Differential gene expression in the small intestines of wildtype and W/W(V) mice.
Much of the evidence demonstrating the role of interstitial cells of Cajal (ICC) in pacemaking and neurotransmission in the gastrointestinal tract comes from studies of W/W(V) mice. These animals have few pacemaker ICC in the small bowel due to reduced functional Kit protein. We examined gene expression in the small intestines of wildtype and W/W(V) mice. RNA expression in the jejunums of wildtype and W/W(V) mutants was studied using a differential gene expression Seven known genes were differentially expressed in wildtype and W/W(V) mice. COX7B (cytochrome c oxidase, subunit VIIb) and SORCIN (encoding multidrug-resistance complex, class 4) were suppressed in both fed and fasted W/W(V) mice. Expression of another five genes was increased in W/W(V) mice: ADA (adenosine deaminase), MDH1 (malate dehydrogenase), RPL-8 (ribosomal protein L8), SPTB2 (spectrin, nonerythroid, beta subunit), and p6-5 (encoding phosphorylcholine [PC] T-cell suppressor factor [TsF]). Differential expression was the same in fasted and fed animals, suggesting that the differences were independent of the dietetic state. We conclude that several genes are differentially expressed in the small intestines of W/W(V) mice where the major lesion is loss of pacemaker ICC. Differential gene display may help develop a molecular profile of motility disorders in which ICC are lost.


High-Speed Integrated Endoscopic Photoacoustic and Ultrasound Imaging System.
Endoscopic integrated photoacoustic and ultrasound imaging has the potential for early detection of the cancer in the gastrointestinal tract. Currently, slow imaging speed is one of the limitations for clinical translation. Here, we developed a high speed integrated endoscopic PA and US imaging system, which is able to perform PA and US imaging simultaneously up to 50 frames per second. Using this system, the architectural morphology and vasculature of the rectum wall were visualized from a Sprague Dawley rat in-vivo.


A comparison of in vitro assay systems for the measurement of drug sensitivity of Trypanosoma evansi.
Two in vitro assay systems were investigated for their effectiveness in detecting the sensitivity of Trypanosoma evansi stocks to the trypanocide suramin. These assay systems measured 1) incorporation of radiolabelled nucleic acid precursor, hypoxanthine; and 2) pyruvate production. They were compared with the direct counting method in which numbers of motile trypanosomes were estimated using a Neubauer haemocytometer chamber. Three stocks of T. evansi were tested-2 suramin sensitive stocks from Indonesia, TREU 1840 and TREU 1981, and a suramin resistant stock from the Sudan, TREU 2136. Each assay system distinguished between the suramin sensitive and resistant stocks. However, inhibition compared to untreated control cultures was less when assessed from pyruvate concentration in culture supernatants than by direct counting. The length of incubation with drug before addition of radio-label was the most important variable in the hypoxanthine incorporation assay. A pre-incubation time of 16 hours with the drug before adding the label for the further 8 hours of the assay was found to be the most sensitive. Under these conditions, the IC50 values (drug concentrations causing 50% inhibition) were similar to those obtained from direct counts. Pre-incubation of parasites with drug before adding the label resulted in a decrease of the IC50. These results suggest that the discrepancy between the levels of pyruvate production and relative growth at inhibitory concentrations of the drug are due to metabolism by the parasites during the initial stages of the assay, before the drug has began to inhibit cell growth.


Ultrathin Fe-NiO nanosheets as catalytic charge reservoirs for a planar Mo-doped BiVO4 photoanode.
The energy conversion efficiency of a photoelectrochemical system is intimately connected to a number of processes, including light absorption, charge excitation, separation and transfer processes. Of these processes, the charge transfer rate at the electrode|electrolyte interface is the slowest and, hence, the rate-limiting step causing charge accumulation. Such an understanding underpins efforts focused on applying highly active electrocatalysts, which may contribute to the overall performance by augmenting surface charge accumulation, prolonging charge lifetime or facilitating charge transfer. How the overall effect depends on these individual possible mechanisms has been difficult to study previously. Aiming at advancing knowledge about this important interface, we applied first-order serial reactions to elucidate the charge excitation, separation and recombination kinetics on the semiconductor|electrocatalyst interfaces in air. The study platform for the present work was prepared using a two-step Mo-doped BiVO4 film modified with an ultrathin Fe-doped NiO nanosheet, which was derived from an Fe-doped α-Ni(OH)2 nanosheet by a convenient precipitation and ion-exchange method. The simulation results of the transient surface photovoltage (TSPV) data showed that the surface charge accumulation was significantly enhanced, even at an extremely low coverage (0.12-120 ppm) using ultra-thin Fe-NiO nanosheets. Interestingly, no improvement in the charge separation rate constants or reduction of recombination rate constants was observed under our experimental conditions. Instead, the ultra-thin Fe-NiO nanosheets served as a charge storage layer to facilitate the catalytic process for enhanced performance.


The results of vitreous surgery for chronic macular holes.
To evaluate the visual and anatomic results of macular hole surgery in eyes that have had symptoms of a macular hole for 2 years or longer. Fifty-one eyes with chronic macular holes (> or = 2 years' duration) were treated in a retrospective analysis of the results of vitrectomy, 16% perfluoropropane gas tamponade, and one of three adjunctive agents (bovine transforming growth factor beta-2, recombinant transforming growth factor beta-2, or autologous platelet extract). Of 51 eyes, 45 (88.2%) were examined 3 months after surgery. Visual acuity of these 45 eyes was measured preoperatively and 3 months postoperatively using the Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity chart. Twenty-eight eyes (62.2%) had no prior vitrectomy and 17 eyes (37.8%) had a prior vitrectomy for the macular hole that failed. The macular holes had a mean duration of 3.7 years and were successfully closed in 32 of 51 total eyes (62.7%) and 32 of 45 eyes (71.1%) that were examined 3 months after surgery. The mean preoperative visual acuity was 20/100 -2 and the mean visual acuity at 3 months was 20/80 for a mean gain of 6.6 ETDRS letters (+ 1.3 lines). Of 45 eyes, 17 (37.8%) were 20/63 or better 3 months after surgery; 21 (46.7%) gained 2 or more ETDRS lines. There was no statistically significant difference in macular hole closure (P = 0.311) or visual acuity change (P = 0.095) in eyes with or without prior vitreous surgery. Eyes with macular holes between 2-2.99 years experienced a somewhat better anatomic and functional result overall than eyes with macular hole from 3-14 years, duration, but the visual acuity change was not statistically significant (P = 0.187). There was substantial variability in visual improvement among eyes with successful closure of the chronic macular hole. Macular holes of > or = 2 years' duration may be more difficult to close successfully than are more recent macular holes, and the visual improvement appears to be less favorable. Many eyes with chronic macular holes in our study gained substantial visual acuity, so vitreous surgery can be considered in selected eyes with chronic macular holes based on visual needs.


