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A prospective study of fluconazole treatment for breast and nipple thrush. Breastfeeding women with continuous burning nipple pain, often associated with post-feed radiating breast pain, may be diagnosed with nipple and breast Candida (thrush) infection. This project examined the efficacy of the three fuconazole capsule regime (one 150 mg capsule alternate days) and explored factors associated with longer courses of fluconazole. Women diagnosed with nipple and breast Candida and treated with oral fuconazole at a tertiary hospital (n = 96) were followed up until pain resolution. Women took between 1 and 29 fluconazole capsules, mean = 7.3, median = 6. The number of capsules was not related to socio-demographic or health characteristics of mothers or babies; women with more severe breast pain were more likely to take > 3 capsules than women with less severe breast pain. Only minor side-effects were reported. Most women require more than three capsules of fluconazole, but two-thirds of women will require six or less.

The Age-Related Performance Decline in Ironman Triathlon Starts Earlier in Swimming Than in Cycling and Running. Käch, I, Rüst, CA, Nikolaidis, PT, Rosemann, T, and Knechtle, B. The age-related performance decline in Ironman triathlon starts earlier in swimming than in cycling and running. J Strength Cond Res 32(2): 379-395, 2018-In Ironman triathlon, the number of overall male and female finishers increased in the past 30 years, while an improvement in performance has been reported. Studies concluding these numbers only analyzed the top 10 athletes per age group instead of all finishers; therefore, a selection bias might have occurred. The aim of this study was to investigate participation, performance, and the age-related performance decline of all pro- and age-group triathletes ranked in all Ironman triathlons held worldwide between 2002 and 2015. Split and overall race times of 329,066 (80%) male and 81,815 (20%) female athletes competing in 253 different Ironman triathlon races were analyzed. The number of finishers increased in all age groups with the exception of women in age group 75-79 years. In pro athletes, performance improved in all disciplines. In age-group athletes, performance improved in younger age groups for running (from 18-24 to 40-44 years) and older age groups for swimming (from 50-54 to 65-69 years) and cycling (from 35-39 to 55-59 years), whereas it impaired in younger age groups for swimming (from 18-24 to 45-49 years) and cycling (from 18-24 to 30-34 years), and older age groups in running (from 45-49 to 70-74 years). The age-related performance decline started in women in age group 25-29 years in swimming and in age group 30-34 years in cycling, running, and overall race time, whereas it started in men in age group 25-29 years in swimming and in age group 35-39 years in cycling, running, and overall race time. For athletes and coaches, performance improved in younger age groups for running and older age groups for swimming and cycling, and the age-related decline in performance started earlier in swimming than in cycling and running. In summary, women should start competing in Ironman triathlon before the age of 30 years and men before the age of 35 years to achieve their personal best Ironman race time.

The vasorelaxing action of rutaecarpine: direct paradoxical effects on intracellular calcium concentration of vascular smooth muscle and endothelial cells. We have examined both the hypotensive effect and the mechanism of intracellular Ca++ regulation, underlying rutaecarpine (Rut)-induced vasodilatation. An i.v. bolus injection of Rut in anesthetized Sprague-Dawley rats produced a dose-dependent hypotensive effect. In isolated rat aorta rings, Rut (0.1-3 mu M) inhibited the phasic and tonic responses of norepinephrine- and phyenylephrine-induced contractions, respectively, mainly through an endothelium-dependent mechanism. However, the vasorelaxing effect of Rut (3 microM) persisted in denuded aorta, although to a much less extent than in intact tissue. As determined by the fura-2/AM (1-[2-(5-carboxyoxazol-2-yl)-6-aminobenzofuran-5-oxy]-2-(2'- amino-5'-methylphenoxy)-ethane-N,N,N,N-tetraacetic acid pentaacetoxymethyl ester) method, Rut (10 microM), in the presence of extracellular Ca++, suppressed the KCI-induced increment in the intracellular Ca++ concentration ([Ca++]i) of cultured vascular smooth muscle cells (VSMC). Rut (10 microM) also attenuated the norepinephrine-induced peak rise of [Ca++]i in VSMC placed in Ca++-free solution. On the other hand, Rut (1 and 10 microM) increased the level of [Ca++]i of cultured endothelial cells (EC) in the presence of extracellular Ca++. In conclusion, Rut acts on both VSMC and EC directly. In VSMC, it reduces [Ca++]i through the inhibition of Ca++ influx and Ca++ release from intracellular stores. In EC, Rut augments EC [Ca++]i by increasing Ca++ influx, possibly leading to nitric oxide release. The paradoxical regulation of Ca++ in both VSMC and EC acts simultaneously to cause vasorelaxation which could account, at least in part, for the hypotensive action. This is a most significant and a unique feature of this study.

Reversible self-association of a human myeloma protein. Thermodynamics and relevance to viscosity effects and solubility. Monoclonal IgG paraproteins associated with multiple myeloma, Felty's syndrome, and idiopathic cryoglobulinemia frequently produce disease due to a tendency to self-associate in vivo. The insolubility and viscosity effects of these proteins are of specific interest as molecular disease mechanisms. In sedimentation equilibrium studies at 21 degrees C an IgG1-lambda myeloma protein (IgG-MIT) associated with the hyperviscosity syndrome is shown to undergo a reversible polymerization reaction. On the basis of the theory and data-fitting methods of Adams and co-workers [Tang, L. H., Powell, D. R., Escott, B. M., & Adams, E. T., Jr. (1977) Biophys. Chem. 7, 121-139], the data are consistent with a nonideal cooperative indefinite (SEK type III) model self-association in which one equilibrium constant (K12 = 6.3 X 10(3) L/m) governs dimerization while another (K = 1.7 X 10(4) L/m) governs all subsequent additions of monomer to the polymer. Temperature effects on K12 and K between 11 and 30 degrees C suggest negative van't Hoff enthalpies for all association steps and a positive entropy change [delta S degree = 2.5 cal/(mol-deg)] for steps beyond the dimer. An increase in ionic strength from I = 0.03 to I = 0.18 promotes the polymerization of IgG-MIT through a marked increase in K while paradoxically enhancing bulk solubility. These results suggest that this self-association proceeds through a combination of weak nonionic and hydrophobic interactions. The enhancement of both polymerization and solubility by increased ionic strength suggests that the hyperviscosity induced by IgG-MIT results from its ability to form large, highly soluble polymers in serum.(ABSTRACT TRUNCATED AT 250 WORDS)

Heat conduction from the exceedingly hot fiber tip contributes to the endovenous laser ablation of varicose veins. Lower-extremity venous insufficiency is a common condition, associated with considerable health care costs. Endovenous laser ablation is increasingly used as therapy, but its mechanism of action is insufficiently understood. Here, direct absorption of the laser light, collapsing steam bubbles and direct fiber-wall contact have all been mentioned as contributing mechanisms. Because fiber tips have reported temperatures of 800-1,300 degrees C during endovenous laser ablation, we sought to assess whether heat conduction from the hot tip could cause irreversible thermal injury to the venous wall. We approximated the hot fiber tip as a sphere with diameter equal to the fiber diameter, having a steady state temperature of 800 degrees C or 1,000 degrees C. We computed venous wall temperatures due to heat conduction from this hot sphere, varying the pullback velocity of the fiber and the diameter of the vein. Venous wall temperatures corresponding to irreversible injury resulted for a 3 mm diameter vein and pullback velocities <3 mm/s but not for 5 mm and > or =1 mm/s. The highest wall temperature corresponded to the position on the wall closest to the fiber tip, hence it moves longitudinally in parallel with the moving fiber tip. We concluded that heat conduction from the hot fiber tip is a contributing mechanism in endovenous laser ablation.

Drug prescribing patterns: a study of four institutions in Sri Lanka. Drug prescribing patterns were studied retrospectively in 600 patients admitted to the medical wards of three Government hospitals and one private nursing home in the Kandy area of Sri Lanka. The mean drug exposure in the governmental institutions varied between 3.6 and 3.7, whereas at the private institution, patients were exposed to an average of 7.2 drugs. The three Government institutions used 87, 91 and 107 drugs. The private institution 201. There was no difference in drug exposure in relation to sex, but a tendency towards increased drug exposure was noted with increasing age and longer duration of stay. Antimicrobial agents were the most frequently prescribed class of drugs and diazepam the most prescribed single drug. The reasons for the extensive use of diazepam observed in this study are not clear.

Associated multiple congenital malformations in domestic animals. Contribution of four cases. The incidence and significance of the appearance of various associated congenital malformations in a single individual have received poor attention in veterinary medicine. In this article, the malformations exhibited by four animals pertaining to three different animal species are described, and the possible reasons for the association of these anomalies are discussed from the viewpoint of the comparative medicine. All four animals showed two or three malformations constituting unrecognized teratological syndromes, so-called one-of-a-kind syndromes, which have not previously been described, at least in these particular animal species. A pig was affected by a series of craniofacial anomalies consisting in a first arch syndrome together with an occipito-parietal meningocele. Another member of the porcine species showed holoprosencephaly with cyclopia, various defects in the left forelimb and an extensive omphalocele. A dicephalic cat with cervical rachischisis and myeloschisis and a dog exhibiting spina bifida, curled tail and atresia ani are also described.

Exploring the potential energy surface of retinal, a comparison of the performance of different methods. The ground state structure of retinal has been investigated. We found that DFT and CASSCF produce different results for the bond length alternation in a model system of retinal. Quantum mechanics/molecular mechanics calculations including the closest surrounding amino acids have been performed, using DFT and CASSCF to calculate the structure of retinal in the protein cavity. The planarity of the retinal molecule is affected by the surrounding protein. DFT and CASSCF produce different twist angles. The difference between CASSCF and DFT appears to be related to the positively charged nitrogen of the Schiff base, which leads to different pi-bond orders produced by the two methods.

Ultrastructural and cytochemical aspects of Schistosoma mansoni cercaria. An alternative to identify the critical processes necessary to the parasite establishment of the host is to focus on the evolutionary stage responsible for the primary invasion, i.e. the infection structure. The objective of this study was to ultrastructurally characterize Schistosoma mansoni cercariae, using cytochemical techniques. In order to identify basic proteins, techniques such as ethanolic phosphotungstic acid (EPTA) and ammoniacal silver staining were used. Calcium sites location was achieved using the Hepler technique and to evidence anionic groups, we used cationic ferritin particles and enzyme treatment with trypsin Vibrio cholerae, chondroitinase and neuraminidase. The EPTA technique highlighted the presence of basic tegument proteins, nucleus and nucleolus from subtegumental cells, inclusion bodies and preacetabular glands. After using ammoniacal silver, we observed a strong staining in all infective larvae, particularly in the nuclei of muscle cells, circular muscle tissue and preacetabular glands. Calcium site locations were shown to be uniform, thereby limiting the inner spaces of the larvae, especially muscle cells. Samples treated with cationized ferritin particles presented strong staining at the cuticular level. Neuraminidase treatment did not alter the stained shape of such particles on the trematode surface. However, trypsin or chondroitinase treatment resulted in absence of staining on the larval surface. This information on the biochemical composition of the infecting S. mansoni larvae provides data for a better understanding of the biology of this parasite and background on the intriguing parasite-host relationship.

[Results of radiculomyelography with dimer-X following lumbar intervertebral disk operations]. In radiculomyelogram after operation of lumbar intervertebral disk has been investigated an adhesive arachnopathy in 24 out of 86 patients. It appears increased in patients with two operations of the intervertebral disk, revision of several intervertebral spaces and after massed prolapses. The etiological importance of hyperosmolar X-ray contrast media is comparatively slight. Characteristical clinical findings were not evident in patients with arachnopathy. In some patients the protein content in cerebrospinal fluid was raised, it could be observed as an unspecific reaction and a relative monocytosis in the cytogram. Two third of the patients with recurrent nucleus pulposus prolapse were diagnosed rightly by radiculomyelography, though there are difficulties in the differentiation of adhesive-fibrotic changes.

Team physicians in college athletics. There has been little documentation of what constitutes the clinical work of intercollegiate team physicians. Team physicians could be recruited based on the needs of athletes. A multidisciplinary team of physicians is necessary to treat college athletes. Most physician evaluations are for musculoskeletal injuries treated nonoperatively. Descriptive epidemiology study. For a 2-year period, a database was created that recorded information on team physician encounters with intercollegiate athletes at a major university. Data on imaging studies, hospitalizations, and surgeries were also recorded. The diagnoses for physician encounters with all undergraduates through the university's health service were also recorded. More initial athlete evaluations were for musculoskeletal diagnoses (73%) than for general medical diagnoses (27%) (P < .05). Four percent of musculoskeletal injuries required surgery. Most general medical evaluations were single visits for upper respiratory infections and dermatologic disorders, or multiple visits for concussions. Football accounted for 22% of all physician encounters, more than any other sport (P < .05). Per capita, men and women sought care at an equal rate. In contrast, 10% of physician encounters with the general pool of undergraduates were for musculoskeletal diagnoses. Student athletes did not require a greater number of physician encounters than did the general undergraduate pool of students on a per capita basis. Intercollegiate team physicians primarily treat musculoskeletal injuries that do not require surgery. General medical care is often single evaluations of common conditions and repeat evaluations for concussions.

Nonreciprocal acoustic propagation and leaky-wave radiation in a waveguide with flow. Isolators, devices with unidirectional wave transmission, are integral components in computing networks, enabling a one-way division of a large system into independent subunits. Isolators are created by breaking the inversion symmetry between a source and a receiver, known as reciprocity. In acoustics, a steady flow of the background medium in which sound travels can break reciprocity, but significant isolation is typically achieved only for large, often impractical speeds. This article proposes acoustic isolator designs enabled by duct flow that do not require large flow velocities. A basic isolator design is simulated based on the acoustic analogue of a Mach-Zehnder interferometer, with monomodal entry and exit ports. The simulated device footprint is then reduced by using bimodal ports. Further, a nonuniform velocity profile combined with a grating to induce phononic transitions is considered, which, combined with filters, can provide significant isolation. By coupling a waveguide with flow to free space through an array of small apertures, largely nonreciprocal leaky-wave radiation is demonstrated, breaking the symmetry between reception and transmission patterns of an acoustic linear aperture array. These investigations open interesting pathways towards efficient acoustic isolation, which may be translated into integrated acoustic and surface acoustic waves, as well as phononic technology.

