Ciguatera in Australia. Occurrence, clinical features, pathophysiology and management.
Ciguatera is a type of food poisoning that results from eating certain tropical fish which have become toxic. It is common in Australia: 175 outbreaks, which involved 527 people, were reported in Queensland between 1965 and 1984. It seems restricted to certain areas around the Australian coastline. Most reports have involved the narrow-barred Spanish mackerel, Scomberomorus commersoni, most of which were caught in southern Queensland waters. Up to 2100 cases may have occurred in north Queensland between 1965 and 1984, which were not recorded by the writers. The symptoms of ciguatera in Australia are similar to those reported elsewhere in the South Pacific. Ciguatoxin acts by increasing the permeability of excitable membranes to sodium ions. This type of membrane is found throughout the body in nerve tissue as well as in heart and skeletal muscle. The treatment of ciguatera remains symptomatic and supportive only. Major advances in treatment for ciguatera and detection of ciguatoxin await the means of producing additional ciguatoxin.


[Acute pancreatitis triggered by an impacted minor papillary stone in a patient with pancreas divisum improved after spontaneous evacuation of the pancreatic stone:a case report].
A 56-year-old woman with epigastric pain was admitted to our hospital. Blood tests and abdominal computed tomography (CT) suggested acute pancreatitis. Abdominal CT revealed a pancreas divisum and stone in the minor papilla. Stone impaction was the most likely cause of the acute pancreatitis. The patient's abdominal pain promptly improved after admission. The patient was treated conservatively, and the pancreatitis resolved. Abdominal CT on the 10th day confirmed spontaneous evacuation of the pancreatic stone. This is a rare case of acute pancreatitis in a patient with pancreas divisum triggered by an impacted stone in the minor papilla, which improved after spontaneous evacuation of the pancreatic stone.


Domestic violence. Risk factors and outcomes.
Domestic violence is a pervasive and frequently unrecognized cause of injury among women. We reviewed data from standardized interviews with 218 women who presented to an emergency department with injuries due to domestic violence. Victims ranged in age from 16 to 66 years and constituted a wide range of socioeconomic and ethnic backgrounds. Domestic violence often resulted in severe injury; 28% of the women interviewed required admission to hospital for injuries, and 13% required major surgical treatment. The typical presentation was injuries to the face, skull, eyes, extremities, and upper torso. A third of the cases involved a weapon, such as a knife, club, or gun. In all, 10% of the victims were pregnant at the time of abuse, and 10% reported that their children had also been abused by the batterer. Most victims (86%) had suffered at least one previous incident of abuse, and about 40% had previously required medical care for abuse. Victim recognition and referral to appropriate agencies could be improved if primary care physicians were more aware of the prevalence, severity, frequency of occurrence, and typical presentation of domestic violence.


Cutaneotrichosporon suis sp. nov., a lipolytic yeast species from food and food-related environment.
Two conspecific yeast strains, which based on DNA sequence comparisons represented an undescribed species in the order Trichosporonales were isolated during two independent studies in Hungary and France. One of them (NCAIM Y.02224) was recovered from minced pork in Hungary while the other one (UBOCC-A-218003) was isolated from the air of a dairy plant in France. The two strains shared identical nucleotide sequences in the D1/D2 domain of the nuclear large subunit (LSU) rRNA gene and in the internal transcribed spacer (ITS) region. Analysis of the concatenated DNA sequences for the ITS region and D1/D2 domain of the LSU rRNA gene indicated that the novel species belongs to the recently erected genus Cutaneotrichosporon. According to sequence comparisons and phylogenetic analysis, the novel species is most closely related to Cutaneotrichosporon curvatum (formerly Cryptococcus curvatus), which is often associated with humans and warm-blooded animals. The physiological characteristics of this novel species are also very similar to that of Cutaneotrichosporon curvatum. The only clear-cut difference is that, unlike C. curvatum, the novel species does not utilize imidazole as a nitrogen-source. The species name Cutaneotrichosporon suis sp. nov. is proposed to accommodate the above-noted two strains.


Evolution of the ribosomal DNA spacers of Drosophila melanogaster: different patterns of variation on X and Y chromosomes.
Length variation of the ribosomal gene spacers of Drosophila melanogaster was studied. Analysis of 47 X chromosomal and 47 Y chromosomal linked rDNA arrays collected from five continents indicates that the arrays on the two chromosomes differ qualitatively. The Y-linked arrays from around the world share little or no similarity for either their overall length or the organization of their spacers. Most of the X-linked arrays do, however, share a major length spacer of 5.1 kb. In addition, those X-linked arrays that have a major 5.1-kb band have similar spacer organization as demonstrated by genomic DNA digestions with several restriction enzymes. These data strongly support the hypothesis that spacer length patterns on only X-linked genes are maintained primarily by natural selection.


Monoclonal antibodies to the L1210 murine leukemia cell line and to a drug-altered subline.
A panel of murine monoclonal antibodies (MAbs) was produced by fusing NS-0 myeloma cells with spleen cells of a BALB/c X DBA/2 F1 mouse hyperimmunized against a highly immunogenic subline of the L1210 leukemia obtained by in vivo treatment of the L1210 parental line with the antitumor drug 5-(3,3'-dimethyl-1-triazeno)imidazole-4-carboxamide (DTIC). Among the 52 MAbs produced 16 (anti-D) were specifically cytotoxic in a complement-dependent cytotoxicity assay for the drug-altered subline and the others (anti-L) also cross-reacted with the L1210 parental leukemia. Six anti-D and three anti-L MAbs were selected for detailed studies of tissue specificity. In quantitative absorption experiments the antigens defined by these antibodies could not be detected on cells from normal mouse tissues (lung, liver, kidney, heart, spleen, and thymus). The reactivities of both anti-D and anti-L MAbs against a panel of L1210/DTIC sublines obtained at different times were assayed. The results showed that the antigenic specificities defined by anti-L MAbs were expressed on almost every L1210/DTIC subline while the anti-D MAbs detected antigenic structures specific for the L1210/DTIC used for the immunization. None of the MAbs tested cross-reacted with the L5178Y lymphoma or with its DTIC-altered sublines. The failure of anti-D MAbs to cross-react with cells from other L1210/DTIC sublines supports the hypothesis that the immunological alterations induced by the DTIC treatment are the consequence of mutagenic activity of the drug. On the other hand the presence of anti-L antigens on the cells of every L1210 subline indicates that the DTIC alteration is not accompanied by a loss of the tumor-associated antigen from the L1210 leukemia.


Role and experience determine decision support interface requirements in a neonatal intensive care environment.
The aim of this paper is to describe a novel approach to the analysis of data obtained from card-sorting experiments. These experiments were performed as a part of the initial phase of a project, called NEONATE. One of the aims of the project is to develop decision support tools for the neonatal intensive care environment. Physical card-sorts were performed using clinical "action" and patient "descriptor" words. Thirty-two staff (eight junior nurses, eight senior nurses, eight junior doctors, and eight senior doctors) participated in the actions card-sorts and the same number of staff participated in separate descriptors card-sorting experiments. To check for consistency, the card-sorts were replicated for nurses during the action card-sorts. The card-sort data were analysed using hierarchical cluster analysis to produce tree-diagrams or dendrograms. Differences were shown in the way various classes of staff with different levels of experience mentally map clinical concepts. Clinical actions were grouped more loosely by nurses and by those with less experience, with a polarisation between senior doctors and junior nurses. Descriptors were classed more definitively and similarly by nurses and senior doctors but in a less structured way and quite differently by junior doctors. This paper presents a summary of the differences in the card-sort data for the various staff categories. It is shown that concepts are used differently by various staff groups in a neonatal unit and that this may diminish the effectiveness of computerised decision aids unless it is explored during their development.


Decreased cyclic AMP degradation in NG 108-15 neuroblastoma X glioma hybrid cells and S49 lymphoma cells chronically treated with drugs that inhibit adenylate cyclase.
The increase in hormone-stimulated cyclic AMP accumulation observed in a variety of intact cells after chronic pretreatment with drugs that inhibit adenylate cyclase activity has been attributed to an increase in adenylate cyclase activity following withdrawal of the inhibitory drug. In NG 108-15 mouse neuroblastoma X rat glioma hybrid cells (NG cells) chronically treated with the muscarinic cholinergic agonist carbachol, we have found a significant decrease in the apparent degradation rate constant for cyclic AMP, in addition to an increase in the prostaglandin E1 (PGE1)-stimulated cyclic AMP synthesis rate in intact cells. In carbachol-pretreated NG cells that were stimulated with a maximally effective dose of PGE1, and that accumulated steady-state cyclic AMP concentrations fourfold or more higher than in control cells, the apparent rate constant for degradation was about 53% lower than the value for control cells. In carbachol-pretreated cells stimulated with a submaximal dose of PGE1 to yield a steady-state cyclic AMP concentration comparable to control cells, the apparent rate constant was 31% lower than the value for control cells. In S49 mouse lymphoma cells (S49 cells) chronically treated with an analog of the inhibitory agonist somatostatin, the first-order rate constant for cyclic AMP degradation in intact cells following isoproterenol stimulation was 29% lower than the value for control cells. Despite these changes in the kinetics of cyclic AMP degradation in intact NG cells and S49 cells, there was either no change or a minimal change (less than 10%) in phosphodiesterase activities assayed in extracts of cells chronically exposed to inhibitory drugs.(ABSTRACT TRUNCATED AT 250 WORDS)


Tunable molecular plasmons in polycyclic aromatic hydrocarbons.
We show that chemically synthesized polycyclic aromatic hydrocarbons (PAHs) exhibit molecular plasmon resonances that are remarkably sensitive to the net charge state of the molecule and the atomic structure of the edges. These molecules can be regarded as nanometer-sized forms of graphene, from which they inherit their high electrical tunability. Specifically, the addition or removal of a single electron switches on/off these molecular plasmons. Our first-principles time-dependent density-functional theory (TDDFT) calculations are in good agreement with a simpler tight-binding approach that can be easily extended to much larger systems. These fundamental insights enable the development of novel plasmonic devices based upon chemically available molecules, which, unlike colloidal or lithographic nanostructures, are free from structural imperfections. We further show a strong interaction between plasmons in neighboring molecules, quantified in significant energy shifts and field enhancement, and enabling molecular-based plasmonic designs. Our findings suggest new paradigms for electro-optical modulation and switching, single-electron detection, and sensing using individual molecules.


