Tube drainage of lung abscesses.
We treated 14 patients who had complicated lung abscesses (all over 4 cm in diameter); 9 patients had concomitant respiratory failure requiring mechanical ventilation. A percutaneous tube was inserted in 11 patients (3 subsequently underwent rib resection) and 3 underwent rib resection with operative insertion of the tube. The resultant bronchopleural fistulas did not interfere with respiratory management despite the use of mechanical ventilation, and only 2 patients required subsequent surgical closure. Eleven patients were discharged from the hospital. Complications were minimal and consisted of 2 episodes of hemorrhage, 1 during operative debridement of the abscess and 1 delayed. Both complications were managed successfully. Three patients died in the hospital, only 1 from complications of the lung abscess. We have concluded from this review that tube drainage can be safe, simple, and efficacious. We recommend it for the treatment of complicated lung abscesses even when associated with respiratory failure and mechanical ventilatory support.


Late outflow graft stenosis of left ventricular assist device and endovascular treatment.
Left ventricular assist device (LVAD) systems are preferred as a bridging to transplantation or as a destination therapy in the treatment of end-stage heart failure. LVAD-related complications are seen in different clinical variations with the widespread use of LVADs. Some of these complications are seen as related to outflow graft, such as graft stenosis, graft kinking and graft thrombosis. Outflow graft complications have a direct impact on LVAD flow rate and acutely impair the clinical condition of patients. Treatment modalities include surgical approach, endovascular approach, and medical approach. In this case report, we aim to share a 57-year-old male patient, who had outflow graft stenosis near the anastomosis line between ascending aorta and the left ventricular assist device outflow graft, and the endovascular treatment.


Identification, expression and antigenic analysis of recombinant hemagglutinin proteins of canine distemper virus.
Canine distemper (CD) is a widely distributed disease of dogs, caused by the canine distemper virus (CDV). In the present study, the gene encoding the hemagglutinin (H) protein of a CDV isolate from central Taiwan was sequenced and compared with other strains. Sequence variations were noticed in the H gene from the field CDV strain that had previously been implicated in the increasing incidence of CD. To establish a serology-based diagnostic test, the full-length H protein, as well as five deletion mutants of a recombinant H protein of the local isolate, were produced using an E. coli expression system. Three truncated recombinant proteins with relatively high expression levels, designated HM3, HM4 and HM5, were used as antigens to examine their reactivity with canine sera. By using three negative sera and 17 CD-positive sera, the high specificity of recombinant H proteins was observed by ELISA. In addition, immunoblotting demonstrated that all three purified recombinant proteins exhibit an antigenic property recognized by the serum of a CD-suspected dog.


Guidelines for guidelines.
Clinical practice guidelines (CPGs) are suited tools for controlling and improving the effectiveness and efficiency of medical care. With the upcoming internet, the numbers of CPGs have increased rapidly, however, only few offer the attributes of good guidelines such as reliability/reproducibility, applicability, flexibility, clarity, multidisciplinary process, scheduled review and documentation of clinical and scientific evidence. Nearly identical criteria for appraisal of CPGs have been developed in many countries consisting of a checklist with questions concerning the quality of development, the content and format, and the applicability of the guideline. In the United States, guidelines which successfully passed the appraisal (or clearing) process, were stored in the National Guideline Clearinghouse, an internet-based database. A German counterpart is under construction, which will comprise clearing reports reviewing and appraising all existent guidelines covering a medical topic. Developing high-quality CPGs is a time consuming and expensive process. A widely accepted guideline for guideline development was published by the Scottish Intercollegiate Guideline Network. CPGs touching neurosurgical topics are rare and often developed without neurosurgical participation. Due to the potential medico-economic impact of CPGs in the future, national neurosurgical societies and their international associations should play a more active role in the development and implementation of CPGs.


Role of auxin in regulating Arabidopsis flower development.
To elucidate the role of auxin in flower morphogenesis, its distribution patterns were studied during flower development in Arabidopsis thaliana (L.) Heynh. Expression of DR5::GUS was regarded to reflect sites of free auxin, while immunolocalization with auxin polyclonal antibodies visualized conjugated auxin distribution. The youngest flower bud was loaded with conjugated auxin. During development, the apparent concentration of free auxin increased in gradual patterns starting at the floral-organ tip. Anthers are major sites of high concentrations of free auxin that retard the development of neighboring floral organs in both the acropetal and basipetal directions. The IAA-producing anthers synchronize flower development by retarding petal development and nectary gland activity almost up to anthesis. Tapetum cells of young anthers contain free IAA which accumulates in pollen grains, suggesting that auxin promotes pollen-tube growth towards the ovules. High amounts of free auxin in the stigma induce a wide xylem fan immediately beneath it. After fertilization, the developing embryos and seeds show elevated concentrations of auxin, which establish their axial polarity. This developmental pattern of auxin production during floral-bud development suggests that young organs which produce high concentrations of free IAA inhibit or retard organ-primordium initiation and development at the shoot tip.


[Problems in the differential diagnosis and therapy of tumorous and infectious anemias].
Despite the complexity of etiological factors and pathogenetic processes was tried to demarcate differential-diagnostically the different forms of tumour anaemias (haemorrhagic anaemia, aplastic anaemia, megaloblastic and haemolytic anaemia as well as tumour anaemia in closer sense) and the infection anaemia with the aim to make possible a differentiated practical therapy.


Household food insecurity and mental distress among pregnant women in Southwestern Ethiopia: a cross sectional study design.
There are compelling theoretical and empirical reasons that link household food insecurity to mental distress in the setting where both problems are common. However, little is known about their association during pregnancy in Ethiopia. A cross-sectional study was conducted to examine the association of household food insecurity with mental distress during pregnancy. Six hundred and forty-two pregnant women were recruited from 11 health centers and one hospital. Probability proportional to size (PPS) and consecutive sampling techniques were employed to recruit study subjects until the desired sample size was obtained. The Self Reporting Questionnaire (SRQ-20) was used to measure mental distress and a 9-item Household Food Insecurity Access Scale was used to measure food security status. Descriptive and inferential statistics were computed accordingly. Multivariate logistic regression was used to estimate the effect of food insecurity on mental distress. Fifty eight of the respondents (9%) were moderately food insecure and 144 of the respondents (22.4%) had mental distress. Food insecurity was also associated with mental distress. Pregnant women living in food insecure households were 4 times more likely to have mental distress than their counterparts (COR = 3.77, 95% CI: 2.17, 6.55). After controlling for confounders, a multivariate logistic regression model supported a link between food insecurity and mental distress (AOR = 4.15, 95% CI: 1.67, 10.32). The study found a significant association between food insecurity and mental distress. However, the mechanism by which food insecurity is associated with mental distress is not clear. Further investigation is therefore needed to understand either how food insecurity during pregnancy leads to mental distress or weather mental distress is a contributing factor in the development of food insecurity.


Effect of 5-benzylacyclouridine, a potent inhibitor of uridine phosphorylase, on the metabolism of circulating uridine by the isolated rat liver.
5-Benzylacyclouridine (BAU) is a specific inhibitor of uridine phosphorylase, the first enzyme in the catabolism of uridine. It was found that 20 and 100 microM BAU dramatically reduced the rapid clearance of trace amounts of either [14C]uridine or hyperphysiologic concentrations of non-labeled uridine by the isolated rat liver perfused with an artificial oxygen carrier. In the absence of exogenously added uridine, non-treated livers maintained circulating concentrations of 1-2 microM uridine. In the presence of 20 microM BAU, these concentrations were increased 2- to 3-fold higher than physiologic levels (1.4 +/- 0.6 microM) and remained elevated for the duration of the experiment (120-160 min). In the presence of 100 microM BAU, uridine concentrations rose continuously at rates of between 80 and 150 nmoles per hr per g of liver, and the clearance of a single radioactive spike of uridine was reduced extensively. The half-life of a uridine spike was extended 2-fold in the presence of 20 microM BAU and 5- to 6-fold in the presence of 100 microM BAU. Exogenously added uridine (15 and 40 microM) was cleared rapidly by nontreated livers, with a half-life of approximately 10 min. However, BAU at a concentration of 20 microM increased the half-life of 15 or 40 microM uridine added to the perfusate by approximately 10-fold. A 100 microM concentration of BAU inhibited the removal of 40 microM circulating uridine, but with 15 microM uridine there was a continuous increase in the circulating concentration similar to that seen in the absence of added uridine. We conclude that extensive inhibition of uridine phosphorylase occurs at 100 microM BAU and partial inhibition at 20 microM BAU. These data indicate independent catabolic and excretory functions of the rat liver with respect to uridine.


7-Hydroxycoumarin inhibits oncogene-induced transformation of murine fibroblasts.
7-Hydroxycoumarin (7-HC) is a naturally occurring substance with a variety of biological activities, e.g. antitumoral and immunomodulatory action. The potential mechanisms of 7-HC action on tumor cells have been investigated in a model of mouse fibroblasts transformed by distinct retroviral vectors carrying the oncogenes myc and ras. Treatment of the different oncogenic transformants with 7-HC in non-cytotoxic concentrations causes a strong inhibition of their proliferative capacity as measured by growth curves. Furthermore, incubation of the ras and myc transformants with 7-HC abrogated soft agar colony formation when compared to untreated cultures. These changes in cell growth characteristics of the various oncogene-transformed mouse fibroblasts were transient, since removal of 7-HC from the cultures caused a reappearance of the transformed properties of these cells within 6 days. The 7-HC-mediated inhibition of the proliferative capacity of the transformants was preceded by a selective down-regulation of oncogene expression. These data suggest that 7-HC causes a reversible inhibition of ras- and myc-induced neoplastic properties in transformed fibroblasts by selective down-regulation of retroviral RNA levels.


Oleoma: rare complication of mesotherapy for cellulite.
Mesotherapy or intradermotherapy is used as a cosmetic procedure for many purposes, among them for cellulite. We report a case of oleoma on the thighs and buttocks that appeared two years after the injection of an unknown substance for improvement of cellulite. Lesions and associated pruritus resolved with colchicine, leaving depressed scars. Serious and peer-reviewed investigations must be performed to certify the efficacy and safety of this procedure.


