 and 1,469 mg Cu/kg, respectively. Sediment AVS concentrations were <0.15 micromol/g, while simultaneously extracted metal (SEM) concentrations were >/=5. 71 micromol Cu/g. Dissolved interstitial water concentrations ranged from below detection (0.010 mg/L) to 0.24 mg Cu/L, with interstitial water toxicity units as high as 3.4. Based on this study, effects to C. dubia may occur at bulk sediment concentrations >906 mg Cu/kg. Further, AVS and interstitial water concentrations are not accurate predictors of copper bioavailability in Steilacoom Lake.


[Choice of form and parameters of the probing current in a rheographic device with temporal channel separation].
The paper considers specific features of bioimpedance measurements in the condition of time division of channels in which pulse probing currents are used. Fitness analysis has been made of the main classes of pulse signals, video and radio impulses for probing biological objects in rheographic measurements. A well-founded and verified approach to choosing the probing current form and indices providing minimum error value have been proposed.


Separation and quantitative determination of 2,4-disulfamyl-5-trifluoromethylaniline in hydroflumethiazide using high-pressure liquid chromatography.
A high-pressure liquid chromatographic method was developed to quantify 2,4-disulfamyl-5-trifluoromethylaniline in hydroflumethiazide using a bonded pellicular packing. An internal standard was added to the samples to ensure reproducibility. The results were compared with methods currently in use.


Expression of IGF-1 mRNA in the murine subventricular zone during postnatal development.
Insulin-like growth factor-1 (IGF-1) stimulates the proliferation and maturation of neuroglia in vitro. To further investigate its role in gliogenesis, in situ hybridization was utilized to determine whether IGF-1 mRNA was expressed in the subventricular zone (SVZ) of the postnatal mouse forebrain. The SVZ is a transient germinal zone and in the neonate is the principle source of oligodendroglia for myelinating fiber tracts of the forebrain. Strong hybridization signal was detected over cells in the SVZ at postnatal day (PND) 4, the earliest time point examined. Positive signal persisted in the SVZ at PND 8, however, the number of IGF-1-labeled cells declined rapidly during the second postnatal week. IGF-1 mRNA was not uniformly distributed throughout the SVZ and the majority of labeled cells were located within its so-called 'border' region. In contrast to the SVZ, IGF-1 mRNA-expressing cells were only rarely found in forebrain fiber tracts. IGF-1 transcripts were not detected in ependymal lining or choroid plexus of the lateral ventricle. In light of its known gliotrophic activity, the localization of IGF-1 mRNA in the SVZ suggests that locally produced IGF-1 may act as a mitogen or differentiation-inducing agent during gliogenesis.


Prospective study of signalling pathways in myeloma bone disease with regard to activity of the disease, extent of skeletal involvement and correlation to bone turnover markers.
The aim of our study was to address the utility of serum levels of selected parameters of myeloma bone disease (MBD) signalling with regard to the pathogenesis of multiple myeloma (MM), activity, markers of bone turnover and extent of skeletal changes. We assessed prospectively 77 individuals with monoclonal gammopathies - 46 patients with active MM (AMM), 12 patients with smouldering MM (SMM) and 19 individuals with monoclonal gammopathy of undetermined significance (MGUS) to determine the role of HGF, MIP-1α, Syndecan-1, osteoprotegerin, Activin A, DKK1, Annexin A2 and NF-κB. We found significant differences of most of the parameters between MGUS and AMM, and with respect to the activity of MM assessed by International Staging System. Most of the parameters of MBD signalling correlated with traditional markers of bone turnover. All the signalling pathways were activated in MM with more pronounced osteoclastogenesis in comparison with bone formation but not in MGUS regardless of its risk category, suggesting that MBD is not activated in MGUS until the process of transformation into MM. The parameters of MBD signalling might precede the increase of conventional parameters of bone turnover suggesting their possible role in early indication of anti-resorption therapy.


