Chitosan/starch beads as bioinoculants carrier: long-term survival of bacteria and plant growth promotion.
Immobilization of microorganisms in biodegradable polymeric matrices constitutes a promising technology for plant growth promoting to overcome the challenging conditions of the rhizosphere. Previously, we demonstrated that beads prepared from blends of chitosan/starch of analytical grades ionically cross-linked are useful carriers for Azospirillum brasilense and Pseudomonas fluorescens. The aims of this work were to study A. brasilense Az39 and P. fluorescens ZME4 immobilization in industrial quality beads produced with a blend of chitosan/starch, to assess bacterial survival during long-term storage and biofilm distribution in the beads. We also proposed to analyze the consortia root colonization and its performance as plant growth-promoting bioinoculants compared to liquid counterpart. Our results revealed that A. brasilense Az39 and P. fluorescens ZME4 can coexist in industrial grade chitosan/starch beads, and this mixed immobilization benefits the survival rates of both species, even for more than a year under shelf storage. Confocal laser scanning microscopy with fluorescent dyed strains showed that both species remain mainly in different locations inside and over the beads. Additionally, maize seed treatment with beads-loaded bacteria resulted in growth promotion of roots in a similar manner than traditional liquid-based inoculation. The evidence collected here demonstrate that low-cost chitosan/starch beads are a suitable carrier for bacteria consortia and could be a reliable alternative to liquid inoculation in agronomic practices with additional benefits for industrial management. KEY POINTS: • Mixed immobilization increases bacterial survival in chitosan/starch industrial beads • Beads increase competence of bacteria in rhizosphere of maize • Inoculation mediated by beads promotes plant growth of maize.


Clinical consequences of corticectomies involving the supplementary motor area in man.
Three patients with well-mapped, circumscribed ablations of the medial part of the frontal lobe are reported. A specific clinical evolution in 3 stages was observed: (1) post-operatively there was global akinesia, more prominent contralaterally, with an arrest of speech; (2) recovery occurred suddenly but even then there was severe reduction of spontaneous motor activity contralaterally, an emotional type facial palsy and a reduction of spontaneous speech; (3) long after the operation the only sequela was disturbance of the alternating movements of the hands. The anatomical basis of these disorders appears to be a lesion of the supplementary motor area (SMA). Three main points have been discussed, namely: (1) the nature of the motor disorder which may be a disturbance of the function of the SMA in initiating and sustaining spontaneous and automatic motor activity; (2) the nature of the arrest of speech which appears not to be aphasic; the studies reported in the present paper do not support a left cerebral dominance for the SMA as suggested by previous studies; (3) the method of clinical examination appears to be important in distinguishing between spontaneous and voluntary motor and speech performance. Differences in method may account for differences between our findings and those reported in previous studies.


Retracted: Diagnostic Value of MRI Combined with CXCR4 Expression Level in Lymph Node Metastasis Head and Neck Squamous Cell Carcinoma.
[This retracts the article DOI: 10.1155/2022/4073918.].


Partial trisomy for the long arm of chromosome 7 due to familial balanced translocation.
A partial trisomy for the distal segment of the long arm of chromosome 7 (bands q32 replaced by qter) was observed in a severely retarded child with somatic and CNS anomalies. The phenotypically normal father and paternal grandmother had a balanced reciprocal translocation between the long arm of a chromosome 2 and the long arm of a chromosome 7: 46,XX-XY,t(2;7) (q37;q32). The clinical features of the child at birth and at the ages of 5 months and 2 years are compared with those previously reported in cases of partial trisomy 7q.


Schwann cell-mediated delivery of glial cell line-derived neurotrophic factor restores erectile function after cavernous nerve injury.
To evaluate the time-course of functional recovery after cavernous nerve injury using glial cell line-derived neurotrophic factor-transduced Schwann cell-seeded silicon tubes. Sections of the cavernous nerves were excised bilaterally (5 mm), followed by immediate bilateral surgical repair. A total of 20 study nerves per group were reconstructed by interposition of empty silicon tubes and silicon tubes seeded with either glial cell line-derived neurotrophic factor-overexpressing or green fluorescent protein-expressing Schwann cells. Control groups were either sham-operated or received bilateral nerve transection without nerve reconstruction. Erectile function was evaluated by relaparotomy, electrical nerve stimulation and intracavernous pressure recording after 2, 4, 6, 8 and 10 weeks. The animals underwent re-exploration only once, and were killed afterwards. The nerve grafts were investigated for the maturation state of regenerating nerve fibers and the fascular composition. Recovery of erectile function took at least 4 weeks in the current model. Glial cell line-derived neurotrophic factor-transduced Schwann cell grafts restored erectile function better than green fluorescent protein-transduced controls and unseeded conduits. Glial cell line-derived neurotrophic factor-transduced grafts promoted an intact erectile response (4/4) at 4, 6, 8 and 10 weeks that was overall significantly superior to negative controls (P < 0.001). Maximum intracavernous pressure on electrostimulation was significantly elevated using glial cell line-derived neurotrophic factor-transduced grafts compared with negative controls (P = 0.018) and unseeded tubes (P = 0.034). Return of function was associated with the electron microscopic evidence of preganglionic myelinated nerve fibers and postganglionic unmyelinated axons. Schwann cell-mediated delivery of glial cell line-derived neurotrophic factor presents a viable approach for the treatment of erectile dysfunction after cavernous nerve injury.


β-Catenin recognizes a specific RNA motif in the cyclooxygenase-2 mRNA 3'-UTR and interacts with HuR in colon cancer cells.
RNA-binding proteins regulate multiple steps of RNA metabolism through both dynamic and combined binding. In addition to its crucial roles in cell adhesion and Wnt-activated transcription in cancer cells, β-catenin regulates RNA alternative splicing and stability possibly by binding to target RNA in cells. An RNA aptamer was selected for specific binding to β-catenin to address RNA recognition by β-catenin more specifically. Here, we characterized the structural properties of the RNA aptamer as a model and identified a β-catenin RNA motif. Similar RNA motif was found in cellular RNA, Cyclooxygenase-2 (COX-2) mRNA 3'-untranslated region (3'-UTR). More significantly, the C-terminal domain of β-catenin interacted with HuR and the Armadillo repeat domain associated with RNA to form the RNA-β-catenin-HuR complex in vitro and in cells. Furthermore, the tertiary RNA-protein complex was predominantly found in the cytoplasm of colon cancer cells; thus, it might be related to COX-2 protein level and cancer progression. Taken together, the β-catenin RNA aptamer was valuable for deducing the cellular RNA aptamer and identifying novel and oncogenic RNA-protein networks in colon cancer cells.


Yttrium-90 Radioembolization in the VX2 Rabbit Model: Radiation Safety and Factors Influencing Delivery Efficiency.
The purpose of this study was to define the optimal infusion parameters and operator radiation exposure for yttrium-90 (90Y) radioembolization in the VX2 rabbit model of liver cancer. Forty-one rabbits with VX2 were treated with glass microspheres with vial sizes of 1, 3, and 5 GBq. The mean administered activity was 51.5 MBq (95% CI, 39.1-63.9). Delivery efficiency improved with 1 GBq versus with 3 GBq (residual 11.0% vs 46.4%, respectively; P = .0013) and improved with 1 GBq versus with 5 GBq (residual 11.0% vs 33.8%, respectively; P = .0060). The mean operator extremity exposure was 41.7 μSv/infusion. The optimal minimum infusion volume and rate was 49 mL and 21 mL/min, respectively. Fecal elimination occurred with microsphere uptake in the gallbladder at 1 and 2 weeks. 90Y radioembolization can be safely and efficiently performed in the VX2 rabbit model. Methodological considerations as a "how-to" for the setup of a preclinical 90Y laboratory are included to support future translational research.


Chukrasia tabularis limonoid plays anti-inflammatory role by regulating NF-κB signaling pathway in lipopolysaccharide-induced macrophages.
Chukrasia tabularisis, a well-known tropical tree native to southeastern China, has anti-inflammatory and antioxidant activities, and contains large amounts of limonoids and triterpenoids. The aim of this study was to investigate the potential anti-inflammatory activity of limonoids from C. tabularis on lipopolysaccharide (LPS)-mediated RAW264.7 cells. Using a bioassay-guided approach, the chemical fraction with high anti-inflammatory activity was found and its chemical constituents were investigated. Phytochemical studies on active extracts resulted in the separation of three novel phragmalin limonoids (1-3), together with two known limonoids (4-5) and 11 tirucallane triterpenes (6-16). The activity of these isolated compounds in the production of nitric oxide (NO) on LPS-reated macrophages was evaluated. Limonoid 2 indicated significant anti-inflammatory activities with IC50 value of 4.58 μM. Limonoid 2 notably inhibited the production of NO, interleukin- 6 and tumor necrosis factor-α on macrophage. Signal transduction and activation of STAT and NF-κB activators were effectively blocked by limonoid 2. These results indicate that limonoid 2 has an anti-inflammatory effect by the inhibiting JAK2/STAT3, iNOS/eNOS, and NF-κB signaling pathways and regulating inflammatory mediators.


Evaluation of enhanced thermostability and operational stability of carbonic anhydrase from Micrococcus species.
Carbonic anhydrase (CA) was purified from Micrococcus lylae and Micrococcus luteus with 49.90 and 53.8 % yield, respectively, isolated from calcium carbonate kilns. CA from M. lylae retained 80 % stability in the pH and temperature range of 6.0-8.0 and 35-45 °C, respectively. However, CA from M. luteus was stable in the pH and temperature range of 7.5-10.0 and 35-55 °C, respectively. Cross-linked enzyme aggregates (CLEAs) raised the transition temperature of M. lylae and M. luteus CA up to 67.5 and 74.0 °C, while the operational stability (T(1/20) of CA at 55 °C was calculated to be 7.7 and 12.0 h, respectively. CA from both the strains was found to be monomeric in nature with subunit molecular weight and molecular mass of 29 kDa. Ethoxozolamide was identified as the most potent inhibitor based on both IC(50) values and inhibitory constant measurement (K(i)). The K(m) and V(max) for M. lylae CA (2.31 mM; 769.23 μmol/mg/min) and M. luteus CA (2.0 mM; 1,000 μmol/mg/min) were calculated from Lineweaver-Burk plots in terms of esterase activity. Enhanced thermostability of CLEAs alleviates its role in operational stability for application at an on-site scrubber. The characteristic profile of purified CA from Micrococcus spp. advocates its effective application in biomimetic CO(2) sequestration.