Immunological cross-reactivity of anionic proteins from caries-free and caries-active salivas which differ in biological properties toward oral streptococci.
We examined whether the anionic antimicrobial proteins in the saliva of certain caries-free (CF) individuals are immunologically cross-reactive with proteins in caries-active (CA) saliva which display identical isoelectric points but which exhibit growth-supportive properties for the oral streptococci. In the immunoblotting experiments reported here, the proteins present in CF and CA whole salivas reacted similarly with an antiserum prepared against the anionic inhibitory proteins. This antiserum also showed identical reactivity with the purified protein fraction containing the anionic proteins of interest from whole saliva of either CF or CA subjects. Additionally, an antiserum to CA saliva was found to react with the CF anionic inhibitory proteins. The fact that the inhibitory and noninhibitory proteins react similarly with the antisera used provides further evidence for similarity between both classes of proteins.


Temporomandibular Joint Herniation: Review of the Literature.
To define clear clinical characteristics and management strategies of herniation of temporomandibular joint (TMJ) into the external auditory canal (EAC). MEDLINE, PubMed, and EMBASE databases. A search was conducted using the keywords "temporomandibular joint" and "herniation" with all of their synonyms. Literature selection criteria included articles published in English, and articles dating back no further than 1970. Forty articles regarding 51 cases were eligible for critical appraisal. According to the previously published papers, TMJ herniation has following characteristics; symptoms are nonspecific, but a distinguishable feature is a protruding mass into the EAC that can be seen to appear and disappear as the mouth opens and closes. High-resolution computed tomography scans are sensitive to the bony defect and are helpful in diagnosing TMJ herniation. In the surgical treatment of TMJ herniation, wall reconstruction rather than simple mass excision could be a safe and long-lasting strategy. Herniation of TMJ into the EAC is a rare condition, but can be encountered in the clinic at any time. This literature review could be helpful in the diagnosis and treatment of TMJ herniation into the EAC.


Clathrin-mediated endocytosis: what works for small, also works for big.
Clathrin and the endocytosis machinery has recently been described as being required in mammalian cells for the internalization of large particles including pathogenic bacteria, fungi, and large viruses. These apparently unexpected observations, within the framework of the classical mechanisms for the formation of clathrin-coated vesicles, are now considered as examples of a new non-classical function of clathrin, which can promote the internalization of membrane domains associated to planar clathrin lattices. The role of actin downstream of clathrin seems to be critical for this still poorly characterized process. The historical frontier between endocytosis and phagocytosis is vanishing in the light of this new role for clathrin.


Thermodynamic instability of viral proteins is a pathogen-associated molecular pattern targeted by human defensins.
Human defensins are innate immune defense peptides with a remarkably broad repertoire of anti-pathogen activities. In addition to modulating immune response, inflammation, and angiogenesis, disintegrating bacterial membranes, and inactivating bacterial toxins, defensins are known to intercept various viruses at different stages of their life cycles, while remaining relatively benign towards human cells and proteins. Recently we have found that human defensins inactivate proteinaceous bacterial toxins by taking advantage of their low thermodynamic stability and acting as natural "anti-chaperones", i.e. destabilizing the native conformation of the toxins. In the present study we tested various proteins produced by several viruses (HIV-1, PFV, and TEV) and found them to be susceptible to destabilizing effects of human α-defensins HNP-1 and HD-5 and the synthetic θ-defensin RC-101, but not β-defensins hBD-1 and hBD-2 or structurally related plant-derived peptides. Defensin-induced unfolding promoted exposure of hydrophobic groups otherwise confined to the core of the viral proteins. This resulted in precipitation, an enhanced susceptibility to proteolytic cleavage, and a loss of viral protein activities. We propose, that defensins recognize and target a common and essential physico-chemical property shared by many bacterial toxins and viral proteins - the intrinsically low thermodynamic protein stability.


Comparison of quick point-of-care test for small-bowel hypolactasia with biochemical lactase assay in children.
The aim of the present study was to compare the Biohit Lactose Intolerance Quick Test (BLIQT) to the criterion standard biochemical duodenal lactase (DL) activity assay in the paediatric population using standard statistical comparative tests. Using standard Olympus endoscopes, 2 postbulbar duodenal biopsies were taken from 38 prospective children (0-16 years) from June 2008-May 2009 at a single tertiary paediatric gastroenterology unit. The biopsies were used for the BLIQT and for biochemical disaccharides assay. Thirty-eight children (19 boys) of median age 5.45 years (0.3-14.8 years) underwent the combined BLIQT and disaccharidase testing. We subdivided the group into those who had biopsies with a larger endoscope (XQ, n = 26) and those who had a smaller endoscope (XP, n = 12) and thus a smaller biopsy forcep. When using a larger endoscope, the BLIQT showed a sensitivity of 100%, specificity of 86%, and positive and negative predictive value of 57.1% and 100%, respectively, on comparing it with DL. With a smaller endoscope, the BLIQT had a sensitivity of 100%, specificity of 80%, positive predictive value of 50%, and a negative predictive value of 100%. As in adult studies, the sensitivity and negative predictive value of the BLIQT was 100%. The specificity too appears to be high but variable, probably because of smaller biopsies obtained, and may warrant the need for 2 biopsies. The high sensitivity, specificity, and negative predictive value of the BLIQT for indicating hypolactasia make it an effective point-of-care test for paediatric hypolactasia.


Properties and Therapeutic Implications of an Enigmatic D477G RPE65 Variant Associated with Autosomal Dominant Retinitis Pigmentosa.
RPE65 isomerase, expressed in the retinal pigmented epithelium (RPE), is an enzymatic component of the retinoid cycle, converting all-trans retinyl ester into 11-cis retinol, and it is essential for vision, because it replenishes the photon capturing 11-cis retinal. To date, almost 200 loss-of-function mutations have been identified within the RPE65 gene causing inherited retinal dystrophies, most notably Leber congenital amaurosis (LCA) and autosomal recessive retinitis pigmentosa (arRP), which are both severe and early onset disease entities. We previously reported a mutation, D477G, co-segregating with the disease in a late-onset form of autosomal dominant RP (adRP) with choroidal involvement; uniquely, it is the only RPE65 variant to be described with a dominant component. Families or individuals with this variant have been encountered in five countries, and a number of subsequent studies have been reported in which the molecular biological and physiological properties of the variant have been studied in further detail, including observations of possible novel functions in addition to reduced RPE65 enzymatic activity. With regard to the latter, a human phase 1b proof-of-concept study has recently been reported in which aspects of remaining vision were improved for up to one year in four of five patients with advanced disease receiving a single one-week oral dose of 9-cis retinaldehyde, which is the first report showing efficacy and safety of an oral therapy for a dominant form of RP. Here, we review data accrued from published studies investigating molecular mechanisms of this unique variant and include hitherto unpublished material on the clinical spectrum of disease encountered in patients with the D477G variant, which, in many cases bears striking similarities to choroideremia.


