[A case of primary orthostatic hypotension of the Bradbury-Eggleston type].
A patient with idiopathic orthostatic hypotension not accompanied by other neurologic disorders was examined. Pulmonary function tests demonstrated the failure of the autonomic innervation of airways. A syndrome of chronic primary alveolar hypoventilation was present, with the vocal cord paralysis. The symptoms of neurogenic bladder were also present. While recumbent, the patient had low levels of plasma norepinephrine, that failed to increase after standing and exercising. During Kaplan-Silah test the patient was proved to be supersensitive to intravenously administered norepinephrine and angiotensin. The finding was consistent with the view of peripheral denervation. The syndrome of orthostatic hypotension and other symptoms referable to peripheral autonomic dysfunction, without evidence of central nervous system involvement appears to represent a clinical entity distinct from the Shy-Drager syndrome. It can be defined Bradbury-Eggleston syndrome.


Single-photon transistor using a Förster resonance.
An all-optical transistor is a device in which a gate light pulse switches the transmission of a target light pulse with a gain above unity. The gain quantifies the change of the transmitted target photon number per incoming gate photon. We study the quantum limit of one incoming gate photon and observe a gain of 20. The gate pulse is stored as a Rydberg excitation in an ultracold gas. The transmission of the subsequent target pulse is suppressed by Rydberg blockade, which is enhanced by a Förster resonance. The detected target photons reveal in a single shot with a fidelity above 0.86 whether a Rydberg excitation was created during the gate pulse. The gain offers the possibility to distribute the transistor output to the inputs of many transistors, thus making complex computational tasks possible.


Genetic diversity of HLA system in seven populations from Veracruz, Mexico: Veracruz city, Coatzacoalcos, Córdoba, Orizaba, Poza Rica, Xalapa and rural Veracruz.
We studied HLA class I (HLA-A, -B) and class II (HLA-DRB1, -DQB1) alleles by PCR-SSP based typing in 1113 Mexicans from the state of Veracruz living in the cities of Coatzacoalcos (N = 55), Orizaba (N = 60), Córdoba (N = 56), Poza Rica (N = 45), Veracruz (N = 171), Xalapa (N = 187) and rural communities (N = 539) to obtain information regarding allelic and haplotypic frequencies. We found that the most frequent haplotypes include 12 Native American haplotypes. Admixture estimates revealed that the main genetic components are Native American (64.93 ± 1.27% by ML; 55.10% of Native American haplotypes) and European (26.56 ± 0.89% by ML; 28.38% of European haplotypes), and a relatively high African genetic component (8.52 ± 1.82% by ML; 8.78% of African haplotypes).


Salt-induced silk gel-derived N and trace Fe co-doped 3D porous carbon as an oxygen reduction catalyst in microbial fuel cells.
Inexpensive and high-efficiency oxygen reduction reaction (ORR) catalysts play a significant role in achieving practical applications of microbial fuel cells (MFCs). Hence, herein, novel nitrogen (N) and trace iron (Fe) co-doped three-dimensional (3D) porous carbon (NFex-C) was synthesized as an excellent ORR catalyst from an interesting salt-induced silk gel, which was beneficial to the spontaneously formation of porosity and boosted the ORR activity. Among the series of NFex-C, NFe0.5-C (1.20% N-ORR/C, 0.07 at% Fe) possessed a higher specific surface area (538.94 m2 g-1) and pore volume (2.158 cm3 g-1). Note that NFe0.5-C exhibited a significantly higher positive initial potential (0.274 V vs. Ag/AgCl) and half-wave potential (0.095 V vs. Ag/AgCl) than other catalysts and commercial Pt/C (20 wt%); this implied that it possessed prominent ORR catalytic activity. In the MFC tests, the output-voltage and maximum power density of NFe0.5-C were enhanced to 517.37 ± 7.87 mV and 605.35 ± 15.39 mW m-2, respectively. Moreover, NFe0.5-C (0.15 $ g-1) exhibits excellent anti-poisoning ability and is thousands of times cheaper than commercial Pt/C (20 wt%, 220.04 $ g-1); therefore, NFe0.5-C should be a prospective catalyst to substitute precious commercial Pt/C in MFCs and even for application in other types of fuel cells.


Student and clinician identities: how are identities constructed in interprofessional narratives?
Although the literature on professional identity formation in medical education is increasing, it is scant by comparison on student and clinician identities within interprofessional contexts. We therefore adopt a novel discursive approach to identities to explore how soon-to-become graduates and workplace-based clinicians construct their own and others' identities in interprofessional student-clinician (IPSC) interaction narratives. We conducted a qualitative narrative interview study with 38 students and 23 clinicians representing the fields of medicine, midwifery, nursing, occupational therapy, paramedicine and physiotherapy. Through framework analysis, we identified the breadth of student and clinician identity constructions across 208 IPSC interaction narratives, and explored how common constructions differed by narrative and narrator. Through in-depth positioning analysis, we explored how student and clinician identities are discursively positioned within two selected IPSC interaction narratives. We identified 11 common constructions of student identities and eight common constructions of clinician identities across all 208 narratives. We found differences in identity constructions across positively versus negatively evaluated narratives, and student versus clinician narrators, highlighting the rhetorical nature of narratives. Our in-depth positioning analysis of two narratives illustrates how one student and one clinician discursively positioned theirs and others' identities during interprofessional interactions, and how identities vary depending on narrators' evaluations of their stories. Although both positioning analyses illustrate how the narrators' language serves to reproduce the common societal discourse of interprofessional conflict, the clinician narrative also draws on the competing discourse of interprofessional collaboration. Although some of the identities support previous uniprofessional research, our findings illustrate greater breadth and depth in terms of student and clinician identities within interprofessional contexts. We encourage educators to embed identities curricula into existing workplace learning for students and clinicians to help them make sense of their developing professional and interprofessional identities. Workplace educators should facilitate meaningful IPSC interactions to promote interprofessional learning and collaboration.


Therapeutic alternatives for chronic urticaria: an evidence-based review, part 1.
To evaluate the use of alternative therapies for chronic urticaria refractory to first-line treatments in an evidence-based manner. MEDLINE searches were performed cross-referencing urticaria with the names of multiple therapies. Articles were then reviewed for additional citations. Articles published after 1950 were considered. All articles, including case reports, were reviewed for soundness and relevance. Experience has been reported for a wide variety of alternative therapies in the treatment of chronic idiopathic and physical urticarias. Evidence for most agents is limited to anecdotal reports. The second-line therapies reviewed are also categorized based on criteria of safety, efficacy, convenience, and cost, in relation to the first-line antihistamines. Alternative agents should be considered in patients with chronic urticaria who are both severely affected and unresponsive to antihistamines. Although monitoring for toxicity is important in management with many alternative agents, safety is favorable compared with corticosteroids.


Reconstituted basement membrane induces glandular-like morphogenesis but no difference in ACTH synthesis of anterior pituitary cells.
Basement membrane, a thin extracellular matrix, promotes tissue integrity and differentiated phenotype. This study was performed in order to investigate the effect of basement membrane components on adrenocorticotropin (ACTH) synthesis and to observe its relationship with cell morphology. Rat anterior pituitary cells were cultured on plastic culture plate coated with either Matrigel or poly-D-lysine. Phase-contrast microscopy and scanning electron microscopy showed that cells cultured on Matrigel appeared as a three-dimensional glandular-like cell aggregate, while those cultured on plastic showed a flat, confluent monolayer. Reverse-transcription polymerase chain reaction (RT-PCR) and Northern blot analysis revealed that ACTH synthesis in the Matrigel culture was not significantly different from that in the plastic culture. Our results suggest that the relationship between the morphological changes caused by cell-substrate interaction and pituitary hormone synthesis does not exist in all pituitary cell types and that other factors associated with cell-substrate interaction influence the hormone synthesis of some pituitary cells.


Infantile aperiodic alternating nystagmus.
This study identifies the clinical and ocular motility characteristics of the periodic and aperiodic forms of infantile alternating nystagmus (IAPAN) and establishes the range of electrophysiological and clinical characteristics while providing clues to its presence and pathophysiology. Seventy-eight patients with ocular oscillations consistent with IAPAN were reported. Outcome variables were: age, follow-up in months, vision, strabismus, other eye and systemic abnormalities, head position, periodicity, cycle and null period duration, foveation time, waveforms, and cycle symmetry. Age range was 1 to 67 years, 50% had pure periodic and aperiodic forms, 46% had albinism, 26% had binocular acuity of 20/40 or greater, 72% had strabismus, 35% had amblyopia, 31% had other eye disease, 14% had systemic disease, 87% had an anomalous head posture, and 65% had binocular directional asymmetry. The periodic cycle averaged 224 seconds and the aperiodic cycle ranged from 2 to more than 300 seconds. One in three patients with strabismus and nystagmus periodicity had a static head posture. Fifteen percent of the infantile nystagmus syndrome population had either the periodic or aperiodic form. A changing null period is often clinically missed because of long or irregular cycles, decreased acuity, associated strabismus, and either a nonexistent or inconsistent head posture. The changing null period is easier to recognize using eye movement recordings or if the non-preferred eye is occluded and the preferred eye is examined with the head straight and gaze in primary position for at least 5 to 7 minutes. The recognition of this variant has profound treatment implications.