Simultaneous staining of sister chromatid exchanges and Q-bands in human chromosomes after treatment with methyl methane sulphonate, quinacrine mustard, and quinacrine.
Human peripheral lymphocyte chromosomes were stained simultaneously for sister chromatid exchanges (SCEs) and Q-banding. No effect of treatment with MMS, QM, and Q on the distribution of SCEs in chromosomes was found compared with controls. The SCEs were distributed between chromosomes roughly according to metaphase length, with the shorter chromosomes underrepresented. The majority of SCEs were located to pale bands, while a few occurred in bright bands and at interfaces between pale and bright bands. A greater frequency than expected of SCEs had occurred at identical sites in homologous chromosomes. This frequency was significantly increased after treatment with MMS.


2-O-Sulfated Domains in Syndecan-1 Heparan Sulfate Inhibit Neutrophil Cathelicidin and Promote Staphylococcus aureus Corneal Infection.
Ablation of syndecan-1 in mice is a gain of function mutation that enables mice to significantly resist infection by several bacterial pathogens. Syndecan-1 shedding is induced by bacterial virulence factors, and inhibition of shedding attenuates bacterial virulence, whereas administration of purified syndecan-1 ectodomain enhances virulence, suggesting that bacteria subvert syndecan-1 ectodomains released by shedding for their pathogenesis. However, the pro-pathogenic functions of syndecan-1 ectodomain have yet to be clearly defined. Here, we examined how syndecan-1 ectodomain enhances Staphylococcus aureus virulence in injured mouse corneas. We found that syndecan-1 ectodomain promotes S. aureus corneal infection in an HS-dependent manner. Surprisingly, we found that this pro-pathogenic activity is dependent on 2-O-sulfated domains in HS, indicating that the effects of syndecan-1 ectodomain are structure-based. Our results also showed that purified syndecan-1 ectodomain and heparan compounds containing 2-O-sulfate motifs inhibit S. aureus killing by antimicrobial factors secreted by degranulated neutrophils, but does not affect intracellular phagocytic killing by neutrophils. Immunodepletion of antimicrobial factors with staphylocidal activities demonstrated that CRAMP, a cationic antimicrobial peptide, is primarily responsible for S. aureus killing among other factors secreted by degranulated neutrophils. Furthermore, we found that purified syndecan-1 ectodomain and heparan compounds containing 2-O-sulfate units potently and specifically inhibit S. aureus killing by synthetic CRAMP. These results provide compelling evidence that a specific subclass of sulfate groups, and not the overall charge of HS, permits syndecan-1 ectodomains to promote S. aureus corneal infection by inhibiting a key arm of neutrophil host defense.


Development and evaluation of a new colorimetric DGT technique for the 2D visualisation of labile phosphate in soils.
A new colorimetric technique for the measurement of labile phosphate in soils using the diffusive gradients in thin films (DGT) technique was developed in this study. This technique can determine the mass of phosphate accumulated on the precipitated Zr-oxide based binding gel by forming the blue colour following the standard molybdate-ascorbic acid method. The optimal reaction temperature and coloration time were 20 °C (room temperature) and 26 min. After determining a well-fitted calibration equation, the technique was able to measure phosphate concentration up to 2.5 mg/L for 24 h deployment with a detection limit of 10.1 μg/L. Two-dimensional quantitative visualisation of phosphate diffusion in three phosphorus (P) fertilised soils were obtained using the colorimetric technique. The results from the colorimetric DGT technique were compared to the elution DGT technique and Colwell P extraction. The DGT techniques (colorimetric and elution) and Colwell P measurements demonstrated similar patterns of phosphate diffusion in soil. Both DGT techniques showed similar phosphate concentration along the concentric rings around the fertiliser application. A new, convenient, and fast DGT colorimetric technique was developed, and successfully used to measure the distribution of potentially available phosphate in soils. The new technique is less laborious than current techniques as it does not require any pre-treatment of the binding gel layers or heating during scanning, thus providing faster results. Therefore, the technique may be more suitable for in-field applications and can be used to investigate the in situ diffusion of potentially available phosphate from fertilisers, and relate this to the plant uptake of P.


Results of clipping surgery for aneurysmal subarachnoid hemorrhage in the ninth and tenth decades of life.
This study investigated the outcome of clipping surgery for ruptured aneurysms in patients older than 80 years of age. From 1988 to 2011 data were retrospectively reviewed, and 196 patients treated with clipping obliteration for aneurysmal subarachnoid hemorrhage were identified. Patients were divided into two age groups of 80-84 and ⩾ 85 years old. The Glasgow Outcome Scale score was assessed at discharge and classified as favorable (good recovery or moderate recovery) or unfavorable (severe disability, vegetative state, or dead). Radiological and clinical characteristics were compared between the two groups. A favorable outcome was achieved in 106 (54.1%) of the 196 patients. Preoperative grade and Fisher grade were significantly associated with unfavorable outcome, but age was not. Based on logistic regression analysis, poor preoperative grade and ruptured anterior cerebral artery aneurysm were the predictors of unfavorable outcome, but advanced age (⩾ 85 years old) was not. Advanced age itself did not affect the outcome of the elderly patients who underwent clipping surgery for aneurysmal subarachnoid hemorrhage.


Residual levels and dietary intake risk assessment of 11 pesticides in apricots from different ecological planting regions in China.
The frequent and massive use of pesticides has led to pesticide residues in apricot, threatening food safety and human health. A reliable and simple modified QuEChERS method with ultra-performance liquid chromatography-tandem mass spectrometry was developed for the simultaneous determination of 11 pesticides in apricot. Method validation indicated that satisfied linearity (R2 ≥ 0.9959), accuracy (recoveries of 72-119%), sensitivity (limits of detection, 0.03-0.30 μg/kg; limits of quantification, 0.13-1.00 μg/kg), and precision (relative standard deviations ≤ 11.9%), and matrix effects were 0.89-1.13. Apricot samples from different ecological regions in China were collected and tested using the proposed methods. Monitoring results were used to assess the dietary intake risk of Chinese populations of different ages and genders. Dietary risk assessment revealed that the risk quotients were 0.003-1.184% for different gender and age groups in China, indicating none unacceptable public health risk for general population. This work was thus significant in developing a simpler, more efficient and economical analysis method and food safety risks of the 11 pesticides on apricot and facilitated the establishment of maximum residue limits.


Cardiac Metastatic Melanoma Causing Ventricular Arrhythmias Through Impaired Coronary Artery Vasodilation.
Melanoma is an aggressive malignant disease with a high rate of cardiac metastasis. There is a reported association between myocardial tumor invasion and ventricular arrhythmias. We present a case of cardiac metastatic melanoma causing ventricular arrhythmias through a novel mechanism of encasement of coronary arteries leading to reduced myocardial perfusion. (Level of Difficulty: Intermediate.).


Features of the comparative pharmacokinetics of lithium; a potential application of its use in livestock farming.
Lithium is used in man for the treatment and prevention of manic depressive psychoses. The collective use of lithium was proposed in intensive livestock farming in order to reduce stress and aggressive behaviour. This objective was thwarted by the pharmacokinetic properties of lithium: slow intracerebral penetration, narrow therapeutic index, high individual variability plus unpleasant secondary effects. The neuroprotective and neurotrophic properties of lithium recently discovered could create renewed interest in lithium in livestock farming for neurodegenerative diseases such as sub-acute transmissible spongiform encephalopathies (TSEs). With this in mind, prior pharmacokinetic tests are proposed on mink and cattle.


Regulation of nonsense-mediated mRNA decay: implications for physiology and disease.
Nonsense-mediated mRNA decay (NMD) is an mRNA quality control mechanism that destabilizes aberrant mRNAs harboring premature termination (nonsense) codons (PTCs). Recent studies have shown that NMD also targets mRNAs transcribed from a large subset of wild-type genes. This raises the possibility that NMD itself is under regulatory control. Indeed, several recent studies have shown that NMD activity is modulated in specific cell types and that key components of the NMD pathway are regulated by several pathways, including microRNA circuits and NMD itself. Cellular stress also modulates the magnitude of NMD by mechanisms that are beginning to be understood. Here, we review the evidence that NMD is regulated and discuss the physiological role for this regulation. We propose that the efficiency of NMD is altered in some cellular contexts to regulate normal biological events. In disease states-such as in cancer-NMD is disturbed by intrinsic and extrinsic factors, resulting in altered levels of crucial NMD-targeted mRNAs that lead to downstream pathological consequences. This article is part of a Special Issue entitled: RNA Decay mechanisms.


Effects of adrenergic α-antagonists on the early life stages of Japanese medaka (Oryzias latipes).
The occurrence of pharmaceuticals in the aquatic environment has stimulated considerable research efforts into their potential ecotoxicological consequences. There are a number of pharmaceuticals targeting adrenergic receptors; however, relatively few studies have explored the effects of adrenergic α-antagonists (or α-blockers) on fish. In this study, moxisylyte was selected as a representative α-blocker, and Japanese medaka embryos were exposed to moxisylyte (1-625 μg/L) for 44 days. Moxisylyte caused no significant or only marginal effects on the mortality, development, and growth; however, most genes involved in detoxification and antioxidant were transcriptionally upregulated, and antioxidant enzymes activities were induced as well. Moxisylyte exposure resulted in transcriptional downregulation of most of the steroidogenesis genes, and accordingly, the mRNA levels of steroid hormone receptors and vitellogenin decreased, particularly in males, indicating that moxisylyte disrupts the hypothalamic-pituitary-gonadal (HPG) axis in a gender-specific manner. Therefore, the risk of α-blockers on fish should not be overlooked and deserves further investigation.


Elevated cerebrospinal fluid tau protein levels in Wernicke's encephalopathy.
Limited neuronal cell loss is seen in the neuropathology of Wernicke's encephalopathy (WE), but the extent of neuronal damage has not been well studied. Moreover, there is still a debate as to whether alcohol itself causes brain damage in humans. Although, it is difficult to examine the extent of neuronal damage in living patients, recent studies have revealed that total tau protein levels in the cerebrospinal fluid (CSF) reflect the rate of neuronal degeneration. Therefore, we hypothesized that the elevated CSF total tau in patients with WE was due to neuronal damage and thus we examined CSF total tau protein in patients with WE, as well as in those with alcohol withdrawal delirium (WD) and Korsakoff syndrome (KS). We also examined CSF total tau in nonalcohol dependent patients with Alzheimer's disease (AD) as a disease control. CSF samples were obtained from 13 acute WE patients with alcohol dependence, 9 WD patients with alcohol dependence and 16 KS patients with alcohol dependence, and from 20 nonalcohol dependent AD patients. CSF was also obtained from 10 of the WE patients after their disease had progressed to the chronic stage. CSF tau protein levels in all samples were determined by sandwich enzyme-linked immunosorbent assay. Tau phosphorylated at threonine 181 (p-tau(181)) and amyloid beta-protein ending at amino acid 42 (A beta 42) in CSF were also determined for comparison between acute WE with AD. Total tau was significantly elevated in acute WE and decreased on long-term follow-up, but was not elevated in WD or KS. The patterns of p-tau(181) and A beta 42 differed between acute WE and AD. Intense neuronal cell death occurs transiently in WE, and the mechanism differs from that in AD. Neuronal damage is generally unaccompanied in WD. These results suggest that CSF total tau is a useful biological marker for WE.