Methylation analysis by targeted bisulfite sequencing in large for gestational age (LGA) newborns: the LARGAN cohort.
In 1990, David Barker proposed that prenatal nutrition is directly linked to adult cardiovascular disease. Since then, the relationship between adult cardiovascular risk, metabolic syndrome and birth weight has been widely documented. Here, we used the TruSeq Methyl Capture EPIC platform to compare the methylation patterns in cord blood from large for gestational age (LGA) vs adequate for gestational age (AGA) newborns from the LARGAN cohort. We found 1672 differentially methylated CpGs (DMCs) with a nominal p < 0.05 and 48 differentially methylated regions (DMRs) with a corrected p < 0.05 between the LGA and AGA groups. A systems biology approach identified several biological processes significantly enriched with genes in association with DMCs with FDR < 0.05, including regulation of transcription, regulation of epinephrine secretion, norepinephrine biosynthesis, receptor transactivation, forebrain regionalization and several terms related to kidney and cardiovascular development. Gene ontology analysis of the genes in association with the 48 DMRs identified several significantly enriched biological processes related to kidney development, including mesonephric duct development and nephron tubule development. Furthermore, our dataset identified several DNA methylation markers enriched in gene networks involved in biological pathways and rare diseases of the cardiovascular system, kidneys, and metabolism. Our study identified several DMCs/DMRs in association with fetal overgrowth. The use of cord blood as a material for the identification of DNA methylation biomarkers gives us the possibility to perform follow-up studies on the same patients as they grow. These studies will not only help us understand how the methylome responds to continuum postnatal growth but also link early alterations of the DNA methylome with later clinical markers of growth and metabolic fitness.


Molecular typing of Borrelia burgdorferi sensu lato by randomly amplified polymorphic DNA fingerprinting analysis.
To study whether pathogenic clusters of Borrelia burgdorferi sensu lato strains occur, we typed 136 isolates, cultured from specimens from patients (n = 49) with various clinical entities and from ticks (n = 83) or dogs (n = 4) from different geographic regions, by randomly amplified polymorphic DNA (RAPD) fingerprinting with four arbitrary primers. The RAPD patterns were reproducible up to the 95% similarity level as shown in duplicate experiments. In these experiments the purified DNAs prepared on different days, from different colonies, and after various passages were used as templates. With an intergroup difference of 55%, the 136 strains could be divided into seven genetic clusters. Six clusters comprised and corresponded to the established species B. burgdorferi sensu stricto (n = 23), Borrelia garinii (n = 39), Borrelia afzelii (n = 59), Borrelia japonica (n = 1), Borrelia valaisiana (n = 12), and genomic group DN127 (n = 1). One strain from a patient with erythema migrans (EM) did not belong to any of the species or genomic groups known up to now. The RAPD types of B. burgdorferi sensu stricto, B. garinii, and B. afzelii isolates, which may give rise to human Lyme borreliosis (LB), were associated with their geographic origins. A high degree of genetic diversity was observed among the 39 B. garinii strains, and six subgroups could be recognized. One of these comprised eight isolates from patients with disseminated LB only and no tick isolates. B. afzelii strains from patients with EM or acrodermatitis chronica atrophicans were not clustered in particular branches. Our study showed that RAPD analysis is a powerful tool for discriminating different Borrelia species as well as Borrelia isolates within species.


Reoperative thyroid surgery in hospital universiti sains malaysia.
From 1996 to 2001, 393 thyroidectomies were performed and 25 (6.4%) patients underwent reoperative thyroid surgery at Hospital Universiti Sains Malaysia. All reoperated patients had undergone one prior thyroid operation. All were females with an average age of 39.1 years (18-61 years). The most frequent indication for reoperation was cancer in resected specimen of an originally misdiagnosed carcinoma treated by partial thyroid resection. Final histological diagnosis of 25 reoperations showed thyroid carcinoma in 22 (88%) cases and multinodular goiter in 3 cases. The overall interval between the initial and the reoperative procedures ranged from 3 weeks to 15 years. There was no post-operative mortality after reoperation. Post-operative complications were discovered in 5 patients, as 3 (12%) of whom had transient hypocalcaemia, one (4%) had wound breakdown and one (4%) had permanent recurrent laryngeal nerve palsy. Reoperative thyroid surgery is an uncommon operation with high complication rate.


Investigating the genetic basis of pork tenderness: genomic analysis of porcine CAST.
A quantitative trait locus (QTL) affecting pork tenderness was recently detected within the Illinois Meat Quality Pedigree (IMQP) and fine-mapped to the region of porcine chromosome 2 (SSC2) harbouring the functional candidate gene calpastatin (CAST). To identify molecular variation that may underlie the observed differences in tenderness phenotypes, we characterized the porcine CAST gene and analysed allelic variation within the F(1) boars of the IMQP. The complete genomic sequence of porcine CAST has been determined, and was found to contain 35 exons spanning nearly 123 kb. Using the rapid amplification of cDNA ends (RACE) method, calpastatin transcript types I-III, as well as a putative novel transcript type, were detected within porcine skeletal muscle. Variability in transcription initiation and termination sites was observed, and alternative splicing of exons 1y and 3 was evident. Nearly 77.6% of the CAST gene, including all exons, was re-sequenced from each of six IMQP F(1) boars, and almost 900 polymorphisms were identified. The heterozygosity of nearly 400 polymorphisms appeared to be concordant with the previous QTL data, and the location of this variation within the CAST gene suggests that a causative mutation is likely to be regulatory. Functional characterization of CAST variation should enhance understanding of the molecular basis of pork tenderness, and thus allow for genetic improvement of pork products. The effectiveness of CAST polymorphisms for marker-assisted selection of pork tenderness can now be assessed.


Report of three cases of gastric choriocarcinomas-an emphasis on morphologic changes in the non-affected gastric mucosa.
Primary gastric choriocarcinomas (PGC) are very rare and aggressive neoplasms with a worrisome prognosis. Most cases are reported in Asia and presented in middle-aged adults with male predominance. Most cases are associated with an intestinal adenocarcinoma; however, the pathogenesis of this tumor is uncertain. No previous reports exist of the characteristics of the non-tumoral stomach in these patients, and this data that could help to clarify their pathogenesis. We presented a series of three cases of PGC in Latin American patients, emphasizing the characteristics of non-neoplastic mucosa.


Digital transformation in higher education: A qualitative evaluative study of a hybrid virtual format using a smart classroom system.
This study presents the salient perceptions of students and instructors in a master's program taught in a hybrid virtual format using the pocket Bipolar Laddering tool, a written open-ended electronic data collection system. Perceptions about the hybrid virtual format were tested on the participants of a master's program taught in the 2021-2022 academic year through a hybrid virtual format based on a Smart Classroom system developed as part of the digital innovations implemented to overcome the COVID-19 pandemic restrictions. This work aims to shed light on the users' salient perceptions of the format, detect the positive elements mentioned by the surveyed participants and identify the negative items in a bid to minimize, or even revert, their effects for future editions of the master. As expected, the findings suggest that one of the main advantages of this format is that it allows students who have difficulty attending classes on campus to enroll on courses. However, the participants detected diverse elements that could be improved such as interaction, the degree of socialization, or the technical problems that arose during teaching sessions. It is hoped that these findings will be of use when adjusting new editions of the program and will help to determine the design and implementation of other hybrid virtual programs in the Institution.


Semiparametric Bayesian modeling of random genetic effects in family-based association studies.
We consider the inference problem of estimating covariate and genetic effects in a family-based case-control study where families are ascertained on the basis of the number of cases within the family. However, our interest lies not only in estimating the fixed covariate effects but also in estimating the random effects parameters that account for varying correlations among family members. These random effects parameters, though weakly identifiable in a strict theoretical sense, are often hard to estimate due to the small number of observations per family. A hierarchical Bayesian paradigm is a very natural route in this context with multiple advantages compared with a classical mixed effects estimation strategy based on the integrated likelihood. We propose a fully flexible Bayesian approach allowing nonparametric modeling of the random effects distribution using a Dirichlet process prior and provide estimation of both fixed effect and random effects parameters using a Markov chain Monte Carlo numerical integration scheme. The nonparametric Bayesian approach not only provides inference that is less sensitive to parametric specification of the random effects distribution but also allows possible uncertainty around a specific genetic correlation structure. The Bayesian approach has certain computational advantages over its mixed-model counterparts. Data from the Prostate Cancer Genetics Project, a family-based study at the University of Michigan Comprehensive Cancer Center including families having one or more members with prostate cancer, are used to illustrate the proposed methods. A small-scale simulation study is carried out to compare the proposed nonparametric Bayes methodology with a parametric Bayesian alternative.


[Evaluation of an adaptive filter for CT under low-CNR condition: comparison with linear filter].
The use of an adaptive filter for CT images is becoming a common procedure and is said to reduce image noise while preserving sharpness and helping to reduce the required X-ray dose. Although many reports support this view, the validity of such evaluations is arguable. When the linearity of a system is in question, physical performance indexes should be measured under conditions similar to those of clinical use. Evaluations of diagnosis using clinical images may be fallible because the non-filtered image used as the reference might not have been optimally reconstructed. We have chosen simple, but commonly used, adaptive filters for our evaluation. As a reference for comparing performance, we designed linear filters that best approximate the noise characteristics of the adaptive filters. MTF is measured through observation of the edge-spread function. Clinical abdominal images are used to compare the performance of adaptive filters and linear filters. We conclude that the performance of the type of adaptive filter we have chosen is virtually the same as that of the linear filter, as long as the image quality of soft tissues is our interest. Both the noise SD and MTF are virtually the same if the contrast of the object is not substantially higher than 150 HU. Images of soft tissues obtained with the use of adaptive filters are also virtually the same as those obtained by linear filters. The edge-preservation characteristic of this adaptive filter is not observable for soft tissues.