A microscopy investigation of the complex problem of infertility of insect hybrids. Studies on the reproductive systems, eggshells, and karyotypes of the representatives of the genus Platymeris (Heteroptera, Reduviidae) and their hybrids.
Hybridisation is still a widely studied phenomenon that allows us to look at some processes differently. However, obtaining fertile hybrids, which we might consider in the long term as precursors of a new species, is still a field that requires research. Much of the research done so far indicates that hybrids are sterile - either sex or both. It is influenced by various mechanisms, both prezygotic and postzygotic reproductive isolation. Thanks to the use of light and transmission electron microscopy, our research has made it possible to understand, at least partially, the causes of infertility in male hybrids resulting from the crossing of two Afrotropical species of the genus Platymeris Laporte, 1833. The analysis of microscopic images showed that one of the possible causes of the infertility of hybrids might be spermatogenesis, during which sperm cells were not formed. In turn, the use of scanning electron microscopy revealed potential abnormalities in the structure of the hybrid eggshell. Moreover, karyotyping analyses suggest possible causes of infertility at the genetic level.


HLA-DRB1 alleles and cervical cancer: A meta-analysis of 36 case-control studies.
Human leukocyte antigens (HLA) are encoded by closely linked genetic loci, and are important in cervical carcinogenesis. The association between HLA-DRB1 alleles with cervical cancer has been studied extensively, but results reported thus far have been inconsistent. Hence, we performed a meta-analysis to precisely assess this association. A literature search was conducted in various online databases to identify suitable articles. Case-control studies investigating the association between HLA-DRB1 alleles and cervical cancer were included in this study. Fixed and random-effect models were used to calculate the pooled odds ratio (OR) and 95% confidence intervals (CIs). A total of 6645 cases and 9095 controls from 36 case-control studies were included. Of the 13 HLA-DRB1 family alleles, DRB1*09 (OR = 1.30) and DRB1 *15 (OR = 1.60) were associated with cervical cancer risk, whilst DRB1*13 (OR = 0.66) exerted a protective effect. Among the 44 HLA-DRB1 specific alleles, DRB1*04:01 (OR = 1.25), DRB1*10:01 (OR = 1.45), DRB1*11:01 (OR = 1.32), DRB1*15:01 (OR = 1.21) and DRB1*15:02 (OR = 1.55) were associated with an increased risk of cervical cancer. However, DRB1*04:06 (OR = 0.52), DRB1*12:02 (OR = 0.61), DRB1*13:01 (OR = 0.62), DRB1*13:02 (OR = 0.57), and DRB1*14:04 (OR = 0.37) were associated with a decreased risk of cervical cancer. Subgroup analysis also revealed that HLA-DRB1 alleles are associated with cervical cancer in Asian, Caucasian, Hispanic or Latin American and black sub-Saharan Africa populations. Our meta-analysis revealed that multiple HLA-DRB1 alleles are associated with cervical cancer in women of diverse ancestry populations.


The depressive effects of 5,8,11-eicosatrienoic Acid (20:3n-9) on osteoblasts.
In cases of essential fatty acid deficiency, 5,8,11-eicosatrienoic acid (Mead acid, 20:3n-9) is synthesized from oleic acid as a 20-carbon analog of arachidonic acid. It was reported that 20:3n-9 levels were markedly higher in human fetal cartilage than in the muscle, liver and spleen. We, therefore, hypothesized that 20:3n-9 decreased osteoblastic activity. Goldfish scales were incubated either with 20:3n-9 or with oleic acid at 15 degrees C for 6 and 18 h. Both osteoblastic and osteoclastic activities in the scale were assessed by measuring alkaline phosphatase (ALP) and tartrate-resistant acid phosphatase, respectively. MC3T3-E1 cells (an osteoblast cell line derived from the mouse) were incubated with 20:3n-9 or oleic acid at 37 degrees C for 6 and 18 h. ALP activity in cell lysate was measured. In the case of experiments with scales, 20:3n-9 (1-100 muM) significantly suppressed osteoblastic activity after 6 and 18 h of incubation, whereas oleic acid did not change this activity. Osteoclastic activity was not affected either by 20:3n-9 or by oleic acid. In the case with the cell line, osteoblastic activity was again significantly decreased with 20:3n-9 (10-30 muM) after 6-h incubation but not after 18 h incubation. The presence of 20:3n-9 in fetal cartilage may be important for the prevention of calcification in the cartilage. 20:3n-9 could be applied to some clinical situations where bone formation should be inhibited.


Bodily illusions modulate tactile perception.
Touch differs from other exteroceptive senses in that the body itself forms part of the tactile percept. Interactions between proprioception and touch provide a powerful way to investigate the implicit body representation underlying touch. Here, we demonstrate that an intrinsic primary quality of a tactile object, for example its size, is directly affected by the perceived size of the body part touching it. We elicited proprioceptive illusions that the left index finger was either elongating or shrinking by vibrating the biceps or triceps tendon of the right arm while subjects grasped the tip of their left index finger. Subjects estimated the distance between two simultaneous tactile contacts on the left finger during tendon vibration. We found that tactile distances feel bigger when the touched body part feels elongated. Control tests showed that the modulation of touch was linked to the perceived index-finger size induced by tendon vibration. Vibrations that did not produce proprioceptive illusion had no effect on touch. Our results show that the perception of tactile objects is referenced to an implicit body representation and that proprioception contributes to this body representation. We also provide, for the first time, a quantitative, implicit measure of distortions of body size.


Measurement of speed of sound dispersion in soft tissues using a double frequency continuous wave method.
We introduce a method for measuring the speed of sound dispersion. It combines a short pulse transmission followed by a long burst comprised of two frequencies, one being double that of the other. The method allows the determination of the speed of sound dispersion using a single transmission. To validate the method, the dispersion was first measured in plastic samples and then in in vitro soft tissues samples. The results obtained for Perspex samples are in excellent agreement with values reported in the literature. The dispersion index in soft tissues ranged for a bovine heart from 0.63 +/- 0.24 (m/s.MHz) at 1.5 MHz to 0.27 +/- 0.05 (m/s.MHz) at 4.5 MHz and for a turkey breast from 1.3 +/- 0.28 (m/s.MHz) at 1.75 MHz to 0.73 +/- 0.1 (m/s.MHz) at 3.8 MHz. The significant difference in the speed of sound dispersion index between the studied materials indicates that dispersion may be used as a new index for soft tissue characterization by ultrasound.


International harmonization of standards for diagnostic tests and vaccines: role of the Office International des Epizooties (OIE).
The OIE is recognized as the world organization for animal health. Serving 145 member countries, the OIE provides current information on disease occurrence, coordinates studies on disease surveillance and control, and harmonizes regulations for trade in animals and animal products. This paper focuses on the role of one the OIE's specialist commissions, the Standards Commission. The Standards Commission works in close collaboration with the Scientific and Technical Department of the OIE's Central Bureau on the international harmonization of standards for diagnostic tests and vaccines. The Manual of Standards for Diagnostic Tests and Vaccines, approved by the International Committee, defines the international standards for diagnostic tests and for the production of biological products as applied to mammals, birds, and bees. The Manual lists and details those tests which are prescribed for international trade and others which are suitable for bilateral trade agreements. The Manual represents one of the key scientific and technical references for harmonization of regulations for trade in animals and animal products. The commission coordinates the activities of a network of some 110 OIE reference laboratories and six collaborating centers. By creating and nurturing this network, international harmonization is promoted through the sharing of knowledge and the establishment of collaborative projects related to methods development and standardization, production and distribution of international reference standards, quality assurance, and assay validation. Through a series of guidelines provided to participants, the commission ensures the quality and focus of these projects. In matters of a scientific and technical nature concerning diagnostic tests and vaccines, the Standards Commission collaborates with other international organizations such as the FAO, WHO, IICA, and PAHO, thus promoting harmonization at the international program level. Underscoring the important role of the OIE at this level, the Sanitary and Phytosanitary Agreement of the World Trade Organization, as included in the Marrakech agreement (1994), specifically recommends the use of standards, guidelines, and recommendations developed under the auspices of the OIE in order to promote harmonization of regulations for trade in animals and animal products.


Effect of vaginal delivery on anal sphincter function in Asian primigravida: a prospective study.
The true incidence of obstetric anal sphincter injuries (OASI) among Asian primigravida is not known. This study aimed to evaluate OASI in Sri Lankan primigravida. One hundred and one consecutive primigravida in their last trimester were recruited from antenatal clinics at a tertiary care centre in Sri Lanka and followed up 6 weeks and 6 months after delivery. They were assessed using anorectal manometry (3D-ARM) and endoanal ultrasound (3D-EAUS) on both occasions. Seventy-three (75.3 %) had vaginal delivery without instrumentation, whereas 3 (3.1 %) each delivered using forceps or vacuum. Twelve (12.4 %) had emergency caesarean sections and 6 (6.2 %) had elective caesarean sections. None had clinically identified anal sphincter injuries. EAUS identified IAS defects in 3 (5.1 %) and EAS defects in 28 (47.5 %). Both resting (p = 0.3) and squeeze (p = 0.001) pressures had decreased following childbirth. Multivariate analysis identified antepartum RP and postpartum EAS defects to be associated with RP reduction (χ(2)(4)=17.825, p < 0.0005) and antepartum SP and postpartum EAS defects to be associated with SP reduction (χ(2)(5)=31.517, p < 0.0005). Episiotomy was protective, whereas delivering after 40 weeks' gestation and delivering a baby with a longer length increased the risk of SP reduction. EAS defects (χ(2) (6)=23.502, p = .001) were more common in mothers who had labour augmented by oxytocin and in those who delivered a baby with a larger head circumference. Labour induction and delivering a longer baby were protective for EAS defects. Several risk and protective factors for the structural and functional damage of sphincters were identified. These findings will help to formulate a policy to minimize future obstetric anal sphincter injuries.


Myeloid Sarcoma of Temporal Bone: A Rare Manifestation of Relapse Acute Myeloid Leukemia.
Myeloid sarcoma is a rare malignant extramedullary neoplasm of myeloid precursor cells. This disorder may occur in concomitance with or precede development of acute or chronic myeloid leukemia. Sometimes, it is the initial manifestation of relapse in a previously treated acute myeloid leukemia. We report a case of 11 years old boy with acute myeloid leukemia in remission state, presented with short history of right otalgia associated with facial nerve palsy. Diagnosis of right acute mastoiditis with facial nerve palsy as complication of acute otitis media was made initially. Patient underwent simple cortical mastoidectomy but histopathology from soft tissue that was sent revealed diagnosis of myeloid sarcoma. A leukemic relapse was confirmed by paediatric oncologist through bone marrow biopsy. Chemotherapy was commenced but patient responded poorly to the treatment.