Notes from the field: the economic value chain in disease management organizations. The disease management (DM) "value chain" is composed of a linear series of steps that include operational milestones in the development of knowledge, each stage evolving from the preceding one. As an adaptation of Michael Porter's "value chain" model, the process flow in DM moves along the following path: (1) data/information technology, (2) information generation, (3) analysis, (4) assessment/recommendations, (5) actionable customer plan, and (6) program assessment/reassessment. Each of these stages is managed as a major line of product operations within a DM company or health plan. Metrics around each of the key production variables create benchmark milestones, ongoing management insight into program effectiveness, and potential drivers for activity-based cost accounting pricing models. The value chain process must remain robust from early entry of data and information into the system, through the final presentation and recommendations for our clients if the program is to be effective. For individuals involved in the evaluation or review of DM programs, this framework is an excellent method to visualize the key components and sequence in the process. The value chain model is an excellent way to establish the value of a formal DM program and to create a consultancy relationship with a client involved in purchasing these complex services.

The functional morphology of the petioles of the banana, Musa textilis. Bananas are among the largest herbs in the world and their lightweight petioles hold up huge leaves. This study examined how the petioles manage to achieve adequate rigidity to do this, while allowing extensive and reversible reconfiguration in high winds. Morphological and anatomical examination of the petioles and leaves of Musa textilis suggested how these two apparently incompatible abilities are achieved. The hollow U-shaped section of the petiole and the longitudinal strengthening elements in its outer skin give it adequate rigidity, while its ventral curvature help support the leaf without the need for thick lateral veins. These features, however, also allow the petiole to reconfigure by twisting away from the wind, while the leaf can fold away. In addition, two sets of internal structures, longitudinal partitions and transverse stellate parenchyma plates, help prevent dorsoventral flattening, allowing the petiole to flex further away from the wind without buckling. These ideas were tested and verified by a range of mechanical tests. Simple four-point-bending and torsion tests showed that the petioles are indeed far more compliant in torsion than in bending. Axial bending tests and crushing tests showed that petioles could be flexed twice as far and were four times as resistant to dorsoventral flattening when intact than when the internal tissue is removed. The banana petiole, therefore, seems to be an excellent example of natural integrated mechanical design.

Management of pneumothorax in cystic fibrosis. The increased longevity of patients with cystic fibrosis has resulted in a concomitant increase in the frequency with which pneumothorax is seen. While several approaches to this problem have been available from both a medical and surgical standpoint, unsettled questions remain regarding the efficacy of various modalities of therapy. A review of our own experience with 170 episodes of pneumothorax has provided a basis for proposing what appears to be a reasoned approach to therapy. During the past 12 years, 65 patients ages 5 to 32 years experienced 170 episodes of pneumothorax. Of the 211 trials of treatment, all yielded a high rate of initial resolution (70% to 100%) but rates of recurrence were high. The recurrence rates were: observation 60%, thoracentesis 79%, trochar thoracotomy 63%, tetracycline sclerosis 86%, and silver nitrate 43%. Quinacrine sclerosis yielded an acceptable recurrence rate of 12.5% and partial pleurectomy had no recurrence. There was no statistical difference in the pulmonary function parameters determined before pneumothorax and after chemical pleurodesis or partial pleurectomy. Based upon the data obtained in this review, we recommend that initial management of the pneumothorax include evacuation of the pneumothorax using a chest tube and then chemical pleurodesis using quinacrine sclerosis. In those cases where this pleurodesis fails, upper-partial pleurectomy with obliteration of pleural blebs via a limited thoracentesis is the treatment of choice. An occasional patient requires a concomitant lobectomy.

Odontoblast alkaline phosphatases and Ca2+ transport. The same isoenzyme of nonspecific alkaline phosphatase (APase), assayed with p-nitrophenylphosphate (p-NPP), was shown be present in different calcifying tissues, bone, calcifying cartilage, odontoblasts and enamel organ. Indications were also found that the enzymatic degradation of inorganic pyrophosphate (PPi) in calcifying tissues is mediated by APase. By using specific APase inhibitors, it was shown that two enzymes capable of degrading ATP exist. These were characterized in dentinogenically active odontoblasts, and it was concluded that one is the classical APase, the other is a Ca2+ and Mg2+ activated ATPase, named Ca2+-ATPase. The two phosphatases were solubilized from odontoblasts and separated. The localization of APase and Ca2+-ATPase in odontoblasts was investigated by subcellular fractionation and EM histochemistry. Routine methods for fixation were found to almost completely inactivate the enzymes. By using a mild fixation technique that preserved 80% of the enzyme activity, the main localization for both APase and Ca2+-ATPase was found to be in the membranes of intercellular vesicles located in the cell body and odontoblasts process. No activity was found in the cell membranes. It is concluded that there are at least two enzymes able to degrade phosphate compounds at alkaline pH in hard tissue forming cells. One is the nonspecific alkaline phosphatase (APase; EC 3. 1. 3. 1), which is active against p-NPP, PPi, glycerophosphates and ATP among other substrates. The other is a more specific Ca2+-ATPase (EC 3. 6. 1. 3). There seems to be an intimate relation between these two enzymes in the tissue. The function of APase in biological calcification is still obscure. In contrast, the finding of an ATP dependent, intravesicularly directed, transmembranous Ca2+-transport in vesicles derived from the microsomal fraction of odontoblasts may explain the role of Ca2+-ATPase.

Small Buccal Fat Pad Cells Have High Osteogenic Differentiation Potential. Dedifferentiated fat (DFAT) cells derived from mature adipocytes have mesenchymal stem cells' (MSCs) characteristics. Generally, mature adipocytes are 60-110 μm in diameter; however, association between adipocyte size and dedifferentiation efficiency is still unknown. This study, therefore, investigated the dedifferentiation efficiency of adipocytes based on cell diameter. Buccal fat pad was harvested from five human donors and dissociated by collagenase digestion. After exclusion of unwanted stromal cells by centrifugation, floating adipocytes were collected and their size distribution was analyzed. The floating adipocytes were then separated into two groups depending on cell size using 40- and 100-μm nylon mesh filters: cell diameters less than 40 μm (small adipocytes: S-adipocytes) and cell diameters of 40-100 μm (large adipocytes: L-adipocytes). Finally, we evaluated the efficiency of adipocyte dedifferentiation and then characterized the resultant DFAT cells. The S-adipocytes showed a higher capacity to dedifferentiate into DFAT cells (S-DFAT cells) compared to the L-adipocytes (L-DFAT cells). The S-DFAT cells also showed a relatively higher proportion of CD146-positive cells than L-DFAT cells, and exhibited more osteogenic differentiation ability based on the alkaline phosphatase activity and amount of calcium deposition. These results suggested that the S- and L-DFAT cells had distinct characteristics, and that the higher dedifferentiation potential of S-adipocytes compared to L-adipocytes gives the former group an advantage in yielding DFAT cells.

A study of matching fluid loss in a biomedical microwave tomography system. Effective imaging of human tissue with microwave tomography systems requires a matching fluid to reduce the wave reflections at the tissue boundary. Further, in order to match the idealized mathematical model used for imaging with the complicated physical measurement environment, loss must be added to the matching fluid. Both too little and too much loss result in low-quality images, but due to the nonlinear nature of the imaging problem, the exact nature of loss-to-image quality cannot be predicted a priori. Possible optimal loss levels include a single, highly sensitive value, or a broad range of acceptable losses. Herein, the authors outline a process of determining an appropriate level of loss inside the matching fluid and attempt to determine the bounds for which the images are the highest quality. Our biomedical microwave tomography system is designed for 2D limb imaging, operating from 0.8 to 1.2 GHz. Our matching fluid consists of deionized water with various levels of loss introduced by the addition of table salt. Using two homogeneous tissue-mimicking phantoms, and eight different matching fluids of varying salt concentrations, the authors introduce quantitative image quality metrics based on L-norms, mean values, and standard deviations to test the tomography system and assess image quality. Images are generated with a balanced multiplicative regularized contrast source inversion algorithm. The authors further generate images of a human forearm which may be analyzed qualitatively. The image metrics for the phantoms support the claim that the worst images occur at the extremes of high and low salt concentrations. Importantly, the image metrics show that there exists a broad range of salt concentrations that result in high-quality images, not a single optimal value. In particular, 2.5-4.5 g of table salt per liter of deionized water provide the best reconstruction quality for simple phantoms. The authors argue that qualitatively, the human forearm data provide the best images at approximately the same salt concentrations. There exists a relatively large-range of matching fluid losses (i.e., salt concentrations) that provide similar image quality. In particular, it is not necessary to spend time highly optimizing the level of loss in the matching fluid.

Rapid and simple quantitative assay method for diastereomeric flurbiprofen glucuronides in the incubation mixture. Acyl glucuronides of nonsteroidal anti-inflammatory drugs having a chiral center are known to be chemically very active and form covalently bound adducts with proteins, such as human serum albumin, which may be the cause of hypersensitive reactions. Hepatic acyl glucuronosyltransferase catalyzes the transformation of alpha-aryl propionates into these diastereoisomeric acyl glucuronides, and, hence, its activity needs to be characterized. From this point of view, we developed a rapid, accurate and reproducible analytical method for the separation and determination of diastereoisomeric glucuronides of flurbiprofen, one of the nonsteroidal anti-inflammatory drugs, in the incubation mixture of the hepatic microsomal preparation by high-performance liquid chromatography with a simple column-switching technique for deproteinization. The glucuronides were separated on a TSKgel ODS-80Ts column with 20 mM ammonium acetate buffer (pH 5.6)-ethanol-acetonitrile as the mobile phase and monitored with a UV detector at 246 nm. The detection limit of the proposed method was 600 fmol/injection at a signal-to-noise ratio of 10. The validation results indicated that this method would be very useful for the determination of diastereomeric acyl glucuronides formed from flurbiprofen in an incubation mixture.

Collaboration in classical political economy and noncooperative game theory. This commentary suggests (1) that there are precedents for Smaldino's "collaboration" in the history of economic thought before 1900 and (2) that the distinction of collaboration from what is thought of as cooperation in game theory is less clear than Smaldino suggests.

Association of serum uric acid level and coronary blood flow. Slow coronary flow (SCF) has long since been identified and endothelial dysfunction and atherosclerosis of the epicardial coronary arteries and microvasculature are reported to be associated with SCF. Serum uric acid is an independent biochemical marker of atherosclerosis, oxidative stress and endothelial dysfunction. Consequently, we aimed to investigate the association between coronary blood flow and serum uric acid level by means of thrombolysis in myocardial infarction frame count (TFC) and other laboratory parameters, in patients with SCF compared with control participants. Sixty-four patients with SCF and 369 control participants with normal coronary flow were studied after quantifying coronary blood flow according to TFC. Serum uric acid levels were determined using commercially available assay kits. The association between TFC and serum uric acid level and other clinical and laboratory parameters were evaluated. Statistically significant differences were present between SCF and control groups with respect to serum uric acid, and hemoglobin levels, heart rate, cigarette smoking and sex (P<0.05 for all). The mean TFC was significantly correlated with serum uric acid, urea, creatinine, high-density lipoprotein-cholesterol and hemoglobin levels, platelet count, male gender, cigarette smoking, heart rate and systolic blood pressure (P<0.05 for all). Serum uric acid level (chi(2)=22.86, beta=0.54, P<0.001), heart rate (chi(2)=7.42, beta=-0.034, P=0.032) and cigarette smoking (chi(2)=12.343, beta=0.969, P=0.025) were independent predictors of SCF, whereas serum uric acid level was the only independent predictor of the mean TFC (beta=0.298, P<0.001). These findings have shown that serum uric acid level is significantly associated with coronary blood flow and that elevated uric acid might be an independent predictor for the presence of SCF.

Unconventional energy resources in a crowded subsurface: Reducing uncertainty and developing a separation zone concept for resource estimation and deep 3D subsurface planning using legacy mining data. Over significant areas of the UK and western Europe, anthropogenic alteration of the subsurface by mining of coal has occurred beneath highly populated areas which are now considering a multiplicity of 'low carbon' unconventional energy resources including shale gas and oil, coal bed methane, geothermal energy and energy storage. To enable decision making on the 3D planning, licensing and extraction of these resources requires reduced uncertainty around complex geology and hydrogeological and geomechanical processes. An exemplar from the Carboniferous of central Scotland, UK, illustrates how, in areas lacking hydrocarbon well production data and 3D seismic surveys, legacy coal mine plans and associated boreholes provide valuable data that can be used to reduce the uncertainty around geometry and faulting of subsurface energy resources. However, legacy coal mines also limit unconventional resource volumes since mines and associated shafts alter the stress and hydrogeochemical state of the subsurface, commonly forming pathways to the surface. To reduce the risk of subsurface connections between energy resources, an example of an adapted methodology is described for shale gas/oil resource estimation to include a vertical separation or 'stand-off' zone between the deepest mine workings, to ensure the hydraulic fracturing required for shale resource production would not intersect legacy coal mines. Whilst the size of such separation zones requires further work, developing the concept of 3D spatial separation and planning is key to utilising the crowded subsurface energy system, whilst mitigating against resource sterilisation and environmental impacts, and could play a role in positively informing public and policy debate.

ROS generation and DNA damage contribute to abamectin-induced cytotoxicity in mouse macrophage cells. The widespread use of abamectin has recently raised safety concerns as abamectin has yielded various toxicities to non-target organisms. However, the underlying mechanisms of abamectin-induced toxicity are still largely unknown. The present study aimed to investigate the abamectin-induced cytotoxicity in mouse macrophage cells (RAW264.7) and its underlying mechanisms. Abamectin treatment caused oxidative stress as characterized by increased intensity of the ROS indicator. Abamectin also led to DNA damage as demonstrated by increased 8-OHdG/dG ratio in cells even at a relatively low dose (NOAEL). Pretreatment with catalase-PEG, a ROS inhibitor, attenuated abamectin-induced DNA damage, indicating that ROS overproduction should be the reason for abamectin-induced DNA damage. The effects of abamectin on ROS elimination and generation were also investigated, and the results showed that abamectin induced concentration-dependent alteration in the expression and activities of CAT, SOD, GPx enzymes and GSH level (ROS elimination), but had limited effects on the expression and activities of NOX, mitochondrial complex I and III (ROS production) in RAW264.7 cells. Therefore, the effects of abamectin on ROS elimination should be the main reason for abamectin-induced oxidative stress in RAW264.7 cells. Abamectin treatment activated MAPK and ATM/ATR signaling pathways as demonstrated by increased phosphorylation of JNK, ATM and ATR. In addition, inhibiting JNK and ATM/ATR signaling pathways partially rescued the decrease in cell viability, indicating that abamectin-induced ROS overproduction and DNA damage might finally lead to cytotoxicity through JNK and ATM/ATR signaling pathways. These findings should be useful for the more comprehensive assessment of the toxic effects of abamectin.