Carcinogenicity of N1-[tris(hydroxymethyl)]methyl-4-nitro-o-phenylenediamine fed to mated and non-mated Sprague-Dawley rats.
N1(-)[tris(hydroxymethyl)]methyl-4-nitro-o-phenylenediamine was fed in the diet to groups of 30 male and 55 female Sprague-Dawley rats at levels of 0.2, 0.6 and 2.0% for up to 6 months. One mid-dose and two high-dose females developed palpable mammary masses that were subsequently diagnosed as mammary adenocarcinomas at a 13-wk interim kill involving 10 rats/sex/group. After 14 wk, 25 females per group with no apparent masses were mated in a reproduction/teratology study. Mammary tumours developed in a dose-related fashion both in the pregnant rats and in the remaining 20 females/group that continued on treatment for 6 months. On gestation day 20 (wk 17-18) the final incidences of mammary adenocarcinomas in the low-, mid- and high-dose mated dose groups were 20, 60 and 84%, respectively, while the corresponding incidences in the non-mated females at 6 months were 5, 40 and 85%. Most mammary tumours were encapsulated but, at 6 months, lung metastases were noted in four rats, and four females also had Zymbal's gland tumours. Non-neoplastic changes in male and female rats considered to be related to treatment included increases in thyroid follicular cell size accompanied by an accumulation of golden-brown pigment, multifocal hepatic necrosis with non-suppurative inflammation, and renal tubular pigmentation. Increases in foetal variations in the mid- and high-dose groups were considered to be related non-specifically to retarded growth. Malformations observed in the high-dose group were found primarily in single foetuses and were not considered to be treatment related. Although the mean numbers of micronucleated polychromatic erythrocytes in bone marrow obtained from high-dose treated females after 13 wk slightly exceeded historical negative control values, the data were not considered indicative of a genotoxic effect because of the absence of either a dose relationship or a substantive increase in the frequency of micronucleated cells.


Discovery and validation of serum glycoprotein biomarkers for high grade serous ovarian cancer.
This study aimed to identify serum glycoprotein biomarkers for early detection of high-grade serous ovarian cancer (HGSOC), the most common and aggressive histotype of ovarian cancer. The glycoproteomics pipeline lectin magnetic bead array (LeMBA)-mass spectrometry (MS) was used in age-matched case-control serum samples. Clinical samples collected at diagnosis were divided into discovery (n = 30) and validation (n = 98) sets. We also analysed a set of preclinical sera (n = 30) collected prior to HGSOC diagnosis in the UK Collaborative Trial of Ovarian Cancer Screening. A 7-lectin LeMBA-MS/MS discovery screen shortlisted 59 candidate proteins and three lectins. Validation analysis using 3-lectin LeMBA-multiple reaction monitoring (MRM) confirmed elevated A1AT, AACT, CO9, HPT and ITIH3 and reduced A2MG, ALS, IBP3 and PON1 glycoforms in HGSOC. The best performing multimarker signature had 87.7% area under the receiver operating curve, 90.7% specificity and 70.4% sensitivity for distinguishing HGSOC from benign and healthy groups. In the preclinical set, CO9, ITIH3 and A2MG glycoforms were altered in samples collected 11.1 ± 5.1 months prior to HGSOC diagnosis, suggesting potential for early detection. Our findings provide evidence of candidate early HGSOC serum glycoprotein biomarkers, laying the foundation for further study in larger cohorts.


Metformin monotherapy in youth with recent onset type 2 diabetes: experience from the prerandomization run-in phase of the TODAY study.
TODAY (Treatment Options for type 2 Diabetes in Adolescents and Youth) is a federally funded multicenter randomized clinical trial comparing three treatments of youth onset type 2 diabetes. To describe the experience of youth participating in a 2-6 month run-in period in preparation for randomization into TODAY. An ethnically diverse sample of 927 youth, 65.4% females, aged 13.7 ± 2.0 yr old, with type 2 diabetes for a median of 2 months (0.7-7.8 months, 25th-75th percentiles). A run-in period was conducted to achieve HbA1c <8% with metformin monotherapy and diabetes education, and to evaluate adherence to pill taking, visit attendance, and other procedures. At entry, mean body mass index (BMI) and z-BMI were 35.6 ± 7.7 and 2.3 ± 0.4, respectively, mean HbA1c was 7.7 ± 2.2%, only 42.5% were on a hypoglycemic treatment, and 35.6% had HbA1c ≥8%. Comorbid conditions were common; 18.8% had hypertension, 24.2% had elevated cholesterol, and 6.5% had abnormal liver enzymes. After a median 71 d of run-in, 90.9% had HbA1c <8%, 77.9% had HbA1c <7%, and 46.4% had HbA1c <6%. Of the 772 youth achieving the target HbA1c <8%, 704 (91.2%) were randomized; non-adherence to metformin treatment was the main cause for non-randomization. Youth proceeding to randomization decreased weight by 0.68 kg and HbA1c by 1.45% compared to a weight gain of 0.71 kg and HbA1c decrease of 0.74% in the non-randomized youth (p = 0.01 in both cases). However, change in z-BMI was not significantly different between the two groups. Most youth with recent onset type 2 diabetes can achieve target HbA1c <8.0% with short-term metformin monotherapy and standard diabetes education (ClinicalTrials.gov identifier: NCT00081328).