Chemotherapy-induced ovarian toxicity in patients affected by endocrine-responsive early breast cancer.
Cytotoxic chemotherapy may variably affect ovarian function depending on age and ovarian reserve at diagnosis, type of chemotherapy and use of tamoxifen. Ascertaining whether a premenopausal patient with endocrine-responsive early breast cancer and chemotherapy-induced amenorrhea has reached menopause is essential not only in order to provide accurate information on residual fertility, but also to appropriately prescribe endocrine therapy. Indeed, aromatase inhibitors are contraindicated in women with residual ovarian reserve. However, the diagnosis of menopause in patients with chemotherapy-induced amenorrhea is challenging, since clinical features, follicle-stimulating hormone and estradiol levels may be inaccurate to this aim. Recent studies demonstrated that the anti-müllerian hormone may improve the assessment of ovarian reserve residual to chemotherapy in women with early breast cancer. Herein, we review the incidence of amenorrhea and menopause induced by cytotoxic chemotherapy in women affected by early breast cancer and the suggested mechanisms that sustain these side-effects. Furthermore, it has been scrutinized the potential of new markers of ovarian reserve that may facilitate the selection of appropriate endocrine treatment for premenopausal women who develop amenorrhea following adjuvant chemotherapy for early breast cancer.


Bacterial and Fungal Coinfection in Critically Ill COVID-19 Cases and Predictive Role of Procalcitonin During the First Wave at an Academic Health Center.
Coinfection at various sites can complicate the clinical course of coronavirus disease of 2019 (COVID-19) patients leading to worse prognosis and increased mortality. We aimed to investigate the occurrence of coinfection in critically ill COVID-19 cases, and the predictive role of routinely tested biomarkers on admission for mortality. This is a retrospective study of all SARS-CoV-2-infected cases, who were admitted to King Fahad Hospital of the University between March 2020 and December 2020. We reviewed the data in the electronic charts in the healthcare information management system including initial presentation, clinical course, radiological and laboratory findings and reported all significant microbiological cultures that indicated antimicrobial therapy. The mortality data were reviewed for severely ill patients who were admitted to critical care units. Of 1091 admitted patients, there were 70 fatalities (6.4%). 182 COVID-19 persons were admitted to the critical care service, of whom 114 patients (62.6%) survived. The in-hospital mortality was 13.4%. Coinfection was noted in 67/68 non-survivors, and Gram-negative pathogens (Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter baumanni) represented more than 50% of the etiological agents. We noted that the serum procalcitonin on admission was higher for non-survivors (Median = 1.6 ng/mL ± 4.7) than in survivors (Median = 0.2 ng/mL ± 4.2) (p ≤ 0.05). Coinfection is a serious complication for COVID-19 especially in the presence of co-morbidities. High levels of procalcitonin on admission may predict non-survival in critically ill cases in whom bacterial or fungal co-infection is likely.


Lateral hypothalamic area mediated the aggravated effect of microinjection of Baclofen into cerebellar fastigial nucleus on stress gastric mucosal damage in rats.
Cerebellum, primarily believed as a subcortical somatic motor center, is increasingly considered to be implicated in visceral activities. However, little is known about its regulation on gastrointestinal organs. In this research, we investigated the aggravated effect of microinjection of gamma-aminobutyric acid receptor subtype B (GABA(B)R) agonist, Baclofen into cerebellar fastigial nucleus (FN) on stress gastric mucosal damage (SGMD) and its possible regulatory mechanism. The gastric mucosal damage index was chosen to indicate the severity of gastric mucosal injure. Immunohistochemistry and transferase-mediated dUTP-biotin nick-endlabeling (TUNEL) methods were used to detect the variations of lateral hypothalamic area (LHA) and gastric mucosa. It had been demonstrated that FN participates in regulation of SGMD via its GABA(B)R and GABA neural pathway, which passes through the decussation of superior cerebellar peduncle and projects to the GABA receptors in LHA. Meanwhile, celiac sympathetic nerve involves in this process via mediating neural discharge, which results in the decrease of gastric mucosal blood flow. Additionally, apoptosis, proliferation and oxidation in gastric mucosa, and gastric acid contribute in the mechanism. It could be expected that these results might suggest insights to the cerebellar and hypothalamic function, and the treatment of gastrointestinal diseases.


Characteristics and pathologies of the vitreo-macular interface-results from the Gutenberg Health Study.
We aimed to determine the prevalence of characteristics and pathologies of the vitreo-macular interface within the general population. The Gutenberg Health Study is a population-based study in Germany, including an ophthalmological examination with refraction, biometry and optical coherence tomography (OCT) imaging. Characteristics of the vitreo-macular interface were graded on volume scans including visibility of an epiretinal membrane, full-thickness macular hole, lamellar hole and pseudohole. Overall and age-specific prevalences including 95% confidence intervals [95%-CI] were calculated. Association analyses were conducted to determine systemic and ocular factors that are associated with epiretinal membranes (the most common pathology) using multivariable logistic regression. A total of 1890 people aged 40-80 years were included in the study. Of these, 4.7% (95%-CI: 3.8%-5.8%) had an epiretinal membrane in at least one eye, 0.1% a full-thickness macular hole, 0.6% a lamellar hole and 0.6% a pseudohole. The presence of an epiretinal membrane was associated with higher age, myopic refractive error and prior retinal laser therapy, but not with gender, body height, body weight, smoking, prior cataract surgery or intraocular pressure. Epiretinal membranes are more frequent in older and myopic subjects and in those with prior retinal laser therapy.


Fibrinolytic potential is significantly increased by oestrogen treatment in postmenopausal women with mild dyslipidaemia.
To study the effects of oestrogen replacement treatment on fibrinolytic potential in postmenopausal women. Randomised, double blind, placebo controlled trial of oral 17 beta-oestradiol. Subjects were evaluated in the outpatient setting. Nineteen postmenopausal women with mild dyslipidaemia, aged 44 to 69 years (mean (SD) 55.7 (6.7)). Fibrinolytic activity (fibrin plate assay) and tissue plasminogen activator (t-PA) antigen were measured at baseline and after three, six, and nine weeks of each treatment. After nine weeks of 2 mg oestradiol treatment, there was a significant increase in fibrinolytic potential compared with placebo, as indicated by an increase in fibrinolytic activity (mean (SEM), 80 (9) v 54 (5) mm2 of lysis in the fibrin plate, 2 mg v placebo, p = 0.002) and a decrease in t-PA antigen (5.8 (0.9) v 8.4 (1.2) ng/ml, 2 mg v placebo, p < 0.001). There was a similar trend with the 1 mg dose but the changes were less noticeable. Hormone replacement treatment with 17 beta-oestradiol for nine weeks significantly increased fibrinolytic potential in postmenopausal women with mild dyslipidaemia. This suggests that the cardioprotective effect of oestrogen may be mediated, in part, by an increase in fibrinolytic potential.


Distinguish different Chinese medicine types of metabolic syndrome by combining body mass index and uric acid.
To provide clinical support for traditional Chinese medicine classification of metabolic syndrome patients. The retrospective study was conducted at Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, and Sichuan Provincial Hospital of Chinese Medicine, Chengdu, China, and comprised data of metabolic syndrome patients having visited the two hospitals between January and December 2017. The patients were divided into 2 groups based on the different types of Chinese medicine. Group1 had Qi-Yin deficiency and group 2 had phlegm-blood stasis. Various laboratory tests related to metabolic syndrome were conducted, analysed and compared in both the groups. Of the 263 patients, 173(66%) were in group 1 and 90(34%) were in group 2. Body mass index and blood uric acid level had statistical significance between the groups (p<05) .The sensitivity was over 90% and the accuracy was 60%. Body mass index and blood uric acid level were found to be the two independent factors to distinguish between different types of metabolic syndrome.


Turner's syndrome: index case after 44 years (a tribute to Dr. Henry H. Turner).
Forty-four years after Dr. Henry Turner's original observations, the index case of Turner's syndrome was re-examined. Mild hypertension and sensorineural deafness were found in addition to the classic somatic changes of gonadal dysgenesis. Buccal smear examination and chromosome analysis, previously not performed, revealed absence of chromation bodies and 45,X, respectively.


Unilateral Versus Bilateral Cochlear Implantation in Children With Auditory Neuropathy Spectrum Disorder (ANSD).
To evaluate audiologic outcomes following unilateral cochlear implantation with contralateral hearing aid (unilateral CI + HA) versus bilateral CI in children with auditory neuropathy spectrum disorder (ANSD). Retrospective case review. Tertiary Care Otologic Practice. Twenty-three patients with ANSD who underwent unilateral CI + HA or bilateral CI. Rehabilitative (CI). Speech perception scores and achievement of open-set speech. Preoperatively, all patients demonstrated lack of open-set speech perception with hearing aids (HAs) alone. Of the 23 patients included, 56.5% (n = 13) had developmental delay. Thirteen patients underwent unilateral CI + HA and 10 patients underwent bilateral CI. The median ages at CI activation were 3.3 and 2.0 years in the unilateral CI + HA and bilateral CI groups, respectively (p = 0.0688), with median lengths of CI use of 45.9 and 47.2 months, respectively (p = 0.8438). The unilateral CI + HA and bilateral CI groups achieved open-set speech perception in 76.9% and 90.0% of cases, respectively (p = 0.6036), within median times of 19.5 and 28.0 months, respectively (p = 0.6334). Within the unilateral CI + HA group, the median aided PTAs in the contralateral ears of patients who did and did not achieve open-set speech were 57.5 dB HL (range, 42.5-91.7 dB HL) and 75.0 dB HL (range, 62.5-111.3 dB HL) (p = 0.0455). Both bilateral CI and unilateral CI + HA groups achieved high rates of open-set speech perception. Bilateral CI may be beneficial in patients with bilateral hearing loss or those that fail to progress with unilateral CI + HA.


Long-term survival after triple-valve replacement.
A 29-year-old man with rheumatic stenosis and insufficiency of the aortic, mitral, and tricuspid valves underwent urgent triple-valve replacement on January 12, 1966, because of uncontrollable congestive heart failure. Twenty-two years and 8 months later (September 13, 1988) reoperation was necessary to replace the Kay-Shiley tricuspid prosthesis because of progressive stenosis of the valve due to pannus formation. The aortic and mitral prostheses continue to function normally. The patient has again returned to full activity.