Consistency of refrigerated pathological urine sediment. Urinalysis is a routine medical laboratory investigation, as examination of the urine plays a vital role in the diagnosis of kidney diseases. Sometimes the identification of urine sediment needs confirmation by expertise in clinical microscopy, and this is difficult in the far rural area in the developing countries. Here, the author evaluated a feasibility to use refrigerated urine sediment for repeated analysis. In this work, the author found that it is feasible to use refrigerated urine sediment for repeated analysis. The good correlation (> 0.9) can be seen for the epithelium, red blood cell, and cast but not for the white blood cell. The consistency of the repeat analysis results are an orderly decrease from epithelium (4 days), red blood cell (3 days), white blood cell (3 days), and cast (2 days). However, as time passes, reliability decreases.

Salt sensitivity in hypertension. Renal and cardiovascular implications. The mechanisms responsible for the increase in blood pressure response to high salt intake in salt-sensitive patients with essential hypertension are complex and only partially understood. A complex interaction between neuroendocrine factors and the kidney may underlie the propensity for such patients to retain salt and develop salt-dependent hypertension. The possible role of vasodilator and natriuretic agents, such as the prostaglandins, endothelium-derived relaxing factor, atrial natriuretic factor, and kinin-kallikrein system, requires further investigation. An association between salt sensitivity and a greater propensity to develop renal failure has been described in certain groups of hypertensive patients, such as blacks, the elderly, and those with diabetes mellitus. Salt-sensitive patients with essential hypertension manifest a deranged renal hemodynamic adaptation to a high dietary salt intake. During a low salt diet, salt-sensitive and salt-resistant patients have similar mean arterial pressure, glomerular filtration rate, effective renal plasma flow, and filtration fraction. On the other hand, during a high salt intake glomerular filtration rate does not change in either group, and effective renal blood flow increases in salt-resistant but decreases in salt-sensitive patients; filtration fraction and glomerular capillary pressure decrease in salt-resistant but increase in salt-sensitive patients. Salt-sensitive patients are also more likely than salt-resistant patients to manifest left ventricular hypertrophy, microalbuminuria, and metabolic abnormalities that may predispose them to cardiovascular diseases. In conclusion, salt sensitivity in hypertension is associated with substantial renal, hemodynamic, and metabolic abnormalities that may enhance the risk of cardiovascular and renal morbidity.

Changing provider practices to enhance preconceptional wellness. Primary care providers who fail to provide preconceptional care to every woman of reproductive age during each primary care visit are losing key preventive opportunities. Changing provider practices involves multidisciplinary input into the planning of care, support of clinical leaders and professional organizations, and adequacy of funding for proposed changes. Programs in California, North Carolina, and South Carolina have demonstrated significant changes in provider acceptance of preconceptional.

The phonon dynamics of Sr(2)RuO(4): microscopic calculation and comparison with that of La(2)CuO(4). The phonon dynamics of the low-temperature superconductor Sr(2)RuO(4) is calculated quantitatively in linear response theory and compared with that of the structurally isomorphic high-temperature superconductor La(2)CuO(4). Our calculation corrects for a typical deficiency of local density approximation-based calculations, which always predict too large an electronic k(z)-dispersion insufficient for describing the c-axis response of real materials. With a more realistic computation of the electronic band structure, the frequency and wavevector dependent irreducible polarization part of the density response function is determined and used for adiabatic and nonadiabatic phonon calculations. Our analysis for Sr(2)RuO(4) reveals important differences from the lattice dynamics of p- and n-doped cuprates. Consistently with experimental evidence from inelastic neutron scattering, the anomalous doping related softening of the strongly coupling high-frequency oxygen bond-stretching modes which is generic for the cuprate superconductors is largely suppressed or completely absent, respectively, depending on the actual value of the on-site Coulomb repulsion of the Ru 4d orbitals. Also the presence of a characteristic Λ(1) mode in La(2)CuO(4) with a very steep dispersion coupled strongly to the electrons is not found for Sr(2)RuO(4). Moreover, we evaluate the possibility of a phonon-plasmon scenario for Sr(2)RuO(4), which has been shown recently to be realistic for La(2)CuO(4). In contrast to the case for La(2)CuO(4), in Sr(2)RuO(4) the plasmons that are very low lying are overdamped along the c-axis.

The incidence of complications associated with lip and/or tongue piercings: a systematic review. This review determines the incidence of complications associated with lip and/or tongue piercings based on a systematic evaluation of the available literature. MEDLINE-PubMed, Cochrane-CENTRAL and EMBASE databases were comprehensively searched through June 2014 to identify appropriate studies. The incidence of complications, as established by a dental professional associated with oral and peri-oral piercings, was evaluated in populations with lip and/or tongue piercings. The quality of the case-control studies was assessed using the Newcastle-Ottawa Scale. For case series studies, the risk of bias was assessed using the National Institute for Health and Clinical Excellence scale. An independent screening of 1580 unique titles and abstracts revealed 15 publications that met the eligibility criteria. The incidence of gingival recessions appeared to be 50% in subjects with lip piercings and 44% in subjects with a tongue piercing. Tooth injuries were observed in 26% individuals with lip piercings and in up to 37% of individuals with tongue piercings. Subjects with a lip piercing were 4.14 times (P = 0.005) more likely to develop gingival recession than those without a lip piercing. Subjects with a tongue piercing were more likely than non-pierced subjects to experience gingival recession (relative risk (RR) 2.77; P = 0.00001) and tooth injuries (RR 2.44; P = 0.003). Both lip and tongue piercings are highly associated with the risk of gingival recession, and tongue piercings are also associated with tooth injuries.

Cell cycle kinetic measurements in an irradiated rat rhabdomyosarcoma using a monoclonal antibody to bromodeoxyuridine. Cell cycle kinetics after X-irradiation were studied in a solid rat rhabdomyosarcoma using a monoclonal antibody to bromodeoxyuridine (BrdUrd) in cells in which the DNA was labeled by BrdUrd. It could be shown that this tumor was composed of about 80% diploid host cells, and only 20% of the cells in the dissociated tumor were actually tetraploid tumor cells. When rats were injected intraperitoneally with BrdUrd to label S-phase cells in the tumor, only a fraction of both types of cells became labeled with BrdUrd during S-phase, even 24 h after injection. The diploid BrdUrd-labeled cells progressed rapidly into cycle; 4 h after injection of BrdUrd, labeled diploid G1-phase cells could be observed. Only 25% of the tetraploid S-phase cells could be labeled by a single injection of BrdUrd (160 mg/kg body weight). These labeled tetraploid cells progressed through the cell cycle with similar velocities as did labeled diploid cells. Using a "Mini Osmotic Pump" containing bromodeoxycytidine (BrdCyd) at high concentration (0.3 mol/L) that released BrdCyd continuously into the organism where it was converted to BrdUrd, it could be shown that after 2 days about 60% of cells in S-phase and 70% of cells in G2-phase were labeled. The fraction of labeled G2-phase cells in irradiated tumors (D = 10 and 20 Gy) was enhanced between 10 and 50 h after irradiation due to a radiation-induced G2 block in cycling tetraploid tumor cells.(ABSTRACT TRUNCATED AT 250 WORDS)

FAPA mass spectrometry of designer drugs. Application of a flowing atmospheric-pressure afterglow ion source for mass spectrometry (FAPA-MS) for the analysis of designer drugs is described. In this paper, we present application of FAPA MS for identification of exemplary psychotropic drugs: JWH-122, 4BMC, Pentedrone, 3,4-DNNC and ETH-CAT. We have utilized two approaches for introducing samples into the plasma stream; first in the form of a methanolic aerosol from the nebulizer, and the second based on a release of vapors from the electrically heated crucible by thermal desorption. The analytes were ionized by FAPA and identified in the mass analyzer. The order of release of the compounds depends on their volatility. These methods offer fast and reliable structural information, without pre-separation, and can be an alternative to the Electron Impact, GC/MS, and ESI for fast analysis of designer-, and other psychoactive drugs.

Rabbit serum against K1 peptide, an immunogenic epitope of the Trypanosoma cruzi KMP-11, decreases parasite invasion to cells. KMP-11 is a highly conserved protein of Trypanosoma cruzi implicated in parasite's motility. Here we show that K1, a peptide derived from KMP-11, induced polyclonal antibodies capable of decreasing T. cruzi infection in vitro. Rabbit sera rose against K1 peptide showed recognition of the recombinant protein by ELISA and Western blot and also of the native protein in both epimastigotes and trypomastigotes as evaluated by immunofluorescence test and flow cytometry. Invasion assays showed a significant reduction of trypomastigotes infection of eukaryotic cells when parasites were pre-incubated with anti-K1 rabbit serum. Computational modeling predicted that the K1 sequence conserved its α-helical configuration into the protein, and some of the amino acid residues appear accessible for recognition by antibodies in vivo. Taken together, these results support the idea that the K1 peptide induces antibodies than can have a potential role in protective immunity in Chagas disease.

In vitro assessment of the upper gastrointestinal tolerance of potential probiotic dairy propionibacteria. This study aimed to assess the transit tolerance of potential probiotic dairy propionibacteria strains in human upper gastrointestinal tract in vitro, and to evaluate the effect of food addition on viability of these strains in simulated pH 2.0 gastric juices. The transit tolerance of 13 dairy propionibacteria strains was determined at 37 degrees C by exposing washed cell suspensions to simulated gastric juices at pH values at 2.0, 3.0, and 4.0, and simulated small intestinal juices (pH 8.0) with or without 0.3% bile salts. The viability of dairy propionibacteria in pH 2.0 simulated gastric juice with So-Good original soymilk or Up & Go liquid breakfast was also determined. The simulated gastric transit tolerance of dairy propionibacteria was strain-dependent and pH-dependent. All tested strains were tolerant to simulated small intestinal transit. The addition of So-Good original soymilk or Up & Go liquid breakfast greatly enhanced the survival of dairy propionibacteria strains in pH 2.0 simulated gastric juices. Dairy propionibacteria strains demonstrate high tolerance to simulated human upper gastrointestinal tract conditions and offer a relatively overlooked, yet alternative source for novel probiotics besides Lactobacillus and Bifidobacterium.

Development and validation of the Acculturative Stress Scale for Chinese College Students in the United States (ASSCS). Chinese students are the biggest ethnic group of international students in the United States. This study aims to develop a reliable and valid scale to accurately measure their acculturative stress. A 72-item pool was sent online to Chinese students and a five-factor scale of 32 items was generated by exploratory factor analysis. The five factors included language insufficiency, social isolation, perceived discrimination, academic pressure, and guilt toward family. The Acculturative Stress Scale for Chinese Students demonstrated high reliability and initial validity by predicting depression and life satisfaction. It was the first Chinese scale of acculturative stress developed and validated among a Chinese student sample in the United States. In the future, the scale can be used as a diagnostic tool by mental health professionals and a self-assessment tool by Chinese students.

Seasonal changes in thermotropic behavior of phosphatidylcholine and phosphatidylethanolamine in different organs of the ascidian Halocynthia aurantium. Differential scanning calorimetry and polarising microscopy were used to investigate the crystal-liquid crystal-isotropic melt phase transitions of phosphatidylcholine (PC), and phosphatidylethanolamine (PE), isolated from muscles, gill pouches, gonads and digestive glands of Halocynthia aurantium, collected in summer and winter. We also analyzed the fatty chain composition of these phospholipids. In summer, the crystalline to liquid crystalline phase transitions of PC and PE from different organs were more co-operative than in winter. Their peak maximum temperatures were close and temperature ranges overlapped for summer samples. Peak maximum temperatures of winter samples decreased sharply, by 18-27 degrees C for PC and by 10-44 degrees C for PE, respectively, depending on the organ. Total heat changes of transitions also decreased. Thermograms were completely located at temperatures below -1.7 degrees C (minimal temperature of seawater in winter). In contrast to summer samples, peak maximum temperatures for PC and PE in winter differed significantly, (by 14-30 degrees C depending on organ), while the temperature ranges of their transitions still showed considerable overlap. Simultaneously, the temperature ranges of the liquid crystalline to isotropic phase transitions decreased. The main reason for changes in thermotropic behavior of phospholipids seems to be the decrease of saturated/unsaturated ratios. The existence of stable and thermoadaptative labile phospholipid pools in the membrane structure is proposed. The relationship of these transitions to low- and high-temperature adaptation is discussed.

Sequential ofatumumab and lenalidomide for the treatment of relapsed and refractory chronic lymphocytic leukemia and small lymphocytic lymphoma. Ofatumumab is a fully human anti-CD20 monoclonal antibody with enhanced antibody dependent and complement dependent cytotoxicity. Lenalidomide induces T cell and natural killer (NK) cell activation and in vitro enhances clearance of chronic lymphocytic leukemia (CLL) cells by monoclonal antibodies. We performed a multi-center, phase 2 trial of sequential treatment with ofatumumab and lenalidomide in patients with advanced, relapsed and refractory (R/R) CLL, consisting of ofatumumab 2000 mg intravenously on day 1 and lenalidomide 10 mg on days 8-28, for up to six cycles. Twenty-one subjects were included with median age of 63 years and two prior lines of therapy. The overall response rate was 47.6% and 23.8% had stable disease. Median overall survival was 21.5 months. Neutropenia and thrombocytopenia were the most frequent adverse events. Tumor flare reaction occurred in 43% of subjects. Intracycle sequential ofatumumab plus lenalidomide is active in high-risk R/R CLL and well tolerated except for frequent cytopenias.

Immediate breast reconstruction using the skin expander: a modification in technique. A modification in the technique of immediate postmastectomy reconstruction of the small to moderate-size breast using the skin expander is presented. The advantage of the technique is that it simplifies the replacement of the expander with the permanent prosthesis while establishing a symmetrical inframammary crease and a laterally supported breast mound. Representative cases are shown.