Cyanobacteriochrome SesA is a diguanylate cyclase that induces cell aggregation in Thermosynechococcus.
Cyanobacteria have unique photoreceptors, cyanobacteriochromes, that show diverse spectral properties to sense near-UV/visible lights. Certain cyanobacteriochromes have been shown to regulate cellular phototaxis or chromatic acclimation of photosynthetic pigments. Some cyanobacteriochromes have output domains involved in bacterial signaling using a second messenger cyclic dimeric GMP (c-di-GMP), but its role in cyanobacteria remains elusive. Here, we characterize the recombinant Tlr0924 from a thermophilic cyanobacterium Thermosynechococcus elongatus, which was expressed in a cyanobacterial system. The protein reversibly photoconverts between blue- and green-absorbing forms, which is consistent with the protein prepared from Escherichia coli, and has diguanylate cyclase activity, which is enhanced 38-fold by blue light compared with green light. Therefore, Tlr0924 is a blue light-activated diguanylate cyclase. The protein's relatively low affinity (10.5 mM) for Mg(2+), which is essential for diguanylate cyclase activity, suggests that Mg(2+) might also regulate c-di-GMP signaling. Finally, we show that blue light irradiation under low temperature is responsible for Thermosynechococcus vulcanus cell aggregation, which is abolished when tlr0924 is disrupted, suggesting that Tlr0924 mediates blue light-induced cell aggregation by producing c-di-GMP. Given our results, we propose the name "sesA (sessility-A)" for tlr0924. This is the first report for cyanobacteriochrome-dependent regulation of a sessile/planktonic lifestyle in cyanobacteria via c-di-GMP.


Acidic mammalian chitinase in dry eye conditions.
An acidic mammalian chitinase (AMCase) seems to be implicated in allergic asthma and allergic ocular pathologies. The aim of this work was to investigate the role of AMCase during Sjögren's Syndrome (SS) and Meibomian Gland Dysfunction (MGD) dry eye diseases. Six patients with MGD dry eye (20-58 years, median 40) and six patients with dry eye associated to SS (32-60 years, median 47) were enrolled in this study. AMCase activity was measured in tears and AMCase mRNA expression was evaluated by real-time polymerase chain reaction from RNA extracted from epithelial cells of the conjunctiva. Six healthy adult subjects of the same age (34-44 years, median 39) were also studied as the control group. AMCase activity was significantly increased in patients affected by MGD dry eye (18.54 +/- 1.5 nmol/ml/h) and SS dry eye (8.94 +/- 1.0 nmol/ml/h) respectively, compared to healthy controls (1.6 +/- 0.2 nmol/ml/h). AMCase activity was higher in the tears of subjects with MGD dry eye (P < 0.001). AMCase mRNA was detected in conjunctival epithelial cells and the expression was significantly higher in MGD dry eye than SS dry eye. A significant correlation between AMCase activity in the tears and mRNA in conjunctival epithelial cells was found. AMCase may be an important marker in the pathogenesis of dry eye, suggesting the potential role of AMCase as a therapeutic target in these frequent pathologies.


Human coronavirus NL63: a clinically important virus?
Respiratory tract infection is a leading cause of morbidity and mortality worldwide, especially among young children. Human coronaviruses (HCoVs) have only recently been shown to cause both lower and upper respiratory tract infections. To date, five coronaviruses (HCoV-229E, HCoV-OC43, SARS-CoV, HCoV-NL63 and HCoV HKU-1) that infect humans have been identified, four of which (HCoV-229E, HCoV-OC43, HCoV-NL63 and HCoV-HKU-1) circulate continuously in the human population. Human coronavirus NL63 (HCoV-NL63) was first isolated from the aspirate from a 7-month-old baby in early 2004. Infection with HCoV-NL63 has since been shown to be a common worldwide occurrence and has been associated with many clinical symptoms and diagnoses, including severe lower respiratory tract infection, croup and bronchiolitis. HCoV-NL63 causes disease in children, the elderly and the immunocompromised, and has been detected in 1.0-9.3% of respiratory tract infections in children. In this article, the current knowledge of human coronavirus HCoV-NL63, with special reference to the clinical features, prevalence and seasonal incidence, and coinfection with other respiratory viruses, will be discussed.


Nucleus reprogramming/remodeling through selective enucleation (SE) of immature oocytes and zygotes: a nucleolus point of view.
It is now approximately 25 years since the sheep Dolly, the first cloned mammal where the somatic cell nucleus from an adult donor was used for transfer, was born. So far, somatic cell nucleus transfer, where G1-phase nuclei are transferred into cytoplasts obtained by enucleation of mature metaphase II (MII) oocytes followed by the activation of the reconstructed cells, is the most efficient approach to reprogram/remodel the differentiated nucleus. In general, in an enucleated oocyte (cytoplast), the nuclear envelope (NE, membrane) of an injected somatic cell nucleus breaks down and chromosomes condense. This condensation phase is followed, after subsequent activation, by chromatin decondensation and formation of a pseudo-pronucleus (i) whose morphology should resemble the natural postfertilization pronuclei (PNs). Thus, the volume of the transferred nuclei increases considerably by incorporating the content released from the germinal vesicles (GVs). In parallel, the transferred nucleus genes must be reset and function similarly as the relevant genes in normal embryo reprogramming. This, among others, covers the relevant epigenetic modifications and the appropriate organization of chromatin in pseudo-pronuclei. While reprogramming in SCNT is often discussed, the remodeling of transferred nuclei is much less studied, particularly in the context of the developmental potential of SCNT embryos. It is now evident that correct reprogramming mirrors appropriate remodeling. At the same time, it is widely accepted that the process of rebuilding the nucleus following SCNT is instrumental to the overall success of this procedure. Thus, in our contribution, we will mostly focus on the remodeling of transferred nuclei. In particular, we discuss the oocyte organelles that are essential for the development of SCNT embryos.


Effects of static magnetic field on the sulfate metabolic pathway involved in Magnetospirillum magneticum AMB-1 cell growth and magnetosome formation.
Magnetotactic bacteria (MTB) can use their unique intracellular magnetosome organelles to swim along the Earth's magnetic field. They play important roles in the biogeochemical cycles of iron and sulfur. Previous studies have shown that the applied magnetic fields could affect the magnetosome formation and antioxidant defense systems in MTB. However, the molecular mechanisms by which magnetic fields affect MTB cells remain unclear. We aim to better understand the interactions between magnetic fields and cells, and the mechanism of MTB adaptation to magnetic field at molecular levels. We performed microbiological, transcriptomic and genetic experiments to analyze the effects of a weak static magnetic field (SMF) exposure on the cell growth and magnetosome formation in MTB strain Magnetospirillum magneticum AMB-1. The results showed that a 1.5 mT SMF significantly promoted the cell growth but reduced magnetosome formation in AMB-1, compared to the geomagnetic field. Transcriptomic analysis revealed decreased expressions of genes primarily involved in the sulfate reduction pathway. Consistently, knockout mutant lacking adenylyl-sulfate kinase CysC did no more react to the SMF and the differences in growth and Cmag were disappeared. Together with experimental findings of increased reactive oxidative species in the SMF-treated Wild-type strain, we proposed that cysC, as a key gene, can participate in the cells growth and mineralization in AMB-1 by SMF regulation. This study suggests that the magnetic field exposure can trigger a bacterial oxidative stress response involved in AMB-1 growth and magnetosome mineralization by regulating sulfur metabolism pathway. CysC may serve as a pivotal enzyme in mediating sulfur metabolism to synchronize the impact of SMF on both growth and magnetization of AMB-1.


When unbearable suffering incites psychiatric patients to request euthanasia: qualitative study.
BackgroundThe concept of 'unbearable suffering' is central to legislation governing whether euthanasia requests may be granted, but remains insufficiently understood, especially in relation to psychiatric patients.AimsTo provide insights into the suffering experiences of psychiatric patients who have made a request for euthanasia.MethodTestimonials from 26 psychiatric patients who requested euthanasia were analysed using QualiCoder software.ResultsFive domains of suffering were identified: medical, intrapersonal, interpersonal, societal and existential. Hopelessness was confirmed to be an important contributor. The lengthy process of applying for euthanasia was a cause of suffering and added to experienced hopelessness, whereas encountering physicians who took requests seriously could offer new perspectives on treatment.ConclusionsThe development of measurement instruments to assess the nature and extent of suffering as experienced by psychiatric patients could help both patients and physicians to better navigate the complicated and sensitive process of evaluating requests in a humane and competent way. Some correlates of suffering (such as low income) indicate the need for a broad medical, societal and political debate on how to reduce the burden of financial and socioeconomic difficulties and inequalities in order to reduce patients' desire for euthanasia. Euthanasia should never be seen (or used) as a means of resolving societal failures.


Three point dynamic orthosis.
The present method of static three point bracing is unsatisfactory. The static type orthosis becomes ineffectual in reducing flexion deformities in upper and lower extremities and requires constant adjustment as the contractures are reduced. A three point dynamic orthosis using a flexible rod construction has been designed to contain and reduce flexion deformities. This orthosis has certain advantages over the static type and has been used successfully in children with contractures due to cerebral palsy and burns.


Epitaxial-like growth of anisotropic mesostructure on an anisotropic surface of an oblique nanocolumnar structure.
Tetrahedral amorphous carbon (ta-C) films with nanoscale structural anisotropy, which are obliquely deposited on a substrate by a filtered cathodic vacuum arc deposition (FAD) technique, allow anisotropic growth of mesostructured silica films thereon. The ta-C films have a uniformly tilted nanoscale columnar structure, which is caused by the self-shadowing effect during the oblique deposition, and consequently, the surface of the film can be morphologically anisotropic when the deposition angle is large enough. When silica films with a two-dimensional hexagonal mesostructure are grown under hydrothermal conditions on these ta-C films, the cylindrical mesochannels are aligned perpendicularly to the deposition direction of ta-C. The distribution of the in-plane alignment direction of the mesochannels can be controlled by the deposition angle of ta-C; it becomes narrower with the increase of the deposition angle and the consequent increase of the surface roughness. The observed alignment of the mesochannels is caused by the anisotropic accommodation of the surfactant molecules on the structurally anisotropic surface of the ta-C films, which is consistent with the fact that the ta-C films prepared at small deposition angles with smoother surface morphology have little alignment controllability. The ta-C film can be removed with the surfactant by calcination, allowing the formation of an aligned mesoporous silica film directly on a substrate. In contrast to this, obliquely evaporated SiO(2) films with a distinct tilted columnar structure and an anisotropic surface morphology provide neither continuous film formation nor controlled alignment of mesochannels even after providing hydrophobicity by a silylation process. This suggests the specificity, in particular, intrinsic strong hydrophobicity, of the ta-C films for the aligned mesostructured silica film formation.