[Calculation of the mean pressure of the pulmonary artery and of the valve surface by ECG in mitral stenosis].
From a group of 50 patients affected by pure mitral stenosis with sinus rhythm, we have tried to obtain multiple correlation equations which enable in to calculate, in each particular case, the mean pressure of the pulmonary artery and mitral valvular area from purely electrocardiographic facts. In an additional group of 16 patients we have been able to verify the mentioned equations, placing all the calculated points within the presumed limits of tolerance. So it appears that the electrocardiographic calculation of these hemodynamic parameters is possible, with sufficient approximation for clinical requirements.


The regulation and measurement of plasma volume in heart failure.
Plasma volume, the intravascular portion of the extracellular fluid volume, can be measured using standard dilution techniques with radiolabeled tracer molecules. In healthy persons, plasma volume remains relatively constant as a result of tight regulation by the complex interaction between neurohormonal systems involved in sodium and water homeostasis. Although chronic heart failure (CHF) is characterized by activation of many of these neurohormonal systems, few studies have evaluated plasma volume in this condition under treatment. Untreated edematous decompensated heart failure (HF) is associated with a significant expansion of plasma volume. Patients with stable CHF, receiving conventional therapy, appear to have a contracted plasma volume, a concept that is in contrast to the widely held belief that CHF is associated with long-term hypervolemia. It is likely that significant changes in plasma volume occur during intensification of medical therapy or during transition from the edematous to the stable state. Clinical assessment of plasma volume may be of particular value during treatment in patients with decompensated HF, in whom the plasma volume is contracted despite an increase in total extracellular fluid volume. Under these circumstances, treatment with inotropes or renal vasodilators may be more appropriate than intravenous diuretics alone. Further studies evaluating plasma volume in HF may help to improve our understanding of the pathophysiologic mechanisms occurring in the development and progression of this complex condition.


Intravenous organophosphate injection: an unusual way of intoxication.
Organophosphate insecticides strongly inhibit both true cholinesterase and pseudocholinesterase activities. In this report, we have reported a patient who injected himself a strong organophosphate compound, methamidophos, and showed the typical clinical picture of organophosphate intoxication. As far as we know, this is the first case of intoxication by intravenous (i.v.) injection. With the appropriate therapy, his symptoms disappeared in a few days.


The stop-flow arm equilibrium pressure in preoperative patients: Stressed volume and correlations with echocardiography.
The distending intravascular pressure at no flow conditions reflects the stressed volume. While this haemodynamic variable is recognised as clinically important, there is a paucity of reports of its range and responsiveness to volume expansion in patients without cardiovascular disease and no reports of correlations to echocardiographic assessments of left ventricular filling. Twenty-seven awake (13 male), spontaneously breathing patients without any history of cardiopulmonary, vascular or renal disease were studied prior to induction of anaesthesia. The no-flow equilibrium pressure in the arm following rapid circulatory occlusion (Parm ) was measured via a radial arterial catheter. Transthoracic echocardiography was used to measure left ventricular end diastolic area and volume as well as the diameter of the inferior vena cava. The Parm and echocardiographic variables were measured before and after administration of 500 mL 0.9% NaCl over 10 minutes. Changes were analysed by paired t test, Pearson's correlation and multiple linear regression. Parm increased overall from 22 ± 5 mm Hg to 25 ± 6 mm Hg (mean difference 3.0 ± 4.5 mm Hg, P = 0.002) following the fluid bolus with corresponding increases in arterial pressure and echocardiographic variables. Variability in the direction of the Parm response reflected concomitant changes in vascular compliance. Only weak correlations were observed between changes in Parm and inferior vena cava diameter indexed to body surface area (R2 = 0.29, P = 0.01). Preoperative measurements of Parm increased following acute expansion of the intravascular volume. Echocardiography demonstrated poor correlation with Parm .


Approved drugs screening against the nsP1 capping enzyme of Venezuelan equine encephalitis virus using an immuno-based assay.
Alphaviruses such as the Venezuelan equine encephalitis virus (VEEV) are important human emerging pathogens transmitted by mosquitoes. They possess a unique viral mRNA capping mechanism catalyzed by the viral non-structural protein nsP1, which is essential for virus replication. The alphaviruses capping starts by the methylation of a GTP molecule by the N7-guanine methyltransferase (MTase) activity; nsP1 then forms a covalent link with m7GMP releasing pyrophosphate (GT reaction) and the m7GMP is next transferred onto the 5'-diphosphate end of the viral mRNA to form a cap-0 structure. The cap-0 structure decreases the detection of foreign viral RNAs, prevents RNA degradation by cellular exonucleases, and promotes viral RNA translation into proteins. Additionally, reverse-genetic studies have demonstrated that viruses mutated in nsP1 catalytic residues are both impaired towards replication and attenuated. The nsP1 protein is thus considered an attractive antiviral target for drug discovery. We have previously demonstrated that the guanylylation of VEEV nsP1 can be monitored by Western blot analysis using an antibody recognizing the cap structure. In this study, we developed a high throughput ELISA screening assay to monitor the GT reaction through m7GMP-nsP1 adduct quantitation. This assay was validated using known nsP1 inhibitors before screening 1220 approved compounds. 18 compounds inhibiting the nsP1 guanylylation were identified, and their IC50 determined. Compounds from two series were further characterized and shown to inhibit the nsP1 MTase activity. Conversely, these compounds barely inhibited a cellular MTase demonstrating their specificity towards nsP1. Analogues search and SAR were also initiated to identify the active pharmacophore features. Altogether the results show that this HT enzyme-based assay is a convenient way to select potent and specific hit compounds targeting the viral mRNA capping of Alphaviruses.


Cytomorphologic features of metastatic urothelial carcinoma in serous effusions.
Metastatic urothelial carcinoma (UC) to serous effusion (SE) is extremely rare and its cytomorphological features have only been described in case reports. In this study, we searched the pathology database at University of Michigan for SEs due to metastatic UC in the last 20 years. A total of 25 cases from 20 patients with clinically and pathologically confirmed metastatic UC in SEs were retrieved. The specimens consisted of 15 pleural, 8 peritoneal, and 2 pericardial effusions. Smears were reviewed and evaluated for the following features: cellularity, single cells, cell clusters or short cords, cell wrapping, "windows" between the cells, two-tone cytoplasm, cytoplasmic vacuoles, signet ring cells, nuclear to cytoplasmic (N/C) ratio, nuclear hyperchromasia, irregular nuclear membrane, nuclear centricity, double or multiple nuclei, nucleoli, anaplastic cells and mitosis. Our results showed that UC manifested in SEs predominantly as a single cell population with or without clusters or short cords, and frequently exhibited the "cell wrapping" of two or more cells. Individual UC cell in SEs exhibited nuclear enlargement with increased N/C ratio, irregular nuclear membranes, hyperchromatic coarse chromatin and frequently prominent nucleoli. Double or multinucleated cells, cells with vacuolated cytoplasm or signet ring appearance were also frequently present. Our results demonstrated that while certain features could suggest the diagnosis of UC, the cytomorphological features are not specific and often overlap with those of reactive mesothelium, mesothelioma, metastatic adenocarcinoma, or squamous cell carcinoma in SEs. Accurate diagnosis of UC rests on the combination of clinical history, cytomorphologic features and appropriate immunohistochemical panel.


