Cadmium and lipid balance in outdoor workers exposed to urban stressor.
The aim of our study was to evaluate the association between levels of blood and urinary cadmium and lipid balance in a group of outdoor workers. The study was conducted on a group of 146 individuals (average age 45,1 ± 8,5). Blood and urinary samples were collected for the detection of total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, blood cadmium and urinary cadmium. We divided the group of workers into two subgroups according to the task:75 traffic policemen and 71 police drivers. Gender differences were found. The Pearson correlation coefficient showed a positive association between blood and urinary cadmium levels and total cholesterol, LDL and triglycerides levels. Total cholesterol, LDL cholesterol and triglycerides were significantly higher in the group of traffic policemen than in police drivers. In conclusion, the results suggest a statistically significant association between blood and urinary cadmium levels and lipid balance contributing to an increase of the cardiovascular risk.


Opening up the politics of knowledge and power in bioscience.
Public engagement is not in tension with science, but actually a way to be more rigorous - as well as more democratic - about social choice of biotechnology.


Synthesis, characterization and in vitro antimicrobial activity of novel sulfonylureas of 15-membered azalides.
Three series of the novel sulfonylurea derivatives of 15-membered azalides, i.e. 9a-N-[N'-(aryl)sulfonylcarbamoyl] (4a-4f, 5a-5f), 9a-N-{N'-[(aryl)sulfonylcarbamoyl-gamma-aminopropyl]} (10a-10f, 11a, 11c) and 9a-N-{N'-(beta-cyanoethyl)-N'-[(aryl)sulfonylcarabamoyl-gamma-aminopropyl]} (14a-14f, 15a, 15b, 15f) derivatives of 9-deoxo-9-dihydro-9a-aza-9a-homoerythromycin A (2) and 5-O-desosaminyl-9-deoxo-9-dihydro-9a-aza-9a-homoerythronolide A (3) were prepared and their structures elucidated by NMR and IR spectroscopic methods and mass spectrometry. Minimal inhibitory concentration (MIC) of these compounds was determined on a panel of sensitive and resistant Gram-positive and Gram-negative bacterial strains. Several compounds of the series of 9a-N-[N'-(aryl)sulfonylcarbamoyl] derivatives that showed significant improvements in activity against inducible resistant Streptococcus pyogenes strain were suggested for further optimization.


Investigations on the deiodination of thyroxine (T4) to 3,3'-diiodothyronine (3,3'-T2) in rat liver homogenate.
Properties of an inactivating pathway of T4 to 3,3'-diiodothyronine (T2') in rat liver homogenate are described. The intermediate product (of this reaction sequence) is reverse T3 (rT3) which is very labile and cannot be measured at pH 7.5. The apparent KM of the reaction rT3 to T2' is 2 X 10(-8) M. The activities catalyzing the reactions T4 to T3, T4 to T2' and rT3 to T2' are found in the 100 000 X g pellet. Propylthiouracil inhibits all three activities to a similar degree; alpha-methyl-p-tyrosine has no effect. T3 seems to be only a minor source of T2' production. The molar ratio of the two T4 deiodination pathways T4 to T3/T4 to T2' under these conditions is about 1.7; however, by changing the pH this ratio could be significantly altered.


The Brain Trauma Foundation. The American Association of Neurological Surgeons. The Joint Section on Neurotrauma and Critical Care. Initial management.
The fundamental goals of resuscitation of the head-injured patient are the restoration of circulating volume, blood pressure, oxygenation, and ventilation. The physician should initiate maneuvers that serve to lower ICP and do not interfere with these aims as early as possible during resuscitation of any patient with a head injury. Treatment modalities such as hyperventilation and mannitol administration that have the potential of exacerbating intracranial ischemia or interfering with resuscitation should be reserved for patients who show signs of intracranial hypertension such as evidence of herniation or neurologic deterioration.


A novel amphiphilic acrylic copolymer based on Triton X-100 for a poly(alkenoate) glass-ionomer cement.
The aim of this study was to synthesize a novel ampiphilic polyalkenoic acid copolymer based on acrylic acid and a methacrylic macromonomer of Triton X-100 and determine the efficacy of the novel copolymeric polyalkenoic acid in the formation of glass-ionomer cements. Two water soluble copolymers of acrylic acid (AA) and a new amphiphilic macromonomer derived from Triton X-100 (MT) were prepared via radical copolymerisation at 60 degrees C, using azobisisobutyronitrile (AIBN) as the initiator and used to formulate conventional glass-ionomer cements with reactive glass fillers. The acid-base reaction was carried out by reacting aqueous solutions of the new copolymer (40 and 50%) with a commercial aluminofluorosilicate glass as used in conventional glass-ionomer cements. The efficacy of the new copolymer in the formation of glass-ionomer cements was investigated and preliminary results on setting parameters, FTIR analysis, mechanical properties and SEM analysis are reported in this paper. The copolymers were synthesized and characterized and further used to successfully prepare glass-ionomer cements. The experimental cements exhibited longer setting and working times in comparison to conventional glass-ionomer cements and the inclusion of tartaric acid enhanced the mechanical properties, which were comparable to the commercial glass-ionomer cement, Fuji IX. Glass-ionomer cements prepared using ampiphilic comonomers is expected to influence their behavior in both polar and non-polar environments. As bulky side chains have been incorporated within the polymeric chain it is expected to affect the reaction kinetics of the acid-base reaction.


Antioxidant Compounds and Health Benefits of Citrus Fruits.
Recent evidence emanating from epidemiological prospective studies shows that increased intakes of antioxidant-rich fruits, vegetables, and legumes are associated with a lower risk of developing chronic oxidative stress-related diseases like cardiovascular diseases and cancer, as well as with a lower risk of cardiovascular, cancer, and all-cause mortality rates [...].


Tazarotene induces epidermal cell differentiation in the mouse tail test used as an animal model for psoriasis.
Disturbed epidermal proliferation and keratinization are major features of psoriatic skin lesions. The so-called mouse tail test is known as an animal model to evaluate the antipsoriatic efficacy of topical drugs with regard to the induction of orthokeratosis. The purpose of the present study was to investigate the effect of tazarotene, a novel, receptor-specific retinoid, by the mouse tail test in a direct comparison to dithranol representing a classical topical antipsoriatic compound. The tails of CFLP mice were treated with tazarotene gel (0.1%, 0.05%), dithranol ointment (1.0%), tretinoin cream (0.05%) and methylcellulose (5%) hydrogel (vehicle control) for 2 weeks. Longitudinal histological sections were prepared from the tail skin, and the degree of orthokeratosis was determined by measuring the horizontal length of the fully developed granular layer within an individual scale in relation to its total length according to a method originally described by Bosman and co-authors. The degree of orthokeratosis was significantly (p < or = 0.05) increased by 0.1% tazarotene (87+/-20%), 1.0% dithranol (75+/-26%), 0.05% tazarotene (59+/-27%), and 0.05% tretinoin (23+/-13%) as compared to untreated (11+/-6%) and methylcellulose hydrogel-treated (13+/-6%) controls. Under the conditions of the mouse tail test, tazarotene showed a strong potency to induce orthokeratosis. With regard to clinically relevant concentrations this effect was even more pronounced than that observed for dithranol.


Fra-1 substitutes for c-Fos in AP-1-mediated signal transduction in retinal apoptosis.
Lack of the AP-1 member c-Fos protects photoreceptors against light-induced apoptosis, a model for retinal degeneration. In mice, light damage increases the activity of the transcription factor AP-1, while pharmacological suppression of AP-1 prevents apoptosis, suggesting the involvement of pro-apoptotic AP-1 target genes. Recently, however, it was shown that photoreceptors expressing Fra-1 in place of c-Fos (Fos (Fosl1/Fosl1) ) are apoptosis competent despite the lack of transactivation domains in Fra-1. Here, we show that morphological features of light-induced apoptosis were indistinguishable in Fos (Fosl1/Fosl1) and wild-type mice. Furthermore, light exposure comparably increased AP-1 activity in both genotypes. Opposite to wild-type mice, Fra-1, but not c-Fos, was detectable in AP-1 complexes of Fos (Fosl1/Fosl1) mice. Importantly, AP-1 responsiveness for glucocorticoid receptor-mediated inhibition was preserved in Fos (Fosl1/Fosl1) mice. Thus, Fra-1 takes over for c-Fos in pro- and anti-apoptotic signal transduction. As Fra-1 lacks transactivation domains, AP-1 may not induce, but rather suppress genes in retinal light damage.


10-Year Comparative Follow-up of Familial versus Multifactorial Chylomicronemia Syndromes.
The relative incidence of acute pancreatitis, ischemic cardiovascular disease, and diabetes in hyperchylomicronemic patients exhibiting familial chylomicronemia syndrome (FCS) or multifactorial chylomicronemia syndrome (MCS) is unknown. The objective was to study the occurrence of these events in FCS and MCS patients compared with the general population. Twenty-nine FCS and 124 MCS patients, with genetic diagnosis, in 4 lipid clinics were matched with 413 controls. Individual hospital data linked to the national claims database were collected between 2006 and 2016. The occurrence of complications was retrospectively assessed before follow-up and during a median follow-up time of 9.8 years, for 1500 patient years of follow-up. Patients with FCS were younger than those with MCS (34.3 ± 13.6 vs 45.2 ± 12.6 years, P < 0.01). During the study period, 58.6% of the FCS patients versus 19.4% of the MCS patients had at least 1 episode of acute hypertriglyceridemic pancreatitis (AHP) (hazard ratio [HR] = 3.6; P < 0.01). Conversely, the ischemic risk was lower in FCS than in MCS (HR = 0.3; P = 0.05). The risk of venous thrombosis was similar in both groups. The incidence of diabetes was high in both groups compared with matched controls (odds ratio [OR] = 22.8; P < 0.01 in FCS and OR = 30.3; P < 0.01 in MCS). The incidence of AHP was much higher in FCS than in MCS patients, whereas the incidence of ischemic cardiovascular events was found to be increased in MCS versus FCS patients and a representative matched control group. Differences in both triglyceride-rich lipoproteins metabolism and comorbidities in MCS versus FCS drive the occurrence of different patterns of complications.


Relevance study of bare and coated zero valent iron nanoparticles for lindane degradation from its by-product monitorization.
Zero-valent iron nanoparticles (NZVI) as well as polymer-stabilized nanoparticles were synthesized and used for lindane (γ-hexachlorocyclohexane) degradation in aqueous solution. To study the effectiveness of the different coated nanoparticles, simple and rapid analytical methods have been developed to measure and to detect lindane and its by-products. For the monitorization of lindane degradation solid-phase extraction (SPE) was used, while volatile by-products formation measurement was carried out by headspace-solid phase microextraction (HS-SPME) followed by GC/MS. The SPE-GC/MS method provides low detection limits (0.2 μg L(-1)), high recovery (above 95%) and it is a valuable tool for kinetic studies of the degradation process for each polymer used, while HS-SPME-GC/MS has proved to be an effective tool for the extraction and evaluation of volatile degradation by-products.