Neuroimaging and recovery of language in aphasia.
The use of functional neuroimaging techniques has advanced what is known about the neural mechanisms used to support language processing in aphasia resulting from brain damage. This paper highlights recent findings derived from neuroimaging studies focused on neuroplasticity of language networks, the role of the left and right hemispheres in this process, and studies examining how treatment affects the neurobiology of recovery. We point out variability across studies as well as factors related to this variability, and we emphasize challenges that remain for research.


NF-κB acts downstream of EGFR in regulating low dose cadmium induced primary lung cell proliferation.
Apart from cytotoxicity cadmium has no special attributes towards cell's physiological function. The role of cadmium with respect to cell growth is still under debate. Mitogen activated protein kinase and Ca(2+)/calmodulin dependent protein kinase dependent pathways are the two elaborately studied concerning cadmium induced cell proliferation. Low concentration of cadmium chloride (2.5 μM) was applied to mice primary lung epithelial cells and cell proliferation was measured both by cell cycle analysis and Brdu incorporation assay. Effects of differential dose of cadmium chloride on lung epithelial cells were evaluated morphologically by atomic force microscopy. RT-PCR and western blot altogether corroborated the specific signalling pathways concerning cadmium induced lung cell proliferation. Cadmium induced lung epithelial cells which over-expressed EGFR, were transfected with siEGFR, revealed downstream molecules and RNAi induced EGFR silencing. Use of siEGFR effectively prevents expression of proinflammatory and cell proliferative markers. Moreover N-acetyl cysteine and ascorbic acid mediated inhibition of EGFR and downstream signalling molecules indicate the involvement of reactive oxygen species. Exposure to low concentration of cadmium promotes the growth of primary mice lung epithelial cell by EGFR signalling. We have also transfected the primary lung epithelial cell with siRNA against the regulatory subunit of nuclear factor-κB (NF-κB) and the data shows that cadmium induced lung cell proliferation is the effect of EGFR mediated NF-κB activation.


Retracted: Novel Prognostic Biomarkers for Cervical Squamous Cell Carcinoma and Endocervical Adenocarcinoma (CESC) Patients via Analysis of Competing Endogenous RNA (ceRNA) Network.
[This retracts the article DOI: 10.1155/2023/1766080.].


Magnetic resonance imaging-guided focused ultrasound thermal therapy in experimental animal models: correlation of ablation volumes with pathology in rabbit muscle and VX2 tumors.
To further investigate the use of magnetic resonance-guided focused ultrasound therapy (MRgFUS) as a noninvasive alternative to surgery in the local control of soft-tissue tumors by ablating prescribed volumes of VX2 rabbit tumors and comparing with ablation of normal tissue volumes. Small, ellipsoidal ablations at shallow depth were created using 5- to 15-second sonication pulses at radio frequency (RF) powers of 50-125 W using a spherical, air-backed transducer operating at 1.463 MHz under MR guidance in a 1.5-T clinical scanner. Excellent correlation was observed between prescribed treatment volumes, MR thermal dosimetry, post-treatment verification MRI, and histopathology. Multifocal ablations of VX2 tumors in rabbits at depths of up to 2.5 cm resulted in complete ablation of the prescribed treatment volume. MRgFUS is an effective technique for treating tumors in vivo. Techniques developed for treatments in homogeneous tissue volumes are applicable in the more complicated tumor environment if MR temperature feedback is available to modify treatment delivery parameters.


Recovery Capital and Symptom Improvement in Gambling Disorder: Correlations with Spirituality and Stressful Life Events in Younger but Not Older Adults.
Although age-related differences have been reported in gambling disorder, prior studies have not examined how age may influence recovery in gambling disorder. Recovery may be influenced by positive factors (e.g., spirituality and recovery capital) and negative factors (e.g., depression, anxiety, and stressful life events). The current study examined associations between these positive and negative factors and gambling disorder DSM-5 symptom improvement in younger and older adults. Younger (less than 55 years of age; n = 86) and older (55 years or older; n = 54) adults, with lifetime gambling disorder treated currently or within the past 5 years in five treatment centers in Israel were assessed using structured scales on past-year and lifetime DSM-5 gambling disorder, intrinsic spirituality, recovery capital, anxiety, depression and stressful life-events. Among younger adults, recovery capital and intrinsic spirituality were associated with gambling disorder symptom improvement. Among older adults, only recovery capital was associated with gambling disorder symptom improvement. Correlations between recovery capital and spirituality (z = 2.34, p = 0.02) and recovery capital and stressful life events (z = 2.29, p = 0.02) were stronger in younger than in older adults. Recovery capital is an important resource that should be considered across older and younger adults with gambling disorder. Spirituality and stressful life events may operate differently across age groups in gambling disorder. Future studies should investigate whether the findings may extend to other groups and the extent to which promoting recovery capital should be integrated into treatments for gambling disorder.


Behavior of the extensor pollicis longus tendon in experiment.
Several experimental rupture tests of the extensor pollicis longus tendon proved that a rupture of a tendon caused by experiments is located in a region in which the rupture is mainly found clinically as well. By using a newly developed Silicon impression system it can be proved that in the course of a tendon there is always a certain place which has the smallest cross section. This is more or less identical with the location of the rupture. Thus, ruptures of the extensor pollicis longus tendon can be experimentally simulated.


Measurement of ice friction and aerodynamic drag for sliding on ice: Faster sliding in winter sports.
This Method Article is co-submitted with the article Nr. JTRI_106967 in "Tribology International". In the article we investigate the reasons behind a change in friction coefficient at low sliding velocities for a skeleton on ice. To complete the study a numerical model was created with air drag and the coefficient of friction in an equation representing sliding on ice. An experiment with two measurement systems, timing sensors on an ice track and a portable accelerometer at the base of the skeleton, was performed. A numerical model was amended with experimental data. Finally, changes of friction coefficient were analyzed, the difference in results provided by experiment and numerical calculations were illustrated, and conditions at the start when static friction transitioned to kinetic friction highlighted. The main findings about the methods used were as follows: • Portable accelerometer helped to define the speed for transition to smooth sliding; • The numerical model of time and velocity had greater error; • The numerical model of distance and velocity was very close to experimental results.


Enhanced BMP signaling results in supernumerary tooth formation in USAG-1 deficient mouse.
Uterine sensitization associated gene-1 (USAG-1) is a BMP antagonist, and also modulates Wnt signaling. We previously reported that USAG-1 deficient mice have supernumerary teeth. The supernumerary maxillary incisor appears to form as a result of the successive development of the rudimentary upper incisor. USAG-1 abrogation rescued apoptotic elimination of odontogenic mesenchymal cells. We confirmed that BMPs were expressed in both the epithelium and mesenchyme of the rudimentary incisor at E14 and E15. BMP signaling in the rudimentary maxillary incisor, assessed by expressions of Msx1 and Dlx2 and the phosphorylation of Smad protein, was significantly enhanced. Wnt signaling as demonstrated by the nuclear localization of beta-catenin was also up-regulated. Inhibition of BMP signaling rescues supernumerary tooth formation in E15 incisor explant culture. Based upon these results, we conclude that enhanced BMP signaling results in supernumerary teeth and BMP signaling was modulated by Wnt signaling in the USAG-1 deficient mouse model.


Strategies for Imputing and Analyzing Rare Variants in Association Studies.
Rare genetic variants may be responsible for a significant amount of the uncharacterized genetic risk underlying many diseases. An efficient approach to characterizing the disease burden of rare variants may be to impute them into existing large datasets. It is well known that the ability to impute a rare variant is dependent both on the array choice and number of individuals in the reference panel carrying that variant, although it is still unclear exactly how well imputation will work for rare variants. Here, we review the additional challenges that arise when imputing rare variants, looking at studies that have been able to impute rare variants, methods behind merging reference panels, approaches for imputing rare variants, and methods for analyzing rare variants.


Reflex sympathetic dystrophy: a review.
Reflex sympathetic dystrophy is a unique traumatic disorder with unusual cutaneous signs. The case of a patient with an uncommon, poorly understood, sharply marginated geometric zone of erythema is reported. Pseudo-Kaposi's sarcoma developed in the same patient in the foot affected by reflex sympathetic dystrophy, an association not previously reported. For effective treatment this disorder must be diagnosed as early as possible. The clinical stages of evolution through which reflex sympathetic dystrophy progresses are described.


Primary pulmonary sporotrichosis.
A patient with primary pulmonary sporotrichosis with infiltration and cavitation is reported. Treatment for one year with potassium iodide resulted in marked resolution of the inflammatory lesions but persistent cavitation and fungal infection. Cure followed bisegmental lung resection with no recurrence during eight-year follow-up. Excellent results are reported in 10 patients treated by resection despite less then optimal preoperative iodide therapy. Surgical treatment of primary sporotrichosis with cavitation is indicated and should be unattended by complications or recurrence.


Multiorgan emboli due to an intraluminal thrombus from frozen elephant trunk.
The impact of kinking of the nonstented part of a frozen elephant trunk on the development of adverse effects is unclear. We report a case of an infected thrombus within the kinked nonstented portion of the frozen elephant trunk that resulted in multiorgan embolization. A 45-year-old man presented with a 1-month history of high-grade fever and fatigue. He had undergone emergent total arch replacement and frozen elephant trunk implantation for type A acute aortic dissection 7 years previously. Computed tomography showed an intraluminal thrombus within the kinked nonstented portion of the frozen elephant trunk. An autopsy also showed an intraluminal thrombus within the graft and diffuse microembolization in the abdominal organs. Therefore, in this case, kinking of the nonstented part of the frozen elephant trunk had resulted in an infected intraluminal thrombus, which subsequently caused multiorgan embolization.


Mechanism delineating differential effect of an antiestrogen, tamoxifen, on the serum LH and FSH in adult male rats.
Tamoxifen, a synthetic non-steroidal antiestrogen with residual estrogenic activity, administered to adult male rats reduces their fertility. A decrease in the circulating LH and testosterone levels with a transient rise or no change in circulating FSH levels was observed. The present study was carried out to delineate the mechanism causing the differential effect of tamoxifen on circulating gonadotropins by correlating it to changes in the hypothalamic LHRH, pituitary gonadotropins and testicular inhibin/activin. Hypothalamus, pituitary-hypothalamus complex (PHC) and intact pituitary (PI) from control and tamoxifen-treated male rats were superfused in vitro, and pulsatile release of LHRH by hypothalamus and that of LH and FSH by the PHC and PI were studied. Concomitantly, testicular immunoexpression of alpha and betaB subunits of inhibin/activin were studied by immunohistochemistry and enzyme-linked immunosorbent assays (ELISA). At 0.4 mg/kg/day dose of tamoxifen a decrease in mean hypothalamic LHRH and LH pulse frequency from PHC construct was observed. FSH pulse frequency was not affected under the same experimental conditions. At the same dose of tamoxifen, testicular expression of both alpha and betaB subunits of inhibin/activin was upregulated. The study demonstrated that reduced circulating LH levels were due to a decrease in hypothalamic LHRH concentration and in LH pulsatility following tamoxifen treatment. The lack of effect on circulating FSH under the same experimental conditions was likely due to its modulation by inhibin and activin.