Electrophoretic analysis of RNA segments of human rotaviruses cultivated in cell culture.
Human rotaviruses (HRVs) derived from stools were cultivated to high titres in an established cell line (MA-104) using the rotary culture system. Analysis of the 11 double-stranded RNA segments of the culture-adapted HRVs was carried out by polyacrylamide gel electrophoresis. Tissue culture-adapted HRVs, uncloned or cloned, had the same RNA gel patterns as those of the original HRVs from the individual stool specimens. The migrations of the RNA segments from the culture-adapted HRVs were markedly different from that of the RNA segments from calf rotavirus (Lincoln strain). Considerable heterogeneity in electrophoretic migration of the RNA was found among eight strains of the HRVs grown in cell culture. These results confirmed that viruses isolated from stool specimens were indeed of human origin and were not the result of laboratory contamination with tissue culture-adapted calf rotavirus or other viruses.


[Characteristics of the frontal hypothalamic neuron reactions to the electrical stimulation of the cerebral cortex in cats].
In acute experiments we have used the glass microelectrodes and registered outside cell's impulse activity of the cats' hypothalamic neurons. We used the serial stimulation during 5 s (with frequency impulse 12, 30, 100 s(-1)) to the hippocampus (zone CA3), pyriform, cingulated and proreal cortexes. We have compared the background impulse activity (in the bine) of the neurons with the impulse activity after the stimulation. Two types of the neuron' reactions in response to the cortical stimulations were defined, they consisted in the mean frequency changes to the impulse activity during stimulation and during period in 15-30 sec after completion the stimulation. It is shown that the most of hypothalamic neurons explored (and neurons of the preoptic region) have changed their impulse activity during period, which approached through 15-30 sec after completion the-high frequency (100 s(-1)) stimulation to the all cortical zones and the stimulation of hippocampwith frequency 30 s(-1). We supposed that the cortical stimulations have a significant effect on the impulse activity pattern of the rostral hypothalamic neurons


Non-mulberry silk sericin/poly (vinyl alcohol) hydrogel matrices for potential biotechnological applications.
This study reports a novel biopolymeric matrix fabricated by chemically cross-linking poly (vinyl alcohol) with silk sericin protein obtained from cocoons of the tropical tasar silkworm Antheraea mylitta. Glutaraldehyde was used as a cross-linking agent with hydrochloric acid acting as an initiator. The matrices were biophysically characterized and the cytocompatibility of the matrices was evaluated for their suitability as biomaterials. The surface morphology was assessed using atomic force microscopy while the changes taking place after cross-linking were confirmed by Fourier transform infrared spectroscopy. The enhanced thermal stability of the constructs was assessed by thermogravimetric and differential scanning calorimetry. Fourier transform infrared spectroscopy analysis showed that sericin was chemically cross-linked with poly (vinyl alcohol) using glutaraldehyde. Silk sericin protein demonstrated a favorable effect on animal cell culture by successfully improving the adhering and spreading of cells on the poorly adhering surface of poly (vinyl alcohol). Confocal microscopy revealed cell spreading and actin filament development in sericin/poly (vinyl alcohol) hydrogel matrices. These findings prove the potential of non-mulberry silk sericin/poly (vinyl alcohol) hydrogel matrices to be used as biocompatible and biopolymeric material for tissue-engineering and biotechnological applications.


Association of smoking with coronary artery disease in Nepalese populations: a case control study.
There are well-known traditional risk factors for coronary artery disease (CAD). Among them, smoking is one of the most prominent and modifiable risk factors. This study aims to determine the magnitude of smoking as a risk factor for CAD in the Nepalese population. A hospital-based age- and sex-matched case-control study was carried out with a total of 612 respondents. Bivariate analysis showed that the risk of developing CAD in ex-smokers and current smokers was higher (odds ratio (OR): 1.81 (confidence interval (CI): 1.21-2.7) and OR: 5.2 (CI: 3.4-7.97)), with p-values less than 0.004 and <0.00001, respectively, compared to the risk in never smokers. From stratified socio-demographic, cardio-metabolic, behavioural and psychosocial risk factor analysis, smoking was found to be associated with CAD in almost all subgroups. In the subsequent multivariate analysis, adjustment for socio-demographic, cardio-metabolic and psychosocial risk factors showed a steady increase in risk. However, further adjustment for behavioural risk factors (alcohol use and physical activity) showed that the risk was attenuated by 59% in current smokers. After adjusting for the covariates, current smokers and ex-smokers had an increased risk of CAD (OR: 6.64, 95% CI: 3.64-12.12, p < 0.00001; OR: 1.89, 95% CI: 1.08-3.31, p < 0.012, respectively) compared with non-smokers. In conclusion, smoking was found to increase the risk of CAD in the Nepalese population.


Bordetella pertussis strain variation and evolution postvaccination.
Bordetella pertussis is a Gram-negative bacterium that causes pertussis or whooping cough in humans. The incidence of pertussis has increased in young infants, adolescents and adults in many countries where the vaccination against pertussis has been used extensively. Marked changes have been found in the B. pertussis population and differences have been observed between vaccine strains and circulating isolates. Moreover, clonal expansion of certain B. pertussis strains has been associated with the recent epidemics of pertussis in several European countries. In this review, we present data on strain variation and evolution of B. pertussis in different vaccinated populations and summarize the common methods for typing of B. pertussis and their relative discriminatory power.


The evolution of Staphylococcus aureus.
A broad variety of infections, ranging from minor infections of the skin to post-operative wound infections can be caused by Staphylococcus aureus. The adaptive power of S. aureus to antibiotics leaded, in the early 1960s, to the emergence of methicillin-resistant S. aureus (MRSA). The cause of resistance to methicillin and all other beta-lactam antibiotics is the mecA gene, which is situated on a mobile genetic element, the staphylococcal cassette chromosome mec (SCCmec). Seven major variants of SCCmec, type I to VII, are distinguished. The most important techniques used to investigate the molecular epidemiology of S. aureus are pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), S. aureus protein A (spa) typing and SCCmec typing (only for MRSA). These techniques have been used to study the evolution of the MRSA clones that have emerged since the early 1960s, and to study their subsequent worldwide dissemination. The early MRSA clones were hospital-associated (HA-MRSA). However, from the late 1990s, community-associated MRSA (CA-MRSA) clones emerged worldwide. CA-MRSA harbors SCCmec type IV, V or VII, the majority belong to other S. aureus lineages compared to HA-MRSA, and CA-MRSA is often associated with the presence of the toxin Panton-Valentine leukocidin (PVL). However, during recent years, the distinction between HA-MRSA and CA-MRSA has started to disappear, and CA-MRSA is now endemic in many US hospitals. MRSA probably originated trough the transfer of SCCmec into a limited number of methicillin-sensitive S. aureus (MSSA) lineages. This review describes the latest observations about the structure of SCCmec, the techniques used to study the molecular epidemiology and evolution of S. aureus as well as some challenges that researchers face in the future.