[A case of domestic violence-related Page kidney]. Page kidney is caused by the accumulation of blood in the perinephric or subcapsular space, resulting in compression of the involved kidney, renal ischemia and high renin hypertension. We describe a case of domestic violence-related Page kidney. This report also reviews previously described cases of Page kidney.

Differences in distribution and severity of Helicobacter pylori gastritis in children and adults with duodenal ulcer disease. The presence of Helicobacter pylori and the gastric mucosa histology were investigated in 15 children and 15 adults with duodenal ulcer. The microorganism was isolated from antral and oxyntic mucosa in 100% of patients, both adults and children. The results of Gram stain and preformed urease test were compared with those of culture and there was no difference in sensitivity among the tests. Antral chronic gastritis was observed in all patients. However, children presented oxyntic gastritis more frequently than adults. It was also observed that the endoscopic aspects were different in the two groups of patients. The results here observed strongly support the idea that, as well as in adults, H. pylori is the causative agent of the gastritis seen in children with duodenal ulceration. On the other hand, the histological findings of oxyntic mucosa of children with duodenal ulcer were different from those of adults.

[Clinical features and combined treatment of the central nervous system in Hodgkin's disease]. Spinal cord compression was diagnosed in 33 patients with Hodgkin's disease. Specific involvement of the brain was identified in 17 cases of dissemination relapse. Timely use of cytostatic and/or radiotherapy resulted in sustained and complete recovery of the spinal cord. The results in cases of sustained spinal disorders were worse. Tumor-induced specific changes in the brain and spinal cord compression had worse prognosis and median of survival from time of tumor detection was approx. 12 months. In patients with spinal cord compression or cerebral involvement and with concomitant neurologic symptoms, sustained response after chemotherapy with derivatives of nitrosourea (nitrosomethylurea, lomustine and carmustine) (CCNU-OPP, NVPP/NOPP, DVCPP) was (59%) and (64%), respectively. Adequate polychemotherapy with nitrosourea and radiotherapy derivatives and surgery, if required, can improve the efficacy of treatment of Hodgkin's disease patients with spinal cord compression.

On the intrinsic optical absorptions by tetrathiafulvalene radical cations and isomers. Gas-phase action spectroscopy shows unambiguously that the low-energy absorptions by tetramethylthiotetrathiafulvalene and tetrathianaphthalene cations in solution phase are due to monomers and not π-dimers.

Are serum inhibin concentrations new markers of placental tumours in the course of chemotherapy? The study was conducted to evaluate whether the detection of serum molecular forms of inhibin (A and B) could be useful for the diagnosis, prognosis and follow-up of placental tumours. A total of 17 patients with hydatidiform mole (n = 13), invasive mole (n = 1) or choriocarcinoma (n = 3) were studied; serum concentrations of inhibins A and B, human chorionic gonadotrophin (HCG) and its free beta subunit (HCGbeta) were measured before chemotherapy (after mole evacuation for eight patients) and also during the course of chemotherapy (for 10 patients). After evacuation or before chemotherapy for refractory disease, serum inhibin A and B concentrations were found to be increased in 10/17 and 4/17 patients, when HCG and HCGbeta were high in all patients. In 10 patients with a follow-up during treatment, nine had a high concentration of inhibin A which correlated with those of HCG and HCGbeta. Normalization of inhibin A was faster than that of HCG and HCGbeta for three and six patients respectively. There was no correlation between changes of inhibin B and HCGbeta concentrations. Our results suggest that inhibins A and B are not useful markers and that HCG determination still remains the most useful marker for diagnosis and follow-up of placental tumours.

Glioblastoma causing granulocytosis by secretion of granulocyte-colony-stimulating factor. We describe a patient with a glioblastoma multiforme with excessive granulocytosis in the peripheral blood. Shown at both protein and mRNA levels, the tumor produced very high levels of granulocyte-colony-stimulating factor (G-CSF). G-CSF is a growth factor that induces the recruitment of granulocytes. The paraneoplastic phenomenon described here partly mimicked a brain abscess. Production of G-CSF by (brain) tumor cells might be related to the granulocytosis common in malignant disease.

Dorsal thoracic fasciocutaneous flap salvage of the failed transverse rectus abdominis musculocutaneous flap. The pedicled lower transverse rectus abdominis musculocutaneous flap, now considered the standard for breast reconstruction using autologous tissues, still may be plagued occasionally by significant flap necrosis in spite of the best intentions. Rather than discarding the residual flap, it may suffice as an autologous implant if an additional source of tissue can be used for surface coverage. The dorsal thoracic fasciocutaneous free flap provides such a large, yet reasonably thin, skin territory that can uniformly cover the new breast, ultimately salvaging an acceptable result after a partially failed transverse rectus abdominis musculocutaneous flap.

Characterization of phosphomevalonate kinase: chromosomal localization, regulation, and subcellular targeting. Phosphomevalonate kinase catalyzes the conversion of mevalonate-5-phosphate to mevalonate-5-diphosphate and was originally believed to be a cytosolic enzyme. In this study we have localized the phosphomevalonate kinase gene to chromosome 1p13-1q22-23 and present a genomic map indicating that the gene spans more than 8.4 kb in the human genome. Furthermore, we show that message levels and enzyme activity of rat liver phosphomevalonate kinase are regulated in response to dietary sterol levels and that this regulation is coordinate with 3-hydroxy-3-methylglutaryl coenzyme A reductase, the rate-limiting enzyme of cholesterol biosynthesis. In addition, we demonstrate that phosphomevalonate kinase is a peroxisomal protein which requires the C-terminal peroxisomal targeting signal, Ser-Arg-Leu, for localization to the organelle.

Gait biomechanics following lower extremity trauma: Amputation vs. reconstruction. Surgical advances have substantially improved outcomes for individuals sustaining traumatic lower extremity injury. Injuries once requiring lower limb amputation are now routinely managed with limb reconstruction surgery. However, comparisons of functional outcomes between the procedures are inconclusive. To compare gait biomechanics after lower limb reconstruction and transtibial amputation. Twenty-four individuals with unilateral lower limb reconstruction wearing a custom ankle-foot orthosis (Intrepid Dynamic Exoskeletal Orthosis), 24 with unilateral, transtibial amputation, and 24 able-bodied control subjects underwent gait analysis at a standardized Froude speed based on leg length. Lower extremity joint angles, moments, and powers, and ground reaction forces were analyzed on the affected limb of patients and right limb of able-bodied individuals. ANOVA with Tukeys post-hoc tests determined differences among groups and post-hoc paired t-tests with Bonferroni-Holm corrections determined differences between limbs. The ankle, knee, and hip exhibited significant kinematic differences between amputated, reconstructed and able-bodied limbs. The reconstruction group exhibited less ankle power and range of motion while the amputee group exhibited lower knee flexor and extensor moments and power generation. Gait deficiencies were more pronounced at the ankle following limb reconstruction with orthosis use and at the knee following transtibial amputation with prosthesis use. Although both groups in the cohorts tested can replicate many key aspects of normative gait mechanics, some deficiencies still persist. These results add to the growing body of literature comparing amputation and limb reconstruction and provide information to inform the patient on functional expectations should either procedure be considered.

The effects of endotoxin pretreatment on subsequent challenge of mice with cycloheximide and a small dose of endotoxin. Mice treated with 15.0 micrograms of S. enteritidis endotoxin are completely protected against the coagulopathic effects, but only partially protected against the fatal glucocorticoid deficiency which follow an otherwise lethal challenge with cycloheximide and 5.0 micrograms of the same endotoxin given 3 days later. Hydrocortisone treatment results in survival of all such tolerant, challenged animals. The protection conferred against occlusion of glomerular capillaries by fibrin coagula is abolished by EACA, suggesting that tolerance has induced high levels of fibrinolytic activity by the time of challenge, and evidence indicates that this protective degree of fibrinolytic activity persists for more than 24 h after cycloheximide and endotoxin challenge.

Function of histone deacetylase inhibitors in inflammation. Histone deacetylases (HDACs) display multi-faceted roles in coordinating the interaction of intracellular signaling pathways with chromatin remodeling and transcription factor function to finely specify gene alterations and maintenance of gene expression during cellular activation, proliferation, and differentiation. These processes, epigenetic and non-epigenetic, are critical to the development of both the adaptive and innate arms of the mammalian immune system, and the measured initiation and resolution of immune responses. Pharmacological modulators of HDAC activity have demonstrated uniformly potent anti-inflammatory effects in experimental animal models of these diseases, in relevant immune and stromal cell populations from patients, as well as initial successes in the clinic. Recent studies have identified key roles for specific HDACs in regulating immune function, as well as alterations in HDAC expression and function in a number of immune-mediated inflammatory diseases (IMIDs), which may contribute to pathology in these diseases. Here, we review recent advances in our understanding of HDAC function in the immune system, their contribution to IMIDs, and the therapeutic potential of altering HDAC activity in IMIDs.

Separation and identification of three epimeric pairs of new C-glucosyl anthrones from Rumex dentatus by on-line high performance liquid chromatography-circular dichroism analysis. Six C-glucosyl anthrones were characterized as three pairs of epimers by on-line high performance liquid chromatography-circular dichroism (HPLC-CD) analysis and isolated from the roots of Rumex dentatus by column chromatography. Their structures were elucidated by mass spectrometry, nuclear magnetic spectroscopy and HPLC-CD analysis. They are 10R-C-beta-D-glucosyl-10-hydroxyemodin-9-anthrone (rumejaposide E, 1) and 10S-C-beta-D-glucosyl-10-hydroxyemodin-9-anthrone (rumejaposide F, 2), 10R-C-beta-D-glucosylemodin-9-anthrone (rumejaposide G, 3) and 10S-C-beta-D-glucosylemodin-9-anthrone (rumejaposide H, 4), 10S-C-beta-D-glucosyl-10-hydroxychrysophanol-9-anthrone (cassialoin, 5) and 10R-C-beta-D-glucosyl-10-hydroxychrysophanol-9-anthrone (rumejaposide I, 6). Rumejaposides F-I (2-4 and 6) were new C-glucosyl anthrones. Rumejaposide E (1) and cassialoin (5) were isolated for the first time in Rumex plants. On-line HPLC-UV-CD analysis was a useful tool for structure elucidating epimeric C-glycosides anthrones 3-6 because of the poor stability of the pure isomers (3 and 4) and the minute quantity of 5 and 6 in the mixture.

Quantitative determination of direct binding of b subunit to F1 in Escherichia coli F1F0-ATP synthase. The stator in F(1)F(0)-ATP synthase resists strain generated by rotor torque. In Escherichia coli, the b(2)delta subunit complex comprises the stator, bound to subunit a in F(0) and to the alpha(3)beta(3) hexagon of F(1). To quantitatively characterize binding of b subunit to the F(1) alpha(3)beta(3) hexagon, we developed fluorimetric assays in which wild-type F(1), or F(1) enzymes containing introduced Trp residues, were titrated with a soluble portion of the b subunit (b(ST34-156)). With five different F(1) enzymes, K(d)(b(ST34-156)) ranged from 91 to 157 nm. Binding was strongly Mg(2+)-dependent; in EDTA buffer, K(d)(b(ST34-156)) was increased to 1.25 microm. The addition of the cytoplasmic portion of the b subunit increases the affinity of binding of delta subunit to delta-depleted F(1). The apparent K(d)(b(ST34-156)) for this effect was increased from 150 nm in Mg(2+) buffer to 1.36 microm in EDTA buffer. This work demonstrates quantitatively how binding of the cytoplasmic portion of the b subunit directly to F(1) contributes to stator resistance and emphasizes the importance of Mg(2+) in stator interactions.

Structure of the capsular polysaccharide from Actinobacillus pleuropneumoniae serotype 10. The capsular polysaccharide of A. pleuropneumoniae serotype 10 was found to be composed of a linear disaccharide repeating unit. By use of methylation analysis, partial hydrolysis, g.l.c.--and f.a.b.- m.s., and 1D and 2D n.m.r. studies, the polysaccharide was determined to be a polymer of a repeating disaccharide unit composed of D-mannose and 3-deoxy-D-manno-octulosonic acid (Kdo) having the structure: [formula; see text]

Rumination Syndrome in Children Presenting with Refractory Gastro-Esophageal Reflux Symptoms. Up to 40% of children presenting with reflux symptoms do not respond to standard medical interventions. In adults, 20% of patients presenting with Proton-Pump Inhibitors refractory Gastro-Esophageal Reflux Disease (GERD) have Rumination syndrome. The management of GERD and Rumination differ significantly. Our study aimed to identify Rumination syndrome amongst children presenting with persistent GERD symptoms based on a distinct pattern on impedance-pH monitoring. The parameters of impedance-pH monitoring were compared between children with Rumination syndrome (n = 12), diagnosed on High Resolution Manometry Impedance (HRM/Z), children with GERD (n = 18), children with an alternative diagnosis (Non-GERD, n = 12) and children negative for rumination based on HRM/Z (n = 14). The parameters that distinguish the rumination group were identified and incorporated into a scoring system, which was blindly applied in a separate group of children with refractory GERD (n = 18) to define its sensitivity and specificity. Rumination syndrome presents in 44% of children with refractory GERD. Children with rumination syndrome present with 1. A large number of proximal reflux episodes (>57.5 episodes/24hrs), 2. A high frequency of non-acid reflux events in the postprandial period (>2/hr) and 3. A highly positive symptom-reflux association analysis (SAP ≥ 95%). A score of ≥ 2 out of the 3 points distinguishes children with rumination syndrome with 75% sensitivity and 80% specificity. Children with rumination syndrome have a distinct pattern of impedance-pH monitoring and can be distinguished amongst children presenting with refractory GERD. Applying a simple scoring system during impedance-pH analysis could lead to early diagnosis of children with rumination syndrome.