Clinical characteristics of miliary pulmonary metastases in non-small cell lung cancer.
The prognosis of miliary pulmonary metastases (MPM), which are characterized as randomly disseminated, innumerable, and small metastatic nodules, has been considered as being poor. The purpose of this study was to evaluate the clinical characteristics and survival of MPM in patients with non-small cell lung cancer (NSCLC). This retrospective study included NSCLC patients with MPM and nonmiliary pulmonary metastases (NMPM) detected during staging evaluation between 2000 and 2020. MPM was defined as >50 bilaterally distributed metastatic pulmonary nodules (<1 cm in diameter), and NMPM was defined as the presence of ≤15 metastatic pulmonary nodules regardless of size. Baseline characteristics, genetic alterations and overall survival (OS) rates were compared between the two groups. Twenty-six patients with MPM and 78 patients with NMPM were analyzed. The median number of patients who smoked was significantly lower in the MPM group than in the NMPM group (0 vs. 8 pack years, p = 0.030). The frequency of EGFR mutation was significantly higher in the MPM group (58%) than in the NMPM group (24%; p = 0.006). There was no significant difference in 5-year OS between the MPM and the NMPM group by the log-rank test (p = 0.900). MPM in NSCLC were significantly related to EGFR mutation. The OS rate of the MPM group was not inferior to that of the NMPM group. The presence of EGFR mutations should be thoroughly evaluated for NSCLC patients with initial presentation of MPM.


Short-Bowel Syndrome: Epidemiology, Hospitalization Trends, In-Hospital Mortality, and Healthcare Utilization.
Short-bowel syndrome (SBS) is a common cause of chronic intestinal failure and is associated with increased morbidity, mortality, poor quality of life, and an increased burden on healthcare costs. We used the US Nationwide Inpatient Sample database from 2005 to 2014. We identified adult SBS hospitalizations by using a combination of International Classification of Diseases, Ninth Revision, Clinical Modification codes. We studied the demographics of the patients with SBS and analyzed the trends in the number of hospitalizations, in-hospital mortality, and healthcare costs. We also identified the risk factors associated with in-hospital mortality. A total of 53,040 SBS hospitalizations were identified. We found that SBS-related hospitalizations increased by 55% between 2005 (N = 4037) and 2014 (N = 6265). During this period, the in-hospital mortality decreased from 40 per 1000 to 29 per 1000 hospitalizations, resulting in an overall reduction of 27%. Higher mortality was noted in SBS patients with sepsis (6.7%), liver dysfunction (6.2%), severe malnutrition (6.0%), and metastatic cancer (5.4%). The overall mean length of stay (LOS) for SBS-related hospitalizations was 14.7 days, with a mean hospital cost of $34,130. We noted a steady decrease in the LOS, whereas the cost of care remained relatively stable. The national burden of SBS-related hospitalizations continues to rise, and the mortality associated with SBS has substantially decreased. Older SBS patients with sepsis, liver dysfunction, severe malnutrition, and metastatic cancer had the highest risk of mortality. Healthcare utilization in SBS remains high. healthcare utilization; hospitalization trend; mortality; research and diseases; short-bowel syndrome.


Association of Adolescent Depressive Symptoms With Health Care Utilization and Payer-Incurred Expenditures.
Screening adolescents for depression is recommended by the US Preventive Services Task Force. We sought to evaluate the impact of positive depression screens in an adolescent population on health care utilization and costs from a payer perspective. We conducted depression screening among 13- to 17-year-old adolescents enrolled in a large integrated care system using the 2- and 9-item Patient Health Questionnaires (PHQ). Health care utilization and cost data were obtained from administrative records. Chi-square, Wilcoxon rank sum, and t tests were used to test for statistical differences in outcomes between adolescents on the basis of screening status. Of the 4010 adolescents who completed depression screening, 3707 (92.4%) screened negative (PHQ-2 <2 or PHQ-9 <10), 186 (3.9%) screened positive for mild depression (PHQ-9 10-14), and 95 (2.4%) screened positive for moderate to severe depression (PHQ-9 ≥15). In the 12 months after screening, screen-positive adolescents were more likely than screen-negative adolescents to receive any emergency department visit or inpatient hospitalization, and they had significantly higher utilization of outpatient medical (mean ± SD, 8.3 ± 1.5 vs 3.5 ± 5.1) and mental health (3.8 ± 9.3 vs 0.7 ± 3.5) visits. Total health care system costs for screen-positive adolescents ($5083 ± $10,489) were more than twice as high as those of screen-negative adolescents ($2357 ± $7621). Adolescent depressive symptoms, even when mild, are associated with increased health care utilization and costs. Only a minority of the increased costs is attributable to mental health care. Implementing depression screening and evidence-based mental health services may help to better control health care costs among screen-positive adolescents.


Netrin Family Genes as Prognostic Markers and Therapeutic Targets for Clear Cell Renal Cell Carcinoma: Netrin-4 Acts through the Wnt/β-Catenin Signaling Pathway.
Clear cell renal cell carcinoma (ccRCC, or KIRC) is the most common type of kidney cancer, originating within the renal cortex. The current outcomes for early diagnosis and late treatment of ccRCC are unsatisfactory. Therefore, it is important to explore tumor biomarkers and therapeutic opportunities for ccRCC. In this study, we used bioinformatics methods to systematically evaluate the expression and prognostic value of Netrin family genes in ccRCC. Through our analysis, three potential biomarkers for ccRCC were identified, namely NTNG1, NTNG2, and NTN4. Moreover, we performed in vitro and in vivo experiments to explore the possible biological roles of NTN4 and found that NTN4 could regulate ccRCC development through Wnt/β-catenin signaling. We elucidate the molecular mechanism by which NTN4 modulates β-catenin expression and nuclear translocation to inhibit ccRCC progression, providing a new theoretical basis for developing therapeutic targets for ccRCC. Thus, we suggest that Netrin-related studies may offer new directions for the diagnosis, treatment, and prognosis of ccRCC patients.


Large-scale evaluation of microorganism inactivation by bipolar ionization and photocatalytic devices.
The COVID-19 pandemic has raised awareness in the spread of disease via airborne transmission. As a result, there has been increasing interest in technologies that claim to reduce concentrations of airborne pathogens in indoor environments. The efficacy of many of these emerging technologies is not fully understood, and the testing that has been done is often conducted at a small scale and not representative of applied settings. There is currently no standard test method for evaluating air treatment technologies, making it difficult to compare results across studies or technology types. Here, a consistent testing approach in an operational-scale test chamber with a mock recirculating heating, ventilation, and air conditioning (HVAC) system was used to evaluate the efficacy of bipolar ionization and photocatalytic devices against the non-enveloped bacteriophage MS2 in the air and on surfaces. Statistically significant differences between replicate sets of technology tests and control tests (without technologies active) are apparent after 1 h, ranging to a maximum of 0.88 log10 reduction for the bipolar ionization tests and 1.8 log10 reduction for the photocatalytic device tests. It should be noted that ozone concentrations were elevated above background concentrations in the test chamber during the photocatalytic device testing. No significant differences were observed between control and technology tests in terms of the amount of MS2 deposited or inactivated on surfaces during testing. A standardized, large-scale testing approach, with replicate testing and time-matched control conditions, is necessary for contextualizing laboratory efficacy results, translating them to real-world conditions, and for facilitating technology comparisons.


Two's a Charm: Endoscopic Therapy of Multiple Pancreatic Pseudocysts.
Pancreatic pseudocysts commonly complicate acute pancreatitis. They can evolve either asymptomatically or with important symptoms. Treatment can be surgical, endoscopic, or percutaneous. The authors present a case report of a 78-year-old man who developed symptoms of an acute abdomen during hospitalization. A CT scan showed two pancreatic pseudocysts (diameters 10 cm and 7.5 cm) that were successfully drained endoscopically. Multiple pancreatic pseudocysts can be treated successfully via an endoscopic approach.


Malignant hyperthermia.
Malignant hyperthermia (MH) is a rare genetic condition which may manifest for the first time during anaesthesia associated with a routine surgical procedure. Characterised initially by muscle rigidity, increased body temperature and metabolic acidosis, the syndrome may prove fatal unless prompt, effective treatment is administered. The sudden development of MH constitutes a medical emergency; hence it is essential that theatre practitioners are knowledgeable about the presenting symptoms and management of the condition.


An improved design for the skin graft board.
A modified design is described for the skin graft board, which improves its performance when used in conjunction with the skin graft knife.


Validation and relevance of Rheumatoid Arthritis Pain Scale (RAPS) in Indian (Asian) patients suffering from rheumatoid arthritis.
Pain in RA is multifaceted and complex. Measuring instruments are inadequate. Rheumatoid Arthritis Pain Scale (RAPS) (Arthritis Care Res 45:317-323, 2001) was designed to measure pain comprehensively but has been sparsely reported. We decided to validate a suitable version for our community. Post translation (contextual), RAPS was administered (face to face interview) to 172 consenting patients of moderately severe RA (mean pain visual analogue scale (VAS) 5.4 cm) in a cross-sectional study using standard rheumatology case record form. RAPS contained 24 questions (numeric score, anchored at 0 (never) and 6 (always); range 0-144). Fifty-seven cohort patients on supervised rheumatology care were followed for 16 weeks. SPSS (v16) was used for statistical analysis, significant p < 0.05. RAPS showed good face and content validity (consensus). Construct/criterion validity was demonstrated for subclass domains and total RAPS (Cronbach's alpha 0.91, test-retest interclass correlation (Pearson) 0.71). Fair to modest correlation (p < 0.05) was seen with swollen joint count (0.16), Indian health assessment questionnaire (0.23), medical outcome short form (SF), 36 physical score (-0.35), SF 36 mental score (-0.21) and C-reactive protein (0.25), not with pain VAS. Similar results were shown for subclass domains (physiologic, affective, sensory, cognitive), except low alpha for affective. Age, disease duration and SF 36 were significant predictors (linear regression). In factor analysis, RAPS loaded with SF 36. The standardized response mean (0.6) was equal to pain VAS and DAS 28. RAPS was found to be a valid and clinically relevant instrument for measuring pain in Indian patients suffering from RA. It merits more widespread clinical use.


Perioperative care of a patient with clam cystoileoplasty undergoing caesarean section: A case review.
This case report describes the care provided to a 35-year-old primagravida having an elective section who had undergone clam cystoileoplasty eight years prior. It examines the literature relating to this surgical technique and its implications for obstetric practice. It also examines anaesthetic considerations related to the surgery. Close involvement with urology surgeons is essential and the patient must be supported in their choices relating to ongoing management of continence.


