Macular microvasculature differences in patients with macular hole after vitrectomy with internal limiting membrane removal or single-layered temporal inverted flap technique.
To compare the macular microvasculature differences in cases with idiopathic macular hole (MH) after vitrectomy when using internal limiting membrane (ILM) removal or temporal inverted ILM flap technique (IFT). A total of 34 patients were included, of whom 20 were treated vitrectomy with ILM removal (group 1), and 14 were treated with IFT (group 2). The OCTA (RTVue; Optovue, Fremont, CA) parameters, including foveal avascular zone (FAZ), vessel density (VD) ratios in superficial capillary plexus (SCP), and deep capillary plexus (DCP) were evaluated at baseline and 6 months follow-up. The VD measurements in DCP and inner retinal thickness (IRT) in temporal and nasal sectors were compared in subanalyses. There was no significant difference in means of post-operative BCVA and FAZ between the two groups (p = 0.943, p = 0.760). The mean VDs of the DCP was significantly decreased at 6 months postoperatively in both groups (p < 0.001, p < 0.001). The mean post-operative temporal VDs of DCP were similar in the two groups, but the mean post-operative nasal VDs of the DCP was lower in group 1 than in group 2 (p = 0.005 and p = 0.03 for parafovea and perifovea, respectively). The mean temporal IRTs were similar in the two groups, but paranasal and perinasal IRTs were significantly thinner in group 1 than in group 2 (p < 0.001, p < 0.001). The mean post-operative VDs of parafoveal and perifoveal temporal and nasal quadrants in DCP significantly and positively correlated with the IRTs. Single-layered temporal IFT causes fewer VD changes when compared to complete ILM removal, especially in the DCP.


The association between HIV infection and precancerous cervical lesion. A systematic review and meta-analysis of case-control studies.
The effect of human immunodeficiency virus (HIV) on precancerous cervical lesion is not consistent across studies. Besides to the variability in the presence of a significant association between HIV and precancerous cervical lesion, the reported strengths are inconsistent among studies that report a significant association. Therefore, we sought to determine the impact of HIV on women's risk of precancerous cervical lesion by conducting a systematic review and meta-analysis of case-control studies in Ethiopia. Relevant articles were systematically searched on African Journals Online, Cochrane Library, Science Direct, Google Scholar, and PubMed from January 1, 2023, to February 20, 2023. After critical appraisal, pertinent data were extracted into an Excel spreadsheet and then exported to STATA 14 for further statistical analysis. The pooled effect size was estimated using the random-effect model. The Egger's regression test and I 2 statistics were employed to assess publication bias and heterogeneity among included studies, respectively. Ten case-control studies with a total of 3035 participants (992 cases and 2043 controls) were involved in this meta-analysis. According to our analysis, HIV-infected women were 2.86 times more likely to develop precancerous cervical lesion as compared with their counterparts (odds ratio: 2.86, 95% confidence interval: 1.79, 4.58). We found that HIV-infected women have a higher risk of precancerous cervical lesion. Thus, targeted screening programs should be considered to reduce the burden of cervical cancer among HIV-infected women in Ethiopia.


Podosomes are dispensable for osteoclast differentiation and migration.
Podosomes are adhesion structures characteristic of the myeloid cell lineage, encompassing osteoclasts, dendritic cells and macrophages. Podosomes are actin-based structures that are dynamic and capable of self-organization. In particular in the osteoclast, podosomes densely pack into a thick ring called the sealing zone. This adhesion structure is typical of osteoclasts and necessary for the resorption of the bone matrix. We thought to explore in more details the role of podosomes during osteoclast differentiation and migration. To this end, we made from soft to stiff substrates that had not been functionalized with extracellular matrix proteins. Such substrates did not support podosome formation in osteoclasts. With such devices, we could show that integrin activation was sufficient to drive podosome assembly, in a substrate stiffness independent fashion. We additionally report here that osteoclast differentiation is a podosome-independent process. Finally, we show that osteoclasts devoid of podosomes can migrate efficiently. Our study further illustrates the great capacity of myeloid cells to adapt to the different environments they encounter during their life cycle.


Alternative reinforcer response cost impacts methamphetamine choice in humans.
Methamphetamine use disorders are a persistent public health concern. Behavioral treatments have demonstrated that providing access to non-drug alternative reinforcers reduces methamphetamine use. The purpose of this human laboratory experiment was to determine how changes in response cost for non-drug alternative reinforcers influenced methamphetamine choice. Seven subjects with past year histories of recreational stimulant use completed a placebo-controlled, crossover, double-blind protocol in which they first sampled doses of oral methamphetamine (0, 8 or 16 mg) and completed a battery of subject-rated and physiological measures. During subsequent sessions, subjects then made eight discrete choices between 1/8th of the sampled dose and an alternative reinforcer ($0.25). The response cost to earn a methamphetamine dose was always 500 responses (FR500). The response cost for the alternative reinforcer varied across sessions (FR500, FR1000, FR2000, FR3000). Methamphetamine functioned as a positive reinforcer and produced prototypical stimulant-like effects (e.g., elevated blood pressure, increased ratings of Stimulated). Choice for doses over money was sensitive to changes in response cost for alternative reinforcers in that more doses were taken at higher FR values than at lower FR values. Placebo choices changed as a function of alternative reinforcer response cost to a greater degree than active methamphetamine choices. These findings suggest that manipulating the effort necessary to earn alternative reinforcers could impact methamphetamine use.


Risk of a blood donation contaminated with hepatitis E virus entering the blood supply before the implementation of universal RNA screening in France.
The risk of a blood donation contaminated with hepatitis E virus (HEV) entering the blood supply before introducing universal HEV-RNA screening in France was estimated to assess the benefit of such a measure. The results of selective HEV nucleic acid testing (HEV-NAT) performed in mini pool of six plasma donations between 2018 and 2020 were extrapolated to the whole blood donor (BD) population after adjustment on three variables: regional establishment, sex and age group. Among the 246,285 plasma donations collected from 172,635 BDs tested for HEV-RNA, 248 (10.1/10,000) were positive. The extrapolation to all BDs led to an estimated rate of 5.9/10,000 donations (95% confidence interval [CI]: 4.5-7.4) which would be positive to HEV-RNA and a prevalence of 9.9/10,000 BDs (95% CI: 7.5-12.3). This prevalence was 4.4 times higher in males than females (16.8/10,000 vs. 3.8/10,000, p < 10-4 ). The highest prevalence was observed in males in the 30-39 age group (20.5/10,000) and the lowest in females in the 50-70 age group (2.8/10,000). The risk of an HEV-RNA-positive donation entering the blood supply was estimated at 1 in 1682 donations. This risk does not translate directly to the risk of HEV transfusion transmission, which mainly depends on the total number of viral particles in the transfused blood component and the sensitivity of NAT.


Correlation of elevated troponin and echocardiography in acute ischemic stroke.
Previous research has revealed a higher prevalence of elevated cardiac troponin T or I levels amongst patients admitted with stroke, which has been associated with increased cardiovascular events, higher mortality rates, and poor inpatient prognosis. Because cardiac comorbidities account for almost 20% of deaths after ischemic stroke, it is important to understand the relationship between troponin elevation, cardiac events, and acute ischemic stroke (AIS). We evaluated 137 consecutive patients ≥ 18 years of age who presented within 48 hours of AIS onset. All patients had laboratory markers drawn on admission, including troponin and brain natriuretic peptide, along with transthoracic echocardiogram with Doppler. The mean age of our study population was 71.7 ± 14.6 years. Twenty-four of 137 patients (17.5%) had a positive troponin level. Sixteen of 24 (67%) patients with a positive troponin level had a new wall motion abnormality on echocardiogram that was suggestive of unstable atherosclerotic disease. On statistical analysis, we found a significant association between troponin and brain natriuretic peptide elevation with positive segmental wall motion abnormality on echocardiogram. These study findings represent a new paradigm of interpreting elevated cardiac biomarkers and may help with risk stratification and diagnosis of patients presenting with AIS.


Predictors of 6-month tobacco abstinence among 1224 cigarette smokers treated for nicotine dependence.
This study examined baseline characteristics associated with abstinence from tobacco 6 months after treatment for nicotine dependence. A total of 1224 cigarette smokers (619 females, 605 males) receiving clinical services for treatment of nicotine dependence between January 1, 1995 and June 30, 1997 were studied. The intervention involves a 45-min consultation with a nicotine dependence counselor. A treatment plan individualized to the patient's needs is then developed. The main outcome measure was the self-reported 7-day point prevalence abstinence from tobacco obtained by telephone interview 6-months after the consultation. A bootstrap resampling methodology for predictor variable selection was used to identify a set of multivariate predictors of 6-month tobacco abstinence. Five variables were multivariately associated with tobacco abstinence: male gender, no current psychiatric diagnosis, higher stage of change, longest duration of previous abstinence from tobacco of <1 or > or =30 days, and Fagerström Test for Nicotine Dependence (FTND) score of < or =5. Assessment of these variables may be useful clinically by assisting health care providers in tailoring nicotine dependence interventions to enhance outcomes.


An Analysis of Radiographic Leg Length Discrepancy and Hip Offset in Patients at Risk of Developing Osteoarthritis.
Leg length and hip offset are important principles in total hip arthroplasty (THA). Patients may endorse leg length differences (LLD) postoperatively that may be anatomical or functional. The objective of this study was to determine the normal radiographic variation in leg length and hip offset in a preosteoarthritic population without a THA. A retrospective study was completed using data from the Osteoarthritis Initiative, a prospective longitudinal study. Patients at risk of developing or with early osteoarthritis without inflammatory arthritis or prior THA were included. Measurements were made from full limb length anterior-posterior (AP) radiographs. Multiple linear regression models were employed to predict side-to-side differences in LLD, Δ femoral offset (FO), Δ abductor muscle length (AML), Δ abductor lever arm, and Δ AP pelvic offset. The mean radiographic LLD was 4.6 mm, with 12 mm within 1 standard deviation. No significant differences were detected between LLD and sex, age, body mass index, or height. The median radiographic differences in FO, AML, abductor lever arm, and AP pelvic offset were 3.2 mm, 4.8 mm, 3.6 mm, and 3.3 mm, respectively. Height was predictive of Δ FO, while both height and age were predictive of Δ AML. Radiographic leg length variations in a population without symptomatic or radiographic osteoarthritis exist. FO and AML are dependent on patient characteristics. Preoperative radiographic LLD is not predicted by age, gender, body mass index, or height. It should be stressed that anatomic reconstruction is one of the many goals of arthroplasty and can stand in conflict with the priority and primary goals of stability and fixation, which should be prioritized.