Conduction Heterogeneity: Impact of Underlying Heart Disease and Atrial Fibrillation.
The goal of this study is to investigate the impact of various underlying heart diseases (UHDs) and prior atrial fibrillation (AF) episodes on conduction heterogeneity. It is unknown whether intra-atrial conduction during sinus rhythm differs between various UHD or is influenced by AF episodes. Epicardial sinus rhythm mapping of the right atrium, Bachmann's bundle (BB), left atrium and pulmonary vein area was performed in 447 participants (median age: 67 [interquartile range (IQR): 59 to 73] years) with or without AF undergoing cardiac surgery for ischemic heart disease, (ischemic and) valvular heart disease, or congenital heart disease. Conduction times (CTs) were defined as Δ local activation time between 2 adjacent electrodes and used to assess frequency (CTs ≥ 4 ms) and magnitude of conduction disorders (in increments of 10 ms). When comparing the 3 types of UHD, there were no differences in frequencies and magnitude of CTs at all locations (p ≥ 0.017 and p ≥ 0.005, respectively). Prior AF episodes were associated with conduction slowing throughout both atria (14.9% [IQR: 11.8 to 17.0] vs. 12.8% [IQR: 10.9 to 14.6]; p < 0.001). At BB, CTs with magnitudes ≥30 ms were more common in patients with AF (n = 56.2% vs. n = 36.0%; p < 0.004). UHD has no impact on the frequency and severity of conduction disorders. AF episodes are associated with more conduction disorders throughout both atria and with more severe conduction disorders at BB. The next step will be to determine the relevance of these conduction disorders for AF development and maintenance.


Under-reporting of direct and indirect obstetrical deaths in Austria, 1980-98.
Under-reporting and misclassification of maternal deaths are common, even in countries with a high quality of death statistics. The aims of this study were to determine to what extent maternal deaths are under-reported in Austria and to determine factors that might explain under-reporting. Confidential enquiries on maternal deaths for the period 1980-98 were linked with the official mortality statistics from Statistics Austria. Maternal deaths were classified as direct and indirect obstetric deaths. Between 1980 and 1998 a total of 119 maternal deaths (112 direct and seven indirect obstetric deaths) were registered at Statistics Austria. Confidential inquiries into maternal deaths accumulated 191 maternal deaths (an additional 43 direct obstetric deaths and 29 indirect obstetric deaths). Total under-reporting was 38% (95% CI 31-45). Significantly more indirect obstetrical deaths were under-reported (81%; 95% CI 64-92) than direct obstetrical deaths (28%; 95% CI 21-36). This study demonstrates the shortcomings of official registration of maternal deaths. Thus, maternal mortality cannot be seen as a reliable basis for health policy decisions.


Male breast cancer: a review of the literature.
Although breast cancer is uncommon in men, it can cause significant morbidity and mortality. The current review was undertaken to determine whether strategies applied for the evaluation and treatment of breast cancer in females are appropriate in male breast cancer. Male breast cancer has biological differences compared with female breast cancer, including a high prevalence in certain parts of Africa, a higher incidence of oestrogen receptor positivity and more aggressive clinical behaviour. It responds to hormonal manipulation and chemotherapy, but optimal treatment regimens in males are unknown. Male breast cancer remains an uncommon disease. Most of our current knowledge regarding its biology, natural history and treatment strategies has been extrapolated from its female counterpart. Much research is needed to further characterise the molecular biological properties of male breast tumours and their prognostic significance, and to devise treatment strategies, including optimal chemotherapy regimens.