Effects of Salt Loading on the Morphology of Astrocytes in the Ventral Glia Limitans of the Rat Supraoptic Nucleus. In the ventral glial limitans (VGL) of the supraoptic nucleus (SON) of the rat, a unique astrocyte type is found with an ability to undergo striking morphological plasticity in response to a wide range of physiological stimulations such as chronic hypernatraemia. This includes a thinning of the VGL, which contains the somata and proximal processes of these astrocytes, as well as an almost complete withdrawal of their vertically-oriented distal processes. Currently, there is little information available on the types of astrocytes that reside in the SON-VGL and which of these exhibit state-dependent structural plasticity. To address this, we enabled the visualisation of single SON-VGL glia using two novel cell labelling techniques with fluorescence microscopy. First, we used an inducible genetic reporter mouse line that allowed the specific labelling of a low density of astrocytes expressing glutamate and aspartate transporter (GLAST)/excitatory amino acid transporter 1. This approach revealed a high degree of variability in the morphology of mouse SON-VGL astrocytes, in contrast to what has been reported for cortical astrocytes. Next, we used the DiOlistlic labelling approach to label single glial cells with DiI in the SON-VGL of rats. Astrocytes observed using this approach shared the morphological features of GLAST-expressing astrocytes in the mouse SON-VGL. Specific structural aspects of these cells were modified by chronic hypernatraemia achieved by 7-day salt loading. Notably, the average area of cells exhibiting protoplasmic features was significantly reduced in the horizontal plane, and the size of varicosities present on fibrous projections was significantly enlarged. These observations indicate that novel cell labelling methods can significantly advance our understanding of SON-VGL cells and reveal specific forms of morphological plasticity that can be driven by chronic hypernatraemia.

Theory and applications of guided-mode resonance filters. The guided-mode resonance properties of planar dielectric waveguide gratings are presented and explained. It is shown that these structures function as filters that produce complete exchange of energy between forward- and backward-propagating diffracted waves with smooth line shapes and arbitrarily narrow filter linewidths. Simple expressions based on rigorous coupled-wave theory and on classical slab waveguide theory give a clear view and quantification of the inherent TE/TM polarization separation and the free spectral ranges of the filters. Furthermore, the resonance regimes, defining the parametric regions of the guided-mode resonances, can be directly visualized. It is shown that the linewidths of the resonances can be controlled by the grating modulation amplitude and by the degree of mode confinement (refractive-index difference at the boundaries). Examples presented of potential uses for these elements include a narrow-line polarized laser, a tunable polarized laser, a photorefractive tunable filter, and an electro-optic switch. The guided-mode resonance filter represents a basic new optical element with significant potential for practical applications.

No more lock-step retirement: Boomers' shifting meanings of work and retirement. Standard pathways for work and retirement are being transformed as the large Boomer cohort moves through typical retirement ages during a moment of economic, social and political change. People are delaying retirement and moving into and out of paid work as the standard lock-step retirement becomes less dominant. However, little research has explored how and why Boomers are taking on these diverse pathways in their later careers. Accordingly, we conduct in-depth interviews with working and retired white-collar Boomers, exploring how they are working and the meanings and motivations for their decisions and plans in their later careers. We find that there is no single dominant pattern for retirement, but rather a diverse mix of pathways shaped by occupational identities, finances, health and perceptions of retirement. Boomers express a desire to have control over their time and to find meaning and purpose in either paid or unpaid activities. However, life course transitions, normative cultural scripts, and gender and class locations as well as workplace and social policies constrain their decisions and plans.

Ultrasound-assisted extraction of gymnemic acids from Gymnema sylvestre leaves and its effect on insulin-producing RINm-5 F β cell lines. Gymnema sylvestre is an important anti-diabetic medicinal plant, hence it is necessary to study the effective extraction of its active medicinal components. To develop an efficient ultrasound-assisted extraction method for anti-diabetic gymnemic acids from Gymnema sylvestre leaves and measure their effect on insulin-producing RINm-5 F β cells. Box-Behnken's design and response surface methodology was applied to the ultrasound-assisted extraction of gymnemic acids from Gymnema sylvestre leaves. Analysis of gymnemic acids was carried out by high-performance thin-layer chromatography by converting total gymnemic acids into gymnemagenin by alkali hydrolysis. Effects of extracts on insulin production were tested on cultured, insulin-producing RINm-5 F β cell lines. The point prediction tool of the design expert software predicted 397.9 mg gymnemic acids per gram of the defatted G. sylvestre leaves using ultrasound-assisted extraction, with ethanol at 60 °C for 30 min. The predicted condition shows 93.34% validity under experimental conditions. The ultrasound-assisted extract caused up to about four times more insulin production from RINm-5 F β cells than extracts obtained from Soxhlet extraction. Response surface methodology was successfully used to improve the extraction of gymnemic acids from G. sylvestre leaves. The ultrasound-assisted extraction process may be a better alternative to prepare such herbal extracts because it saves time and may prevent excess degradation of the target analytes.

Erythema multiforme associated with prophylactic use of phenytoin during cranial radiation therapy. A case of erythema multiforme associated with prophylactic use of phenytoin during cranial radiation therapy is reported. A 60-year-old woman with intraductal adenocarcinoma of the breast and cerebral metastasis who had an implanted central venous catheter arrived at the hospital for the treatment of cerebral metastasis. She underwent whole brain irradiation and was given a total dose of 3750 cGy over 15 fractional doses spaced over three weeks. At the beginning of cranial radiation therapy, prophylactic oral ranitidine, oral dexamethasone, and oral phenytoin were initiated to prevent seizures. After 30 days of continuous prophylactic phenytoin and cranial radiation therapy, the patient developed an episode of coughing with yellow sputum, mucositis, and a minor skin reaction that was diagnosed in the emergency department as radiotherapy-associated lesions. After 2 days, the patient returned to the hospital with severe mucositis and an erythematous macular eruption on the scalp and auricular region within the radiation field. These were believed to be due to the radiation therapy, and the patient was subsequently hospitalized. The eruption dramatically extended over the next day, with itching micropapular urticarial lesions over large areas of the face, trunk, and genital region. The condition had worsened by the next day, with erythematous eruptions on the whole body (including the extremities), skin detachment, and vesicular lesions on the eyelids. The patient was then diagnosed toxic epidermal necrolysis. A patient with intraductal adenocarcinoma of the breast and cerebral metastasis developed erythema multiforme after receiving concurrent phenytoin and radiation therapy.

The demographic and socio-economic situation of the elderly in the Netherlands. An overview. This article aims to give a brief overview of the actual demographic and socio-economic situation of the elderly in the Netherlands. In view of the fact that the ageing process is still in a comparatively early phase, but will gain momentum during the course of the next century, attention is also paid to future developments. In addition, issues which are related to research on the elderly and on an ageing society, are discussed within the framework of Dutch research activities in the field of demography.

Does the placement of an Amplatzer septal occluder device confer benefit in patients with a post-infarction ventricular septal defect? A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was 'Is the placement of an Amplatzer septal occluder device across a post-infarction ventricular septal defect a suitable alternative for patients not eligible for surgical repair?' Altogether, 31 papers were found using the reported search, of which 17 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We conclude that the insertion of an Amplatzer occluder device in patients with a post-infarction ventricular septal defect (VSD) not amenable to surgical repair can offer benefit in selected patients. Patients with cardiogenic shock frequently have an unfavourable outcome and closure should be considered cautiously. From the literature available, patients have a better outcome if the intervention is delayed by 2 weeks or more possibly due to the maturation of the VSD and recovery of myocardial function. In certain situations, device closure may be complicated by device dislocation or embolization, residual shunting or a tortuous course not amenable to device implantation. In such settings, surgical repair is the only option. In patients who proceed straight to surgical repair with no attempt at percutaneous closure, the overall mortality lies in the region of 43% and similar to percutaneous closure, there is an association observed between those operated within 7 days of the VSD occurrence and those greater than this time. Patients presenting in cardiogenic shock experienced an increased risk of death and if the timing of myocardial infarction to VSD closure could be delayed by 3 weeks, there was a statistically significant reduction in operative mortality. Percutaneous closure of a post-infarction VSD may avoid the requirement for surgical closure. However, in some cases, it provides time to allow the VSD to mature and the patient to stabilize and be optimized acting as a bridge to surgery to offer the best possible outcome for the patient.

Gata factor Pannier is required to establish competence for heart progenitor formation. Inductive signaling is of pivotal importance for developmental patterns to form. In Drosophila, the transfer of TGFbeta (Dpp) and Wnt (Wg) signaling information from the ectoderm to the underlying mesoderm induces cardiac-specific differentiation in the presence of Tinman, a mesoderm-specific homeobox transcription factor. We present evidence that the Gata transcription factor, Pannier, and its binding partner U-shaped, also a zinc-finger protein, cooperate in the process of heart development. Loss-of-function and germ layer-specific rescue experiments suggest that pannier provides an essential function in the mesoderm for initiation of cardiac-specific expression of tinman and for specification of the heart primordium. u-shaped also promotes heart development, but unlike pannier, only by maintaining tinman expression in the cardiogenic region. By contrast, pan-mesodermal overexpression of pannier ectopically expands tinman expression, whereas overexpression of u-shaped inhibits cardiogenesis. Both factors are also required for maintaining dpp expression after germ band retraction in the dorsal ectoderm. Thus, we propose that Pannier mediates as well as maintains the cardiogenic Dpp signal. In support, we find that manipulation of pannier activity in either germ layer affects cardiac specification, suggesting that its function is required in both the mesoderm and the ectoderm.

Microinjection of dsRNA into fully-grown mouse oocytes. RNA interference (RNAi) is a suitable method for sequence-specific post-transcriptional gene silencing in a number of model systems. The following protocol describes delivery of a double-stranded RNA (dsRNA) of choice into fully-grown, germinal vesicle-intact (GV) mouse oocytes by microinjection. Microinjected oocytes can be cultured for up to 2 d or they can be matured to metaphase II. The metaphase II eggs can be fertilized in vitro and cultured up to the blastocyst stage. The efficiency of knockdown by RNAi can be assayed by quantitative reverse transcriptase (RT)-PCR (qPCR).

Pulmonary function impairment and airway allergy among workers in traditional bakeries. To assess the effect of exposure to flour dust on pulmonary function tests, prevalence of symptoms (respiratory, allergic/irritating) and parameters of allergic sensitization in terms of skin prick test, and bronchial hyper-responsiveness. 43 bakers (with at least 2 years of occupational exposure) working at different bakeries in Ismailia city, Egypt; and 64 control subjects of comparable socio demographic characteristics were compared. All participants were subjected to an interview questionnaire, clinical chest examination, skin prick test, bronchial hyper-responsiveness test and measurements of pulmonary function parameters. All respiratory and allergic symptoms were more prevalent among bakers compared to the control group, with the highest odds ratio for allergic symptoms (OR = 6.9; p < 0.0001) and dyspnea (OR = 6.3; p = 0.0004). Bakers had a higher percentage of SPT positive results with statistically significant difference between the two groups (p < 0.0001). Bakers had lower observed values compared to the control group with statistically significant difference for FVC, FEV1/FVC ratio, FEF75%, and FEF25-75% parameters. The present study suggested that occupational exposure to flour dust may affect respiratory irritation and sensitization, and reduce the pulmonary function tests such as FVC, FEV1, and FEV1/FVC ratio and FEF25-75%.

[Anesthesia in pregnant women with HELLP syndrome: case report]. HELLP syndrome, characterized by hemolysis, high levels of liver enzyme, and low platelet count, is an advanced clinical stage of pre-eclampsia, progressing to high maternal (24%) and perinatal (up 40%) mortality, despite childbirth care in a timely manner. The goal is to describe the anesthetic management of a case with indication to emergency caesarean. Female patient, 36 years old, gestational age of 24 weeks, with hypertensive crisis (BP 180/100 mmHg) and severe headache, was admitted to the operating room for a cesarean section after diagnosis of HELLP syndrome. Indicated for general anesthesia, we opted for total intravenous with intubation after rapid sequence induction with propofol and remifentanil in continuous target-controlled infusion, and rocuronium at a dose of 1.2 mg/kg. Maintenance was achieved with propofol and remifentanil. The surgical procedure was uneventful, the child was born with APGAR 1/5 and transferred to the NICU. At the end of surgery, the patient was extubated in the operating room and taken to the ICU. The postoperative period was uneventful with no changes worthy of note and the patient was discharged on the sixth postoperative day. When general anesthesia is the choice in parturient with HELLP syndrome, tracheal intubation with rapid sequence induction due to possible difficult airway, as well as the use of drugs to control the hemodynamic response can minimize the complications associated with the procedure, as occurred in this case.

Clinical results of islet transplantation. Islet transplantation is considered an advanced therapy in the treatment of type-1 diabetes, with a progressive improvement of clinical results as seen in the Collaborative Islet Transplant Registry (CITR) report. It is an accepted method for the stabilization of frequent hypoglycemia, or severe glycemic lability, in patients with hypoglycemic unawareness, poor diabetic control, or a resistance to intensive insulin-based therapies. Worldwide data confirm a positive trend in this field, with the integrated management of pivotal factors: adequate islet mass, immunosuppressive protocols, additional anti-inflammatory therapy, and pre-transplant allo-immunity assessment. Insulin independence has been observed in several clinical trials with different rate, ranging 100-65% of patients; the maintenance of this condition during the follow-up progressively decreased, actually arranged on 44% 3 years after the last infusion, according to data reported from the CITR. Successful duration is progressively increasing, with ≥13 years being the longest reported insulin-free condition on record. The immediate results of functioning islet transplantation are an improvement in hypoglycemic awareness and a reduction in the glycated hemoglobin level. Furthermore, many studies have shown its influence on the chronic complications of diabetes, such as peripheral neuropathy, retinopathy, and macroangiopathy. Pre-transplant nephropathy remains an exclusion criterion as immunosuppressive therapy can exacerbate kidney-function deterioration. The problems linked to immunosuppression following islet transplantation for the treatment of type-1 diabetes need to be considered in order to achieve the correct risk/benefit ratio for each patient.

Characterization of auxin transporter PIN6 plasma membrane targeting reveals a function for PIN6 in plant bolting. Auxin gradients are sustained by series of influx and efflux carriers whose subcellular localization is sensitive to both exogenous and endogenous factors. Recently the localization of the Arabidopsis thaliana auxin efflux carrier PIN-FORMED (PIN) 6 was reported to be tissue-specific and regulated through unknown mechanisms. Here, we used genetic, molecular and pharmacological approaches to characterize the molecular mechanism(s) controlling the subcellular localization of PIN6. PIN6 localizes to endomembrane domains in tissues with low PIN6 expression levels such as roots, but localizes at the plasma membrane (PM) in tissues with increased PIN6 expression such as the inflorescence stem and nectary glands. We provide evidence that this dual localization is controlled by PIN6 phosphorylation and demonstrate that PIN6 is phosphorylated by mitogen-activated protein kinases (MAPKs) MPK4 and MPK6. The analysis of transgenic plants expressing PIN6 at PM or in endomembrane domains reveals that PIN6 subcellular localization is critical for Arabidopsis inflorescence stem elongation post-flowering (bolting). In line with a role for PIN6 in plant bolting, inflorescence stems elongate faster in pin6 mutant plants than in wild-type plants. We propose that PIN6 subcellular localization is under the control of developmental signals acting on tissue-specific determinants controlling PIN6-expression levels and PIN6 phosphorylation.

