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[The effects of protein-energy deficiency in candidates for gastric resection]. The nutritional status of patients subjects to surgical operations represent an important element in determining the incidence of morbidity and mortality. We have examined 19 patients suffering both from benign and from malignant pathology subjected to a gastric resection and treated in the preoperative period for 7-8 days and in the postoperative period for 8-10 days with parenteral nutrition. Nutritional valuation was carried on at the time of admission, in the postoperative period and in proximity to discharge; an accurate observation of possible associated was also carried on. The comparison with the not treated with a nutritional support has shown a smaller incidence in complications of a general character and also in those connected with the operation and a reduction in the postoperative stay in hospital.

Widespread Occurrence of Wheat spindle streak mosaic virus in Belgium. In order to assess the occurrence of Wheat spindle streak mosaic virus (WSSMV) in Belgium, a reverse-transcription polymerase chain reaction (RT-PCR) was developed, targeting WSSMV isolates from Canada, France, Germany, Italy, and the United States. The primers also were designed for virus quantification by real-time RT-PCR with SYBR-Green. No cross-reaction with soilborne cereal viruses such as Barley mild mosaic virus, Barley yellow mosaic virus, Soilborne cereal mosaic virus, and Soil-borne wheat mosaic virus was observed. The RT-PCR and real-time quantitative RT-PCR allowed a more sensitive detection of WSSMV than enzymelinked immunosorbent assay. The incidence of WSSMV in Belgium was evaluated using a bioassay with wheat cvs. Cezanne and Savannah and rye cv. Halo, grown in 104 Belgian soils. The presence of WSSMV was detected from plants grown in 32% of the soils. The RT-PCR methods developed here, combined with large sampling, allowed WSSMV to be detected for the first time in Belgium. The real-time quantitative RT-PCR was developed as a tool for evaluating the resistance to WSSMV by quantifying the virus concentration in wheat cultivars.

Improving intracellular doxorubicin delivery through nanoliposomes equipped with selective tumor cell membrane permeabilizing short-chain sphingolipids. To improve nanoliposomal-doxorubicin (DoxNL) delivery in tumor cells using liposome membrane-incorporated short-chain sphingolipids (SCS) with selective membrane-permeabilizing properties. DoxNL bilayers contained synthetic short-chain derivatives of known membrane microdomain-forming sphingolipids; C₈-glucosylceramide (C₈-GluCer), C₈-galactosylceramide (C₈-GalCer) or C₈-lactosylceramide (C₈-LacCer). DoxNL enriched with C₈-GluCer or C₈-GalCer were developed, optimized and characterized with regard to size, stability and drug retention. In vitro cytotoxic activity was studied in a panel of human tumor cell lines and normal cells. Intracellular Dox delivery was measured by flow cytometry and visualized by fluorescence microscopy. For a further understanding of the involved drug delivery mechanism confocal microscopy studies addressed the cellular fate of the nanoliposomes, the SCS and Dox in living cells. C₈-LacCer-DoxNL aggregated upon Dox loading. In tumor cell lines SCS-DoxNL with C₈-GluCer or C₈-GalCer demonstrated strongly increased Dox delivery and cytotoxicity compared to standard DoxNL. Surprisingly, this effect was much less pronounced in normal cells. Nanoliposomes were not internalized, SCS however transfered from the nanoliposomal bilayer to the cell membrane and preceded cellular uptake and subsequent nuclear localization of Dox. C₈-GluCer or C₈-GalCer incorporated in DoxNL selectively improved intracellular drug delivery upon transfer to tumor cell membranes by local enhancement of cell membrane permeability.

[Concentration and change of VOCs in summer and autumn in Tangshan]. In order to study the potential impact of volatile organic compounds (VOCs) in summer and autumn on region ozone, ambient concentrations and changes of VOCs were analyzed at Tangshan from June to September 2007 and 2008, by using the method of two-step-concentration-gas spectrometry/mass (CCD-GC/MS). The average concentration in Tangshan was 163.5 x 10(-9) C. The major components were alkanes, aromatics, alkenes and halogen hydrocarbons which accounted for 45.9%, 29.9%, 5.9% and 18.9% respectively. The average concentration decreased 51.9% compare with 2007 (340.4 x 10(-9) C), confine gas stations is the main reason of the decline of alkyl, the large decline is aromatic hydrocarbons, 67%, which has the most potential impact of ozone formation, and dichlorobenzene in industrial emissions has increased. The concentrations of VOCs in Tangshan were lower 8% than that of Beijing during the same period in 2008. The changes of VOCs during 2008 Beijing Olympic show that in addition to traffic source industrial emissions is also an important source of atmospheric pollution.

Differentiating and defusing theoretical Ecology's criticisms: A rejoinder to Sagoff's reply to Donhauser (2016). In a (2016) paper in this journal, I defuse allegations that theoretical ecological research is problematic because it relies on teleological metaphysical assumptions. Mark Sagoff offers a formal reply. In it, he concedes that I succeeded in establishing that ecologists abandoned robust teleological views long ago and that they use teleological characterizations as metaphors that aid in developing mechanistic explanations of ecological phenomena. Yet, he contends that I did not give enduring criticisms of theoretical ecology a fair shake in my paper. He says this is because enduring criticisms center on concerns about the nature of ecological networks and forces, the instrumentality of ecological laws and theoretical models, and the relation between theoretical and empirical methods in ecology that that paper does not broach. Below I set apart the distinct criticisms Sagoff presents in his commentary and respond to each in turn.

Prenatal dietary supplementation of African women and birth-weight. Gambian women, who show marked seasonal fluctuations in energy balance, were offered a dietary supplement during pregnancy. This resulted in a net energy increment of 431 kcal/day. In the wet season, when the women were normally in marked negative energy balance due to food shortages and a high agricultural work load, the supplementation improved birth-weight by a mean of 224 g and reduced the incidence of low-birth-weight babies (less than 2.5 kg) from 28.2% to 4.7%. In the dry season, when the women were previously in positive energy balance despite an energy intake of only 60% of the recommended dietary allowance, the supplement had no beneficial effect on birth outcome. This threshold effect indicates the need to identify truly at-risk groups for prenatal supplementation programmes in developing countries.

Sympathetic denervation in association with coronary artery grafting in patients with Prinzmetals' angina. Myocardial revascularization in patients with Prinzmetal's angina has yielded variable results. Two patients are presented who underwent partial cardiac sympathectomy in combination with coronary artery grafting for typical variant angina associated with severe organic obstructive coronary artery disease. Late results 12 and 18 months postoperatively have been excellent in both instances as shown by clinical and angiographic evaluation. Although the exact mechanism responsible for Prinzmetal's angina is not known, it is believed that spasm through increased activity of vasomotor tone or of the autonomic nervous system plays a major role. Since this variant form of angina encompasses a whole spectrum at angiography, ranging from normal arteries to severely narrowed ones, including those with spasm, it is suggested that surgical treatment be planned accordingly. Thus, in patients who have organic stenoses with and without spasm, operative treatment may consist of removal of the preaortic or pretracheal plexus in association with conventional coronary artery grafting. In patients who have intractable episodes of ventricular arrhythmia or angina and who angiogram is normal or shows isolated spasm, coronary artery grafting should be abandoned, in view of the poor results reported in the literature in these circumstances, and cervicothoracic sympathectomy should be considered.

Characteristics of Staphylococcus aureus isolated from lesions of horses. Seventy-six Staphylococcus aureus strains isolated from various lesions of horses were characterized. All of the 76 strains were identified as biotypes B (38.2%) and C (61.8%). Of 55 strains tested, 42 (76.4%) were differentiated into 7 coagulase types. Coagulase types V and VII were predominant in the metritis strains. Coagulase type II was found most frequently in the strains from phlegmon, dermatitis, sinusitis, empyema sinus, and nasal catarrh. Forty-two (55.3%) of the 76 strains were differentiated into 24 phage patterns. Twenty (58.8%) of 34 typable strains from metritis were lysed by the human group I phage 52, and group II phages 3A, 3C, 55 and 71. Forty-five (59.2%) of the 76 strains were resistant to 1 or more of 6 antibiotics. Strains resistant to penicillin G, irrespective of source, were most frequent (95.6%). Forty (93.0%) of 43 strains resistant to penicillin G alone or in combination with other antibiotics produced beta-lactamase. Only 8 (10.5%) of the 76 strains produced enterotoxins A (n = 2), B (n = 1) or C (n = 5), and they all were isolated from metritis. Only 1 strain isolated from phlegmon and 2 from metritis produced exfoliative toxin (ET) and toxic shock syndrome toxin-1 (TSST-1), respectively. The latter 2 strains also produced enterotoxin C. The results of the present study showed the first evidence of the presence of both ET- and TSST-1-producing S. aureus isolated from horses.

Morphometric and three-dimensional study of platelets during activation in the rat. In vivo activation of platelets, produced by damaging an artery in the rat with ultrasound, was studied with the electron microscope. We performed both a three-dimensional reconstruction by thin serial sections and a morphometric study of the activation process. This is characterized by exocytosis of the content of granules, widening of tubules of the open canalicular system, and emission of pseudopodia. The three-dimensional reconstruction suggested that some extended pseudopodia adhere to the arterial intima, and confirmed former observations that a locomotor apparatus differentiates in platelets adhering to the arterial intima. We speculate that the contraction of some pseudopodia may pull the platelet body toward the arterial wall. The morphometric study revealed that during activation the volume of the open canalicular system volume increases and that of the dense granules decreases; all other compartments did not change.

Diet: A Source of Endocrine Disruptors. Food is indispensable for human life and determines the health and wellbeing of the consumer. While food is the source of energy for humans, it is also emerging as one of the most important sources of exposure to deleterious chemicals both natural and synthetic. The food exposed chemicals cause a number of detrimental health effects in humans with endocrine disruption being of serious concern amongst these. Such chemicals disrupting the endocrine health are known as endocrine disrupting chemicals (EDCs). The food exposed EDCs need to be identified and classified to effectuate a cautious consumption of food by all and especially by vulnerable groups. The aim of the present review is to discuss food as a source of exposure to common endocrine disruptors in humans. This review presents the occurrence and levels of some of the critical endocrine disruptors exposed through frequently consumed diets. The major source of data was PubMed besides other relevant publications. Focus was laid on data from last five years, however significant earlier data was also considered. The food as a source of endocrine disruptors to humans cannot be neglected. It is highly imperative for the consumer to recognize food as a source of EDCs and make informed choices in consumption of food items.

Quantitative detection of Chlamydia spp. by fluorescent PCR in the LightCycler. Quantitative detection of intracellular bacteria of the genus Chlamydia by the standard cell culture method is cumbersome and operator dependent. As an alternative, we adapted hot-start PCR to the glass capillary quantitative PCR format of the LightCycler. The optimized PCR was consistently more efficient than commercially available pre-assembled PCRs. Detection by quantitative PCR of as few as single copies of DNA of Chlamydia spp. was accomplished by SYBR Green fluorescence of the dsDNA product and by fluorescence resonance energy transfer (FRET) hybridization probes. The PCRs were 15-fold more sensitive than the cell culture quantitative assay of C. psittaci B577 infectious stock. The number of chlamydial genomes detected by C. psittaci B577 FRET PCR correlated well with cell culture determination of inclusion forming units (IFUs) (r = 0.96, P < 0.0008). When infected tissue samples were analyzed by cell culture and PCR, the correlation coefficient between IFUs and chlamydial genomes was higher with C. psittaci B577 FRET PCR (r = 0.90, P < 0.0004) than with Chlamydia omp1 SYBR Green PCR (r = 0.85, P < 0.002).

Pityriasis amiantacea, an unrecognized cause of scarring alopecia, described in four patients. Pityriasis amiantacea is not generally recognized as a cause of scarring alopecia. We describe 4 patients with scarring alopecia in the distribution of past or active pityriasis amiantacea and suggest that it is a not uncommon sequela.

Incidence and impact of implant subsidence after stand-alone lateral lumbar interbody fusion. Few data are available on the occurrence after stand-alone lateral lumbar interbody fusion (LLIF) of implant subsidence, whose definition and incidence vary across studies. The primary objective of this work was to determine the incidence of subsidence 1 year postoperatively, using an original measurement method, whose validity was first assessed. The secondary objective was to assess the clinical impact of subsidence. Implant subsidence after stand-alone LLIF is a common complication that can adversely affect clinical outcomes. Of 69 included patients who underwent stand-alone LLIF, 67 (97%) were re-evaluated at least 1 year later. Furthermore, 63 (91%) patients had two available computed tomography (CT) scans for assessing subsidence, one performed immediately after surgery and the other 1 year later. Reproducibility of the original measurement method was assessed in a preliminary study. Subsidence was defined as at least 4mm loss of fused space height. The incidence of subsidence was 32% (20 patients). Subsidence was global in 7 (11%) patients and partial in 13 (21%) patients. Mean loss of height was 5.5±1.5mm. Subsidence predominated anteriorly in 50% of cases. The lordotic curvature of the fused segment was altered in 50% of patients, by a mean of 8°±3°. Fusion was achieved in 67/69 (97%) patients. The Oswestry score and visual analogue scale scores for low-back and nerve-root pain were significantly improved after 1 year in the overall population and in the groups with and without subsidence. Reproducibility of our measurement method was found to be excellent. Subsidence was common but without significant clinical effects after 1 year. Nevertheless, subsidence can be associated with pain and can result in loss of lumbar lordosis, which is a potential risk factor for degenerative disease of the adjacent segments. A score for predicting the risk of subsidence will now be developed by our group as a tool for improving patient selection to stand-alone LLIF. IV, retrospective cohort study.