Influence of xanthine derivatives on cough and airway reactivity in guinea pigs.
Xanthine derivatives may inhibit phosphodiesterases without selective action on their single isoforms. In this study, effects of theophylline and theobromine on cough and airway reactivity were evaluated in awake guinea pigs using double-chamber whole body plethysmograph. Pre-treatment with theophylline and theobromine (10 mg/kg, i.p.) decreased the number of cough efforts evoked by inhalation of citric acid aerosol (0.6 mol/l) in both healthy and ovalbumin-sensitized animals. Theophylline and theobromine decreased in vivo airway reactivity, i.e., specific airway resistance measured after nebulization of citric acid and histamine aerosol (10(-6) mol/l), only in ovalbumin-sensitized animals, whereas in vitro reactivity to cumulative doses of histamine and acetylcholine (10(8)-10(-3) mol/l) measured in organ chambers significantly decreased in both healthy and ovalbumin-sensitized animals, with more pronounced effect in the latter group. In conclusion, administration of theophylline and theobromine influenced the cough and airway reactivity in ovalbumin-sensitized guinea pigs, indicating the anti-inflammatory potential of xanthine derivatives.


Nasal anatomy of Paradolichopithecus gansuensis (early Pleistocene, Longdan, China) with comments on phyletic relationships among the species of this genus.
Paradolichopithecus was a large cercopithecine primate that existed in Eurasia from the middle Pliocene to the early Pleistocene. Para. arvernensis from the late Pliocene of Senèze, France, shows no maxillary sinus, whereas Para.sushkini from the late Pliocene of Kuruksay, Tajikistan, has this feature. In this study, we examined a new maxillary specimen of Para. gansuensis from the early Pleistocene of Longdan, China. The Longdan maxilla had lost its facial part, which exposed the internal floor of the nasal region. The nasal floor expands laterally, making the maxillary body thin at the P3-M2 level and thick at the M3 level and extending to the maxillary tubercle. Such a topography is seen in the Senèze and Kuruksay crania. The Longdan maxilla shows no evidence of the formation of a maxillary sinus within the inferior portion of the thick maxillary body, as is seen in the Senèze cranium. Such a configuration could reflect the absence of a maxillary sinus in the Longdan specimen. Eastern Para. gansuensis might have dispersed eastward retaining a primitive condition, while central Para. sushkini would have acquired this feature independently in central Eurasia.


Antihypertensive therapy in African Americans: findings from an inner-city ambulatory clinic.
African Americans bear a greater burden of hypertension. Understanding prevailing epidemiologic patterns can facilitate the implementation and successful outcome of community programs. The authors assessed practice patterns of antihypertensive drug utilization and blood pressure (BP) control in a predominantly African American population in Brooklyn, NY, from January 1 to January 31, 2008. A total of 416 (53.1%) had hypertension, with a mean age of 61 years, and 267 (64%) were women. In general, 212 (50.9%) were at goal BP and 59.9% of those at goal were taking at least 2 drugs. Patient age correlated with the number of drugs used (r=0.14; P=.004). Patients taking beta-blockers and calcium channel blockers were older: 63.6 vs 60.1 years (P=.01) and 62.7 vs 60.3 years (P=.07), respectively. The pattern of antihypertensive use was as follows: angiotensin-converting enzyme inhibitors, 194 (46.6%); calcium channel blockers, 162 (38.9%); diuretics, 162 (38.9%); beta-blockers, 133(32%); and angiotensin receptor blockers, 93 (22.4%). The findings of age associated with the class of medications used and a predominance of angiotensin-converting enzyme inhibitors usage highlight possible gaps in appropriateness of antihypertensive therapy. The application of age-appropriate race-based antihypertensive therapy might improve BP control rates. These results strengthen arguments for investing in community-based programs to overcome possible provider-related and local health system barriers to achieving BP control goals.


Effect of new berberine derivatives on colon cancer cells.
The natural alkaloid berberine has been recently described as a promising anticancer drug. In order to improve its efficacy and bioavailability, several derivatives have been designed and synthesized and found to be even more potent than the lead compound. Among the series of berberine derivatives we have produced, five compounds were identified to be able to heavily affect the proliferation of human HCT116 and SW613-B3 colon carcinoma cell lines. Remarkably, these active compounds exhibit high fluorescence emission property and ability to induce autophagy.


The Effect of Radial Shaft Dorsal Screw Prominence in Volar Locking Plate Fixation of Distal Radius Fractures.
The purpose of this study was to determine whether prominent radial shaft screws in volar locked plating of distal radius fractures increase the risk of tendon irritation, tendon rupture, or hardware removal. Patients who underwent volar locked plating of distal radius fractures from April 2002 to March 2016 with at least 6 months of follow-up were evaluated. Variables examined included demographics, extensor tendon irritation, extensor tendon rupture, and hardware removal. The most prominent cortical screws on postoperative lateral radiographs were identified and measured from the dorsal cortex of the radial shaft to the tip of the screw. In all, 261 distal radius fractures in 255 patients were identified. Thirty-nine patients (14.9%) underwent subsequent hardware removal at a mean 15.8 ± 18.6 months. Nine patients (3.45%) were found to have clinically significant extensor tendon irritation including one patient (0.38%) with extensor tendon rupture. The average screw was 1.48 mm proud of the dorsal radial cortex. In all, 22.6% of screws were greater than 2 mm proud. Comparing patients who underwent hardware removal with those who did not, there was no statistically significant difference in mean screw prominence or proportion of patients with screws greater than 2 mm. There was no statistically significant difference between shaft screw prominence and extensor tendon irritation. The effect of dorsal screw prominence of radial shaft screws is not significant. This study does not support the downsizing of prominent screws 2 mm or less.


Putative pathways involved in cardiovascular responses evoked from the caudal pressor area.
1. The caudal pressor area (CPA) is a recently identified site within the ventrolateral medulla which is involved in cardiovascular regulation. CPA chemical stimulation by L-glutamate produces an increase in arterial blood pressure (ABP) while its inhibition by GABA or glycine evokes marked hypotension. In the present study, we sought to determine the potential neural pathways underlying these responses. 2. In urethane-anesthetized, paralyzed, artificially ventilated rats, CPA inhibition by bilateral microinjection of the inhibitory amino acid glycine (Gly, 100 nmol 200 nl-1 site-1) produced an average decrease of -38 +/- 4.3 mmHg in ABP (N = 6). Ten min after bilateral microinjection of the broad-spectrum glutamate antagonist kynurenic acid (KYN, 2 nmol 200 nl-1 site-1) into the caudal ventrolateral medulla (CVLM) depressor responses to CPA inhibition were virtually abolished (-3 +/- 1.7 mmHg, P < 0.05). Similar microinjection of KYN into the rostral ventrolateral medulla (RVLM) or into the CPA itself did not modify depressor responses to CPA inhibition by glycine. 3. CPA stimulation by bilateral microinjection of the excitatory amino acid L-glutamate (L-glu, 50 nmol 200 nl-1 site-1) produced an increase in ABP (+43 +/- 5.4 mmHg, N = 6). Bilateral microinjection of the GABAA antagonist bicuculline methiodide (BIC, 200 pmol 200 nl-1 site-1) into the CVLM markedly reduced pressor responses to CPA stimulation (+6 +/- 2.7 mmHg, P < 0.05). Similar application of BIC into the RVLM or CPA did not modify pressor responses to CPA stimulation by glutamic acid.


Role of the inflammasome in myocardial infarction.
Inflammation plays a crucial role in the pathophysiology of myocardial infarction (MI). In particular, reperfusion caused by increased thrombolytic activity or revascularization therapy may restore the coronary blood flow and reduce the infarct size, but it also simultaneously enhances the inflammatory response and causes harmful effects on the myocardium-a process termed ischemia-reperfusion (I/R) injury. The inflammasome is a large multiprotein complex that is formed in the cytosol in response to danger signals; it drives the proinflammatory cytokine interleukin (IL)-1β. Increasing evidence indicates that the inflammasome is a key player in the disease processes of sterile inflammation. In particular, IL-1β is a prominent and early mediator of inflammation in I/R injury, suggesting the importance of the inflammasome in myocardial I/R injury. This article reviews the role of the inflammasome in the development of myocardial I/R injury and discusses the potential of the inflammasome as a novel therapeutic target for the treatment of myocardial I/R injury.


Activation of BTK by a phosphorylation mechanism initiated by SRC family kinases.
Bruton's tyrosine kinase (BTK) is pivotal in B cell activation and development through its participation in the signaling pathways of multiple hematopoietic receptors. The mechanisms controlling BTK activation were studied here by examination of the biochemical consequences of an interaction between BTK and SRC family kinases. This interaction of BTK with SRC kinases transphosphorylated BTK on tyrosine at residue 551, which led to BTK activation. BTK then autophosphorylated at a second site. The same two sites were phosphorylated upon B cell antigen receptor cross-linking. The activated BTK was predominantly membrane-associated, which suggests that BTK integrates distinct receptor signals resulting in SRC kinase activation and BTK membrane targeting.


Facile fabrication of dextran-based fluorescent nanogels as potential glucose sensors.
Glucose-responsive nanogels based on dextran and poly(3-acrylamidophenylboronic acid) (PAAPBA) were fabricated by a facile self-assembly assisted (SAA) strategy. Further introduction of the fluorescent agent 2-[4-(3-hydroxy-4-oxo-4H-chromen-2-yl)phenoxy]ethylacrylamide (3HF-AM) allowed visualization of this glucose sensitivity, thus ensuring their potential use as glucose sensors.


Properties of putative nicotine receptors identified on cultured cortical neurons.
Cultured cortical neurons derived from fetal rat brain contain putative high-affinity nicotinic receptors. Cortical glial cells do not contain any high-affinity binding sites for nicotine. The affinity, kinetic binding properties and pharmacological specificity of neuronal sites are the same as those determined for adult brain tissue. However, the number of sites in cultured neurons is lower than in adult cortex. Cultured cortical neurons appear to be a suitable model system for defining the location(s) and functional properties of high-affinity nicotinic receptors in mammalian brain.