Cation permeability of the blood-brain barrier in streptozotocin-diabetic rats.
Decreased sodium permeability across the blood-brain barrier occurs in streptozotocin-treated rats after 2 weeks of diabetes. To establish whether this is a phenomenon specific for cations, the blood-brain barrier permeability for sodium, potassium and calcium was studied with an arterial integral uptake technique. Experiments were performed in control rats and, after two weeks after diabetes induction, in untreated streptozotocin-diabetic rats and in insulin-treated streptozotocin rats. In untreated diabetes, the neocortical blood-brain barrier permeability for sodium decreased by 35% (5.2 +/- 1.7 vs 3.4 +/- 1.1 10(-5).cm3.s-1.g-1) and potassium permeability by 39% (19.8 +/- 5.7 vs 12.1 +/- 3.9 10(-5).cm3.s-1.g-1), whereas no differences in calcium permeability occurred. Insulin treatment was associated with an increase in the blood-brain barrier permeability to sodium (4.8 +/- 1.0 10(-5).cm3.s-1.g-1) as compared to untreated diabetes (3.4 +/- 1.1 10(-5).cm3.s-1.g-1). It is concluded that the observed changes in sodium and potassium permeability cannot be caused by electrostatic membrane changes. More specific abnormalities of the transport of sodium and potassium across the blood-brain barrier are likely to occur; disturbances in the sodium-potassium-pump activity could account for such alterations.


Analysis of vascular endothelial growth factor levels in induced sputum samples from patients with cough variant asthma.
We previously found that vascular endothelial growth factor (VEGF) levels in induced sputum samples are increased in patients with classic asthma and are associated with the degree of airflow obstruction and airway microvascular permeability. To examine VEGF levels and the degree of airway microvascular permeability in patients with cough variant asthma (CVA). Levels of VEGF in induced sputum samples and airway microvascular permeability were examined in 12 controls, 16 patients with CVA, and 16 patients with classic asthma. We also evaluated the relationship between VEGF level and the clinical features of these 2 disorders. Mean (SD) VEGF levels and airway vascular permeability index values were significantly higher in patients with CVA (VEGF: 2,520 [1,050] pg/mL; P < .001; vascular permeability index: 0.017 [0.006]; P = .003) and classic asthma (4,750 [1,260] pg/mL; P < .001; 0.028 [0.009]; P < .001) than in controls (1,420 [1,230] pg/mL; 0.009 [0.003]). Furthermore, these values were significantly higher in patients with classic asthma vs CVA. We also found significant correlations between VEGF level and airway vascular permeability index in patients with CVA (r = 0.60; P = .02) vs classic asthma (r = 0.83; P = .001). Furthermore, VEGF levels were inversely correlated with the degree of airflow obstruction and airway hyperresponsiveness to methacholine in patients with CVA and classic asthma. Airway microvascular hyperpermeability induced by elevated VEGF levels contributes to abnormal airway function in CVA and classic asthma, and differences in the clinical features of these 2 disorders may depend on airway VEGF levels.


[Self-perception of health care team leaders in Andalusia. A quantitative and qualitative study].
To determine the perception and self-assessment on leadership among health care team leaders in Andalusia. Design: Exploratory descriptive study using quantitative and qualitative methodology, developed between 2013 and 2015, using a questionnaire and semi-structured interviews. Andalusia. All health managers from the Primary Care Management Units and Health Management Areas of the Departments of Paediatrics, Emergency and Internal Medicine, for the quantitative study. A purposive sample of 24 health managers was used for the qualitative study. Descriptive statistical study and bivariate analysis of comparison of means. Content analysis of the semi-structured interviews: Codification, category tree, and triangulation of results. The best self-assessment dimension relates to support, and the worst to considering oneself as a 'good leader'. The definition of a 'good leader' includes: Honesty, trust, and attitudes of good communication, closeness, appreciation, and reinforcement of the health team members. Different leadership styles were perceived. Main difficulties for leadership are related to the economic crisis and the management of personal conflicts. Health managers describe an adaptive leadership style, based on personal and professional support, and using communication as the main cohesive element for the team project. More studies on leaders' perspectives are important, in order to better understand their experiences, needs and expectations.


Antagonism of postoperative opioid-induced respiratory depression: nalbuphine versus naloxone.
The authors compared naloxone and nalbuphine as antagonists of opioid-induced respiratory depression to determine the relative efficacies and safety of the two agents. In a double-blind, randomized fashion, 90 anesthetized patients received a mean dose of 25 micrograms/kg fentanyl during surgery. Inadequate spontaneous respirations at the end of anesthesia were treated with either naloxone 0.08 mg or nalbuphine 2.5 mg IV every 2 min while heart rate (HR), systolic and diastolic blood pressures (SBP, DBP), respiratory rate (RR), and tidal volume (TV) were measured at 2-min intervals. Arterial blood samples for analysis of PaCO2, PaO2, and pH were drawn when spontaneous ventilation resumed, and 30 and 60 min later. Narcotic antagonism and respiration were deemed adequate when TV was greater than or equal to 4 ml/kg and RR greater than or equal to 8 breaths/min. Heart rate, SBP, DBP, TV and RR were recorded, as were the occurrence of renarcotization (RR less than 8) and analgesic requirements every 5 min during the recovery room stay. Sixty of 90 patients required narcotic antagonism at the end of surgery. No patient required more than three doses (0.24 mg) of naloxone or four doses (10 mg) of nalbuphine. Both antagonists produced similar and moderate increases in SBP and HR while restoring adequate spontaneous ventilation. There were no significant differences in TV, RR, or arterial blood gases (ABGS) between the two groups after narcotic reversal.(ABSTRACT TRUNCATED AT 250 WORDS)


Percutaneous device closure of congenital and iatrogenic ventricular septal defects in adult patients.
We report our 10-year experience with percutaneous closure of adult congenital and acquired (non-post-infarct) ventricular septal defects (VSDs) using different types of Amplatzer occluder devices. Adult congenital and acquired VSDs may produce significant morbidity and mortality. Furthermore, such VSDs pose a significant surgical challenge. Between February 2000 and August 2009, data were retrospectively reviewed from 28 patients who underwent 29 procedures for percutaneous device closure of hemodynamically significant VSDs. Seventeen had unrepaired congenital VSDs, 10 had post-operative VSDs (5 with residual patch-margin defects, 4 post-aortic valve replacement, 1 post-myomectomy), and one had an acquired traumatic VSD. INDICATIONS FOR CLOSURE INCLUDED: symptoms related to significant shunt (dyspnea on exertion); unexplained deterioration of LV function, and/or LV dilation; recurrent endocarditis, and pulmonary hypertension. Outcome parameters were procedural success, procedure-related complications, evidence of residual shunt by echocardiography, and improvement in the signs/symptoms for which the procedure was performed. The mean follow-up interval was 68 months. Of the 28 patients studied, a single VSD was present in 26 patients, while one patient had two defects, and one patient had one defect on the LV side with three openings at the RV side. The median size of the defects by echocardiography was 6 mm. A device was successfully implanted in 28 of 29 (97%) procedures and 28 of 28 (100%) patients. PROCEDURE-RELATED COMPLICATIONS OCCURRED IN TWO CASES: one involving an access site hematoma not requiring transfusion as well as nonsustained ventricular tachycardia that resolved spontaneously and the other involving acute mitral regurgitation due to inadvertent trapping of the anterior mitral valve leaflet between the left ventricular disk and the septum that was resolved by recapturing of the disk. There was immediate complete closure in 20 patients (71%). In six cases there was trivial residual shunt and in two patients the residual shunt was mild. At the latest follow-up, four of the eight with a residual shunt had no shunt and in the remaining four the residual shunt was trivial. Among symptomatic patients 18 (64%), there was marked improvement in symptoms and for those patients 17 (61%) for whom the procedure was performed to address left ventricular enlargement, there was reduction or stabilization in LV size on serial echoes. Percutaneous closure of VSDs in the adult patient appears to be safe and effective.


Effect of organosolv ethanol pretreatment variables on physical characteristics of hybrid poplar substrates.
Hybrid poplar (Populus nigra x P. maximowiczii) chips were pretreated using an organosolv ethanol process. The effect of pretreatment conditions (temperature, time, catalyst, and ethanol concentration) on the substrate characteristics, including fiber size, crystallinity, and degree of polymerization of cellulose, was investigated using an experimental matrix designed with response surface methodology. The conditions ranged 155-205 degrees C, 26-94 min, 0.83-1.67% catalyst (H(2)SO(4)) on oven-dry wood chip (w/w), and 25-75% ethanol concentration (v/v). The results indicated that the substrate characteristics are controllable and predictable. Desirable substrates can be prepared by fine-tuning the processing parameters. The regression models developed, allowed the quantitative prediction of the substrate characteristics from the pretreatment conditions used.


De Novo Extra-Thyroidal Manifestations of Graves' Disease presenting 16 Years after Total Thyroidectomy for Thyroid Cancer.
We present a 61-year-old Chinese female who had a history of angioinvasive follicular thyroid cancer (FTC) treated with total thyroidectomy 16 years ago, without radioactive iodine (RAI) treatment who now presents with de novo pretibial myxedema (PTM) followed by active severe Graves' ophthalmopathy (GO) requiring pulse steroids and radiotherapy.


Contamination by metallic elements released from joint prostheses.
When a metallic implant is in contact with human tissues, the organism reacts and a corrosion process starts. Consequently, we might observe liberation of metallic debris and wear. Our purpose is to measure the contamination and the migration of these metallic elements in the surrounding tissues of the implant. Two types of samples have been studied. First type is sample taken on post-mortem tissues around prostheses to study contamination gradients. Second type is sample taken on pathologic joints on periprosthetic capsular tissues in surgical conditions. These allow estimating contamination degree. The experiments were made on a Van de Graaff accelerator located at CERI (Centre d'Etude et de Recherche par Irradiation, Orléans, France). We measure elemental concentrations resulting from the contamination of the surface of each sample. Results are analysed in function of the pathology and the type of implants. According to the pathology and the location of the sampling, these measurements show a very heterogeneous contamination by metallic elements under particles and/or ionic species which can migrate through soft tissues by various mechanisms.