Effects of disruptive selection on genetic variance. Theoretical predictions of changes in variance with disruptive selection have used models of infinitely many genes so the increase in variance was necessarily due to linkage disequilibrium. With small numbers of loci, the disequilibrium is shown still to comprise the major part of the changes in variance.In a replicated experiment with Drosophila melanogaster, disruptive selection was practised for three generations, and this was followed by 5 or 7 generations of random mating. The heritability, as estimated from regression of progeny on parent, rose from 37% to 68% on selection, and subsequently declined to 45% on random mating. Changes of variance can be interpreted invoking the build up of linkage disequilibrium during selection followed by its breakdown upon relaxation. The results agree well with those obtained from Monte Carlo simulation.

Twenty-four month clinical evaluation of fissure sealants on partially erupted permanent first molars: glass ionomer versus resin-based sealant. Glass ionomer sealants are an alternative to resin-based sealants, especially for use in partially erupted permanent molars. The authors conducted a study to compare the retention, marginal staining and cariostatic properties of a glass ionomer sealant with those of a resin-based sealant during a 24-month period. We included in this study 39 patients aged 5 through 9 years who had bilateral partially erupted first permanent molars. One of us (S.B.) placed a resin-based sealant (Delton Plus FS+, Dentsply Professional, York, Pa.) (group D) on a partially erupted first molar in one quadrant of the maxilla or mandible and a glass ionomer sealant (GC Fuji Triage White, GC America, Alsip, Ill.) (group T) in the other quadrant. Two masked and calibrated investigators (S.A.A., J.C.) evaluated the sealants for retention, marginal staining and carious lesions at three, six, 12 and 24 months. The authors used a multinomial regression for statistical analysis (P < .05). The recall rate was 69.2 percent at 24 months. Two sealants from group D and three from group T were lost completely. Complete retention rates at 24 months were 40.7 and 44.4 percent for groups D and T, respectively. The authors found no statistically significant difference in retention rates between groups at each recall examination (P > .05). For marginal staining, sealants in the resin-based group exhibited statistically higher marginal staining than did sealants in the glass ionomer group (P < .05). Although the authors detected no caries in teeth in group T, teeth in group D in which the sealant was lost completely experienced demineralization. Resin-based and glass ionomer sealants exhibited similar retention rates at 24 months. However, marginal staining was lower in the glass ionomer group, and the authors found no caries in teeth in this group. Consequently, glass ionomer sealants may be a better choice when salivary contamination is expected. Sealing during tooth eruption presents a particular challenge owing to difficulty in isolating the tooth. Glass ionomers may be a better material for sealing partially erupted molars.

The effects on chicks of dietary fibre from different sources: a growth factor in wheat bran. 1. Groups of chicks were given a low-residue diet with or without supplements of dietary fibre in the form of wheat bran, wheat straw or bagasse. Growth and food conversion efficiency (g weight gained/g food eaten; FCE) during the first 4 weeks of life were measured. 2. In every one of seven experiments supplementation of the diet with 100 g wheat bran/kg resulted in improved growth, and in three experiments FCE was also increased. 3. Supplementation with coarsely-milled wheat straw to provide an amount of unavailable carbohydrate equivalent to that in the bran diet resulted in poorer growth; finely-milled wheat straw had little effect on growth. 4. The growth-promoting effect of bran was destroyed by sterilization with heat or gamma-radiation. 5. In some experiments weights, lengths and volumes of small intestines were measured. Differences in intestinal dimensions between birds given the diet with and without fibre were not consistent, nor were they correlated with growth rate or FCE. 6. Histometric observations on small intestines from a few birds indicated that those given coarse wheat straw had longer vili and thicker muscularis layers, and the caecal tonsils had a greater area of lymphoid tissue and more follicles.

A randomized, prospective, double-blind trial comparing 3% chloroprocaine followed by 0.5% bupivacaine to 2% lidocaine followed by 0.5% bupivacaine for interscalene brachial plexus block. The combination of 2-chloroprocaine and bupivacaine (C/B) for regional anesthesia has been described, but its use was largely abandoned due to equivocal results in efficacy. In this prospective, double-blind, randomized study, we compared the onset of an interscalene block using C/B versus a combination of lidocaine and bupivacaine (L/B). Thirty patients scheduled for shoulder arthroscopy under interscalene block were divided into two groups of 15 each. One group (C/B) received 3% 2-chloroprocaine combined with bicarbonate and epinephrine, immediately followed by 0.5% bupivacaine and epinephrine, whereas the other group (L/B) received 2% lidocaine instead of 3% 2-chloroprocaine. Motor and sensory block were assessed every 15 s. The primary end-point was the time of onset to complete motor block. Time-to-event (survival) statistical analysis tests were applied. One L/B patient had a failed block, and was excluded. The median time to motor block for C/B and L/B was 90 (15-575) and 180 (15-3720) s, respectively (P = 0.0325), and to sensory block for C/B and L/B was 90 (30-600) and 210 (30-3900) s, respectively (P = 0.0185). Survival analysis showed that in 5 min, 13 of 15 patients from the C/B group but only 7 of 14 from the L/B group had a successful motor block. In 10 min, 15 of 15 patients from the C/B group but only 10 of 14 from the L/B group had a successful motor block. It took as long as 60 min to assess block success/failure for blocks in the L/B group. This study demonstrates that a successful block was more rapid using C/B than L/B for interscalene blocks.

Human T lymphocytes and T-cell lines as target cells for lymphocyte chemotaxis. We have observed that freshly isolated T lymphocytes from healthy donors give a chemotactic response to complement C5a in 26 of 55 individuals and to epidermal lymphocyte chemotactic factor in 15 of 23 donors using 51chromium-labelled lymphocytes in a double-filter Boyden chamber system. The reason for a lack of demonstrable chemotaxis among some cell populations is unknown, but it makes donor selection important when studying lymphocyte chemotaxis. In order to obtain a standardized screening assay for T lymphocyte chemotactic activity, we investigated a number of T-cell lines or T-cell-related cell lines such as HuT78, Jurkat, MOLT4, K562 and 1301. We observed that HuT78, K562 and Jurkat showed chemotactic responses to a variety of mediators, whereas 1301 showed chemotaxis only towards C5a, and MOLT4 was completely negative. The HuT78 cell line, which is derived from a patient with Sézary's syndrome, exhibited the highest chemotactic capacity similar to freshly isolated T lymphocytes. The only difference was its chemotactic response towards stimulation with recombinant interleukin-1 alpha and beta, which did not induce chemotaxis in human peripheral blood T lymphocytes in the Boyden chamber assay. We conclude that HuT78 can be used in screening various inflammatory mediators for their potential T lymphocyte chemotactic properties.

Olive oil oleuropein has anti-breast cancer properties with higher efficiency on ER-negative cells. Breast cancer constitutes a major health problem for women worldwide. However, its incidence varies between populations and geographical locations. These variations could be diet-related, since there are several carcinogenic compounds in the modern diet, while natural products contain various anti-cancer elements. Several lines of evidence indicate that, in addition to their clear preventive effect, these compounds could also be used as therapeutic agents. In the present report we have shown that oleuropein, a pharmacologically safe natural product of olive leaf, has potent anti-breast cancer properties. Indeed, oleuropein exhibits specific cytotoxicity against breast cancer cells, with higher effect on the basal-like MDA-MB-231 cells than on the luminal MCF-7 cells. This effect is mediated through the induction of apoptosis via the mitochondrial pathway. Moreover, oleuropein inhibits cell proliferation by delaying the cell cycle at S phase and up-regulated the cyclin-dependent inhibitor p21. Furthermore, oleuropein inhibited the anti-apoptosis and pro-proliferation protein NF-κB and its main oncogenic target cyclin D1. This inhibition could explain the great effect of oleuropein on cell proliferation and cell death of breast cancer cells. Therefore, oleuropein warrants further investigations to prove its utility in preventing/treating breast cancer, especially the less-responsive basal-like type.

[Acute failure of the intestinal barrier--pathophysiology, diagnosis, prophylaxis and therapy]. The gut not only serves as a main target for the detrimental effects of stress during and after surgery, but may also promote the development of multiple organ failure after different types of severe shock. According to a current hypothesis, an impaired intestinal barrier function is associated with a decreased separation of intraluminal bacteria and toxins and systemic circulation, which may induce sepsis and multiple organ failure. Hypoperfusion during shock, reperfusion injury of the splanchnic mucosa, alterations of the micro-ecology of the gut and immunologic and hormonal disturbances are important underlying pathophysiological mechanisms. Various therapeutic concepts have been proposed such as improvement of splanchnic perfusion, nutritive and metabolic treatment by means of immunomodulating nutrients, parenteral substitution of glutamine, early onset of enteral nutrition, normalization of gut motility and selective decontamination of the gut. However, no clinical study to date could clearly demonstrate a key role of the gut in the pathogenesis of sepsis and multiple organ failure. Likewise, the efficacy of different prophylactic and therapeutic procedures remain to be studied. An aggressive treatment of shock and avoidance of microcirculatory disturbances are of principal importance for prophylaxis of multiple organ failure.

Propagator for the Fokker-Planck equation with an arbitrary diffusion coefficient. We consider a general diffusion process that is force-free and the corresponding Fokker-Planck equation with an arbitrary diffusion coefficient. A propagator for the Fokker-Planck equation of the Stratonovich form is obtained based on random walks. The characteristics of the solution are analyzed.

[The collecting and processing system of the sound signal of larynx]. This paper presents a new kind of collecting and processing system of the sound signal of larynx where double sound cards and software filter are used. The installation of the double sound cards and processing proposal of software are mainly discussed and a new kind of ADC method of dual-channel sound signal is put forward in this paper. This system has the feature of reliable performance, simple installation and easy maintenance.

Factors that cause the beta-anomeric preference of Na+/glucose cotransporter for intestinal transport of monosaccharide conjugates. The intestinal transport of glucose- and galactose-conjugated acetaminophen (APAP glycoside) by Na+/glucose cotransporter (SGLT1) was studied. SGLT1-mediated transport of APAP glycosides preferred glucoside>galactoside and beta-anomer>alpha-anomer. These preferences agree with previous studies. NMR spectroscopic and molecular modeling studies indicated that the conformation of the glucose ring of alpha- and beta-glucosides of APAP, as well as glycosides in previous studies, is in the 4C1 chair form, the same form as glucose itself. Molecular dynamics analysis also indicated that the glucose ring was in the 4C1 chair form, and that there are differences between the rotational spaces of aglycones and hydroxy groups of glucose moieties between anomers. Therefore, we conclude that the beta-anomeric preference of glucose conjugate transport by SGLT1 is not due to the conformation of the glucose ring, but to the configuration of the aglycone at C-1 of the monosaccharide moiety.

Bacteriology of chronic suppurative otitis media (CSOM) in children in Garissa district, Kenya: a point prevalence study. To identify by type and sensitivity to drugs the bacteria found in ears of school-going children with chronic otitis media in Garissa district. This was a descriptive prevalence study of CSOM bacterial flora in eligible ears conducted among a cohort of children attending public and private primary as well as Islamic religious schools, screened for chronic ear discharge in Garissa district, Kenya. Procedure and bacteriological techniques: We used sterile swab-sticks to collect a specimen of the discharge from eligible ears of consenting pupils at the induction stage of the zinc supplementation trial for treatment of chronic suppurative otitis media conducted between January and July 2010. All pupils below 18 years present on day of visit were eligible. Both aerobic and anaerobic bacterial cultures were done to identify clinically and epidemiologically important bacteria. Sensitivity tests were based on disc diffusion methods. Results are presented as frequencies and proportions. Of the pupils seen, 61% were still in pre- or lower primary school. Majority were aged 13 and 14 years. Of the 261 ear swab samples processed, 336 isolates - either in mixed or pure flora - were identified, being almost exclusively aerobes. Proteus spp., Enterococcus, Staphylococcus aureus and Pseudomonas spp. were isolated in 32.7%, 28.6%, 12.8% and 11.3% respectively. Proteus was susceptible to majority of the antibiotics tested for, while Enterococcus was poorly susceptible. Aerobic bacteria were most prevalent in this study. Several of the bacteria identified are known to require iron for their growth. This may be important for CSOM treatment if biofilm formation is involved in pathogenesis. Majority of the isolates were susceptible to basic antibiotics compared to Enterococcus bacteria. This portends an important consideration for clinical management and therapeutic decision-making. Additionally, given the prevalence of Enterococcus bacteria, which is an indicator of faecal contamination of the environment, there is need to consider relevant public health components in managing childhood CSOM besides the clinical ones alone.

Frontal and lateral characteristics of the osseous configuration in chronic ankle instability. The osseous ankle configuration (tibiotalar sector, talar radius and height) has been discovered as intrinsic risk factor for chronic ankle instability (CAI). These measurements were done on lateral radiographs only. In this study, the osseous characteristics in the frontal plane and further lateral values were measured. Level III case-control study. Radiological measurement of frontal and lateral radiographs by one independent, blinded radiologist using a digital DICOM/PACS system. A group of 52 patients with CAI was compared with an age- and sex-matched control group of 52 healthy subjects. In the frontal plane, the depth of the talar curvature (frontal curvature (froCu)) and the lateral and medial malleolar lengths were measured. In the lateral plane, the position of the centre of rotation to the tibial axis (talar centre of rotation to the anatomical axis of the tibia (TibCOR)) and the tibial lateral surface angle (TLS) were also measured. The froCu was deeper in patients with CAI (1.8 (0.5) mm) than in healthy subjects (1.0 (0.5) mm, p<0.05). The TibCOR was more anterior in patients with CAI (2.5 (1.9) mm) than in healthy subjects (1.6 (2.2) mm, p<0.05). The distance from the fibular tip to the centre of rotation was smaller in patients with CAI (3.5 (3.4) mm) than in healthy subjects (6.5 (3.3) mm, p<0.05). The TLS and the length of the lateral and medial ankle were not significantly different. This study supports that the osseous joint configuration is an intrinsic risk factor for CAI. It could be shown that CAI is characterised by a deeper frontal curvature of the talus and a more anterior position of the talus to the tibia.