Apodizing holographic gratings for dual-wavelength operation of broad-area semiconductor lasers.
Apodizing holographic gratings are designed to have a Gaussian reflectivity profile in the -1 order and a complementary reflectivity profile in the specular (0) order. They are obtained by the interference of two Gaussian beams on a glass plate covered with a photoresist. These gratings are intended to be used as the coupler of the external cavity of a broad-area semiconductor laser. When the grating is oriented to get the -1 order counterpropagating with respect to the incident beam, single-longitudinal- and single-lateral-mode operation is obtained. We report on the fabrication technique of an apodizing holographic grating designed to allow lasing on two wavelengths simultaneously, with a preselected wavelength separation. The results obtained with a commercial broad-area laser are presented.


Surgical approach and oncologic outcomes following multidisciplinary management of retrorectal sarcomas.
Retrorectal sarcomas are rare, and limited data are available on oncologic outcomes following surgery. Our aim was to evaluate outcomes in this patient population at our institution. All patients who underwent surgical resection of a malignant retrorectal/presacral sarcoma between 1985 and 2005 were identified. Data analyzed included demographics, histopathologic diagnosis, surgical morbidity and mortality, use of adjuvant therapy, local and distant recurrence, and survival. A total of 37 patients were identified (20 males) with a median age of 49 years (range, 22-81 years). The most common histopathologic diagnosis was malignant peripheral nerve sheath tumor (n = 8). Also, 22 tumors were high grade and 15 were low grade. Surgical margin status was R0 in 31 patients and R1 in 6. Adjuvant therapy was given to 26 patients. Postoperative morbidity and mortality was 57% and 3%, respectively. Median length of follow-up in 16 patients alive at last contact was 4.7 years. The 5-year survival free of local (LDFS), distant (DDFS), and local or distant recurrence (DFS) was 51, 58, and 39%, respectively. Patient survival at 2, 5, and 10 years was 75, 55, and 47%, respectively. Disease-free survival was not significantly associated with gender (P = .16), primary vs secondary (P = .94), R0 vs R1 resection (P = .26), low vs high tumor grade (P = .17), or the use of surgery with or without adjuvant therapy (P = .33). Retrorectal sarcomas are often high grade and locally advanced. Most tumors are resectable with free margins, and long-term survival may be possible in up to one-half of patients following an aggressive surgical approach.


What is known about the prevalence of household food insecurity in Canada during the COVID-19 pandemic: a systematic review.
Household food insecurity (HFI) is a persistent public health issue in Canada that may have disproportionately affected certain subgroups of the population during the COVID-19 pandemic. The purpose of this systematic review is to report on the prevalence of HFI in the Canadian general population and in subpopulations after the declaration of the COVID-19 pandemic in March 2020. Sixteen databases were searched from 1 March 2020 to 5 May 2021. Abstract and full-text screening was conducted by one reviewer and the inclusions verified by a second reviewer. Only studies that reported on the prevalence of HFI in Canadian households were included. Data extraction, risk of bias and certainty of the evidence assessments were conducted by two reviewers. Of 8986 studies identified in the search, four studies, three of which collected data in April and May 2020, were included. The evidence concerning the prevalence of HFI during the COVID-19 pandemic is very uncertain. The prevalence of HFI (marginal to severe) ranged from 14% to 17% in the general population. Working-age populations aged 18 to 44 years had higher HFI (range: 18%-23%) than adults aged 60+ years (5%-11%). Some of the highest HFI prevalence was observed among households with children (range: 19%-22%), those who had lost their jobs or stopped working due to COVID-19 (24%-39%) and those with job insecurity (26%). The evidence suggests that the COVID-19 pandemic may have slightly increased total household food insecurity in Canada during the COVID-19 pandemic, especially in populations that were already vulnerable to HFI. There is a need to continue to monitor HFI in Canada.


Presence of serum anti-p53 antibodies is associated with pleural effusion and poor prognosis in lung cancer patients.
This study was designed prospectively to evaluate the development of anti-p53 antibodies (Abs) in lung cancer patients in relation to their clinical outcome. Sera, derived from 125 lung cancer patients, consisting of 14 small cell lung cancers (SCLC) and 111 non-SCLCs (NSCLC), were surveyed. The p53-null human NSCLC cell line, NCI-H1299, transfected with a human mutant p53 gene was prepared as the source of p53 antigen for immunoblotting analyses to detect the presence of serum anti-p53 Abs. The control group included sera from 10 healthy adults and 14 patients with benign pulmonary diseases. Clinical data including staging and survival were recorded for statistical analyses. The anti-p53 Abs were found in 8% (10 of 125) of the lung cancer patients studied (8.1% of NSCLC versus 7.1% of SCLC patients), whereas none of the control sera had detectable anti-p53 Abs. The presence of anti-p53 Abs was closely associated with malignant pleural effusions (P = 0.001). The p53 Ab-positive patients had a worse prognosis than the p53 Ab-negative patients (P < 0.02; median survival, 20 versus 41 weeks). In both univariate and multivariate analyses, the tumor extension and probably the presence of anti-p53 Abs were significant predictors for cancer death. The development of anti-p53 Abs (n = 9) was also a predictor for poor survival in patients with malignant effusions (n = 51). In conclusion, the presence of serum anti-p53 Abs is closely associated with malignant pleural effusions in lung cancer patients. It may serve as a negative prognostic factor for survival independent of malignant pleural effusions and tumor staging.


Molecular characterization of full genome sequences of Newcastle disease viruses circulating among vaccinated chickens in Egypt during 2011-2013.
Although intensive vaccination programs have been implemented, Newcastle disease (ND) outbreaks, accompanied by severe economic losses, are still reported in Egypt. The genetic characterization of ND virus (NDV) strains isolated from ND-vaccinated chicken flocks provides essential information for improving ND control strategies. Therefore, here, 38 NDV strains were isolated and identified from outbreaks among vaccinated flocks of broiler chickens located in the provinces of Qena, Luxor, and Aswan of Upper Egypt during 2011-2013. The investigated broiler chicken flocks (aged 28 to 40 days) had high mortality rates of up to 80%. All NDV isolates were genetically analyzed using next-generation DNA sequencing. From these isolates, 10 representative NDV strains were selected for further genetic analyses. Phylogenetic analysis of full-length coding genes revealed that the Egyptian NDV isolates belonged to a single sub-genotype, VII.1.1. These isolates were phylogenetically distant from the vaccine strains, including La Sota or Clone 30 (genotype II), which have been commonly used to vaccinate chicken flocks. Amino acid substitution K78R was observed in the neutralizing epitopes of the F proteins; whereas several mutations were found in the neutralizing epitopes of the hemagglutinin-neuraminidase proteins, notably, E347K. Overall, our results suggested that the occurrence of neutralizing epitope variants may be one of potential reasons for ND outbreaks. Further studies are needed to determine the protective effect of current vaccines against circulating virulent NDV strains.


PI3K-Akt pathway suppresses coagulation and inflammation in endotoxemic mice.
In endotoxemia, lipopolysaccharide (LPS) induces a systemic inflammatory response and intravascular coagulation. Monocytes orchestrate the innate immune response to LPS by expressing a variety of pro-inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-alpha), and the procoagulant molecule, tissue factor (TF). In this study, we analyzed the role of the phosphoinositide 3-kinase (PI3K)-Akt pathway in the activation of coagulation and the innate immune response in a mouse model of endotoxemia. Wortmannin and LY294002 were used to inhibit the PI3K-Akt pathway. We found that wortmannin inhibited LPS-induced Akt phosphorylation in blood cells. Inhibition of the PI3K-Akt pathway significantly increased TF mRNA expression in blood cells, TF antigen, and thrombin-antithrombin III levels in the plasma, and fibrin deposition in the liver of endotoxemic mice. Inhibition of the PI3K-Akt pathway also strongly enhanced LPS-induced cytokine expression and the levels of soluble E-selectin in the plasma, suggesting enhanced activation of both monocytes and endothelial cells. Wortmannin treatment also increased the number of macrophages in the liver and kidney of endotoxemic mice. Finally, wortmannin and LY294002 dramatically reduced the survival time of endotoxemic mice. These data suggest that the PI3K-Akt pathway suppresses LPS-induced inflammation and coagulation in endotoxemic mice.


Phylogeny of Tetillidae (Porifera, Demospongiae, Spirophorida) based on three molecular markers.
Tetillidae are spherical to elliptical cosmopolitan demosponges. The family comprises eight genera: namely, Acanthotetilla Burton, 1959, Amphitethya Lendenfeld, 1907, CinachyraSollas, 1886, CinachyrellaWilson, 1925, Craniella Schmidt, 1870, Fangophilina Schmidt, 1880, Paratetilla Dendy, 1905, and Tetilla Schmidt, 1868. These genera are characterized by few conflicting morphological characters, resulting in an ambiguity of phylogenetic relationships. The phylogeny of tetillid genera was investigated using the cox1, 18S rRNA and 28S rRNA (C1-D2 domains) genes in 88 specimens (8 genera, 28 species). Five clades were identified: (i) Cinachyrella, Paratetilla and Amphitethya species, (ii) Cinachyrella levantinensis, (iii) Tetilla, (iv) Craniella, Cinachyra and Fangophilina and (v) Acanthotetilla. Consequently, the phylogenetic analysis supports the monophyly of Tetilla, a genus lacking any known morphological synapomorphy. Acanthotetilla is also recovered. In contrast, within the first clade, species of the genera Paratetilla and Amphitethya were nested within Cinachyrella. Similarly, within the fourth clade, species of the genera Cinachyra and Fangophilina were nested within Craniella. As previously postulated by taxonomists, the loss of ectodermal specialization (i.e., a cortex) has occurred several times independently. Nevertheless, the presence or absence of a cortex and its features carry a phylogenetic signal. Surprisingly, the common view that assumes close relationships among sponges with porocalices (i.e., surface depressions) is refuted.


Age dependent behaviour of red cell glycolytic enzymes in haematological disorders.
The age dependent behaviour of 11, mainly glycolytic, red blood cell enzymes in 26 patients with various haematological disorders has been investigated after separation of red blood cells by discontinuous density gradient centrifugation. The frequency of enzyme deficiencies in the old cells of these patients was significantly increased in comparison with the unseparated cells, 29 and 13 deficiencies, respectively. Particularly hexokinase activity, although normal or even increased in unseparated cells, was found deficient in old cells in seven cases. In addition, an increased number of phosphofructokinase deficiencies was observed in the patients' old cells (eight cases) as compared to the unseparated cells (three cases). However, the red blood cells of the majority of these patients were found to contain increased enzyme activities, irrespective of cell age. Enzyme activities in the youngest cell population did not correlate with the reticulocyte count. Cases of high pyruvate kinase and hexokinase activities were studied for kinetical, electrophoretical and immunological properties of the respective enzymes, but no abnormalities could be demonstrated, indicating an increased synthesis of these enzymes.