Risk Analysis of Breast Cancer by Using Bilateral Mammographic Density Differences: A Case-Control Study.
The identification of risk factors helps radiologists assess the risk of breast cancer. Quantitative factors such as age and mammographic density are established risk factors for breast cancer. Asymmetric breast findings are frequently encountered during diagnostic mammography. The asymmetric area may indicate a developing mass in the early stage, causing a difference in mammographic density between the left and right sides. Therefore, this paper aims to propose a quantitative parameter named bilateral mammographic density difference (BMDD) for the quantification of breast asymmetry and to verify BMDD as a risk factor for breast cancer. To quantitatively evaluate breast asymmetry, we developed a semi-automatic method to estimate mammographic densities and calculate BMDD as the absolute difference between the left and right mammographic densities. And then, a retrospective case-control study, covering the period from July 2006 to October 2014, was conducted to analyse breast cancer risk in association with BMDD. The study included 364 women diagnosed with breast cancer and 364 matched control patients. As a result, a significant difference in BMDD was found between cases and controls (P < 0.001) and the case-control study demonstrated that women with BMDD > 10% had a 2.4-fold higher risk of breast cancer (odds ratio, 2.4; 95% confidence interval, 1.3-4.5) than women with BMDD ≤ 10%. In addition, we also demonstrated the positive association between BMDD and breast cancer risk among the subgroups with different ages and the Breast Imaging Reporting and Data System (BI-RADS) mammographic density categories. This study demonstrated that BMDD could be a potential risk factor for breast cancer.


Inhibiting NF-κB-Mediated Inflammation by Catechol-Type Diphenylbutadiene via an Intracellular Copper- and Iron-Dependent Pro-Oxidative Role.
Chronic inflammation mediated by nuclear factor-κB (NF-κB) plays a crucial role in the development of cancer. As part of our continuous efforts placed on investigating anticancer mechanisms of dietary catechols, we further applied catechol-type diphenylbutadiene (3,4-DHB) as a model molecule to probe whether it inhibits inflammation by its pro-oxidative role. Employing lipopolysaccharide-stimulated RAW264.7 cells as a model of inflammation, we validated that benefiting from its catechol moiety, 3,4-DHB inhibited significantly the LPS-induced formation of NO (11.48 ± 0.39 μM) compared with the only LPS-stimulated group (31.8 ± 1.78 μM) with an inhibitory rate of 64% at 5 μM, expression of iNOS and COX-2 proteins, phosphorylation of IkB kinase and IkBα, and nuclear translocation of NF-κB. Noticeably, its inhibitory activity against the NF-κB-mediated inflammation can be obviously revised by pretreatment of the cells with dithiothreitol (a quencher of both electrophilic o-quinone and ROS), neocuproine (a specific chelating agent for copper ions), and deferoxamine (a specific chelating agent for iron ions). The above results support that depending on intracellular copper and iron ions, 3,4-DHB, a pro-electrophile, can be converted into its corresponding o-quinone electrophile together with the generation of ROS, a pro-oxidative event that mediates its inhibitory activity against NF-κB signaling and inflammation. The copper- and iron-dependent inhibition against inflammation supports that dietary catechols are probably pro-oxidative anti-inflammatory agents.


Ten-year epidemiological study of chemical burns in Jinshan, Shanghai, PR China.
The epidemiological pattern of chemical burns varies widely in different areas of the world. To analyse effective preventive approaches, an insight into the pattern of injury is desirable. However, our data are only limited to Shanghai area, China. A 10-year retrospective review includes all patients with chemical burns admitted to the Department of Burn and Plastic Surgery from January 2001 to December 2010; those who were admitted to the ophthalmologic department or other departments were excluded. The data collected included age, gender, injury pattern, patient workplaces, aetiological agents, incidence by month and year, burn size, burn depth and site, time for immediate irrigation, length of hospital stay and outcome. A total of 615 patients admitted to our department for in-hospital treatment of chemical burn injury were included in the study. The mean age was 32.1±12.3 years with a range of 2-66 years. A total of 562 cases (91.4%) were male and 53 cases (8.6%) female. The mean total burn surface area (TBSA) was 30.3±24.7% with a mean full-thickness burn area of 17.5±23.8%. Most chemical burns took place in summer and fall. The majority of chemical burns were work related (93.0%); among them accidents that happened in private factories were predominant (70.8%). Although caustic soda was the leading cause of all chemical burns (15.8%), acid burn was the most common (45.2%). The extremities were the most frequent areas of injuries, followed by head and neck. Most cases had none (30.4%) or insufficient (61.1%) immediate irrigation after injury. In all patients, 47 cases had inhalation injuries, 94 cases accompanying ophthalmologic burns, 51 cases accompanying other associated injuries and 67 cases chemical toxicity. A total of 212 cases (34.5%) underwent early total or tangential excision and skin or skin flap grafting in the first week after injury. The mean length of hospital stay was 44.1±24.7 days. Sixteen cases died of respiratory failure, sepsis or multiple organ dysfunction syndrome (MODS), giving a mortality rate of 2.6%. Safety training, preventive measures and following safety rules and strict regulation are of paramount importance for workers to prevent and reduce chemical burns in chemical enterprises, especially in private factories. Appropriate first-aid training that includes copious spot lavage should be emphasised. Eschar excision as early as possible and skin or skin flap grafting in deep wounds could reduce the possibility of poisoning and disability.


Stereocilia bundle stiffness: effects of neomycin sulphate, A23187 and concanavalin A.
The effects that the aminoglycoside antibiotic neomycin sulphate, the ionophore A23187 and the lectin Concanavalin A (Con A) have on the steady state stiffness of the hair-cell stereocilia bundle have been studied using organotypic cultures of the early postnatal mouse cochlea. In normal saline, stereocilia bundle stiffness is increased 1.5-2.0 fold by neomycin sulphate, 1.3-1.7 fold by the ionophore A23187 and 3.0-5.0 fold by Con A. In low-calcium saline neither neomycin sulphate nor A23187 cause increases in stiffness, and the stiffness increases elicited by these two agents in normal saline are reversed on washout with low-calcium saline. In normal saline neomycin sulphate has two independent effects on hair cells; one effect is a reversible inhibition of transduction and the other effect is to cause an irreversible increase in bundle stiffness. Neither Con A nor the ionophore A23187 block transduction. No obvious changes in stereocilia bundle morphology are associated with the increases in stiffness caused by neomycin sulphate, A23187 and Con A. Succinylated Con A binds to stereocilia bundles but does not cause an increase in stiffness, suggesting that the stiffness increase caused by native Con A results from receptor cross-linking. The effects of Con A and neomycin are non-additive, saturating concentrations of neomycin sulphate block the effects of low doses of Con A, and pretreatment of cells with succinylated Con A prevents subsequent neomycin sulphate treatment from causing an increase in stiffness suggesting that neomycin sulphate and Con A are acting via a similar mechanism at the cell surface. Ionophore treatment prevents the subsequent application of neomycin sulphate from causing a further increase in stiffness, but when cells are treated with neomycin sulphate followed by ionophore the effects of the two drugs are additive indicating that they are operating via different mechanisms. The possible nature of these mechanisms and their role in the control of steady state stereocilia bundle stiffness are discussed.


Efficacy and prognostic value of simple wound measurements.
To assess the association between planimetric wound area and simple wound measurements. To ascertain the applicability of planimetry-based research to clinical practice. A retrospective cohort study of 260 consecutive patients followed up for at least 24 weeks. Outpatient dermatology department of a major medical center. Wounds were measured using computer-based planimetry and were treated according to a standard protocol for venous leg ulcers. Two hundred sixty patients with venous leg ulcers. Complete ulcer healing at 24 weeks. Using the Pearson, Spearman, and Kendall correlation coefficients, we found a tight correlation between planimetric wound area and wound width, length, width x length, perimeter, and area based on the formula for an ellipse. The values for all correlation coefficients were greater than 0.80 (P < .001 for all associations). Width, length, length x width, and elliptical area measurements all correlated closely with failure to heal (P < .001). The correlation between simple values and planimetric area dropped considerably for wounds more than 40 cm2, which represented 6% of the wounds in this study. The equivalence between simple and planimetric wound measurements allows for the extrapolation of wound measurements from clinical trials to clinical practice, and suggests that simple wound measurements may confidently be used as predictors of healing in the clinical setting.


Advanced cardiac life support certification for student pharmacists improves simulated patient survival.
Basic life support (BLS) and advanced cardiac life support (ACLS) skills performance, as well as simulated patient survival, were compared for student pharmacist teams with and without at least one member with American Heart Association (AHA) ACLS certification. Doctor of pharmacy students in their third professional year completed a high-fidelity mannequin simulation. Within the previous year, 30 of 184 students (16%) completed ACLS certification. Rapid response teams (n = 31) of five to six members were formed through random student assignment. Two AHA instructors recorded and assessed performance using a checklist adapted from the AHA's standardized forms for BLS and ACLS assessment. Teams with and without ACLS certified members were compared for skills performance and simulated patient survival (i.e. correct performance of all BLS and ACLS skills). Teams with ACLS certified members (n = 21) were superior to teams without certified members (n = 10) for correct performance of all observed BLS and ACLS skills, including pulse assessment and medication selection for cardiovascular support. For teams who had ACLS certified members, simulated patient survival was 86% higher. The study groups did not differ in their ability to calculate a correct vasopressor infusion rate if warranted. BLS and ACLS skills performance were improved by AHA ACLS certification. Additionally, simulated patient survival was improved for teams with students who had at least one ACLS certified member.


Effect of porcine plasma on growth and health of Holstein calves.
The objective of this trial was to compare the health and performance of calves provided high feeding rates of a whey-based all-milk-protein calf milk replacer (MR) with those fed an MR containing either 5% or 10% porcine plasma, which replaced, respectively, either 15% or 30% of the whey-based proteins in the MR formula. A total of 320 male Holstein calves weighing a mean (± SD) of 47.8 ± 4.1 kg were sourced from local dairy farms, auction facilities, and local order buyers. Calves arrived at the research facility in 4 batches of 80 animals each and were randomly assigned to 1 of 3 groups: (1) MR composed of whey-based milk proteins (control group); (2) whey replacement of 5% spray-dried porcine plasma (replacing 15% of protein); or (3) whey replacement of 10% spray-dried porcine plasma (replacing 30% of protein). Calves were housed in individual pens for the first 56 d of the experiment and offered, twice daily, a 26% crude protein (CP), 20% fat MR standardized using synthetic amino acids to 2.4% lysine, 0.8% methionine, and 1.6% threonine. Amounts of MR offered from wk 1 to 8 were 0.65, 0.78, 0.91, 1.04, 1.04, 0.78, 0.52, and 0.325 kg/d, respectively. Calves were also offered a 20% CP texturized calf starter from d 0 to 56 and then transitioned over 7 d (d 56-62) of a 50% calf starter and 50% corn and pellet ration with 2% straw to a corn and pellet ration with 2% straw (18.1% CP) for the remainder of the experiment (d 63-77). Calves were individually weighed upon arrival, weekly through d 56, and at d 77. Grain was fed ad libitum, and remaining grain was weighed weekly to determine weekly consumption. Remaining grain was discarded and was replaced with fresh grain that was weighed and recorded. All milk was offered individually via bucket twice daily, and refusals were recorded following milk feeding by weighing back the remaining unconsumed milk solution. Calves were health scored twice daily, and any medical treatments or mortality were recorded. Time to mortality and medical treatments were analyzed using survival analysis, health scoring data were analyzed using a generalized linear model, and growth was evaluated using a mixed repeated-measures linear regression model. No differences in mortality or incidence of diarrhea were noted between groups. Although there was a high incidence of respiratory disease (65%), no differences were found between groups. Over the entire experimental period, calves gained 67.0 ± 14.9 kg; however, no differences in growth among groups were noted, with the exception that, on d 77, BW was greater for calves in the control group (115.8 ± 15.5 kg) compared with those fed a MR with 5% porcine plasma (113.4 ± 17.8 kg). No differences were found between groups with respect to feed conversion. In this study, an MR composed of either 5% or 10% spray-dried porcine plasma performed comparably to a whey protein-based MR.