Nutritional status assessment in geriatrics: Consensus declaration by the Spanish Society of Geriatrics and Gerontology Nutrition Work Group.
Ongoing population ageing is one of the factors influencing the increase in the prevalence of undernutrition, because elderly people are a vulnerable group due to their biological, psychological and social characteristics. Despite its high prevalence, undernutrition is underdiagnosed in the geriatric sphere. For this reason, the aim of this consensus document is to devise a protocol for geriatric nutritional assessment. A multidisciplinary team has been set up within the Spanish Society of Geriatrics and Gerontology (in Spanish Sociedad Española de Geriatría y Gerontología, SEGG) in order to address undernutrition and risk of undernutrition so that they can be diagnosed and treated in an effective manner. The MNA-SF is a practical tool amongst the many validated methods for nutritional screening. Following suspicion of undernutrition or after establishing the presence of undernutrition, a full assessment will include a detailed nutritional history of the patient. The compilation of clinical-nutritional and dietetic histories seeks to aid in identifying the possible risk factors at the root of a patient's undernutrition. Following this, an anthropometric assessment associated to laboratory data, will describe the patient's physical and metabolic changes associated to undernutrition. Currently, the tendency is to further nutritional assessment through the use of non-invasive techniques to study body composition in association with functional status. The latter is an indirect index for nutritional status which is very interesting from a geriatrician's point of view. To conclude, correct nutritional screening is the fundamental basis for an early undernutrition diagnosis and to assess the need for nutritional treatment. In order to achieve this, it is fundamental to foster research in the field of nutritional geriatrics, in order to expand our knowledge base and to increasingly practice evidence-based geriatrics.


Conjugation of basic fibroblast growth factor on a heparin gradient for regulating the migration of different types of cells.
Regulation of cell migration by cell growth factors is critical in tissue regeneration such as angiogenesis, wound healing, and bone formation. In this work, basic fibroblast growth factor (bFGF) with a density varying between 0 and 295 ng/cm2 was conjugated on heparinized glass slides. The amount of conjugated bFGF was determined by immunofluorescent staining. The mobility of vascular smooth muscle cells (VSMCs) was largely dominated by the bFGF density, whereas that of mesenchymal stem cells (MSCs) and endothelial cells (ECs) was slightly influenced. The migration rate of VSMCs increased initially and then decreased along with the increase of bFGF density. The fastest rate (22 μm/h) was found on the bFGF surface with a density of 83 ng/cm2. The intrinsic mechanisms of the diverse migration behaviors of the VSMCs, MSCs, and ECs were revealed by studying the expression of bFGF receptors and migration-related proteins. The results show that the cell mobility is regulated by complex and synergetic intracellular signals in a cell type-dependent manner.


[Lumbar spondylodiscitis caused by Salmonella enteritidis].
A 19-year-old boy developed paravertebral muscular pain in the lumbar region after an episode of extremely arduous sporting activity, with fever followed by meningism. The cerebrospinal fluid showed a reactive pleocytosis. Initially, no acute inflammatory changes were present on serum and blood analysis, although the erythrocyte sedimentation rate was moderately increased to 25/60 mm. Pyrexia of up to 38.5 degrees C developed 6 days after admission. Because Borrelia IgM and IgG titres were positive, the diagnosis was at first thought to be atypical borreliosis and the patient was treated with antibiotics. However, after a further episode of fever. Salmonella antibody titres, which had initially been normal, rose to 1: 3200 (Salmonella typhi O and H antigens) and 1: 12800 (Salmonella enteritidis, H antigen). At this stage, the erythrocyte sedimentation rate rose to 86/120 mm and the C-reactive protein to 77 mg/dl. The white cell count remained normal throughout. Blood cultures grew Salmonella enteritidis. Abnormalities on bone scintigraphy were confirmed by CT and MRI scans, showing spondylodiscitis of lumbar vertebrae 1 and 2 with limited osteolysis. The lesion resolved completely on 6 week's treatment with ciprofloxacin (200 mg twice a day intravenously) and conservative supportive treatment. Spondylodiscitis is an uncommon complication of salmonellosis and may occur long after the diarrhoea. Cross reactions with Borrelia flagellin antigens may lead to the wrong diagnosis being made.


Improved workflow for quantifying left ventricular function via cardiorespiratory-resolved analysis of free-breathing MR real-time cines.
To evaluate the feasibility of a proposed cardiorespiratory-resolved analysis in left ventricular (LV) function quantification from real-time cines in a cohort of cardiac patients. Electrocardiograph (ECG)-free free-breathing real-time cine imaging based on the balanced steady-state free precession technique was performed on short-axis slices of 20 cardiac patients at 3T. K-means cluster segmentation was used to delineate the endocardial contours, from which the LV centroid and cavity area were determined. Respiratory and cardiac signals were respectively resolved from the filtered LV centroid displacement and time-varied LV cavity area to identify end-expiratory end-diastolic (ED) and end-systolic (ES) images. The obtained LV cavity areas and derived volumetric function indices, including ED volume (EDV), ES volume (ESV), stroke volume (SV), and ejection fraction (EF), were compared with those measured from manual analysis using two-tailed paired Student's t-tests, linear regression analyses, and Bland-Altman plots. Interobserver variability was calculated. The LV cavity area was strongly correlated between the proposed and conventional manual methods (r > 0.87) for three representative slices at the base, middle ventricle, and apex. The average differences between the two methods were 0.66 ± 3.22 mL for EDV, -0.02 ± 2.68 mL for ESV, 0.67 ± 3.73 mL for SV, and 0.17 ± 2.30% for EF. All paired measures exhibited strong correlations (r > 0.96) without significant differences (P = 0.38-0.98). Acceptable interobserver variability (0.19-3.55%) and strong correlations (r > 0.96) were shown for all measures between the two observers. The proposed method is feasible for efficient measurement of LV function from real-time cines. 2 Technical Efficacy: Stage 1 J. MAGN. RESON. IMAGING 2017;46:905-914.


Laparoscopic treatment of complications from endoscopic retrograde cholangiopancreatography.
Complications after endoscopic retrograde cholangiopancreatography (ERCP) usually are treated endoscopically or by traditional surgical procedure. We present two cases of laparoscopic treatment. Patient l had mechanical jaundice. Ultrasound scan showed a common bile duct (CBD) extended to 11 mm, and ERCP disclosed a stone wedged up in the extrapancreatic part of the CBD. Endoscopic techniques did not help to remove the stone, and finally tore off the Dormia basket, leaving it in the bile ducts. After unsuccessful attempts at its endoscopic evacuation, laparoscopy was performed. A choledochoscope was introduced into the CBD, and the Dormia basket was removed. However, the removal of the stone "ingrown" in the wall of the CBD was not successful, leading to a laparotomy. Patient 2 had cholecysto- and choledocholithiasis. On ERCP, multiple stones filling the CBD were found. Combining ECRP with extracorporeal shock-wave lithotripsy, sphincterotomy, and mechanical lithotripsy did not lead to removal of all the stones, so an endoscopic biliary prosthesis was introduced. During consecutive ERCP, one of the prosthetic ends moved into the head of pancreas. Endoscopic attempts to remove it were unsuccessful, so laparoscopy was performed. During the operation, the CBD was incised, allowing all the remaining stones and the prosthetic device to be removed successfully. It seems that laparoscopic treatment currently may be an alternative to traditional surgery in the treatment of some complications after ERCP.


[Radioimmunologic technics for luteinizing hormone determination in cattle and sheep].
The antigen relationship which exists between luteinising hormone of various animal species, on the one hand, and human luteinising hormone as well as human chorionic gonadotrophin, on the other, was the background against which possible approaches were tested to the preparation of a heterologous in-vitro test for serum LH determination in cattle and sheep. The following conclusions may be drawn from the results so far obtained: --A homologous or heterologous test with specific relevance to the determination of human LH, on the basis of hLH-anti-hLH or hLH-anti-hCG is not suitable for the determination of LH in animal serum (cattle, sheep). --Quantitative and specific measurement of LH concentrations in the blood of cattle (sheep) is possible by means of an ovine-LH-anti-ovine/bovine-LH (or anti-bovine-LH) test system which is based on cross-reactivity between luteinising hormones of cattle and sheep. --Differentiated measurement of various LH concentrations in animal serum will be possible under certain specific assay conditions, with ovine LH as tracer, ovine or bovine LH as standard, and hCG antiserum. Yet, the clinical value of that heterologous radio-immuno-assay method is attributable primarily to its potential to measure peak values within the cycle to determine the time of ovulation rather than to the built-in possibility to determine base values of the cycle.


Beneficial effects of ascorbic acid on preimplantation mouse embryos after exposure to cyclophosphamide in vivo.
To study mechanisms of embryotoxicity in early pregnancy, we have evaluated the genotoxic and embryolethal effects of ascorbic acid (AA) alone or in combination with cyclophosphamide (CPA). Female mice were exposed on day 3 of pregnancy. Embryotoxicity was investigated at term and genotoxicity shortly after treatment using the chromosomal aberration test and the sister chromatid exchange (SCE) assay as sensitive end points. Additionally, cytotoxic effects were determined by a proliferation test. AA was not found to be embryotoxic, cytotoxic, or genotoxic when given alone. In combination with 10 mg/kg CPA, however, which induced 50% aberrant metaphases, 100% increase SCE frequency, and a strong inhibition of cell proliferation, AA in a dose range of 25-1,600 mg/kg did not change SCE and proliferation, but reduced the rate of aberrant metaphases significantly. This anticlastogenic effect was clearly correlated to a beneficial effect on embryolethality at term when 200 mg/kg ascorbic acid was given in combination with 40 mg/kg CPA. The results suggest that during early pregnancy AA is not genotoxic even at so-called megadoses doses, but it seems to protect early embryos against damage induced by genotoxic agents like CPA.