Women'S issues and epilepsy.
Women with epilepsy (WWE) may experience changes in seizure control related to alterations in neuronal excitability mediated by estrogen and progesterone. A third or more of women will reliably note seizures that are linked to menstruation or ovulation. Reproductive hormone-related exacerbation of seizure control is also observed during perimenopause. Seizures and antiepileptic drugs (AEDs) also can adversely affect reproductive health. WWE have higher than expected rates of menstrual disorders and infertility. Enzyme-inducing AEDs interact with hormonal contraceptives, potentially limiting options for birth control. Exposure to AEDs during pregnancy increases the risk of congenital malformations and cognitive impairments in children born to WWE. Chronic AED use increases the risk of vitamin D deficiency, decreased bone quality and density, and fractures. These concerns heighten the need to taper AEDs when appropriate and to manage WWE on the simplest AED regimen that will maintain seizure freedom.


Palliative sedation: reliability and validity of sedation scales.
Observer-based sedation scales have been used to provide a measurable estimate of the comfort of nonalert patients in palliative sedation. However, their usefulness and appropriateness in this setting has not been demonstrated. To study the reliability and validity of observer-based sedation scales in palliative sedation. A prospective evaluation of 54 patients under intermittent or continuous sedation with four sedation scales was performed by 52 nurses. Included scales were the Minnesota Sedation Assessment Tool (MSAT), Richmond Agitation-Sedation Scale (RASS), Vancouver Interaction and Calmness Scale (VICS), and a sedation score proposed in the Guideline for Palliative Sedation of the Royal Dutch Medical Association (KNMG). Inter-rater reliability was tested with the intraclass correlation coefficient (ICC) and Cohen's kappa coefficient. Correlations between the scales using Spearman's rho tested concurrent validity. We also examined construct, discriminative, and evaluative validity. In addition, nurses completed a user-friendliness survey. Overall moderate to high inter-rater reliability was found for the VICS interaction subscale (ICC = 0.85), RASS (ICC = 0.73), and KNMG (ICC = 0.71). The largest correlation between scales was found for the RASS and KNMG (rho = 0.836). All scales showed discriminative and evaluative validity, except for the MSAT motor subscale and VICS calmness subscale. Finally, the RASS was less time consuming, clearer, and easier to use than the MSAT and VICS. The RASS and KNMG scales stand as the most reliable and valid among the evaluated scales. In addition, the RASS was less time consuming, clearer, and easier to use than the MSAT and VICS. Further research is needed to evaluate the impact of the scales on better symptom control and patient comfort.


Platelet activating factor antagonist design. 2. X-ray structure of dimethyl 2,3,4,5-tetrahydro-5 beta-(3,4-methylenedioxyphenyl)-2-oxo-3 beta-(3,4,5-trimethoxybenzoyl)-3 alpha,4 alpha-furandicarboxylate.
C25H24O12, Mr = 516.46, triclinic, P-1, a = 8.780 (3), b = 11.298 (4), c = 13.271 (6) A, alpha = 71.77 (4), beta = 70.31 (3), gamma = 72.66 (3) degrees, V = 1189 A3, Z = 2, Dx = 1.44 g cm-3, lambda (Mo K alpha) = 0.71073 A, mu = 0.74 cm-1, F(000) = 540, T = 293 K, final R = 0.046 for 2495 observed [Fo greater than or equal to 5 sigma (Fo)] reflections. The observed structure reveals a trans disposition for the methoxycarbonyl and aryl substituents at positions 4 and 5 of the heterocycle and a cis-3,4-bis(methoxycarbonyl) relationship. There is no crystallographically imposed symmetry. Several intermolecular van der Waals interactions occur in the cell lattice of this compound.


Nutritional intervention for improving treatment tolerance in cancer patients.
This study aims to assess various types of nutritional intervention for improving treatment tolerance in patients with malnutrition related to the cancer anorexia-cachexia syndrome. Malnutrition in cancer patients is associated with a poor prognosis, whereas weight loss is an important predictor of mortality. Disease and treatments have a major impact on nutritional status. By improving the latter, we can change the prognosis, quality of life and functional status, facilitating improved tolerance to treatment. Dietary counselling, recommended for patients at risk of malnutrition, should be introduced early in close collaboration with the patient. Administering oral nutritional supplements to malnourished patients has been shown to lead to a reduction in mortality, in complications and in the length of hospital stay. Supplementation with enteral nutrition has demonstrated an increase in appetite, energy intake, nutritional status and, above all, reduced gastrointestinal toxicity from cancer treatments due to a better response to them. Supplementation with home parenteral nutrition in aphagic and terminal patients has shown improved quality of life, energy balance, body composition and prolonged survival. Supplementation with ω3 fatty acids appears to offer benefits that are verifiable at a biochemical, clinical and functional level. Related literature, however, provides conflicting results; therefore further studies will be required to confirm their efficacy. Supplementation with glutamine appears to support the efficacy of chemoradiotherapy treatment while reducing toxicity of the tissues and improving outcomes. Oral supplementation with branched amino acid appears to reduce the length of hospital stay, decrease morbidity and improve the quality of life, without any changes in mortality. Perioperative supplementation with arginine has shown a reduced incidence of complications and a significant increase in long-term survival.


[Methodology to prevent mercury exposure among adolescents from goldmine areas in Mariana, state of Minas Gerais, Brazil]
The main objective of this study was to promote the evaluation of an educational method to identify health risks among adolescents exposed to mercury by their work in gold mining production.The project was carried out with adolescents from a public school from the District of Monsenhor Horta, Municipality of Mariana, state of Minas Gerais. Statistical evaluation of the results revealed a significant increase in the amount of correct answers between the first and fifth stage concerning the definition of work accidents and its importance in relation to work-related diseases, accidents on route to and from the work place and violence at work site itself.