Synthesis of inorganic polymers using fly ash and primary lead slag.
The present work reports on the synthesis and properties of inorganic polymers ("geopolymers") made of 100% fly ash from lignite's combustion, 100% primary lead slag and mixtures of the two. In the inorganic polymers with both fly ash and lead slag the main crystalline phases detected are wüstite, magnetite, sodium zinc silicate, quartz, anorthite, and gehlenite; litharge partially dissolves. FTIR analysis in these samples revealed that the main peaks and bands of end members also exist, along with a new amorphous reaction product. In terms of microstructure, both fly ash and lead slag dissolve and contribute in the binding phase whereas the larger particles act as aggregates. For an increasing lead slag in the composition, the binding phase is changing in chemistry and reaches PbO values higher than 50 wt.% for the 100% lead slag inorganic polymer. Regarding the properties of fly ash and lead slag inorganic polymers, compressive strength is higher than 35 MPa in all cases and water absorption diminishes as the lead slag content increases. A comparison of leaching results before and after polymerisation reveals that pH is an important factor as Pb is immobilised in the binding phase, unlike Zn and As.


Interpretable Machine-Learning and Big Data Mining to Predict Gas Diffusivity in Metal-Organic Frameworks.
For gas separation and catalysis by metal-organic frameworks (MOFs), gas diffusion has a substantial impact on the process' overall rate, so it is necessary to determine the molecular diffusion behavior within the MOFs. In this study, an interpretable machine learing (ML) model, light gradient boosting machine (LGBM), is trained to predict the molecular diffusivity and selectivity of 9 gases (Kr, Xe, CH4 , N2 , H2 S, O2 , CO2 , H2 , and He). For these 9 gases, LGBM displays high accuracy (average R2 = 0.962) and superior extrapolation for the diffusivity of C2 H6 . And this model calculation is five orders of magnitude faster than molecular dynamics (MD) simulations. Subsequently, using the trained LGBM model, an interactive desktop application is developed that can help researchers quickly and accurately calculate the diffusion of molecules in porous crystal materials. Finally, the authors find the difference in the molecular polarizability (ΔPol) is the key factor governing the diffusion selectivity by combining the trained LGBM model with the Shapley additive explanation (SHAP). By the calculation of interpretable ML, the optimal MOFs are selected for separating binary gas mixtures and CO2 methanation. This work provides a new direction for exploring the structure-property relationships of MOFs and realizing the rapid calculation of molecular diffusivity.


Surgical management for an adult, female patient, with Ebstein Anomaly on Tricuspid Valve that has Subvalvular membrane with severe PS and multiple VSDs-A case report.
Ebstein's anomaly is a rare and complexed heart defect that affects the tricuspid valve and is accountable for around 1% of congenital cardiac abnormalities. It is one of the most common congenital causes of tricuspid valve regurgitation. Ebstein's anomaly is often diagnosed prenatally due to its severe cardiomegaly. Some individuals with this anomaly do not experience any complications until adulthood and even then its mostly minor complaints like exercise intolerance. Atrial septal defect is most commonly (70-90%) associated with Ebstein's anomaly. However, ventricular septal defect (VSD) can be associated with 2-6% of the cases. This particular report presents a case of surgical intervention for a 20 years old female with Ebstein's anomaly that had multiple VSD's and a severe Pulmonary Stenosis (PS).


Abrupt oxygen decrease influences thrombosis and bleeding in stenosed and endothelium-injured rabbit carotid arteries.
Blood oxygen concentration decrease may be associated with haemostatic impairments. We aimed to study the effect of oxygen decrease in a rabbit model of thrombosis and bleeding. A total of 44 rabbits were anaesthetized, ventilated and monitored for blood pressure, blood arterial gas, temperature and carotid blood flow. The Folts model was used: a stenosis (75%) and an injury were carried out on the carotid artery, inducing thrombosis. Blood flow decreased as thrombus size increased until the pressure gradient was such that the thrombus was released and local arterial blood flow was suddenly restored. This is known as a cyclic flow reduction. After counting baseline cyclic flow reductions during a 20-min period (P1), rabbits were randomized blindly to one of three groups: hyperoxic, FiO2=100%; normoxic, FiO2 was decreased to obtain a PaO2 between 80 and 120 mmHg; hypoxic, PaO2 < 80 mmHg. Then CFRs were recorded over a second 20-min period (P2). At the end of the experiment, a hepatosplenic section was done and the amount of blood loss was recorded. After each period, the following parameters were measured: blood gas, ear-immersion bleeding time, haemoglobin, platelet count, prothrombin time, activated partial thromboplastin time and fibrinogen. Oxygen decrease during hypoxic and normoxic periods was associated with a decrease in cyclic flow reductions. Bleeding time increased in the hypoxic group unless hepatosplenic bleeding remained stable. A slight increase in activated partial thromboplastin time was observed in the normoxic and hypoxic groups. An abrupt decrease in oxygen administration was responsible for an antithrombotic effect. Increase in bleeding time occurred during hypoxia. No clinically relevant variation of any haemostasis parameters was observed.