Birth setting, labour experience, and postpartum psychological distress.
although psychosocial risk factors have been identified for postpartum depression (PPD) and perinatal posttraumatic stress disorder (PTSD), the role of labour- and birth-related factors remains unclear. The present investigation explored the impact of birth setting, subjective childbirth experience, and their interplay, on PPD and postpartum PTSD. in this prospective longitudinal cohort study, three groups of women who had vaginal births at a tertiary care hospital, a birthing center, and those transferred from the birthing centre to the tertiary care hospital were compared. Participants were followed twice during pregnancy (12-14 and 32-34 weeks gestation) and twice after childbirth (1-3 and 7-9 weeks postpartum). symptoms of PPD and PTSD did not significantly differ between birth groups; however, measures of subjective childbirth experience and obstetric factors did. Moderation analyses indicated a significant interaction between pain and birth group, such that higher ratings of pain among women who were transferred was associated with greater symptoms of postpartum PTSD. women who are transferred appear to have a unique experience that may put them at greater risk for postpartum psychological distress. It may be beneficial for care providers to help prepare women for pain management and potential unexpected complications, particularly if it is their first childbirth.


[Arterial hypertension in special situations: mild, systolic and in pregnancy].
Mild hypertension is very common, 50% of hypertensives being with their diastolic BP between 90 and 104 mmHg. Many large studies, especially HDFP, had shown not only the deleterious cardiovascular effects of mild hypertension but also the benefits obtained with the therapy. The non-pharmacological approach should be the first step in the treatment of mild hypertension. Isolated systolic hypertension have a high prevalence in the elderly, increasing the cardiovascular morbidity and mortality. Sodium restriction and, if necessary, vasodilators increasing the arterial compliance seem to be the logical approach to treat isolated systolic hypertension. Finally, eclampsia is the most serious complication of pregnancy - induced hypertension. The treatment with bed rest and either betablockers or methyldopa is beneficial. If eclampsia occurs hydralazine, magnesium sulphate or nifedipine should be used.


The bilateral central vestibular system: its pathways, functions, and disorders.
The bilateral anatomical organization of the vestibular system provides three functional advantages: optimal differentiation of head motion and orientation, sensory substitution of a unilateral peripheral failure, and central compensation of a peripheral or central vestibular tone imbalance. The structure is based on bilaterally ascending and descending pathways and at least four crossings: three in the brain stem and one in the cortex. The resulting sensorimotor functions can be subdivided into three major groups: (1) reflexive control of gaze, head, and body in three spatial planes (yaw, pitch, roll) at the brain stem/cerebellar level; (2) perception of self-motion and control of voluntary movement and balance at the cortical/subcortical level; and (3) higher vestibular cognitive functions (e.g., spatial memory and navigation). The bilateral representation of the vestibular system in multiple multisensory cortical areas and the vestibular dominance of the nondominant hemisphere raise the question of how one global percept of motion and orientation in space is formed.


Extensive bilayer perforation coupled with the phase transition region of an anionic phospholipid.
At low ionic strength dimyristoylphosphatidylglycerol (DMPG) exhibits a broad phase transition region characterized by several superimposed calorimetric peaks. Peculiar properties, such as sample transparency, are observed only in the transition region. In this work we use differential scanning calorimetry (DSC), turbidity, and optical microscopy to study the narrowing of the transition region with the increase of ionic strength (0-500 mM NaCl). Upon addition of salt, the temperature extension of the transition region is reduced, and the number of calorimetric peaks decreases until a single cooperative event at T(m) = 23 degrees C is observed in the presence of 500 mM NaCl. The transition region is always coupled with a decrease in turbidity, but a transparent region is detected within the melting process only in the presence of up to 20 mM NaCl. The vanishing of the transparent region is associated with one of the calorimetric peaks. Optical microscopy of giant vesicles shows that bilayers first rupture when the transition region is reached and subsequently lose optical contrast. Fluorescence microscopy reveals a blurry and undefined image in the transparent region, suggesting a different lipid self-assembly. Overall sample turbidity can be directly related to the bilayer optical contrast. Our observations are discussed in terms of the bilayer being perforated along the transition region. In the narrower temperature interval of the transparent region, dependent on the ionic strength, the perforation is extensive and the bilayer completely loses the optical contrast.


[Non septic, surgical complications and their treatment of acute necrotizing pancreatitis in 131 cases].
The authors analyse non septic, surgical complications and their treatment in 131 patients with acute necrotizing pancreatitis. Bleeding occurred in 13 patients 16 times. There were 3 cases with large intestine perforation, small intestine perforation twice in one patient and hydrothorax in 12 patients. The patients APACHE-II score was in the range of 15, 5, which was quite high. They experienced complications such as bleeding and bowel perforations mostly in those who underwent several reoperations. For the bleeding from acute duodenal ulcer conservative and surgical therapy (suturing) was executed. In the cases of intraabdominal bleeding they used several options such as, ligature, collagen mesh, Surgicell net and tamponation. Large intestine perforations were surgically treated with Hartmann's procedure or loop colostomy. The small intestine perforation was simply sutured. From the 12 patients with hydrothorax 8 underwent thoracic drainage. We lost 7 patients with bleeding, 3 with bowel perforations and 2 with hydrothorax. The authors believe that complications during therapy of acute necrotizing pancreatitis are high risk factor, but their treatment is not hopeless.


[Recurrence of pleomorphic xanthoastrocytoma six years after total removal of mural nodule: a case report].
A case of recurrent pleomorphic xanthoastrocytoma (PXA) was reported. A 46-year-old male underwent total removal of mural nodule from cystic tumor in the left temporal lobe in 1986. Histological diagnosis was astrocytoma. There were no abnormal neurological signs or symptoms after the operation. However, 6 years after the operation he complained of strong unpleasant smell as of rotten onions and was admitted to our hospital. MRI revealed a cystic tumor with a mural nodule which was enhanced markedly by Gd-DTPA in the same location as previous tumor site. He was operated upon again and tumor was removed with the cyst wall. Histological diagnosis was PXA. Surgical procedures for removal of cystic PXA has been controversial; removal of tumor only, tumor removal with biopsy of cyst wall, or tumor removal with resection of cyst wall. Real reason for recurrence of this tumor in our case is unknown. However, since astrocytoma cells were found in the biopsy specimen of the cyst wall at time of the first operation, the tumor might have recurred from these cells. Therefore, this time we removed not only the mural nodule but also the cyst wall, because the cyst wall peeled off easily. We would like to propose that PXA cyst walls should be resected, whenever possible, in order to accomplish total removal of tumor.


Sensitivity and specificity of multimodal and ultrasound screening for ovarian cancer, and stage distribution of detected cancers: results of the prevalence screen of the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS).
Ovarian cancer has a high case-fatality ratio, with most women not diagnosed until the disease is in its advanced stages. The United Kingdom Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) is a randomised controlled trial designed to assess the effect of screening on mortality. This report summarises the outcome of the prevalence (initial) screen in UKCTOCS. Between 2001 and 2005, a total of 202 638 post-menopausal women aged 50-74 years were randomly assigned to no treatment (control; n=101 359); annual CA125 screening (interpreted using a risk of ovarian cancer algorithm) with transvaginal ultrasound scan as a second-line test (multimodal screening [MMS]; n=50 640); or annual screening with transvaginal ultrasound (USS; n=50 639) alone in a 2:1:1 ratio using a computer-generated random number algorithm. All women provided a blood sample at recruitment. Women randomised to the MMS group had their blood tested for CA125 and those randomised to the USS group were sent an appointment to attend for a transvaginal scan. Women with abnormal screens had repeat tests. Women with persistent abnormality on repeat screens underwent clinical evaluation and, where appropriate, surgery. This trial is registered as ISRCTN22488978 and with ClinicalTrials.gov, number NCT00058032. In the prevalence screen, 50 078 (98.9%) women underwent MMS, and 48 230 (95.2%) underwent USS. The main reasons for withdrawal were death (two MMS, 28 USS), non-ovarian cancer or other disease (none MMS, 66 USS), removal of ovaries (five MMS, 29 USS), relocation (none MMS, 39 USS), failure to attend three appointments for the screen (72 MMS, 757 USS), and participant changing their mind (483 MMS, 1490 USS). Overall, 4355 of 50 078 (8.7%) women in the MMS group and 5779 of 48 230 (12.0%) women in the USS group required a repeat test, and 167 (0.3%) women in the MMS group and 1894 (3.9%) women in the USS group required clinical evaluation. 97 of 50 078 (0.2%) women from the MMS group and 845 of 48 230 (1.8%) from the USS group underwent surgery. 42 (MMS) and 45 (USS) primary ovarian and tubal cancers were detected, including 28 borderline tumours (eight MMS, 20 USS). 28 (16 MMS, 12 USS) of 58 (48.3%; 95% CI 35.0-61.8) of the invasive cancers were stage I/II, with no difference (p=0.396) in stage distribution between the groups. A further 13 (five MMS, eight USS) women developed primary ovarian cancer during the year after the screen. The sensitivity, specificity, and positive-predictive values for all primary ovarian and tubal cancers were 89.4%, 99.8%, and 43.3% for MMS, and 84.9%, 98.2%, and 5.3% for USS, respectively. For primary invasive epithelial ovarian and tubal cancers, the sensitivity, specificity, and positive-predictive values were 89.5%, 99.8%, and 35.1% for MMS, and 75.0%, 98.2%, and 2.8% for USS, respectively. There was a significant difference in specificity (p<0.0001) but not sensitivity between the two screening groups for both primary ovarian and tubal cancers as well as primary epithelial invasive ovarian and tubal cancers. The sensitivity of the MMS and USS screening strategies is encouraging. Specificity was higher in the MMS than in the USS group, resulting in lower rates of repeat testing and surgery. This in part reflects the high prevalence of benign adnexal abnormalities and the more frequent detection of borderline tumours in the USS group. The prevalence screen has established that the screening strategies are feasible. The results of ongoing screening are awaited so that the effect of screening on mortality can be determined.