Biopolymers Used for Receptor Immobilization for Nickel-Detection Biosensors in Food.
Food is humans' main source of nickel intake, which is responsible for the prevalence of allergic contact dermatitis and other pathological afflictions. While robust, the classical methods for nickel detection-atomic absorption spectrometry and inductively coupled plasma mass spectrometry-are expensive and laborious; in contrast, modern methods that utilize sensors-of which most are electrochemical-have rapid run times, are cost-effective, and are easily assembled. Here, we describe the use of four biopolymers (alginate, agar, chitosan, and carrageenan) for receptor immobilization on biosensors to detect nickel ions and use an optimization approach with three biopolymer concentrations to assay analytical performance profiles. We measured the total performance of screen-printed carbon electrodes immobilized with the biopolymer-sensor combinations using cyclic voltammetry (CV). Voltammetric behavior favored the carrageenan biosensor, based on performance characteristics measured using CV, with sensitivities of 2.68 (for 1% biopolymer concentration) and 2.08 (for 0.5% biopolymer concentration). Our results indicated that among the four biopolymer combinations, carrageenan with urease affixed to screen-printed electrodes was effective at coupling for nickel detection.


Surgery and immunotherapy in renal cell carcinoma involving inferior vena cava.
We herein report 4 cases of renal cell carcinoma with vena caval extension. Appropriate diagnostic studies and a planned surgical approach is the most effective treatment for intravascular spread. Accurate preoperative staging is important for a successful outcome. Although the technical challenges involved in performing a nephrectomy are substantial, these cases illustrate that standard nephrectomy with evacuation of tumor thrombus, ligation of the left renal vein, and even partial resection of the inferior vena cava can be performed with an acceptably low morbidity.


Unusual cause at an unusual time-Powassan virus rhombencephalitis.
Powassan virus lineage II (POWV) is an emerging tick-borne neurotropic pathogen, transmitted to humans by the bite of infected Ixodes scapularis ticks. In the United States, the disease is most prevalent in the Northeast and the upper Midwest and occurs mostly during the spring and summer months when tick activity is the highest. Some patients infected with POWV develop severe encephalitis, with high mortality. We report the case of a 42-year-old healthy man who developed progressive diplopia and dysarthria in December following a deer hunting trip. Routine blood work was unrevealing and MRI was normal. Extensive work-up for infectious, autoimmune, and paraneoplastic causes was positive only for POWV. The patient was treated with supportive care and intravenous corticosteroids, with an excellent outcome. We present a rare clinical presentation of a potentially fatal emerging disease that responded favorably to corticosteroids.


Can a signature molecular-profile define disparate survival in BRAF-positive Gliosarcoma and identify novel targets for therapeutic intervention?
Gliosarcoma (GS) has a low incidence but is aggressively invasive, with poor-survival. Even though GS is recognized as a different subgroup from glioblastoma (GB), there is no molecular panel available to define its clinical outcome. The objective was to identify the molecular imprint of GS in terms of expression of human telomerase reverse transcriptase (hTERT), high mobility group A1 (HMGA-1), kinesin superfamily protein-14 (KIF-14), epidermal growth factor receptor (EGFR) markers with reference to disparate prognosis and identify plausible targets for intervention. We retrieved 9-GS samples from a cohort of 57-GB patients during a 36 months study period and compared them with 10 molecularly typed GB-samples and 15 controls. Conventional-immunohistochemistry (IHC) was used for histopathology of GS and immunofluorescence-IHC was performed for quantification of identified marker-panel. Statistical tools for non-parametric data were used for inferring results. GS was confirmed by reticulin-staining and positivity for glial fibrillary acidic protein, Vimentin, smooth muscle actin. Immune-reactivity for BRAF-V600Ewas present in both glial and sarcomatous cells and negative expression of isocitrate dehydrogenase, ATRX, TP53.Comparison between GS, GB, and control tissues showed that the expression of markers reached significance (P < 0.0001), without the influence of confounders. Significant correlation of EGFR was found with hTERT (r = 0.77), HMGA-1 (r = 0.72), KIF-14 (r = 0.82) suggesting that their combined analysis can define prognosis. To establish the diagnostic accuracy (threshold ≥80% specificity), AUC for EGFR was 0.78 (>3.95), KIF-14 0.97 (>7.45), hTERT 0.63 (>23.86), and HMGA-1 0.53 (>15.45). This is the first evidence-based investigation presenting differential expression of proliferation and stemness markers hTERT, HMGA-1, KIF-14 in-correlation with EGFR, indicating a plausible-association between survival and disease-progression in individual GS-cases. It can serve as a model for further studies in this glioma-subgroup and the designing of a target panel for personalized treatment.


Isolation and characterization of a T7-like lytic phage for Pseudomonas fluorescens.
Despite the proven relevance of Pseudomonas fluorescens as a spoilage microorganism in milk, fresh meats and refrigerated food products and the recognized potential of bacteriophages as sanitation agents, so far no phages specific for P. fluorescens isolates from dairy industry have been closely characterized in view of their lytic efficiency. Here we describe the isolation and characterization of a lytic phage capable to infect a variety of P. fluorescens strains isolated from Portuguese and United States dairy industries. Several phages were isolated which showed a different host spectrum and efficiency of lysis. One of the phages, phage phiIBB-PF7A, was studied in detail due to its efficient lysis of a wide spectrum of P. fluorescens strains and ribotypes. Phage phiIBB-PF7A with a head diameter of about 63 nm and a tail size of about 13 x 8 nm belongs morphologically to the Podoviridae family and resembles a typical T7-like phage, as analyzed by transmission electron microscopy (TEM). The phage growth cycle with a detected latent period of 15 min, an eclipse period of 10 min, a burst size of 153 plaque forming units per infected cell, its genome size of approximately 42 kbp, and the size and N-terminal sequence of one of the protein bands, which gave similarity to the major capsid protein 10A, are consistent with this classification. The isolated T7-like phage, phage phiIBB-PF7A, is fast and efficient in lysing different P. fluorescens strains and may be a good candidate to be used as a sanitation agent to control the prevalence of spoilage causing P. fluorescens strains in dairy and food related environments.


Graft-versus-adult T-cell leukemia/lymphoma effect following allogeneic hematopoietic stem cell transplantation.
Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has proven effective in adult T-cell leukemia/lymphoma (ATL) patients. To study the graft-versus-ATL (Gv-ATL) effects after allo-HSCT, we analyzed 21 ATL patients who had been treated at our hospital. Of these, 18 had acute-, 2 had lymphoma- and 1 had chronic-type ATL; at allo-HSCT, seven patients were in CR, one was in PR, five had stable disease (SD) and eight had progressive disease (PD). Disease state after allo-HSCT was CR in 14, PR in 3, SD in 1 and PD in 3 patients. Among 15 patients who survived longer than 100 days, ATL relapsed in 10 patients, skin relapsed in 9 patients and 5 had relapsed on the skin alone. After we discontinued immunosuppressant therapy in these 10 patients, 8 manifested GVHD; ATL was ameliorated to CR in 6 patients. Donor lymphocytes were infused into two patients who did not show GVHD; one obtained CR. In five patients with skin relapse alone, four patients achieved CR following the discontinuation of the immunosuppressants. Our results demonstrate that relapse of ATL after allo-HSCT tends to develop on skin, and Gv-ATL effects played a critical role in the outcome of allo-HSCT for ATL.


Evaluation of potential immune response and in vivo survival of riboflavin-ultraviolet light-treated red blood cells in baboons.
Pathogen reduction methods have the potential to modify blood components, resulting in immunologic reactions or compromised blood components. This study evaluated the hypothesis that there is no immune response to riboflavin-and-ultraviolet [UV]-light-treated red blood cells (RBCs), as observed by serology and by survival of RBCs in circulation. Three baboons were in each treatment group: 1) untreated (negative control), 2) quinacrine mustard (QM)-treated (positive control), and 3) riboflavin-and-UV light-treated (test group) RBCs. In the immunization phase, autologous test or control RBCs were injected subcutaneously on Days 0, 21, 42, and 49. Plasma samples from these days were tested against test or control RBCs by flow cytometry and standard serology. On Day 56, autologous (51)Cr-labeled test or control RBCs were injected. Blood samples were taken over 21 days after injection to determine RBC survival (t(1/2)). Untreated and riboflavin-and-UV-light-treated RBCs showed no evidence of significant immunoglobulin G (IgG) binding after incubation with autologous plasma. RBC-bound IgG was detected on QM-treated RBCs after incubation with autologous plasma. This antibody was inhibited by QM, as demonstrated by a hapten inhibition study. t(1/2) values for the untreated and riboflavin-and-UV-light-treated RBCs were 7.3 +/- 0.8 and 7.5 +/- 1.7 days, respectively; the t(1/2) value for QM-treated RBCs was 2.3 +/- 2.9 days. Treatment with riboflavin and UV light did not render RBCs immunogenic. Positive controls indicated that immunization promoted an immune response. In the (51)Cr-labeled RBC survival phase of the study, riboflavin-and-UV-light-treated RBCs exhibited behavior similar to negative control RBCs. Detrimental immunologic or functional side effects were not observed.


Debriefing process can strengthen process for critical incidents.
Although debriefings can be extremely short, they are shown to improve performance. Team leaders must create an atmosphere where members feel free to express their opinions. Quality managers can conduct "mini studies" to demonstrate the effectiveness of debriefings.


Bilateral bifid mandibular condyles diagnosed with three-dimensional reconstruction.
Bifid mandibular condyles (BMCs) are rare anomalies. The overwhelming majority of prior reports described their predominantly unilateral occurrence diagnosed by panoramic radiography. We present an even rarer case of bilateral BMC initially identified by panoramic radiography and confirmed with colour-enhanced three-dimensional CT. These images substantiate the theory that the secondary condyles arise from the neck of the mandible (Lopez-Lopez et al. Bifid condyle: review of the literature of the last 10 years and report of two cases. Cianio 2010; 28: 136-140).