Chronic hepatitis B virus infection and preterm labor(birth) in pregnant women-an updated systematic review and meta-analysis. We aimed to explore whether maternal chronic hepatitis B virus (HBV) infection certainly affects preterm labor (birth) in pregnant women. Four databases were systematically searched up to May 31, 2017, without language restriction. Any study was included if it clearly defined exposure to chronic HBV infection, reported risk of preterm labor or birth in pregnant women, and reported relative risks (RRs) or odds ratios (ORs) or provided data for estimation. RRs (or ORs) with 95% confidence intervals were pooled using random-effects models. Statistical heterogeneity was assessed with Cochran's Q statistic and I2 statistic. Twenty-two observational studies involving 6 141 146 pregnant women (three prospective cohort studies, n = 1 116 799; 15 retrospective cohort studies, n = 5 022 513 and four case-control studies, n = 1834) were included. The risk of preterm labor was significantly intensified with chronic HBV infection compared with uninfected women, with substantial heterogeneity. Chronic HBV infection was also significantly associated with a 16% increase in the risk of preterm birth, with substantial heterogeneity. The risk of preterm birth significantly increased by 21% in HBsAg+/HBeAg+ pregnant women compared with uninfected pregnant women. Chronic HBV infection intensifies the risk of preterm labor and birth in pregnant women, but this conclusion should be interpreted with caution given the possibility of residual confounding and be confirmed by well-designed studies in the future.

Direct solvothermal synthesis of early transition metal nitrides. Solvothermal reactions of TaCl5 with LiNH2 in benzene result in nanocrystalline Ta3N5 at 500 or 550 degrees C. The approximately 25 nm Ta3N5 particles have a band gap of 2.08-2.10 eV. The same reactions in mesitylene resulted in a higher crystallization temperature and large amounts of carbon incorporation due to solvent decomposition. Reactions of Ta(NMe2)5 with LiNH2 under the same conditions resulted in TaN. Rocksalt-type MN phases are obtained for Zr, Hf, or Nb when their chlorides (ZrCl4, HfCl4, or NbCl5) or dialkylamides (M(NEtMe)4, M = Zr, Hf) are reacted with LiNH2 under similar conditions. With the amides, there is some evidence for nitrogen-rich compositions (HfN >1), and carbon is incorporated into the products through pyrolysis of the dialkylamide groups.

Blood lactates after prolonged severe exercise Blood was drawn from cross-country skiers at 1–3 min after the finish in competitions on distances from 10 to 85 km and the blood lactate determined. Despite a maximal effort of the skiers, accentuated at the end of the race, there was a successive decrease in the blood lactate concentration with work time. After a 10-km race, work time 35–36 min, the average was 139 mg/100 ml of blood (12.5 mEq/liter); after a 30-km race, with a time of 1 hr 50 min-1 hr 56 min, the mean value was 68 mg/100 ml (6.1 mEq/liter); and after a 50-km race, work time 3 hr 6 min-3 hr 18 min, 39 mg/100 ml (3.5 mEq/liter). A lactate concentration exceeding 100 mg/100 ml is a common finding after maximal muscular exercise involving large muscles. The explanation for the low values after prolonged maximal work, indicating a different kind of fatigue, is presently obscure. Data are presented on the oxygen uptake attained during skiing at actual racing speed (average Vo2 = 4.45 liters/min).

Perioperative use of oxygen: variabilities across age. Enormous interest has emerged in the perioperative use of high concentrations of inspired oxygen in an attempt to increase tissue oxygenation and thereby improve postoperative outcome. An extensive debate has arisen regarding the risk/benefit ratio of oxygen therapy, with some researchers advocating the benefits of perioperative hyperoxia, particularly with regard to surgical site infection, whereas others emphasize its detrimental consequences on multiple organs, particularly the lungs and the brain. As one aspect of this debate, there is increased awareness of effects of reactive oxygen metabolites, a feature that contributes to the complexity of achieving consensus regarding optimum oxygen concentration in the perioperative period. Many reviews have discussed the pros and cons in the use of perioperative oxygen supplementation, but the potential importance of age-related factors in hyperoxia has not been addressed. The present narrative review provides a comprehensive overview of the physiological mechanisms and clinical outcomes across the age range from neonates to the elderly. Risks greatly outweigh the benefits of hyperoxia both in the very young, where growth and development are the hallmarks, and in the elderly, where ageing increases sensitivity to oxidative stress. Conversely, in middle age, benefits of short-term administration of perioperative oxygen therapy exceed potential adverse change effects, and thus, oxygen supplementation can be considered an important therapy to improve anaesthesia management.

[Coronary flow obstruction in percutaneous aortic valve replacement using self-expandable valved stent: an in vitro study]. To study the effects of self-expandable and orthotopically implanted percutaneous aortic valved stent on coronary artery flow in vitro. Self-expandable valved stent was developed with nitinol stent and bovine pericardium. The ascending aorta of Chinese mini swine hearts was cut proximal to the brachiocephalic trunk. The right and left main coronary arteries were dissected. In vitro coronary flow tests were performed. Firstly, baseline coronary flow with the native aortic valve was measured (n = 12). Secondly, the valved stent was deployed orthotopically. The commissures of prosthesis were positioned randomly. Through an endoscope, the effects of valved stent and native valve on coronary ostium were obtained and coronary flow measurements repeated (valve preservation group, n = 12). Then the distance from coronary ostium to native leaflet free edge was measured. Native leaflets were removed before similar valved stent deployment. Coronary flow measurements and endoscopic inspections were repeated post-implantation (valve removal group, n = 12). In valve preservation group, valved stent implantation resulted in a significant decrease in left coronary flow (29.46%, P < 0.05). The obstruction was due to native leaflets sandwiched between the stent and aortic wall. The left ostia were obstructed totally in 3 and partially in 4. The flow of right coronary decreased 7.34% (P > 0.05). The right ostia were obstructed partially in 3. In valve removal group, 6.82% and 5.37% decrement in left and right coronary flow were observed after valved stent placement (P > 0.05). The distances from right coronary ostia to annulus were farther than from left coronary ostia. In two groups, the commissures of prosthesis obstructed partially left coronary ostia in 4 and right coronary ostia in 1. Orthotopic implantation of a percutaneous self-expandable aortic valved stent would obstruct the left coronary ostium with the native valve. Coronary ostium may be obstructed partly by the commissures of prosthesis.

Characterization of enzymatic D-xylulose 5-phosphate synthesis. In this article we report on the characterization of the enzymatic synthesis of D-xylulose 5-phosphate using triosephosphate isomerase and transketolase. Two potential starting substrates are possible with this scheme. The data presented here allow a comparison of both routes for the synthesis, based on experimental information on reaction kinetics. Operational guidelines are proposed which should assist in the scale-up of such syntheses.

Industrial exposure to 1,3-butadiene in monomer, polymer and end-user industries. Researchers from the National Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease Control and Prevention conducted an extent-of-exposure study of 1,3-butadiene monomer, polymer and end-user industries to assess occupational exposure to butadiene and to evaluate control technologies. The findings of the exposure assessment are reported here. Walk-through surveys were conducted in 11 monomer, 17 polymer and two end-user plants; in-depth industrial hygiene surveys were conducted at four monomer, five polymer and two end-user plants. Airborne exposure concentrations of butadiene were determined for various job categories by personal sampling. The samples were analysed by a new method developed at NIOSH that is sensitive to 0.2 microgram per sample. A total of 687 personal (full-shift and short-term) and 232 area samples were taken. The results indicate that all exposures were well below the current permissible exposure limit of the US Occupational Safety and Health Administration of 1000 ppm. The US Occupational Safety and Health Administration (1990) has proposed a new standard that would reduce exposure to 2 ppm. Exposures ranged from less than 0.005 ppm to 374 ppm, and 3.7% of the samples contained more than 10 ppm, 7.8% more than 2 ppm but less than 10 ppm and 88.5% less than 2 ppm. We recommend means for reducing exposure by the use of engineering controls.

Fabrication and photovoltaic characterization of bio-sensitized solar cells using myoglobin-based sensitizers. Myoglobin (Mb), reconstituted zinc protoporphyrin-apomyoglobin (ZnMb), and eosin-modified ZnMb (EoZnMb) were used as photosensitizers to functionalize TiO2 nanocrystalline films for bio-sensitized solar-cell (BSSC) applications. For the Mb-sensitized SC, the poor cell performance was due to a reduction Fe(III) --> Fe(II) that produces a photocurrent density of the device smaller than its unsensitized counterpart. The efficiencies of power conversion of both ZnMb and EoZnMb-sensitized SC were enhanced about ten times due to superior charge separation between TiO2 and the protein, and due to smaller current leakage between TiO2 and the electrolyte. The cell performances of the BSSC devices are discussed in terms of an equivalent-circuit model.

Maternal flu or fever, medication use, and neural tube defects: a population-based case-control study in Northern China. Maternal exposure to flu or fever has been associated with increased risk for neural tube defects (NTDs); however, few studies have considered the effects of medications on the effects of flu or fever. We evaluated the effect of maternal flu or fever, medication use (antibiotics, antipyretics), and their joint effect on NTDs. Data came from an ongoing population-based case-control study of infants with external malformations in northern China. The case group included 363 infants with NTDs identified between January 2003 and June 2005. Controls were 523 newborn infants without identified congenital anomalies matched by county, sex, maternal ethnic group, and the closest date of conception for infants with any major external malformation. Data were collected by a trained health worker through face-to-face interviews after delivery. NTD risks were significantly associated with maternal flu or fever (adjusted odds ratio [AOR] = 3.93, 95% CI: 2.48-6.23) and antipyretic use (AOR = 4.86, 95% CI: 1.33-17.78), but not with antibiotic use (AOR = 1.75, 95% CI: 0.91-3.38) after adjusting for potential confounders. NTD risk associated with maternal antipyretic use was markedly higher for anencephaly (AOR = 7.03, 95% CI: 1.70-29.04) than for spina bifida (AOR = 3.98, 95% CI: 0.95-16.74). Mothers with flu or fever who were also using antipyretics showed a markedly higher AOR for anencephaly (14.75 vs. 4.52), spina bifida (16.30 vs. 3.85), and all NTDs combined (13.91 vs. 4.04) than mothers with flu or fever who were not using antipyretics. Maternal antibiotics did not markedly change the effects of flu or fever on anencephaly (4.17 vs. 4.83), spina bifida (5.08 vs. 4.21), and all NTDs combined (5.05 vs. 4.29). Maternal flu or fever and antipyretic use during the periconceptional period increases the risk for NTDs. Maternal exposure to antipyretics together with flu or fever results in a markedly higher risk of NTDs than exposure to flu or fever alone.

High basal defense gene expression determines sorghum resistance to the whorl-feeding insect southwestern corn borer. Southwestern corn borer (SWCB, Diatraea grandiosella) and fall armyworm (FAW, Spodoptera frugiperda) are major pests of sorghum in the southern United States. Host plant resistance is a desirable means for reducing plant damage and yield losses from both insects. In this study, we evaluated 12 sorghum lines for whorl-stage resistance to leaf-feeding SWCB and FAW in greenhouse and laboratory bioassays. Differential plant responses were detected against the two insects. Among 12 lines tested, CM1821, Della and PI196583 were resistant to both insects, while BTx2752 was largely susceptible. Line R.09110 was resistant to SWCB, but susceptible to FAW, whereas Redbine-60 was susceptible to SWCB, but not to FAW. In addition, we quantified various chemical components in the plants and determined their association with insect resistance. Tannin and chlorophyll in leaves did not show any significant correlation with resistance to either insects, but contents of soluble protein in general were negatively correlated with resistance to both insects. Endogenous soluble sugar and dhurrin were only positively correlated with resistance to SWCB, but not with FAW resistance. To gain some molecular insight into resistance mechanism of sorghum to SWCB, we performed qPCR reactions for key genes encoding enzymes involved in dhurrin and jasmonic acid (JA) biosynthesis on selected resistant or susceptible lines. Although these genes were rapidly and strongly induced by insect feeding in all lines, the observed resistance is likely explained by higher constitutive dhurrin contents in some resistant lines and higher basal JA biosynthesis in others. Our results suggest that sorghum utilizes multiple strategies to defend itself against SWCB.

Identification of NEK3 and MOK as novel targets for lithium. Lithium ion, commonly used as the carbonate salt in the treatment of bipolar disorders, has been identified as an inhibitor of several kinases, including Glycogen Synthase Kinase-3β, for almost 20 years. However, both the exact mechanism of enzymatic inhibition and its apparent specificity for certain metalloenzymes are still a matter of debate. A data-driven hypothesis is presented that accounts for the specificity profile of kinase inhibition by lithium in terms of the presence of a unique protein environment in the magnesium-binding site. This hypothesis has been validated by the discovery of two novel potential targets for lithium, namely NEK3 and MOK, which are related to neuronal function.

Usefulness of lateral internal sphincterotomy in reducing postoperative pain after open hemorrhoidectomy. The aim of the present study was to evaluate the effect of lateral internal sphincterotomy on pain after open hemorrhoidectomy. From 1998 to 2003, seventy-eight (78) patients with fourth-degree hemorrhoids were included in this prospective randomized trial. The patients were randomized into two equal groups of 39 patients. Patients from group I underwent Milligan-Morgan hemorrhoidectomy. Patients from group II, quite apart from Milligan-Morgan hemorrhoidectomy, underwent lateral internal sphincterotomy up to the dentate line, in the left hemorrhoidectomy wound. One surgeon from the Department, who did not know to which group the patients belonged, evaluated the postoperative course in all the patients. After the first bowel movement, there were three (7.7%) patients who did not experience any pain in the internal sphincterotomy group, while in the non-internal sphincterotomy group all patients experienced mild or moderate pain. There were also more patients who experienced excruciating pain in the non-internal sphincterotomy group than in the internal sphincterotomy group (25 vs. 18); these differences were statistically significant (p = 0.034). There was no significant difference in the Wexner Incontinence Scale between the groups (p = 0.228). The addition of lateral internal sphincterotomy to open hemorrhoidectomy seems to have a positive effect on reducing postoperative pain in a few patients, without affecting the postoperative complications rate.