Computer simulation of action potentials and afterpotentials in mammalian myelinated axons: the case for a lower resistance myelin sheath.
Depolarizing afterpotentials, recorded in peripheral nerves [Barrett and Barrett (1982) J. Physiol., Lond. 323, 117-144] and spinal axons [Blight and Someya (1985) Neuroscience 15, 1-12], have been interpreted as representing passive discharge of axolemmal capacitance. This interpretation requires a lower resistance pathway through the myelin sheath than previous measurements have suggested. A computer model was used to examine the contribution of the electrical characteristics of nerve fibers to action potential conduction and afterpotential generation. The model consisted of a resistance-capacitance network representing a chain of 20 internodes. The resistances of node, internode and myelin sheath, deduced from observations in the accompanying paper, [Blight and Someya (1985) Neuroscience, 15] were found to produce suitable length and time constants, and prolonged afterpotentials, when inserted into the model. Similar length and time constants were found using a conventional model of the axon, based on measurements from isolated peripheral fibers, but this did not reproduce the afterpotentials. Action-potential conduction velocity is enhanced by reducing the time constant and increasing the length constant. The problem of minimizing the internodal time constant was met in the conventional model through the low parallel resistance of the node, while in the new model it was met by reducing the resistance of the myelin sheath. The latter strategy required the nodal leakage resistance to be higher than values from single fiber measurements (ca 250 M omega rather than ca 50 M omega) in order to maintain the length constant similar to the conventional model. Simulation of the recorded potentials required the resistance of the myelin lamellae to be approx. 100 omega cm2. The model quantitatively reproduced the voltage response of the axon to injected current pulses and to propagated action potentials, using Frankenhaeuser-Huxley kinetics. [Frankenhaeuser and Huxley (1964) J. Physiol., Lond. 171, 302-315; Frankenhaeuser and Moore (1963) J. Physiol., Lond. 169, 431-437]. The short duration components of the afterpotential, observed in mammalian recordings were reproduced by assuming a leakage pathway in the myelin sheath, at the impalement site. The calculated lower resistance of the myelin sheath was such that it minimized the effective internodal time constant for a given nodal resistance. This appears to free the myelinated fiber from the alternative requirement for a high nodal leakage conductance.(ABSTRACT TRUNCATED AT 400 WORDS)


Two cases of malignant melanoma in turbinate and maxillary sinus.
Malignant melanomas develop from malignant transformation of melanocytes that are present in the skin and mucosal linings throughout the body. The overall rate of mucosal melanoma is rare and malignant melanomas developing from turbinates or maxillary sinuses are extremely rare. Symptoms of nasal melanoma are generally nonspecific, and patients often fail to seek prompt medical attention. Diagnosis can be confirmed by the immunochemical profile of staining with anti-S100 and HMB-45 antibodies, even in the case of melanin-free pigment melanoma. The present study reports two cases of primary malignant melanoma in the turbinate and maxillary sinus.


Making better technology purchasing decisions.
Many health care technologies are being used without a clear idea of their worth, a problem that Congress has addressed through the legislative process. This article describes an approach hospital trustees can use to make more cost-effective decisions about whether to acquire a given technology and when to use it.


Correlation between protein sequence similarity and x-ray diffraction quality in the protein data bank.
As the most widely utilized technique to determine the 3-dimensional structure of protein molecules, X-ray crystallography can provide structure of the highest resolution among the developed techniques. The resolution obtained via X-ray crystallography is known to be influenced by many factors, such as the crystal quality, diffraction techniques, and X-ray sources, etc. In this paper, the authors found that the protein sequence could also be one of the factors. We extracted information of the resolution and the sequence of proteins from the Protein Data Bank (PDB), classified the proteins into different clusters according to the sequence similarity, and statistically analyzed the relationship between the sequence similarity and the best resolution obtained. The results showed that there was a pronounced correlation between the sequence similarity and the obtained resolution. These results indicate that protein structure itself is one variable that may affect resolution when X-ray crystallography is used.


Determination of structural principles underlying three different modes of lymphocytic choriomeningitis virus escape from CTL recognition.
Lymphocytic choriomeningitis virus infection of H-2(b) mice generates a strong CD8(+) CTL response mainly directed toward three immunodominant epitopes, one of which, gp33, is presented by both H-2D(b) and H-2K(b) MHC class I molecules. This CTL response acts as a selective agent for the emergence of viral escape variants. These variants generate altered peptide ligands (APLs) that, when presented by class I MHC molecules, antagonize CTL recognition and ultimately allow the virus to evade the cellular immune response. The emergence of APLs of the gp33 epitope is particularly advantageous for LCMV, as it allows viral escape in the context of both H-2D(b) and H-2K(b) MHC class I molecules. We have determined crystal structures of three different APLs of gp33 in complex with both H-2D(b) and H-2K(b). Comparison between these APL/MHC structures and those of the index gp33 peptide/MHC reveals the structural basis for three different strategies used by LCMV viral escape mutations: 1) conformational changes in peptide and MHC residues that are potential TCR contacts, 2) impairment of APL binding to the MHC peptide binding cleft, and 3) introduction of subtle changes at the TCR/pMHC interface, such as the removal of a single hydroxyl group.


Contact hypersensitivity to sesquiterpene lactones in Chyrsanthemum dermatitis.
In six persons with contact allergy to chrysanthemum of florists, patch tests were performed with 25 sequiterpene lactones. Positive responses were observed to 15 lactones. The most frequently encountered positive responses were to alantolactone (positive in all cases) and to arbusculin A, 8-deoxycumambrin, ambrosin, damsin and psilostachynin. The findings corroborate the assumption that an alpha-methylene group attached to the gamma-lactone ring is an essential prerequisite for allergenic activity of sesquiterpene lactones. Pyrethrum produced a positive reaction in one of the patients, pyrethrins gave negative reactions in all. Some of the chrysanthemum patients were also hypersensitive to turpentine and colophony and to garlic, primin and tars.


[Treatment of pressure sores accompanied by infection in outpatients with spinal cord injury].
The occurrence of infection at pressure sore sites due to multiple drug resistant microbes not only delays healing at the time of infection, but it can become a major factor preventing an acceptable level of ADL (activities of daily living) in the home. We studied a method for treating infection in pressure sores in spinal cord injury patients living at home who were commuting to our hospital for treatment. After establishing drug sensitivity in all patients, we instructed patients and their families how to apply dressings using 2% chloramphenicol (CP) ointment, and then studied the status regarding infection and the course of the pressure sores. Considerable Proteus vulgaris, E. faecalis, P. aeruginosa, and methicillia resistant staphylococcus aureus (MRSA) were detected in cultures from all patients. After the start of treatment at home, the casual microbes disappeared over time, and improvement was seen, including according to the Shea classification, with time from the infection. This was thought to be due to a decrease in the frequency of use of CP at the clinic and a subsequent increase in sensitivity. It was inferred from these results that the local administration of antibacterial CP ointment in the home at the time of infection is effective against pressure sores.


Multistate and phase change selection in constitutional multivalent systems.
Molecular architectures and materials can be constitutionally self-sorted in the presence of different biomolecular targets or external physical stimuli or chemical effectors, thus responding to an external selection pressure. The high selectivity and specificity of different bioreceptors or self-correlated internal interactions may be used to describe the complex constitutional behaviors through multistate component selection from a dynamic library. The self-selection may result in the dynamic amplification of self-optimized architectures during the phase change process. The sol-gel resolution of dynamic molecular/supramolecular libraries leads to higher self-organized constitutional hybrid materials, in which organic (supramolecular)/inorganic domains are reversibily connected.


Polyaluminium chloride (PAX-18) - acute toxicity and toxicity for early development stages of common carp (Cyprinus carpio).
The aim of this study is to assess the toxicity of PAX-18 in different developmental stages of common carp (Cyprinus carpio). The preparation PAX-18, with its active ingredient polyaluminium chloride (9% of Al), is a coagulation agent that is used mainly to precipitate phosphates, to prevent surface water eutrophication and incidences of cyanobacteria. It is applied to the water environment and thus could present a potential risk to fish. The toxicity tests were performed on common carp according to OECD (203, 210) methodologies. The acute toxic effect was evaluated for juveniles and the early development stage effect was observed in embryo-larval toxicity tests. The results of the toxicity tests (the number of dead individuals at particular test concentrations) were subjected to a probit analysis using an EKO-TOX 5.2 programme to determine the LC50 values of PAX-18. Acute toxicity value expressed as 96hLC50 was 753.1 +/- 24.3 mg.l-1 (67.8 mg.l-1 Al). Effect on early development stage expressed as the no observed effect concentration was 10 mg.l-1 (0.9 mg.l-1 Al), the lowest observed effect concentration was 50 mg.l-1 (4.5 mg.l-1 Al). No significant effects of the preparation PAX-18 in concentrations of 50 mg.l-1 of PAX-18 and lower were found on hatching, length and weight parameters, morphology and histopathology. The lethal concentration of PAX-18 found in acute toxicity tests on common carp was 7-14 times higher than the concentration which is usually applied to water (5-10 mg.l-1 Al). Moreover, fish in eutrophicated water sources are exposed to PAX-18 concentrations corresponding with the lowest observed effect concentration only for a short time, therefore the effect on them can be considered as minimal.