A hybrid repair of a superior mesenteric artery pseudoaneurysm using open mesenteric bypass and endovascular exclusion.
Superior mesenteric artery (SMA) aneurysms and pseudoaneurysms are uncommonly encountered in vascular surgery practice, but they typically require repair. Historically, they have been repaired with open aneurysmorrhaphy, bypass and exclusion, or simple ligation. More recently, endovascular repair with coil embolization and stent graft exclusion have been advocated. We present a repair of an SMA pseudoaneurysm via a hybrid approach with common hepatic artery to SMA bypass, exclusion of the pseudoaneurysm with ligation of the SMA proximal to the bypass, plug occlusion of the proximal SMA, and coil embolization of the pseudoaneurysm.


Prothymosin alpha: a ubiquitous polypeptide with potential use in cancer diagnosis and therapy.
The thymus is a central lymphoid organ with crucial role in generating T cells and maintaining homeostasis of the immune system. More than 30 peptides, initially referred to as "thymic hormones," are produced by this gland. Although the majority of them have not been proven to be thymus-specific, thymic peptides comprise an effective group of regulators, mediating important immune functions. Thymosin fraction five (TFV) was the first thymic extract shown to stimulate lymphocyte proliferation and differentiation. Subsequent fractionation of TFV led to the isolation and characterization of a series of immunoactive peptides/polypeptides, members of the thymosin family. Extensive research on prothymosin α (proTα) and thymosin α1 (Tα1) showed that they are of clinical significance and potential medical use. They may serve as molecular markers for cancer prognosis and/or as therapeutic agents for treating immunodeficiencies, autoimmune diseases and malignancies. Although the molecular mechanisms underlying their effect are yet not fully elucidated, proTα and Tα1 could be considered as candidates for cancer immunotherapy. In this review, we will focus in principle on the eventual clinical utility of proTα, both as a tumor biomarker and in triggering anticancer immune responses. Considering the experience acquired via the use of Tα1 to treat cancer patients, we will also discuss potential approaches for the future introduction of proTα into the clinical setting.


ACOG Practice Bulletin: clinical management guidelines for obstetrician-gynecologists. Number 45, August 2003. Cervical cytology screening (replaces committee opinion 152, March 1995).
Although cervical cancer was the leading cause of cancer death in American women as recently as the 1930s, both the incidence and mortality from cervical cancer have decreased by almost one half since the early 1970s, largely as a result of widespread screening with the Pap test. However, the annual incidence rate has remained at approximately 8 cases per 100,000 women over the past few years. New technology for performing cervical cytology is evolving rapidly as are recommendations for classifying and interpreting the results. The purpose of this document is to provide a review of the best available evidence on screening for cervical cancer. Specific equipment and techniques for performing cervical cytology and interpretation of the results are discussed elsewhere.


Purification of a dimethyladenosine compound from silkworm pupae as a vasorelaxation substance.
To identify the active substance in the male silkworm pupae that strengthens men's vitality, the vasorelaxation activity was determined by measuring the vascular endothelial nitric oxide (eNO) produced in calf pulmonary artery endothelial (CPAE) cells treated with extracts from the pupae. Dried silkworm male pupae were extracted with ethanol and suspended in water, then partitioned with hexane, chloroform, ethylacetate, and butanol, sequentially. Among these fractions, the aqueous fraction had maximal NO production (156.87 microM/200 microl well, 10 mg/ml) and minimal cytotoxicity (IC50 362.3 mg/ml). The vasorelaxation substances (VAS) from the aqueous fraction were isolated by a combination of gel filtration and anion-exchange chromatography on DEAE Sephadex A-25 and reverse phase-HPLC. Their chemical structures were determined on the basis of their spectroscopic parameters of EI-MS, MALDI-TOF MS, 1H and 13C NMR, 1H-1H COSY, and GC-MS spectral data. The active substance was subsequently identified as a dimethyladenosine and dimethyladenosine-5'-L-arabinose that has phosphodiesterase (PDE) inhibition activity. This compound was shown to inhibit PDE4 activity in a dose-dependent manner. Also, it inhibited the PDE5 activity of cyclic-GMP-specific PDE5 enzyme. These results imply that dimethyladenosine may be a lead compound for the development and improvement of vasculogenic impotence drugs through phosphodiesterase inhibition and NO production in endothelial cells.


Localization of the accessory pathway in the Wolff-Parkinson-White syndrome from the ventriculo-atrial conduction time of right ventricular apical extrasystoles.
In 18 consecutive patients with the Wolff-Parkinson-White syndrome undergoing electrophysiologic study, the ventriculo-atrial conduction time of right ventricular apical extrasystoles which advanced atrial activation during circus movement tachycardia was studied in relation to accessory pathway location. Accessory pathway location was determined by delta wave morphology during maximal pre-excitation, mapping of atrial activation during circus movement tachycardia and ventricular pacing, the effect of bundle branch block on ventriculo-atrial conduction time during circus movement tachycardia, and the effect of pacing from different sites in the atria on the stimulus-to-delta wave interval. In 7 patients with septal accessory pathways, ventriculo-atrial conduction time was similar during circus movement tachycardia and following right ventricular apical extrasystoles (mean difference 0 +/- 6 ms, range -5 to +10 ms). In contrast, in 11 patients with a left free wall accessory pathway, ventriculo-atrial conduction time increased by 46 +/- 15 ms (range 15 to 65 ms) following right ventricular apical extrasystoles. Therefore, measurement of the ventriculo-atrial conduction time of right ventricular extrasystoles during circus movement tachycardia provides an easy way to distinguish between septal and left free wall accessory pathways. This finding may be of particular use in determining the location of concealed bypass tracts.


Bile duct complications of hepatic arterial infusion chemotherapy evaluated by helical CT.
To describe the imaging findings of bile duct complications of hepatic arterial infusion chemotherapy (HAIC) using helical CT, to set diagnostic criteria, to develop a CT grading system, and to correlate these with clinical findings and laboratory data. Follow-up helical CT of the abdomen was performed every 3 months for 60 patients receiving HAIC. Three radiologists reviewed all CT studies before and after treatment, using either the picture archiving and communication system or hard copies. The findings of bile duct abnormalities were correlated with findings from other imaging techniques, clinical symptoms and laboratory data. Bile duct abnormalities developed in 34 (57%) of cases either during HAIC or 1 to 12 months after treatment. In 14 (41%) of these 34 patients, enhancement of the hepatic parenchyma along the dilated bile duct or in the segmental or lobar distribution was observed. In 43 cases (72%), normal or abnormal alkaline phosphatase levels were consistent with normal or abnormal CT findings, respectively. Increasing alkaline phosphatase and bilirubin levels were related to CT grade. Imaging findings of bile duct complications of HAIC are similar to those of primary sclerosing cholangitis, and correlate well with abnormal clinical and laboratory data. In the presence of such clinical abnormalities, thin-section helical CT with careful review of the imaging studies helps to determine the correct diagnosis, monitor the changes and guide appropriate treatment.


Tanshinone IIA attenuates atherosclerosis in ApoE(-/-) mice through down-regulation of scavenger receptor expression.
This study is designed to investigate the protection of tanshinone IIA (TSIIA) against atherosclerosis in apolipoprotein E deficient (ApoE(-/-)) mice and to explore the mechanisms by focusing on the expressions of scavenger receptors, scavenger receptor-A (SR-A) and CD36. The in vivo study demonstrated that TSIIA (10-90mg/kg) inhibited the atherosclerotic lesions, down-regulated the CD68 protein expression in lesion and decreased the contents of cholesterol in aortas of ApoE(-/-) mice. In addition, TSIIA reduced the serum levels of oxidized LDL (oxLDL) and down-regulated the mRNA expression of CD36, SR-A and peroxisome proliferator-activated receptor gamma (PPARγ) in aortas. The in vitro study showed that TSIIA (0.1-10μM) decreased cholesterol level and DiI-oxLDL uptake in mouse peritoneal macrophages treated with oxLDL (50μg/ml). In addition, TSIIA down-regulated the mRNA and protein expression of CD36 but not that of SR-A in oxLDL treated macrophages. TSIIA also down-regulated the mRNA expression of PPARγ in oxLDL treated macrophages. Furthermore, TSIIA reduced the mRNA expression of CD36 in macrophages treated with PPARγ agonist 15d-PGJ(2) (2μM) or troglitazone (50μM), whereas both 15d-PGJ(2) (0.5-1.5μM) and troglitazone (5-20μM) dose-dependently abolished the down-regulation of CD36 expression by TSIIA in oxLDL treated macrophages. These results suggest that TSIIA attenuates the atherosclerotic lesion in ApoE(-/-) mice, which might be attributed to the properties of both anti-oxidation and down-regulation of scavenger receptors. Furthermore, antagonism of PPARγ might be involved in the down-regulation of CD36 by TSIIA.


Mecamylamine in Tourette's syndrome: a two-year retrospective case study.
To test the efficacy and safety of a nicotinic, acetylcholine antagonist, mecamylamine, in the treatment of Tourette's syndrome (TS). This is a retrospective, open-label study of 24 patients; 18 of whom were not responding to accepted medication for treatment of their TS and six of whom were receiving no medication. All 24 of them received mecamylamine in 2.5-6.25 mgm/day dose, at varying starting dates during the years June 1997 to June 1999. There were four females, 20 males, with 19 patients under the age of 18 years and five over the age of 18. Efficacy was evaluated by the Clinical Global Impression Scale (CGI); safety by adverse events notes during the time mecamylamine was administered. The number of days each patient received mecamylamine varied from 8 days to 550 days; with nine patients more than 200 days, six patients from 100-200 days, five patients for 50-100 days, and four patients 0-50 days. Comparing baseline CGI with that obtained on the date of last evaluation for each patient, a significant improvement in clinical assessment of severity of illness was obtained for the total group (Wilcoxon signed rank test, p < 0.0001). The six patients who received mecamylamine only also significantly improved (Wilcoxon signed rank test, p < 0.2). Case vignettes are described. Mecamylamine at 2.5-6.25 mgm/day has no significant peripheral parasympathetic activity and may be safely taken long term (up to 550 days in this study). It has a significant effect in relieving motor and vocal tics and in mood and behavior disturbances of children, adolescents, and adults with TS.