A Surgical Approach to Location-specific Neuropathic Foot Ulceration.
The management of pedal ulcerations is often challenging because of a failure to correct underlying biomechanical deformities. Without correcting the biomechanical driving force creating the increased plantar pressures, it is unlikely for routine wound care to provide lasting solutions to pedal ulcerations. Patients with diabetes often experience glycosylation of their tendons, leading to contracture and pursuant deformity, creating imbalanced pressure distributions and eventual plantar ulceration. This article evaluates the efficacy of various lower extremity tendon transfers to balance the foot and redistribute plantar pressures to prevent or heal ulceration.


Is simultaneous splenectomy an additive risk factor in surgical treatment for active endocarditis?
Splenic abscess formation is a serious complication in the setting of active endocarditis, and splenectomy is recommended. However, the optimal timing for splenectomy is yet undetermined. The purpose of this study was to evaluate the role of a one-stage splenectomy and valve surgery for active endocarditis. Among 202 consecutive endocarditis patients, 18 had splenic lesions on preoperative abdominal screening, who underwent cardiac surgery and splenectomy as a one-stage procedure (group A) and were compared to patients with unremarkable abdominal screening (group B, n = 184) undergoing sole cardiac surgery. No difference was observed regarding preoperative characteristics (age, gender, New York Heart Association [NYHA] grade, diabetes, coronary artery disease, redo surgery, adiposity, smoking), intubation time, and prolonged ventilation. There were 23 early postoperative deaths in group B (12.5%) vs. none in group A. At 180 days, survival was significantly higher for patients in group A (94.4%) vs. group B (67.9%, p = 0.016), although this difference did not reach statistical significance (log-rank test, p = 0.073). Multivariate Cox proportional hazards regression revealed age above 50 years (hazard ratio [HR] 3.327, 95% confidence interval [CI] 1.279-8.650) and NYHA class above III (NYHA III or IV: HR 3.117, 95% CI 1.119-8.683, p = 0.030; NYHA IV: HR 3.678, 95% CI 1.984-6.817, p < 0.001) as independent risk factors for mortality at 180 days. A trend towards a protective factor was observed for simultaneous splenectomy (HR = 0.171, 95% CI 0.023-1.255). Simultaneous valve surgery and splenectomy is an approach for active endocarditis complicated by splenic lesions with a low 180-day mortality. Despite the expected risk elevation by septic lesions and the additive trauma of a laparotomy, patients with simultaneous splenectomy had a favourable outcome regarding early mortality and mortality at 6 months.


Peptides from the scorpion Vaejovis punctatus with broad antimicrobial activity.
The antimicrobial potential of two new non-disulfide bound peptides, named VpAmp1.0 (LPFFLLSLIPSAISAIKKI, amidated) and VpAmp2.0 (FWGFLGKLAMKAVPSLIGGNKSSSK) is here reported. These are 19- and 25-aminoacid-long peptides with +2 and +4 net charges, respectively. Their sequences correspond to the predicted mature regions from longer precursors, putatively encoded by cDNAs derived from the venom glands of the Mexican scorpion Vaejovis punctatus. Both peptides were chemically synthesized and assayed against a variety of microorganisms, including pathogenic strains from clinical isolates and strains resistant to conventional antibiotics. Two shorter variants, named VpAmp1.1 (FFLLSLIPSAISAIKKI, amidated) and VpAmp2.1 (FWGFLGKLAMKAVPSLIGGNKK), were also synthesized and tested. The antimicrobial assays revealed that the four synthetic peptides effectively inhibit the growth of both Gram-positive (Staphylococcus aureus and Streptococcus agalactiaea) and Gram-negative (Escherichia coli and Pseudomonas aeruginosa) bacteria, with MICs in the range of 2.5-24.0 μM; yeasts (Candida albicans and Candida glabrata) with MICs of 3.1-50.0 μM; and two clinically isolated strains of Mycobacterium tuberculosis-including a multi-drug resistant one- with MICs in the range of 4.8-30.5 μM. A comparison between the activities of the original peptides and their derivatives gives insight into the structural/functional role of their distinctive residues.


Clinicopathologic vs. Molecular Integrated Prognostication of Endometrial Carcinoma by European Guidelines.
This was a retrospective study of 604 patients with endometrial carcinoma, classified into ESGO-ESTRO-ESP 2021 clinicopathologic and molecular integrated risk groups. The Proactive Molecular Risk Classifier for Endometrial Cancer (ProMisE) and Leiden classifier were employed for molecular classification. Median follow-up time was 81 months. Clinicopathologic and molecular integrated risk groups were similarly associated with distinct prognoses (p < 0.001). Disease-specific survival was similar for all molecular subgroups within clinicopathologic intermediate-risk, high-risk, and advanced/metastatic groups. In contrast, the p53 abnormal subgroup (hazard ratio 9.1, 95% confidence interval 2.0-41; p = 0.004) and mismatch repair deficient subgroup (hazard ratio 3.5, 95% confidence interval 1.2-10; p = 0.024) were associated with disease-related death within clinicopathologic low-risk and high-intermediate-risk carcinomas, respectively. A risk-group shift occurred in 6.0% (36/604) and 7.4% (38/515) of patients classified by ProMisE and Leiden, respectively (p = 0.341). Of the 36 patients shifted in the ProMisE cohort, 27 were upshifted and 9 downshifted. Based on the Leiden classifier, polymerase-ϵ sequencing could be omitted in 60% (311/515) of patients without affecting the risk-group assessment. ESGO-ESTRO-ESP 2021 guidelines provide a platform for risk classification in future trials on molecularly directed treatment of endometrial carcinoma.


Physicians' comprehension of the German Patients' Rights Act: A cross-sectional study.
The German Patients' Rights Act (PRA), promulgated on February 25, 2013, was created to enhance transparency of patients' rights. This prospective study aimed to objectively measure physicians' comprehension of the PRA. We generated a controlled study design, developing a questionnaire consisting of six case scenarios with 4-7 dichotomous items each. The survey concluded with seven 5-point-Likert scale questions, dealing with the PRA's effects. Physicians teaching at the Westfälische Wilhelms-Universität (WWU) Münster served as the intervention group, and medical students from WWU Münster at the beginning of their clinical education formed the control group. Physicians were surveyed in November 2015; students were surveyed in February 2016. A total 56 completed surveys of physicians and 134 of students were analyzed. Of a total 33 points, on average physicians answered 21.04 (95% confidence interval (CI) 20.43-21.64) items correctly, a significantly higher result than students' 19.74 (95% CI 19.31-20.17) points (p < 0.001; Hedges' g = 0.53). Estimations of the PRA's effects were ambiguous. Students agreed with the PRA's supporting effect more often than physicians (p < 0.001) whereas physicians felt increased uncertainty arising from the PRA. Comprehension of the PRA increases significantly over the course of medical work experience; however, this comprehension is limited among medical experts. The PRA leads to ambiguity and uncertainty in the medical decision-making process.


Designing a game to assist learning about HIV.
A game can be educational in a non-threatening way. Games can help to build group cohesion. A fresh approach can allow complex topics such as HIV/AIDS to be explored from a different perspective.


Structure-function relationships in human cytochrome c: The role of tyrosine 67.
Spectroscopic and functional properties of human cytochrome c and its Tyr67 residue mutants (i.e., Tyr67His and Tyr67Arg) have been investigated. In the case of the Tyr67His mutant, we have observed only a very limited structural alteration of the heme pocket and of the Ω-loop involving, among others, the residue Met80 and its bond with the heme iron. Conversely, in the Tyr67Arg mutant the Fe-Met80 bond is cleaved; consequently, a much more extensive structural alteration of the Ω-loop can be envisaged. The structural, and thus the functional modifications, of the Tyr67Arg mutant are present in both the ferric [Fe(III)] and the ferrous [Fe(II)] forms, indicating that the structural changes are independent of the heme iron oxidation state, depending instead on the type of substituting residue. Furthermore, a significant peroxidase activity is evident for the Tyr67Arg mutant, highlighting the role of Arg as a basic, positively charged residue at pH7.0, located in the heme distal pocket, which may act as an acid to cleave the O-O bond in H2O2. As a whole, our results indicate that a delicate equilibrium is associated with the spatial arrangement of the Ω-loop. Clearly, Arg, but not His, is able to stabilize and polarize the negative charge on the Fe(III)-OOH complex during the formation of Compound I, with important consequences on cytochrome peroxidation activity and its role in the apoptotic process, which is somewhat different in yeast and mammals.


Microhabitat segregation in two desert rodent species: the relation of prey availability to diet.
I studied diet in relation to microhabitat use in two desert rodents:Microdipodops megacephalus, the dark kangaroo mouse, andPeromyscus maniculatus, the deer mouse. Contrary to expectation, both species ate primarily arthropods, which were most abundant near shrubs.Peromyscus used the area near shrubs, in contrast toMicrodipodops, which used open microhabitat. As a consequence, the diet ofPeromyscus was narrower and more concentrated on abundant prey types than that ofMicrodipodops. Thus microhabitat segregation, which is frequently reported for desert rodents, is related to a diet-breadth difference between these rodents. The use of open microhabitat and low density resources byMicrodipodops, when compared with the large bipedalDipodomys and small quadrupedalPerognatus, suggests that bipedal locomotion in desert rodents is related to use of open microhabitat, and that body size is related to density of food resources.


Neurotoxicity of human eosinophils towards peripheral nerves.
The toxicity of eosinophils towards peripheral nerves was examined using cultures of posterior ganglion cells from chick embryos. Eosinophils were also derived from a patient with significant "hyper-eosinophilia", peripheral neuropathy, bronchial asthma, myocardial damage and skin involvement. A sural nerve biopsy showed a severe to almost complete loss of myelinated fibers without pathological changes suggesting necrotizing vasculitis. Surviving neurons in a culture containing the patient's eosinophils or serum were markedly decreased in number as compared with those in normal subjects. These results support the possibility that the peripheral neuropathy in the patient caused by toxic agents derived from eosinophils.