Prognostic value of urinary prostate cancer antigen 3 (PCA3) during active surveillance of patients with low-risk prostate cancer receiving 5α-reductase inhibitors.
To determine the clinical performance of the urinary prostate cancer antigen 3 (PCA3) test to predict the risk of Gleason grade re-classification amongst men receiving a 5α-reductase inhibitor (5ARI) during active surveillance (AS) for prostate cancer. Patients with low-risk prostate cancer were enrolled in a prospective Phase II study of AS complemented with prescription of a 5ARI. A repeat biopsy was taken within the first year and annually according to physician and patient preference. In all, 90 patients had urine collected after digital rectal examination of the prostate before the first repeat biopsy. The PCA3 test was performed in a blinded manner at a central laboratory. Using a PCA3-test score threshold of 35, there was a significant difference (P < 0.001) in the risk of being diagnosed with Gleason ≥7 cancer during a median of 7 years of follow-up. Adjusted Cox regression and Kaplan-Meier analyses also showed a significantly higher risk of upgrading to Gleason ≥7 during follow-up for those with a higher PCA3-test score. The urinary PCA3 test predicted Gleason grade re-classification amongst patients receiving a 5ARI during AS for low-risk prostate cancer.


Evaluating the morphological features of the lateral pterygoid insertion into the medial surface of the condylar process.
The lateral pterygoid is vital in coordinating multidimensional jaw movements. Since a vector in three-dimensional (3D) space is defined by two 3D points, the role of the lateral pterygoid in 3D jaw movements is defined by its origin and insertion. Reportedly, the lateral pterygoid is inserted into not only the pterygoid fovea but also into the medial surface of the condylar process. The objective was to investigate the morphological features of the region of the lateral pterygoid that inserted into the medial surface of the condylar process. Ten head halves of seven cadaveric donors were analyzed. In all specimens, the insertion area on the medial surface of the condylar process was measured based on microcomputed tomography images. Muscle fibers were separated into ≥50 small bundles, and positional relationships between the origins and insertions were investigated. Overall, 28.8 ± 5.0% of the insertion area of the lateral pterygoid was situated on the medial surface of the condylar process. Moreover, muscle fiber arrangement revealed that origins of the muscle bundles inserting into the medial surface in seven specimens posteriorly occupied the lateral plate of the pterygoid process longitudinally, whereas those in three specimens mainly occupied the posteroinferior portion. Muscle bundle inserting on the medial surface of the condylar process had a broad insertion area and a distinct origin on the posterior region of the lateral plate of the pterygoid process. This muscle bundle could act as one of the significant subunits within the lateral pterygoid. Therefore, anatomical coordination mechanisms underlying jaw movement cannot be elucidated without considering this subunit.


An evaluation of skin grafts for reconstruction of the penis and scrotum.
Skin grafting remains a primary modality for reconstruction of genitourinary defects. Many of these conditions are discussed and emphasis has been placed on the different indications for full-thickness, split-thickness, and dermal grafts. Complications have been few, and long-term results excellent. This experience has allowed the formulation of a number of surgical principles, which are presented. Refinements in reconstruction are currently being evaluated to obtain the optimal result.


Acute hyperglycemia is associated with adverse outcome after acute myocardial infarction in the coronary intervention era.
This study was undertaken to assess the association between acute hyperglycemia and inhospital outcome after acute myocardial infarction (AMI) in the percutaneous coronary intervention (PCI) era. We also assessed outcome of patients with a history of diabetes mellitus in the PCI era. Between January 2001 and December 2001, 1253 patients were admitted to the hospitals within 48 hours after the onset of AMI. Plasma glucose was measured at hospital admission. Acute hyperglycemia was defined as plasma glucose of > 11 mmol/L (198 mg/dL), regardless of the diabetic status. Primary PCI was performed in 898 (72%) patients. The inhospital mortality rate was significantly higher in patients with acute hyperglycemia than in patients without (16% vs 6%, P < .001). However, there was no significant difference in mortality between diabetic and nondiabetic patients (8% vs 9%, P = .54). Acute hyperglycemia was associated with a higher inhospital mortality rate both in nondiabetic patients (24% vs 6%, P < .001) and in diabetic patients (10% vs 5%, P = .039). Acute hyperglycemia was associated with a higher incidence of no reflow during PCI (21% vs 12%, P < .001), but diabetes was not (14% vs 15%, P = .71). Acute hyperglycemia, but not diabetes, was a predictor for inhospital mortality after AMI in the PCI era. No reflow occurred more frequently during PCI in patients with acute hyperglycemia, suggesting that microvascular dysfunction might have contributed to adverse outcome of these patients.


Ratiometically Fluorescent Sensing of Zn(II) Based on Dual-Emission of 2-Pyridylthiazole Derivatives.
A new fluorophore, 4-methyl-2-(2-pyridyl)-5-(2-thiophenyl)thiazole (2-PTT), was reported as a ratiometically fluorescent sensor of zinc(II) based on dual-emission with selectivity and sensitivity. Two emission bands at 440 and 497 nm were observed before and after addition of zinc(II), respectively. Job's plot disclosed the 1:1 stoichiometry between 2-PTT and zinc(II). The binding constant was evaluated as 2.09 × 10(5) M(-1) based on fluorescence titration experiment.


Higher neutrophil counts are associated with successful tyrosine kinase inhibitor discontinuation in patients with chronic myeloid leukemia.
Treatment-free remission (TFR) after tyrosine kinase inhibitor (TKI) discontinuation at the first attempt is a therapeutic goal for patients with chronic phase chronic myeloid leukemia (CML-CP). However, it remains unclear whether discontinuation of TKIs at a second or subsequent attempt can be performed safely. Here, we report a 72-year-old man diagnosed with CML-CP. He achieved TFR successfully after TKI discontinuation at the third attempt. Before discontinuation, the patient received imatinib, nilotinib, and finally nilotinib. His neutrophil count at the third attempt was higher than after the second attempt. We also performed a retrospective investigation of 53 patients who discontinued TKIs on the first or subsequent attempts. Overall, 64 TKI discontinuations were documented (first, 53; second, ten; third, one). We found that a higher neutrophil count at the time of TKI discontinuation (>2439/μL; hazard ratio, 0.325; 95% confidence interval, 0.137-0.772; p = 0.011) was associated independently with lower rates of molecular relapse. We report a case of a patient who successfully achieved third attempt TKI discontinuation and, an increased neutrophil percentage may reflect stronger antitumor immune responses in patients with CML-CP.


Solving transparency in drought forecasting using attention models.
Droughts are one of the most devastating and recurring natural disaster due to a multitude of reasons. Among the different drought studies, drought forecasting is one of the key aspects of effective drought management. The occurrence of droughts is related to a multitude of factors which is a combination of hydro-meteorological and climatic factors. These variables are non-linear in nature, and neural networks have been found to effectively forecast drought. However, classical neural nets often succumb to over-fitting due to various lag components among the variables and therefore, the emergence of new deep learning and explainable models can effectively solve this problem. The present study uses an Attention-based model to forecast meteorological droughts (Standard Precipitation Index) at short-term forecast range (1-3 months) for five sites situated in Eastern Australia. The main aim of the work is to interpret the model outcomes and examine how a deep neural network achieves the forecasting results. The plots show the importance of the variables along with its short-term and long-term dependencies at different lead times. The results indicate the importance of large-scale climatic indices at different sequence dependencies specific to the study site, thus providing an example of the necessity to build a spatio-temporal explainable AI model for drought forecasting. The use of such interpretable models would help the decision-makers and planners to use data-driven models as an effective measure to forecast droughts as they provide transparency and trust while using these models.


HepG2 cell binding activities of different hepatitis B virus isolates: inhibitory effect of anti-HBs and anti-preS1(21-47).
The antigenic relationships among different hepatitis B virus (HBV) isolates were investigated by using monoclonal antibodies (MAbs) specific for HBs, preS2 (pHSA binding site), and preS1 (hepatocyte receptor-binding site) epitopes in a double immunoradiometric assay. In order to define possible functional differences resulting from structural and antigenic differences in the HBV env protein, the HBV isolates were compared in an in vitro cell-binding assay based on the attachment of 125I-labeled HBV to human hepatoma HepG2 cells. We provided evidence for a variability of the expression of preS1 and preS2 specificities in the peplomer (glyco)protein of HBV depending on dly subtype of HBsAg, which could affect the viral infectivity. We showed that the integrity of the HBV envelope structure associated with a large expression of preS1(21-47) epitopes is an essential factor for effective binding to HepG2 cells. Interestingly, the HBs-specific MAbs directed to disulfide-bond-dependent epitopes were found to be the best inhibitors of the preS1-HepG2 cell interaction (greater than 50%, at the final concentration of 0.5 micrograms/ml). The MAb F35.25 directed to the preS1(21-47) sequence corresponding to the hepatocyte receptor recognition site was, however, also found to inhibit binding. Thus, our results demonstrate the abilities of both anti-HBs and anti-preS(21-41) to block the attachment of complete HBV particles to HepG2 cells, suggesting that these antibodies should be virus neutralizing and would be expected to confer protection against reinfection.


Novel assays for proteases using green fluorescent protein-tagged substrate immobilized on a membrane disk.
Green fluorescent protein (GFP) is very stable for various proteases. Using this property, three protease assay methods designated the disk separation assay for remaining GFP (DSAR), the disk separation assay for liberated GFP (DSAL), and the homogeneous assay for fluorescence concentrated on membrane (HAFCOM) were developed. These methods employ a nylon membrane designated "Cleave-Checker" on which GFP-SpA(B) (domain B in staphylococcal protein A) is immobilized. The SpA(B) region was used as a substrate for the protease, and the isolation of GFP from the membrane generated by the digestion of the SpA(B) region was detected. In DSAR, it was possible to detect solution of at least 25 ng/ml trypsin or proteinase K by visual observation. The most important feature of DSAR is that the detection of the protease is possible only under UV light. In contrast, DSAL is suitable for a highly sensitive assay. The assay ranges of DSAL were 1.6 to 100 ng/ml in trypsin and 1.6 to 400 ng/ml in proteinase K. HAFCOM does not require bound/free (B/F) separation; thus, the procedure is simpler than that with DSAL and the reproducibility is high. The assay ranges of HAFCOM were 25 to 400 ng/ml in trypsin and 12.5 to 200 ng/ml in proteinase K. The Cleave-Checker used for these methods was stable in a dry state, and long-term preservation for at least several months was possible.