Early cranial patterning in the direct-developing frog Eleutherodactylus coqui revealed through gene expression. Genetic and developmental alterations associated with the evolution of amphibian direct development remain largely unexplored. Specifically, little is known of the underlying expression of skeletal regulatory genes, which may reveal early modifications to cranial ontogeny in direct-developing species. We describe expression patterns of three key skeletal regulators (runx2, sox9, and bmp4) along with the cartilage-dominant collagen 2alpha1 gene (col2a1) during cranial development in the direct-developing anuran, Eleutherodactylus coqui. Expression patterns of these regulators reveal transient skeletogenic anlagen that correspond to larval cartilages, but which never fully form in E. coqui. Suprarostral anlagen in the frontonasal processes are detected through runx2, sox9, and bmp4 expression. Previous studies have described these cartilages as missing from Eleutherodactylus cranial ontogeny. These transcriptionally active suprarostral anlagen fuse to the more posterior cranial trabeculae before they are detectable with col2a1 staining or with the staining techniques used in earlier studies. Additionally, expression of sox9 fails to reveal an early anterior connection between the palatoquadrate and the neurocranium, which is detectable through sox9 staining in Xenopus laevis embryos (a metamorphosing species). Absence of this connection validates an instance of developmental repatterning, where the larval quadratocranial commissure cartilage is lost in E. coqui. Expression of runx2 reveals dermal-bone precursors several developmental stages before their detection with alizarin red. This early expression of runx2 correlates with the accelerated embryonic onset of bone formation characteristic of E. coqui and other direct-developing anurans, but which differs from the postembryonic bone formation of most metamorphosing species. Together these results provide an earlier depiction of cranial patterning in E. coqui by using earlier markers of skeletogenic cell differentiation. These data both validate and modify previously reported instances of larval recapitulation and developmental repatterning associated with the evolution of anuran direct development.

Adoption of video laryngoscopy in Massachusetts emergency departments. Previous research suggests that video laryngoscopy may be superior to direct laryngoscopy. We sought to determine the proportion of Massachusetts emergency departments (EDs) that have adopted video laryngoscopy, the characteristics of user and non-user EDs, the reasons why non-users do not use video laryngoscopy, and how the adoption of video laryngoscopy compares to typical technology adoption life cycles. Surveys were mailed to directors of all non-federal EDs in Massachusetts (n=74) in early 2009. Non-responders received repeat mailings and were then contacted via telephone or e-mail. Sixty-three of 74 (85%) EDs responded and 43% had adopted video laryngoscopy. EDs with video laryngoscopy had a higher median annual visit volume than EDs without video laryngoscopy (48,000 vs. 36,500, p=0.04), but had similar mean intubations per week (4.5 vs. 4.4, p=0.97) and mean surgical airways per year (0.7 vs. 1.1, p=0.19). Half of the EDs affiliated with emergency medicine residency programs had video laryngoscopy available. Among EDs with video laryngoscopy, the technology had been available for>5 years in 4% (1/27), 1-5 years in 44% (12/27), and<1 year in 52% (14/27). Although EDs not using video laryngoscopy did not do so primarily because it was too expensive (69% [25/36]), video laryngoscopy adoption has still progressed more rapidly than predicted by the typical technology adoption timeline. Video laryngoscopy has been adopted by 43% of Massachusetts EDs; results were similar in academic institutions. Cost is the primary barrier to adoption for non-user EDs, but adoption is progressing more rapidly than expected for a new technology.

From Denmark to Deep River: integrating care in small and rural communities in Ontario. Integrating community-based health and social care for older persons is said to help individuals maintain high levels of independence, well-being and quality of life and contribute to health systems sustainability by moderating the demand for costly emergency services and inappropriate hospital care. Rural settings, however, pose challenges distinct from those in urban areas. Using North Renfrew Long-Term Care Services as a case study, this paper discusses the principles and practices of a small, rural community service agency located in Renfrew County, Ontario, that provides to its scattered populations a range of services across the care continuum. Services include community support programs, supportive housing and long-term care beds as well as an innovative 24-Hour Flexible In-Home Support Pilot program adapted from the ground breaking "night patrol" system in Denmark.

The role of CBT in explicit memory bias in bipolar I patients. Cognitive and Behavioural Therapy (CBT) is widely used in bipolar disorder, but recent meta-analyses showed that its impact is either of limited effect or not significant for important aspects such as recurrence rate. A possible benefit of CBT could concern cognitive functions, known to be frequently impaired in patients with bipolar disorder. We analysed if the positive impact of 6 months group-CBT was associated with the improvement of a specific cognitive function, namely explicit memory, trying to disentangle if memory bias (i.e. different capacity according to the emotional valence of words to be recalled) was more improved than memory performance (i.e., total number of recalled words). Depressive, manic, anxiety symptoms and explicit memory for emotional words were initially assessed in 68 remitted bipolar I patients. Six months later, with an attrition rate of 16.2%, patients were re-assessed after CBT (N = 42) or as control condition (waiting list, N = 15). The expected impact of CBT was assessed through the improvement in the Dysfunctional Attitudes Scale. After CBT, an increase was observed for the number of neutral, positive and total words recalled, whereas the number of negative words recalled decreased. This increase was still significant when the improvement of dysfunctional attitudes and mood symptoms are taken into account. The small sample of control patients. CBT was effective, as it improved dysfunctional attitudes and reduced remaining symptoms, but also, and independently, it improved explicit memory performance while reducing memory bias in favour of negative words.

Fingering patterns in the lifting flow of a confined miscible ferrofluid. Miscible flow displacements of a ferrofluid droplet subjected to various magnetic field configurations and confined in a time-dependent gap Hele-Shaw cell are examined through highly accurate numerical simulations. The interplay between lifting, miscibility, and applied magnetic fields resulted in complex interfacial pattern formation. By varying the symmetry properties of the applied magnetic fields and by considering the action of Korteweg stresses, a number of interesting droplet morphologies are identified and characterized. The possibility of controlling the degree of fluid mixing and the ultimate shape of the emerging patterns by appropriately adjusting the strength of the applied magnetic fields is also discussed.

The clinical application of the arcuate fasciculus for stroke patients with aphasia: a diffusion tensor tractography study. Little is known about the clinical usefulness of diffusion tensor tractography (DTT) for the arcuate fasciculus (AF) in stroke patients with aphasia. Using DTT, we attempted to investigate the clinical usefulness of the AF in patients with aphasia. Five stroke patients and 7 age- and sex-matched normal subjects were recruited for this study. We recruited stroke patients with language dysfunction who had lesions in the left corona radiata and basal ganglia level. DTT for the AF was reconstructed using DTI-studio software. Korean-Western Aphasia Battery (K-WAB) was used for measurement of language function. Patient 1, who showed mild dysarthria, revealed a normal left AF in terms of integrity and DTT parameters. In patient 2, with conduction aphasia, the left AF showed partial injury; however, the integrity of the left AF was spared. Patients 3 and 4, who had no brain lesions at Broca's area on conventional brain MRI, showed disruptions of the left AF over the stroke lesions after originating from Wernicke's area and they presented with Broca's aphasia. Patient 5 revealed global aphasia on K-WAB and the left AF was not reconstructed due to severe injury and Wallerian degeneration. We found that DTT for the AF could provide useful information on the presence or severity of injury of the AF, which could not be detected on conventional brain MRI in stoke patients. In addition, it could be helpful in classification of the aphasia type of stroke patients.

Genotype-phenotype relationship for five CFTR mutations frequently identified in western France. Cystic fibrosis (CF) is the most common inherited disorder in Caucasian populations, with more than 1000 cystic fibrosis transmembrane conductance regulator (CFTR) mutations presently described. The distribution of the mutations ranges widely between countries and/or ethnic groups. Multicentric studies are usually needed to study the genotype-phenotype correlations. Since 1992, the French CF Registry (FCFR) has collected and analyzed data from most of the CF patients regularly seen in CF care centres in France. We compared the mutation distribution of the patients born in western France to that of those born elsewhere in France. Then we extracted the available data for all the compound heterozygotes carrying the DeltaF508 allele and one of the following mutations: DeltaI507, 1078delT, 4005+1G->A, E60X and W846X, and matched a patient homozygous for the DeltaF508 mutation for each of them. Western France appeared to have a specific distribution of some CF mutations. Furthermore, disparities were found regarding the mutation repartition (DeltaI507 in Normandy, 1078delT, 4005+1G->A and W846X in western Brittany). Genotype-phenotype correlations showed a wide heterogeneity. Although variations were found, DeltaI507/DeltaF508, 4005+1G->A/DeltaF508 and 1078delT/DeltaF508 patients appeared to have a similar disease as the DeltaF508/DeltaF508 patients. Although the W846X and E60X mutations should be considered as severe alleles as regards to pancreatic function, they were associated with less severe pulmonary manifestations and, probably, better prognosis. The knowledge of the distribution of uncommon CF mutations specific to particular areas and of their associated phenotype makes up an essential tool in the management of local CF patients.

Expression, purification, crystallization, and NMR studies of the helicase interaction domain of Escherichia coli DnaG primase. In Escherichia coli, the DnaG primase is the RNA polymerase that synthesizes RNA primers at replication forks. It is composed of three domains, a small N-terminal zinc-binding domain, a larger central domain responsible for RNA synthesis, and a C-terminal domain comprising residues 434-581 [DnaG(434-581)] that interact with the hexameric DnaB helicase. Presumably because of this interaction, it had not been possible previously to express the C-terminal domain in a stably transformed E. coli strain. This problem was overcome by expression of DnaG(434-581) under control of tandem bacteriophage lambda-promoters, and the protein was purified in yields of 4-6 mg/L of culture and studied by NMR. A TOCSY spectrum of a 2mM solution of the protein at pH 7.0, indicated that its structured core comprises residues 444-579. This was consistent with sequence conservation among most-closely related primases. Linewidths in a NOESY spectrum of a 0.5mM sample in 10mM phosphate, pH 6.05, 0.1M NaCl, recorded at 36 degrees C, indicated the protein to be monomeric. Crystals of selenomethionine-substituted DnaG(434-581) obtained by the hanging-drop vapor-diffusion method were body-centered tetragonal, space group I4(1)22, with unit cell parameters a=b=142.2A, c=192.1A, and diffracted beyond 2.7A resolution with synchrotron radiation.

Will cytokines alter the treatment of myelodysplastic syndrome? Myelodysplastic syndrome is a frustrating disorder, which until recently lacked effective treatment. Patients usually succumb to infection, bleeding complications, or progression to acute leukemia. Recombinant cytokines such as granulocyte macrophage-colony stimulating factor, granulocyte-colony stimulating factor, interleukin-3, and erythropoietin have been used to ameliorate the cytopenias associated with this disease. Small clinical trials in myelodysplastic syndrome patients, using cytokines with myeloid activity (G-CSF, GMCSF, IL-3), have shown consistent elevations in the white blood cell counts with little success in elevating hemoglobin or platelets. Erythropoietin is able to increase the hemoglobin in a small group of myelodysplastic syndrome patients. Future trials using combinations of these cytokines may lead to multilineage effects.

Tissue specific distribution, clearance and vascular effects of endothelin in the pig. Endothelin-like immunoreactivity (-LI) was detected in the kidney, spleen, skeletal muscle, lung and in plasma of the pig. The highest tissue levels were found in the lung (1.5 +/- 0.07 pmol/g) and the lowest in the muscle (0.08 +/- 0.02 pmol/g). I.v. infusion of endothelin (20 pmol/kg/min for 20 min) increased plasma endothelin-LI from 18 +/- 3 to 628 +/- 109 pM and renal, splenic and femoral vascular resistance by 570, 430 and 50%, respectively. There was a close correlation between the increase in plasma endothelin-LI and the vasoconstrictor effects. During the infusion 92, 82 and 76% of arterial endothelin-LI was removed by the kidney, spleen and hindlimb, respectively, whereas there was no clearance over the lung or degradation in plasma. After the infusion, arterial endothelin-LI decreased with a half life of 77 s, while the renal and splenic vasoconstriction persisted for 60 min. Characterization by reversed phase HPLC revealed that endothelin-LI in plasma and tissue co-eluted with synthetic endothelin. It is concluded that endothelin has tissue specific distribution, clearance and vascular effects in the pig.

Managed competition of alternative delivery systems. The markets for health insurance and health care are not naturally competitive: they are susceptible to many forms of market failure. Health plans and consumers may use strategies that lead to inequity and inefficiency. But experience with successful models of competition suggests that tools are available to enable sponsors (active collective agents on the demand side who contract with health plans to structure and manage competition) to use competition to achieve a reasonable degree of efficiency and equity for their sponsored populations. All this implies a more complex, dynamic, and sophisticated view of competition than one usually finds in apologia for free markets. A free market is not possible in health insurance.