Same-evening discharge after carotid endarterectomy: our initial experience.
The purpose of this study was to review the initial implementation of a same-evening discharge algorithm for patients undergoing carotid endarterectomy (CEA). We conducted a retrospective review of a prospective database of patients undergoing CEA over 3 years. From January 2000 to December 2002, 207 patients underwent CEA, of which 186 qualified for same-evening discharge. Fifty-nine patients (32%) who qualified were discharged to home the same evening; none had an adverse event after discharge. The most common reason for patients not to be discharged the same evening was exiting the operating room too late (n = 63, 34%). Thirteen patients chose to stay overnight, and 11 patients did not go home secondary to physician choice. None of these patients experienced any adverse sequelae during the overnight stay. Same-evening discharge after CEA is safe and feasible in selected patients. Currently, nearly one third of our patients are discharged within 8 hours of CEA. With appropriate scheduling, patient education, and increasing physician awareness, most patients can be discharged to home the same evening after CEA.


Clarifying the Dioscoreabuchananii Benth. species complex: a new potentially extinct subspecies for South Africa.
The Dioscoreabuchananii complex is shown to comprise three species, one of which is divided into two subspecies, based on morphological data. Two species, Dioscorearupicola Kunth and Dioscoreamultiloba Kunth, are endemic or subendemic to South Africa and of widespread occurrence in KwaZulu Natal. They differ markedly from each other in inflorescence and floral morphology and appear to be ecologically differentiated. The third species, Dioscoreabuchananii Benth., is primarily found in southeastern tropical Africa, but a small number of specimens collected in South Africa in the late 19(th) and early 20(th) centuries are placed in an endemic subspecies, Dioscoreabuchananiisubsp.undatiloba (Baker) Wilkin. The latter taxon is a high priority in terms of rediscovery and conservation. Keys, descriptions, supporting information and illustrations are provided and made available online through eMonocot biodiversity informatics tools. Three nomenclatural acts are undertaken: two names are placed in synonymy and a new combination made.


Evidence for an inhibitory action of methyldopa on spinal sympathetic reflexes.
The antihypertensive activity of methyldopa is mediated primarily by effects on the central nervous system. A number of centrally acting hypotensive substances has recently been shown to depress spinal pathways and reflexes as well as inhibiting supraspinal areas. The present series of experiments evaluated the potential influence of methyldopa on spinal mechanisms. Stimulation of an intercostal nerve evoked a two-component response (early and late) in the splanchnic nerve of anesthetized cats. The "late" phase involves supraspinal neurons, whereas, the "early" component involves only spinal pathways. The i.v. administration of 100 mg/kg of methyldopa reduced systemic blood pressure and both components of the evoked potential progressively. These experiments indicate that methyldopa exerts an effect of spinal sympathetic mechanisms which may contribute to the antihypertensive response to the compound.


[Characteristics of multiple resistance in methicillin resistant strains of staphylococci in patients with otorhinolaryngologic diseases].
Antibiotic resistance of 155 methicillin resistant strains of staphylococci of various species was investigated. The strains were susceptible to macrolides, gentamicin and rifampicin. The antibiotics could be recommended for the treatment of otorhinolaryngologic diseases.


[Allogeneic hematopoietic stem cell transplantation for chronic myelomonocytic leukemia: a report of 12 patients].
To retrospectively review the efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) for chronic myelomonocytic leukemia (CMML). The engraftment, graft versus host disease (GVHD), infection, relapse and survival of 12 CMML patients received allo-HSCT were observed. The clinical outcome of allo-HSCT for CMML was analyzed. Twelve (7 males and 5 females) CMML patients with a median age of 39 years old received allo-HSCT including 7 from HLA-matched sibling and 5 from haploidentical related donors. All 12 patients achieved engraftment. The median time of neutrophil engraftment and platelet engraftment were 15 (11 - 20) days and 13 (11 - 18) days, respectively. 4 patients occurred acute GVHD, and 3 occurred chronic GVHD. After the median follow-up of 17.5 months (12 - 32 months), the overall survival, disease free survival and relapse rate were 66.7%, 66.7%, and 16.7%, respectively. Allo-HSCT can improve the survival of patients with CMML, and is a effective therapy for CMML.


Clinical implications of the presence of anti-Ro (SSA) antibodies in patients with rheumatoid arthritis.
The clinical and serologic findings in 25 patients with rheumatoid arthritis (RA) of more than 5 years' duration, who had antibodies to Ro(SSA) cellular antigen, were analyzed and compared with those in 50 anti-Ro(SSA) negative RA patients with similar disease duration. Ninety-six percent of the anti-Ro(SSA) positive patients were female, compared to 74% in the negative group. The majority of antibody positive patients had symmetric erosive synovitis, similar to that observed in the negative group. Extra-articular manifestations were similar in both groups, except for features of Sjögren's syndrome (keratoconjunctivitis sicca and positive labial salivary gland biopsy), which were significantly more common in patients with anti-Ro(SSA) antibodies. Anemia of chronic disease was also more common in these patients, as were rheumatoid factor (RF) and antinuclear antibodies (ANAs). No patient in either group had antibodies to ds-DNA or Sm and none developed clinical features suggestive of systemic lupus erythematosus (SLE). D-penicillamine, given in the majority of patients in both groups, produced adverse reactions in 72% of the anti-Ro(SSA) positive patients, but only in 27% of the negative ones. Thus, anti-Ro(SSA) antibodies seem to characterize a distinct group of RA patients who are almost exclusively female, express more activated B-cell function, have a high prevalence of Sjögren's features and commonly develop side effects to D-penicillamine.


Self-assembly of a redox active water soluble Pd6L8 'molecular dice'.
A water soluble 'molecular dice' was synthesised via coordination driven self-assembly of a Pd(II) ion with a flexible cationic tritopic donor and was fully characterised using NMR, ESI-MS and single crystal X-ray diffraction analysis. The donor-inherited redox active nature of the 'molecular dice' was studied using cyclic voltammetry.


The association between sleep duration and weight gain in adults: a 6-year prospective study from the Quebec Family Study.
To investigate the relationship between sleep duration and subsequent body weight and fat gain. Six-year longitudinal study. Community setting. Two hundred seventy-six adults aged 21 to 64 years from the Quebec Family Study. More than half of the sample is drawn from families with at least 1 parent and 1 offspring with a body mass index of 32 kg/m2 or higher. Body composition measurements and self-reported sleep duration were determined. Changes in adiposity indices were compared between short- (5-6 hours), average- (7-8 hours), and long- (9-10 hours) duration sleeper groups. After adjustment for age, sex, and baseline body mass index, short-duration sleepers gained 1.98 kg (95% confidence interval: 1.16-2.82) more and long-duration sleepers gained 1.58 kg (95% CI: 1.02-2.56) more than did average-duration sleepers over 6 years. Short- and long-duration sleepers were 35% and 25% more likely to experience a 5-kg weight gain, respectively, as compared with average-duration sleepers over 6 years. The risk of developing obesity was elevated for short- and long-duration sleepers as compared with average-duration sleepers, with 27% and 21% increases in risk, respectively. These associations remained significant after inclusion of important covariates and were not affected by adjustment for energy intake and physical activity participation. This study provides evidence that both short and long sleeping times predict an increased risk of future body weight and fat gain in adults. Hence, these results emphasize the need to add sleep duration to the panel of determinants that contribute to weight gain and obesity.


Impact of radiotherapy parameters on outcome in the International Society of Paediatric Oncology/United Kingdom Children's Cancer Study Group PNET-3 study of preradiotherapy chemotherapy for M0-M1 medulloblastoma.
To analyze the impact of radiotherapy (RT) parameters on outcome in a randomized study of pre-RT chemotherapy for M0-M1 medulloblastoma. Patients were randomized to RT alone or RT preceded by chemotherapy with vincristine, etoposide, carboplatin, and cyclophosphamide. RT consisted of craniospinal RT, 35 Gy in 21 fractions, followed by a posterior fossa (PF) boost of 20 Gy in 12 fractions. The accuracy of cribriform fossa, skull base, and PF field placement was assessed. Between 1992 and 2000, 217 patients were randomized, of whom 179 were eligible for analysis. At a median follow-up of 5.4 years, the 3- and 5-year overall survival rate was 79.5% and 70.7%, respectively. The 3- and 5-year event-free survival (EFS) rate was 71.6% and 67.0%, respectively. EFS was significantly better for the chemotherapy plus RT group (3-year EFS rate 78.5% vs. 64.8%, p = 0.0366). Overall survival and EFS were significantly better for patients completing RT within 50 days compared with those taking >50 days to complete RT (3-year overall survival rate 84.1% vs. 70.9%, p = 0.0356, 3-year EFS rate 78.5% vs. 53.7%, p = 0.0092). Multivariate analysis identified the use of chemotherapy (p = 0.0248) and RT duration (p = 0.0100) as predictive of better EFS. Planning films were reviewed for 131 (74.4%) of 176 patients. Sixty-five (49.6%) had no targeting deviations and 58 (44.3%) had one or more deviations. PF recurrence occurred in 11 (34.4%) of 32 with a PF targeting deviation compared with 13 (16.3%) of 80 without (p = 0.043). No statistically significant impact of other targeting deviations on recurrence risk or EFS were found. The results of this study have confirmed the importance of the duration of RT for medulloblastoma. Also, attention to detail when planning RT is important, as illustrated in the case of PF field placement.


Validation of the PD home diary for assessment of motor fluctuations in advanced Parkinson's disease.
The Parkinson's disease (PD) home diary is frequently used in clinical trials to measure efficacy of medical treatments for motor fluctuations in advanced PD. This prospective study in fluctuating PD patients examines the validity of the diary for quantification of motor states in comparison to direct clinical observation. 51 patients (median age: 65 years, disease duration: 11 years) completed the diary half-hourly for two consecutive days and were simultaneously rated by an experienced observer, who independently evaluated motor states half-hourly throughout daytime. Overall agreement (Cohen's kappa) between patient and observer diary entries was 59.8% (0.387). Patients documented more On without dyskinesia (52.3% vs. 38.9%, P < 0.001) and less On with dyskinesia (21.5% vs. 34.2%, P < 0.001), whereas proportions for Off intervals were not different between patient and observer diaries (26.2% vs. 27.0%, P = 0.97). Temporal agreement between diary ratings was unsatisfactory, particularly for On with dyskinesia. Taken together, our study suggests that the PD home diary only inadequately reflects actual motor states compared to direct clinical observation.


Diagnostic imaging of the equine fetlock region using radiography and ultrasonography. Part 1: Soft tissues.
The equine fetlock is the joint most commonly associated with lameness. Although the fetlock is regarded as a simple joint, diagnosis of a fetlock disorder can be a challenge and various imaging modalities are routinely used to arrive at an accurate diagnosis. This review describes the principal disorders affecting the soft tissues of the fetlock region and addresses some of the technical aspects involved in taking radiographic and ultrasonographic images of the different soft tissue lesions. A combination of radiography and ultrasonography is still the most commonly used diagnostic approach in clinical practice.