Should the EuroQol-Five Dimensions Replace the Oswestry Disability Index When Tracking Lumbar Tubular Microdecompression Outcomes?
Patient-reported outcomes measures (PROMs) are critical in evaluating the effectiveness of surgical spine interventions. The Oswestry Disability Index (ODI) is commonly used but tedious to administer routinely. The EuroQol-5 Dimensions (EQ-5D) questionnaire is easier to administer but not traditionally used to measure spine surgical results. This study aimed to investigate the correlation of commonly administered PROMs in lumbar tubular microdecompression patients, and to consider whether ODI could be predicted from remaining PROMs. This study examined 304 index lumbar tubular microdecompression patients with PROMs collected at routine intervals. Spearman correlation coefficients were calculated for each pairwise combination of the following PROMs: ODI, EQ-5D index, leg pain visual analog scale (VAS), low back pain VAS, health state item. Linear regression modeling was conducted to predict ODI from the remaining four PROMs. The patients had a mean age of 65.55 ± 12.97 years and 46.4% were male. Each combination of PROMs demonstrated a statistically significant pairwise correlation (P < 0.001). ODI showed strong correlation with EQ-5D index (r = -0.77), leg pain VAS (r = 0.73), and back pain VAS (r = 0.65), but weak correlation with health state item (r = -0.33). Forwards stepwise model selection yielded a multiple linear regression model including all four PROMs predictors, with an adjusted R2 of 0.690. There was strong correlation between predicted and observed ODI (r = 0.83, P < 0.001). ODI can be predicted from EQ-5D, leg and low back pain VAS, and health state items with moderate accuracy. The added utility of capturing ODI routinely may not out-weigh the challenges in doing so.


Disruption of the epithelial barrier during intestinal inflammation: Quest for new molecules and mechanisms.
The intestinal epithelium forms a key protective barrier that separates internal organs from the harmful environment of the gut lumen. Increased permeability of the gut barrier is a common manifestation of different inflammatory disorders contributing to the severity of disease. Barrier permeability is controlled by epithelial adherens junctions and tight junctions. Junctional assembly and integrity depend on fundamental homeostatic processes such as cell differentiation, rearrangements of the cytoskeleton, and vesicle trafficking. Alterations of intestinal epithelial homeostasis during mucosal inflammation may impair structure and remodeling of apical junctions, resulting in increased permeability of the gut barrier. In this review, we summarize recent advances in our understanding of how altered epithelial homeostasis affects the structure and function of adherens junctions and tight junctions in the inflamed gut. Specifically, we focus on the transcription reprogramming of the cell, alterations in the actin cytoskeleton, and junctional endocytosis and exocytosis. We pay special attention to knockout mouse model studies and discuss the relevance of these mechanisms to human gastrointestinal disorders.


The value of sonication on orthopaedic implants in an everyday clinical setting - an exploratory study.
Sonication of removed orthopaedic implants in suspected implant-associated infections (IAI) is widely applied internationally. However, evaluation of the utility of sonication on all implants removed in everyday standard practice is scarce. This exploratory study was performed to evaluate the application of sonication fluid (SF) culture on removed orthopaedic implants, irrespective of the reason for removal. Out of 100 removed orthopaedic implants collected between August 2019 and September 2020, 77 implants with availability of concurrent tissue culture samples were included in the study. Removed implants were categorized into a confirmed or suspected IAI group and a presumed aseptic group based on pre-operative diagnosis by the responsible surgeon. Implants were sonicated and SF culture performed under both aerobic and anaerobic conditions. The significance of all bacterial isolates was evaluated based on the CFU/mL cut-offs of the EBJIS guidelines, except for C. acnes where additional investigations were performed. The results of SF culture in the two groups were compared with their corresponding tissue cultures. Out of the 12 cases in the confirmed/suspected IAI group, SF culture was positive in 11 cases and had increased diagnostic yield in two (17%) cases compared to tissue culture. Increased diagnostic yield of SF compared to tissue culture was seen in seven (11%) of the 65 implants in the presumed aseptic group. If growth of Cutibacterium species isolates were interpreted based on EBJIS cut-off for SF culture instead of the study-specific criteria, then two isolates considered to represent infection might have been missed while three other isolates considered contaminants would have fallen under the 'infection confirmed' category in the EBJIS guidelines. Sonication with SF culture has increased diagnostic yield compared to tissue cultures in all implants irrespective of reason for removal. However, positive SF cultures with Cutibacterium species should always be interpreted with extreme care.


Cross sectional analysis of scoliosis-specific information on the internet: potential for patient confusion and misinformation.
Patients and their families are increasingly turning to the internet for medical information. Most of these patients believe the information to be accurate and reliable. However, the quality and accuracy of that information on the internet is variable and unregulated. Accurate and applicable information may align patients' expectations and improve satisfaction and overall outcomes. This study aimed to evaluate the quality and accuracy of scoliosis-related information available on the internet. Cross-sectional analysis. Independent searches were conducted on the three most commonly accessed search engines (Google, Yahoo and Bing) using the keyword "scoliosis". The top 30 sites from each search engine were reviewed. Each website was categorized as per its authorship and sourcing. Each site was then evaluated for accuracy, readability and with quality-assurance markers such as Health on the Net code (HONcode), DISCERN, Journal of American Medical Association (JAMA) systems. The accuracy of the website was assessed by two fellowship-trained spine specialists. Website accuracy was rated on a scale of 1-4 based on the level of agreement with the information presented. Websites with greater than 75% agreement were rated 4. Finally, the sites were evaluated with a validated website distraction index and assessed for mobile friendliness. 42 unique websites were analyzed. 31% of the sites were categorized as academic (13 academic, 9 healthcare system, 12 health news outlets and 8 unspecified) and had the highest rate of physician authorship (54%). Accuracy ranged from less than 25% to more than 75% were recorded with a mean accuracy of 3 signifying 50-75% agreement. Academic sites had the highest scoliosis specific accuracy score (P < 0.05). Overall, average readability was at a 12th grade reading level. More than 90% of the sites were mobile friendly. Approximately 71% of the websites did not have HONcode certification, although health news outlets had the highest rate of certification (67%). There was a significant effect of HONcode certification on DISCERN, JAMA, grade level and reading ease. On average, HONcode certified websites had lower grade level readability with greater reading ease and higher DISCERN and JAMA scores than un-certified sites (p < 0.05). On average, health news outlets had the highest DISCERN, JAMA, and reading ease scores and were written at the lowest grade reading level but had the highest level of distraction (p < 0.05). For the iGeneration and their care-givers, the internet remains the most popular source of health-related and medical information. Despite the wide number of sources available, the quality, accuracy, pertinence and intelligibility of the information remains highly variable. As clinicians, we should direct patients to verifiable sites with regulated information and, where possible, contribute high quality information to those sites.


TIC-Tox: A preliminary discussion on identifying the forcing agents of DBP-mediated toxicity of disinfected water.
The disinfection of drinking water is a major public health achievement; however, an unintended consequence of disinfection is the generation of disinfection by-products (DBPs). Many of the identified DBPs exhibit in vitro and in vivo toxicity, generate a diversity of adverse biological effects, and may be hazards to the public health and the environment. Only a few DBPs are regulated by several national and international agencies and it is not clear if these regulated DBPs are the forcing agents that drive the observed toxicity and their associated health effects. In this study, we combine analytical chemical and biological data to resolve the forcing agents associated with mammalian cell cytotoxicity of drinking water samples from three cities. These data suggest that the trihalomethanes (THMs) and haloacetic acids may be a small component of the overall cytotoxicity of the organic material isolated from disinfected drinking water. Chemical classes of nitrogen-containing DBPs, such as the haloacetonitriles and haloacetamides, appear to be the major forcing agents of toxicity in these samples. These findings may have important implications for the design of epidemiological studies that primarily rely on the levels of THMs to define DBP exposure among populations. The TIC-Tox approach constitutes a beginning step in the process of identifying the forcing agents of toxicity in disinfected water.


Laparoscopic sleeve gastrectomy combined with Rossetti fundoplication (R-Sleeve) for treatment of morbid obesity and gastroesophageal reflux.
Gastroesophageal reflux (GERD) can be considered an obesity-related disease. Roux-en-Y gastric bypass is considered the gold standard for its therapeutic effects on acid reflux. The aim of this retrospective study is to assess the effectiveness of combined laparoscopic sleeve gastrectomy and Rossetti antireflux fundoplication for the treatment of morbidly obese patients with GERD. A private academic hospital in Italy. Forty obese patients with GERD underwent laparoscopic sleeve gastrectomy-Rossetti laparoscopic fundoplication from January 1 to October 31, 2015. A specific informed consent was obtained. Minimum follow-up was 12 months. No cases were lost to follow-up. Mean body mass index was 44.4 ± 4.7 kg/m2; all patients had GERD. Mean operative time was 38 ± 6 minutes. The mortality rate was 0%. No intraoperative or medium- or long-term complications were reported. Excess weight loss percent at 1, 3, 6, 12 months was 25.6 ± 6.1, 41.9 ± 12.5, 56.7 ± 13.0, 61.7 ± 13.6, respectively. Excess body mass index loss percent at 1, 3, 6, 12 months was 29.3 ± 3.4, 47.2 ± 5.2, 64.0 ± 8.6, 73.3 ± 9.9, respectively. At the 12-month follow-up visit, 95% of the patients reported a good sense of repletion without episodes of vomiting, nausea, or dysphagia. Rossetti laparoscopic fundoplication is well tolerated, feasible, and safe in obese patients with GERD, with good postoperative weight results. Following this evidence, 2 monocentric prospective and randomized studies will start to analyze and confirm the reported data.


Effects of L-364,718, a new cholecystokinin receptor antagonist, on camostate-induced growth of the rat pancreas.
Chronic feeding of rats with camostate results in pancreatic hypertrophy or hyperplasia, or both. Previous studies suggest that this effect of camostate occurs via an increase in endogenous cholecystokinin due to an enteral feedback mechanism involving the inhibition of trypsin in the duodenum. Studies employing proglumide, a weak and relatively nonspecific cholecystokinin antagonist, have failed to fully abolish camostate-induced pancreas growth. We examined the effects of L-364,718, a new and highly potent cholecystokinin receptor antagonist, on camostate-induced pancreas growth in rats. The pancreas weights and the concentrations of ribonucleic acid, protein, and chymotrypsinogen in the pancreas of rats treated with camostate alone were significantly elevated over those of controls. These effects of camostate were completely abolished in rats treated with camostate + L-364,718. The pancreas weights and the concentrations of deoxyribonucleic acid and ribonucleic acid in the pancreas of rats treated with L-364,718 alone were significantly lower than values in control rats. These data indicate that camostate-induced pancreas growth in rats appears to be dependent on the actions of endogenous cholecystokinin and that cholecystokinin may play a role in the maintenance of pancreatic growth in normal rats.