Excellent local control of paraganglioma in the head and neck with fractionated radiotherapy. Radiotherapy is an important treatment option for paraganglioma in the head and neck region. It seems to be highly effective and avoids important surgical morbidity, which can impair quality of life. The aim of this study was to evaluate the outcomes of radiotherapy for paraganglioma of the head and neck region in order to inform our future practice. The cohort of patients for the present study comprised 21 patients who received radiotherapy between 1998 and 2008. Follow-up ranged from 6 to 132 months, median 55 months. The mean age was 48.7 years, range 20-78 years. The female:male ratio was 2 : 1. Two patients had confirmed familial tumour syndromes. The gross tumour volume in 20 cases ranged from 1.3 to 74 cm(3), mean 23.2 cm(3), median 14.7 cm(3). Five patients were treated with intensity-modulated radiotherapy. The median dose was 50 Gy in 30 fractions. The crude 5-year local control rate was 95% (20/21), although the 5-year actuarial local control rate was 87%. The one patient who relapsed, at 45 months after radiotherapy, had a comparatively small tumour of 10.8 cm(3). A relationship between tumour volume and local control seems unlikely. It was possible to obtain details of side-effects from electronic records for 11 patients. Grade 3 headache, which resolved, was the most serious acute side-effect. One patient had three teeth extracted due to exacerbation of dental caries, and one had deterioration of hearing thought to be due to a combination of tumour and radiotherapy. There were two serious complications in patients who had embolisation, which we no longer use. Our results show a high level of efficacy for fractionated external beam radiotherapy, with minimal toxicity, in keeping with other series. This should encourage the use of radiotherapy as primary treatment for paragangliomas of the head and neck region.

Effect of nitrate concentration, pH, and hydraulic retention time on autotrophic denitrification efficiency with Fe(II) and Mn(II) as electron donors. The role of electron donors (Fe(2+) and Mn(2+)) in the autotrophic denitrification of contaminated groundwater by bacterial strain SY6 was characterized based on empirical laboratory-scale analysis. Strain SY6 can utilize Fe(2+) more efficiently than Mn(2+) as an electron donor. This study has shown that the highest nitrate removal ratio, observed with Fe(2+) as the electron donor, was approximately 88.89%. An immobilized biological filter reactor was tested by using three levels of influent nitrate (10, 30, and 50 mg/L), three pH levels (6, 7, and 8), and three levels of hydraulic retention time (HRT; 6, 8, and 12 h), respectively. An optimal nitrate removal ratio of about 95% was achieved at pH 6.0 using a nitrate concentration of 50 mg/L and HRT of 12 h with Fe(2+) as an electron donor. The study showed that 90% of Fe(2+) and 75.52% removal of Mn(2+) were achieved at pH 8.0 with a nitrate concentration of 50 mg/L and a HRT of 12 h. Removal ratio of Fe(2+) and Mn(2+) is higher with higher influent nitrate and HRT. A weakly alkaline environment assisted the removal of Fe(2+) and Mn(2+).

High shear stress relates to intraplaque haemorrhage in asymptomatic carotid plaques. Carotid artery plaques with vulnerable plaque components are related to a higher risk of cerebrovascular accidents. It is unknown which factors drive vulnerable plaque development. Shear stress, the frictional force of blood at the vessel wall, is known to influence plaque formation. We evaluated the association between shear stress and plaque components (intraplaque haemorrhage (IPH), lipid rich necrotic core (LRNC) and/or calcifications) in relatively small carotid artery plaques in asymptomatic persons. Participants (n = 74) from the population-based Rotterdam Study, all with carotid atherosclerosis assessed on ultrasound, underwent carotid MRI. Multiple MRI sequences were used to evaluate the presence of IPH, LRNC and/or calcifications in plaques in the carotid arteries. Images were automatically segmented for lumen and outer wall to obtain a 3D reconstruction of the carotid bifurcation. These reconstructions were used to calculate minimum, mean and maximum shear stresses by applying computational fluid dynamics with subject-specific inflow conditions. Associations between shear stress measures and plaque composition were studied using generalized estimating equations analysis, adjusting for age, sex and carotid wall thickness. The study group consisted of 93 atherosclerotic carotid arteries of 74 participants. In plaques with higher maximum shear stresses, IPH was more often present (OR per unit increase in maximum shear stress (log transformed) = 12.14; p = 0.001). Higher maximum shear stress was also significantly associated with the presence of calcifications (OR = 4.28; p = 0.015). Higher maximum shear stress is associated with intraplaque haemorrhage and calcifications.

Adjuvant chemotherapy in ocular malignant melanoma. Study of 20 cases. The frequency of hematogenously propagated hepatic metastases occurring from ocular melanoma led us to treat 20 patients with adjuvant chemotherapy, 19 patients starting chemotherapy during the month following enucleation and 1 patient, a year after enucleation. With a median follow-up of 6 years, 17 patients (80%) are disease-free. Three patients developed hepatic metastases at 24, 24 and 30 months, respectively. The results suggest that adjuvant chemotherapy is effective in preventing metastases from ocular melanoma.

Development of a fast and simple gas chromatographic protocol based on the combined use of alkyl chloroformate and solid phase microextraction for the assay of polyamines in human urine. Polyamines are aliphatic amines with low molecular weight that are widely recognized as one of the most important cancer biomarkers for early diagnosis and treatment. The goal of the work herein presented is the development of a rapid and simple method for the quantification of free polyamines (i.e., putrescine, cadaverine, spermidine, spermine) and N-monoacetylated polyamines (i.e., N1-Acetylspermidine, N8-Acetylspermidine, and N1-Acetylspermine) in human urine. A preliminary derivatization with propyl chloroformate combined with the use of solid phase microextraction (SPME) allowed for an easy and automatable protocol involving minimal sample handling and no consumption of organic solvents. The affinity of the analytes toward five commercial SPME coatings was evaluated in univariate mode, and the best result in terms of analyte extraction was achieved using the divinylbenzene/carboxen/polydimethylsiloxane fiber. The variables affecting the performance of SPME analysis were optimized by the multivariate approach of experimental design and, in particular, using a central composite design (CCD). The optimal working conditions in terms of response values are the following: extraction temperature 40 °C, extraction time of 15 min and no addition of NaCl. Analyses were carried out by gas chromatography-triple quadrupole mass spectrometry (GC-QqQ-MS) in selected reaction monitoring (SRM) acquisition mode. The developed method was validated according to the guidelines issued by the Food and Drug Administration (FDA). The satisfactory performances reached in terms of linearity, sensitivity (LOQs between 0.01 and 0.1 μg/mL), matrix effect (68-121%), accuracy, and precision (inter-day values between -24% and +16% and in the range 3.3-28.4%, respectively) make the proposed protocol suitable to be adopted for quantification of these important biomarkers in urine samples.

Anticoagulation risk in spine surgery. Systematic review. To determine the high-risk populations for thromboembolic events in spine surgery patients, the risk of anticoagulation in spine surgery patients by type of anticoagulation, and whether there is a safe perioperative window of nonanticoagulation for these high-risk patients. Thromboembolic complications after major spinal surgery is a significant risk for patients. Anticoagulation to reduce this risk is of concern because of the possibility of excessive bleeding or postoperative hematomas and associated neurologic deficits. There seems to be a paucity of literature on this topic. A systematic review of the English-language literature was undertaken for articles published between January 1990 and December 2008. Electronic databases and reference lists of key articles were searched to identify published studies examining coagulopathy in major spine surgery. Two independent reviewers assessed the strength of literature using the Grading of Recommendations Assessment, Development, and Evaluation criteria, assessing quality, quantity, and consistency of results. Disagreements were resolved by consensus. A total of 93 articles were initially screened, and 29 ultimately met the predetermined inclusion criteria. The risk of thromboembolism in patients not receiving chemical prophylaxis was slightly higher in surgery to correct deformity (5.3%) and trauma patients (6.0%) than in surgery for degenerative conditions (2.3%). Fatal pulmonary embolism was rare. Bleeding complications occurred rarely with the use of anticoagulation; risk of major bleeding ranged from 0.0% to 4.3% across several types of anticoagulants. Postoperative hematoma was reported in only 10 of 2507 patients. Venous thromboembolism is uncommon after elective spine surgery. Trauma patients are at increased risk, and chemical prophylaxis should be considered. The safe timing of the administration of anticoagulation agents is unknown.

Isolation of ssDNA aptamers that inhibit rabies virus. Aptamers, functional nucleic acids, capable of binding a variety of molecular targets with high affinity and specificity, have emerged as promising therapeutic agents. In this study, the cell surface-systematic evolution of ligands by exponential enrichment (Cell-SELEX) strategy was used to generate DNA aptamers which targeted to the intact rabies virus-infected live cells. Through 35 iterative rounds of selection, five high-affinity single-stranded DNA (ssDNA) aptamers were generated by cell-SELEX. Virus titer assay and real-time quantitative reverse transcription PCR (qRT-PCR) assay revealed that all five aptamers could inhibit replication of rabies virus (RABV) in cultured baby hamster kidney (BHK)-21 cells; and T14 and F34 aptamers were most effective. The qRT-PCR also showed a dose-dependent inhibitory effect in BHK-21 cells. Collectively, these data show the feasibility of generating functionally effective aptamers against rabies virus-infected cells by the Cell-SELEX iterative procedure. These aptamers may prove clinically useful as therapeutic molecules with specific antiviral potential against RABV infections.

Influence of fresh date palm co-products on the ripening of a paprika added dry-cured sausage model system. Date palm co-products are a source of bioactive compounds that could be used as a new ingredient for the meat industry. An intermediate food product (IFP) from date palm co-products (5%) was incorporated into a paprika added dry-cured sausage (PADS) model system and was analysed for physicochemical parameters, lipid oxidation and sensory attributes during ripening. Addition of 5% IFP yielded a product with physicochemical properties similar to the traditional one. Instrumental colour differences were found, but were not detected visually by panellists, who also evaluated positively the sensory properties of the PADS with IFP. Therefore, the IFP from date palm co-products could be used as a natural ingredient in the formulation of PADS.

Bioacoustic analysis of advertisement call in Hyla nana and Hyla sanborni (Anura, Hylidae) in Botucatu, São Paulo, Brazil. Vocal communication traits of Hyla nana and Hyla sanborni, of the nana species group, were studied from August 1997 until June 1999 in two large permanent ponds located in an open field in Botucatu, São Paulo State. One hundred thirty-one individuals, 71 of H. nana and 58 of H. sanborni, were recorded in the beginning of their vocalization activity and during chorus vocalization. The rhythms of sound emission on the two occasions were different. An advertisement call consists in a consecutive series of simple notes in rapid succession. Both species have two types of notes in their advertisement calls, here named types A and B. Type A notes are introductory and have a longer and higher pulse number and are emitted more frequently in the beginning of vocalization activity. Introductory notes are the first to be emitted in chorus activity. Type B notes are secondary, of shorter duration and lower pulse number, and are emitted during chorus vocalization. The notes of both types differ significantly in their temporal structure. Both species present acoustic segregation in both spectral and temporal structure.

Interferon Induced Transmembrane Protein-1 Gene Expression as a Biomarker for Early Detection of Invasive Potential of Oral Squamous Cell Carcinomas. Early detection of malignant transformation with expression biomarkers has significant potential to improve the survival rate of patients as such biomarkers enable prediction of progression and assess sensitivity to chemotherapy. The expression of interferon inducible transmembrane protein 1 (IFITM1) has been associated with early invasion events in several carcinomas, including head and neck cancers, and hence has been proposed as a novel candidate biomarker. As the incidence of oral squamous cell carcinoma (OSCC) is highest in the Indian population, we sought to investigate: 1) the expression pattern of IFITM1 in OSCC tissue samples obtained from Indian patients of Dravidian origin; and 2) the possibility of using IFITM1 expression as a potential biomarker. Total RNA extracted from thirty eight OSCC biopsy samples was subjected to semi-quantitative RT-PCR with IFITM1 and GAPDH specific primers. Of the thirty eight OSCC samples that were analyzed, IFITM1 overexpression was identified in fifteen (39%). Seven expressed a low level, while the remainder expressed high level of IFITM1. The overexpression of IFITM1 in OSCC samples indicates that IFITM1 may be explored for the possibility of use as a high confidence diagnostic biomarker in oral cancers. To the best of our knowledge, this is the first time that IFITM1 overexpression is being reported in Indian OSCC samples.

Paramorphogenic and genotoxic activity of Triton X-100 and sodium dodecyl sulphate in Aspergillus nidulans. The genotoxic activities of Triton X-100 and sodium dodecyl sulphate in Aspergillus nidulans were assessed in order to evaluate their relative merits as paramorphogenic agents. Triton X-100 was found to be ideally suited to this purpose due to its efficient paramorphogenic effect and lack of genotoxicity. Sodium dodecyl sulphate was considered unsuitable since it reduced viability and was inconsistent in its paramorphogenic action.

[Does partial anterior cruciate ligament rupture really exist?]. From 1983 to 1989 129 partial tears of the anterior cruciate ligament were diagnosed by arthroscopy. To confirm the diagnosis of a partial rupture of the anterior cruciate ligament, we began to split the synovial sheath of the anterior cruciate ligament in 1986 in order to prove the continuity of the fibers. Applying this technique, we quite often found the anterior cruciate ligament completely torn. Hence the rate of partial tears of the anterior cruciate ligament decreased from about 10% of all anterior cruciate ligament ruptures 1983 to about 3% 1989. 42 patients whose diagnosis had been a partial rupture of the anterior cruciate ligament were reviewed clinically to determine whether the anterior cruciate ligament injury had finally proved to be an insignificant lesion or had caused a knee instability. The overall results were very good in 12% and good in 14%; 41% showed a fair, 26% a poor result. Because of this unfavourable outcome, we believe that most of the partial tears of the anterior cruciate ligament should be regarded as complete ruptures.