Orexin/hypocretin activates mTOR complex 1 (mTORC1) via an Erk/Akt-independent and calcium-stimulated lysosome v-ATPase pathway.
The lack of the neuropeptide orexin, also known as hypocretin, results in narcolepsy, a chronic sleep disorder characterized by frequent sleep/cataplexy attacks and rapid eye movement sleep abnormalities. However, the downstream pathways of orexin signaling are not clearly understood. Here, we show that orexin activates the mTOR pathway, a central regulator of cell growth and metabolism, in the mouse brain and multiple recombinant cell lines that express the G protein-coupled receptors (GPCRs), orexin 1 receptor (OX1R) or orexin 2 receptor (OX2R). This orexin/GPCR-stimulated mTOR activation is sensitive to rapamycin, an inhibitor of mTOR complex 1 (mTORC1) but is independent of two well known mTORC1 activators, Erk and Akt. Rather, our studies indicate that orexin activates mTORC1 via extracellular calcium influx and the lysosome pathway involving v-ATPase and Rag GTPases. Moreover, a cytoplasmic calcium transient is sufficient to mimic orexin/GPCR signaling to mTORC1 activation in a v-ATPase-dependent manner. Together, our studies suggest that the mTORC1 pathway functions downstream of orexin/GPCR signaling, which plays a crucial role in many physiological and metabolic processes.


Identification of B epitopes in human papillomavirus type 16 E7 open reading frame protein.
Human papillomavirus (HPV) type 16 is implicated in the aetiology of anogenital dysplasia which may progress to malignancy. HPV-16 DNA is actively transcribed in cervical carcinomas, the most abundant transcripts being from the E6 and E7 early open reading frames. The E7 protein has been shown to have transforming activity in vitro. In this report we define four immunodominant B epitopes within the protein corresponding to the E7 gene, using a panel of murine monoclonal antibodies. Three epitopes are linear and lie within the N-terminal region of the molecule, and are unique to the HPV-16 E7 protein. One epitope is non-linear and presumed to be conformational. At least three of the four epitopes of the E7 protein are detectable by immunoprecipitation from an HPV-16-infected cervical carcinoma cell line. The demonstrated immunogenicity of the E7 protein allows us to deduce that this molecule may be a potential candidate for incorporation in a vaccine against cervical cancer.


Continuous monitoring of mixed venous oxygen saturation during aortofemoral bypass grafting.
Measurement of mixed venous oxygen saturation (SvO2) may be helpful in the care of critically ill patients. Serial determinations of SvO2 give an index of the relationship between oxygen delivery and tissue oxygen consumption. Continuous monitoring of SvO2 is now readily available with the Shaw Oximetrix pulmonary artery catheter (Oximetrix Inc., Mountain View, CA). This system has provided useful information in the high risk cardiac surgery patient. Continuous monitoring of mixed venous saturation may be helpful in high risk or critically ill general and peripheral vascular surgery patients both in the intensive care unit and in the operating room. The following clinical report is presented to illustrate the usefulness of continuous SvO2 monitoring in a high risk vascular surgery patient.


Thermal and mass transfer properties of a shrinkable industrial sludge: experimental determination and modeling approach.
In this study the thermo-physical and mechanical properties of an industrial sludge like shrinkage coefficient, density, water activity, apparent moisture diffusivity, effective thermal conductivity and heat capacity are determined experimentally. These properties constitute a major part of the required input data to model the sludge drying. The sludge shrinks linearly until reaching a critical water content Xcr = 23% and then maintains a constant volume until the end of drying. Therefore, the density increases with decreasing the water content until the critical value (Xcr = 23%) then it decreases until the end of drying. The Henderson equation seems to be the most appropriate statistical model to describe the water sorption isotherm of the sludge. The apparent moisture diffusivity is determined from the numerical solution of Richard's law of diffusion with shrinkage. The results show that the effective thermal conductivity and the heat capacity decrease with the reduction of the water content from 2.60 W m-1 K-1 and 2.52 J g-1 K-1 for a wet sludge to 1.71 W m-1 K-1 and 0.78 J g-1 K-1 for a dry sludge respectively. The relationships between thermo-physical / mechanical properties and the water content / temperature of the sludge are established to be introduced in the created numerical drying model.


Behavioural avoidance and enhanced dispersal in neonicotinoid-resistant Myzus persicae (Sulzer).
The peach potato aphid Myzus persicae is a major agricultural pest capable of transmitting over 100 plant viruses to a wide range of crops. Control relies largely upon treatment with neonicotinoid insecticides such as thiamethoxam (TMX). In 2009, a strain denoted FRC, which exhibits between 255- and 1679-fold resistance to current neonicotinoids previously linked to metabolic and target site resistance, was discovered in France. Dispersal behaviour may potentially further enhance the resistance of this strain. This study investigated this possibility and is the first to compare the dispersal behaviour of aphid clones of the same species with differing levels of neonicotinoid resistance. Comparing the dispersal behaviour of the FRC strain with that of a clone of lower neonicotinoid resistance (5191A), and a susceptible clone (US1L) highlighted several differences. Most importantly, the FRC strain exhibited an increased ability to locate untreated areas when presented with an environment consisting of both TMX-treated and untreated plant tissue. The altered dispersal behaviour of the FRC may partially account for the high level of neonicotinoid resistance exhibited by this strain in the field. Since the dispersal of aphid vectors is key to the transmission of viruses across crop fields this has implications for current crop protection practice.


[Lipolysis in fatty tissue of patients with adrenohypercorticism].
Lipolytic activity was studied in subcutaneous and peripheric adipose tissue of patients with adrenohypercorticism (25 patients with Itsenko-Cushing disease and 4 patients with Cushing syndrome caused by corticosteroma of adrenal gland) and in 11 persons without this pathology. The lipolytic activity of the both adipose tissues in the patients with Itsenko-Cushing disease was similar to that of healthy persons and decreased in the patients with Cushing syndrome. The receptor-enzymatic system, responsible for lipolysis in adipose tissue, was not impaired in Itsenko-Cushing disease; differences found in lipolytic effects of corticotropin and somatotropin were caused by deteriorations in secretion of endogenous hormones in the disease. This system was inhibited in Cushing syndrome. Antilipolytic effect of insulin (especially in presence of glucose) was more distinct in subcutaneous adipose tissue of patients with Itsenko-Cushing disease as compared with controls.


Goodstart: a cluster randomised effectiveness trial of an integrated, community-based package for maternal and newborn care, with prevention of mother-to-child transmission of HIV in a South African township.
Progress towards MDG4 for child survival in South Africa requires effective prevention of mother-to-child transmission (PMTCT) of HIV including increasing exclusive breastfeeding, as well as a new focus on reducing neonatal deaths. This necessitates increased focus on the pregnancy and early post-natal periods, developing and scaling up appropriate models of community-based care, especially to reach the peri-urban poor. We used a randomised controlled trial with 30 clusters (15 in each arm) to evaluate an integrated, scalable package providing two pregnancy visits and five post-natal home visits delivered by community health workers in Umlazi, Durban, South Africa. Primary outcomes were exclusive and appropriate infant feeding at 12 weeks post-natally and HIV-free infant survival. At 12 weeks of infant age, the intervention was effective in almost doubling the rate of exclusive breastfeeding (risk ratio 1.92; 95% CI: 1.59-2.33) and increasing infant weight and length-for-age z-scores (weight difference 0.09; 95% CI: 0.00-0.18, length difference 0.11; 95% CI: 0.03-0.19). No difference was seen between study arms in HIV-free survival. Women in the intervention arm were also more likely to take their infant to the clinic within the first week of life (risk ratio 1.10; 95% CI: 1.04-1.18). The trial coincided with national scale up of ARVs for PMTCT, and this could have diluted the effect of the intervention on HIV-free survival. We have demonstrated that implementation of a pro-poor integrated PMTCT and maternal, neonatal and child health home visiting model is feasible and effective. This trial could inform national primary healthcare reengineering strategies in favour of home visits. The dose effect on exclusive breastfeeding is notable as improving exclusive breastfeeding has been resistant to change in other studies targeting urban poor families.


Measurement of optical intensity fluctuation over an 11.8 km turbulent path.
An 11.8km optical link is established to examine the intensity fluctuation of the laser beam transmission through atmosphere turbulence. Probability density function, fade statistic, and high-frequency spectrum are researched based on the analysis of the experimental data collected in each season of a year, including both weak and strong fluctuation cases. Finally, the daily variation curve of scintillation index is given, compared with the variation of refractive-index structure parameter C(n) (2), which is calculated from the experimental data of angle of arrival. This work provides the experimental results that are helpful to the atmospheric propagation research and the free-space optical communication system design.


Stage-specific application of allogeneic and autologous marrow transplantation in the management of acute myeloid leukemia.
Allogeneic (alloBMT) and autologous bone marrow transplantation (ABMT) have become standard approaches for the management of adults with acute myeloid leukemia (AML). The indications for transplantation remain controversial as parallel improvements in intensive chemotherapy have resulted in excellent outcomes for many patients. AlloBMT is the therapy of choice for patients who fail to respond to induction chemotherapy. For those patients in first remission (CRI), a policy of intensive postremission chemotherapy with transplantation upon relapse appears to be optimal. There are no data to support transplantation in CRI, allogeneic or autologous, for those patients with leukemia characterized by favorable cytogenetic abnormalities [ie, core-binding factor type or t(15;17)], as these patients do well with nonmyeloablative strategies. Patients with relapsed disease appear to be best served with allogeneic transplantation from a human leukocyte antigen (HLA)-matched sibling or one-antigen-mismatched family member, whereas for those patients lacking a related donor, unrelated donor alloBMT or ABMT provides similar long-term overall survival. Randomized studies for the optimal management of relapsed disease are lacking but are needed. The objective of this review is to discuss the data supporting the use of alloBMT or ABMT at various points during the course of de novo adult AML.