Bladder and Urinary Deep Pelvic Endometriosis: A Step-by-Step Standard Approach.
To demonstrate how to treat bladder and ureteral deep pelvic endometriosis using a laparoscopic approach with partial cystectomy and resection and end-to-end anastomosis of the ureter. Step-by-step explanation of the surgery using a video approved by the local institutional review board. University Hospital of Strasbourg, France. A 27-year-old nulliparous woman with severe endometriosis stage IV (revised American Fertility Society classification score >40) of the bladder and left ureter. On pelvic magnetic resonance imaging, we found dilatation of the left ureter and left hydronephrosis induced by a 17-mm endometriosis nodule. A JJ probe was placed on the left ureter before the surgery because of dilatation of the ureter and decreased renal function. During the exploration, we found an abdominal cavity free of adhesion. There was an endometriosis implant in the bladder in front of the uterus and a large nodule of the left uterosacral ligament that was compressing the ureter. In the first step, we made a section of the round ligament to perform anterior ureterolysis and progressive dissection of the nodule surrounding the ureter. Once the nodule was resected, tight stenosis was observed approximately 1 cm from the bladder. The vesicouterine and vesicovaginal spaces were then dissected to pass under the nodule to the vagina. We opened the dome of the bladder using the thunderbeat (Olympus) and dissected the bladder to remove the transfixing nodule while staying away from the ureters. The closure of the bladder was performed by 2 lateral sutures and a running suture using a braided suture (V-Loc) 2-0, with good tightness as checked by a blue test. Ureteral resection was performed around the JJ probe in place to remove the stenotic zone; thereafter, we performed an end-to-end anastomosis of the ureter using 4 sutures of monofilament (Monocryl) 4-0 with a good anatomic result. Finally, an omentoplasty was fixed around the ureter using a 2-0 monofilament suture (Monocryl). The postoperative course was uneventful. A Foley catheter was left in place for 10 days, and the JJ probe was removed 6 weeks later. The operative time was 140 minutes. The step-by-step explanation technique was simple with minimal operative difficulty and a low rate of morbidity. This video shows how deep urinary endometriosis can be treated laparoscopically. Mastering suturing is essential to avoid complications.


Glutamate dehydrogenase: biochemical and clinical aspects of an interesting enzyme.
The molecular properties and possible metabolic functions of glutamate dehydrogenase (GLDH-EC 22.214.171.124) are described. The distribution of this enzyme in the body and particularly in the liver are outlined. The significance of these properties for GLDH release into the extracellular space, for the distribution and elimination of the enzyme and, foremost, for the assay of GLDH as a diagnostic indicator of hepatic and biliary disease are shown. Analytical methods are reviewed.


Data processing of stress ECGs using discrete cosine transform.
The signal processing steps for the analysis of stress ECGs are aimed at improving the signal to noise ratio (SNR) of recordings in addition to eliminating artifacts due to respiration, movement of arms, etc. In this paper, we bring forth two important applications of the discrete cosine transform (DCT) for noise suppression and removal of baseline wander. The noise suppression algorithm has been framed on the basis of a two step procedure involving singular value decomposition (SVD) smoothing operation in transform domain followed by that in time domain. The mean square error (MSE) resulting from the first step is shown to effectively follow the trend obtained by using an ideal Wiener filter using DCT. In the second step, the degree of closeness to the minimum mean square error (MMSE) of the ideal Wiener filter is improved by subjecting the filtered outputs to a second SVD smoothing operation in time domain. Application of this scheme to noisy records has resulted in near perfect reproduction of the original noise free ECG without significant alterations in its morphological features.


Safety and efficacy of video-assisted retroperitoneal debridement for infected pancreatic collections: a multicenter, prospective, single-arm phase 2 study.
The feasibility of video-assisted retroperitoneal debridement (VARD) for infected pancreatic walled-off necrosis is established. We provide prospective data on the safety and efficacy of VARD. Multicenter, prospective, single-arm phase 2 study. Six academic medical centers. We evaluated 40 patients with pancreatic necrosis who had infection determined using Gram stain or culture. Percutaneous drains were placed at enrollment, and computed tomographic scans were repeated at 10 days. Patients who had more than a 75% reduction in collection size were treated with drains. Other patients were treated with VARD. Crossover to open surgery was performed for technical reasons and/or according to surgeon judgment. Efficacy (ie, successful VARD treatment without crossover to open surgery or death) and safety (based on mortality and complication rates). Patients received follow-up care for 6 months. We enrolled 40 patients (24 men and 16 women) during a 51-month period. Median age was 53 years (range, 32-82 years). Mean (SD) Acute Physiology and Chronic Health Evaluation II score at enrollment was 8.0 (5.1), and median computed tomography severity index score was 8. Of the 40 patients, 24 (60%) were treated with minimally invasive intervention (drains with or without VARD). Nine patients (23%) did not require surgery (drains only). For 31 surgical patients, VARD was possible in 60% of patients. Most patients (81%) required 1 operation. In-hospital 30-day mortality was 2.5% (intent-to-treat). Bleeding complications occurred in 7.5% of patients; enteric fistulas occurred in 17.5%. This prospective cohort study supports the safety and efficacy of VARD for infected pancreatic walled-off necrosis. Of the patients, 85% were eligible for a minimally invasive approach. We were able to use VARD in 60% of surgical patients. The low mortality and complication rates compare favorably with open debridement. An unexpected finding was that a reduction in collection size of 75% according to the results of computed tomographic scans at 10 to 14 days predicted the success of percutaneous drainage alone.


Eyebrows, Facial Expression, and "Poem to the Eyebrow (Blason du Sourcil)".
This review aims to introduce the role of facial expression in communication, the areas involved in facial expression especially the eye and eyebrow, the "Poem of the Eyebrow" (Blason du Sourcil), and preferred brow archetypes.The ability to interpret and respond properly to facial expressions contributes to emotional self-competence and satisfactory social and cognitive development. Certain areas may intensify the emotional message, clarifying the expression and reducing ambiguity. Specific facial areas might make expressions more difficult to interpret. The region of the eye is the most prominent facial region for emotion interpretation. Roles of eyebrow density and position in the interpretation of facial expression of emotion depend, at least in part, upon the emotion being expressed. For face recognition, the eyebrows may be at least as influential as the eyes.French poet Maurice Sceve wrote "Poem to the Eyebrow." This poem contains some noteworthy verses about the function of the eyebrow: Eyebrow that makes the boldest fearful, and gives courage to even cowards.Among brow archetypes, "Anastasia type" (brow starts on a perpendicular line drawn from the middle of the nostril, arches on a line drawn from the center of the nose through the center of the pupil, and ends on a line drawn from the edge of the corresponding nasal ala through the outer edge of the eye) was the most preferred. The middle brow height was most preferred (the distance from the lateral canthus to the lateral end of eyebrow is two-thirds of the eye width).


Endocannabinoid Modulation of Predator Stress-Induced Long-Term Anxiety in Rats.
Individuals who experience life-threatening psychological trauma are at risk of developing a series of chronic neuropsychiatric pathologies that include generalized anxiety, depression, and drug addiction. The endocannabinoid system has been implicated in the modulation of these responses by regulating the activity of the amygdala and the hypothalamic-pituitary-adrenal axis. However, the relevance of this signaling complex to the long-term consequences of traumatic events is unclear. Here we use an animal model of predatory stress-induced anxiety-like behavior to investigate the role of the endocannabinoid system in the development of persistent anxiety states. Our main finding is that rats exposed to the fox pheromone 2,5-dihydro-2,4,5-trimethylthiazoline (TMT), a life-threatening stimulus for rodents, display a marked and selective increase in the mobilization of the endocannabinoid, 2-arachidonoyl-sn-glycerol (2-AG), in the amygdala. This effect lasts for at least 14 days after the stress has occurred. In addition, systemic or local pharmacological inhibition of monoacylglycerol lipase (MGL)-a lipid hydrolase that degrades 2-AG in presynaptic nerve terminals-elevates 2-AG levels and suppresses the anxiety-like behavior elicited by exposure to TMT. The results suggest that predator threat triggers long-term changes in 2-AG-mediated endocannabinoid signaling in the amygdala, and that pharmacological interventions targeting MGL might provide a therapeutic strategy for the treatment of chronic brain disorders initiated by trauma.


The role of anterior and medial dorsal thalamus in associative memory encoding and retrieval.
A growing body of work has revealed a role for the anterior and medial dorsal thalamus in memory. Very few studies, however, have used neuroimaging to test hypotheses regarding these structures' predicted roles in associative memory encoding and retrieval. To fill this gap, our study used fMRI in a group of healthy adults as they performed a face-scene associative memory task. We are the first to report that greater deactivation of the anterior thalamus (AT) during encoding was related to subsequent memory. This finding suggests that the AT contributes to the gating of irrelevant information during memory formation. While the medial dorsal thalamus (MD) demonstrated a positive BOLD response during the memory decision, this activity was not significantly related to the ability to correctly choose the face that "matched" the paired scene, despite this region being implicated in familiarity memory. When contrasting connectivity to the medial temporal lobe between the anterior and medial dorsal thalamic nuclei, results revealed that the medial dorsal thalamus was more strongly connected to the hippocampus, perirhinal cortex, and parahippocampal cortex. However, there was no relationship between anterior or medial dorsal thalamic functional connectivity with the MTL and memory success. These results were unexpected as extant theories of the function of the AT relate to its communication with the hippocampus and theories of the MD propose its function relates to communication with the prefrontal cortex. These findings provide novel evidence for differential roles of the anterior and medial dorsal thalamic nuclei in associative memory and inform existing models of the role of the extended hippocampal system in memory.


Is olfactory detection of human cancer by dogs based on major histocompatibility complex-dependent odour components?--A possible cure and a precocious diagnosis of cancer.
Given the reports made about dogs detecting cancer on the basis of odour, our hypothesis is that the volatile organic compounds produced by tumours, and detected by dogs, are products of MHC genes. Two lines of evidences support this hypothesis: (1) human body odour is genetically determined by MHC. These antigen molecules (HLA in humans) have soluble and detectable isoforms that are present in body fluids such as blood, urine and sweat; (2) there is a strong association between changes in HLA expression and cancer. Tumour transformation is frequently associated with low classical HLA class I molecules expression, namely HLA-A, HLA-B, and HLA-C. In addition, cancer is associated with high nonclassical HLA class I molecules expression, such as HLA-G and HLA-E. These evidences suggest that these HLA-associated olfactory cues of human cancer could be easily analysed, for example, by the "electronic nose", making possible a very precocious and reliable diagnostic of cancer. Because cancer immunescape mechanism is similar to that observed in the materno-fetal immune tolerance, we propose also that immunomodulatory abortifacients could be a good strategy in cancer treatment.