Measurements and future projections of Gd-based contrast agents for MRI exams in wastewater treatment plants in the Tokyo metropolitan area.
Large amounts of Gd-based contrast agents are used in magnetic resonance imaging (MRI) that are then excreted in urine. These agents are subsequently discharged into the environment because they are difficult to remove by usual sewage treatment techniques. In this study, changes of the Gd anomaly during wastewater treatment processes were determined by analyzing wastewater samples and the possibility for future prediction of the changes was evaluated based on the relationship between the Gd anomaly and the number of MRI devices in use. After the wastewater treatment processes, the values of final effluent were increased 1.8 times compared to those of influent, and the Gd anomaly of effluent had a positive correlation to the number of MRI devices. The finding suggested that the changes of environmental impact were predictable based on the number of MRI devices.


Ethanol lowers heart carnitine in the methionine and choline deficient rat.
In agreement with the findings of others, heart carnitine levels of male, weanling Sprague-Dawley rats fed nutritionally adequate liquid diets with 35% of calories as ethanol for 3 weeks were not different from control or pair-fed rats (Experiment 1). When ethanol was given as 30% of energy in combination with a diet deficient in methionine and choline, and the feeding period was extended to 5 weeks, heart carnitine levels were significantly affected (Experiment 2). Carnitine levels in whole heart homogenates of the methionine and choline deficient chronic ethanol-fed group were 2.14 +/- 0.74 mumoles per g dry wt. significantly lower (p less than 0.05) than deficient controls, 3.08 +/- 0.85 mumoles per g dry wt. We conclude that a methionine and choline deficient diet exacerbates the effects of alcohol on methyl-group metabolism so as to produce decrements in heart carnitine not seen when alcohol is given with an adequate diet.


The occurrence of lipidic particles in lipid bilayers as seen by 31P NMR and freeze-fracture electron-microscopy.
A new type of lipid organization is observed in mixtures of phosphatidyl-choline with cardiolipin (in the presence of Ca2+), monoglycosyldiglyceride and phosphatidylethanolamine (in the presence of cholesterol). This phase is characterised by an isotropic 31P NMR signal and is visualised by freeze-fracturing as particles and pits on the fracture faces of the lipid bilayer. As the most favourable model for this phase we propose the inverted micelle sandwiched in between the two monolayers of the lipid bilayer.


Interaction of E1B 19K with Bax is required to block Bax-induced loss of mitochondrial membrane potential and apoptosis.
The Bcl-2 homologous region 3 (BH3) is sufficient for interaction of pro-apoptotic with anti-apoptotic Bcl-2 family members, and functional antagonism may determine whether cell survival or death is the outcome of this protein-protein interaction. To address the biological role of BH3, two Bax-Bcl2 chimeras were generated in which 13 amino acids encompassing BH3 was swapped between anti-apoptotic Bcl-2 and pro-apoptotic Bax, thereby generating Bax with BH3 of Bcl-2 (Bax-BH3Bcl2), and Bcl-2 with BH3 of Bax (Bcl2-BH3Bax). Function and binding of the chimeras was then assessed utilizing the adenoviral Bcl-2 homologue, E1B 19K, which blocks apoptosis, and interacts with Bax, but not with Bcl-2. E1B 19K did not interact with Bax-BH3Bcl2 but did interact with Bcl2-BH3Bax. Bax-BH3Bcl2 retained pro-apoptotic function, while Bcl2-BH3Bax did not exhibit either pro- or anti-apoptotic activity. Thus, BH3 of Bcl-2 encodes binding specificity but not the apoptotic propensity. E1B 19K could not block Bax-BH3Bcl2-induced apoptosis, suggesting that E1B 19K may act to antagonize pro-apoptotic proteins rather than as an effector of survival. Furthermore, Bax expression disrupted the mitochondrial membrane potential, which could be rescued by E1B 19K expression. Thus, BH3 controls the binding specificity among Bcl-2 family members, and direct interaction between pro-apoptotic and anti-apoptotic proteins is a mechanism to regulate mitochondrial membrane potential and apoptosis.


Risk factors associated with history of falls in adults with intellectual disability.
Adults with intellectual disability (ID) have a higher risk for falls than the general population. The purpose of this study was to identify risk factors for falls in adults with ID using objective measurements. Eighty adults with ID (men 36 women 44 age 43 ± 13 years) provided data on falls history, health problems or limitations in daily life, physical activity (PA), and physical performance. We conducted independent-samples t-tests, and Chi-square (χ2) tests to examine the difference between fallers and non-fallers. Multivariate logistic regressions were performed to identify the independent effects of risk factors for falls in adults with ID. Fallers had significantly lower SPPB, mobility, and moderate PA than non-fallers (p < .05). Fallers were more likely to be older, need support with activities of daily living (ADLs), and have arthritis or rheumatism, walking problem, and limitations to participating in PA than non-fallers (p < .05). Among these variables, only needing support with ADLs remained a significant independent predictor of falls in a multivariate model. Support need for ADLs can predict falls in individuals with ID. Caregivers may need to closely monitor adults with ID who need support for ADLs.


Cetyltrimethylammonium bromide-coated titanate nanotubes for solid-phase extraction of phthalate esters from natural waters prior to high-performance liquid chromatography analysis.
As a novel nanomaterial, titanate nanotube has attracted considerable attention recently. However, most of the research work is focused on the preparation of this nanomaterial, and there is lack of information about its application in the fields of environmental monitoring and analytical chemistry. The purpose of our study is to investigate the feasibility of titanate nanotubes as an adsorbent for solid-phase extraction of several phthalate esters. The titanate nanotubes in this study were prepared by alkaline hydrothermal method. The cationic surfactant cetyltrimethylammonium bromide (CTAB)-titanate nanotube system was adopted based on hemimicelles/admicelles formed on the mineral oxide surface. It was shown in the batch experiment that the highest adsorption of phthalate esters onto the CTAB-titania and -titanate nanotube system occurred when the CTAB was varied from 100 to 200mgg(-1) titania or 80 to 300mgg(-1) titanate nanotube separately. According to the fluorescent spectra of a molecular probe, N-phenyl-1-naphthylamine, and the binding constant of solute in CTAB admicelles, the CTAB-titanate nanotube admicelles was more hydrophobic than CTAB-titania admicelles. Consequently, CTAB-titanate nanotube admicelles system was suitable for concentrating phthalates esters in water. An admicelle column was prepared with 100mg of titanate nanotubes by passing through 100mgg(-1) titanate nanotube of CTAB. And excellent collection yields were obtained for all the analytes when the sample volume was up to 1000mL. Under the optimal conditions, the detection limits found for di-n-propyl-phthalate, di-n-butyl-phthalate, di-cyclohexyl-phthalate, and di-n-octyl-phthalate were 39, 19, 35 and 20ngL(-1), respectively. The developed method was successfully applied to the analysis of several real water samples and satisfactory recoveries were achieved. All the results indicated the application potential of titanate nanotubes as solid-phase extraction adsorbents to pre-treat water samples.


Single neurones of the basal forebrain and laterodorsal tegmental nucleus project by collateral axons to the olfactory bulb and the mediodorsal nucleus in the rat.
The branching pattern of axons arising from cells in the basal forebrain and laterodorsal tegmental nucleus of the pontine grey, was examined using the double retrograde transport of rhodamine- and coumarin-labelled latex microspheres injected into the olfactory bulb and the mediodorsal thalamic nucleus. About 30-50% of basal forebrain neurones were double-labelled, and approximately 30-40% of laterodorsal tegmental neurones were double-labelled ipsilateral to the injections. No contralateral single or double label was observed in the basal forebrain, but approximately 30% of the contralateral laterodorsal tegmental projection was also double-labelled.


Effect of Home Cage Bedding in the Induction Chamber on Serum Cortisol and Corticosterone Levels in Response to Isoflurane-induced Anesthesia in C57BL/6J Mice.
Mice are routinely anesthetized with isoflurane in an induction chamber. The AVMA Guidelines for the Euthanasia of Animals states that distress should be minimized during euthanasia but does not address this point in regard to induction of anesthesia. Here we evaluated the potential for familiar surroundings to reduce the adrenocortical response of mice during anesthesia induction with isoflurane. However, adding bedding from the animals' home cage to the induction chamber failed to significantly reduce serum cortisol or corticosterone levels in male and female C57BL/6J mice. These results indicate that familiar surroundings do not appear sufficient to reduce the adrenocortical response of mice during anesthesia induction with isoflurane.


Sample evaporation from pierceable cups: still an important source of analytical error.
We illustrate the impact of sample evaporation on analytical results in laboratory practice and highlight preventive measures. Plasma (n=10) was analysed for glucose, Na(+), HCO(3)(-) and calcium on six different sample configurations at 5 time points within 2h. With time glucose, Na(+) and calcium values increased and HCO(3)(-) values decreased in a clinically significant way. Analytical error due to evaporation may be significant, but can be reduced with optimal sample handling. A pierceable cover does not prevent loss of HCO(3)(-).


Proteomic changes in Bacteroides fragilis exposed to subinhibitory concentration of piperacillin/tazobactam.
Bacteroides fragilis is the anaerobe most frequently isolated from clinical specimens and piperacillin/tazobactam is among the drugs that can be used to treat polymicrobial infections in which this bacteria is often involved. During antibiotic therapy, inhibitory concentrations of antibiotics are always followed by subinhibitory concentrations which can generate phenotypic changes in bacteria. So, in this study we aimed to evaluate changes in the proteomic profile of B. fragilis grown in a sub-MIC of PTZ, using 2-D electrophoresis followed by matrix-assisted laser desorption/ionization time-of-flight/time of-flight. Analysis of the 2-DE gels showed 18 spots with significantly different volume percentages between experimental conditions and 12 were successfully identified by MS/MS. Two proteins with decreased abundance in sub-MIC condition were involved in the glycolysis (glyceraldehyde-3-phosphate dehydrogenase and triose phosphate isomerase), others two involved in amino acid metabolism (Oxoacyl-(acyl-carrier protein) synthase II and dihydrodipicolinate reductase), and finally, one protein involved in fatty acid metabolism (UDP-N-acetylglucosamine acyltransferase). Among the proteins with increased abundance, we founded three ATP synthase (alpha, beta, and alpha type V), which could be involved in antibiotic bacterial resistance by efflux pump, one protein involved in glycolysis (enolase), and one involved in protein degradation (aminoacyl-histidine dipeptidase). In conclusion, our data show overall changes in the proteome of B. fragilis conducted by sub-MIC of PTZ, whose consequences on bacterial physiology deserve further investigation.