Blood pressure variability in children with primary vs secondary hypertension.
Increased blood pressure variability (BPV) is correlated with adverse cardiovascular (CV) events in adults. However, there has been limited research on its effect in the pediatric population. Additionally, BPV differences between primary and secondary hypertension (HTN) are not known. Children with primary and secondary HTN underwent 24-hour ambulatory blood pressure monitoring and echocardiography studies. BPV measures of standard deviation (SD), average real variability (ARV), and range were calculated for the 24-hour, daytime, and nighttime periods. Seventy-four patients (median age, 13.5 years; 74% boys) were examined, 40 of whom had primary HTN. Body mass index z score and age were independent predictors of systolic ARV (R(2) =0.14) and SD (R(2) =0.39). There were no statistically significant differences in overall or wake period BPV measures between secondary or primary HTN groups, but sleep period diastolic SD was significantly greater in the secondary HTN group (9.26±3.8 vs 7.1±2.8, P=.039). On multiple regression analysis, secondary HTN was associated with increased sleep period diastolic SD (P=.025). No metrics of BPV in the overall, wake, and sleep periods were found to be significantly associated with left ventricular hypertrophy (LVH). The results of this study do not show a strong relationship between overall or wake BPV with primary vs secondary HTN, but the association of secondary HTN with sleep period diastolic BPV deserves further exploration. Contrary to expectation, the findings of this study failed to indicate a relationship between BPV and LVH for all patients as well for primary hypertensive and secondary hypertensive patients.


Quantification of epicardial fat with cardiac CT angiography and association with cardiovascular risk factors in symptomatic patients: from the ALTER-BIO (Alternative Cardiovascular Bio-Imaging markers) registry.
We aimed to assess the association between features of epicardial adipose tissue and demographic, morphometric and clinical data, in a large population of symptomatic patients with clinical indication to cardiac computed tomography (CT) angiography. Epicardial fat volume (EFV) and adipose CT density of 1379 patients undergoing cardiac CT angiography (918 men, 66.6%; age range, 18-93 years; median age, 64 years) were semi-automatically quantified. Clinical variables were compared between diabetic and nondiabetic patients to assess potential differences in EFV and adipose CT density. Multiple regression models were calculated to find the clinical variables with a significant association with EFV and adipose CT density. The median EFV in diabetic patients (112.87 mL) was higher compared with nondiabetic patients (82.62 mL; P < 0.001). The explanatory model of the multivariable analysis showed the strongest associations between EFV and BMI (β=0.442) and age (β=0.365). Significant yet minor association was found with sex (β=0.203), arterial hypertension (β=0.072), active smoking (β=0.068), diabetes (β=0.068), hypercholesterolemia (β=0.046) and cardiac height (β=0.118). The mean density of epicardial adipose tissue was associated with BMI (β=0.384), age (β=0.105), smoking (β=0.088), and diabetes (β=0.085). In a large population of symptomatic patients, EFV is higher in diabetic patients compared with nondiabetic patients. Clinical variables are associated with quantitative features of epicardial fat.


Leishmania model for microbial virulence: the relevance of parasite multiplication and pathoantigenicity.
Leishmanial mechanisms of virulence have been proposed previously to involve two different groups of parasite molecules. One group consists of largely surface and secretory products, and the second group includes intracellular molecules, referred to as 'pathoantigens'. In the first group are invasive/evasive determinants, which protect not only parasites themselves, but also infected host cells from premature cytolysis. These determinants help intracellular amastigotes maintain continuous infection by growing at a slow rate in the parasitophorous vacuoles of host macrophages. This is illustrated in closed in vitro systems, e.g. Leishmania amazonensis in macrophage cell lines. Although individual macrophages may become heavily parasitized at times, massive destruction of macrophages has not been observed to result from uncontrolled parasite replication. This is thus unlikely to be the direct cause of virulence manifested as the clinical symptoms seen in human leishmaniasis. Of relevance is likely the second group of immunopathology-causing parasite 'pathoantigens'. These are highly conserved cytoplasmic proteins, which have been found to contain Leishmania-unique epitopes immunologically active in leishmaniasis. How these intracellular parasite antigens become exposed to the host immune system is accounted for by periodic cytolysis of the parasites during natural infection. This event is notable with a small number of parasites, even as they grow in an infected culture. The cytolysis of these parasites to release 'pathoantigens' may be inadvertent or medicated by specific mechanisms. Information on the pathoantigenic epitopes is limited. T-cell epitopes have long been recognized, albeit ill-defined, as important in eliciting CD4+ cell development along either the Th1 or Th2 pathway. Their operational mechanisms in suppressing or exacerbating cutaneous disease are still under intensive investigation. However, immune response to B-cell epitopes of such 'pathoantigens' is clearly futile and counterproductive. Their intracellular location within the parasites renders them inaccessible to the specific antibodies generated. One example is the Leishmania K39 epitope, against which antibodies are produced in exceedingly high titers, especially in Indian kala-azar. Here, we consider the hypothetical emergence of this pathoantigenicity and its potential contributions to the virulent phenotype in the form of immunopathology. Microbial virulence may be similarly explained in other emerging and re-emerging infectious diseases. Attenuation of microbial virulence may be achieved by genetic elimination of pathoantigenicity, thereby providing mutants potentially useful as avirulent live vaccines for immunoprophylasis of infectious diseases.


Effects of temporal variability on rare plant persistence in annual systems.
Traditional conservation biology regards environmental fluctuations as detrimental to persistence, reducing long-term average growth rates and increasing the probability of extinction. By contrast, coexistence models from community ecology suggest that for species with dormancy, environmental fluctuations may be essential for persistence in competitive communities. We used models based on California grasslands to examine the influence of interannual fluctuations in the environment on the persistence of rare forbs competing with exotic grasses. Despite grasses and forbs independently possessing high fecundity in the same types of years, interspecific differences in germination biology and dormancy caused the rare forb to benefit from variation in the environment. Owing to the buildup of grass competitors, consecutive favorable years proved highly detrimental to forb persistence. Consequently, negative temporal autocorrelation, a low probability of a favorable year, and high variation in year quality all benefited the forb. In addition, the litter produced by grasses in a previously favorable year benefited forb persistence by inhibiting its germination into highly competitive grass environments. We conclude that contrary to conventional predictions of conservation and population biology, yearly fluctuations in climate may be essential for the persistence of rare species in invaded habitats.


Short-term exposure to JP-8 jet fuel results in long-term immunotoxicity.
Chronic exposure to jet fuel has been shown to have adverse effects on human liver function, to cause emotional dysfunction, to cause abnormal electroencephalograms, to cause shortened attention spans, and to decrease sensorimotor speed. Due to the decision by the United States Air Force to implement the widespread use of JP-8 jet fuel in its operations, a thorough understanding of its potential effects upon exposed personnel is both critical and necessary. Exposure to potential environmental toxicants such as JP-8 may have significant effects on host systems beyond those readily visible (i.e., physiology, cardiology, respiratory, etc.); e.g., the immune system. Previous studies have shown that short-term, low concentration JP-8 exposure had significant effects on the immune system, which should have serious consequences for the exposed host in terms of susceptibility to infectious agents. If these alterations in immune function were long-lasting, it might also result in an increased likelihood of development and/or progression of cancer, as well as autoimmune disease. In the current study, mice were exposed for 1 h/day for 7 days to a moderate (1000 mg/m3) and a high (2500 mg/m3) concentration of aerosolized JP-8 jet fuel to stimulate occupational exposures. One to 28 days after the last exposure the mice were analyzed for effects of the exposure on their immune systems. It was observed that decrease in viable immune cell numbers and immune organ weights found at 24 h after exposure persisted for extended periods of time. Further, JP-8 exposure resulted in significantly decreased immune infection, as analyzed by mitogenesis assays, which persisted for up to 4 weeks post-exposure. Thus, short-term exposure of mice to JP-8 jet fuel caused significant toxicological effects on the immune system, which were long-lasting and persistent. It appears that the immune system may be the most sensitive indicator of toxicological damage due to JP-8 exposure. Such long-term changes in immune status may have significant effects on the health of the exposed individual.


[Peculiarities of operative treatment of complicated forms of abdominal hernias].
The experience of treatment of 150 patients, suffering complicated forms of postoperative abdominal hernias (PAH), was summarized, In majority of patients the large and giant hernias, on a background of associated diseases, were revealed. It was established that complicated forms of PAH are associated with local or systemic infection component, causing the necessity of complex prophylactic measures conduction. Autoplastic and prosthetic methods of operations were applied; the indications for implantation procedures were elaborated. The analysis of lethality and early postoperative complications rate was conducted. Late results were studied up to ten years after the operation. The hernia recurrence had occurred in 12 (7.8%) patients.


Single dose of fluoxetine increases muscle activation in chronic stroke patients.
This pilot study explores the influence of a single dose of fluoxetine (20 mg) on the muscle activation patterns and functional ability of the muscles in the lower part of the arm in chronic stroke patients. A crossover, placebo-controlled clinical trial was conducted in 10 patients. After administration of either a single dose of fluoxetine (20 mg) or a placebo, muscle activation of the lower arm was measured during maximum (isometric) force of the musculus flexor carpi radialis and musculus extensor carpi radialis. Delay times, grip strength, and Motricity Index were measured to assess functional ability. After fluoxetine intake, a significant increase in activation was found in both agonist and antagonist muscles of the paretic arm (P < 0.05). This increase did not influence the motor function. In this pilot study, it was found that fluoxetine influences motor output in chronic stroke patients. Therefore, fluoxetine may influence motor recovery after stroke. Additional studies have to be conducted to explore the effects of fluoxetine on motor recovery after stroke.


[Changes in neuromediator regulation of the small intestine in experimental alcoholic intoxication].
The effect of ethanol on the bioamin containing structures of the jejunum and ileum walls at different periods of chronic alcoholic intoxication was investigated. The quantitative description of the catecholamine and serotonin content in the enterocytes of epithelial lining villi, submucosa mast cells, crypt enterocytes and muscle membrane is given for the first time by means of luminescent microscopy and cyto spectrofluorimetry. It was established that in the initial period of chronic alcohol intoxication for 60 days in rats increased serotonin effect on intestinal functional structures was observed. On longer terms there is a disturbance of relationships of biogenic amines and the regulating role of catecholamines starts to prevail.