[Estimation of the total mutagenic activity of the industrial environment at ferrous metallurgy enterprises].
Complex cytogenetical and genetico-epidemiological examination has been conducted with workers of metallurgic industry. It is shown that a complex of factors of the blast-furnace and steel plants produces a 2-3 times higher cytogenetic effect in groups of workers as against the control level. A considerable increase in the level of intrauterine losses (the frequency of spontaneous abortions) is observed in the case of contact of father and mother with a complex of the industrial environment pollutants.


Do web-based follow-up surveys have a better response rate than traditional paper-based questionnaires following outpatient arthroscopic rotator cuff repair? A randomized controlled trial.
Considering the extensive use of smartphones in current societies, web-based applications could be considered as a new option for patient follow-up in surgery. By means of such tool, automated and periodic questionnaires could improve the rigor, accuracy and the comprehensiveness of postoperative monitoring, as well as early detection of complications, especially in the current context of evolving ambulatory surgery. The web-based surveys would improve the quality of immediate postoperative monitoring. For 7 months, we included all patients who underwent outpatient arthroscopic rotator cuff repair. After preoperative randomization, each patient was asked postoperatively to complete either paper-based forms or digital questionnaires via a website (Orthense.com®, Digikare Inc. Blagnac, France). Both media (i.e. paper and digital) followed the same postoperative agenda (i.e., D+3, D+14, D+28, D+45, D+90) and had the same content, including pain and discomfort assessments, functional scores (i.e. Shoulder subjective value, simple shoulder test and auto-constant scores). The main objective was to investigate the quality of postoperative follow-up after outpatient arthroscopic rotator cuff surgery, using either printed questionnaires or web-based surveys. The hypothesis was that using a web-based survey would result in greater response rates and increased patient satisfaction regarding follow-up. Primary outcomes were questionnaire response rates at D+45 and D+90, while secondary outcomes were overall response rates, patient recommendation for the monitoring medium and overall patient satisfaction regarding their follow-up using the net promoter score (NPS). Among the 59 consecutive patients who were included, there were 27 females and 26 males with a mean age of 57±10.2 years; 27 patients completed the web-based survey (Group A) and 26 patients answered paper-based questionnaires (Group B). Regarding the D+45 questionnaire, response rates were 85.2% (n=23) in group A and 42.3% (n=11) in group B (p=.005); a similar significant difference was observed regarding the D+90 questionnaire, with response rates of 70.4% and 34.6%, respectively (p=.027). The mean NPS for the survey was 10 in Group A and 8.29 in Group B (p=.016). Overall, satisfaction regarding postoperative care did not differ between the two groups. Compared to traditional paper-based forms, web-based surveys appear to increase patient adherence to short-term postoperative monitoring. If these findings were to be confirmed in long-term follow-up, such straightforward and cost-effective tool could be of great use in clinical care and research. I; Randomized controlled clinical trial.


BRAF alterations in pediatric low grade gliomas and mixed neuronal-glial tumors.
Low grade astrocytomas are the most common brain tumor in children. Recent studies have identified alterations in the BRAF serine/threonine kinase gene that result in mitogen activated protein kinase pathway activation. Herewith, we investigated the genetic changes of BRAF in pediatric low grade gliomas and their relation to pathological findings and Ki-67 proliferation index. The results showed gene fusions between KIAA1549 and BRAF in 66.7 % of tumors. The majority involved the KIAA1549-BRAF exon 16-exon 9 variant. Fusion junction between KIAA1549 exon 15 and BRAF exon 9 was found in five tumors, in which the myxoid component was the predominant. This has not been previously reported. No significant correlation was found between specific KIAA1549 and BRAF fusion junctions and Ki-67 index. All of the samples included in this study were tested for the presence of the BRAF(V600E) mutation, and no positive sample was found.


Seizure documentation in people living with epilepsy.
Seizure documentation is an essential component of epilepsy management. Not all persons with epilepsy choose to document their seizures, but many view the practice as essential to managing their disease. While seizure documentation is a valuable aspect of patient care, clinicians and patients must remain aware that seizure underreport and overreport commonly occur due to lack of seizure awareness. Additionally, in rare cases, persons with epilepsy may intentionally conceal their seizures from clinicians. The continued development of electronic seizure diaries and epilepsy self-management software provides patients with new and expanding options for seizure documentation and disease management. In order for these tools to be utilized most effectively, patient input must be central to their development. Given the limitations of seizure documentation, the development of accurate, non-invasive seizure detection devices is crucial for accurate seizure monitoring.


Activation of local and systemic anti-tumor immune responses by ablation of solid tumors with intratumoral electrochemical or alpha radiation treatments.
Cancer, the most devastating chronic disease affecting humankind, is treated primarily by surgery, chemotherapy, and radiation therapy. Surgery and radiotherapy are mainly used for debulking the primary tumor, while chemotherapy is the most efficient anti-metastatic treatment. To control better metastatic cancer, the host immune system should be stimulated. Yet, successful specific stimulation of the immune system against tumors was seldom achieved even in antigenic tumors. Our working hypothesis is that aggressive in situ tumor ablation can release tumor antigens and danger signals, which will enhance anti-tumor T cell responses resulting in the destruction of residual malignant cells in primary tumors and distant metastases. We developed two efficient in situ ablation treatments for solid cancer, which can be used to destroy the primary tumors and stimulate anti-tumor immune responses. The first treatment, electrochemical ablation, is applied through intratumoral electrodes, which deliver unipolar-pulsed electric currents. The second treatment, diffusing alpha-emitters radiation therapy (DaRT), is based on intratumoral (224)Ra-loaded wire(s) that release by recoil its daughter atoms. These short-lived alpha-emitting atoms spread in the tumor and spray it with lethal alpha particles. It was confirmed that these treatments effectively destroy various malignant animal and human primary solid tumors. As a consequence of such tumor ablation, tumor-derived antigenic material was released and provoked systemic T cell-dependent anti-tumor immunological reactions. These reactions conferred protection against a secondary tumor challenge and destroyed remaining malignant cells in the primary tumor as well as in distant metastases. Such anti-tumor immune responses could be further amplified by the immune adjuvant, CpG. Electrochemical ablation or DaRT together with chemotherapy and immunostimulatory agents can serve as treatment protocols for solid metastatic tumors and can be applied instead of or in combination with surgery.


The stimulation of rat brain monoamine oxidase by dietary lithium chloride.
Lithium chloride administered to rats in drinking water for 30 days caused an increase of whole brain monoamine oxidase specific activity to approximately 140% of control. Carboxylesterase and formyltetrahydrofolate synthetase activities were not affected by Li+ either in vivo or in vitro.


Body weight and risk of oral contraceptive failure.
To examine the hypothesis that higher body weight increases the risk of oral contraceptive (OC) failure. We conducted a retrospective cohort analysis of data from 755 randomly selected female enrollees of Group Health Cooperative of Puget Sound who completed an in-person interview and dietary questionnaire between 1990 and 1994 as control subjects for a case-control study of ovarian cysts. Among the 618 women who were OC ever-users, we used Cox proportional hazards regression models to estimate the relative risk (RR) of pregnancy while using OCs associated with body weight quartile. During 2822 person-years of OC use, 106 confirmed pregnancies occurred (3.8 per 100 person-years of exposure). After controlling for parity, women in the highest body weight quartile (70.5 kg or more) had a significantly increased risk of OC failure (RR 1.6, 95% confidence interval [CI] 1.1, 2.4) compared with women of lower weight. Higher elevations of risk associated with the highest weight quartile were seen among very low-dose OC users (RR 4.5, 95% CI 1.4, 14.4) and low-dose OC users (RR 2.6, 95% CI 1.2, 5.9), controlling for parity, race, religion, and menstrual cycle regularity. Our findings suggest that body habitus may affect metabolism sufficiently to compromise contraceptive effectiveness. Consideration of a woman's weight may be an important element of OC prescription.


Involvement of globus pallidus and midbrain nuclei in pantothenate kinase-associated neurodegeneration: measurement of T2 and T2* time.
To quantify involvement of globus pallidus and two midbrain nuclei (substantia nigra and red nucleus) in Pantothenate Kinase-Associated Neurodegeneration (PKAN). We performed T2 and T2* weighted imaging with calculation of the corresponding relaxation times on a subset of 5 patients from a larger group of 20 patients with PKAN from the southwest part of the Dominican Republic. Examinations were carried out on a 3T scanner and included a multi-echo spin-echo as well as a multi-echo gradient echo sequence. Results were compared to a control group of 19 volunteers. T2 and T2* weighted sequences showed abnormal signal reduction in the globus pallidus of all patients. On T2* weighted imaging, abnormal signal in the substantia nigra could reliably be detected in 75% of cases, but differentiation from normal was less reliable in T2 weighted scans. Correspondingly, relaxation times differed from normal with very high significance (p < 0.0001) in the globus pallidus, but with with less significance in the substantia nigra (p ≤ 0.03). The red nucleus was not affected. Signal reduction in the globus pallidus, which probably is due to abnormal accumulation of iron, is severe in PKAN and can be differentiated from normal with high reliability. The substantia nigra is affected to a lesser degree, and the red nucleus is not involved. The reason for this selective susceptibility of normally iron-rich brain structures for pathological accumulation of iron remains speculative. Our quantitative results might be helpful to assess the value of an iron chelation approach to therapy.


Measurement of thyroid cell surface antibodies by radioassay using human cultured thyroid cells.
The present report describes a sensitive and quantitative binding radioassay for measurement of thyroid cell surface antibodies (TCSAb). Enzyme-dispersed thyroid cells from surgical specimens of human normal thyroid tissue were used after 7 days of culture. 125I-labelled Graves' IgG was shown to bind to cultured thyroid cells. The binding was time-and temperature-dependent and increased linearly with the number of thyroid cells. Evidence for specificity was provided by the lack of binding of radioiodinated Graves' IgG to human fibroblasts and by the negligible binding of 125I-labelled normal IgG to thyroid cells. A dose-dependent inhibition of binding of 125I-labelled Graves' igG to thyroid cells was produced by the addition of graded amounts of the unlabelled original Graves' IgG preparation, but not by normal IgG. Assays for TCSAb were performed on IgG preparations from patients with and without thyroid autoimmune disorders using the original Graves' IgG preparation as reference standard. Results were expressed in terms of arbitrary units/100 microgram IgG, 1 unit corresponding to the minimum amount of the standard IgG producing a significant inhibition of binding. Negative tests were found in most normal subjects (15/18) while low TCSAb levels (less than or equal to 1.8 U/100 microgram IgG) were detected in 3 cases. Increased TCSAb levels were found in the majority of the patients wit Graves' disease (14/21), in most of the patients with idiopathic myxedema (9/10) and in all of those with Hashimoto's thyroiditis (10/10).