Long-Term Follow-Up with Dorsal Preservation Rhinoplasty.
The rapid resurgence of interest in performance of dorsal preservation (DP) rhinoplasty techniques in recent years has come with scarcity of data for long-term outcomes. In this article, the authors aim to contribute to preservation rhinoplasty (PR) literature by providing long-term follow-up with dorsal preservation, specifically presenting data related to superior strip DP functional and esthetic complications, followed by a detailed analysis of the same.


Taking a history: A roundtable discussion of APSA's past.
During the APSA 50th Anniversary Meeting, a panel of pediatric surgery legends and leaders captured our attention for a special session on the history of our organization. Learning from history is an important means of shaping the future. As APSA moves forward, we look to our past to understand how our organization and our specialty have emerged, evolved, and expanded. We had the privilege of hearing from Drs. Kathryn Anderson, Arnold Coran, Dick Ellis, Lucian Leape, and Alberto Peña, as well as other distinguished APSA members in the audience. They shared first-hand accounts of the origins of our organization, stories of adversity and growth, tales of caution, and words of advice. Their collective experiences from their remarkable careers in pediatric surgery offer invaluable insight into our mission of saving lifetimes.


Carbonic anhydrase III in the salivary glands and kidney of the Japanese monkey (Macaca fuscata).
Carbonic anhydrase III (CA-III) was found in muscles of the Japanese monkey by the double immunodiffusion test and western blotting using antiserum raised against equine CA-III. Immunocytochemical localization of CA-III in the salivary glands and kidney of the monkey was studied using an avidin-biotinylated glucose oxidase complex. CA-III was found mainly in the striated duct and interlobular duct cells of the parotid glands. In the submandibular glands, striated duct, interlobular duct, and excretory duct cells were strongly stained for CA-III. In the kidney of the monkey, CA-III was localized mainly in the dark cells of the collecting duct at the medulla and in the epithelial cells of thick limb of Henle's loop.


A preventable cause of transplant hydroureteronephrosis: inguinal herniation of the transplant ureter: case report and review of the literature.
Transplant ureter obstruction is an important cause of graft loss after kidney transplantation. Most cases occur early after transplantation and are related to surgical causes or ischaemic strictures. Underlying mechanisms of late ureteral obstruction are less well understood. We present the case of a 61-year-old man who showed gradual decline in renal allograft function and hydronephrosis nine years after transplantation, due to an inguinal herniation of the transplant ureter. After urinary diversion using a percutaneous nephrostomy, graft function restored and the patient underwent surgery. The ureter was reduced from the inguinal hernia and re-implanted in the bladder, with primary closure of the abdominal wall defect. Postoperative course was uneventful and serum creatinine returned to baseline levels. Search of relevant literature revealed a number of similar cases, which allowed identification of risk factors associated to the development of uretero-inguinal herniation leading to obstructive nephropathy. Diagnosis of this rare cause of transplant dysfunction and operative treatment strategies are discussed. Inguinal herniation of the transplant ureter leading to ureteral obstruction is a rare, probably underreported, cause graft of dysfunction. Therefore, we advocate elective repair of inguinal or incisional hernias in renal transplant recipients.


Genetic and phenotypic analysis of B-cell post-transplant lymphoproliferative disorders provides insights into disease biology.
B-cell post-transplant lymphoproliferative disorders (PTLD) are classified as early lesions, polymorphic lymphomas (P-PTLD) and monomorphic lymphomas (M-PTLD). These morphologic categories are thought to reflect a biologic continuum, although supporting genetic data are lacking. To gain better insights into PTLD pathogenesis, we characterized the phenotypes, immunoglobulin (Ig) gene alterations and non-Ig gene (BCL6, RhoH/TTF, c-MYC, PAX5, CIITA, BCL7A, PIM1) mutations of 21 PTLD, including an IM-like lesion, 8 P-PTLD and 12 M-PTLD. Gene expression profile analysis was also performed in 12 cases. All PTLD with clonal Ig rearrangements showed evidence of germinal centre (GC) transit based on the analysis of Ig and BCL6 gene mutations, and 74% had a non-GC phenotype (BCL6 +/- MUM1+). Although surface Ig abnormalities were seen in 6/19 (32%) PTLD, only three showed 'crippling' Ig mutations indicating other etiologies for loss of the B-cell receptor. Aberrant somatic hypermutation (ASHM) was almost exclusively observed in M-PTLD (8/12 vs. 1/8 P-PTLD) and all three recurrent cases analysed showed additional mutations in genes targeted by ASHM. Gene expression analysis showed distinct clustering of PTLD compared to B-cell non-Hodgkin lymphomas (B-NHL) without segregation of P-PTLD from non-GC M-PTLD or EBV+ from EBV- PTLD. The gene expression pattern of PTLD appeared more related to that of memory and activated B-cells. Together, our results suggest that PTLD represent a distinct type of B-NHL deriving from an antigen experienced B-cell, whose evolution is associated with accrual of genetic lesions.


Butyrylcholinesterase-knockout reduces brain deposition of fibrillar β-amyloid in an Alzheimer mouse model.
In Alzheimer's disease (AD), numerous β-amyloid (Aβ) plaques are associated with butyrylcholinesterase (BChE) activity, the significance of which is unclear. A mouse model, containing five human familial AD genes (5XFAD), also develops Aβ plaques with BChE activity. Knock-out of BChE in this model showed diminished fibrillar Aβ plaque deposition, more so in males than females. This suggests that lack of BChE reduces deposition of fibrillar Aβ in AD and this effect may be influenced by sex.


Recent progress in antiretrovirals--lessons from resistance.
Recent failures in efforts to develop an effective vaccine against HIV-1 infection have emphasized the importance of antiretroviral therapy in treating HIV-1-infected patients. Thus far, inhibitors of two viral enzymes, reverse transcriptase and protease, have had a profoundly positive impact on the survival of HIV-1-infected patients. However, new inhibitors that act at diverse steps in the viral replication cycle are urgently needed because of the development of resistance to currently available antiretrovirals. This review summarizes recent progress in antiretroviral drug discovery and development by specifically focusing on novel inhibitors of three phases of replication: viral entry, integration of the viral DNA into the host cell genome and virus particle maturation.


Soil translocation by termites of the genus Odontotermes (Holmgren) (Isoptera: Macrotermitinae) in an arid area of Northern Kenya.
The study was conducted in an arid area of Northern Kenya, Marsabit District. The area receives an average annual rainfall of 200 mm and supports scanty plant and animal life.The most common termite species are of the genus Odontotermes. The assessment of soil sheeting translocated on food surfaces by O. latericius (Haviland) and O. boranicus Ghidini was carried out using a stratified random design.Both species were found to translocate soil at a rate equivalent to 1059 kg of soil per hectare per year. Rainfall was found to have an influence on the building activity of Odontotermes soil sheeting. Odontotermes soil sheeting was shown to differ from other surrounding soils in both physical and chemical properties. Therefore, Odontotermes have a significant effect on soil structure and texture.


Methacrylic acid/butyl acrylate onto feruloylated bagasse xylan: Graft copolymerization and biological activity.
In this paper, feruloylated bagasse xylan (FBX) was synthesized with a method based on homogeneous catalytic esterification of bagasse xylan (BX) with ferulic acid (FA) in the presence of triethylamine as a catalyst, and it was further grafted with methacrylic acid (MAA) and butyl acrylate (BA) to synthesize FBX-g-MAA/BA grafted copolymer by using ammonium persulfate as initiator and N,N-methylene acrylamide as cross-linker. The effects of reaction variables including reaction time, temperature and reactant concentration on the esterification and graft reactions were investigated carefully by conducting orthogonal tests. A maximum degree of substitution (DS) of 1.76 for the esterification and a maximum graft ratio (GR) of 31% can be achieved by performing the reaction at optimized reaction parameters. The molecular docking was further performed to study the binding mode of the final product into the active site of human Caprin-2 C1q domain (4OUM, cause gastric cancer protein), liver cancer protein (1UV0) and lung cancer protein (3B9S). The software generated results were in satisfactory agreement with the evaluated biological activity. The anticancer performances of BX, FBX and FBX-g-MAA/BA copolymer were investigated by using a 3-(4,5-dimethythiazol-2-yl)-2,5-diphenyl tetrazoliumbromide (MTT) method. The results indicated that the inhibition ratio of FBX-g-MAA/BA copolymer on BEL-7407 (liver cancer cells) can reach 25.28% ± 4.01%, which is two times higher than that of BX.


Neuron-Specific Enolase and S100B: The Earliest Predictors of Poor Outcome in Cardiac Arrest.
Background: Proper prognostication is critical in clinical decision-making following out-of-hospital cardiac arrest (OHCA). However, only a few prognostic tools with reliable accuracy are available within the first 24 h after admission. Aim: To test the value of neuron-specific enolase (NSE) and S100B protein measurements at admission as early biomarkers of poor prognosis after OHCA. Methods: We enrolled 82 consecutive patients with OHCA who were unconscious when admitted. NSE and S100B levels were measured at admission, and routine blood tests were performed. Death and poor neurological status at discharge were considered as poor clinical outcomes. We evaluated the optimal cut-off levels for NSE and S100B using logistic regression and receiver operating characteristic (ROC) analyses. Results: High concentrations of both biomarkers at admission were significantly associated with an increased risk of poor clinical outcome (NSE: odds ratio [OR] 1.042 per 1 ng/dL, [1.007−1.079; p = 0.004]; S100B: OR 1.046 per 50 pg/mL [1.004−1.090; p < 0.001]). The dual-marker approach with cut-off values of ≥27.6 ng/mL and ≥696 ng/mL for NSE and S100B, respectively, identified patients with poor clinical outcomes with 100% specificity. Conclusions: The NSE and S100B-based dual-marker approach allowed for early discrimination of patients with poor clinical outcomes with 100% specificity. The proposed algorithm may shorten the time required to establish a poor prognosis and limit the volume of futile procedures performed.