Pupil Dilation Response to Prosody and Syntax During Auditory Sentence Processing.
Pupil dilation response has been shown to reflect different levels of sentence processing during prosodic and syntactic processing in language comprehension. Our pupillometry experiment aimed to investigate whether pupil diameter was sensitive to the auditory sentence processing involved in comprehending congruent and incongruent statements. Twenty-one participants were presented with 300 auditory stimuli consisting of syntactically and/or prosodically congruent and incongruent sentences in Turkish. The pupillary response results were significant only for syntactically incongruent sentences and for sentences that were both syntactically and prosodically incongruent. This indicates that prosody had no significant effect on its own. Based on the hypothesis that prosodic and syntactic processing require cognitive sensitivity for auditory sentence comprehension, we expected an increase in pupil diameter for both processes. However, our findings are consistent with the previous assumptions that pupil size increases during syntactic manipulation, but our findings showed that prosodic processing does not increase pupil size, contrary to previous studies.


Non-surgical management of ankle contracture following acquired brain injury.
The purpose of this study was to document the outcome of non-surgical management of equinovarus ankle contracture in a cohort of patients with acquired brain injury admitted to a specialist Neurosurgical Rehabilitation Unit. This prospective descriptive study examined all patients with a new diagnosis of moderate to severe acquired brain injury (Glasgow Coma Scale score </=12) admitted for rehabilitation over a 1 year period. Ankle dorsiflexion range and plantarflexor/invertor muscle activity were evaluated weekly during the period of hospitalization. Contracture was defined as maximal passive range of motion </= 0 degrees dorsiflexion, with the knee extended, on a minimum of two measurement occasions. Patients were retrospectively allocated to one of four treatment outcome categories according to ankle dorsiflexion range, type of intervention required and response to treatment. Ankle contracture was identified in 40 of the 105 patients studied. Contracture resolved with a standard physiotherapy treatment programme, including prolonged weight-bearing stretches and motor re-education, in 23 patients. Contracture persisted or worsened in 17 of 40 cases, all of whom exhibited dystonic muscle overactivity producing sustained equinovarus posturing. Ten of 17 cases required serial plaster casting (+/- injection of botulinum toxin type A) in order to achieve a functional range of ankle motion. Remediation of ankle contracture was not considered a priority in the remaining seven patients due to the severity of their overall disability. The incidence of ankle contracture identified in this population was considerably less than previously reported. Reduced dorsiflexion range was remediated with standard physiotherapy treatment in over half of the cases. Additional treatment with serial casting +/- botulinum toxin type-A injection was required to correct persistent or worsening contracture in one quarter of cases. Dystonic extensor muscle overactivity was a major contributor to persistent or progressive ankle contracture.


A haplotype-based algorithm for multilocus linkage disequilibrium mapping of quantitative trait loci with epistasis.
For tightly linked loci, cosegregation may lead to nonrandom associations between alleles in a population. Because of its evolutionary relationship with linkage, this phenomenon is called linkage disequilibrium. Today, linkage disequilibrium-based mapping has become a major focus of recent genome research into mapping complex traits. In this article, we present a new statistical method for mapping quantitative trait loci (QTL) of additive, dominant, and epistatic effects in equilibrium natural populations. Our method is based on haplotype analysis of multilocus linkage disequilibrium and exhibits two significant advantages over current disequilibrium mapping methods. First, we have derived closed-form solutions for estimating the marker-QTL haplotype frequencies within the maximum-likelihood framework implemented by the EM algorithm. The allele frequencies of putative QTL and their linkage disequilibria with the markers are estimated by solving a system of regular equations. This procedure has significantly improved the computational efficiency and the precision of parameter estimation. Second, our method can detect marker-QTL disequilibria of different orders and QTL epistatic interactions of various kinds on the basis of a multilocus analysis. This can not only enhance the precision of parameter estimation, but also make it possible to perform whole-genome association studies. We carried out extensive simulation studies to examine the robustness and statistical performance of our method. The application of the new method was validated using a case study from humans, in which we successfully detected significant QTL affecting human body heights. Finally, we discuss the implications of our method for genome projects and its extension to a broader circumstance. The computer program for the method proposed in this article is available at the webpage http://www.ifasstat.ufl.edu/genome/~LD.


Combination among VEP, OCT and TCD data in patients with relapsing-remitting Multiple Sclerosis during attack-free period.
Multiple sclerosis (MS) is characterized by inflammation, demyelination, glial cell pathology and axonal injury in the central nervous system, and also progressive axonal loss of the optic nerve in cases with optic neuritis (ON). The previous transcranial Doppler (TCD) investigations suggest cortical hyperreactivity in patients with relapsing-remitting Multiple sclerosis (RRMS). We investigated the effect of ON involvement on visual reactivity. One hundred thirty patients with RRMS during attack-free period and 12 healthy subjects were enrolled to the study. Visual evoked potential (VEP), optic coherence tomography (OCT) and TCD examinations of all subjects were performed. Cerebrovascular reactivity measured with breath holding (BH) test was found to be normal. VEP amplitude, visual reactivity and peripapillary retinal nerve fibre layer (pRNFL) measurements were found to be low in patients with ON involvement, whereas VEP latencies were long. Visual reactivity was negatively correlated with VEP amplitude and RFNL measurements, and positively correlated with VEP latency. The present study supports that cerebrovascular reactivity is preserved in patients with RRMS except for attacks, and neurovascular reactivity is increased in patients without ON involvement.


A Case Study of Exercise Adherence during Stereotactic Ablative Radiotherapy Treatment in a Previously Active Male with Metastatic Renal Cell Carcinoma.
Stereotactic Ablative Radiotherapy (SABR) is increasingly replacing thoracotomy for resection of lung cancers and oligometastatic lung lesions but it is not known whether exercise can be maintained during SABR, the major side-effect of which is fatigue. This case study describes a 57-year-old male who exercised regularly (above American College of Sports Medicine minimum weekly exercise guidelines) and continued to exercise during SABR for a renal cell metastasis in his left lung. His exercise program included 5x60-minute moderate intensity aerobic exercise sessions and 3x45-minute resistance exercise sessions per week for 12 weeks post-treatment. Cardiorespiratory fitness and strength, as well as self-reported fatigue, depression, anxiety, physical wellbeing and sleep quality were assessed at baseline and fortnightly. Exercise adherence was 98% and no adverse events occurred. Fatigue was elevated from Weeks 2-8, which adversely impacted exercise intensity perception. Minimal changes were observed in cardiorespiratory fitness, depression, anxiety and sleep quality, but strength decreased, and physical wellbeing was improved above baseline levels. This is the first reported clinical case of exercise during SABR for a lung carcinoma. The data suggest that exercise may be feasible for patients undergoing SABR and may improve physical wellbeing. Larger controlled studies are needed to confirm these findings.