Value of serum procalcitonin as an early predictor of antibiotic treatment response in inpatients with pelvic inflammatory disease (VALID).
This study aimed to investigate the value of serum procalcitonin as an early predictor of antibiotic treatment response in the inpatient management of pelvic inflammatory disease (PID). A prospective observational study was carried out at a university hospital. Patients admitted for pelvic inflammatory disease were classified into 2 groups: responders and non-responders. The primary outcome measure was the serum level of procalcitonin at the time of admission. The secondary outcome measures were other serum inflammatory markers including C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and white blood cell (WBC) count. Baseline characteristics were similar between the groups. Serum level of procalcitonin at the time of admission did not differ between the groups (P = 0.564). However, the non-responders had more elevated CRP and ESR compared to the responders (P = 0.045 and P = 0.030, respectively). CRP showed the highest accuracy of 72.1% (95% confidence interval [CI], 59.2 to 82.9) in predicting antibiotics response, while procalcitonin showed the lowest accuracy of 49.1% (95% CI, 35.1 to 63.2). Compared with standard inflammatory markers such as CRP or ESR, procalcitonin had limited diagnostic value in predicting antibiotics response in patients admitted for PID. Therefore, procalcitonin measurement cannot be recommended as a laboratory test for patients with PID and the value of its routine use remains inconclusive.


A 90-day subchronic study of rats fed lean pork from genetically modified pigs with muscle-specific expression of recombinant follistatin.
Because cardiovascular disease incidence has rapidly increased in recent years, people are choosing relatively healthier diets with low animal fat. A transgenic pig with low fat and a high percentage of lean meat was created in 2011; this pig overexpresses the follistatin (FST) gene. To evaluate the safety of lean pork derived from genetically modified (GM) pigs, a subchronic oral toxicity study was conducted using Sprague-Dawley rats. GM pork and non-GM pork were incorporated into the diet at levels of 3.75%, 7.5%, and 15% (w/w), and the main nutrients of the various diets were subsequently balanced. The safety of GM pork was assessed by comparison of the toxicology response variables in Sprague-Dawley rats consuming diets containing GM pork with those consuming non-GM pork. No treatment-related adverse or toxic effects were observed based on an examination of the daily clinical signs, body weight, food consumption, hematology, serum biochemistry, and organ weight or based on gross and histopathological examination. The results demonstrate that GM pork is as safe for consumption as conventional pork.


Synchronous leaf production and herbivory in juveniles of Gustavia superba.
Synchronous leaf production has been proposed as a mechanism to reduce herbivore damage to young leaves by satiating herbivores. To test this hypothesis, I measured leaf production, leaf survivorship, and herbivore damage on juveniles of Gustavia superba (H.B.K.) Berg (Lecythidaceae), in two sites in Central Panama. Leaves were produced throughout the year, but there were peaks in leaf production at the beginning of the wet scason. Plants that produced leaves synchronously with conspecifics received significantly less damage than plants that produced leaves out of synchrony, and high levels of leaf damage were correlated with shorter leaf lifetimes. These data suggest that plant phenology can influence risks of herbivory.


Neuroblastoma: biology and molecular and chromosomal pathology.
Neuroblastoma is the most frequently occurring solid tumour in children, with an incidence of 1.3 cases per 100000 children aged 0-14 years. Despite many advances during the past three decades, neuroblastoma has remained an enigmatic challenge to clinical and basic scientists. 20 years ago, the MYCN gene was found to be amplified in neuroblastomas, and research since then has focused on the search for other genetic markers. It has emerged that neuroblastoma cells, like cells of many other tumour types, often suffer from extensive, non-random genetic damage at multiple genetic loci. Elucidation of the exact molecular make-up of neuroblastomas will enable researchers to analyse how much specific markers, alone or in combination, can help to stratify disease in prospective studies; at present, stratification is based on age, stage, MYCN, and Shimada pathology. Neuroblastoma may be one of the first examples of the use of genetic tumour markers as a tool for defining tumour behaviour and to aid clinical staging.


Disruption of shape-complementarity markers to create cytotoxic variants of ribonuclease A.
Onconase (ONC), an amphibian member of the bovine pancreatic ribonuclease A (RNase A) superfamily, is in phase III clinical trials as a treatment for malignant mesothelioma. RNase A is a far more efficient catalyst of RNA cleavage than ONC but is not cytotoxic. The innate ability of ONC to evade the cytosolic ribonuclease inhibitor protein (RI) is likely to be a primary reason for its cytotoxicity. In contrast, the non-covalent interaction between RNase A and RI is one of the strongest known, with the RI.RNase A complex having a K(d) value in the femtomolar range. Here, we report on the use of the fast atomic density evaluation (FADE) algorithm to identify regions in the molecular interface of the RI.RNase A complex that exhibit a high degree of geometric complementarity. Guided by these "knobs" and "holes", we designed variants of RNase A that evade RI. The D38R/R39D/N67R/G88R substitution increased the K(d) value of the pRI.RNase A complex by 20 x 10(6)-fold (to 1.4 microM) with little change to catalytic activity or conformational stability. This and two related variants of RNase A were more toxic to human cancer cells than was ONC. Notably, these cytotoxic variants exerted their toxic activity on cancer cells selectively, and more selectively than did ONC. Substitutions that further diminish affinity for RI (which has a cytosolic concentration of 4 microM) are unlikely to produce a substantial increase in cytotoxic activity. These results demonstrate the utility of the FADE algorithm in the examination of protein-protein interfaces and represent a landmark towards the goal of developing chemotherapeutics based on mammalian ribonucleases.


[Pseudomalignant, hyperacute circumscribed myositis. Contribution and limitations of echography. Review of the literature. Apropos of a case].
The very sudden onset of a painful muscular tumefaction was suggestive of a para-ostal osteosarcoma or myosarcoma. Ultrasound imaging showed a heterogeneous echogenic mass with several extending shadow cones, raising the possibility of the benign nature of the lesion, but urgent operation showed the pseudomalignant circumscribed myositis nature of the affection.


Atypical complex endometrial hyperplasia treated with the GyneLase system.
A 47-year-old premenopausal, para 1, gravida 1 woman complained of menometrorrhagia. She had no risk factors for endometrial hyperplasia or cancer, and office endometrial biopsy indicated focal, nonatypical endometrial hyperplasia. Seven months later the patient was scheduled for hysteroscopic endometrial resection. Instead she was treated by hysteroscopy, curettage, and the GyneLase system. The curetting indicated atypical, complex endometrial hyperplasia. The woman refused hysterectomy and salpingo-oophorectomy and adjunctive therapy with progesterone. She agreed to close surveillance and further treatment if she had any vaginal bleeding. At 13 months she remains amenorrheic, the endometrial echo is 2 mm, and follicle-stimulating hormone level is 63 IU/L. Based on the patient's amenorrhea and ultrasound uterine measurement, it is tempting to assume that GyneLase treatment may have cured her atypical hyperplasia. However, at this time, we have no evidence to substantiate this assumption.


Effect of diabetes mellitus on the outcomes of total ankle arthroplasty: is controlled diabetes mellitus a risk factor?
It is still uncertain whether diabetes mellitus (DM) is a risk factor for poor outcomes and increased complications after total ankle arthroplasty (TAA). The objective of this study was to compare clinical outcomes and complication rates of TAA in patients with and without DM. This study enrolled patients with symptomatic end-stage ankle osteoarthritis with a minimum follow-up period of 24 months after TAA. A total of 252 patients (266 ankles) were classified into two groups according to the presence of DM: (1) DM group (59 patients, 67 ankles) and (2) non-DM group (193 patients, 199 ankles). We defined controlled diabetes as (1) HbA1c level < 7.0%, or (2) fasting glucose level < 130 mg/dL with HbA1c level ≥ 7.0% for hospitalization period. Clinical outcomes data (Ankle Osteoarthritis Scale, American Orthopedic Foot and Ankle Society ankle-hindfoot score, Short Form-36 Physical Component Summary score, and visual analog scale for pain) were compared preoperatively and at the final follow-up between the two groups. Complications following TAA were also compared between the two groups. All clinical variables had improved in both groups by the final follow-up (mean follow-up = 77.8 months). There was no significant difference in any clinical variable between the two groups at the final follow-up (P > 0.05). Of the 266 ankles, 73 ankles (19 in the DM group, 54 in the non-DM group) developed periprosthetic osteolysis. Although the DM group showed a higher prevalence of aseptic loosening or subsidence, the difference between the two groups was not statistically significant (P = 0.236). In the intermediate-term follow-up, TAA in patients with controlled DM showed clinical outcomes and complication rates comparable to patients without DM. Our results suggest that TAA can be done safely in diabetic patients if the DM is controlled in the perioperative period. Therapeutic Level III.


Selection of rice and maize varieties with low cadmium accumulation and derivation of soil environmental thresholds in karst.
Cadmium (Cd) is considered the primary dietary toxic element. Previous studies have demonstrated significant differences in heavy metal accumulation among crop species. However, this information in karst areas with low heavy metal activity is missing. In this study, the uptake and accumulation characteristics of cadmium in soil-crop samples of group 504 in the core karst region of East Asia were analyzed. Cadmium low-accumulating maize and rice were screened using cluster and Pareto analytic methods. In addition, a new method, the species-sensitive distribution model (SSD), was proposed, which could be used to estimate the environmental threshold for cadmium in regional cropland. The results showed that both maize and rice soils in the research area were contaminated with varying degrees of cadmium. The total concentrations of cadmium ω(T-Cd) in maize and rice fields are 0.18-1.32 and 0.20-4.42 mg kg-1, respectively. The ω(T-Cd) of heavy metals in maize kernels and rice grains is 0.002-0.429 and 0.003-0.393 mg kg-1, respectively. The bioaccumulation factor (BCF) of cadmium in maize ranged from 0.0079 to 0.9701, with a coefficient of variation of 1.71; the BCF of cadmium in rice ranged from 0.0074 to 0.1345, with a coefficient of variation of 0.99. According to cluster and Pareto analyses, the maize crop varieties with low cadmium accumulation suitable for local cultivation were screened as JHY809, JDY808, AD778, SN3H and SY13, and the rice varieties were DMY6188, GY725, NY6368, SY451 and DX4103. In addition, the environmental cadmium threshold ranges of 0.30-10.05 mg kg-1 and 0.89-24.39 mg kg-1 for maize and rice soils, respectively, were deduced in this study. This threshold will ensure that 5-95% of maize and rice will not be contaminated with cadmium in the soil.