Receptor-mediated activation of human B lymphocytes in a nonphosphotyrosine-dependent manner. The B cell AgR regulates two signal transduction pathways: the tyrosine kinase and the phosphatidylinositol (PtdIns) pathways. Stimulation of B cells with Ag or anti-Ig antibody results in a rapid increase in tyrosine phosphorylation of multiple substrates. The AgR also mediates the activation of phospholipase C-gamma 1 (PLC-gamma 1) thus producing the second messengers, inositol trisphosphate and diacylglycerol. Although the detailed relationship between these two signaling pathways remains unclear, it has recently become apparent that PLC-gamma 1 might be a target for the AgR-associated protein tyrosine kinase. To address the question of whether tyrosine kinase activity is essential for B cell activation, we studied early biochemical changes and later cellular events induced by ligation of the purinoceptor (P2R). Ligation of ATP to its receptor on B cells has been previously shown to elicit increases in cytosolic free Ca2+ and inositol phosphate production as well as induction of c-fos mRNA expression and increased expression of IL-2 and transferrin receptors. We show here that ATP in a wide range of concentrations did not increase protein tyrosine kinase activity. In contrast with the AgR, P2R did not mediate tyrosine phosphorylation of PLC-gamma 1, thus suggesting that it may use another phosphoinositide-specific PLC that does not require phosphorylation on tyrosine residues for its activation. The results were supported by experiments with a specific tyrosine kinase inhibitor, tyrphostin AG-126. Preincubation with this inhibitor blocked AgR but not P2R-mediated inositol phosphate production, cytosolic free Ca2+ changes, and IL-2 and transferrin receptor expression. The results indicate that the PtdIns pathway may be sufficient to induce activation of B cells and that the tyrosine phosphorylation pathway is not necessary for nonantigenic B cell activation.

Coronary venous hypertension prevents the formation of the electrophysiological arrhythmogenic substrate of acute ischemia in the dog: salutary effects of preserved myocardial hydration. Coronary venous hypertension induced by partial coronary sinus obstruction (CSO) in the dog, prevents or delays the predictable ventricular fibrillation (VF) of the early phase of acute ischemia. Also, CSO acting presumably through enhanced myocardial hydration, normalizes the inhomogenous extracellular potassium ([K+]o) accumulation, a major factor in producing the electrophysiological disparities, characteristic of arrhythmogenic substrate. To further clarify the mechanism of early ischemic VF prevention in dogs, radioactive microspheres were used to evaluate regional perfusion changes, resulting from CSO sufficient to raise the coronary sinus pressure to 40 mmHg, before and during ischemia induced by double coronary artery occlusion (CAO) (n=5). Also, global or regional unipolar electrogram mapping was used to assess changes of epicardial ventricular activation times (AT) and sequence and activation recovery intervals (ARI) during CSO, CAO and combined CSO and CAO, induced in random order (n=8). CSO did not affect regional perfusion nor improved collateral blood flow during ischemia. With CSO, AT shortened modestly over time (0.41+/-1.1 ms/min, r=0.85, P<0. 05) and ARI transiently decreased by up to 5.5%. With CAO, AT became variably delayed and isochrone map distortions were indicative of localized conduction delays or blocks, consistent with elevated [K+]o. In contrast, when CAO was preceded by CSO, AT delays were homogenous and normal activation sequence was preserved. Also, whereas with CAO, ARI shortened unequally over the ischemic region by as much as 43% at individual sites (average of 38.3+/-6.8 ms, P<0. 001), with combined CSO and CAO, ARI shortening was less pronounced and more homogenous (26.1+/-5.6 ms, P<0.05), not exceeding 29% at any site. Thus, in accordance with previous findings of enhanced [K+]o homogeneity, coronary venous hypertension reduces the disparities of activation and refractoriness of ischemia attributable, at least in part, to disparate [K+]o accumulation. Since no collateral blood flow improvement could be identified, the salutary electrophysiological effects of CSO may reflect a more homogenous extracellular environment, due to preservation of normal microvascular pressure (Pmv) and sustained filtration and lymph flow.

[Drug interactions and antibiotics]. Situations that require the use of systemic antibiotic therapy are common and drug interactions are potentially frequent. These interactions may be deleterious and lead to reduction of therapeutic index, enhancement of toxic risk or may be favourable, with optimization of pharmacokinetics or pharmacodynamics. The mechanisms of these interactions are discussed.

Loss of plant biodiversity over a seven-year period in two constructed wetlands in Central New York. Since wetland construction projects are becoming more commonplace, meaningful follow-up studies are needed to evaluate how these systems change over time. To that end, the objective of our study was to examine the temporal changes in plant community composition and water chemistry in two constructed wetlands. We investigated two wetland sites that were constructed in 2003 in northern Otsego County, NY, a county that is largely dominated by agriculture. Site 1 was previously an active cow pasture and site 2 was previously a wet meadow surrounded by agricultural fields. No active plant introduction was made during the construction; however, both sites were located in areas with many remnant wetlands and were connected to through-flowing streams. In 2004 (Year 1) and 2010 (Year 7), the plant community composition and nitrogen retention were assessed. We found that both sites experienced site-wide declines in plant species richness, including the loss of upland and facultative upland species and the unanticipated loss of facultative wetland and some obligate species. We propose that high water levels, which, at their maximum depth were >1.5 m deeper than in Year 1, maintained by landowners in the years after the initial survey, may have been responsible for the unexpected loss of wetland species. We also found that site 1 exhibited considerable nitrogen retention in both Year 1 and Year 7; however, N concentrations were low at site 2 in both years.

Probing V5/MT excitability with transcranial magnetic stimulation following visual motion adaptation to random and coherent motion. The response to stimulating the visual cortex with transcranial magnetic stimulation (TMS) depends on its initial activation state, for example, visual motion adaptation biases perceived TMS-induced phosphene characteristics (e.g., color). We quantified this state dependence by assessing the probability of reporting a phosphene (P(λ) ) with "threshold" TMS (i.e., the TMS intensity producing P(λ) = 0.5 at baseline) following visual motion adaptation to a random dot motion display. Postadaptation, P(λ) was increased, and this effect was confined to the adapted neuronal population. We then adapted subjects using a population of moving dots of fixed average motion direction with standard deviations (SD) ranging from 1° to 128° (SD fixed for a given trial). P(λ) was significantly increased at all dot motion SDs except SD = 1°. Neuronal adaptation increases the susceptibility of the neuronal population to activation by threshold intensity TMS. Thus the process of neuronal adaption is not necessarily synonymous with a downmodulation of neuronal excitability.

Bilaterally dilated upper urinary tract and bladder induced by diabetes insipidus. A case of hypothalamic diabetes insipidus accompanied by nonobstructive dilatation of the bladder and upper urinary tract is reported. Treatment with dDAVP resulted in decrease of the urine volume and improvement of dilatation of the urinary tract.

Effect of multiple-dose potassium cardioplegia on myocardial ischemia, return of ventricular function, and ultrastructural preservation. To evaluate the myocardial protection afforded by multiple-dose versus single-dose administration of potassium cardioplegic solution, we studied 24 isolated feline hearts before, during, and after 1 hour of ischemic arrest. Intramyocardial gas tensions, ventricular function, histologic preservation, and postischemic myocardial edema were compared in hearts maintained at 27 degrees C during the ischemic period. Equal groups of hearts received no infusion of cardioplegic solution, a single dose of potassium solution at the onset of ischemia, or multiple infusions of the cardioplegic solution throughout the arrest period. During ischemia, single-dose cardioplegic administration resulted in less accumulation of myocardial carbon dioxide (Pmco2) than did hypothermia alone, reflecting a reduction in metabolic activity during ischemia. The fact that multiple-dose cardioplegia further reduced Pmco2 accumulation suggests an intermittent washout of metabolic end products. During reperfusion, hearts protected by multidose cardioplegia demonstrated superior preservation of ventricular performance compared to hearts protected by single-dose cardioplegia or hypothermia alone. In addition, multiple infusions of the cardioplegic solution resulted in optimal structural preservation in both light and electron microscope studies.

Clinical Education In psychiatric mental health nursing: Overcoming current challenges. In response to current challenges in psychiatric mental health nursing education, nursing schools have implemented new strategies in teaching undergraduate nursing students. The objectives of the study were to evaluate learning outcomes of a mental health nursing clinical practicum and to explore students' perceptions of the clinical practicum. This was a mixed-method study. Sixty-three undergraduate nursing students, who were undertaking their first mental health clinical practicum, completed a set of structured questionnaires and answered open-ended questions about the clinical practicum. Answers to open-ended questions were analyzed qualitatively, and learning outcomes (i.e., empathy, mental illness prejudice, simulation-related efficacy, and satisfaction) were measured at three time points: pre-clinical, post-simulation, and post-clinical. Students reported improvement in empathy and simulation-related self-efficacy after the clinical practicum, but no change was found in mental illness prejudice. Students' expectations for and evaluation of the clinical practicum are summarized. The observed improvement in learning outcomes of the clinical practicum may be attributed to the unique contribution of each component of the clinical practicum and the synergic effect of these diverse components. To manage emerging challenges in clinical settings and nursing education, it is critical to develop systematic and comprehensive mental health nursing clinical practicums for undergraduate nursing students.

Oxidation of Organic Molecules with a Redox-Active Guanidine Catalyst. Herein, we report the first examples of the use of redox-active guanidines as catalysts in the green oxidation of organic molecules with dioxygen. In one half-reaction, the oxidized form of the redox-active guanidine is converted into the reduced, protonated state, thereby enabling dehydrogenative oxidation of the substrate (3,5-di-tert-butylcatechol→ortho-benzoquinone, benzoin→benzil, and 2,4-di-tert-butylphenol→biphenol). In the other half-reaction, efficient re-oxidation of the guanidine to the oxidized state is achieved with dioxygen in the presence of a copper catalyst. These results pave the way for the broader use of redox-active guanidines as oxidation catalysts.

Effects of xenon anaesthesia on intestinal oxygenation in acutely instrumented pigs. Xenon is a narcotic gas that might be able to replace volatile anaesthetics or nitrous oxide due to its favourable pharmacological properties, such as providing haemodynamic stability. Intestinal oxygenation is affected by most volatile anaesthetics as a result of cardiodepressive effects. Reducing oxygenation of the gut might be a factor leading to perioperative organ dysfunction. This animal study was designed to assess the effects of xenon on intestinal oxygenation. After ethical approval, 24 anaesthetized, acutely instrumented pigs were randomly assigned to three groups: nine animals received xenon anaesthesia with inspiratory concentrations of 0, 20, 50 and 65% in addition to their basic i.v. anaesthesia, nine animals served as a study control group, and five animals were used to assess model stability. Measurement of systemic and regional haemodynamic and oxygenation parameters was made 30 min after changing the xenon concentration. Xenon elicited dose-dependent systemic haemodynamic changes: heart rate and cardiac output decreased by 30%, while mean arterial pressure was stable. Superior mesenteric artery blood flow was lower in the xenon group. Vascular resistance of the superior mesenteric artery increased. The small intestinal oxygen supply decreased with increasing xenon concentration; the mucosal tissue oxygen partial pressure decreased but did not reach hypoxic (<5 mm Hg) values. Serosal tissue oxygen partial pressure was maintained. Xenon, in addition to basic i.v. anaesthesia, elicited a decrease in cardiac output and maintained mean arterial pressure. Intestinal oxygenation was maintained, although regional macrohaemodynamic perfusion decreased. Xenon does not impair intestinal oxygenation under physiological conditions.

Elastic constants and dimensions of imprinted polymeric nanolines determined from Brillouin light scattering. Elastic constants and cross-sectional dimensions of imprinted nanolines of poly(methyl methacrylate) (PMMA) on silicon substrates are determined nondestructively from finite-element inversion analysis of dispersion curves of hypersonic acoustic modes of these nanolines measured with Brillouin light scattering. The results for the cross-sectional dimensions, under the simplifying assumption of vertical sides and a semicircular top, are found to be consistent with dimensions determined from critical-dimension small-angle x-ray scattering measurements. The elastic constants C(11) and C(44) are found to be, respectively, 11.6% and 3.1% lower than their corresponding values for bulk PMMA. This result is consistent with the dimensional dependence of the quasi-static Young's modulus determined from buckling measurements on PMMA films with lower molecular weights. This study provides the first evidence of size-dependent effects on hypersonic elastic properties of polymers.

Interaction of divalent minerals with liposoluble nutrients and phytochemicals during digestion and influences on their bioavailability - a review. Several divalent minerals, including the macroelements calcium and magnesium, are essential nutrients for humans. However, their intake, especially via high-dose supplements, has been suspected to reduce the availability of lipophilic dietary constituents, including lipids, liposoluble vitamins, and several phytochemicals such as carotenoids. These constituents require emulsification in order to be bioavailable, and high divalent mineral concentrations may perturb this process, due to precipitations of free fatty acids or bile salt complexation, both pivotal for mixed micelle formation. Though in part based on in vitro or indirect evidence, it appears likely that high-dose supplements of divalent minerals around or even below their recommended dietary allowance perturb the availability of certain liposoluble miroconstituents, in addition to reducing absorption of dietary lipids/cholesterol. In this review, we investigate possible negative influences of divalent minerals, including trace elements (iron, zinc), on the digestion and intestinal uptake of lipophilic dietary constituents, with a focus on carotenoids.