[A calorimetric study of the triple helix formation: interaction of poly(C) - guanosine - protonated poly(C)].
The triple helix formation of poly(C) - guanosine - poly(C+) was investigated by the help of an LKB scanning micro-calorimeter. The existence of the triple helix could also be shown by recording the melting curves. The ultraviolet absorption at different wave lengths namely 275 nm, 260 nm, and 245 nm was plotted as a function of the temperature. Furthermore formation of the triple helix was shown by plotting the ultraviolet absorption at 245 nm during the increasing addition of guanosine solution to a fixed amount of poly(C) in the solution. Finally the formation of the triple helix was demonstrated by plotting the ultraviolet absorption at 245 nm of a certain mixture of the components while the pH value of the solution was continuously lowered. All these methods show that the monomer interacts with the polymer double helix to form a triple helix. The calorimetric measurements show that the reaction enthalpy is concentration dependent. Above a threshold concentration a rapid increase of the reaction enthalpy is observed. This increase occurs in a very narrow concentration interval. Above this interval a final value of the reaction enthalpy is reached. The amount of the reaction enthalpy for the interaction of guanosine with poly(C) - poly(C+) double helix is 5.5 Kcal (mol base triplet)-1.


Gas chromatographic determination of thiamine in meats, vegetables and cereals with a nitrogen-phosphorus detector.
A gas chromatograph with a nitrogen-phosphorus detector has been used to quantitate thiamine in a number of meats, vegetables and cereals. Thiamine concentrations found in the foods investigated are in the acceptable range of concentrations determined by spectrophotometric methods. For most foods, deviation from an experimental mean concentration of ten trials was usually within +/- 10% when reported at the 95% confidence level.


Using epidemiological and health economic measures to inform maternity staffing decisions: A guide.
There is growing concern around unnecessary intervention (particularly caesarean section) at birth in high-income countries. Caseload midwifery care aims to offset this, but is perceived to be costly to health services. To use epidemiological and health economic techniques to estimate health outcomes and cost-savings of different levels of equivalent full time (EFT) midwives working in caseload midwifery care. Two simulations were conducted - one assuming 10 EFT midwives working in a caseload model, with 35 women per caseload, and one assuming 50 EFT midwives working in a caseload model, with 45 women per caseload. Both were based on a sample of 5000 women. The main model inputs included rates of health outcomes for women (caesarean section, epidural anaesthesia, and episiotomy) and infants (low birthweight and admissions to special care nursery (SCN) or neonatal intensive care unit (NICU)), and the cost savings associated with health outcome avoidance. The first simulation estimated 27 fewer caesarean sections, 12 fewer epidurals, 12 fewer episiotomies, 10 fewer low birthweight births, and 23 fewer infants admitted to SCN or NICU annually, at a total cost saving of AU$1,874,715. The second simulation estimated 173 fewer caesarean sections, 76 fewer epidurals, 76 fewer episiotomies, 65 fewer low birthweight births, and 150 fewer infants admitted to SCN or NICU annually, at a total cost saving of AU$12,051,741. This study provides local-level decision-makers with a decision-tool to calculate the potentially avoidable health outcomes and cost savings associated with implementing caseload midwifery care in their own service.


Preoperative MELD score predicts mortality and adverse outcomes following radical cystectomy: analysis of American College of Surgeons National Surgical Quality Improvement Program.
The model for end-stage liver disease (MELD) has been widely used to predict the mortality and morbidity of various surgical procedures. We aimed to correlate a high preoperative MELD score with adverse 30-day postoperative complications following radical cystectomy. Patients who underwent elective, non-emergency radical cystectomy were identified from the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database from 2005 to 2017. Patients were categorized according to a calculated MELD score. The primary outcomes of this study were 30-day postoperative mortality, morbidity, and length of hospital stay following radical cystectomy. For further sensitivity analysis, propensity score matching was used to yield a total of 1387 matched pairs and primary outcomes were also assessed in the matched cohort. Compared with patients with a MELD < 10, those with MELD ⩾ 10 had significantly higher rates of mortality [odds ratio (OR) = 1.71, p = 0.004], major complications (OR = 1.42, p < 0.001), and prolonged hospital stay (OR = 1.29, p < 0.001) on multivariate analysis. Following risk-adjustment for race, propensity-matched groups revealed that patients with MELD score ⩾ 10 were significantly associated with higher mortality (OR = 1.85, p = 0.008), major complications (OR = 1.34, p < 0.001), yet similar length of hospital stay (OR = 1.17, p = 0.072). MELD score ⩾ 10 is associated with higher mortality and morbidity in patients undergoing radical cystectomy compared with lower MELD scores. Risk-stratification using MELD score may assist clinicians in identifying high-risk patients to provide adequate preoperative counseling, optimize perioperative conditions, and even consider nonsurgical alternatives.


Use of Japanese Society for Dialysis Therapy dialysis tables to compare the local and national incidence of dialysis.
The Japanese Society for Dialysis Therapy generates many tables of data on dialysis patients in their annual reports. These tables, derived from over 37 000 patients who started dialysis in 2008, allow comparison of the local incidence of new dialysis patients with the national incidence by estimating a standardized incidence ratio and confidence interval. Since this method adjusts for age and gender, it may be useful to evaluate local strategies for managing chronic kidney disease, including the response to campaigns and local quality assurance. Furthermore, the end-stage renal disease population of other countries can also be directly compared by this method. That is, the age- and gender-adjusted incidence of dialysis can be calculated for another country and compared with the national data for Japan. This might be one step toward improving local care and preventing the progression of chronic kidney disease.


Effects of a beta-agonist (clenbuterol) on growth, carcass composition, protein and energy metabolism of veal calves.
Twenty-two British Friesian bull calves were used in a comparative slaughter experiment to determine the effects of a beta-agonist (clenbuterol) on body composition and energy retention. Four calves were slaughtered at 18 d of age and constituted the initial slaughter group. Of the remaining calves, eight (group A, controls) were given milk replacer only, and ten calves (groups B and C, five calves per group) were given milk replacer plus clenbuterol (0.1 and 1.0 mg clenbuterol/kg milk replacer equivalent to approximately 2 and 20 micrograms/kg body-weight respectively over the 105 +/- 3 d of the experimental period). Calves were slaughtered over the weight range 146-177 kg. Clenbuterol had no significant effect on dry matter (DM) intake, daily live-weight gain or feed conversion ratio. DM digestibility of the milk replacer was not affected by treatment. Nitrogen balance was measured on three separate occasions starting when the calves weighed approximately 60, 110 and 130 kg. N retention was increased over the experimental period in clenbuterol-treated calves, although the effect only achieved significance in calves weighing approximately 110 kg live weight (P less than 0.05). Clenbuterol (20 micrograms/kg body-weight) increased estimated mean daily N retention in the carcass of the calves from 22 to 25 g whilst N retention in the non-carcass components decreased from to 8 g/d. Effects of clenbuterol on N retention occurred mainly in skeletal muscle. Fat in both carcass and non-carcass components was reduced by treatment with clenbuterol. The total energy content of live-weight gain was reduced from 1077 to 897 MJ in clenbuterol-treated calves and mean daily heat production was estimated to increase from 23.1 in controls to 25.9 MJ/d in calves in group C. In calves of mean live weight during balance of 120 and 136 kg, clenbuterol significantly increased daily urinary creatinine excretion and in 120 kg calves N tau-methylhistidine was significantly decreased (P less than 0.05). Based on estimates of muscle mass from urinary creatinine and protein degradation from N tau-methylhistidine excretion, the fractional breakdown rate of muscle protein in clenbuterol-treated calves was only 0.66 of that in the controls when the calves weighed 120 kg.


Anti-angiogenic therapy for advanced primary pulmonary lymphoepithelioma-like carcinoma: a retrospective multicenter study.
Primary pulmonary lympho-epithelioma-like carcinoma (PPLELC) is a rare subtype of primary non-small cell lung cancer (NSCLC). Currently, there is still lack of research data on anti-angiogenic therapy of advanced PPLELC. The purpose of this study was to investigate the efficacy and safety of anti-angiogenic therapy combined with chemotherapy compared with traditional chemotherapy for these patients. Advanced PPLELC patients admitted to six grade A hospitals from January 2013 to January 2021 were selected. The patients received anti-angiogenic therapy combined with chemotherapy (AT group) or chemotherapy (CT group) alone. A total of 65 patients were included in this study, including 31 patients in the AT group treated with anti-angiogenic therapy combined with chemotherapy and 34 patients in the CT group treated with chemotherapy alone. As of October 1, 2021, the median progression-free survival (PFS) in the AT group was 11.2 months [95% confidence interval (CI), 5.9-16.5]. The median PFS in the CT group was 7.0 months [95%CI, 5.1-8.9] [Hazard Ratio (HR), 0.49; 95%CI, 0.29-0.83; P = 0.008]. The 1-year PFS rates were 41.9% and 17.6%, respectively. The overall response rates (ORR) of two groups were 45.2% (95% CI, 0.27-0.64), 38.2% (95% CI, 0.21-0.56), (P = 0.571). The disease control rates (DCR) of two groups were 93.5% (95% CI, 0.84-1.03), 88.2% (95% CI, 0.77-1.00), (P = 0.756). Among patients with advanced PPLELC, the PFS of patients with anti-angiogenic therapy combined with chemotherapy is better than that of patients with chemotherapy alone. Anti-angiogenic therapy combined with chemotherapy is an optional treatment scheme.


Viewpoint on tuberculosis in elderly in India.
With increase in the number of the elderly population in India, the number of patients suffering from tuberculosis has shown an increased prevalence in the elderly. In many of them, the condition is linked to the reactivation of the lesions that were dormant. Immunosenescence appears to play an important role in activating the lesions. The clinical features are often non-specific and pose difficulties in the diagnosis. Radiological changes in the chest, though are suggestive, the microbiological proof is difficult. Though effective drugs are available, often they tolerate them poorly. There is poor adherence to the therapy leading to therapeutic failure. Co morbidities and physical dependency contribute to failure of therapy.


Effectiveness of indocyanine green gel in the identification and complete removal of the medial wall of the lacrimal sac during endoscopic endonasal dacryocystorhinostomy.
We investigated the effect of using indocyanine green (ICG) gel, a mixture of ICG and Viscoat, on complete removal of the medial wall of the lacrimal sac as well as the success rate of endoscopic endonasal dacryocystorhinostomy (DCR) for primary acquired nasolacrimal duct obstruction. Consecutive cases of endoscopic endonasal DCR between January and December 2010 were included in a retrospective, comparative manner. A total of 91 patients with primary acquired nasolacrimal duct obstruction were enrolled. Surgical method was selected according to time period. In the ICG gel group, we used ICG gel, which is a fluorescent-colored viscoelastic substance made of ICG dye (25 mg) and Viscoat. ICG gel was injected into the lacrimal sac via the inferior canaliculus prior to lacrimal sac dissection. The anatomic and functional surgical success rates of endoscopic endonasal DCR in each group were compared. Our study included 49 cases in the ICG gel group and 42 cases in the control group. The functional success rate of endoscopic endonasal DCR reached 93.9% (46 of 49) in the ICG gel group compared with 71.4% (30 of 42) in the control group (Pearson's χ2 test, p value = 0.004). In contrast, there was no statistically significant correlation between use of ICG gel and anatomic success rate of endoscopic endonasal DCR. Using ICG gel during lacrimal sac dissection may enhance the functional success rate of endoscopic endonasal DCR for primary acquired nasolacrimal duct obstruction by facilitating easier identification and subsequent complete removal of the medial wall of the lacrimal sac.