Real-world relapse-free survival data on adjuvant anti-PD-1 therapy for patients with newly diagnosed and recurrent stage III melanoma.
We aimed to compare the relapse-free survival (RFS) in patients treated with adjuvant anti-programmed cell death-1 (anti-PD-1) therapy for a first diagnosis of stage III melanoma to patients treated after resection of the recurrences. Patients treated with adjuvant anti-PD-1 therapy after complete resection of stage III melanoma between September 2018 and January 2021, were included. Depending on when adjuvant anti-PD-1 treatment was initiated, patients were divided over 2 cohorts: for the first diagnosis (cohort A) or for a second or subsequent diagnosis (cohort B) of stage III melanoma. Clinical data and RFS were compared between cohorts. 66 patients were included: 37 in cohort A, 29 in cohort B. Median follow-up time from the start of adjuvant therapy was 21 months and 17 months in cohorts A and B, respectively. Significant differences in ulceration of the primary tumor (P = 0.032), stage according to the 7th AJCC (American Joint Committee on Cancer, P = 0.026) and type of metastatic involvement (P = 0.005) were found between cohorts. In cohorts A and B, 18 (49%) and 8 (28%) patients developed a recurrence and the 1-year RFS was 51% and 72%, respectively. In cohort B, RFS remained longer in the patients of which the interval between first diagnosis of stage III melanoma and start of adjuvant therapy was >48 months compared to ≤48 months (83% vs. 65%, P = 0.253). This study demonstrates that patients with recurrent stage III disease, not previously treated with adjuvant systemic therapy, may derive similar benefit to a first diagnosis of stage III patients if access to adjuvant therapy changes.


High prognostic value of 18F-FDG PET for metastatic gastroenteropancreatic neuroendocrine tumors: a long-term evaluation.
This study aimed to evaluate the long-term prognostic usefulness of (18)F-FDG PET for patients with metastatic gastroenteropancreatic neuroendocrine tumors (GEPNETs). Thirty-eight patients with metastatic GEPNETs were prospectively enrolled. Initial check-up comprised CT scan, (111)In-pentetreotide scintigraphy (SRS), and (18)F-FDG PET. Only (18)F-FDG PET-positive lesions with a maximum standardized uptake value (SUVmax) greater than 4.5 or an SUV ratio (SUVmax tumor to SUVmax nontumoral liver tissue, or T/NT ratio) of 2.5 or greater were considered positive for prognosis-that is, indicating a poor prognosis. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Factors associated with survival were assessed with univariate and multivariate analyses, using the Cox regression model. Median PFS and OS were significantly higher for patients with a negative (18)F-FDG PET finding, with an OS of 119.5 mo (95% confidence interval [CI], 72-∞), than for patients with a positive (18)F-FDG PET finding (only 15 mo [95% CI, 4-27]) (P < 10(-3)). Median PFS and OS were significantly higher for the patient group that had a positive SRS than the group with a negative SRS (P = 0.0002). For patients with a positive SRS, PFS and OS were significantly shorter when the (18)F-FDG PET finding was positive: 19.5 mo (95% CI, 4-37) for PFS and 119.5 mo (95% CI, 81-∞) for OS (P < 10(-3)). In the patient group with a low-grade GEPNET and a positive SRS, PFS and OS were also significantly lower for patients with a positive (18)F-FDG PET. At 48-mo follow-up, 100% of patients who had a positive (18)F-FDG PET for disease progression (of which 47% were also SRS-positive) were deceased, and 87% of patients with a negative (18)F-FDG PET were alive (P < 0.0001). The T/NT ratio was the only parameter associated with OS on multivariate analysis. Overall, (18)F-FDG PET appears to be of major importance in the prognostic evaluation of metastatic GEPNET. A positive (18)F-FDG PET with an SUV ratio (T/NT) of 2.5 or greater was a poor prognostic factor, with a 4-y survival rate of 0%. A positive SRS does not eliminate the need for performing (18)F-FDG PET, which is of greater prognostic utility.


[Feasibility study of transplantation of penile corpus cavernosum and major pelvic ganglion in renal subserous region].
To study the feasibility of transplantation of normal rat penile corpus cavernosum and major pelvic ganglion (MPG) into the renal subserous region of a Nu/Nu mouse based on allograft technology. Penile corpus cavernosum and MPG, harvested from Sprague-Dawley (SD) rats under sterile condition, were transplanted underneath the kidney capsule of Nu/Nu mice through the microsurgery instruments and surgery microscope. The histopathologic changes and cellular proliferation in the transplanted penile corpus cavernosum and MPG were then analyzed at the end of 1week and 4 weeks after transplantation. Histological staining and immunohistochemical staining were used to evaluate the main outcome measures. After 1 week, the tissue morphology of the transplanted corpus cavernosum underneath the kidney capsule of Nu/Nu mice was consistent with normal penile corpus cavernosum, and blood could be observed in the penis cavernous sinus of the graft; after 4 weeks, the mophorlogy of the tranplanted corpus cavernosum near the kidney was consistent with normal penile corpus cavernosum, while fibrosis was noteworthy in the graft away from the kidney, but blood could still be seen in the penis cavernous sinus. After 1 week, the tissue morphology of the transplanted MPG was consistent with normal MPG, multiple islet-like cell clusters could be seen in the transplanted MPG in the renal subserous region, and angiogenesis could be observed near the kidney; after 4 weeks, a network of blood vessels was clearly visible away from the kidney, and islet-like cell clusters were still clearly observed in the transplanted MPG. In addition, ki67 positive cells were observed in the transplanted penile corpus cavernosum and MPG after 4 weeks of transplantation, which indicated that there was still cell proliferation activity in the grafts. The transplanted corpus cavernosum and MPG underneath the kidney capsule of Nu/Nu mice could survive at least 4 weeks. Moreover, the inner structure of the transplanted corpus cavernosum and MPG was close to the normal tissue. The underlining mechanism may be related to the local microenvironment underneath the kidney capsule of Nu/Nu mice and the neovascularization in the transplanted grafts.


Social insurance programs and later-life mortality: Evidence from new deal relief spending.
A growing body of research explores the long-run effects of social programs and welfare spending. However, evidence linking welfare support in early life with longevity is limited. We add to this literature by evaluating the effect of in-utero and early-life exposure to the largest increases in welfare spending in the US history under the New Deal programs. Using Social Security Administration death records linked with the 1940-census and spending data for 115 major cities, we show that the spending is correlated with improvements in old-age longevity. A treatment-on-treated calculation focused on a period when spending rose by approximately 1900 percent finds that a 100 percent rise in municipal spending in the year of birth is associated with roughly 3.5 months higher longevity. We show that these effects are not driven by endogenous selection of births, selective fertility, endogenous migration, and sample selection caused by endogenous data linking. Additional analysis suggests that rises in education and socioeconomic status are likely channels of impact.