The Lashley-Hull debate revisited.
N. Weidman (1994) claimed that "Karl Lashley and Clark Hull had a long and unresolved controversy about the structure and function of the brain, its relationship to the mind, and the use of machine metaphors to explain intelligence" (p. 162). The record contained in published articles and unpublished correspondence indicates otherwise. The clash was explicitly about continuity versus noncontinuity in discrimination learning, stimulus generalization, and the development of quantitative and mathematical psychological theory and its relation to neurophysiological data. Weidman also contended that the subtext of the debate was whether heredity or environment was more important in determining intelligence and behavior. This is doubtful. It is more probable that the debate stemmed from Lashley's career-long opposition to connectionism.


Effect of two fluorescent dyes on color of restorative materials.
The objective of these two studies was to determine whether the use of dyes in vitro would affect the shade of tooth-colored restorative materials. Two separate studies were performed. In Study 1, four groups (N = 36) of restorative materials; (1) resin composite (RSN), (2) resin-modified glass ionomer (RMGI), (3) conventional glass ionomer (CGI), and (4) porcelain (PCN), were subjected to a rinse in either tap water (control) or Pyrromethene 556 dye at a concentration of 0.01M for 30 seconds or 0.0015 M for 60 seconds. They were then rinsed with 25% ethanol as would be done in clinical usage. In Study 2, the same restorative materials (except PCN) were subjected to a rinse in either tap water (control) (N = 8) or 0.0018 M sodium fluorescein (N = 8) for 60 seconds followed by a 5-second rinse with tap water. For both studies the specimens were analyzed for overall color changes (delta E*) comparing baseline to immediately post dye exposure and then again after 1, 4, 24, and 48-hour storage under running tap water. In addition, an image of each specimen, illuminated under an argon laser light (HGM), was captured with a miniature charged-coupled device (CCD) color camera at the same time intervals when the color was measured. These images were analyzed for fluorescence using computer assisted methods. A software program then computed the mean and standard deviation of the fluorescence values for each image. The data were analyzed using repeated measures ANOVA. delta E* values from baseline on specimens treated with either Pyrromethene 556 or sodium fluorescein were not significantly different from water at any time. The only exceptions were CGI specimens exposed to 0.01 M Pyrromethene 556 and RMGI exposed to sodium fluorescein which had a higher delta E* immediately after treatment, however this effect was reversed after 1-hour rinse. Mean delta E* was less than 2.69 for specimens treated with Pyrromethene 556 and less than 3.20 for specimens treated with sodium fluorescein after 1-hour rinse in water. When the mean fluorescence level, as determined by the computer, was averaged there was no difference between the Pyrromethene 556 treatments and control for RMGI, RSN and PCN after 4-hour rinse in water and, as time in storage increased, the fluorescence level decreased. CGI treated with 0.01 M Pyrromethene 556 was significantly more fluorescent even after 48-hour rinse in water. All specimens treated with sodium fluorescein were also significantly more fluorescent than control even after 48-hour rinse in water. It was concluded that exposure of these restorative materials to Pyrromethene 556 at 0.01 M or 0.0015 M or to 0.0018 M sodium fluorescein will not lead to any prolonged visually detectable color changes.


Procoagulant effects of lung cancer chemotherapy: impact on microparticles and cell-free DNA.
Lung cancer is the second leading type of cancer, with venous thromboembolism being the second leading cause of death. Studies have shown increased levels of microparticles and cell-free DNA (CFDNA) in cancer patients, which can activate coagulation through extrinsic and intrinsic pathways, respectively. However, the impact of lung cancer chemotherapy on microparticle and/or CFDNA generation is not completely understood. The aim of the study was to study the effects of platinum-based chemotherapeutic agents on generation of procoagulant microparticles and CFDNA in vitro and in vivo. Microparticles were isolated from chemotherapy-treated monocytes, human umbilical vein endothelial cells, or cancer cells. Tissue factor (TF) and phosphatidylserine levels were characterized and thrombin/factor Xa generation assays were used to determine microparticle procoagulant activity. CFDNA levels were isolated from cell supernatants and plasma. A murine xenograft model of human lung carcinoma was used to study the procoagulant effects of TF microparticles and CFDNA in vivo. In vitro, platinum-based chemotherapy induced TF/phosphatidylserine microparticle shedding from A549 and A427 lung cancers cells, which enhanced thrombin generation in plasma in a FVII-dependent manner. CFDNA levels were increased in supernatants of chemotherapy-treated neutrophils and plasma of chemotherapy-treated mice. TF microparticles were elevated in plasma of chemotherapy-treated tumour-bearing mice. Plasma CFDNA levels are increased in chemotherapy-treated tumour-free mice and correlate with increased thrombin generation. In tumour-bearing mice, chemotherapy increases plasma levels of CFDNA and TF/phosphatidylserine microparticles. Platinum-based chemotherapy induces the shedding of TF/phosphatidylserine microparticles from tumour cells and the release of CFDNA from host neutrophils.


Putative Probiotic Strains Isolated from Kefir Improve Gastrointestinal Health Parameters in Adults: a Randomized, Single-Blind, Placebo-Controlled Study.
The dairy products remain as the largest reservoir for isolation of probiotic microorganisms. While probiotics have been immensely reported to exert various health benefits, it is also a common notion that these health potentials are strain and host dependent, leading to the need of more human evidence based on specific strains, health targets, and populations. This randomized, single-blind, and placebo-controlled human study aimed to evaluate the potential benefits of putative probiotic strains isolated from kefir on gastrointestinal parameters in fifty-six healthy adults. The consumption of AB-kefir (Bifidobacterium longum, Lactobacillus acidophilus, L. fermentum, L. helveticus, L. paracasei, L. rhamnosus, and Streptococcus thermophiles; total 10 log CFU/sachet) daily for 3 week reduced symptoms of abdominal pain, bloating (P = 0.014), and appetite (P = 0.041) in male subjects as compared to the control. Gut microbiota distribution profiles were shifted upon consumption of AB-kefir compared to baseline, where the abundance of bifidobacteria was increased in male subjects and maintained upon cessation of AB-kefir consumption. The consumption of AB-kefir also increased gastrointestinal abundance of total anaerobes (P = 0.038) and total bacterial (P = 0.049) in female subjects compared to the control after 3 weeks. Our results indicated that AB-kefir could potentially be developed as a natural strategy to improve gastrointestinal functions in adults.


The challenges of dementia care and the (un)making of meaning: Analysis of an online forum on carer spirituality.
Although one writer has called dementia 'the theological disease', there has been remarkably little research on how people with dementia and their carers find spiritual meaning and significance in their experience. While there is a significant body of literature examining the role of existing spiritual or religious beliefs and practices in supporting the carer of a person with dementia, there is very little research which offers an insight into the reverse process: how the experience of caring challenges a carer's sources of spiritual or religious meaning, and what strategies are adopted to resolve the experienced tension between belief and experience. The present study aimed to supplement this incomplete picture by examining the archive of an online forum responding to a request for 'thoughts which lend a spiritual perspective to going through dementia'. Interpretative Phenomenal Analysis (IPA) was undertaken on two levels. First, attention was focussed on the forum as an integrated discussion, identifying its recurrent and superordinate themes. The contributions of selected individual participants were then analysed to further examine the way in which their positions were developed. The analysis uncovered the importance which at least some carers of people with dementia attached to spiritual perspectives, as supplying strength for and meaning to the challenges they faced; but also how meaning was undermined by their experience. Few participants identified with traditional religious resources, but attempted to find meaning by reflection on their personal narrative. Six distinct types of response to the initial question were identified. These findings indicate that the wellbeing and resilience of at least some carers may benefit from validation of their spiritual concerns along with sensitive and attentive spiritual support. In this task, a key resource is their reflection on their personal narrative in relation to current challenges.


A selDABC cluster for selenocysteine incorporation in Eubacterium acidaminophilum.
The four genes required for selenocysteine incorporation were isolated from the gram-positive, amino acid-fermenting anaerobe Eubacterium acidaminophilum, which expresses various selenoproteins of different functions. The sel genes were located in an unique organization on a continuous fragment of genomic DNA in the order selD1 (selenophosphate synthetase 1), selA (selenocysteine synthase), selB (selenocysteine-specific elongation factor), and selC (selenocysteine-specific tRNA). A second gene copy, encoding selenophosphate synthetase 2 (selD2), was present on a separate fragment of genomic DNA. SelD1 and SelD2 were only 62.9% identical, but the two encoding genes, selD1 and selD2, contained an in-frame UGA codon encoding selenocysteine, which corresponds to Cys-17 of Escherichia coli SelD. The function of selA, selB, and selC from E. acidaminophilum was investigated by complementation of the respective E. coli deletion mutant strains and determined as the benzyl viologen-dependent formate dehydrogenase activity in these strains after anaerobic growth in the presence of formate. selA and selC from E. acidaminophilum were functional and complemented the respective mutant strains to 83% (selA) and 57% (selC) compared to a wild-type strain harboring the same plasmid. Complementation of the E. coli selB mutant was only observed when both selB and selC from E. acidaminophilum were present. Under these conditions, the specific activity of formate dehydrogenase was 55% of that of the wild type. Transformation of this selB mutant with selB alone was not sufficient to restore formate dehydrogenase activity.


Assessing the prevalence of and factors associated with overweight, obesity, and binge eating as a function of ethnicity.
This study aimed to examine the prevalence of and factors associated with overweight, obesity, and binge eating as a function of ethnicity among a national sample of college students. Data were drawn from the 2010 Healthy Minds Study sample. Participants were 24,396 college students from 26 colleges and universities. This sample included 62 % females and a broad range of ethnic backgrounds; 30 % were overweight, 10 % were obese, and 7 % met criteria the for binge eating. While African Americans reported the highest prevalence of overweight (49 %) and obesity (24 %), Arab-Americans reported the highest prevalence of binge eating (10 %). The factors associated with weight problems and binge eating differed by ethnicity. Research is warranted to develop more culturally sensitive interventions to target those ethnic minorities at elevated risk. Further study of binge eating among Arab-Americans is particularly important, as the prevalence of this condition was higher among this group over any other.