Semi-solid state promotes the methane production during anaerobic co-digestion of chicken manure with corn straw comparison to wet and high-solid state.
Total solid content (TS) is an important factor for biogas production during anaerobic digestion. In this study, we explored the influence of different TS (5% wet, 15% semi-solid and 25% solid state) on the relative cumulative methane production (RCMP) during anaerobic co-digestion of chicken manure with corn straw. Results showed that total ammonium nitrogen and free ammonia nitrogen concentration increased with the increase of TS. Ammonium nitrogen in treatments at 15% TS was 2.25-2.76 times as high as that at 5% TS, which was below 3 times. The highest chemical oxygen demand removal and RCMP were obtained in the treatment of 15% TS with a ratio of 2:1 chicken manure: corn straw (based on TS). The RCMP in the treatments of 15% TS were 3.63-4.59 times higher than that of 5% TS based on the volume of substrates. The abundance of Caldicoprobacter improving the degradation of corn straw was significantly positively correlated with the RCMP, and the average abundance of Caldicoprobacter at 15% TS was 8.33 and 7.02 times higher than that at 5% and 25% TS, respectively. Structural equation models analysis suggested that TS significantly impacted the RCMP by indirectly impacting free ammonia nitrogen and microbial abundance. These findings indicated semi-solid state (15% TS) decreased ammonia nitrogen releasing and improved the abundance of Caldicoprobacter, and increased RCMP during anaerobic co-digestion of chicken manure with corn straw.


Gaze behavior in analytical and holistic face processing.
We conducted two experiments examining children's and adults' gaze behavior when processing faces analytically (focusing on a single feature) or holistically (comparing the overall similarity of the faces). Children 6-8 and 9-10 years of age and adults were instructed to assign schematically drawn faces in Experiment 1 and photos of real faces in Experiment 2 to two categories. The categories were constructed so as to allow either an analytical or holistic categorization of the faces. During all trials, gaze behavior was recorded from stimulus onset until reaction. The location and duration of the fixations used were analyzed. Whereas the holistic processors fixated the whole area of the eyes and nose most and longest independently of age, analytical processors showed a more feature-specific gaze behavior, focusing their fixations upon the particular feature used for subsequent processing. Thus, differences in analytical and holistic face processing can be detected early in gaze behavior-that is, at the visual encoding stage.


Adsorption and bonding strength of chromium species by ferrihydrite from acidic aqueous solutions.
The adsorption behavior of Cr(III) and Cr(VI) ions onto laboratory-synthesized 2-line ferrihydrite was investigated under a batch method as a function of initial chromium concentration (0.1-1000 mg L-1) and pH (3.0 and 5.0). Moreover, the effect of the type of anion (chloride and sulfate) on Cr(III) adsorption was studied. The affinity of Cr(III) ions for the ferrihydrite surface depended on both the type of anion and pH of the solution and the maximum adsorption capacities decreased as follows: q (SO4 2-, pH 5.0) > q (SO4 2-, pH 3.0) > q (Cl-, pH 5.0) > q (Cl-, pH 3.0), and were found to be 86.06 mg g-1, 83.59 mg g-1, 61.51 mg g-1 and 40.67 mg g-1, respectively. Cr(VI) ions were bound to ferrihydrite in higher amounts then Cr(III) ions and the maximum adsorption capacity increased as the pH of the solution decreased and was 53.14 mg g-1 at pH 5.0 and 83.73 mg g-1 at pH 3.0. The adsorption process of Cr species was pH dependent, and the ions were bound to the surface of ferrihydrite by surface complexation. The Sips isotherm was the best-fit model to the results obtained from among the four isotherm models used, i.e., Freundlich, Langmuir, Dubinin-Radushkevich and Sips, indicating different adsorption centers participate in Cr uptake. In order to assess the bonding strength of the adsorbed chromium ions the modified BCR procedure, dedicated to the samples with a high iron content, was used. The results of the sequential extraction showed that Cr(III) ions were bound mainly in the immobile residual fraction and Cr(VI) ions were bound in the reducible fraction. The presence of Fe (oxyhydr)oxides in soil and sediments increases their adsorption capacity for Cr, in particular for hexavalent Cr in an acid environment due to their properties (high pHPZC).


Acute mucocutaneous toxicity following high-dose hydroxyurea.
Three patients with advanced acute myeloid leukemia were treated with oral high-dose hydroxyurea at a dose of 10 g daily for 8-10 days. Severe acute stomatitis developed in all three patients. In addition, two of the patients developed a peculiar acute cutaneous type of toxicity associated with soreness, violet erythema, and edema of the palms and foot soles followed by intense universal hyperpigmentation of the skin. Apparently, the pronounced acute mucocutaneous toxicity was caused by the sustained high daily dose of hydroxyurea, indicating that myelosuppression may not be the dose-limiting toxicity of this drug.


[Center of Studies and Research in Nursing (CEPEn): a trajectory of 36 years].
The study presents some trajectory highlights of the Center of Studies and Research in Nursing of the Brazilian Nursing Association, considering the period from 1971 to 2007. This is a historical study based on the Information Catalog of Research and Researchers in Nursing and the reports of the National Seminars of Nursing Research. The objectives were to rescue the contribution of CEPEn and to present one of the most important events for Brazilian Nursing. The concern with the future and the need for empowerment and enrichment, of professors as well as for assistance professionals, is one of the marks in nowadays and it is a challenge to be faced in present time.


Eyelid tattooing.
Tattooing has recently regained popularity in medicine. Cosmetic blepharopigmentation for eyelid enhancement by permanent eyeliner has received considerable attention. In addition, permanent pigmentation has been used for eyebrow simulation, camouflaging of scars, nipple areolar pigmentation following breast reconstruction, and the management of several other pigment disorders. This article emphasizes the principles and technique of blepharopigmentation.


High rate of suicide attempt and associated psychological traits in an isolated tribal population of North-East India.
Cases of suicide documented earlier all over the world reflect the presence of suicide behavior in primitive world at a higher rate compared to general urban population. The cause of such behavior is thought to be different among tribes and mental health was rarely presumed to be associated. In India, several ethnographic narratives described instances of suicides among several tribes, but evaluation of psychological traits were lacking. The present study on Idu Mishmi is an attempt to further validate earlier report of high rate of suicides among them and to evaluate psychological traits. Interview and administration of Patient Health Questionnaire (PHQ) on 218 individuals comprised the data. Bi-variate analyses and linear multiple regression were done to evaluate psychological traits in suicide behavior. In the Idu Mishmi Population suicide attempt (14.22%) was higher than urban population in general (0.4-4.2%) and females were at higher risk. Depression (8.26%) was comparable with earlier reports, whereas anxiety syndrome (6.42%), alcohol abuse (36.24%) and eating disorder like Binge eating (6.42%), Bulimia nervosa (1.38%) were also recorded in the population. Absence of psychiatry clinic and mechanism of recording suicide occurrences in remote tribal area is the basic limitation of the study. Depression and gender turned out to be significant determinants of suicide attempt in the studied population, whereas alcohol abuse was not a significant factor.


Interleukin-1 beta effects on cyclic GMP and cyclic AMP in cultured rat islets of Langerhans-arginine-dependence and relationship to insulin secretion.
When islets were cultured with interleukin-1 beta (1 or 100 pmol/l) for 12 h in arginine-containing medium, cyclic GMP levels were increased 1.6- and 4.5-fold respectively. The arginine analogue, N-omega-nitro-L-arginine methyl ester, which blocks nitric oxide formation and partially reverses inhibition of insulin secretion by 100 pmol/l interleukin-1 beta, largely, but not completely, blocked generation of cyclic GMP. Treatment of islets with 100 pmol/l interleukin-1 beta for 12 h significantly decreased islet cyclic AMP generation in the absence of isobutylmethylxanthine (from 13.1 +/- 0.7 to 9.3 +/- 0.8 fmol/micrograms islet protein), this fall was arginine-dependent and may have resulted from an effect on a cyclic AMP phosphodiesterase, since it was masked if isobutylmethylxanthine was present. Isobutylmethylxanthine (0.4 mmol/l) reduced the inhibitory potency of interleukin-1 beta in 15 h slightly but significantly from 80.5 to 59.0%. The morpholinosydnonimine SIN-1, which is a nitric oxide donor, inhibited insulin secretion, raised islet cyclic GMP and lowered cyclic AMP; its effects were similar to those of interleukin-1 beta. However, 6-anilinoquinoline-5,8-quinone, [LY83583 (1-10 mumol/l)], inhibited insulin secretion, and significantly decreased cyclic GMP while 8-bromocyclic GMP stimulated insulin secretion. Both low- and high-dose interleukin-1 beta treatment give a large arginine-dependent and a small, yet significant, arginine-independent increase in cyclic GMP. The inhibitory effect of SIN-1 or interleukin-1 beta on insulin secretion seems to depend to a small extent on decreased islet cyclic AMP, though sustained increases in nitric oxide or depleted islet GTP may directly affect the secretory process.


Motor nerve regeneration across a conduit.
A 3-cm gap in the ulnar nerve at the elbow in a subhuman primate was the first model of nerve regeneration across a polyglycolic, bioabsorbable conduit. When a prospective trial was begun in humans, the first clinically available bioabsorbable conduit, the Neurotube, was utilized to reconstruct sensory nerves, but motor nerve injuries were not included. Thus, we sought to evaluate our patients with short-gap motor nerve injuries repaired with bioabsorbable conduits. We performed a retrospective chart review of all patients with bioabsorbable nerve conduit repair of short-gap motor nerve injuries over a 7-year period--six patients were identified. All patients had some return of motor function. Our case series, along with the nonhuman primate studies and other human reports, demonstrates that motor nerves will regenerate through bioabsorbable conduits and will reinnervate appropriate motor-target end-organs if they can reach them within an appropriate time frame for persistence of the motor-endplates.


Honest People Tend to Use Less-Not More-Profanity: Comment on Feldman et al.'s (2017) Study 1.
This article shows that the conclusion of Feldman et al.'s (2017) Study 1 that profane individuals tend to be honest is most likely incorrect. We argue that Feldman et al.'s conclusion is based on a commonly held but erroneous assumption that higher scores on Impression Management Scales, such as the Lie Scale, are associated with trait dishonesty. Based on evidence from studies that have investigated (1) self-other agreement on Impression Management Scales, (2) the relation of Impression Management Scales with personality variables, and (3) the relation of Impression Management Scales with objective measures of cheating, we show that high scores on Impression Management Scales are associated with high-instead of low-trait honesty when measured in low-stakes conditions. Furthermore, using two data sets that included an "I never swear" item, we show that profanity use is negatively related to other reports of HEXACO honesty-humility and positively related to actual cheating.