Can machine learning models predict maternal and newborn healthcare providers' perception of safety during the COVID-19 pandemic? A cross-sectional study of a global online survey.
Maternal and newborn healthcare providers are essential professional groups vulnerable to physical and psychological risks associated with the COVID-19 pandemic. This study uses machine learning algorithms to create a predictive tool for maternal and newborn healthcare providers' perception of being safe in the workplace globally during the pandemic. We used data collected between 24 March and 5 July 2020 through a global online survey of maternal and newborn healthcare providers. The questionnaire was available in 12 languages. To predict healthcare providers' perception of safety in the workplace, we used features collected in the questionnaire, in addition to publicly available national economic and COVID-19-related factors. We built, trained and tested five machine learning models: Support Vector Machine (SVM), Random Forest (RF), XGBoost, CatBoost and Artificial Neural Network (ANN) for classification and regression. We extracted from RF models the relative contribution of features in output prediction. Models included data from 941 maternal and newborn healthcare providers from 89 countries. ML models performed well in classification and regression tasks, whereby RF had 82% cross-validated accuracy for classification, and CatBoost with 0.46 cross-validated root mean square error for regression. In both classification and regression, the most important features contributing to output prediction were classified as three themes: (1) information accessibility, clarity and quality; (2) availability of support and means of protection; and (3) COVID-19 epidemiology. This study identified salient features contributing to maternal and newborn healthcare providers perception of safety in the workplace. The developed tool can be used by health systems globally to allow real-time learning from data collected during a health system shock. By responding in real-time to the needs of healthcare providers, health systems could prevent potential negative consequences on the quality of care offered to women and newborns.


Oxidative Stress in Cognitive and Epigenetic Aging: A Retrospective Glance.
Brain aging is the critical and common factor among several neurodegenerative disorders and dementia. Cellular, biochemical and molecular studies have shown intimate links between oxidative stress and cognitive dysfunction during aging and age-associated neuronal diseases. Brain aging is accompanied by oxidative damage of nuclear as well as mitochondrial DNA, and diminished repair. Recent studies have reported epigenetic alterations during aging of the brain which involves reactive oxygen species (ROS) that regulates various systems through distinct mechanisms. However, there are studies which depict differing roles of reactive oxidant species as a major factor during aging. In this review, we describe the evidence to show how oxidative stress is intricately linked to age-associated cognitive decline. The review will primarily focus on implications of age-associated oxidative damage on learning and memory, and the cellular events, with special emphasis on associated epigenetic machinery. A comprehensive understanding of these mechanisms may provide a perspective on the development of potential therapeutic targets within the oxidative system.


Evaluation of the effects of Er:YAG laser, Nd:YAG laser, and two different desensitizers on dentin permeability: in vitro study.
The purpose of this in vitro study was to evaluate and compare the efficacy of erbium-doped yttrium aluminum garnet (Er:YAG) laser, neodymium-doped yttrium aluminum garnet (Nd:YAG) laser, PrevDent nano-hydroxyapatite toothpaste plus Repairing Serum Kit (PNH), and NUPRO Sensodyne Prophylaxis Paste with NovaMin (NPP) on dentin permeability reduction. Forty dentin discs obtained from bovine incisors were divided into four study groups: Er:YAG laser-treated (2940 nm; 0.2 W, 80 mJ/pulse, 3 Hz); Nd:YAG laser-treated (1064 nm; 1 W, 10 Hz); PNH-treated; and NPP-treated groups. The quantitative changes in permeability of each dentin disc were measured using a computerized fluid filtration method (CFFM) before and after desensitizer treatments. The data were analyzed using the Wilcoxon, paired-samples t, Kruskal-Wallis, and Mann-Whitney U tests. The dentin surfaces and tubules were also morphologically detected by scanning electron microscopy (SEM). In all groups, dentin permeability was significantly reduced after the desensitizer and laser treatments (p < 0.05). Among the groups, we detected a significant difference in only when comparing the Er:YAG laser- and NPP-treated groups (p = 0.034). SEM analysis revealed physical changes in the dentin surface in all groups. This in vitro study shows that all tested desensitizers and laser treatments reduced dentin permeability. Also, surface changes, such as complete or partial occlusion or shrinkage of dentin tubules, were observed in all groups. Although the laser groups performed best, the PNH protocol can be considered as an alternative therapeutic product. In addition, clinical and laboratory studies should be performed for this product, and their efficacy should be assessed by combined therapy with lasers.


Disparate changes in kisspeptin and neurokinin B expression in the arcuate nucleus after sex steroid manipulation reveal differential regulation of the two KNDy peptides in rats.
Kisspeptin, neurokinin B (NKB) and dynorphin A are coexpressed in a population of neurons in the arcuate nucleus (ARC), termed KNDy neurons, which were recently recognized as important elements for the generation of GnRH pulses. However, the topographic distribution of these peptides and their regulated expression by sex steroids are still not well understood. In this study, detailed examination of NKB and kisspeptin immunoreactivity in the rat ARC was carried out, including comparison between sexes, with and without sex steroid replacement. Neurons expressing kisspeptin and NKB were more prominent in the caudal ARC of females, whereas neurons expressing NKB, but not kisspeptin, were the most abundant in the male. Sex steroid manipulation revealed differential regulation of kisspeptin and NKB; although kisspeptin immunoreactive (ir) cells increased in response to gonadectomy, NKB remained unchanged. Furthermore, the number of NKB-ir cells increased upon sex steroid replacement compared with gonadectomy, whereas kisspeptin did not, suggesting that sex steroids differently regulate these peptides. In addition, only in females did the density of kisspeptin- and NKB-ir fibers in the ARC increase upon sex steroid replacement in relation to sham and ovariectomy, respectively, suggesting sex-specific regulation of release. In conclusion, our observations reveal sex differences in the number of kisspeptin- and NKB-ir cells, which are more prominent in the caudal ARC. The divergent regulation of kisspeptin and NKB peptide contents in the ARC as a function of sex and steroid milieu enlarge our understanding on how these neuropeptides are posttranscriptionally regulated in KNDy neurons.


Nuclear pore protein NUP88 activates anaphase-promoting complex to promote aneuploidy.
The nuclear pore complex protein NUP88 is frequently elevated in aggressive human cancers and correlates with reduced patient survival; however, it is unclear whether and how NUP88 overexpression drives tumorigenesis. Here, we show that mice overexpressing NUP88 are cancer prone and form intestinal tumors. To determine whether overexpression of NUP88 drives tumorigenesis, we engineered transgenic mice with doxycycline-inducible expression of Nup88. Surprisingly, NUP88 overexpression did not alter global nuclear transport, but was a potent inducer of aneuploidy and chromosomal instability. We determined that NUP88 and the nuclear transport factors NUP98 and RAE1 comprise a regulatory network that inhibits premitotic activity of the anaphase-promoting complex/cyclosome (APC/C). When overexpressed, NUP88 sequesters NUP98-RAE1 away from APC/CCDH1, triggering proteolysis of polo-like kinase 1 (PLK1), a tumor suppressor and multitasking mitotic kinase. Premitotic destruction of PLK1 disrupts centrosome separation, causing mitotic spindle asymmetry, merotelic microtubule-kinetochore attachments, lagging chromosomes, and aneuploidy. These effects were replicated by PLK1 insufficiency, indicating that PLK1 is responsible for the mitotic defects associated with NUP88 overexpression. These findings demonstrate that the NUP88-NUP98-RAE1-APC/CCDH1 axis contributes to aneuploidy and suggest that it may be deregulated in the initiating stages of a broad spectrum of human cancers.


Patching, microvilli, and the agglutination of normal and transformed cells.
Transmission and scanning electron microscopy were used to study possible structural correlates in the process of agglutination of several types of normal and transformed cells by Concanavalin A. In parallel studies we found that post-confluence inhibition of cell division and agglutiniability of cells by Concanavalin A were not correlated with patching of surface bound lectin molecules as determined with a hemocyanin marker. Transformed cells growing in monolayer cultures were found to have many more microvilli than the corresponding normal cells. However, when cells were brought into suspension with EDTA, all cells developed numerous microvilli and we were not able to distinguish between agglutinable and nonagglutinable cells on the basis of morphological appearance. Cells agglutinated by Concanavalin A had numerous interdigitated microvilli at points of cell-cell contact. The appearance of spontaneously agglutinated cells and lectin agglutinated cells was very similar with respect to the involvement of microvilli in cell-cell attachments, and labeling studies with hemocyanin indicated that Concanavalin A bound to microvilli is rapidly cleared from these surface specializations in a manner analogous to that observed with patching of surface bound lectin. Several lines of SV-40 transformed fibroblasts were shown to be considerably more spontaneously agglutinable than untransformed cells. These results indicate that Concanavalin A may amplify an intrinsic membrane property common to many transformed cells that is expressed as an increase in the rate of adhesion of suspended cells. It is proposed that the membrane change detected by the agglutination reaction may also be involved in the loss of post-confluence inhibition of cell division and growth of transformed cells in semisolid media, due to a surface interaction that allows transformed cells to use each other as growth substrata.


Rain increases the energy cost of bat flight.
Similar to insects, birds and pterosaurs, bats have evolved powered flight. But in contrast to other flying taxa, only bats are furry. Here, we asked whether flight is impaired when bat pelage and wing membranes get wet. We studied the metabolism of short flights in Carollia sowelli, a bat that is exposed to heavy and frequent rainfall in neotropical rainforests. We expected bats to encounter higher thermoregulatory costs, or to suffer from lowered aerodynamic properties when pelage and wing membranes catch moisture. Therefore, we predicted that wet bats face higher flight costs than dry ones. We quantified the flight metabolism in three treatments: dry bats, wet bats and no rain, wet bats and rain. Dry bats showed metabolic rates predicted by allometry. However, flight metabolism increased twofold when bats were wet, or when they were additionally exposed to rain. We conclude that bats may not avoid rain only because of sensory constraints imposed by raindrops on echolocation, but also because of energetic constraints.