Life-threatening megaloblastic pancytopenia with normal mean cell volume: Case series.
The mean red blood cell volume (MCV) is usually increased in severe megaloblastic anemia due to pernicious anemia. However, during one year in a university hospital, three patients with life-threatening pancytopenia and normal MCV were proven to have severe vitamin B12 deficiency. The red blood cell distribution width was markedly increased (three times normal) and led to review of the blood smear and recognition of megaloblastosis as well as prominent red cell fragmentation. These three cases illustrate that vitamin B12 status should be evaluated in cases of pancytopenia, independent of the MCV value.


Myocardial dysfunction in rheumatoid arthritis: epidemiology and pathogenesis.
Data from population- and clinic-based epidemiologic studies of rheumatoid arthritis patients suggest that individuals with rheumatoid arthritis are at risk for developing clinically evident congestive heart failure. Many established risk factors for congestive heart failure are over-represented in rheumatoid arthritis and likely account for some of the increased risk observed. In particular, data from animal models of cytokine-induced congestive heart failure have implicated the same inflammatory cytokines produced in abundance by rheumatoid synovium as the driving force behind maladaptive processes in the myocardium leading to congestive heart failure. At present, however, the direct effects of inflammatory cytokines (and rheumatoid arthritis therapies) on the myocardia of rheumatoid arthritis patients are incompletely understood.


Reduced mitochondria provide an essential function for the cytosolic methionine cycle.
The loss of mitochondria in oxymonad protists has been associated with the redirection of the essential Fe-S cluster assembly to the cytosol. Yet as our knowledge of diverse free-living protists broadens, the list of functions of their mitochondrial-related organelles (MROs) expands. We revealed another such function in the closest oxymonad relative, Paratrimastix pyriformis, after we solved the proteome of its MRO with high accuracy, using localization of organelle proteins by isotope tagging (LOPIT). The newly assigned enzymes connect to the glycine cleavage system (GCS) and produce folate derivatives with one-carbon units and formate. These are likely to be used by the cytosolic methionine cycle involved in S-adenosyl methionine recycling. The data provide consistency with the presence of the GCS in MROs of free-living species and its absence in most endobionts, which typically lose the methionine cycle and, in the case of oxymonads, the mitochondria.


Nutritional Deficiencies in Celiac Disease: Current Perspectives.
Gluten-induced T-cell-mediated immune response damages the villous structure that significantly affects the functioning of the small intestinal mucosa [...].


Optimization via response surface methodology of the synthesis of a dust suppressant and its performance characterization for use in open cut coal mines.
To relieve dust pollution in open cut coal mines and reduce the hazards of coal dust pollution to the environment and workers we optimized the synthesis of a dust suppressant by graft copolymerization of environmentally friendly soy protein isolate with methyl methacrylate. This dust suppressant could effectively control dust pollution in open cut coal mines. The optimized conditions for graft copolymerization in this case were determined by a response surface experiment designed with Design-Expert 10 software. Characterization by scanning electron microscopy showed a significant morphology change of the dust suppressant and the generation of a rigid and dense layer on its surface after interacting with coal dust. The layer exhibited good bonding and dust suppression performance. The analysis with Fourier-transform infrared spectroscopy revealed the appearance of new absorption peaks near 1300, 1072, and 1631 cm-1, demonstrating effective graft copolymerization. The proposed dust suppressant exhibited excellent wind erosion resistance, with a resistance that exceeded 90% at a wind speed of 6.5 m/sec. The successful graft copolymerization and effective bonding and curing of the dust suppressant on coal dust were experimentally verified. This is of great significance to the control of coal dust pollution.


The prevalence of hepatitis C virus infection in Egypt 2015: implications for future policy on prevention and treatment.
In 2015, a national Egyptian health issue survey was conducted to describe the prevalence of hepatitis C virus (HCV) infection. In this paper, we describe the HCV burden in 2015, compare the results with the national survey conducted in 2008, and discuss the implications of the new findings on prevention of HCV in Egypt. A multistage probability sampling approach was used, similar to the national demographic survey conducted in 2008. More than 90% of sampled individuals complied with the interview and provided blood samples. In the 15-59-year age groups, the prevalence of HCV antibody was found to be 10.0% (95% CI 9.5-10.5) and that of HCV RNA to be 7.0% (95% CI 6.6-7.4). In children, 1-14 years old, the prevalence of HCV antibody and HCV RNA were 0.4% (95% CI 0.3-0.5) and 0.2% (95% CI 0.1-0.3) respectively. Approximately, 3.7 million persons have chronic HCV infection in the age group 15-59 in 2015. An estimated 29% reduction in HCV RNA prevalence has been seen since 2008, which is largely attributable to the ageing of the group infected 40-50 years ago during the mass schistosomiasis treatment campaigns. Prevention efforts may have also contributed to this decline, with an estimated 75% (95% CI 6-45) decrease in HCV incidence in the 0-19 year age groups over the past 20 years. These findings can be used to shape future HCV prevention policies in Egypt.


The role of focal liver ablation in the treatment of unresectable primary and secondary malignant liver tumors.
Surgical resection is often the first-line treatment option for primary and select metastatic hepatic malignancies. A minority of patients with hepatocellular carcinoma undergo potentially curative resection. Similarly, patients with liver-only metastasis are candidates for resection less than 15% of the time because of bilobar disease in which resection would sacrifice too great a volume of hepatic parenchyma, tumor proximity to major vascular or biliary structures thus preventing adequate margins, or unfavorable tumor biology. Ablative techniques directed at tumor elimination while minimizing injury to the surrounding functional hepatic parenchyma may be offered to select patients with unresectable cancers. Radiofrequency ablation, percutaneous ethanol injection, transarterial chemoembolization, cryoablation, microwave coagulation, and laser-induced interstitial thermotherapy all offer potential local tumor control and occasionally achieve long-term disease-free survival. This review focuses on the indications, anticipated benefits, and limitations of these ablative techniques.


Characterization of a foamy virus isolated from Cercopithecus aethiops lymphoblastoid cells.
A virus derived from cells of a lymphoblastoid line originating from the lymph node of a healthy African green monkey was characterized as a typical member of the foamy virus subgroup of retroviridae by its morphological, physicochemical, biological and biochemical properties (reverse transcriptase activity). Besides the usual host range of foamy viruses, the isolated strain revealed a remarkable T-lymphotropism, distinguishing it from the prototypes of foamy viruses previously isolated from African green monkeys. Two foamy virus infections are demonstrated in human contacts of the African green monkey colony, with the animal harbouring the isolate.


Effects of the delta F508 mutation on the structure, function, and folding of the first nucleotide-binding domain of CFTR.
The fatal autosomal recessive disease cystic fibrosis (CF) is caused by mutations in the gene which encodes the cystic fibrosis transmembrane conductance regulator (CFTR). Many of these disease-causing mutations, including the deletion of F508 (delta F508) which accounts for approximately 70% of the disease alleles, occur in one of the two consensus nucleotide binding sequences. Peptide studies have directly demonstrated that the N-terminal nucleotide binding sequences bind adenine nucleotides. Structurally, circular dichroism spectropolarimetry indicates that this region of CFTR assumes a beta-stranded structure in solution. The delta F508 mutation causes a diminution in the amount of beta-stranded structure and a concomitant increase in the amount of random coil structure present, indicating that either the mutant peptide has a different native structure or that the conformational equilibrium is shifted toward a more disordered form. Furthermore, the mutant peptide is more sensitive to denaturation, indicating that delta F508 is a stability, or protein-folding mutant. Here we review these results and discuss their implications for interpreting the behavior of delta F508 in situ and for the rational design of new CF drugs.


The localization of oxytocin receptors in the islets of Langerhans in the rat pancreas.
In this study, oxytocin receptors (OTRs) in the islets of Langerhans were detected using real-time RT-PCR and immunohistochemical technique. Indeed, OTR mRNA was expressed in the rat pancreas. Double immunohistochemical staining for OTR and either glucagon or insulin demonstrated their co-localization in A-cells or B-cells, respectively. OTR-immunoreactivity in A-cells was stronger than that of B-cells. All A-cells and 94.8% of B-cells were OTR-immunoreactive. We reveal the statistically significant relations of OTR with A-cells and B-cells in the islets of Langerhans. This is the first demonstration of the OTR localization in the islets of Langerhans immunohistochemically. It suggests that oxytocin (OT) is involved in the release of insulin and glucagon.


Recent progress in the management of gestational trophoblastic disease.
This review was undertaken to record recent progress in understanding and management of this unusual, relatively rare, but potentially fatal disease of trophoblast in the fetal allograft. The generic term "gestational trophoblastic neoplasia" has been introduced to represent the broad spectrum of clinical behaviour. The cytogenetic origin is interestingly diverse and the chromosomal karyotype of the tumour is varied, depending upon the type of antecedent pregnancy. The major contribution to progress in the last decade has come from the accumulation of experience by tumour registries and referral centres. Data from studies of biochemical markers, especially of hCG-beta and more recently, SP1, and their accurate measurement have led to the development of a sensitive method of monitoring the disease during follow-up and treatment. Diagnosis is enhanced by ultrasound examination and treatment by suction aspiration is generally regarded as the safest mode of molar evacuation. Although prophylactic chemotherapy has resulted in reduction in incidence of persistent disease (especially in the "high risk" patient), an alternative and, perhaps more rational method, is close follow-up by hCG-beta levels. A better understanding of the use of chemotherapy and the success in achieving the objectives of early treatment when tumour load is small, and selection of the most effective regimen, on the basis of matching type of treatment to the likelihood of drug response (or resistance), are now extended to consideration of treatment for the resistant tumour or tumour in less accessible sites, such as in the brain. With these advances, reproductive function can safely be preserved in the younger patient, unnecessary drug toxicity avoided, mortality reduced considerably and long-term sequelae of chemotherapy kept at an insignificant level.U


Effects of propafenone associated with propofol on myocardial contractility, heart rate, coronary flow, and the incidence of arrhythmia in isolated hearts of rats.
To study the influence of propafenone associated with propofol on myocardial contractility (dP/dt and heart rate), coronary flow, and the incidence of arrhythmia in isolated rat hearts. Forty albino rats were anesthetized with sulfuric ether, a modified Langendorff method was performed, and the rats were fed with Krebs-Henseleit (K-H) solution, (95% O2, 5% CO2, pH 7.4+/-0.1, perfusion pressure between 90 and 100cm of water, and temperature 37+/- 0.5 masculine C). Control records were obtained after a stabilization period and rats were distributed into the following 4 groups: I (control), II (100mcg propafenone), III (25mcg propofol), and IV (propafenone-propofol). A decrease (P<0.05) in the heart rate in groups II and IV was observed, with a greater decrease in group II. A decrease was noted in the dP/dt ratio (P< 0.05) in groups II and IV, during all periods. Group III experienced depression from the 1st to the 3rd minute. Coronary flow had a decrease (P<0.05) in all groups, compared with the control group, especially in group IV with a decrease from 14mL/min to 11mL/min. Arrhythmogenic effects of propafenone (pro-arrhythmia) were verified in 50% of group II. In the association with propofol (group IV), no significant difference occurred, and arrhythmias (pro-arrhythmic effect) were observed in 40% of the hearts. The association propafenone-propofol was not harmful to the use of propafenone solely, regarding the effects observed in myocardial contractility, coronary flow, and in the incidence of arrhythmias.