[Inhibition of platelet migration. A simple technic for typing of PLA1 and the detection of platelet allo- and autoantibodies].
In vitro, platelets can migrate in an active way. This migration can be immunologically inhibited through specific antibodies. This test (PMI-test) can be easily carried out in any laboratory. In that study this test was used: 1) For the detection of anti-platelet allo-antibodies in neonatal thrombopenia. Out of nine cases studied, two anti-PLA1 were identified and three anti-HLA antibodies (anti-B8, anti-B17+21 and a polyspecific serum) detected thanks to the micro-lymphocyto-toxicity test were confirmed by that test. 2) To find free auto-antibodies in the sera of patients suffering from idiopathic thrombopenic purpura. In five cases out of twelve the presence of auto-antibodies could be shown, that is 41,6%. In some cases, the auto-antibodies showed a certain degree of specificity as it had already been pointed out in other studies. When the thrombopenias were associated with other diseases, all the tests were negative. 3) For the PLA1 typing of donors: 1,85% donors submitted to the test proved to be PLA1 negative. 4) To identify anti-HLA antibodies and to compare this test with the micro-lymphocyto-toxicity-test: the anti-A2, A11, B8, B17, CW3 and CW4 antibodies used titrated the same in both tests. 5) Eventually to study the possible action of ABO-system antibodies in this test; this study shows that only sera containing immune antibodies can bring about an inhibition of the incompatible platelet migration. The sensitivity of the PMI-test which has previously been mentioned as equal to platelet-lysis and superior to aggregometry and platelet factor-3 release, is superior to the complement fixation test since with an 1/16 titre in PMI test for the two anti-PLA1 antibodies, the latter could not be detected through the complement fixation test; it seems to be equal to platelet indirect radioactive Coombs since both sera titrate in the same way.


The many faces of the helicase RTEL1 at telomeres and beyond.
Regulator of telomere elongation 1 (RTEL1) is known as a DNA helicase that is important for telomeres and genome integrity. However, the diverse phenotypes of RTEL1 dysfunction, the wide spectrum of symptoms caused by germline RTEL1 mutations, and the association of RTEL1 mutations with cancers suggest that RTEL1 is a complex machine that interacts with DNA, RNA, and proteins, and functions in diverse cellular pathways. We summarize the proposed functions of RTEL1 and discuss their implications for telomere maintenance. Studying RTEL1 is crucial for understanding the complex interplay between telomere maintenance and other nuclear pathways, and how compromising these pathways causes telomere biology diseases, various aging-associated pathologies, and cancer.


Factors determining maintenance of sinus rhythm after chronic atrial fibrillation with left atrial dilatation.
Successful therapy of atrial fibrillation (AF) has been reportedly influenced by a variety of factors including patient age, type of underlying heart disease, duration of arrhythmia, left ventricular function and left atrial (LA) size. To determine which of these factors are associated with maintenance of sinus rhythm after conversion, 43 patients with symptomatic chronic AF in the setting of a dilated left atrium (greater than or equal to 45 mm, range 45 to 78) were followed for at least 6 months after the return of sinus rhythm. Class IA drugs, IC drugs or amiodarone were used for therapy. Life table analysis showed sinus rhythm to be maintained in 81% for 6 months, 79% for 12 months and 60% for 24 months. Factors positively associated with success were conversion with drug therapy alone, duration of chronic AF less than or equal to 1 year, absence of mitral valve disease and LA dimension less than or equal to 60 mm (all p less than 0.05). Patient age, left ventricular function and presence of coronary disease were not associated with outcome. Thus, patients with moderate LA dilatation (45 to 60 mm) and a short duration of chronic AF can often be maintained in sinus rhythm, especially if they convert with pharmacologic intervention alone.


Natural killer cell receptor-expressing innate lymphocytes: more than just NK cells.
Recently, additional subsets that extend the family of innate lymphocytes have been discovered. Among these newly identified innate lymphoid cells is a subset sharing phenotypic characteristics of natural killer cells and lymphoid tissue inducer cells. These cells co-express the transcription factor RORγt and activating NK cell receptors (NKR), but their lineage and functional qualities remain poorly defined. Here, we discuss recent proposals to place these NKR(+)RORγt(+) innate lymphocytes on hematopoietic lineage maps. An overview of the transcriptional circuitry determining fate decisions of innate lymphocytes and a summary of current concepts concerning plasticity and stability of innate lymphocyte effector fates are provided. We will conclude by discussing the function of RORγt-expressing innate lymphocytes during inflammatory bowel diseases and in the immune response to tumors.


Urologic problems associated with imperforate anus.
A total of 120 children with both high, intermediate, and low types of imperforate anus were evaluated urologically. Genitourinary anomalies were associated with all types of imperforate anus but were found more often in children with high rectal deformities. Because the over-all incidence of genitourinary anomalies was high, early and complete urologic evaluation is necessary to achieve the best functional result.


Overexpression of Bcl-2 in hepatocytes protects against injury but does not attenuate fibrosis in a mouse model of chronic cholestatic liver disease.
The role of hepatocyte apoptosis in the physiopathology of obstructive cholestasis is still controversial. Although some data have strongly suggested that hepatocellular cholestatic injury is due to Fas-mediated hepatocyte apoptosis, some others concluded that necrosis, rather than apoptosis, represents the main type of hepatocyte death in chronic cholestasis. Moreover, it has also been suggested that the reduced liver injury observed in the absence of Fas receptor after bile duct ligation was not due to lower hepatocyte apoptosis but to the indirect role of this receptor in non-hepatocytic cells such as cholangiocytes and inflammatory cells. The aim of this work was therefore to determine whether a protection against cell death limited to hepatocytes could be sufficient to reduce liver injury and delay cholestatic fibrosis. With this purpose, we performed bile duct ligation in transgenic mice overexpressing Bcl-2 in hepatocytes and in wild-type littermates. We found that, compared with necrosis, apoptosis was negligible in this model. Our results also showed that hepatocyte Bcl-2 expression protected hepatocytes against liver injury only in the early steps of the disease. This protection was correlated with reduced mitochondrial dysfunction and lipid peroxidation. However, in contrast to Fas receptor-deficient lpr mice, fibrosis progression was not hampered and liver inflammatory response was not reduced by Bcl-2 overexpression. These results therefore comfort the hypothesis that Fas-mediated apoptotic hepatocyte pathway is not a significant contributing factor to the clinical features observed in cholestasis. Moreover, in the absence of a blunted inflammatory response in transgenic mice, Bcl-2 protection against hepatocyte mitochondrial dysfunction and lipid peroxidation was not sufficient to block fibrosis progression.


Light adaptation of red cones and L1-horizontal cells in the turtle retina: effect of the background spatial pattern.
Electrical coupling allow red cones and L1-horizontal cells to respond to light stimuli illuminating remote retinal loci. The contribution of the spatial pattern of background light to flash sensitivity of red cones and L1-horizontal cells was studied intracellularly in the turtle retina. Lateral spread of background adaptation was observed in the cones. The sensitivity of the cones was related to the steady hyperpolarization of the cells irrespective of the background's spatial pattern. Light sensitivity of L1-horizontal cells mainly depended upon the background illuminating their dendritic field. Unlike red cones, the horizontal cells responded differently to spot and annular backgrounds regardless of the steady hyperpolarization induced.


Practice patterns of urologists in managing Korean men aged 40 years or younger with high serum prostate-specific antigen levels.
To investigate the practice patterns of urologists in managing Korean men aged 40 years or younger with high serum prostate-specific antigen (PSA). Data were collected from general health screenings conducted at 4 university hospitals between 2004 and 2012. Eligibility criteria were Korean men aged≤40 years who were seen by urologists for high PSA (>2.5 ng/mL). After excluding individuals with chronic prostatitis and any infectious symptoms and/or signs, the practice patterns of urologists managing 237 eligible men were analyzed. The most common practice was observation after antibiotics (40.5%), followed by reassurance (38.4%), prostate biopsy (PBx) after antibiotics (11.8%), PBx after PSA follow-up (7.6%), and immediate PBx (1.7%). Antibiotics were prescribed empirically to 124 patients (52.3%). Of the entire patients, 145 of 237 (61.2%) had at least 1 follow-up PSA, and the follow-up PSA with median interval of 43 days (interquartile range, 26-149) was higher than initial PSA in 66 of 145 (45.5%). Of the 98 patients undergoing follow-up PSA after initial antibiotic treatment, 53 (54.1%) experienced a decline in PSA, whereas 45 (45.9%) experienced a rise in PSA. PBx was performed in 50 of 237 (21.1%), and only a single case (2%) of prostate cancer was diagnosed. In managing men≤40 years with high PSA, the most common practice pattern was observation after antibiotic treatment despite lack of evidences. Furthermore, 1 in 5 urologists performed PBx to rule out cancer. Given the very low prevalence of cancer in this age group, clear guidelines are needed for appropriate management and consistency of care.


Neuroendocrine neoplasms of the thymus.
Neuroendocrine tumors of the thymus bear many similarities to "carcinoids" and "oat-cell carcinomas" in other organs, and are clinicopathologically distinct from thymomas, thymic seminomas, and other primary tumors of this gland. They are associated with Cushing's syndrome or multiple endocrine neoplasia in 35% of cases, and are often locally aggressive. Approximately 30-40% of patients have distant metastases of their tumors that ultimately result in fatality, since the response of thymic neuroendocrine neoplasms to irradiation and chemotherapy is poor. Ultrastructural studies and immunohistochemical stains for chromogranin, protein gene product 9.5, and synaptophysin are effective tools for the diagnosis of thymic carcinoid and oat-cell carcinoma.


The technical quality of mammography in centers participating in a regional breast cancer awareness program.
Quality control is particularly critical in mammography. Data presented here suggest that even among centers established for breast cancer detection, there is need for improvement.


Antioxidant activity of a halogenated monoterpene isolated from a Namibian marine algal Plocamium species.
The antioxidant potential of various marine natural products is well documented. The aim of this study was to evaluate the antioxidant potential of a rare halogenated monoterpene, namely; 1E,3R,4S,5E,7Z-1-bromo-3,4,8-trichloro-7-(dichloromethyl)-3-methylocta-1,5,7-triene (1) for the first time. This compound was isolated from a Namibian red algal Plocamium species. The antioxidant activity of the compound was evaluated using a series of antioxidant assays, namely; 2,2-diphenyl-1-picryl-hydrazyl radical (DPPH), reducing power, nitric oxide (NO) and hydrogen peroxide (H2O2). The compound demonstrated remarkable DPPH, NO and H2O2 scavenging activities with IC50 values of 0.05 ± 0.01, 4.18 ± 0.22 and 5.58 ± 1.11 mM, respectively. The reducing power of the compound increased with an increase in concentration. These results were compared to the absorbance of ascorbic acid, which was used as a standard control in all the antioxidant assays. The results strongly suggest that compound 1 is a promising antioxidant agent with potential commercial applications.