Computer-Generated, Three-Dimensional Spine Model From Biplanar Radiographs: A Validity Study in Idiopathic Scoliosis Curves Greater Than 50 Degrees. Reproducibility study of SterEOS 3-dimensional (3D) software in large, idiopathic scoliosis (IS) spinal curves. To determine the accuracy and reproducibility of various 3D, software-generated radiographic measurements acquired from a 2-dimensional (2D) imaging system. SterEOS software allows a user to reconstruct a 3D spinal model from an upright, biplanar, low-dose, X-ray system. The validity and internal consistency of this system have not been tested in large IS curves. EOS images from 30 IS patients with curves greater than 50° were collected for analysis. Three observers blinded to the study protocol conducted repeated, randomized, manual 2D measurements, and 3D software generated measurements from biplanar images acquired from an EOS Imaging system. Three-dimensional measurements were repeated using both the Full 3D and Fast 3D guided processes. A total of 180 (120 3D and 60 2D) sets of measurements were obtained of coronal (Cobb angle) and sagittal (T1-T12 and T4-T12 kyphosis; L1-S1 and L1-L5; and pelvic tilt, pelvic incidence, and sacral slope) parameters. Intra-class correlation coefficients were compared, as were the calculated differences in values generated by SterEOS 3D software and manual 2D measurements. The 95% confidence intervals of the mean differences in measures were calculated as an estimate of reproducibility. Average intra-class correlation coefficients were excellent: 0.97, 0.97, and 0.93 for Full 3D, Fast 3D, and 2D measures, respectively (p = .11). Measurement errors for some sagittal measures were significantly lower with the 3D techniques. Both the Full 3D and Fast 3D techniques provided consistent measurements of axial plane vertebral rotation. SterEOS 3D reconstruction spine software creates reproducible measurements in all 3 planes of deformity in curves greater than 50°. Advancements in 3D scoliosis imaging are expected to improve our understanding and treatment of idiopathic scoliosis.

Complex network from pseudoperiodic time series: topology versus dynamics. We construct complex networks from pseudoperiodic time series, with each cycle represented by a single node in the network. We investigate the statistical properties of these networks for various time series and find that time series with different dynamics exhibit distinct topological structures. Specifically, noisy periodic signals correspond to random networks, and chaotic time series generate networks that exhibit small world and scale free features. We show that this distinction in topological structure results from the hierarchy of unstable periodic orbits embedded in the chaotic attractor. Standard measures of structure in complex networks can therefore be applied to distinguish different dynamic regimes in time series. Application to human electrocardiograms shows that such statistical properties are able to differentiate between the sinus rhythm cardiograms of healthy volunteers and those of coronary care patients.

Identification of an ionic strength sensitive nuclear protein kinase activity from the cervical carcinoma HeLa. A cyclic nucleotide independent, serine-threonine protein kinase activity has been purified approximately 700 fold from the nuclei of HeLa cells. This activity has a very strict ionic strength requirement. Maximum activity is obtained in a monovalent cation environment under 50 mM, where Mg++ is preferred over Mn++ as the required divalent cation.

Acute feasibility and safety of a smoking reduction strategy for smokers with schizophrenia. The authors examined whether smoking while wearing a transdermal nicotine patch over 32 h was well-tolerated and led to smoking suppression in heavy smokers with schizophrenia. In a crossover design, 10 male veteran smokers with schizophrenia were admitted for two brief inpatient stays to smoke while wearing a transdermal nicotine or placebo patch. Carbon monoxide in expired air, self-reported cigarettes per day, nicotine plasma levels, and psychiatric ratings were measured. Nicotine levels increased during active patch treatment, without evidence of nicotine toxicity. Psychiatric symptoms, carbon monoxide and cigarettes per day did not change, although eight subjects had a decrease in expired carbon monoxide on the active patch. Dyskinesias showed a small, but significant, increase during smoking plus active patch. The heaviest smokers (identified by placebo phase nicotine plasma level or CO level above group median; n = 5) had a statistically significant decrease in expired carbon monoxide of at least 20%. Smoking while wearing the nicotine patch over 32 h was well tolerated. Significant decreases in carbon monoxide smoking indices were seen for the heaviest smokers. These findings suggest further investigation of a smoking reduction intervention in this population.

Gluten-Free Diet and Lipid Profile in Children With Celiac Disease: Comparison With General Population Standards. A gluten-free diet (GFD) may carry high energy and fat load. We verified lipid profile and dietary indicators cross-sectionally and prospectively in patients with celiac disease (CD). In any consecutive child receiving a GFD (group 1) or newly diagnosed as having CD (group 2), total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL) cholesterol, blood pressure (BP), anthropometric data, physical activity, and a 24-hour food diary were collected during follow-up visits (yearly in group 1 and during the first year of GFD in group 2). In group 1 (132 girls, 73 boys, 10.7 ± 4.2 years), TC (P = 0.006), TG (P = 0.014), and HDL (P = 0.019) were significantly higher in girls than in boys. Compared with the general pediatric population, group 1 girls had higher TC, TG, HDL, and low-density lipoprotein; group 1 boys had lower TC, TG, and low-density lipoprotein and higher HDL. TC was significantly and positively affected by age, sex, and time receiving GFD, whereas HDL was significantly and positively affected by body mass index, diastolic BP, and sex; TG was negatively affected by diastolic BP. Compared with recommendations, group 1 children introduced less calories, iron, and calcium; one-third more sodium; similar amounts of fiber; and twice as many proteins. In group 2 (20 girls, 10 boys, 8.6 ± 3.55 years), TC did not change over time and TG diminished, whereas HDL, blood glucose, and body mass index increased; saturated fats and caloric intake were below recommendations, whereas proteins were excessively introduced. Fibers were optimal. HDL was inversely correlated to calories and saturated fat (R² = 80, P = 0.011). Lipid profiles of children with CD differ across sexes and from reference population. GFD, being unexpectedly appropriate in fibers and fat proportion, may be a contributor.

Protective effects of neurotrophic factors on tumor necrosis factor-related apoptosis-inducing ligand (TRAIL)-mediated apoptosis of murine adrenal chromaffin cell line tsAM5D. We previously established the murine adrenal chromaffin cell line tsAM5D, which was immortalized with the temperature-sensitive simian virus 40 large T-antigen. tsAM5D cells have the capacity to differentiate into neuron-like cells in response to neurotrophic factors when the culture temperature is shifted from 33 to 39 degrees C. In this model system, the temperature shift in the absence of neurotrophic factors led to cell death. Hoechst staining analysis revealed that typical apoptotic nuclei appeared in a time-dependent manner after the temperature shift. Upon shifting to 39 degrees C, the degradation of T-antigen was accompanied by the transcriptional activation of p53 protein. Among the p53 target genes, death receptor 5 (DR5), which is the receptor for tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), showed the highest level of induction. Interestingly, TRAIL-neutralizing antibody protected tsAM5D cells from the temperature shift-induced apoptotic cell death by blocking the activation of caspase-8 and -3, indicating the involvement of TRAIL-mediated death signaling in the temperature shift-induced apoptosis. Glial cell line-derived neurotrophic factor (GDNF) inhibited the TRAIL-mediated activation of caspase-8 in tsAM5D cells exposed to 39 degrees C and cooperated with basic fibroblast growth factor and ciliary neurotrophic factor. Interestingly, the temperature shift induced oligomerization of DR5, which is the earliest process necessary for transduction of the death signal. This oligomerization was inhibited by treatment with GDNF plus ciliary neurotrophic factor but not by that with GDNF alone or GDNF plus basic fibroblast growth factor. These results are discussed with respect to the intracellular mechanism underlying the protective function of neurotrophic factors against TRAIL-mediated death signaling.

Malignant female adnexal tumor of probable Wolffian origin: a case report. Female adnexal tumor of probable Wolffian origin (FATWO) is a rare tumor arising in locations with Wolffian remnants, such as the broad ligament. It is thought to be a benign lesion, although this is not always the case, with scattered case reports of more aggressive behavior, sometimes years later. A rare case of disseminated malignant FATWO is presented and the literature reviewed. FATWO has the potential for malignant behavior. Familiarity with this lesion will enhance recognition. Patients need long-term follow-up.

Major hemorrhagic and thromboembolic complications in patients with mechanical heart valves receiving oral anticoagulant therapy. Patients with mechanical heart valve prostheses are obligated to receive lifelong oral anticoagulant therapy to prevent thromboembolic complications; however, this treatment is associated with an increased risk of bleeding. The aim of this study was to evaluate the frequency of major hemorrhagic and thromboembolic complications in patients with mechanical heart valves who received oral anticoagulant therapy. The analysis involved 225 patients who underwent successful surgery in 2000; the mean (+/-SD) follow-up period was 43.3 +/- 9.2 months. Aortic, mitral, and double valve replacement was performed in 128 (56.7%), 70 (31.1%), and 27 (12.1%) of the patients, respectively. There were 128 men (57.3%), and the mean patient age was 57.9 +/- 18.8 years. The following data were assessed: rate of major hemorrhagic and thromboembolic complications, frequency of international normalized ratio (INR) rate measurements, and percentage of results within the therapeutic range. Major hemorrhagic and thromboembolic complications occurred in 25 patients (11.1%). Seventeen patients (7.5%) survived, and 8 (3.6%) died of the complications. Major hemorrhagic and thromboembolic complications occurred in 17 patients (7.6%) and 8 patients (3.6%), respectively. The mean time between sequential measurements was 4.3 +/- 3.0 weeks, and of all the INR values collected, 42.4% were within, 31.3% were below, and 26.3% were above the target ranges. Patients with a mechanical heart valve prosthesis receiving acenocoumarol are susceptible to major hemorrhagic and thromboembolic complications, some of which lead to death. Despite the danger related to these complications, patients receiving anticoagulant therapy still have difficulty achieving INR values within the therapeutic range.

Health risks in the cleaning industry: a Belgian census-linked mortality study (1991-2011). Cleaning work has been associated with a wide range of occupational health hazards. However, little is known about mortality risks in the cleaning industry. This study examines differences in cause-specific mortality between cleaners, manual and non-manual workers. Using exhaustive census-linked mortality data, the total Belgian working population aged 30-60 was selected from the 1991 census. Analyses were based on 202,339 male and 58,592 female deaths between 1 March 1991 and 31 December 2011. Standardized Mortality Ratios were calculated and indirectly adjusted for smoking (SMR). In addition, Cox proportional hazards regression models were used to account for age, educational level, part-time employment and marital status. Large mortality differences were observed between cleaners, manual and non-manual workers. In 2001-2011, smoking-adjusted SMRs for all-cause mortality were higher among cleaners than among non-manual workers (Men 1.25 CI 1.22-1.28; women 1.10 CI 1.07-1.13). SMRs also show cleaners had significantly more deaths due to COPD (men 2.13 CI 1.92-2.37; women 2.03 CI 1.77-2.31); lung cancer (men 1.31 CI 1.22-1.39; women 1.21 CI 1.11-1.32); pneumonia (men 1.64 CI 1.35-1.97; women 1.31 CI 1.00-1.68); ischaemic heart diseases (men 1.22 CI 1.13-1.31; women 1.40 CI 1.25-1.57) and cerebrovascular diseases (men 1.19 CI 1.05-1.35; women 1.13 CI 1.00-1.27). Mortality risks among cleaners remained elevated after adjustment for education. Respiratory and cardiovascular mortality is considerably higher for male and female cleaners than for non-manual workers.

Risk Factors in Preschool Children for Predicting Asthma During the Preschool Age and the Early School Age: a Systematic Review and Meta-Analysis. The aim of this study was to identify risk factors of asthma among children < 6 years old (preschool age) for predicting asthma during the preschool age and early school age (≤ 10 years of age). MEDLINE, Cochrane, EMBASE, and Google Scholar databases were searched until June 30, 2017. Prospective or retrospective cohort and case-control studies were included. Studies had to have evaluated risk factors or a predictive model for developing asthma in children ≤ 6 years of age or persistent asthma in early school age. A total of 17 studies were included in the analysis. Factors associated with developing asthma in children ≤ 10 years of age (both pre-school and early school age) included male gender (pooled OR = 1.70, P < 0.001), atopic dermatitis (pooled OR = 2.02, P < 0.001), a family history of asthma (pooled OR = 2.20, P < 0.001), and serum IgE levels ≥ 60 kU/l or having specific IgE (pooled OR = 2.36, P < 0.001). A history of exposure to smoke or wheezing was also associated with persistent asthma in early school age (pooled OR = 1.51, P = 0.030 and pooled OR = 2.59, P < 0.001, respectively). In general, asthma predictive models (e.g., API, PIAMA, PAPS) had relatively low sensitivity (range, 21% to 71.4%) but high specificity (range, 69% to 98%). The study found that male gender, exposure to smoke, atopic dermatitis, family history of asthma, history of wheezing, and serum IgE level ≥ 60 kU/l or having specific IgE were significantly associated with developing asthma by either preschool or early school age. Asthma predictive models can be developed by those risk factors.

Permeability-increasing ability of PAF-acether in rat skin. Platelet-activating factor (PAF-acether), a phospholipid compound with effects on several cells, e.g., platelets and polymorphonuclear leukocytes (PMNs), was examined for its effect on microvascular permeability in rat skin. It was found to increase microvascular permeability, measured as exudation of [125I]human serum albumin, in amounts exceeding 1 pmol, and was more than 1000 times as potent as histamine. The effect was independent of cell infiltration, as no accumulation of PMNs, measured as the amount of myeloperoxidase in the skin, occurred and as the response was unaltered in animals rendered neutropenic due to treatment with an antiserum against PMNs.

[Vegetative hyperthermia: a thermoregulation disorder or a variant from the norm?]. A diagnosis of low-grade idiopathic fever was made in 85 women and 15 men, examined for subfebrile temperature of unknown origin, after organic disease had been excluded. Compared with 100 healthy control subjects these patients had inadequate movement-dependent temperature elevations with a usually pronounced discrepancy between the rectal temperature, predominantly more than 38 degrees C, and a normal or only slightly raised axillary temperature recorded after bodily movement. Other characteristics were that the elevated temperature was uninfluenced by antipyretic drugs. Almost all patients initially complained about general lassitude as well as frequently about atypical functional complaints and psychological symptoms. These observations indicate that low-grade fever is a functional syndrome due to a harmless faulty regulation of body temperature. In addition to a special constitutional reactivity, psychological factors and possibly previous febrile infections are likely to be involved as precipitating causes.