Early changes in insulin receptor signaling and pain sensation in streptozotocin-induced diabetic neuropathy in rats.
The objective of the present study was to evaluate the time course of changes in peripheral nerve insulin receptor (IR) signaling and compare observed findings with behavioral responses to noxious mechanical and thermal stimuli in streptozotocin (STZ)-diabetic rats over 12 weeks of diabetes. Diabetic rats developed mechanical hyperalgesia, as indicated by decreased paw withdrawal thresholds to mechanical stimuli that were detectable after 2 weeks of diabetes; they also developed thermal hypoalgesia, as indicated by increased tail flick latencies to thermal stimuli that were detectable at 1 week of diabetes. Western blot analysis revealed decreased phosphorylated: total IR protein ratio that was detectable as early as 2 weeks of diabetes, whereas phosphorylated:total Akt protein ratio was decreased at 2 weeks and increased at 12 weeks of diabetes with unchanged PI-3K protein levels. To our knowledge, the present study is the first to demonstrate that impaired peripheral nerve IR signaling, as indicated by decreased phosphorylated:total IR protein ratio, coincides with early mechanical hyperalgesia and thermal hypoalgesia in STZ-diabetic rats. This finding may improve understanding of how altered pain sensation develops rapidly in this model. This study examined peripheral nerve IR signaling during the early course of altered nociception in STZ-diabetic rats. In diabetic rats, impaired peripheral nerve IR signaling is observed shortly after STZ injection, as is altered nociception. This finding suggests a possible role of impaired IR signaling in diabetic sensory neuropathy.


Hybrid peptides endomorphin-2/DAMGO: design, synthesis and biological evaluation.
Endomorphin-2 [Tyr-Pro-Phe-Phe-NH2] and DAMGO [Tyr-D-Ala-Gly-(N-Me)Phe-Gly-ol] are natural (EM2) and synthetic (DAMGO) opioid peptides both selective for μ opioid receptor with high analgesic activity. In this work we report synthesis, in vitro and in vivo biological evaluation of five new hybrid EM2/DAMGO analogues, with the aim to obtain compounds with high affinity at μ-opioid receptor, high activity in animal nociception tests (hot plate and tail flick) and improved enzymatic stability. Double N-methylation on both Phe residues and C-terminal ethanolamide led to analogue 6e, which possesses a good in vitro μ affinity (Kiμ=34 nM), combined with a remarkable in vivo antinociceptive activity.


Closed reduction of bilateral locked facets of the cervical spine under general anaesthesia.
Bilateral facet interlocking of the cervical spine is a relatively uncommon type of cervical spinal injury. It is frequently associated with devastating neurological symptoms and signs. Early reduction of the locked facets is thought to be critical in preventing progressive secondary spinal cord injury. Whereas skull tong traction remains our primary option for closed reduction of bilateral locked facets of the cervical spine, it is not always successful, even with heavy traction weights. Other more aggressive measures may occasionally be required. The authors report their experience in reducing bilateral locked facets of the cervical spine by manual closed reduction. This small series consists of six cases of cervical spinal injury with bilateral locked facets in which manual closed reduction under general anaethesia and muscle relaxation was used. Three of them presented with complete quadriplegia (Frankel class A). One case presented with incomplete but severe neurological deficits (Frankel class B). After unsuccessful closed reduction with skull traction, these patients were treated by manual closed reduction under general anaesthesia and muscle relaxation, followed by anterior discectomy, interbody fusion and stabilization. All cases made neurological improvement after the procedures. Even in cases with initial severe neurological deficits, the recovery was remarkable. The recovery was dramatic in two cases. Case 1 improved from Frankel class B to E; and Case 5 from Frankel class A to D. No case deteriorated neurologically after the procedures. Pneumonia occurred in Case 3; and stress ulcer accompanied by haemorrhage was noted in Case 4. None of these complications was directly related to the procedures. The potential for improvement of neurological function following early and successful reduction and fixation of the dislocated spine is emphasized. With meticulous techniques, manual closed reduction may be an effective alternative to skull tong traction when the latter fails.


Focused force coronary venoplasty to eliminate a refractory stenosis preventing LV lead placement in two patients.
This report describes two patients who underwent a second attempt at cardiac resynchronization therapy (CRT) in the setting of a severe stenosis in the lateral coronary vein that prevented passage of a left ventricular lead. Both stenoses were unresponsive to standard noncompliant balloon dilatation but were successfully treated with the addition of a second stiff angioplasty wire beside the noncompliant balloon. Venoplasty with the addition of a side wire beside the balloon should be considered for resistant coronary vein stenosis encountered during CRT device implantation.


Personal discovery in diabetes self-management: Discovering cause and effect using self-monitoring data.
To outline new design directions for informatics solutions that facilitate personal discovery with self-monitoring data. We investigate this question in the context of chronic disease self-management with the focus on type 2 diabetes. We conducted an observational qualitative study of discovery with personal data among adults attending a diabetes self-management education (DSME) program that utilized a discovery-based curriculum. The study included observations of class sessions, and interviews and focus groups with the educator and attendees of the program (n = 14). The main discovery in diabetes self-management evolved around discovering patterns of association between characteristics of individuals' activities and changes in their blood glucose levels that the participants referred to as "cause and effect". This discovery empowered individuals to actively engage in self-management and provided a desired flexibility in selection of personalized self-management strategies. We show that discovery of cause and effect involves four essential phases: (1) feature selection, (2) hypothesis generation, (3) feature evaluation, and (4) goal specification. Further, we identify opportunities to support discovery at each stage with informatics and data visualization solutions by providing assistance with: (1) active manipulation of collected data (e.g., grouping, filtering and side-by-side inspection), (2) hypotheses formulation (e.g., using natural language statements or constructing visual queries), (3) inference evaluation (e.g., through aggregation and visual comparison, and statistical analysis of associations), and (4) translation of discoveries into actionable goals (e.g., tailored selection from computable knowledge sources of effective diabetes self-management behaviors). The study suggests that discovery of cause and effect in diabetes can be a powerful approach to helping individuals to improve their self-management strategies, and that self-monitoring data can serve as a driving engine for personal discovery that may lead to sustainable behavior changes. Enabling personal discovery is a promising new approach to enhancing chronic disease self-management with informatics interventions.


Toxoplasma gondii infection in wild omnivorous and carnivorous animals in Central Europe - A brief overview.
Toxoplasmosis is an important zoonosis caused by the intracellular protozoan Toxoplasma gondii. This parasite is known to infect almost all warm blooded animals, and meat containing tissue cysts is one of the main sources of infection for omnivorous an carnivorous animals. Over recent years, increasing numbers of omnivorous and carnivorous animals have been drawn to urban or suburban areas by easy access to food or safe shelter, and the presence of wild animals has became more natural to urban residents. However, infected animals can act as intermediate hosts to T. gondii and contribute to the transmission of disease to humans and domestic animals, as well as other wild animal species. This extensive spread of the parasite in the natural environment can be attributed to geographic location, landform or local climate. The present paper summarizes the data available on the prevalence of T. gondii infection among wildlife from Poland, Germany, Slovakia, Czechia, Austria and Hungary. The findings highlight the importance of conducting studies on the presence of the parasite in wildlife, where the data is limited or outdated.


Less necessity of adjuvant S-1 treatment in non-monarchE-eligible patients.
In monarchE and Postoperative Therapy with Endocrine and TS-1 (POTENT) trials, abemaciclib and S-1 have, respectively, shown to be effective as adjuvant therapies for luminal breast cancer (BC), although whether patients who meet the criteria are at high risk of recurrence compared to non-eligible patients is still unknown. Here, we investigated recurrence risk according to the criteria of each trial in Japanese patients. We reviewed the records of 992 patients who received surgery at Chiba University Hospital for stage I-III BC from January 2017 to May 2022 and selected 553 analytic cohort patients and retrospectively analyzed the relapse-free survival of the patients as the primary endpoint. High-recurrence risk was defined according to monarchE trial and POTENT trial. The 5-year RFS for monarchE cohort 1 and cohort 2 eligible patients were 77.78% and 89.33%, respectively, which were significantly lower than monarchE non-eligible patients (98.31%; p < 0.0001). However, the 5-year RFS rate for POTENT eligible patients (90.51%) was lower than for POTENT non-eligible patients (98.75%; p = 0.0001); excluding those who met the monarchE criteria, the prognosis of POTENT eligible patients had no significant differences from the prognosis of patients with POTENT non-eligible BC (p = 0.3100). MonarchE criteria accurately identify patients who are prone to relapse. Moreover, although POTENT criteria also suggested a reasonable capacity for recurrence prediction, there was no significant difference in recurrence between POTENT non-eligible patients and the patients who were POTENT but not monarchE eligible. This might offer justification for reconsidering the use of S-1 in monarchE non-eligible patients.


Clinical evaluation of a pasteurized factor XIII concentrate administration in Henoch-Schönlein purpura. Japanese Pediatric Group.
Arthral, abdominal and renal symptoms in Henoch-Schönlein purpura (HSP) were scored. Coagulation factor XIII (F XIII) activity was determined in fifty-six children with HSP and the correlation with the severity score of the clinical symptoms was investigated. As a result, it was found that the decrease in F XIII level was correlated with the severity score of clinical symptoms, particularly abdominal symptoms. Based on the results, a controlled study was performed in 24 cases with moderate symptoms divided into a group treated with F XIII concentrate and a non-treated group to investigate clear-cut efficacy as a next study. In three days after the administration the symptoms were improved remarkably in accordance with the increase of F XIII level compared with non-treated group and scoring of clinical symptoms was confirmed to be useful for assessing the application of the F XIII concentrate to HSP.