Self-remitting and reversible parkinsonism associated with neuro-Sweet disease. We describe a 72-year-old man who developed subacute onset parkinsonism caused by neuro-Sweet disease (NSD). Magnetic resonance imaging of this patient's brain suggested inflammation of the bilateral basal ganglia and amygdalae. Clinical symptoms and MRI findings gradually improved without medication. However, his parkinsonism recurred one month after discharge from the hospital, at which time he was treated with corticosteroids, resulting in improvement again. His clinical course and human leukocyte antigen typing suggested that he was suffering from NSD. This case is the first report of NSD presenting with self-remitting and reversible parkinsonism.

Vibration Damping Mechanism of Fiber-Reinforced Composites with Integrated Piezoelectric Nanowires. Here, both piezoelectric and nonpiezoelectric nanostructures are used within fiber-reinforced composites to improve the damping capabilities of the host material. This work investigates and isolates the role of both piezoelectricity and the mechanical redistribution of strain on the damping properties of fiber-reinforced composites through the integration of a nanowire interphase between the fiber and matrix. Prior works have successfully studied and reported the effectiveness of modifying the surface of the reinforcing fibers in a composite material using nanowires and other nanostructured interfaces to increase mechanical damping, however, have yet to fully investigate the mechanism dictating the observed behavior. This study analyzes the effects of nonpiezoelectric nanowire interfaces in comparison to piezoelectric nanowire interfaces of the same microscale morphology. The damping properties of carbon fiber-reinforced composites containing both sets of nanowires are investigated via dynamic mechanical analysis over a range of temperatures as well as modal analysis at the first resonant frequency. The results conclusively indicate that a combination of both mechanical and piezoelectric effects contributes to the significant increase in damping properties of fiber-reinforced composites and quantifies the individual contributions.

Malignant triton tumour of the anterior mediastinum as incidental finding. A rare case of malignant peripheral nerve sheath tumour with rhabdomyoblastic differentiation (malignant triton tumour) of the anterior mediastinum in a 30-year-old male is reported. The tumour was an incidental finding during the diagnostic work-up following a motor vehicle accident. The patient underwent median sternotomy with a tumour resection performed. Local relapse was suspected one month later, as per the chest CT-scan, and post-operative chemoradiation was applied, which produced a response. Twelve months later the patient is doing well while radiological findings remain invariable. Localization of a triton tumour in the anterior mediastinum is extremely rare, adjuvant treatment is necessary, recurrence frequently occurs and the prognosis is dismal.

[A research on JPEG2000 used in DICOM store service]. In view of the fact that the large quantities of data contained in the medical image do not have a favorable setting for effective storage and transmission in the existing network, we have developed a JPEG2000 DICOM image compression kit using VC++, and we have realized the medical image storage service according to the C-STORE rule of DICOM standard. The results showed that the medical image processed by JPEG2000 compression algorithm not only greatly saved the storage space, but also reduced the band width needed by transmission. In this paper is discussed the DICOM image compressed by JPEG2000 compression algorithm in DICOM strorage service application. The significance of JPEG2000 compression algorithm in the development of picutre archiving and communication systems (PACS) and telemedicine is also explained.

Relationships between bone mineral density and incident vertebral fracture risk with raloxifene therapy. Although low absolute values of bone mineral density (BMD) predict increased fracture risk in osteoporosis, it is not certain how well increases in BMD with antiresorptive therapy predict observed reductions in fracture risk. This work examines the relationships between changes in BMD after 1 year or 3 years of raloxifene or placebo therapy and the risk for new vertebral fractures at 3 years. In the Multiple Outcomes of Raloxifene Evaluation (MORE) trial, 7705 postmenopausal women with osteoporosis were randomized to placebo or raloxifene 60 mg/day or 120 mg/day. Relationships between baseline BMD and changes in BMD from baseline with the risk of new vertebral fractures were analyzed in this cohort using logistic regression models with the raloxifene doses pooled. As has been observed in other populations, women with the lowest baseline lumbar spine or femoral neck BMD in the MORE cohort had the greatest risk for vertebral fractures. Furthermore, for any percentage change, either increase or decrease in femoral neck or lumbar spine BMD at 1 year or 3 years, raloxifene-treated patients had a statistically significantly lower vertebral fracture risk compared with placebo-treated patients. The decrease in fracture risk with raloxifene was similar across the range of percentage change in femoral neck BMD observed at 3 years; patients receiving raloxifene had a 36% lower risk of vertebral fracture compared with those receiving placebo. At any percentage change in femoral neck and lumbar spine BMD observed at 1 year, raloxifene treatment decreased the risks of new vertebral fractures at 3 years by 38% and 41%, respectively. The logistic regression model showed that the percentage changes in BMD with raloxifene treatment accounted for 4% of the observed vertebral fracture risk reduction, and the other 96% of the risk reduction remains unexplained. The present data show that the measured BMD changes observed with raloxifene therapy are poor predictors of vertebral fracture risk reduction with raloxifene therapy.

Ovulation rate, embryo survival and ovarian sensitivity to gonadotrophins in mice selected for litter size and body weight. Single trait selection of mice for either large body size or large litter size resulted in an increased ovulation rate because of possible enhanced ovarian sensitivity to gonadotrophins. There was no difference in pre-implantation embryonic survival in either of the selected lines when compared to control mice. Selection for body weight did not alter post-implantation embryo survival, but fewer fetuses were lost after implantation in the litter size line compared to the control line. Index selection for large body size and small litter size did not change ovulation rate but increased pre- and post-implantation embryonic mortality. Selection for small body size and large litter size increased ovulation rate and decreased early embryonic death.

Giant cell tumor of the tendon sheath involving skin. Giant cell tumor of the tendon sheath is the second most common tumor of the fingers and hands but is only rarely mentioned in the dermatologic literature. Although its pathogenesis has been debated, it is probably a type of fibrous histiocytoma. This tumor is almost always benign but may locally invade the overlying dermis and be confused with a malignant neoplasms. It often extends to the synovium of the adjacent joint space and necessitates total excision to prevent local recurrence. Therefore, excision should be undertaken by a physican who is surgically qualified for such procedure. We report a case that illustrates the clinical and pathologic aspects of this lesion.

Postcooking temperature changes in beef patties. Beef patties (86 and 143 g) formed from high-fat (20 to 29%) and low-fat (6 to 10%) ground beef obtained in eight different selections for both high and low fat content were cooked by either a gas grill or an electric griddle. Patties were cooked to either 66.1 or 68.3 degrees C as determined in the thickest section, and internal temperatures were recorded after cooking at 1-s intervals for 180 s in both thick and thin sections of patties. Time-temperature curves (after cooking) were evaluated for compliance with regulatory requirements for classifying patties as fully cooked. For patties cooked to 66.1 degrees C, the maximum highest temperature in the thickest patty section often did not reach 71.1 degrees C (recommended for cooking of beef patties by consumers). Although thin sections of patties had higher temperatures than thick sections at the termination of cooking, temperature variability was greater and declines in temperature occurred sooner in thin patty sections. Failure to meet fully cooked, time-temperature requirements was greater in thin than thick sections. Thicker (143-g) patties possessed longer postcooking times before declining in temperature than thinner (86-g) patties. Although many beef patties cooked in this study achieved regulatory time requirements for maintaining 66.1 or 68.3 degrees C (as well as attaining 71.1 degrees C), some patties did not meet these requirements. Because of the considerable temperature variability that can exist within patties at the conclusion of cooking, use of end point temperatures of less than 71.1 degrees C is not recommended for consumers. Consumers should allow several minutes of holding following cooking before consumption to maximize the increases in postcooking temperature. Further research is required to establish cooking procedures that will improve temperature uniformity and eliminate "cold spots" during cooking of beef patties.

Removal of endotracheal tube obstruction with a secretion clearance device. Accumulation of secretions may suddenly occlude an endotracheal tube (ETT), requiring immediate medical attention. The endOclear catheter (Endoclear LLC, Petoskey, Michigan) is a novel device designed to clear mucus and debris from an ETT and restore luminal patency. We present 3 subsequent cases of life-threatening partial ETT occlusions recorded over a period of 6 months at Massachusetts General Hospital. After conventional methods (standard tracheal suctioning and bronchoscopy) failed, the endOclear was used, with successful restoration of the airways in all 3 cases. The respiratory conditions rapidly improved, and all 3 patients tolerated the ETT-cleaning maneuver. These results show that such a device is safe and easy to use during an emergency airway situation for efficient and rapid removal of secretions from obstructed ETTs by respiratory therapists.

Long-term effect of monophosphoryl lipid A adjuvanted specific immunotherapy in patients with grass pollen allergy. Ultra-short course pollen immunotherapy adjuvanted with monophosphoryl lipid A (MPL) is attractive to conventional allergen-specific immunotherapy (AIT). Long term efficacy of MPL-AIT has not been evaluated. 68 patients (age 16.75 ± 5.3 years) with allergic rhinitis to grass pollen were investigated. Group 1: 21 controls; Group 2: 19 after complete AIT, and Group 3: 28 with AIT and treatment cessation: 4 years range 3-6 years ago. The clinical symptoms (running nose, sneezing, conjunctivitis and the weekly overall score) were significantly reduced in patients group 2 and 3 compared with controls without AIT p < 0.0001. T-regulatory cells and TH1/TH2 cytokine pattern did not differ between patient groups. The patients in our trial with grass pollen allergy exhibited significant and long-lasting improvements after MPL-AIT, however larger trials are needed to support this finding.

The ornithodoros (Alectorobius) talaje species group (Acari: Ixodida: Argasidae): description of Ornithodoros (Alectorobius) rioplatensis n. sp. from southern South America. A new species of argasid tick, Ornithodoros (Alectorobius) rioplatensis Venzal, Estrada-Peña, & Mangold, is described from larval and adult specimens collected in Uruguay. Further specimens from Argentina, Paraguay, and Chile are ascribed to the new species. Key distinguishing characters of larvae of the species are the number of pairs of dorsal setae (19-20 but typically 20 in O. rioplatensis, compared with 16-17 but typically 17 in O. puertoricensis and O. talaje), and the length of the hypostome, which is clearly longer in O. rioplatensis than in O. talaje. Morphological details of the adults of these species are inadequate for taxonomic purposes. The genetic distance between O. puertoricensis and O. rioplatensis, based on 16S rDNA sequencing, is approximately 12.7%. Variability in some morphological features, using multivariate morphometric discrimination to assess congruence between populations, was examined among larval specimens of O. talaje and O. puertoricensis collected from the United States, and Central and South America. Larval specimens of O. talaje from Guatemala (near the type locality of the species) were morphologically different from Mexican and southern U.S. populations originally described as O. talaje. In the absence of DNA data for these populations, and because of inadequate statistical discrimination among body characters, we prefer to refer to the Mexican and U.S. material as O. nr. talaje until further analysis of population variability is conducted using an adequate sample size.

Dedifferentiation of epidermal cells to stem cells in vivo. The effects of growth factors on wound healing have been studied extensively; however epidermal regeneration is not fully understood. We treated eight patients with leg ulcers with recombinant human epidermal growth factor (rhEGF) and compared biopsies of regenerating epidermis with those of controls who did not receive rhEGF. We used immunohistochemistry to identify cells expressing keratin 19 and beta1 integrin in regenerated epidermis from patients and controls. Patients treated with rhEGF had stem cells in the spinous and granular layers of regenerated epidermis. Histological analysis showed that these stem cells had reverted from differentiated to undifferentiated stem cells. Our findings provide evidence for epidermal cell reversion.

Effect of scopolamine on spontaneous yawning in men. The effect of scopolamine hydrobromide (0.4 mg s.c.) on spontaneous yawning was studied in 16 male volunteers in a double-blind study. Scopolamine (or placebo) was given 60 min before (-60 min) placebo (physiological saline s.c.) (time 0 min) and yawning monitored from -15 to +60 min by recording displacement of the lower jaw and storing the traces on diskettes. After placebo, the number of yawns was 5.3 +/- 1.4 (means +/- SE) and after scopolamine pretreatment 4.3 +/- 1.6 (p = NS). Drowsiness was assessed with the Stanford Sleepiness Scale and the Analog Sleepiness Scale at -15, 0, +20, +40, +60 min. There was no significant correlation between total sleepiness scores (area under the curve, 0 min to +60 min), peak sleepiness score or peak increment in sleepiness score and number of yawns on either scale. These data suggest that (a) spontaneous yawning in man is not mediated by a central muscarinic cholinergic link, and (b) the assumed relationship between drowsiness and yawning remains to be verified experimentally.

Inflation pressure, gastric insufflation and rapid sequence induction. An investigation was carried out into the relationship between the inflation pressures of normally compliant lungs and the airways pressure necessary to produce the insufflation of gas to the stomach. This relationship was examined during manual ventilation with a mask, using a rapid sequence induction technique. In the absence of cricoid pressure the lungs of all the patients could be ventilated "gently" satisfactorily by hand without gas entering the stomach. In only half of the patients could gas be redirected to the stomach when maximal inflation pressures were generated. It was not possible to cause gas to enter the stomach in any patient with a patent airway when cricoid pressure was applied.

Semidry electrophoretic transfer of RNA to membranes. We describe a method using a semi-dry gel electro-blotter to transfer RNA from standard agarose-formaldehyde denaturing gels in less than 30 min. The method requires equilibrating the gel in a low ionic strength buffer. The transfer is done under high-current and low-voltage conditions. This method maintains the overall sharpness of the bands on the final autoradiogram while shortening the time required for Northern transfer by approximately 12 hours.