Lymphatic spread of ductal pancreatic adenocarcinoma is independent of lymphangiogenesis.
Early lymph node metastasis is common in pancreatic ductal adenocarcinoma (PDAC). The present study has examined the relationship of lymphatic spread to lymph vessel development and the expression of lymphangiogenic cytokines in a series of well-characterized PDACs. The hot spot method revealed the intratumoural and peritumoural lymphatic vessel density (LVD) to be slightly higher in PDACs than in the normal pancreas. The average intratumoural LVD, however, was strikingly decreased. There was no overexpression of vascular endothelial growth factor (VEGF)-C and VEGF-D in PDACs compared with the normal pancreas. LVD and expression of lymphangiogenic cytokines were not related to any of the biological tumour features or to patient survival. Three orthotopic nude mouse PDAC models did not reveal any increase in tumour-associated LVD, despite a high rate of lymph node metastasis. Lymph vessel proliferation was comparable in PDAC and chronic pancreatitis, in both humans and mice. In conclusion, increased lymphangiogenic activity is not required for and does not significantly affect the lymphatic spread of PDAC. The reduced number of human and murine intratumoural lymph vessels indicates that lymphatic metastasis takes place predominantly via peritumoural lymphatic vessels. The weak expression of lymphangiogenic cytokines in neoplastic cells and lymphatic vessel proliferation in peritumoural regions and chronic pancreatitis indicate that inflammation may be the reason for the low rate of lymphangiogenesis.


Identification and determination of ionic surface active agents.
A general colorimetric method has been developed to analyze either anionic or cationic surfactants in fresh water. An appropriate dye will react with ionic surfactant to form a chloroform-soluble, colored complex in the presence of chloroform. The color intensity of the vigorously rocked and subsequently settled chloroform layer is proportional to the concentration of the "dye-ionic surfactant complex", and can then be measured by making spectrophotometric readings of the chloroform solution at the optimum wavelength of the instrument used. When cationic surfactants are to be analyzed, methyl orange shall be used as a dye; when anionic surfactants are to be analyzed, azure A or methylene blue shall be used as a dye; Other chemical reagents, apparatus and spectrophotometers, however, can be nearly identical for either cationic surfactant or anionic surfactant measurement. The new analytical method is stoichiometric, and can be easily performed by a laboratory technician within a very short period of time.


Hyperpolarized 13 C NMR Spectroscopy of Urine Samples at Natural Abundance by Quantitative Dissolution Dynamic Nuclear Polarization.
Hyperpolarized nuclear magnetic resonance (NMR) offers an ensemble of methods that remarkably address the sensitivity issues of conventional NMR. Dissolution Dynamic Nuclear Polarization (d-DNP) provides a unique and general way to detect 13 C NMR signals with a sensitivity enhanced by several orders of magnitude. The expanding application scope of d-DNP now encompasses the analysis of complex mixtures at natural 13 C abundance. However, the application of d-DNP in this area has been limited to metabolite extracts. Here, we report the first d-DNP-enhanced 13 C NMR analysis of a biofluid -urine- at natural abundance, offering unprecedented resolution and sensitivity for this challenging type of sample. We also show that accurate quantitative information on multiple targeted metabolites can be retrieved through a standard addition procedure.


Sequence composition predicts immunoglobulin superfamily members that could share the intrinsically disordered properties of antibody CH1 domains.
Antibodies are central to the growing sector of protein therapeutics, and increasingly they are being manipulated as fragments and combinations. An improved understanding of the properties of antibody domains in isolation would aid in their engineering. We have conducted an analysis of sequence and domain interactions for IgG antibodies and Fab fragments in the structural database. Of sequence-related properties studied, relative lysine to arginine content was found to be higher in CH1 and CL than in variable domains. As earlier work shows that lysine is favoured over arginine in more soluble proteins, this suggests that individual domains may not be optimised for greater solubility, giving scope for fragment engineering. Across other sequence-based features, CH1 is anomalous. A sequence-based scheme predicts CH1 to be folded, although it is known that CH1 folding is linked to IgG assembly and secretion. Calculations indicate that charge interactions in CH1 domains contribute less to folded state stability than in other Fab domains. Expanding to the immunoglobulin superfamily reveals that a subset of non-antibody domains shares sequence composition properties with CH1, leading us to suggest that some of these may also couple folding, assembly and secretion.


In situ and operando magnetic resonance imaging of electrochemical cells: A perspective.
Nuclear Magnetic Resonance (NMR) spectroscopy and Magnetic Resonance Imaging (MRI) of electrochemical devices have become powerful tools for the in situ investigation of electrochemical processes. The techniques often take advantage of NMR's nondestructive/noninvasive properties, its sensitivity to frequency shifts, internal interactions, and transport processes, as well as its ability to measure liquid phases and disordered materials. Here, we provide a perspective on recent work on in situ MRI of electrochemical devices, batteries and relevant model systems, and discuss their applications and promises in assessing device performance, and electrochemical processes in cells.


Wing geometric morphometrics to distinguish and identify Haematobosca flies (Diptera: Muscidae) from Thailand.
The hematophagous flies of the genus Haematobosca Bezzi, 1907 (Diptera: Muscidae) are important ectoparasites in domestic animals and wildlife. Two species of this genus have been recorded in Thailand, viz., Haematobosca sanguinolenta (Austen, 1909) and Haematobosca aberrans (Pont, Duvallet & Changbunjong, 2020). They have a similar morphology and coexist in the same habitat. The correct species identification of these flies is extremely important for understanding disease epidemiology and developing effective control measures. Geometric morphometrics (GM) has been confirmed to be a useful tool for differentiating and identifying morphologically similar insect species. Therefore, GM was used to distinguish and identify H. sanguinolenta and H. aberrans in Thailand. Adult flies of both sexes were collected using Nzi traps, morphologically identified, and analyzed by landmark-based GM of the wing. Results showed that GM was highly effective in distinguishing the two Haematobosca species based on their wing shape, with an overall accuracy score of 99.3%. We also revealed that our study material could be used as reference data to identify new field specimens collected from other geographic locations. We propose that wing GM can be used as a supplement to conventional morphology identification, particularly for Haematobosca specimen that has been damaged or has lost its diagnostic characteristics due to specimen collection and processing in the field.


Pathogenicity of Mengo virus to mice. III. Potentiation of infection by immunosuppressants.
Mengo virus has been described to cause, in dependence on the virus dose, lethal panencephalomyelitis and exocrine pancreatitis in mice after i.p. inoculation. Two immunosuppressive agents, cyclophosphamide and 1,3-bis(piperidinomethyl)-5-ethyl-5-phenyl-barbituric acid (ZIMET 176/68), were shown to potentiate Mengo virus infection as demonstrated by histopathology and enhanced mortality. Organotropism of Mengo virus did not change under the drug treatment. However, the histological lesions in brain, spinal cord and pancreas failed to exhibit any inflammatory reaction in case of cyclophosphamide, due to its antiphlogistic properties. Considering the mode of action of the drugs employed and the pathogenesis of Mengo virus infection in mice, it is concluded that in the system used both cyclophosphamide and ZIMET 176/68 exert their potentiating effects by interfering with primary virus-macrophage interaction.


Co-existence of lepromatous leprosy and myasthenia gravis.
Various circulating autoantibodies are known to occur commonly in patients with lepromatous leprosy. However, the association with autoimmune diseases has rarely been reported. One such association of lepromatous leprosy with myasthenia gravis is being reported.


Fractional laser-assisted administration of human umbilical cord mesenchymal stem cells to reduce hypertrophic scars in rabbit ears.
The formation of hypertrophic scar is due to the abnormal accumulation and remodeling of the extracellular matrix, especially collagen tissue. Our research was designed to investigate the treatment effect of different administrations of human umbilical cord-derived stem cells and to hypertrophic scars on rabbit ears. Thirty New Zealand female white rabbits were treated as hypertrophic scar models. PBS was injected into the scars on the right ear of each group as control, while human umbilical cord-derived stem cells or condition medium of human umbilical cord-derived stem cells were administrated into the left ear through subcutaneous injection or fractional laser-assisted administration. Gross examination, scar elevation index (SEI) calculation and sampling were executed 5 weeks after administration. Then H&E and Masson staining analysis and the expression levels detections of α-SMA, Collagen I, TGF-β1, IL-1β, and IL-6 were performed. Our results demonstrated that the severity of hyperplasia was lower than the model group after stem cells and conditioned medium treatment. H&E and Masson staining results showed that the inflammation in scars was greatly alleviated and the degree of fibrosis was reduced after treatment. There was no significant difference in the therapeutic effect between subcutaneous injection or fractional laser-assisted administration. Both stem cells and conditioned medium can down-regulate SEI and factors expression levels in all groups. However, compared with the stem cells, the therapeutic effects of the conditioned medium were lower. The results confirmed that stem cells had an available treatment effect on hypertrophic scars of rabbit ears. In addition to the paracrine pathway, stem cells may have other ways to treat hypertrophic scars. Fractional laser-assisted administration may become a potential administration of stem cell clinical application in the future.


Novel approach to the treatment of hyperpigmented photodamaged skin: 4% hydroquinone/0.3% retinol versus tretinoin 0.05% emollient cream.
Mild to moderately photodamaged skin is characterized by dyspigmentation, fine wrinkles, and tactile roughness. An optimal approach to the topical treatment of photoaging would simultaneously address all appearance issues. This study was undertaken to evaluate the effect of 4% hydroquinone and 0.3% retinol in photoaging. A 16-week study was designed to evaluate the efficacy and tolerance of a single cream containing prescription topical 4% hydroquinone for dyspigmentation and the cosmeceutical 0.3% retinol for fine wrinkles in an emollient vehicle for tactile roughness. This novel formulation was compared with 0.05% tretinoin emollient cream, the standard against which all other topical photoaging treatments are compared. Investigator assessments, subject assessments, and photography represented the evaluation end points. The cosmeceutical emollient 4% hydroquinone/0.3% retinol cream more effectively diminished the collective signs of photodamage than 0.05% tretinoin emollient cream in terms of dyspigmentation, fine wrinkles, and tactile roughness in 16 weeks. Combination therapy of hydroquinone and retinol may improve photoaging-associated hyperpigmentation.


Massive Transfusion Protocol Adherence: Relationship to Trauma Patient Outcomes.
Ongoing evaluation of massive transfusion protocol adherence is critical to ensure better trauma patient outcomes. This quality improvement initiative aimed to determine provider adherence to a recently revised massive transfusion protocol and its relationship to clinical outcomes among trauma patients requiring massive transfusion. A retrospective, descriptive, correlational design was used to determine the association between provider adherence to a recently revised massive transfusion protocol and clinical outcomes in trauma patients with hemorrhage treated at a Level I trauma center from November 2018 to October 2020. Patient characteristics, provider massive transfusion protocol adherence, and patient outcomes were assessed. Patient characteristics and massive transfusion protocol adherence associations with 24-hr survival and survival to discharge were determined using bivariate statistical methods. A total of 95 trauma patients with massive transfusion protocol activation were evaluated. Of the 95, 71 (75%) survived the initial 24 hr following massive transfusion protocol activation and 65 (68%) survived to discharge. Based on protocol applicable items, the median massive transfusion protocol overall adherence rate per patient was 75% (IQR = 57.1-85.7) for the 65 survivors and 25% (IQR = 12.5-50.0) for the 21 nonsurvivors to discharge whose death occurred at least 1 hr after massive transfusion protocol activation (p < .001). Findings indicate the importance of ongoing evaluations of adherence to massive transfusion protocols in hospital trauma settings to target areas for improvement.