Tooth extraction by orthodontic force after radiation therapy: report of case.
This report presents a therapeutic approach to orthodontic tooth extraction in a patient at high risk for the development of osteoradionecrosis with conventional techniques. The rationale for this procedure is discussed in detail, combining principles of radiation biology, clinical radiation therapy, and biomechanics of tooth movement.


Quality and Outcome Assessment for Surgery.
This forum summarizes the proceedings of the joint European Surgical Association (ESA)/American Surgical Association (ASA) symposium on Quality and Outcome Assessment for Surgery that took place in Bordeaux, France, as part of the celebrations of the 30th anniversary of the ESA. Three presentations focused on a) the main messages from the Outcome4Medicine Consensus Conference, which took place in Zurich, Switzerland, in June 2022, b) the patient perspective, and c) benchmarking were hold by ESA members and discussed by ASA members in a symposium attended by members of both associations.


Synthesis and crystal structure of [tBu3SiPAg2]8: a novel Ag16-cluster featuring a remarkable symmetrical structure.
The synthesis of [tBu3SiPAg2]8 which features an Ag16-cluster in the solid state was achieved by metathesis reaction of AgOCN with tBu3SiPNa2.


Utilizing granulocyte colony-stimulating factor to enhance vascular graft endothelialization from circulating blood cells.
Cells in the blood circulating through a vascular graft can contribute to endothelialization of its flow surface. We hypothesized that granulocyte colony-stimulating factor (G-CSF) could enhance this process by increasing circulating bone marrow progenitor cells. Ten dogs received composite grafts that were shielded from any source of endothelialization other than the circulating blood. On the seventh postoperative day and for 7 days thereafter, five dogs were injected subcutaneously with 10 mg/kg/day of human G-CSF. The additional five dogs, used as controls, received no G-CSF. Grafts were retrieved at 4 weeks. All dogs recovered promptly postoperatively. White cell counts in G-CSF dogs increased by an average of 9.5-fold at the end of treatment, and had returned to normal before retrieval. All grafts remained patent. G-CSF grafts had significantly higher endothelialization than the controls (82.2 +/- 9.2% vs. 23.7 +/- 4.4%, p = 0.0004), with extensive flow surface neointima, covered with a single layer of endothelium verified by FVIII/vWF and CD34 staining. Control grafts had virtually no neointima and were covered with a thin layer of fibrin coagulum. Significantly more endothelial-lined microvessels were also found in the G-CSF grafts than in the controls. Dogs treated with G-CSF have increased endothelialization of synthetic vascular grafts due to increased circulating bone marrow progenitor cells.


Can Procalcitonin Be Dosed in Bovine Milk Using a Commercial ELISA Kit?
The aim was to evaluate the use of a bovine procalcitonin (PCT) ELISA kit (Cusabio, China) for assessing PCT in bovine milk samples. Validation was performed by using 10 plasma and corresponding milk samples from mastitic cows. The limit of detection (LOD) was calculated. The coefficient of variation (CV%) of the readings of five plasma samples measured five times in the same plate (intra-assay) and the CV% of the same five samples read five times in three separate plates was evaluated. Parallelism was determined by serial twofold dilutions of five plasma and corresponding milk samples. Milk samples were analyzed with and without centrifugation. Regarding plasma PCT, the method presented an inter- and intra-CV < 23.7% and parallelism had very good recovery values. The ELISA kit studied can measure bovine plasma PCT concentrations. The kit antibodies fail in binding PCT in milk samples because all centrifuged milk samples showed a lower LOD than blank samples. Only three uncentrifuged milk samples showed measurable PCT concentrations. Due to these results, the commercial ELISA kit investigated could not be employed for the detection of PCT in milk samples.