Confluence of disparate carbido chemistries: [WRuAu2(μ-C)2Cl2(CO)2(PCy3)2(Tp*)].
The reaction of [Ru(CAuCl)Cl2(PCy3)2] with [W([triple bond, length as m-dash]CSnnBu3)(CO)2(Tp*)] (obtained from [W([triple bond, length as m-dash]CBr)(CO)2(Tp*)], nBuLi and ClSnnBu3) affords the heterotetrametallic bis(carbido) complex [WRuAu2(μ-C)2Cl3(CO)2(PCy3)2(Tp*)] in which the two distinct μ-carbido ligands adopt linear and T-shaped geometry at carbon.


Controversial topic: return to competitive sport after severe traumatic brain injury.
Various guidelines have been proposed for returning to sport after concussion or mild TBI. However, no such guidelines exist for severe TBI. This study presents three cases of athletes who sustained severe TBIs and returned to competition. The rational for their clearance will be discussed.


A scaled-down model for the translation of bacteriophage culture to manufacturing scale.
Therapeutic bacteriophages are emerging as a potential alternative to antibiotics and synergistic treatment of antimicrobial-resistant infections. This is reflected by their use in an increasing number of recent clinical trials. Many more therapeutic bacteriophage is being investigated in preclinical research and due to the bespoke nature of these products with respect to their limited infection spectrum, translation to the clinic requires combined understanding of the biology underpinning the bioprocess and how this can be optimized and streamlined for efficient methods of scalable manufacture. Bacteriophage research is currently limited to laboratory scale studies ranging from 1-20 ml, emerging therapies include bacteriophage cocktails to increase the spectrum of infectivity and require multiple large-scale bioreactors (up to 50 L) containing different bacteriophage-bacterial host reactions. Scaling bioprocesses from the milliliter scale to multi-liter large-scale bioreactors is challenging in itself, but performing this for individual phage-host bioprocesses to facilitate reliable and robust manufacture of phage cocktails increases the complexity. This study used a full factorial design of experiments approach to explore key process input variables (temperature, time of infection, multiplicity of infection, agitation) for their influence on key process outputs (bacteriophage yield, infection kinetics) for two bacteriophage-bacterial host bioprocesses (T4 - Escherichia coli; Phage K - Staphylococcus aureus). The research aimed to determine common input variables that positively influence output yield and found that the temperature at the point of infection had the greatest influence on bacteriophage yield for both bioprocesses. The study also aimed to develop a scaled down shake-flask model to enable rapid optimization of bacteriophage batch bioprocessing and translate the bioprocess into a scale-up model with a 3 L working volume in stirred tank bioreactors. The optimization performed in the shake flask model achieved a 550-fold increase in bacteriophage yield and these improvements successfully translated to the large-scale cultures.


Endothelin A-receptor blockade in experimental diabetes improves glucose balance and gastrointestinal function.
Secondary complications of diabetes mellitus often involve gastrointestinal dysfunction. In the experimental Goto Kakizaki rat, a model of Type II diabetes, hyperglycaemia and reduced glucose clearance is associated with elevated plasma endothelin (ET)-1 levels and selective decreases in nitric oxide synthase in circular muscle, longitudinal muscle and neuronal elements of the gastrointestinal tract. Functionally, this is accompanied by decreased nitrergic relaxatory responses of jejunal longitudinal muscle to tetrodotoxin-sensitive electrical field stimulation. Long-term treatment with a selective ET A-type receptor antagonist, markedly reduced hyperglycaemia and restored plasma glucose clearance rates towards normal. This was associated with a restoration of N(G)-nitro-L-arginine methyl ester-sensitive relaxatory responses of jejunal longitudinal muscle to electrical field stimulation. The results indicate that beneficial effects of ETA receptor blockade on gastrointestinal function may result from an improvement in insulin sensitivity with concomitant reduction of the severity of hyperglycaemia. ETA receptor blockade may represent a new therapeutic principle for improving glucose tolerance in Type II diabetes and could be beneficial in alleviating or preventing hyperglycaemia-related secondary complications in this condition.


Vaginal hysterectomy vs abdominal hysterectomy.
This was a prospective study, conducted to analyze the intraoperative complications, postoperative morbidities and complications between abdominal and vaginal hysterectomy. This study was carried out on 100 patients (50 cases abdominal and 50 cases vaginal hysterectomy), in Services Hospital, Lahore in the year 2002 from April to December. Among the intraoperative observation, the mean duration of surgery of abdominal hysterectomy was 96.8 min and that of vaginal was 89 min (p=0.0192). The mean blood loss in abdominal hysterectomy was 311 ml and that in vaginal hysterectomy was 244ml (p=0.0017). Postoperatively febrile morbidity was seen in 10 (20.0%) cases of abdominal hysterectomy group and 6 (12.0%) of vaginal hysterectomy group. Wound infection was the main cause for febrile morbidity in abdominal hysterectomy group where as urinary tract infection was the main cause for febrile morbidity in vaginal hysterectomy. There was one case of bladder injury and 1 case of ureteric injury in abdominal hysterectomy group while none in vaginal hysterectomy group. There were 2 (4.0%) cases of postoperative haemorrhage in abdominal hysterectomy group and none in vaginal hysterectomy group. Vault infection occurred in 2 (4.0%) cases of both the groups. Two (4.0%) cases of paralytic ileus, 2 (4.0%) cases of chest infection and 1 (2.0%) case of rectal muscle hematoma were seen in abdominal hysterectomy group. Overall 39 (78.0%) cases of abdominal hysterectomy and 1 (32.0%) case of vaginal hysterectomy had complications (p=0.0002). This study showed that vaginal hysterectomy was associated with less intraoperative complications and postoperative morbidities and complications as compared to abdominal hysterectomy.


Nodules and draining tracts.
Many potential causes exist of nodules and draining tracts in cats. Treatment should not be undertaken until a definitive diagnosis is made. This may involve biopsies for histopathologic evaluation, sample collection and submittal for culture and sensitivity, cytologic evaluation of impression smears or needle aspirates, and serologic testing.


New perspectives for the treatment of thoracic aortic aneurysm with self-expanding endoprostheses. Preliminary experience.
We present our preliminary experience with the application of covered aortic stents to treat aneurysms and dissections of the thoracic artery, a technique that was developed in 1996. Seven selected patients were treated with World Medical Talent bare spring tip endoprostheses and followed up for a total of 67 months. All prostheses were implanted at the Parma General Hospital Cardiovascular Department. Seven patients, average age 57.8 years, range 44-73 years, were treated; a total of 11 prosthetic segments were implanted. Aortic pathologies included: 2 isthmic atherosclerotic aneurysms, 2 chronic dissections, 1 acute dissection, 1 thoracic aneurysm associated with an aneurysm of the abdominal aorta below the renal arteries. Dilation diameters ranged from 6-9 cm, lengths from 4-12 cm. All patients underwent computerized tomography and angiography before stent implantation. The procedure was carried out in an operating room with the patient under general anesthesia and in controlled hypotension. In 2 cases the common iliac artery, prepared for the extraperitoneal route by application of a No. 10 Dacron introducer sheath, was used as the insertion site; in 4 cases the common femoral artery was used, in the case of the double aneurysm the traditional surgical route was used to correct the abdominal aneurysm, and the thoracic aneurysm was repaired through the abdominal prosthesis. All patients were released in good condition; thrombosis of the aneurysm surrounding the graft was immediate in all cases except one which required the application of a second segment shortly after the initial procedure. There were no major complications; one case of iatrogenic dissection of the femoral artery used as the access site required a prosthetic bypass. No implant-related complications were observed during follow-up. Our initial experience has been favorable and demonstrates that stents can be utilized for aortic pathologies of varying etiologies; we had no mortality or major complications, and hospital stays were short. Long term results must be confirmed before the therapeutic potential of this technique can be fully evaluated.


PTEN, Insulin Resistance and Cancer.
The tumor suppressor PTEN serves as a negative regulator of PI3K/PTEN/Akt signaling pathway that regulates cellular functions such as cell growth, differentiation, proliferation and migration. The PI3K/PTEN/Akt signaling cascades might also have effect on glucose uptake via translocation of GLUT-4. Insulin controls energy storage and the whole body glucose homeostasis. Its binding to insulin receptor on the surface of diverse cells allows glucose entry into cells, and activates a variety of cellular actions. Insulin resistance is a common metabolic feature and established risk factor of many diseases. Its fundamental principle is inability of insulin to exert its normal metabolic effects, and nutrient imbalance and abnormal lipid accumulation in skeletal muscle, liver and adipose tissues. We review the literature on the structure and function of PTEN and its involvement in insulin resistance and tumor regulation, and summarized the detailed scientific achievements on this topic. Suppressing PTEN expression plays a role in pro- or anti-inflammatory state during insulin resistance associated with obesity. Selective disruption of PTEN in pancreatic α-cells demonstrates that a lack of PTEN reduces circulating glucagon levels and protects against hyperglycemia and insulin resistance in high-fat diet-fed mice. Loss-of-function PTEN mutations in adipose tissue results in systemic glucose tolerance and insulin sensitivity improvement because of ascended recruitment of the GLUT-4 towards the membrane. Targeting tissuespecific PTEN deletion improves insulin sensitivity and protects from systemic insulin resistance. PTEN, as an important tumor suppressor gene, is frequently deleted or mutated in a variety of human tumors. Inactivation of PTEN by loss-of-function mutations leads to deregulated hyperproliferation of cells, leading to oncogenic transformation. Considering PTEN's important role in insulin resistance and tumor regulation, targeting the PTEN gene and/or protein will likely provide an efficient strategy for therapeutic intervention in cancer and metabolic diseases like type 2 diabetes mellitus, obesity, and cardiovascular dysfunction.