Developmental patterns of copper and zinc concentrations in mouse liver and brain: evidence that the gene crinkled (cr) is associated with an abnormality in copper metabolism. An abnormality in copper metabolism during both the prenatal and postnatal (preweaning) periods was found to be associated with the autosomal recessive gene "crinkled" (cr) in mice. Liver copper concentration was significantly lower in crinkled mice (cr/cr) than in littermate controls (+/?) from 18 days of gestation to 20 days after birth. Crinkled mice older than 20 days of age and liver copper concentrations similar to those of littermate controls. Liver zinc and brain copper and were similar in crinkled and noncrinkled mice at all times tested. In both crinkled and noncrinkled mice, brain copper concentration increased during the suckling period, and liver copper concentration decreased.

Immunologic effects of combined protease inhibitor and reverse transcriptase inhibitor therapy in previously treated chronic HIV-1 infection. To evaluate the efficacy of combination protease and reverse transcriptase inhibitor therapy in correcting HIV-1-induced lymphocyte subset abnormalities in previously treated adults. A 48-week observational study of lymphocyte subsets in 12 participants in the Multicenter AIDS Cohort Study who were already taking at least one reverse transcriptase inhibitor and added a protease inhibitor to their treatment regimen. Comparison groups were HIV-seronegative homosexual men, HIV-seronegative heterosexual men, and homosexual HIV-1-infected men who were long-term non-progressors. Three-color immunofluorescence and monoclonal antibodies were used to assess HIV-1-induced lymphocyte subset alterations related to immune deficiency and immune activation. Plasma HIV-1 RNA levels were monitored to assess suppression of viral replication. CD4+ cell counts significantly increased and lymphocyte activation measured as CD38 and HLA-DR expression on CD8+ T cells significantly decreased by 48 weeks. CD4+ cell values remained abnormal even in those who were fully suppressed. Some T-cell activation markers decreased to levels observed in long-term non-progressors. The increase in CD4+ T-cell numbers reached a plateau by week 24, but the increase in resting HLA-DR- CD38-T cells was sustained through week 48. Proportions of CD45RA+ CD62L-selectin+ and CD28+ CD4+ T-cell subsets and Fas expression were not abnormal at baseline compared with seronegative homosexual controls. The most significant impact of suppression of viral replication was reversal of T-cell activation. However, normalization of lymphocyte subset perturbations associated with chronic HIV-1 infection was not achieved after 1 year of treatment with current combination antiretroviral regimens. More profound viral suppression, therapy for longer than 1 year, or immunologic augmentation may be needed to fully reverse the abnormalities.

Tumors of the oral cavity and pharynx. We have compiled all the reported cases of smooth muscle (stromal) tumors of the oral cavity and pharynx from 1884 through 1996. Our collective data included 139 leiomyomas (LM) and 68 leiomyosarcomas (LMS); but because we did not have sufficient information for 13 cases of LM, we report on only 126; and we report on only 66 of 68 cases of LMS. The peak age of incidence was 40 to 49 years for benign tumors and 50 to 59 years for malignant lesions, with the incidence in men slightly predominating over that in women. The most common sites of LM of the oral cavity and pharynx were the lips, tongue, and hard and soft palate. The most common sites of LMS included the maxilla and mandible. More than 40% of LMs presented as an intraoral mass, and more than half were known to be present for longer than 1 year. About 10% presented with pain, difficulty chewing or swallowing, swelling, toothache or loose teeth, or a combination of these symptoms. Patients with LMS were much more likely to have obvious symptoms of shorter duration, and one-third presented with pain or swelling (or both). Other relatively common symptoms of LMS included tenderness, interference with dentures, or an intraoral mass. In this review, there were almost twice as many LMs as LMSs, which was consistent with smooth muscle tumors found in other areas of the gastrointestinal tract.

Ultrasound stimulation of maxillofacial bone healing. A substantial part of the maxillofacial surgery practice deals with maxillofacial bone healing. In the past decades, low-intensity ultrasound treatment has been shown to reduce the healing time of fresh fractures of the extremities up to 38%, and to heal delayed and non-unions up to 90% and 83%, respectively. Based on the assumption that the process of bone healing in the bones of the extremities and maxillofacial skeleton is essentially the same, the potential of ultrasound to stimulate maxillofacial bone healing was investigated. Although limited evidence is available to support the susceptibility of maxillofacial bone to the ultrasound signal, ultrasound may be of value in the treatment of delayed unions, in callus maturation after distraction, and in the treatment of osteoradionecrosis.

Mupirocin resistance after long-term use for Staphylococcus aureus colonization in patients undergoing chronic peritoneal dialysis. Mupirocin (Mup) has been used extensively to prevent Staphylococcus aureus (SAu) infections in patients undergoing peritoneal dialysis (PD). Resistance to Mup has been reported, but its relevance after long-term use of this drug in PD is unknown. Colonization by SAu was treated with topic Mup in our unit between September 1990 and December 2000. Sensitivity to Mup was tested in 437 strains of SAu isolated from 155 PD patients and 62 dialysis partners. Resistance to Mup was classified as low (minimal inhibitory concentration [MIC] > or = 8 microg/mL) or high (MIC > or = 512 microg/mL) degree. MIC90 was 0.125 microg/mL in 1990 to 1996 (5% low, 0% high-degree resistance), 64 microg/mL in 1997 to 1998 (6.6% low, 8.3% high-degree resistance), and 1,024 microg/mL in 1999 to 2000 (2.3% low, 12.4% high-degree resistance). Mup-resistant SAu were isolated from 25 patients and 13 partners a median of 15 months after starting PD. Resistance was associated frequently with repeated treatments of SAu recolonization, but was detected in 3 cases at the start of PD therapy. The accumulated incidence of SAu exit-site infection in the period 1997 to 2000 was 32.3% in patients colonized by Mup-resistant SAu as compared with 14.5% in those colonized by Mup-sensitive SAu (P = 0.03). Mup-resistant SAu have emerged in a significant proportion of our PD patients and dialysis partners. This emergence has resulted in a moderate, but significant, increase in the risk of SAu exit-site infection and raises concerns about the future of Mup as the therapy of choice for SAu colonization in patients undergoing chronic PD.

Electronic Structure of [Pt(2)(&mgr;-O(2)CCH(3))(4)(H(2)O)(2)](2+) Using the Quasi-Relativistic Xalpha-SW Method: Analysis of Metal-Metal Bonding, Assignment of Electronic Spectra, and Comparison with Rh(2)(&mgr;-O(2)CCH(3))(4)(H(2)O)(2). The electronic structure and metal-metal bonding in the classic d(7)d(7) tetra-bridged lantern dimer [Pt(2)(O(2)CCH(3))(4)(H(2)O)(2)](2+) has been investigated by performing quasi-relativistic Xalpha-SW molecular orbital calculations on the analogous formate-bridged complex. From the calculations, the highest occupied and lowest unoccupied metal-based levels are delta(Pt(2)) and sigma(Pt(2)), respectively, indicating a metal-metal single bond analogous to the isoelectronic Rh(II) complex. The energetic ordering of the main metal-metal bonding levels is, however, quite different from that found for the Rh(II) complex, and the upper metal-metal bonding and antibonding levels have significantly more ligand character. As found for the related complex [W(2)(O(2)CH)(4)], the inclusion of relativistic effects leads to a further strengthening of the metal-metal sigma bond as a result of the increased involvement of the higher-lying platinum 6s orbital. The low-temperature absorption spectrum of [Pt(2)(O(2)CCH(3))(4)(H(2)O)(2)](2+) is assigned on the basis of Xalpha-SW calculated transition energies and oscillator strengths. Unlike the analogous Rh(II) spectrum, the visible and near-UV absorption spectrum is dominated by charge transfer (CT) transitions. The weak, visible bands at 27 500 and 31 500 cm(-)(1) are assigned to Ow --> sigma(Pt(2)) and OAc --> sigma(Pt(2)) CT transitions, respectively, although the donor orbital in the latter transition has around 25% pi(Pt(2)) character. The intense near-UV band around 37 500 cm(-)(1) displays the typical lower energy shift as the axial substituents are changed from H(2)O to Cl and Br, indicative of significant charge transfer character. From the calculated oscillator strengths, a number of transitions, mostly OAc --> sigma(Pt-O) CT in nature, are predicted to contribute to this band, including the metal-based sigma(Pt(2)) --> sigma(Pt(2)) transition. The close similarity in the absorption spectra of the CH(3)COO(-), SO(4)(2)(-), and HPO(4)(2)(-) bridged Pt(III) complexes suggests that analogous spectral assignments should apply to [Pt(2)(SO(4))(4)(H(2)O)(2)](2)(-) and [Pt(2)(HPO(4))(4)(H(2)O)(2)](2)(-). Consequently, the anomalous MCD spectra reported recently for the intense near-UV band in the SO(4)(2)(-) and HPO(4)(2)(-) bridged Pt(III) complexes can be rationalized on the basis of contributions from either SO(4) --> sigma(Pt-O) or HPO(4) --> sigma(Pt-O) CT transitions. The electronic absorption spectrum of [Rh(2)(O(2)CCH(3))(4)(H(2)O)(2)] has been re-examined on the basis of Xalpha-SW calculated transition energies and oscillator strengths. The intense UV band at approximately 45 000 cm(-)(1) is predicted to arise from several excitations, both metal-centered and CT in origin. The lower energy shoulder at approximately 40 000 cm(-)(1) is largely attributed to the metal-based sigma(Rh(2)) --> sigma(Rh(2)) transition.

Transfer of a selected single blastocyst optimizes the chance of a healthy term baby: a retrospective population based study in Australia 2004-2007. The practice of single embryo transfer (SET) is highly accepted by clinicians in Australia. This study investigates whether the SET of blastocysts results in optimal perinatal outcomes. This retrospective population-based study included 34 035 single or double embryo transfer cycles in women who had their first fresh autologous treatment in Australia during 2004-2007. Pregnancy, live delivery and 'healthy baby' (live born term singleton of > or = 2500 g birthweight and survived for at least 28 days without a notified/reported congenital anomaly) rates per transfer cycle were compared in four groups: selective single embryo transfer (SSET), unselective single embryo transfer (USSET), selective double embryo transfer (SDET) and unselective double embryo transfer (USDET). Live delivery and 'healthy baby' rates per transfer following SSET were further compared by number of embryos available. The analysis was stratified by woman's age and stage of embryo development. The highest rates of live delivery and 'healthy baby' per transfer cycle (46.2 and 38.0%) were achieved with transfer of a single blastocyst in women aged younger than 35 years. In women aged younger than 40 years, SSET had a significantly higher rate of 'healthy baby' per transfer cycle than did SDET regardless of stage of embryo development. In woman aged younger than 35 years who had SSET, there was no significant difference in live delivery and 'healthy baby' rates per transfer cycle whether two, three, four or five embryos were available. For all of these women, SSET of a cleavage embryo had significantly lower rates of live delivery and 'healthy baby' per transfer cycle compared with SSET of a blastocyst where only two blastocysts were available. Consultation with the patient with respect to the advantage of extended culture and selective single blastocyst transfer will result in better success rates following assisted reproductive technology treatment in Australia.

Robot-assisted cholecystectomy is a safe but costly approach: A national database review. This study sought to evaluate surgical outcomes, cost, and opiate utilization of patients who underwent laparoscopic (LC) or robotic cholecystectomy (RC). The Vizient database was queried for patients admitted with mild to moderate severity of illness (SOI) scores who underwent LC or RC from January 2015 through December 2017. Rates of overall complications, postoperative infection, mortality, LOS, cost, and opiate utilization were compared between groups using IBM SPSS v.25.0, α = 0.05. 91,849 patients (LC:N = 89,878; RC:N = 1,971) met the inclusion criteria. Robotic approach was associated with more complications (LC:0.9%, RC:1.7%; p < 0.001), postoperative infections (LC:0.2%, RC:0.4%; p = 0.033) and a higher direct cost (LC:$6782 ± 3421, RC:$9354 ± 5497; p < 0.001). Opiates were prescribed more frequently in the laparoscopic group (LC:98.3%, RC:97.2%; p = 0.002). The direct cost of RC is significantly higher than LC with no added benefit. Routine use of the robotic platform for cholecystectomy should be discouraged until costs are reduced.

Mechanisms for hydrogen evolution on transition metal phosphide catalysts and a comparison to Pt(111). Earth-abundant transition metal phosphides have been demonstrated to be promising alternative catalysts to replace Pt for hydrogen evolution reaction (HER). However, the mechanism for the hydrogen evolution reaction on transition metal phosphides remains unclear. Here, we explore the catalytically active sites and the reaction mechanisms on a variety of model transition metal phosphide surfaces by building cluster expansion models and running Monte Carlo simulations. We demonstrate that the effect of hydrogen coverage, interaction between hydrogen atoms and desorption kinetics all dictate the HER mechanisms and the active sites, and we propose mechanisms that are in good agreement with experimental studies. The present method provides a general and effective way to probe the active sites and study the mechanisms of catalytic reactions, which can facilitate the rational design of highly active electrocatalysts.

The spiny stellate neurons in layer IV of the human auditory cortex. A Golgi study. The spiny stellate neurons have been studied by the Golgi method in the auditory koniocortex and parakoniocortex of man. Spiny stellate cells are a consistent though not very common component of layer IV. They are not confined to specific sublayers but occur at all depths of layer IV, and also in layer IIIc. Spiny stellate cells in the auditory areas show a great variety of their dendritic arborization pattern. The presence of all intermediate forms between small pyramidal cells--which constitute the dominant cell type in layer IV and which display an extraordinary heteromorphism--and spiny stellate cells shows the close kinship between both neuronal types. The morphology and distribution of spines along the dendrites of spiny stellate neurons are similar to those of the small pyramidal cells of the same layer. The axons, which were impregnated only in their proximal portions, mostly descend, giving rise to recurrent ascending collaterals, but initially ascending axons do also occur. Spiny stellate neurons are present in the different cytoarchitectonic areas examined, and thus they are not confined to the auditory koniocortex.