The use of silver-zinc-allantoin powder for the prehospital treatment of burns.
We describe our experimental studies of a powder formulated to treat serious burn wounds on-the-scene. The wound powder comprises two parts silver-citro-allantoinate, two parts zinc allantoinate and 96 parts pure allantoin. The back skin of 62 rats was shaved and exposed to actively boiling water for ten seconds, resulting in third degree burns of 20% of the total body surface. Immediately, 1 ml of a culture containing 2 X 10(8) Pseudomonas aeruginosa was applied to the burn. The animals were isolated. Of the 30 control rats, six were powdered with allantoin only. Thirty-two rats were dusted with the silver-zinc-allantoin powder within 15 minutes of burning. Cultures were taken at 48 hour intervals. Eighty-seven percent of the control animals died an average of six days postburn. In the treated animals, the mortality was 15%. A mean of 27% of the applied silver (0.35 gm) became incorporated in the eschar. In all control rats, sepsis was detected under the eschar. In treated animals, bacterial concentration fell from an initial average of 5 X 10(4) at 4 hours postburn to 6 X 10(2) at 96 hours.


Novel dual inhibitory function aptamer-siRNA delivery system for HIV-1 therapy.
The successful use of small interfering RNAs (siRNAs) for therapeutic purposes requires safe and efficient delivery to specific cells and tissues. In this study, we demonstrate cell type-specific delivery of anti-human immunodeficiency virus (anti-HIV) siRNAs through fusion to an anti-gp120 aptamer. The envelope glycoprotein is expressed on the surface of HIV-1-infected cells, allowing binding and internalization of the aptamer-siRNA chimeric molecules. We demonstrate that the anti-gp120 aptamer-siRNA chimera is specifically taken up by cells expressing HIV-1 gp120, and that the appended siRNA is processed by Dicer; this releases an anti-tat/rev siRNA which, in turn, inhibits HIV replication. We show for the first time a dual functioning aptamer-siRNA chimera in which both the aptamer and the siRNA portions have potent anti-HIV activities. We also show that gp120 expressed on the surface of HIV-infected cells can be used for aptamer-mediated delivery of anti-HIV siRNAs.


Cardiac cycle-dependent variation of integrated backscatter is not distorted by abnormal myocardial wall motion in human subjects with paradoxical septal motion.
To define the dependence of cardiac cycle-dependent variation of integrated backscatter on regional myocardial wall motion, 8 children mean age 10.6 +/- 1.3 y with congenital cardiac lesions associated with paradoxical septal motion were studied (study group). Six healthy children mean age 9.0 +/- 0.3 y with no history of cardiac disease served as controls (control group). Subjects in the study group had paradoxical septal motion but normal septal wall thickening detected by conventional two-dimensional and M-mode echocardiography. The control group had normal septal motion evident by conventional echocardiographic criteria. The percentage of systolic septal thickening was 46 +/- 4.5% and 42 +/- 5.9% in the study and control groups (p = NS). Cyclic variation was measured in parasternal long-axis views from several septal sites in each subject. Mean values of the magnitude of cyclic variation from independent septal sites were averaged to yield a regional average value for each subject. The average regional magnitude of cyclic variation was 8.3 +/- 1.0 dB and 5.7 +/- 0.4 dB in the study and control groups (p = NS). The results indicate that the measurement of cyclic variation of integrated backscatter is not distorted by altered regional wall motion, and that it reflects intrinsic contractile function.


Into the wild: digging at immunology's evolutionary roots.
The two pillars of modern immunology have been man and mouse; in both settings, investigators seek to reduce complexity and control environmental conditions. However, the world outside the laboratory is immensely variable; this is not 'noise' but represents the genetic and environmental framework in which the immune system evolved and functions. Placing the ever-growing understanding of immunological mechanisms in wider real-world contexts is a massive but fundamentally important challenge.


Respiratory Complications in Children and Adolescents with Human Immunodeficiency Virus.
Respiratory complications comprise a large proportion of the burden of mortality and morbidity in children with human immunodeficiency virus (HIV). HIV-associated lower respiratory tract infection (LRTI) has declined in incidence with early diagnosis and use of antiretroviral therapy (ART) but is widespread in areas with limited access to ART. HIV-exposed uninfected infants have a higher risk of LRTI early in life than unexposed infants. Pulmonary tuberculosis (PTB) presenting as acute or chronic disease is common in highly TB endemic areas. Chronic lung disease is common; preceding LRTI, PTB or late initiation of ART are risk factors.


Mechanical thrombectomy for acute ischemic stroke with large vessel occlusion in pregnancy with mechanical heart valves: A case report.
The management of anticoagulation for mechanical heart valves (MHVs) during pregnancy posed a special challenge. Mechanical thrombectomy (MT) was the standard treatment for acute ischemic stroke (AIS) in anterior circulation with large vessel occlusion. However, the efficacy and safety of MT in the treatment of acute ischemic stroke in pregnancy were unknown. A 29-year-old woman with MHVs in her first pregnancy at 7 weeks' gestation underwent MT because of a large occlusive thrombus in the end of the internal carotid artery despite therapeutic anticoagulation with low-molecular-weight heparin. This pregnant woman recovered well after MT with a modified rank score (mRS) of 0 at 90 days. At present, there was no standard protocol of anticoagulation therapy for pregnant women with MHVs. Acute ischemic stroke with large vessel occlusion in pregnancy was rare, but could bring devastating consequences for both mother and infant. Our case report demonstrated that MT could be safe and effective in pregnancy.


Adolescent idiopathic scoliosis with concomitant spondylolysis: choice of fusion levels and evaluation of the outcomes obtained leaving the lytic level not instrumented.
7% of adolescent idiopathic scoliosis (AIS) patients also present with a pars defect. To date, there are no available data on the results of fusion ending proximal to a spondylolysis in the setting of AIS. The aim of this study was to analyze the outcomes of posterior spinal fusion (PSF) in this patient cohort, to investigate if maintaining the lytic segment unfused represents a safe option. Retrospective review of all patients who received PSF for AIS, presented with a spondylolysis or spondylolisthesis and had a min. 2-year follow-up. Demographic data, instrumented levels, and preoperative radiographic data were collected. Mechanical complications, coronal or sagittal parameters, amount of slippage, and pain levels were evaluated. Data from 22 patients were available (age 14.4 ± 2.5 years), 18 Lenke 1-2 and 4 Lenke 3-6. 5 patients (24%) had an isthmic spondylolisthesis, all Meyerding I. The mean preoperative Cobb angle of the instrumented curves was 58 ± 13°. For 18 patients, the lowest instrumented vertebra (LIV) was the last touched vertebra (LTV); for 2, LIV was distal to the LTV; for 2, LIV was one level proximal to the LTV. The number of segments between the LIV and the lytic vertebra ranged from 1 to 6. At the last follow-up, no complications were observed. The residual curve below the instrumentation measured 8.5 ± 6.4°, the lordosis below the instrumented levels was 51.4 ± 13°. The magnitude of the isthmic spondylolisthesis remained constant for all included patients. Three patients reported minimal occasional low back pain. The LTV can be safely used as LIV when performing PSF for the management of AIS in patients with L5 spondylolysis.


A review on the ecotoxicological effect of sulphonamides on aquatic organisms.
Antibiotics are extensively used to treat human and animal diseases and are especially used in animal production to promote the growth performance of livestock and aquatic animals. Sulphonamides, as important drugs for aquatic animals, are often used in aquaculture to prevent and treat diseases. However, various antibiotics found in the aquatic environment exhibit varying degrees of toxicity to aquatic organisms. Antibiotics in wastewater produced in industrial and agricultural processes are not thoroughly removed by sewage treatment and are released into water, which results in varying degrees of pollution of the surrounding water environment, forcing people to pay attention towards the ecosystem. Several studies have investigated the impact of antibiotics on aquatic organisms in water environment; however, only a few studies have investigated the underlying mechanism. Antibiotics persisting in an aquatic environment for a long time can cause genotoxicity and histopathological changes in various aquatic organisms. Therefore, this paper reviews the sources of antibiotics in aquatic environment, the pollution status of sulfonamides in aquatic environment at home and abroad, and focuses on the research status of ecotoxicological effects of sulfonamides on aquatic organisms. Because there are not only antibiotic pollution, but also many other pollutants, such as heavy metals, micro plastics and other chemicals, it will be a challenge to determine the combined effects of antibiotics or other pollutants on aquatic organisms in future environmental toxicity studies.


CD4(+) CD25(+) FoxP3(+) regulatory T cells suppress cytotoxicity of CD8(+) effector T cells: implications for their capacity to limit inflammatory central nervous system damage at the parenchymal level.
CD4(+) CD25(+) forkhead box P3 (FoxP3)(+) regulatory T cells (T reg cells) are known to suppress adaptive immune responses, key control tolerance and autoimmunity. We challenged the role of CD4(+) T reg cells in suppressing established CD8(+) T effector cell responses by using the OT-I/II system in vitro and an OT-I-mediated, oligodendrocyte directed ex vivo model (ODC-OVA model). CD4(+) T reg cells dampened cytotoxicity of an ongoing CD8(+) T effector cell attack in vitro and within intact central nervous system tissue ex vivo. However, their suppressive effect was limited by the strength of the antigen signal delivered to the CD8(+) T effector cells and the ratio of regulatory to effector T cells. CD8(+) T effector cell suppression required T cell receptor-mediated activation together with costimulation of CD4(+) T reg cells, but following activation, suppression did not require restimulation and was antigen non-specific. Our results suggest that CD4(+) T reg cells are capable of suppressing CD8(+) T effector cell responses at the parenchymal site, that is, limiting parenchymal damage in autoimmune central nervous system inflammation.


Tuning pore features of mineralized collagen/PCL scaffolds for cranial bone regeneration in a rat model.
Porosity is indispensable for a bone tissue-engineered scaffold for facilitating endogenous cell migration and nascent bone ingrowth. In large-sized cranial bone defect repair, porous scaffolds meet great challenges to match cranial bone regeneration and provide sufficient protection with structural integrity. Therefore, the pore features of the scaffolds for cranial bone regeneration should differ from those typical porous scaffolds used in tubular bone repair and be finely tuned. In this study, a series of porous mineralized collagen/PCL scaffolds with different pore features were fabricated via freeze-drying and applied in a Sprague Dawley rat cranial bone calvarial defect model. The pore size for four groups increased from 10-45 μm to 40-130 μm. As scaffold porosity increased, the compressive strength decreased from 2.09 ± 0.12 MPa to 0.51 ± 0.04 MPa. The micro-computed tomography three-dimensional reconstruction images showed that as pore size and porosity increased, the amount of new bone formation had a maximum in group 3 (pore size: 20-100 μm, compressive strength: 1.06 ± 0.03 MPa). In addition, the histological and histomorphometric analyses showed a consistent tendency which confirmed the Micro-CT results. Meanwhile, histological findings including bony bridging, tissue response at the bone-implant interface and fibrous capsule thickness indicated that the dura mater pathway played the most important role in the regenerative process of this calvarial defect model.