Brain Connectome Imaging Markers Research of Glucose Metabolism in the Early Stage of Alzheimer's Disease.
In recent years, increasing evidence had suggested that subjective cognitive decline (SCD) in unimpaired individuals may be the first symptom of Alzheimer's disease (AD). This study investigated the differences in the glucose metabolism network and the influence of the Apolipoprotein E (ApoE) gene between the SCD and normal control (NC) group by using graph theory. In this study, we included 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) scans from Xuanwu Hospital in Beijing, China. 85 SCD subjects and 74 NC subjects were included. First, we calculated and compared network parameters between the two groups. We then identified the bilateral insula and bilateral parahippocampal gyrus as seed sites and studied the connections to the whole brain. The results showed that both the SCD and the NC showed small-world nature, but the metabolic network of SCD tended to be more regular. The clustering coefficient and local efficiency of SCD were significantly higher than those of NC (P<0.05). In addition, we found that carrying APOE resulted in enhanced metabolic connectivity, but with weaker aggregation and local information exchangeability. Our results suggested that there are differences in the glucose metabolic brain network between SCD and NC, suggesting that the graph-theoretic analysis method may provide evidence for the early pathological mechanism of AD.Clinical relevance- This study suggests that the graph-theoretic analysis method may provide evidence for the early pathological mechanism of AD.


The therapeutic potential of a novel PSMA antibody and its IL-2 conjugate in prostate cancer.
Prostate-specific membrane antigen (PSMA) is an attractive target for treatment of prostate cancer. Using the PSMA-recognizing mouse monoclonal antibody 2C9 obtained in our previous study, the biological activities of PSMA antibody were evaluated. Mouse-human chimeric IgG1 of 2C9 (KM2777) showed antibody-dependent cellular cytotoxicity activity against PSMA-expressing prostate cancer cells in the presence of human peripheral blood mononuclear cells (PBMCs). To increase lymphocyte-mediated cytotoxicity of KM2777, C-terminus interleukin-2 (IL-2)-fused KM2777 (KM2812) was constructed. KM2812 retained binding activity to PSMA and exhibited growth-stimulating activity equivalent to IL-2 on the IL-2-dependent T-cell line CTLL-2. Moreover, KM2812 exhibited enhanced cytotoxic activity against PSMA-expressing prostate cancer cells in the presence of PBMCs compared with KM2777. In a xenograft tumor model using PSMA-expressing prostate cancer cells, KM2812 exhibited marked antitumor activity, accompanied by complete regression of tumor in some of the KM2812-treated mice. These results suggest that KM2812 has a therapeutic potential for prostate cancer by stimulating lymphocyte-mediated antitumor cytotoxicity.


Unilateral spinal anesthesia or combined sciatic-femoral nerve block for day-case knee arthroscopy. A prospective, randomized comparison.
To evaluate the time required to achieve surgical block and fulfill standardized discharge criteria in outpatients receiving knee arthroscopy with either unilateral spinal anesthesia or combined sciatic-femoral nerve block. After a standard midazolam/ketoprofen premedication and baseline measurement of cardiovascular parameters, 50 ASA physical status I-II patients scheduled for elective outpatient knee arthroscopy were randomized to receive unilateral spinal anesthesia with 8 mg of 0.5% hyperbaric bupivacaine injected without barbotage through a 25-gauge Whitacre spinal needle (group USA, n = 25), or combined sciatic-femoral nerve block with 25 ml of 2% mepivacaine (15 ml for femoral nerve block and 10 ml for sciatic nerve block) (group SFNB, n = 25). Times from local anesthetic injection to achievement of surgical block defined as the presence of adequate motor (complete motor blockade of the operated limb in the USA group and inability to move the ankle and the knee of the operated limb in the SFNB group) and sensory (loss of pinprick sensation at T12 on the operated side in the USA group, or in the femoral and sciatic nerves distribution in the SFNB group) blocks was recorded. Times to block resolution, urination, unassisted ambulation, and readiness to home discharge were also recorded by a blind observer, as well as occurrence of untoward events during surgery. Surgical block was achieved in 15 +/- 6 min in group USA and 16 +/- 6 min in group SFNB (p = NS). No differences in hemodynamic undesired effects and success rate were observed. Even though USA patients showed a faster time to ambulation (166 +/- 44 min versus 217 +/- 49 min, p = 0.002) and later urination (240 +/- 90 min versus 145 +/- 36 min, p = 0.0001) than SFNB group, no differences in home discharging were reported (246 +/- 98 min versus 211 +/- 77 min, respectively). Bladder catheterization was required in 2 patients of USA group only; however, no patient was admitted to the hospital because of urinary retention. In outpatient knee arthroscopy, a combined sciatic-femoral nerve block with 2% mepivacaine provides similarly successful anesthesia with onset times and home discharge similar to those provided by unilateral spinal anesthesia.


Preanalytical influence of pneumatic tube delivery system on results of routine biochemistry and haematology analysis.
Pneumatic tube delivery system (PTS) enables to reduce considerably turnaround times. The aim of the study was to assess the influence of the PTS on the quality of routine biochemical and hematological tests in our laboratory. Blood samples from 6 hospitalized patients and 8 healthy volunteers were analyzed. Blood samples were delivered to the laboratory by a PTS and by a human courier. We performed the following analysis: ionized calcium, sodium, potassium, lactate deshydrogenase (LDH), aspartate aminotransferase (ASAT), arterial blood gas, complete blood count and coagulation test as prothrombin time, activated partial thromboplastin time, factors V and VIII. Results were compared between the both method of transport according to the recommendation of the Société française de biologie clinique and the French committee for accreditation (SH-GTA01, norme NF ISO 5275-6). The hemolysis index of plasma was similar between the groups and no morphological differences were found on blood cells. For three samples, when delivered by PTS, LDH levels (two samples) and neutrophil polynuclear count (one sample) were above the recommended guidelines compared to those delivered by courier. Conversely, LDH levels and FVIII were below in two samples delivered by PTS. LDH levels, PNN count or factor VIII can be affected by PTS without the clinical interpretation being modified. We concluded that the PTS can be used to transport blood samples for routine biochemical and hematological analysis in our hospital.


Airsacculitis in the baboon.
A baboon (Papio anubis) that had been given opiate compounds through an indwelling catheter developed mucopurulent airsacculitis. After a prolonged course, the infection was eventually controlled by medical and surgical means. Air-sac involvement, though rarely reported in nonhuman primates, appeared frequently in the group of baboons to which this subject belonged--all of which were being treated experimentally with opiates. Proposed explanations for this unusual incidence included the propensity of opiates to induce a histamine response, almost continuous contamination of pathogenic bacteria in the indwelling catheters, and a suggested anatomic predisposition of the baboon larynx to drain secretions into the air sac.


[Screening of single doses of nitrates, calcium antagonists and beta-adrenoblockaders in patients with stenocardia of effort by using pharmacodynamic treadmill studies].
Standard single doses of nitrates, Ca-antagonists and beta-adrenoblockers were studied and compared in 37 patients presenting with stable angina pectoris of effort by repeated treadmill tests coupled with ECG monitoring. The use of isosorbide dinitrate (10 mg), nifedipin (20 mg) and propranolol (40 mg) enabled the effective drug to be screened in 86% of patients. Eleven per cent more of patients responded to the raising of the drug dosage. Isosorbide dinitrate was found to be the most effective in 27% of cases, nifedipin in 19%, and propranolol in 11%. The effect of 2 to 3 drugs was similar in 40% of patients. The data obtained during the screening of the most effective drug in 13 patients, performed by two different methods (treadmill pharmacodynamic and pair bicycle ergomentry tests showed a good agreement in the majority of cases).


Guanine is a growth factor for Legionella species.
Evaluation of previously described chemically defined media for the growth of Legionella pneumophila showed that these media supported poor growth of several strains of L. pneumophila and did not support growth of certain of the Legionella species described later. Growth was stimulated by the dialysate from yeast extract but not by the nondialyzable fraction. Further investigations indicated that the active factors from the yeast extract dialysate were purine or pyrimidine derivatives, and certain known purines and pyrimidines were found to stimulate growth. Of these, guanine universally stimulated growth of all Legionella strains and was a growth requirement for several of the species tested. A balanced, N-(2-acetamido)-2-aminoethanesulfonic acid-buffered, chemically defined medium having guanine or a purine-pyrimidine mix is presented for the general growth of Legionella species.


The effect of a single intravenous dose of metamizol 2 g, ketorolac 30 mg and propacetamol 1 g on haemodynamic parameters and postoperative pain after heart surgery.
Although nonopiate analgesics may be particularly useful in the immediate postoperative period after major surgery, their use has been associated with haemodynamic adverse effects during postoperative pain treatment and in critically ill patients in intensive care. The effect of a single intravenous dose of metamizol (dipyrone) 2 g, ketorolac 30 mg and propacetamol 1 g on haemodynamic variables and pain control in the immediate postoperative period after heart surgery is compared. Seventy-two patients undergoing elective coronary and/or heart valve surgery, were included in a cohort study of 1-years duration (1998). After weaning from mechanical ventilation and extubation, haemodynamic variables and a 4-point verbal rating pain scale were asseseed at base-line and 60 min after the administration of a single doses of metamizol, ketorolac or propacetamol. The Student's t-test for paired samples was used to compare changes produced by the study medications. A significant, but small, decrease in radial artery blood pressure was observed in all treatment groups which had little clinical relevance; no vasodilator effects were observed and ventricular function showed only minor changes: propacetamol decreased cardiac index by 10% and a 15% decrease in right ventricular work was also observed. Metamizol and ketorolac produced a 10% decrease in the left ventricular work index. Pain scores showed a statistically significant decrease in all treatment groups. The analgesic effects of metamizol, ketorolac and propacetamol were not associated with a clinically significant impairment in haemodynamic function when administered to haemodynamically stable patients.


Complicated sea urchin-induced wound infection caused by Vibrioalginolyticus and Staphylococcus lugdunensis in a 14-year-old boy.
Wound infections with Vibrio alginolyticus, a Gram-negative bacterium found in all temperate oceans, are rarely reported. However, a rising incidence of wound infections caused by V. alginolyticus requires better knowledge about this infectious agent. We report the case of a 14-year-old boy suffering from a wound infection caused by V. alginolyticus and Staphylococcus lugdunensis after stepping on a sea urchin. Despite wound debridement and antibiotic therapy with cefaclor, the lesion did not heal over several weeks. After identification of the pathogens and antibiotic-susceptibility testing, antibiotic therapy was switched to ciprofloxacin, followed by trimethoprim/sulfamethoxazole. Two months after the accident the wound was re-epithelialized. Follow up after 6 months revealed a painful scar. Non-cholera vibrios like V. alginolyticus should be considered as possible causative agents in seawater-contaminated wounds. S. lugdunensis is a relevant pathogen in mixed wound infections. Early microbiological diagnosis and antibiotic-susceptibility testing is crucial to prevent therapeutic failure.