Validity of the Japanese version of the GHQ among antenatal clinic attendants.
The validity of the Japanese version of the 30-item General Health Questionnaire (GHQ) was examined against the semi-structured interview-based Research Diagnostic Criteria (RDC) as external criteria. The GHQ total score discriminated 'cases' and 'non-cases' satisfactorily but its recommended cut-off point was higher (7/8) than that of the original English version (4/5). Discriminant function analysis revealed that only 13 items contributed to the discriminatory power and that their discriminant function score was better than a simple summation of the 30 GHQ item scores in terms of validity.


All-optical control of phase singularities using strong light-matter coupling.
Strong light-matter coupling occurs when the rate of energy exchange between an electromagnetic mode and a molecular ensemble exceeds competing dissipative processes. The study of strong coupling has been motivated by applications such as lasing and the modification of chemical processes. Here we show that strong coupling can be used to create phase singularities. Many nanophotonic structures have been designed to generate phase singularities for use in sensing and optoelectronics. We utilise the concept of cavity-free strong coupling, where electromagnetic modes sustained by a material are strong enough to strongly couple to the material's own molecular resonance, to create phase singularities in a simple thin film of organic molecules. We show that the use of photochromic molecules allows for all-optical control of phase singularities. Our results suggest what we believe to be both a new application for strong light-matter coupling and a new, simplified, more versatile means of manipulating phase singularities.


Congenital aural atresia: stability of surgical results.
To compare early (<1 y) and longer-term (1.0-7.5 y; mean follow-up, 2.8 y) hearing results following surgery for congenital aural atresia and to analyze revision cases for cause of failure, time of occurrence, and outcome. Retrospective study of 55 consecutive patients (59 ears) undergoing surgery during an 11-year period for congenital aural atresia. The best speech reception threshold (SRT) during the first postoperative year was compared with the most recent SRT beyond the first postoperative year. The complication rate and long-term hearing results (>1 y) for initial and revision surgeries were compared. In the early postoperative period, an SRT of < or =25 dB was achieved in 60% and an SRT of < or =30 dB in 70%. With longer follow-up (mean, 2.8 y), 46% of patients maintained an SRT < or =25 dB. Revision surgery was necessary in approximately one third of patients. Longer-term hearing results following initial surgery only or after revision surgery showed an SRT < or =25 dB in 53% and an SRT < or =30 dB in 64%. For primary and revisions surgeries the incidence of temporary facial paralysis was 1.5% and for significant hearing loss, 3.0%. Some degradation in hearing does occur as patients are followed beyond the first postoperative year. Revision surgery will be necessary in approximately one third of cases. With revisions, an SRT < or =25 dB can be expected in half of cases and an SRT < or =30 dB in two thirds of cases. The ability to provide these hearing results supports this surgery in unilateral cases.


Uncal decompression in gliomatosis cerebri.
Gliomatosis cerebri is defined as an infiltration, by an infiltrative glioma, of more than two cerebral lobes. Depending on response to treatment (chemotherapy and radiotherapy), clinical course may prolong over several months. Surgical excision has a very limited role in the management of this diagnosis. We present the case of a 48 year-old woman in whom a decompressive temporal lobectomy was performed in the context of a gliomatosis. Relief of intracranial hypertension allowed further treatment and a survival of 23 months. Relevant literature on the subject has been reviewed. There is the possibility of offering a decompressive lobectomy in selected cases of gliomatosis, allowing to undergo other treatment modalities.


Giant lipoma of the colon presenting as a case of adult intussusception: A case series.
Lipoma of the intestine is one of the uncommon benign tumors of the alimentary tract first reported by Bauer in 1957. The peak incidence is usually seen between 50 and 60 years of age and more commonly in females. They are usually either asymptomatic or mildly symptomatic. The occurrence of symptoms is mostly related to the diameter of the lesion. We present a single center consecutive case of three patients who had giant colonic lipomas presented with colonic intussusception. Two of the cases presented for the first time with an emergency condition: acute intestinal obstruction. The mode of presentation, diagnosis, and management outcome of colonic lipoma was assessed. Symptomatic lipoma may present with non-specific abdominal pain, change in bowel habits, intussusception, and hemorrhage. The clinical diagnosis is usually challenging, given the non-specificity of symptoms of the disease. Computed tomography is considered to be a diagnostic modality of choice in recognizing the presence of lipoma. However, a definitive diagnosis of lipoma is usually obtained after a histopathologic examination of the resected specimen. The management of colonic lipoma depends on the size of the lesion and the presence or absence of symptoms. Colonic lipoma is a rare benign tumor that occurs in the elderly, frequently misdiagnosed as a malignant tumor. Despite the rarity of the disease, lipoma should be considered in the differential diagnosis of large bowel tumors and adult intussusception.


Neurological outcomes and reperfusion strategies in out-of-hospital cardiac arrest patients due to pulmonary embolism who underwent venoarterial extracorporeal membrane oxygenation: A post-hoc analysis of a multicenter retrospective cohort study.
This study aimed to evaluate the effect of different reperfusion strategies on neurological outcomes in patients with pulmonary embolism who received venoarterial extracorporeal membrane oxygenation (VA-ECMO) for out-of-hospital cardiac arrest (OHCA). This was a post-hoc analysis of a multicenter retrospective cohort study conducted in 36 institutions in Japan over six years. We included patients who underwent VA-ECMO and were diagnosed with pulmonary embolism caused by OHCA. Neurological outcomes were evaluated on the basis of the cerebral performance category at hospital discharge. We also assessed the association between reperfusion strategies and successful separation from ECMO. Among the 78 included patients, approximately half were successfully weaned from ECMO. Hospital mortality and favorable neurological outcomes at hospital discharge were 60.3% and 17.9%, respectively. Thirty-one patients (39.7%) underwent reperfusion strategies after ECMO, including 13 who received systemic thrombolytic therapy and 18 who underwent mechanical reperfusion strategy. After adjusting for prespecified covariates using the competing risk model, reperfusion strategies increased ECMO separation rate (systemic thrombolytic therapy: subdistribution hazard ratio [sHR] 2.24, 95% confidence interval [CI] 1.21-4.17, P = 0.011; mechanical reperfusion strategy: sHR 1.70, 95% CI 0.86-3.41, P = 0.129) compared with anticoagulation therapy alone, whereas higher cardiac Sequential Organ Failure Assessment score decreased ECMO separation rate (sHR 0.81, 95% CI 0.67-0.97, P = 0.020). Favorable neurological outcomes were observed in less than 20% of patients with OHCA due to pulmonary embolism undergoing ECMO. Reperfusion strategies may be associated with shorter ECMO durations in these patients. https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000041577 (unique identifier: UMIN000036490).


[Cervicobrachial neuralgia revealing neurosarcoma].
Malignant peripheral nerve sheath tumor (MPNST) or neurofibrosarcoma, previously described as malignant Schwannoma or neurosarcoma, is an extremely rare cause of malignancy localized in the neck. Half of reported cases occurred in patients with neurofibromatosis in Von Recklinghausen disease type I. Typical features include high grade malignancy and a tendency to recurrence and distant metastases. We report the case of a 56-year-old woman with neurosarcoma of the neck, which was revealed by a cervicobrachial neuralgia. The physical examination found a mass on the left side of the neck. Plain radiographs showed osteoarthritis. MRI showed a well-defined paravertebral mass. Pathologic diagnosis was neurosarcoma. Radiotherapy was delivered.


Comparison of preoperative, operative and postoperative variables in asymptomatic or minimally symptomatic patients to severely symptomatic patients three years after coronary artery bypass grafting: analysis of 423 patients.
During a follow-up period of 3 years, among a consecutive series of 423 patients who gave informed consent for recatheterization both 1 and 3 years after coronary artery bypass grafting, the incidence of severely symptomatic patients with New York Heart Association class III or IV was 19% (79 of 423). The predictive value of approximately 80 clinical, angiographic and perioperative variables was too low to be of clinical value. Adverse clinical outcome was associated with a high closure rate of the grafts. Forty-six percent of the patients could not undergo reoperation because of unsuitable coronary anatomy. With intensive medical therapy half of these patients improved to functional class I or II, while of those patients who were reoperable 32% improved to class I or II with intensive pharmacologic treatment instead of reoperation. The nonresponders underwent reoperation, which resulted in improvement of symptoms to functional class I or II in most (83%).


Endothelin-1 receptor antagonist: effects on endothelin- and cyclosporine-treated mesangial cells.
Endothelin-1 (Et) has profound effects on glomerular microcirculation and mesangial cell contraction. A parameter of mesangial cell contraction was examined by measuring myosin light chain phosphorylation (MLCP) in glomerular mesangial cells in the presence and absence of a newly developed endothelin-1 receptor antagonist (EtA). Addition of Et alone (10 nM) caused a marked increase in MLCP, which, on average, rose by 53 +/- 6% above the level in cells exposed to vehicle (P less than 0.0005). This effect was shown to continue for at least one hour; MLCP at 60 minutes was 64 +/- 12% higher than controls, (P less than 0.025), constituting a unique observation of an in vitro parameter which parallels the characteristic in vivo effect of Et. Treatment of cells with EtA virtually abolished this Et-induced increase in MLCP, which rose by only 2 +/- 3% and -1 +/- 4% for doses of EtA of 44 nM and 66 nM, respectively. Examination of the intracellular calcium concentration, [Ca2+]i, revealed that EtA almost completely abolished the transient increase in [Ca2+]i evoked by Et and also suppressed the early portions of the sustained increase in [Ca2+]i. EtA was ineffective in abolishing [Ca2+]i increase in response to arginine vasopressin. Finally, to evaluate EtA's efficacy in a pathophysiologic setting, we also studied mesangial cells exposed to cyclosporine (Cs). Exposure of mesangial cells to Cs (10(-5) M) for 60 minutes caused a significant increase in MLCP, on average, by 38 +/- 6% above control (P less than 0.0005), while cells exposed to Cs in the presence of EtA increased MLCP significantly less, by only 15 +/- 9%. These data provide further evidence for Et's long-lasting cellular actions, and demonstrate inhibitory effects of an Et receptor antagonist after direct cellular exposure to Et and also after Cs exposure, a pathophysiologic setting which likely involves Et.