Logistic model analysis of neurological findings in Minamata disease and the predicting index.
To establish a statistical diagnostic method to identify patients with Minamata disease (MD) considering factors of aging and sex, we analyzed the neurological findings in MD patients, inhabitants in a methylmercury polluted (MP) area, and inhabitants in a non-MP area. We compared the neurological findings in MD patients and inhabitants aged more than 40 years in the non-MP area. Based on the different frequencies of the neurological signs in the two groups, we devised the following formula to calculate the predicting index for MD: predicting index = 1/(1+e(-x)) x 100 (The value of x was calculated using the regression coefficients of each neurological finding obtained from logistic analysis. The index 100 indicated MD, and 0, non-MD). Using this method, we found that 100% of male and 98% of female patients with MD (95 cases) gave predicting indices higher than 95. Five percent of the aged inhabitants in the MP area (598 inhabitants) and 0.2% of those in the non-MP area (558 inhabitants) gave predicting indices of 50 or higher. Our statistical diagnostic method for MD was useful in distinguishing MD patients from healthy elders based on their neurological findings.


The Arabidopsis homologue of an eIF3 complex subunit associates with the COP9 complex.
The Arabidopsis COP9 complex is a multi-subunit repressor of photomorphogenesis which is conserved among multicellular organisms. Approximately 12 proteins copurify with the COP9 complex. Seven of these proteins are orthologues of subunits of the recently published mammalian COP9 complex. Four of the proteins show amino acid similarity to various subunits of the COP9 complex, eIF3 complex and 19S cap of the proteasome. We have studied one of these proteins in order to determine if it is a component of the COP9 complex. Arabidopsis p105 is highly similar to the p110 subunit of the human elF3. The p105 gene is induced during photomorphogenesis, and RNA and protein analysis reveal different tissue accumulation patterns. p105 is found in a large protein complex. p105 interacts in yeast with both COP9 and FUS6, two known components of the COP9 complex. Our results indicate that p105 is not a component of the COP9 core complex, though it may interact with components of the complex.


Bacterial mutagenicity testing of urine from rats dosed with 2-ethylhexanol derived plasticizers.
Di-(2-ethylhexyl)phthalate (DEHP) produced hepatocellular carcinomas in rodents at high doses in a NTP/NCI bioassay. DEHP has not shown evidence of genotoxic activity in in vitro mutagenicity tests. We extended these studies by examining the mutagenicity of urine from rats dosed with DEHP, 2-ethylhexanol (2-EH), and several other 2-EH derived plasticizers, i.e. di-(2-ethylhexyl)adipate (DEHA), di-(2-ethylhexyl)terephthalate (DEHT) and tri-(2-ethylhexyl)trimellitate (TEHT). A modified Ames Salmonella/microsome assay was used to determine mutagenicity. Urine was pooled from male Sprague--Dawley rats dosed daily for 15 days with 2000 mg/kg of each test substance with the exception of 2-EH which was given at 1000 mg/kg. Direct plating procedures were used to determine the presence of mutagens in urine. Urine from rats dosed with 8-hydroxyquinoline was used as a positive control. There was no evidence that mutagenic substances were excreted in the urine by rats dosed with either DEHP, DEHA, DEHT, TEHT or 2-EH as determined in the presence or absence of rat liver microsomes, and with or without treatment with beta-glucuronidase/aryl sulfatase. Our findings indicate that the above test compounds were not converted to urinary metabolites that were mutagenic. These observations provide no evidence for a genotoxic mechanism for DEHP carcinogenicity in rodents.


Hollow cylinder protein in the cytoplasm of human erythrocytes.
A "Hollow Cylinder Protein' (HCP) similar to the protein originally isolated by Harris from human erythrocyte membranes (Harris, J.R. (1968) Biochim. Biophys. Acta 150, 534--537) is present in the cytosol of erythrocytes at a concentration of more than 15 micrograms/ml packed erythrocytes. When negatively stained and examined in the electron microscope, cytosol HCP is similar in morphology to the HCP associated with erythrocyte ghost membranes. Cytosol HCP can be purified by isoelectric precipitation at pH 5.2 followed by repeated sucrose gradient centrifugation at alkaline pH. Negatively stained purified cytosol HCP appears as a hollow cylinder with apparent dimensions of 18.0 nm in length by 11.8 nm in diameter and contains a hollow core. Purified cytosol HCP migrates as a single band by non-denaturing polyacrylamide gel electrophoresis. SDS-polyacrylamide gel electrophoresis shows that it is composed of five peptides having apparent molecular weights 21 500, 23 500, 26 000, 27 500 and 29 000. Chymotryptic peptide maps of each of these bands indicate that each is a unique polypeptide chain. These results indicate that erythrocyte cytosol HCP is a macromolecular complex composed of multiple copies of five non-identical subunits arranged as a hollow cylinder.