Correlation of bone histology with parathyroid hormone, vitamin D3, and radiology in end-stage renal disease.
We analyzed transiliac bone biopsy specimens from 30 end-stage renal failure patients, taken at the time of admission for CAPD training. Results were compared with values of iPTH, bone alkaline phosphatase, 1,25-dihydroxyvitamin D3, skeletal survey, quantitative computed tomography (QCT) and single photon absorptiometry (SPA) bone density measurements. Osteitis fibrosa was the most common histological diagnosis, present in 15 of the 30 patients (50%), with eight classified as "severe" and seven as "mild." Eight patients (27%) had adynamic bone lesion, four mixed renal osteodystrophy (13%), and two (7%) osteomalacia. The mean age of the adynamic group was higher than the osteitis fibrosa group (41 +/- 12.1 vs. 56 +/- 10.2 years; P < 0.01), and than the mixed group (39 +/- 7.5 vs. 56 +/- 10.2 years; P < 0.02). Levels of iPTH enabled discrimination between groups, but not between individual patients, and values correlated with bone alkaline phosphatase (r = 0.62; P < 0.001). Erosion of the terminal phalanges was seen on the plain X-rays of 7 of 15 patients with mild or severe OF, and in three patients with another diagnosis. The majority of patients (> 90%) had bone density measurements within the normal range. No significant correlation existed between QCT or SPA scores and any of the histomorphometric parameters, or iPTH. We conclude that iPTH is the most helpful non-invasive investigation in this group of patients. Plain X-ray of the hands is the most useful radiological investigation, but single measurements of bone density are not diagnostic.


Fatty Acid Profiles of Cow's Milk and Cheese as Affected by Mountain Pasture Type and Concentrate Supplementation.
The aim of this trial was to assess the effect of pasture type and concentrate supplementation on the fatty acids (FA) composition of milk and cheese obtained during summer grazing on mountain pasture. Seventy-two Italian Simmental dairy cows were assigned to two groups that differed by the amount of concentrate supplementation: 3.0 kg/head/d (HIGH) vs. 1.5 kg/head/d (LOW). The dairy cows grazed on a Poion alpinae alliance pasture (PAST1), and subsequently they grazed on a Seslerion caeruleae alliance pasture (PAST2) for 10 d each. In the last three days of each experimental period, milk samples were collected immediately before each cheese-making event. Cheese samples were collected from each cheese loaf after 60 d of ripening. LOW showed higher isoFA, FA intermediates of the ruminal biohydrogenation, C18:3 c9,c12,c15, and total polyunsaturated fatty acid (PUFA) levels than HIGH. The pasture type had a more limited effect on FA composition of milk than concentrate level and was mainly related to monounsaturated fatty acids (MUFA), which were higher in PAST1 than PAST2 (p < 0.05). In cheeses, these differences were reduced. The phytanic acid and phytanic isomer ratio (SRR/RRR) in milk were not affected either by supplement level (p > 0.05) or by type of pasture (p > 0.05). Increasing the concentrate offered to dairy cows from 1.5 to 3.0 kg/d did not markedly influence the level of PUFA in cheeses produced during summer grazing on high mountain pasture.


Analysis of creams. V. Application of thin layer chromatography. Part I.
A standard procedure, consisting of two TLC systems, for the qualitative control of creams is presented. All common cream excipients, except those of very high polarity, are separated in a simple gradient elution system, using diethyl ether as the eluent in a chromatographic chamber saturated with n-pentane. The very polar cream base components are separated using n-butanol-glacial acetic acid-water (20 + 2 + 5) as the eluent. The chromatographic behaviour of common cream excipients as well as three FNA cream bases and four commercial cream bases is discussed.


First-principles investigation of polytypic defects in InP.
In this paper we study polytypic defects in Indium Phosphide (InP) using the complementary first-principles methods of density functional theory and non-equilibrium Greens functions. Specifically we study interfaces between the ground state Zincblende crystal structure and the meta-stable Wurtzite phase, with an emphasis on the rotational twin plane defect, which forms due to the polytypic nature of InP. We found that the transition of the band structure across the interface is anisotropic and lasts 7 nm (3.5 nm). Due to this, a crystal-phase quantum well would require a minimal width of 10 nm, which eliminates rotational twin planes as possible quantum wells. We also found that for conducting current, the interfaces increase conductivity along the defect-plane ([11[Formula: see text]]), whereas due to real growth limitations, despite the interfaces reducing conductivity across the defect-plane ([111]), we found that a high degree of polytypic defects are still desirable. This was argued to be the case, due to a higher fraction of Wurtzite segments in a highly phase-intermixed system.


Chronic Constipation: a Review of Current Literature.
Chronic constipation is a common health condition representing a substantial proportion of primary care visits and referrals to specialist providers. Chronic constipation can have a significant negative effect on health-related quality of life and has been associated with psychological distress in severely affected patients. It has the potential to cause patients to curtail work, school, and social activities. While different pathophysiological mechanisms have been implicated in the development of chronic constipation, in some instances, the causes of chronic constipation are not easily determined. Expenditures for the evaluation and management of chronic constipation represent a significant burden on patients and payers, and it is important for clinicians to have a clear understanding of the different pathophysiological mechanisms associated with constipation, understand the different testing modalities and treatments that are available including their appropriateness and limitations, and tailor that knowledge to the management of individual patients.


[Clinical case of the month. Bilateral optic neuropathy secondary to biphosphonate therapy].
Ocular side effects associated with biphosphonates have been described. Conjunctivitis, uveitis and scleritis are the most common adverse events. We report a case of bilateral toxic optic neuropathy with optic dies edema occurring soon after a pamidronate intravenous infusion in a patient who previously presented both a conjunctivitis and an uveitis of moderate intensity associated with alendronate therapy.


Growth, differentiation capacity, and function of mesenchymal stem cells expanded in serum-free medium developed via combinatorial screening.
The presence of serum in cell culture medium presents an obstacle to safe and efficient production of hMSCs for therapeutic purposes. Availability of defined medium will be crucial to elucidating the mechanism of action of hMSCs in many indications as well as a prerequisite to consistently produce cells with predictable performance characteristics. Using a bioinformatics driven approach, which we call the BD Discovery Platform, we have developed a novel serum-free medium that supports highly efficient growth while maintaining the surface markers and functional characteristics defining hMSCs. In a comparison with serum-containing and other commercially available serum-free formulations, all conditions led to expansion of cells that meet the minimal criteria for hMSCs as set by the International Society for Cellular Therapy (ISCT). However, differences in growth characteristics and gene expression patterns suggest that expansion in serum-free growth conditions can provide greater yields in a shorter time. The mRNA expression profile observed in cells grown without serum suggests upregulation of several genes implicated in hMSC function as well as downregulation of the proinflammatory cytokine IL6.


Relationship between the Epstein-Barr virus genome and nasopharyngeal carcinoma in Caucasian patients.
In order to explore whether undifferentiated nasopharyngeal carcinoma (NPC) shows a regular association with Epstein-Barr virus (EBV), regardless of the geographical and ethnic origin of the patient, a correlated histopathological and nucleic acid hybridization study was performed on biopsies from Caucasian patients with nasopharyngeal carcinomas and from various controls. Among 12 undifferentiated NPCs, 11 were positive for EBV-DNA, with multiple copies of the viral genome per cell. Serological tests showed elevated anti-VCA and anti-EA(DA) titers. Six NPCs with various degrees of squamous differentiation, four malignant lymphomas of the nasopharynx and seven carcinomas located outside the nasopharynx were EBV-DNA negative. These findings further stress the uniqueness and regularity of the association between EBV-DNA and undifferentiated NPC. Clearly, the association extends over geographical barriers and holds true not only in the previously studied, moderate-incidence African ethnic group, but also in the low-incidence Western patients.


Effect of diclofenac on experimental pleurodesis induced by tetracycline in rabbits.
Pleurodesis is a frequently preferred procedure in thoracic surgery, and many factors may affect the process. We aimed to determine whether the administration of systemic diclofenac sodium diminishes the effectiveness of the pleurodesis induced by intrapleural tetracycline in rabbits. Twelve male New Zealand rabbits that received tetracycline 35 mg/kg intrapleurally were allocated into two groups. The first group (diclofenac group, n = 6) received 2 mg/kg diclofenac sodium intramuscularly for 10 days, and the second group (control group, n = 6) received acetaminophen 30 mg/kg orally for 10 days after the pleurodesis procedure. The rabbits were sacrificed after 28 days, and the pleural spaces were assessed grossly for evidence of pleurodesis and microscopically for evidence of fibrosis, inflammation, and collagenization. The mean macroscopic pleurodesis score of the diclofenac group was 2.16 +/- 0.40 compared with 2.83 +/- 0.40 in the control group (p = .027). The mean microscopic pleurodesis score of the diclofenac group was 2. 3 +/- 1.03, whereas it was 3.5 +/- 0.54 in the control group (p = .045). The administration of diclofenac sodium for 10 days following tetracycline pleurodesis reduces the effectiveness of pleurodesis in rabbits.


IQCN disruption causes fertilization failure and male infertility due to manchette assembly defect.
Total fertilization failure (TFF) is an important cause of infertility; however, the genetic basis of TFF caused by male factors remains to be clarified. In this study, whole-exome sequencing was firstly used to screen for genetic causes of TFF after intracytoplasmic sperm injection (ICSI), and homozygous variants in the novel gene IQ motif-containing N (IQCN) were identified in two affected individuals with abnormal acrosome structures. Then, Iqcn-knockout mice were generated by CRISPR-Cas9 technology and showed that the knockout male mice resembled the human phenotypes. Additionally, we found that IQCN regulates microtubule nucleation during manchette assembly via calmodulin and related calmodulin-binding proteins, which resulted in head deformity with aberrant oocyte activation factor PLCζ. Fortunately, ICSI with assisted oocyte activation can overcome IQCN-associate TFF and male infertility. Thus, our study firstly identified the function of IQCN, highlights the relationship between the manchette assembly and fertilization, and provides a genetic marker and a therapeutic option for male-source TFF.