Survival and detection of rotaviruses on environmental surfaces in day care centers.
Previously, we demonstrated that children in day care centers commonly experience diarrhea due to rotavirus, giardia, and bacterial pathogens. Multiple agents frequently coexist, and the environment is heavily contaminated with enteric bacteria during outbreaks. A study of environmental surface contamination with rotavirus was performed during three non-outbreak periods. Of 25 samples collected from environmental surfaces and teachers hands at a day care center, 4 (16%) were positive for rotavirus antigen when a fluorescence assay was used. We also examined the survival of two animal viruses, rotavirus SA-11 and poliovirus type 1, and bacteriophage 12 on similar environmental surfaces in a laboratory. Poliovirus type 1 and bacteriophage f2 were more resistant to drying than rotavirus SA-11 and could be recovered after a 90-min exposure on a dry surface. Rotavirus SA-11 could be detected for 30 min. All three viruses survived longer when they were suspended in fecal material than when they were suspended in distilled water. These data suggest that several agents, including rotavirus, can remain viable on contaminated surfaces long enough to be transmitted to susceptible children. This finding helps explain why rotavirus shows a mode of spread like that of parasitic and bacterial agents within day care center settings.


Effect of total lymphoid irradiation on levels of serum autoantibodies in systemic lupus erythematosus and in rheumatoid arthritis.
The effects of total lymphoid irradiation (TLI) on serum levels of autoantibodies, and of antibodies to diphtheria toxoid, tetanus toxoid, and pneumococcal polysaccharide in patients with lupus nephritis were compared with those previously observed in rheumatoid arthritis (RA) patients. Baseline levels of antibodies to diphtheria toxoid and tetanus toxoid decreased significantly after TLI in patients with lupus and RA, but antibody levels to pneumococcal polysaccharide remained unchanged. After TLI, the levels of antinuclear and anti-DNA antibodies were reduced significantly in lupus, but levels of rheumatoid factor, antinuclear, and antigranulocyte antibodies all tended to increase in RA.


Cytological spectrum of salivary gland lesions and their correlation with epidemiological parameters.
The role fine-needle aspiration (FNA) in the diagnosis of salivary gland lesions has evolved over the years. Although clinical and radiological parameters help to narrow the differential diagnosis the tissue diagnosis still remains the gold standard. This study is from January 2013 to December 2015 in our Department of Pathology where 170 salivary gland lesions were aspirated. The aim of the present study was to analyze adequacy rate in relation to the size of lesion and to evaluate varied cytological spectrum of salivary gland lesions with emphasis on differential diagnosis and to correlate cytological diagnosis with age, gender and anatomical site. The 170 cytological smears were categorized into two groups: Group 1 adequate aspirations (88.2%), Group 2 inadequate aspirations (11.7%). The adequate aspirations were subdivided as neoplastic (53.33%) and nonneoplastic (46.66%). The distribution of the various neoplastic lesions (80; 53.33%) were 66 (82.5%) benign, 12 (15%) were malignant and 2 (2.5%) were suspicious of malignancy. Among benign neoplasms, the pleomorphic adenoma (62; 93.3%) was the most frequent followed by Warthins tumor (4; 6%). The most common malignant neoplasms were adenoid cystic carcinoma (6; 50%), followed by mucoepidermoid carcinoma (4; 33.3%), malignant lymphoma (1; 8.3%) and metastatic carcinomatous deposits (1; 8.3%). In two cases, cytological picture indicated suspicion for malignancy however specific tumor typing could not be done. The neoplasms occurred more frequently in the parotid gland (65%), followed by submandibular gland (21.3%) and minor salivary glands (13.8%). The nonneoplastic lesions (70) included 68.6% cases of chronic sialadenitis, 17.1% cases were reported as mucocele, 11.4% cases of acute sialadenitis 2.9% cases as tubercular granulomas. FNA cytology provides useful information on the management of salivary gland lesions and prevents unnecessary surgery in cases of nonneoplastic lesions and identification of malignancy helps the surgeon in deciding type and extent of surgery.


The Mental Deterioration Battery: normative data, diagnostic reliability and qualitative analyses of cognitive impairment. The Group for the Standardization of the Mental Deterioration Battery.
This study aimed at investigating the clinical usefulness of the Mental Deterioration Battery (MDB) in the neuropsychological diagnosis and characterization of the dementia syndrome. In this paper, we report: (a) normative data for various test scores derived from the analysis of performance of 340 normal subjects living in urban areas; (b) an evaluation of the reliability of the single tests and of the battery as a whole in differentiating normal subjects from patients affected by cognitive deterioration derived from the analysis of performance of 130 normal subjects living in rural areas and 134 patients affected by probable Alzheimer's dementia; (c) a cluster analysis of performances of the 340 normal subjects in the standardization group to evaluate possible criteria of homogeneity according to which the various MDB scores tend to aggregate; (d) an analysis of performance profiles of 183 patients with right monohemispheric focal lesions, 159 patients with left unilateral lesions with aphasia and 131 left-lesioned nonaphasic patients to evaluate the specificity of the single tests of the battery in documenting a selective impairment of one of the two cerebral hemispheres. Results confirm the reliability of the MBD in discriminating between normal and demented patients and provide indications for use of the battery in differentiating qualitative patterns of cognitive impairment.


A pathogenesis for alcoholic pancreatitis.
Twelve patients with prior episodes of alcoholic pancreatitis and hyperlipemia were admitted to a metabolic ward during a quiescent period. By lipid feeding (316 to 894 Gm. per day), significant hypertriglyceridemia (greater than 600 mg. per 100 ml.) was induced in 11 of the 12 patients. Seven of the 11 patients with hypertriglyceridemia developed abdominal pain similar to but not as severe as that experienced during prior attacks of pancreatitis. Four of the seven patients with abdominal pain developed serum amylase elevations, and, of the remaining three, one had a serum lipase elevation and one a urinary amylase elevation. Alcohol ingestion is known to increase serum triglyceride levels in many individuals. A prior study demonstrated that 41 percent of the patients presenting to our hospital with alcoholic pancreatitis had serum triglyceride elevations. The data from the present study suggest that increased serum triglycerides act as an important intermediary in the pathogenesis of acute pancreatitis in some alcoholic patients.


Epidemiology of participation: an Australian community study.
To determine the levels of participation in social and civic community life in a metropolitan region, and to assess differential levels of participation according to demographic, socioeconomic and health status. To contribute to policy debates on community participation, social capital and health using these empirical data. Cross sectional, postal, self completed survey on health and participation. Random sample of the population from the western suburbs of Adelaide, the capital city of South Australia, a population of approximately 210 000. 2542 respondents from a sample of 4000 people aged 18 years and over who were registered on the electoral roll. The response rate to the survey was 63.6% (n=2542). Six indices of participation, on range of social and civic activities, with a number of items in each, were created. Levels of participation were highest in the informal social activities index (46.7-83.7% for individual items), and lowest in the index of civic activities of a collective nature (2.4-5.9% for individual items). Low levels of involvement in social and civic activities were reported more frequently by people of low income and low education levels. Levels of participation in social and civic community life in an urban setting are significantly influenced by individual socioeconomic status, health and other demographic characteristics. An understanding of the pattern of participation is important to inform social and health policy making. Increasing levels of participation will reduce social exclusion and is likely to improve the overall quality of community life.