Prevalence and mechanism of appositional angle closure in acute primary angle closure after iridotomy.
A prospective observational case series to assess the prevalence of appositional angle closure in darkness among iridotomized Chinese eyes after acute primary angle closure (APAC) with the use of both clinical methods and ultrasound biomicroscopy. Sixteen Chinese patients who had history of APAC and subsequent successful treatment with laser peripheral iridotomy were examined. Fourteen additional control subjects were studied. Gonioscopy and ultrasound biomicroscopic examination were performed in the dark. Gonioscopic appearance of the angle was assessed, and quantitative measurements of the angle from the ultrasound biomicroscopic images were taken. Of the APAC eyes 55.6% had appositionally closed angle clinically and in 38.9% only Schwalbe's line was visible on gonioscopy. Ultrasound biomicroscopy confirmed structurally different anterior segments between eyes with APAC and the control eyes. In particular, the trabecular-ciliary-process distances were markedly different between the two groups. This study documented a high prevalence of appositional closure in iridotomized eyes after APAC in Chinese patients. The anteriorly positioned ciliary body, as documented in these cases by ultrasound biomicroscopy, is the likely mechanism of the angle crowding in this patient population.


Development of a diagnostic PCR assay targeting the Mn-dependent superoxide dismutase gene (sodA) for identification of Streptococcus gallolyticus.
A PCR-based assay to identify Streptococcus gallolyticus has been developed. The assay uses an oligonucleotide primer pair targeting a partial sequence of the manganese-dependent superoxide dismutase gene (sodA). The assay distinguished members of the S. gallolyticus group from other, closely related taxa successfully by yielding a 408-bp specific amplicon.


Breast imaging for aesthetic surgery: British Society of Breast Radiology (BSBR), Association of Breast Surgery Great Britain & Ireland (ABS), British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS).
This is an overview of the guidelines for breast imaging before and after aesthetic (cosmetic) breast surgery, which includes but is not limited to implants, lipomodelling and mammoplasty procedures. The guidelines are based on a review of the literature and consensus of breast imaging and aesthetic breast surgery specialists. 1. Pre-aesthetic surgery 2. Post-aesthetic surgery If breast imaging or breast assessment is required, it should be performed in a designated breast facility with access to specialist breast imaging and a complete breast multidisciplinary team in accordance with national guidelines and recommendations.


Advanced glycation end products increase collagen-specific chaperone protein in mouse diabetic nephropathy.
Advanced glycation end products (AGEs) appear to contribute to the diabetic complications. This study reports the inhibitory effect of OPB-9195 (OPB), an inhibitor of AGEs formation, and the role of a collagen-specific molecular chaperone, a 47-kDa heat shock protein (HSP47) in diabetic nephropathy. Transgenic mice carrying nitric-oxide synthase cDNA fused with insulin promoter (iNOSTg) leads to diabetes mellitus. The iNOSTg mice at 6 months of age represented diffuse glomerulosclerosis, and the expression of HSP47 was markedly increased in the mesangial area in parallel with increased expression of types I and IV collagens. OPB treatment ameliorated glomerulosclerosis in the iNOSTg mice associated with the decreased expression of HSP47 and types I and IV collagens. The expression of transforming growth factor-beta (TGF-beta) was increased in glomeruli of iNOSTg mice and decreased after treatment with OPB. To confirm these mechanisms, cultured mesangial cells were stimulated with AGEs. AGEs significantly increased the expression of HSP47, type IV collagen, and TGF-beta mRNA. Neutralizing antibody for TGF-beta inhibited the overexpression of both HSP47 and type IV collagen in vitro. In conclusion, AGEs increase the expression of HSP47 in association with collagens, both in vivo and in vitro. The processes may be mediated by TGF-beta.


The increase in fiber size in male rat gastrocnemius after chronic central leptin infusion is related to activation of insulin signaling.
Insulin potentiates leptin effects on muscle accrual and glucose homeostasis. However, the relationship between leptin's central effects on peripheral insulin sensitivity and the associated structural changes remain unclear. We hypothesized that central leptin infusion modifies muscle size through activation of insulin signaling. Muscle insulin signaling, enzymes of fatty acid metabolism, mitochondrial respiratory chain complexes, proliferating cell nuclear antigen (PCNA) and fiber area were analyzed in the gastrocnemius of chronic central infused (L), pair-fed (PF) and control rats. PCNA-positive nuclei, fiber area, GLUT4 and glycogen levels and activation of Akt and mechanistic target of rapamycin were increased in L, with no changes in PF. Acetyl-CoA carboxylase-β mRNA levels and non-esterified fatty acid and triglyceride content were reduced and carnitine palmitoyltransferase-1b expression and mitochondrial complexes augmented in L. These results suggest that leptin promotes an increase in muscle size associated with improved insulin signaling favored by lipid profile.


Effects of 13-cis-retinoic acid on hindbrain and craniofacial morphogenesis in long-tailed macaques (Macaca fascicularis).
Hindbrain and craniofacial development during early organogenesis was studied in normal and retinoic acid-exposed Macaca fascicularis embryos. 13-cis-retinoic acid impaired hindbrain segmentation as evidenced by compression of rhombomeres 1 to 5. Immunolocalization with the Hoxb-1 gene product along with quantitative measurements demonstrated that rhombomere 4 was particularly vulnerable to size reduction. Accompanying malformations of cranial neural crest cell migration patterns involved reduction and/or delay in pre- and post-otic placode crest cell populations that contribute to the pharyngeal arches and provide the developmental framework for the craniofacial region. The first and second pharyngeal arches were partially fused and the second arch was markedly reduced in size. The otocyst was delayed in development and shifted rostrolaterally relative to the hindbrain. These combined changes in the hindbrain, neural crest, and pharyngeal arches contribute to the craniofacial malformations observed in the retinoic acid malformation syndrome manifested in the macaque fetus.


Exerting power or striking back: a gendered comparison of motivations for domestic violence perpetration.
This study compares the motivations for using violence and the context in which violence occurs among male and female domestic violence perpetrators. One hundred twenty-five participants in batterer intervention counseling in Los Angeles County, California, were surveyed. The sample was approximately half male and half female. Males and females were found to differ in their motivations for using violence in relationships. Females reported using violence in response to prior abuse, citing revenge and retaliation as a primary motivation. Because treatment approaches are commonly derived from the power and control model, which indicates that violence is used to gain power and control, batterer intervention counseling may not be appropriate for women, who appear more motivated by the desire to maintain personal liberties in a relationship where they have been victimized. Treatment must walk the fine line between addressing victimization issues and holding women accountable for decisions to use violence.


Contractile effect of succinylpurines on guinea pig uterus.
1. The effects of adenosine analogues on isolated guinea pig uterus were studied in vitro. 2. Low concentrations of adenosine analogues contracted guinea pig uterus. The relative potencies of contractive effect were adenosine greater than AMP greater than ADP greater than ATP greater than 2-chloroadenosine greater than N6-phenylisopropyl-adenosine (PIA) greater than 5'-N-ethylcarboxamidoadenosine (NECA) greater than adenylosuccinate greater than succinyladenosine. 3. Pretreatment of the uterus strips with theophylline blocked the action of adenosine. However, dipyridamole did not impair the adenosine actions. 4. The role of naturally occurring adenosine analogues was discussed.


Data on the impact of scan quality on the diagnostic performance of CCTA, SPECT, and PET for diagnosing myocardial ischemia defined by fractional flow reserve on a per vessel level.
Scan quality directly impacts the diagnostic performance of non-invasive imaging modalities as reported in a substudy of the PACIFC-trial: "Impact of Scan Quality on the Diagnostic Performance of CCTA, SPECT, and PET for Diagnosing Myocardial Ischemia Defined by Fractional Flow Reserve" [1]. This Data-in-Brief paper supplements the hereinabove mentioned article by presenting the diagnostic performance of CCTA, SPECT, and PET on a per vessel level for the detection of hemodynamic significant coronary artery disease (CAD) when stratified according to scan quality and vascular territory.


Loss of beta-adrenoceptor binding sites in rat striatum following kainic acid lesions.
Intrastriatal injection of kainic acid (5 nmoles) to rats led to severe destruction of nerve cell bodies throughout the caudate-putamen complex and an extensive proliferation of glial cells. Lesioned striata displayed a significant 23% loss of beta-adrenoceptor binding sites 21--24 days after injection of kainic acid. Further analysis of these changes revealed that this loss of sites was selectively within the beta 1 receptor population. Although these results do not rule out a partial glial cell localisation for beta-adrenoceptors, they do indicate that at least a proportion of beta 1 receptors are present on striatal perikarya.


Prevalence and Correlates of Homelessness Among American Indian and Alaska Native Youth.
Youth homelessness is a serious national challenge affecting millions of young people every year. However, due to their relatively small population size, together with limitations related to data and research efforts on homelessness to date, prevalence estimates and evidence of homelessness experiences among American Indian and Alaska Native (AIAN) youth have been scarce. This is particularly the case at the national level. We report findings on the prevalence, characteristics, and correlates of AIAN youth experiencing homelessness that are based on a nationally representative survey on homelessness among adolescents and young adults, age 13 to 25. The overall national survey sample included 25,492 respondents. During a 12-month period, approximately 10.2% of AIAN households with 13-17 year olds reported youth homelessness or runaway experiences that lasted at least one night. For AIAN 18-25 year olds, the 12-month population prevalence of homelessness experiences was 12.2%. AIAN young adults had three times the prevalence rate of homelessness as their White non-Hispanic peers. Furthermore, most AIAN youth experiencing homelessness, like most AIAN people overall, reside in predominantly urban counties. Controlling for other variables, lower educational attainment, and parenting (especially if unmarried) were associated with higher likelihood of homelessness. There is a clear and urgent need for tailored, culturally-responsive homelessness prevention and intervention strategies, along with focused housing and support investments, for AIAN young people and the communities in which they live. The federal government and local jurisdictions need to take policy actions to address high rates of AIAN youth homelessness in urban and suburban communities, in addition to policies centered on AIAN reservations and rural communities.


Expression of beta amyloid protein precursor mRNAs: recognition of a novel alternatively spliced form and quantitation in Alzheimer's disease using PCR.
We have analyzed alternatively spliced beta amyloid protein precursor (beta APP) mRNAs by using the polymerase chain reaction to amplify beta APP cDNAs produced by reverse transcription. With this approach the three previously characterized beta APP mRNAs (beta APP695, beta APP751, and beta APP770) are readily detected and compared in RNA samples extracted from specimens as small as a single cryostat section. We show that the results obtained with this method are not affected by partial RNA degradation and use it to identify a novel alternatively spliced beta APP714 mRNA that is present at low abundance in each of the many human brain regions, peripheral tissues, and cell lines that we have examined; demonstrate that nonneuronal cells in the adult human brain and meninges produce appreciable beta APP695, beta APP751, and beta APP770 mRNA; and identify changes in beta APP gene expression in the AD brain and meninges that may contribute to amyloid deposition.