The role of p23, Hop, immunophilins, and other co-chaperones in regulating Hsp90 function. Molecular chaperones are a diverse group of highly conserved proteins that transiently interact with partially folded polypeptide chains during normal cellular processes, such as protein translation, translocation, and disassembly of protein complexes (1). Prior to folding or after denaturation, hydrophobic residues that are normally sequestered within a folded protein are exposed to the aqueous environment and are prone to aggregation or misfolding. Multiple classes of molecular chaperones, such as Hsp70s and Hsp40s, recognize and transiently bind polypeptides with exposed hydrophobic stretches in order to prevent misfolding. Other types of chaperones, such as Hsp90, have more specialized functions in that they appear to interact with only a subset of cellular proteins. This chapter focuses on the role of Hsp90 and partner co-chaperones in promoting the folding and activation of a diverse group of proteins with critical roles in cellular signaling and function.

Three's company: co-crystallization of a self-assembled S(4) metallacyclophane with two diastereomeric metallacycle intermediates. Three discrete supramolecular self-assembled arsenic(iii) complexes including an unusual S(4)-symmetric tetranuclear [As(4)L(2)Cl(4)] metallacyclophane and two diastereomeric cis/trans-[As(2)LCl(2)] metallacycle intermediates co-crystallize within a single crystal lattice.

Cytochrome oxidase histochemistry in the effect of light deprivation on the fly visual system. Deprivation of visual experience for a short time during the early period postemergence in the fly influences strongly the development of visual pattern discrimination. Cytochrome oxidase histochemistry was used to examine the effect of visual deprivation on the development of the neuronal network in the optic lobe. Flies in which one compound eye was covered immediately after emergence were raised under normal light and dark conditions (LD). Other flies were raised without covering of the compound eyes under LD or continuous darkness (DD) as controls. At various periods of postemergence flies from the 3 groups were used for histochemistry. The results indicated that the deprivation caused by unilateral eye covering produced a decrease in cytochrome oxidase staining of the covered side of the retina and optic lobe, but not in the central part of the brain. This asymmetry in staining was not seen in flies of 1-5 days postemergence but became evident after the sixth day postemergence. When flies were raised in DD until the 5th day postemergence and then in LD, the development of asymmetry in cytochrome oxidase staining was delayed. These results confirm previous behavioral experiments on visual deprivation. Both suggest that visual deprivation during the early period of postemergence leads to a long-lasting decrease in neuronal activity.

[Retinal imaging in hereditary chorioretinal dystrophies]. The paper presents retinal imaging (color and red-free photografs, fluorescein angiograms and optical coherence tomography) of the most common hereditary chorioretinal dystrophies: retinitis pigmentosa, Stargardt's disease, choroideremia, cone dystrophy vitteliform dystrophy. Retinal imaging has an important role in the diagnosis and the follow-up of these diseases, but genetic investigations are frequently necessary.

Sexually transmitted infections among prostitutes in Bratislava, Slovakia. Sera from 18 prostitutes from Bratislava were examined for the presence of antibodies to several sexually transmitted pathogens, namely Herpes simplex virus 2 (HSV-2), Human immunodeficiency viruses 1 and 2 (HIV-1 and HIV-2), Hepatitis B and C viruses (HBV and HCV), Chlamydia trachomatis, and Treponema pallidum. Results of this screening indicated that 11 prostitutes (61%) carried 1 or more sexually transmitted infections. The most prevalent antibodies were directed against HSV-2 (9 cases, i.e. 50%), which represents the most common sexually transmitted infection agent.

Efficient storage of large MODFLOW models. We present a methodology for storing the bulkier portions of a set of MODFLOW input and output files in a compressed binary format using the HDF5 library. This approach results in compression ratios of up to 99% with no significant time penalty. The highly compressed format is particularly beneficial when dealing with large regional models or Monte Carlo simulations. The strategy is focused on the list- and array-based portions of the input files including the cell property and recharge arrays, and is compatible with models containing parameters, including pilot points. The utilities are based on a modified version of the MODFLOW code and are, therefore, compatible with any standard MODFLOW simulation. We present used cases and instructions on how to use the utilities.

Small effects of neck torsion on healthy human voluntary eye movements. Although several lines of research suggest that the head and eye movement systems interact, previous studies have reported that applying static neck torsion does not affect smooth pursuit eye movements in healthy controls. This might be due to several methodological issues. Here we systematically investigated the effect of static neck torsion on smooth pursuit and saccadic eye movement behavior in healthy subjects. In twenty healthy controls, we recorded eye movements with video-oculography while their trunk was in static rotation relative to the head (7 positions from 45° to the left to 45° to right). The subject looked at a moving dot on the screen. In two separate paradigms, we evoked saccadic and smooth pursuit eye movements, using both predictable and unpredictable target motions. Smooth pursuit gain and saccade peak velocity decreased slightly with increasing neck torsion. Smooth pursuit gains were higher for predictable target movements than for unpredictable target movements. Saccades to predictable targets had lower latencies, but reduced gains compared to saccades to unpredictable targets. No interactions between neck torsion and target predictability were observed. Applying static neck torsion has small effects on voluntary eye movements in healthy subjects. These effects are not modulated by target predictability.

Perceptual scaling of whole-body low frequency linear oscillatory motion. Evidence that Z-axis oscillation in the Earth-vertical plane is more provocative of motion sickness than the equivalent imposed oscillation acting in the Earth-horizontal raises the possibility that horizontal oscillation is perceived as less intense than equivalent vertical oscillation. In Experiment 1, subjects (n = 8) were oscillated through their head Z-axis in both the Earth-vertical and horizontal planes. In Experiment 2, another group (n = 10) were oscillated through their head Y-axis in the Earth-horizontal. Stimuli were 5 cycles of motion at 0.3 Hz ranging in 3.5 dB intervals from 0.19 to 2.15 m.s-2 (Expt. 1) and from 0.1 to 3.98 m.s-2 (Expt. 2). Perceptual scaling of intensity against acceleration was similar irrespective of direction of oscillation in the Earth-plane or head-body axis. Displacement tended to be overestimated, this being most marked for the lower acceleration levels in the horizontal condition. Results supported the notion that Stevens' Power Law exponents decrease as a function of increasing stimulus range. Differences in perception of oscillation intensity and displacement do not seem to explain the markedly greater nauseogenic potential of vertical oscillation.

Hong Kong Liberals Are WEIRD: Analytic Thought Increases Support for Liberal Policies. This study tests whether liberals and conservatives within the same society think as if they were from different cultures. I tested this by measuring the cultural thought style of social liberals and conservatives in Hong Kong (Study 1). Liberals tended to think more analytically (more "WEIRD"), and conservatives tended to think more holistically (more common in East Asia). In Study 2, I trained people to think analytically or holistically before they read articles on political issues. Analytic thought caused people to form more liberal opinions, and holistic thought caused people to form more conservative opinions. The thought training affected participants' responses to a social issue, but not an economic issue or whether they identified as liberal or conservative. This study replicates a previous U.S. finding in an East Asian culture and a different political environment, suggesting that the link between politics and thought style extends beyond the United States.

The influence of uveitis on patients with immune-mediated inflammatory disease. Uveitis, defined as an intraocular inflammatory disease, is one of the main causes of visual impairment in the working-age population. The condition often coexists with other immune-mediated inflammatory diseases (IMID) and greatly contributes to reduced quality of life (QOL) in affected individuals. While visual acuity remains the most commonly used measure of visual function in patients with uveitis, the US National Eye Institute Visual Function Questionnaire is frequently used to assess their health-related QOL. However, despite intuition that coexisting uveitis might exaggerate already impaired QOL in patients with IMID, specific questions related to their visual functioning are rarely included in clinical trials or assessed in daily practice. We provide an overview of the occurrence and significance of uveitis in patients with IMID, its consequences, and the role of tumor necrosis factor-α inhibitors in overall treatment approaches.

An immunocytochemical study of isolated human retinal Müller cells in culture. We report a modified method for the isolation and propagation of adult human Müller cells in culture. The retina of postmortem human eyes was mechanically dissociated and cultured. Using immunocytochemical techniques, these cells were stained with monoclonal antibodies specific for Müller cells, glial fibrillary acidic protein (GFAP), vimentin, glutamine synthetase (GS) and keratin. Transmission electron microscopy (TEM) was also performed. The dissociated and cultured cells expressed vimentin and GS, but not GFAP. At least 85% of these cells stained with a Müller cell-specific monoclonal antibody. Using TEM, flat cells containing 13-nm intermediate filaments and glycogen were identified. Human retinal Müller cells can be isolated and propagated in culture. Purified cell cultures are required for controlled studies of the normal physiology and pathologic responses of Müller cells.

Drastic down-regulation of Krüppel-like factor 4 expression is critical in human gastric cancer development and progression. Krüppel-like factor 4 (KLF4) is highly expressed in epithelial tissues such as the gut and skin. However, the role of KLF4 in human gastric cancer development and progression is unknown. Here we show that KLF4 protein expression was decreased or lost in primary tumors and, in particular, lymph node metastases when compared with that in normal gastric mucosa. Moreover, loss of KLF4 expression in the primary tumors was significantly associated with poor survival, and also an independent prognostic marker in a multivariate analysis. Consistently, most human gastric cancer cell lines exhibited loss of or a substantial decrease in KLF4 expression at both RNA and protein levels. Enforced restoration of KLF4 expression resulted in marked cell growth inhibition in vitro and significantly attenuated tumor growth and total abrogation of metastasis in an orthotopic animal model of gastric cancer. Mechanism studies indicated that promoter hypermethylation and hemizygous deletion contributed to the down-regulation of KLF4 expression and the induction of apoptosis contributed to the antitumor activity of KLF4. Collectively, our data provide first clinical and casual evidence and potential mechanism that the alteration of KLF4 expression plays a critical role in gastric cancer development and progression.

On-Line Monitoring of the Photolysis of Benzyl Acetate and 3,5-Dimethoxybenzyl Acetate by Membrane Introduction Mass Spectrometry. Membrane introduction mass spectrometry (MIMS) allows on-line monitoring of the products of photolysis (254 nm) of benzyl acetate in aqueous methanol and 3,5-dimethoxybenzyl acetate in water. The reaction mixture is continuously exposed to a silicone membrane through which analyte molecules permeate into a triple quadrupole mass spectrometer for qualitative and quantitative analysis. Ionization is achieved by either isobutane or ammonia chemical ionization, and ions characteristic of the reactant ester and its products are monitored simultaneously and continuously. Three products, benzyl methyl ether, ethylbenzene, and bibenzyl are observed in the benzyl acetate photolysis. Two products, 3,5-dimethoxybenzyl alcohol and 3,5-dimethoxyethylbenzene, are formed in the photolysis of 3,5-dimethoxybenzyl acetate. Quantitation is achieved through calibration using external standard solutions and, in the case of benzyl methyl ether, tandem mass spectrometry is used to verify product identification. During the photolysis of benzyl acetate, benzyl methyl ether and ethylbenzene are produced at onset with similar efficiencies. For the 3,5-dimethoxy ester photolysis, performed in aqueous solution, the efficiency of formation of the polar product 3,5-dimethoxybenzyl alcohol is about 300 times greater than that of the nonpolar product 3,5-dimethoxyethylbenzene. The results show that the relative reaction rates are dependent on the solvent and on the photon intensity and are consistent with earlier off-line experiments by Pincock et al. which showed that the photolysis proceeds through both ion and radical pair intermediates. To the best of our knowledge, the work reported here describes the first analysis of the photochemistry of an aralkyl ester in water and the first use of on-line mass spectrometry in a mechanistic study.

[Turner's syndrome and pregnancy in donor oocytes and in vitro fertilization. Three case reports]. It is extremely rare for pregnancy to occur spontaneously in a woman with a mosaic or non-mosaic karyotype 45 x 0. (Till now only 13 patients with a homogeneous x 0 karyotype have been reported out of 62 patients who between them have had 138 pregnancies). Furthermore these pregnancies have been plagued by a number of important complications or fetal malformations (21% have had chromosome anomalies). It is therefore clear that in vitro fertilization with donor oocytes is a tempting solution for these women. The authors having three personal cases try and point out the conditions under which this technique can be used. It is important to realise that from the age of 10 or 12 years these patients have to have hormone treatment in order to avoid hypoplasia and hypovascularization of the uterus. Those conditions explain why so many these women had premature labours and also suffer from pre-eclampsia. Caesarean section was often found to be necessary because of feto-pelvic disproportion.

A method for the rapid quantitation of methylated hepatic DNA-purines using high pressure liquid chromatography. An isocratic high pressure liquid chromatography system that can be employed for the separation and quantitation of four of the major methylated purines commonly found in DNA after exposure to carcinogenic/mutagenic alkylating agents (1-methyladenine, 3-methyladenine, O6-methylguanine and 7-methylguanine) is presented in this paper. Data from experiments in which rats were treated with methyl-N-nitrosourea have been used to illustrate the applicability of the method. The amounts of the methylated bases observed were consistent with values reported in the literature.

Effects of different supplements on splanchnic oxygen consumption and net fluxes of nutrients in sheep consuming bromegrass (Bromus inermis) hay ad libitum. Fifteen sheep (53 kg), with catheters in a hepatic vein, the portal vein and a mesenteric vein and artery, were offered a bromegrass (Bromus inermis) hay (104 g crude protein (CP), 700 g neutral-detergent fibre and 65 g acid-detergent lignin/kg dry matter (DM) ad lib. with different supplements to determine the effects on net flux of oxygen and nutrients across the portal-drained viscera (PDV) and liver. The sheep were unsupplemented (Control) or received 5 g DM/kg body weight (BW) of ground maize (M), 7 g DM/kg BW of soya-bean hulls (H) or 0.73 g DM/kg BW of a mix of feedstuffs high in rumenundegradable protein (P). Apparent digestible energy (DE) intakes were 5.3, 10.4, 10.6 and 6.7 (SE 0.74) MJ/d and apparent digestible CP intakes were 37, 50, 79 and 68 (SE 4.3) g/d for Control, M, H and P treatments respectively. Splanchnic tissue oxygen consumption rates were 0.23, 0.32, 0.30 and 0.27 (SE 0.054) mol/h, and oxidative metabolism accounted for 0.46, 0.31, 0.33 and 0.47 (SE 0.051) of DE intakes for Control, M, H and P treatments respectively. Supplements increased (P < 0.05) release of alpha-amino nitrogen (AAN) by the PDV (4.2, 17.5, 19.6 and 18.1 mmol/h for Control, M, H and P treatments respectively). Splanchnic net flux of AAN was not affected by supplement treatments. Hepatic release of urea-N was increased (P < 0.05) by supplement treatments (27, 40, 46 and 44 mmol/h for Control, M, H and P respectively); the P treatment increased (P < 0.05) and the H treatment tended (P = 0.10) to increase splanchnic release of urea-N (7, 10, 20 and 27 mmol/h for Control, M, H and P treatments respectively). Net flux of glucose across the PDV was -4.6, 1.4, -5.6 and -7.2 (SE 1.65) mmol/h for Control, M, H and P treatments respectively. Hepatic glucose released averaged 23 (SE 2.0) mmol/h and was not affected by treatment. Treatments M and H increased (P < 0.05) PDV release of propionate compared with the Control treatment (4.5, 15.5, 16.8 and 7.7 mmol/h for Control, M, H and P treatments respectively). Release of acetate by the PDV was 43, 97, 118 and 67 (SE 23.9) mmol/h for Control, M, H and P treatments respectively. In summary, different supplements of low-quality grass did not increase the efficiency of N metabolism by splanchnic tissues. Treatment P had little effect on net flux across splanchnic tissues of glucose, L-lactate, beta-hydroxybutyrate and volatile fatty acids (VFA).(ABSTRACT TRUNCATED AT 400 WORDS)

Evidence of hormesis on human neuronal SK-N-BE cells treated with sodium arsenate: impact at the mitochondrial level. Exposure of human neuronal SK-N-BE cells to sodium arsenate (AsV 0.1-400 μM; 48 h) induced a biphasic toxic effect evoking hormesis. Indeed, at low concentrations, AsV stimulates cell proliferation visualized by phase contrast microscopy, whereas at high concentrations, an induction of cell death associated with a loss of cell adhesion was observed. These side effects were confirmed with crystal violet test, cell cycle analysis, evaluation of the percentage of Ki67 positive cells, and staining with propidium iodide. The impact of AsV on mitochondrial functions, which was determined by the MTT assay, the measurement of mitochondrial transmembrane potential with DiOC6(3), and the rate of mitochondrial ATP, also support an hormesis process. In addition, in the presence of high concentrations of AsV, a significant decrease of the protein expression of OXPHOS complexes of the respiratory chain was observed by western blot supporting that AsV-induced cell death is associated with mitochondrial alterations. Therefore, there are some evidences of hormesis on AsV-treated SK-N-BE cells, and at high concentrations, the mitochondria are a target of toxicity induced by AsV.

Amino acid substitutions around the chromophore of the chromoprotein Rtms5 influence polypeptide cleavage. Extension of the conjugated pi-system of many all-protein chromophores with an acylimine bond is the basis for their red-shifted optical properties. The presence of this post-translational modification is evident in crystal structures of these proteins. Harsh denaturation of proteins containing an acylimine bond results in partial polypeptide cleavage. For the red fluorescent protein DsRed, the extent of cleavage is quantitative. However, this is not the case for the blue non-fluorescent chromoprotein Rtms5, even though all chromophores in tetrameric Rtms5 contain an acylimine bond. We have identified two positions around the chromophore of Rtms5 where substitutions can promote or suppress the extent of cleavage on harsh denaturation. We propose a model in which cleavage of Rtms5 is facilitated by a trans to cis isomerisation of the chromophore.

The effect of pre-operative anxiety on induction of anaesthesia with propofol. In this prospective study, we investigated the effects of anxiety on the induction dose of propofol and subsequent cardiovascular changes in 197 patients. Pre-operative state and trait anxiety scores were measured using the State Trait Anxiety Inventory. Propofol was administered at 40 mg x kg(-1) x h(-1). Propofol dose was recorded at loss of verbal response and when EEG Bispectral Index decreased to 50. Thereafter, propofol infusion rate was reduced to 8 mg x kg(-1) x h(-1). Cardiovascular data were collected for 15 min after starting induction. Maximum percentage decreases in heart rate and mean arterial pressure, and the point at which the latter occurred, were recorded. On multivariate analysis, anxiety scores did not significantly affect propofol dose or cardiovascular end-points, although Bispectral Index at loss of verbal response decreased with increasing trait anxiety (p = 0.02). Anxiety, measured using State Trait Anxiety Inventory, does not appear independently to affect the induction characteristics of propofol.

[Rescue thrombectomy after stent implantation in a degenerating aortocoronary bypass]. Distal showering of atherosclerotic debris or thrombus is a feared event during percutaneous angioplasty of degenerated vein grafts. We report on a 66-year-old male patient with a history of coronary artery disease who was admitted into hospital with an acute coronary syndrome. He had had coronary artery bypass graft surgery in 1995. His chest pain resolved under treatment with aspirin, heparin, betablocker, and nitrate. A diagnostic angiogram demonstrated two critical stenoses of the left anterior descending graft. After a continuous infusion of tirofiban administered for 24 h prior to elective angioplasty, a JR 4SH 6 F guiding catheter (Cordis) was positioned. The lesions were crossed with a 0.014" Galeo F wire (Biotronik). A 4 mm x 16 mm stent graft (Jostent, Jomed) was deployed in the distal stenosis and a 4.5 mm x 32 mm self-expandable stent (Magic Wallstent, Boston Scientific) in the proximal stenosis. Thereafter, the patient suffered from chest pain, and the ECG showed ST elevation from V1 to V5. Angiography revealed total occlusion of the left anterior descending artery. An X-Sizer catheter (EndiCOR Medical, Inc.) was introduced and advanced through the vein graft with slow back-and-forth movements. After several aspirations, blood flow was significantly improved. A modest CK elevation (127 U/l) indicated a rather small loss of myocardial tissue. Percutaneous revascularization of narrowed aortocoronary saphenous vein grafts is associated with increased risk of distal embolization and "no reflow". The X-Sizer catheter system is compatible with commercially available guiding catheters, and capable of retrieving thrombotic debris after macroembolization from degenerated saphenous vein grafts including the native coronary artery.

Special problems relating to the use of hypnotics in the elderly. The problems experienced by elderly patients taking hypnotic drugs are reviewed. They include those associated with accumulation, tolerance, drug dependence and the intensity and duration of response. Biological mechanisms associated with ageing enhance some of these effects in the elderly. Care should be taken to define the precise indications for hypnotic use and to choose the correct drug and dose for the patient's condition and age.

Efficacy of budesonide in collagenous colitis Evaluation of: Miehlke S, Madisch A, Kupcinskas L, et al. Budesonide is more effective than mesalamine or placebo in short-term treatment of collagenous colitis. Gastroenterology 2014;146(5):1222-1230 e1222. Collagenous colitis (CC) is a less common colonic disease with variable prevalence and undulating course. Among the available therapies, budesonide was demonstrated to induce a rapid and sustained remission in many cases, but little is known about the comparative efficacy of other treatments, such as mesalamine. Evaluation of a randomized study assessing the efficacy and safety of budesonide over mesalamine in patients with CC. Data from the study showed that budesonide was significantly superior to placebo and to mesalamine and further supports the recommendation of the current guidelines on the use of budesonide in CC. However, other forms of mesalamine may further be evaluated for this disease.

Serial MRI in infantile bilateral striatal necrosis. A 3-year-old girl with left hemiparesis suffered from bilateral paresis, motor rigidity, gait disturbance, axial hypotonia, dysarthria, apathy, and incontinence. After steroid therapy, mild improvement occurred, but muscle weakness, gait disturbance, and rigidity remained. Leigh encephalopathy was excluded on the basis of muscle biopsy and laboratory findings. Computed tomography and serial magnetic resonance imaging at an early stage revealed right-sided dominant lesions in the putamen and caudate nucleus and later bilateral striatal lesions, appearing as hyperintense signals on T2-weighted images and mixtures of hypo- and hyperintense signals on T1-weighted images. This is the first demonstration of serial magnetic resonance imaging findings in infantile bilateral striatal necrosis.

Particle swarm optimization method for small retinal vessels detection on multiresolution fundus images. Retinal vessel segmentation plays an important role in the diagnosis of eye diseases and is considered as one of the most challenging tasks in computer-aided diagnosis (CAD) systems. The main goal of this study was to propose a method for blood-vessel segmentation that could deal with the problem of detecting vessels of varying diameters in high- and low-resolution fundus images. We proposed to use the particle swarm optimization (PSO) algorithm to improve the multiscale line detection (MSLD) method. The PSO algorithm was applied to find the best arrangement of scales in the MSLD method and to handle the problem of multiscale response recombination. The performance of the proposed method was evaluated on two low-resolution (DRIVE and STARE) and one high-resolution fundus (HRF) image datasets. The data include healthy (H) and diabetic retinopathy (DR) cases. The proposed approach improved the sensitivity rate against the MSLD by 4.7% for the DRIVE dataset and by 1.8% for the STARE dataset. For the high-resolution dataset, the proposed approach achieved 87.09% sensitivity rate, whereas the MSLD method achieves 82.58% sensitivity rate at the same specificity level. When only the smallest vessels were considered, the proposed approach improved the sensitivity rate by 11.02% and by 4.42% for the healthy and the diabetic cases, respectively. Integrating the proposed method in a comprehensive CAD system for DR screening would allow the reduction of false positives due to missed small vessels, misclassified as red lesions.

Diversity of the basic defect of homozygous CFTR mutation genotypes in humans. Knowledge of how CFTR mutations other than F508del translate into the basic defect in cystic fibrosis (CF) is scarce due to the low incidence of homozygous index cases. 17 individuals who are homozygous for deletions, missense, stop or splice site mutations in the CFTR gene were investigated for clinical symptoms of CF and assessed in CFTR function by sweat test, nasal potential difference and intestinal current measurement. CFTR activity in sweat gland, upper airways and distal intestine was normal for homozygous carriers of G314E or L997F and in the range of F508del homozygotes for homozygous carriers of E92K, W1098L, R553X, R1162X, CFTRdele2(ins186) or CFTRdele2,3(21 kb). Homozygotes for M1101K, 1898+3 A-G or 3849+10 kb C-T were not consistent CF or non-CF in the three bioassays. 14 individuals exhibited some chloride conductance in the airways and/or in the intestine which was identified by the differential response to cAMP and DIDS as being caused by CFTR or at least two other chloride conductances. CFTR mutations may lead to unusual electrophysiological or clinical manifestations. In vivo and ex vivo functional assessment of CFTR function and in-depth clinical examination of the index cases are indicated to classify yet uncharacterised CFTR mutations as either disease-causing lesions, risk factors, modifiers or neutral variants.

Nail lichen striatus: report of seven cases and review of the literature. Nail involvement in lichen striatus (LS) is rare and has not been documented extensively. This study describes the clinical and histological features, response to treatment, and follow-up in seven patients with nail LS. We reviewed seven cases of nail LS between 2006 and 2012 at the Dermatology Department, Yeouido St Mary's Hospital, Seoul, South Korea. The median patient age was 11 years (range: 4-33 years), and the female:male ratio was 3:4. All patients had both typical skin lesions and nail abnormalities. In these cases, LS usually involved a single digit (n = 5). The most common nail change was longitudinal fissuring (n = 4). We actively treated both skin and nail lesions from the time of diagnosis. Most nail lesions resolved within a mean of four months of the initiation of treatment. Nail involvement in LS is rare; this case series highlights the associated nail changes. We emphasize that early accurate diagnosis and treatment may be beneficial in reducing nail deformities in patients with nail involvement.

Justification of CT scans using referral guidelines for imaging. This study analyses the efficiency of the justification of individual computed tomography (CT) procedures using the good practice guide. The conformity of the CT scans with guide's recommendations was retrospectively analysed in a paediatric emergency hospital in Romania. The involved patient doses were estimated. The results show that around one-third of the examinations were not prescribed in conformity with the guide's recommendations, but these results are affected by unclear guide provisions, discussed here. The implications of the provisions of the revised International Atomic Energy Agency's Basic Safety Standards and of the Council Directive 2013/59/EURATOM were analysed. The education and training courses for medical doctors disseminating the provisions of the good practice guide should be considered as the main support for the justification of the CT scans at the individual level.