Action of a beta-bungarotoxin on autonomic ganglia and adrenergic neurotransmission.
A beta-bungarotoxin was isolated from the venom of Bungarus multicinctus by column chromatography on Sephadex G-50 and SP-Sephadex. The toxin produced presynaptic effects on neuromuscular transmission with characteristics similar to those described by others. In a sympathetic ganglion, the toxin increased spontaneous acetylcholine (ACh) release and decreased ACh release evoked by preganglionic nerve stimulation. The toxin did not block the response of isolated ileum to cholinergic nerve stimulation, did not block the release of noradrenaline from the adrenergic nerve terminals of a nictitating membrane preparation, and did not alter the responses of smooth and cardiac muscle preparations to noradrenaline. It is suggested that the specificity of beta-bungarotoxin for certain nerve terminals is related either to selective binding of the toxin or to the selective presence of a necessary substrate for its action. An attempt to show selective binding of 125I-toxin to cholinergic nerve terminals in skeletal muscle was not successful.


Familial gastric cancer - clinical management.
The clinical management of familial gastric cancer is the same as that for sporadic gastric cancer at the current time. As the causative mutations for these cases are identified this should lead to the development of specific treatments which target the molecular abnormality. The only germline mutations identified so far occur within the E-cadherin gene (CDHI) and they account for approximately 30% of familial gastric cancer cases. When index patients fulfilling the clinical criteria for hereditary diffuse gastric cancer syndrome have a CDHI mutation identified then genetic testing of asymptomatic relatives should be considered. The clinical sequelae of testing positive for such a mutation are profound and therefore it is essential that counselling is given prior to genetic testing. The management options are surveillance endoscopy and prophylactic gastrectomy. In this chapter the practicalities of genetic testing are discussed as well as the pros and cons of the two management options. It is essential that experience of these rare families is pooled so that surveillance and treatment can be optimised in the future.


A genome-wide linkage scan for low spinal bone mineral density in a single extended family confirms linkage to 1p36.3.
Osteoporotic fractures are an increasing cause of mortality and morbidity in ageing populations. A major risk determinant for these fractures is bone mineral density (BMD). Variation on BMD is thought, on the basis of twin and family studies, to be subject to a large amount of genetic variation and it has been hypothesised that this may be due to the influence of multiple genes. However, in families showing segregation of low or high BMD, single major genes have been shown to play a crucial role. We performed a genome-wide screen using 380 microsatellite markers in a single extended family (n=34) in which early-onset low spinal areal BMD segregates in an autosomal dominant-like fashion. A two-point linkage analysis was performed, revealing a maximum LOD score of 3.07 on 1p36.3 (D1S468), confirming results of previous linkage studies of BMD, while no other suggestive linkage peaks (LOD>2.2) were detected elsewhere in the genome. Microsatellite markers were subsequently genotyped for a +/-6.9 Mb region surrounding D1S468. This revealed critical recombination events restricting the candidate region to 1.2 Mb and 19 genes. Sequencing analysis of the coding region of candidate genes WDR8 and EGFL3 revealed no mutations or disease-associated polymorphisms. Our results provide some evidence supporting the hypothesis that there are genetic determinants for spinal BMD on 1p36.3. Although no specific disease causing mutation has yet been found, the delineation of a relatively small candidate region in a single extended family opens perspectives to identify a major gene for spinal BMD.


Variation of RBE between p(75) + Be and d(50) + Be neutrons determined for chromosome aberrations in Allium cepa.
The RBE of p(75) + Be neutrons relative to d(50) + Be neutrons has been determined for chromosome aberrations induced in Allium cepa (onion) roots. Two biological criteria were selected: the average number of aberrations (mainly fragments) per cell in anaphase and telophase, and the percentage of aberration-free cells. The influence of sampling time (3 to 7 h incubation) between irradiation and fixation was investigated systematically. This factor did not significantly influence the results. The RBE values of p(75) + Be neutrons compared to those of d(50) + Be neutrons were 0.85 (0.79-0.91) and 0.87 (0.80-0.95) for the first and the second criteria, respectively. In previous experiments for the same beams, we found an RBE of 0.90 (0.86-0.94) for survival of V79 cells (D0 ratio), 0.96 (0.93-0.99) for the intestinal crypt cell system, and 0.83 (0.70-0.96) for Vicia faba growth delay.


Identification of novel antitubercular compounds through hybrid virtual screening approach.
Growing resistance of prevalent antitubercular (antiTB) agents in clinical isolates of Mycobacterium tuberculosis (MTB) provoked an urgent need to discover novel antiTB agents. Enoyl acyl carrier protein (ACP) reductase (InhA) from Mtb is a well known and thoroughly studied as antitubucular therapy target. Here we have reported the discovery of potent antiTB agents through ligand and structure based approaches using computational tools. Initially compounds with more than 0.500 Tanimoto similarity coefficient index using functional class fingerprints (FCFP_4) to the reference chemotype were mined from the chemdiv database. Further, the molecular docking was performed to select the compounds on the basis of their binding energies, binding modes, and tendencies to form reasonable interactions with InhA (PDB ID=2NSD) protein. Eighty compounds were evaluated for antitubercular activity against H37RV M. tuberculosis strain, out of which one compound showed MIC of 5.70 microM and another showed MIC of 13.85 microM. We believe that these two new scaffolds might be the good starting point from hit to lead optimization for new antitubercular agents.


Recovery of the thyroid function in patients with atrophic hypothyroidism and blocking type TSH binding inhibitor immunoglobulin.
The prognosis of atrophic hypothyroidism with blocking type TSH-binding inhibitor immunoglobulin was studied. Among 45 patients (16 males and 29 females) with overt hypothyroidism (serum TSH greater than 40 mU/l) without goitre, thyroid autoantibody to microsomal antigen was positive in 38 or 84.4%, and 4 or 8.9% had TSH-binding inhibitor immunoglobulin, which was shown to be a TSH-stimulation blocking antibody by cAMP production assay using cultured porcine thyroid cells. Thyroidal radioactive iodine uptake was low and thyroid hormone replacement therapy was required. Long-term follow up of 2 patients with strongly positive TSH-binding inhibitor immunoglobulin for 2 to 7 years, however, revealed recovery of the thyroid function after steroid therapy or spontaneously with iodide restriction, respectively, correlating with decrease in both TSH-binding inhibitor immunoglobulin and TSH-stimulation blocking antibody activities. Thyroidal radioactive iodine uptake became normal and histological examination of the thyroid in one patient revealed well-preserved thyroid follicles with lymphocytic infiltration. Recovery of thyroid function can be expected with a decrease in TSH-binding inhibitor immunoglobulin activity in atrophic hypothyroidism, which is not necessarily the end stage of chronic thyroiditis.


Eye mucosa: an efficient vaccine delivery route for inducing protective immunity.
The external part of the eye shares mucosa-associated common characteristics and is an obvious entry site for foreign Ags. We assessed the potential of eyedrop vaccination for effective delivery of vaccines against viral or bacterial infection in mice. Both OVA-specific IgG Ab in serum and IgA Ab in mucosal compartments were induced by eyedrops of OVA with cholera toxin (CT). Eyedrop vaccination of influenza A/PR/8 virus (H1N1) induced both influenza virus-specific systemic and mucosal Ab responses and protected mice completely against respiratory infection with influenza A/PR/8 virus. In addition, eyedrop vaccination of attenuated Salmonella vaccine strains induced LPS-specific Ab and complete protection against oral challenge of virulent Salmonella. Unlike with the intranasal route, eyedrop vaccinations did not redirect administered Ag into the CNS in the presence of CT. When mice were vaccinated by eyedrop, even after the occlusion of tear drainage from eye to nose, Ag-specific systemic IgG and mucosal IgA Abs could be induced effectively. Of note, eyedrops with OVA plus CT induced organogenesis of conjunctiva-associated lymphoid tissue and increased microfold cell-like cells on the conjunctiva-associated lymphoid tissue in the nictitating membrane on conjunctiva, the mucosal side of the external eye. On the basis of these findings, we propose that the eyedrop route is an alternative to mucosal routes for administering vaccines.


Site-specific recombination in Escherichia coli between the att sites of plasmid pSE211 from Saccharopolyspora erythraea.
pSE211 from Saccharopolyspora erythraea integrates site-specifically into the chromosome through conservative recombination between attP and attB, the plasmid and chromosomal attachment sites. Integration depends on the presence of int, an open reading frame (ORF) that lies adjacent to attP and encodes the putative integrase. Immediately upstream of int lies xis (formerly called orf2) which encodes a basic protein that is thought to exhibit DNA binding. xis and int were cloned in various combinations in pUC18 and expressed constitutively in Escherichia coli from the lac promoter. attP and attB were cloned in Streptomyces or E. coli plasmids containing kanamycin resistance (KmR) or chloramphenicol resistance (CmR) markers. Stable KmR CmR cointegrates formed by attP x attB or attP x attP recombination (integration) were obtained in E. coli hosts that expressed int. Co-integrates were not found in hosts expressing int + xis. Excision (intraplasmid att site recombination) was examined by constructing plasmids carrying attL and attR or two attP sites separating CmR from KmR and by following segregation of the markers in various hosts. Both attL x attR and attP x attP excision depended on both xis and int in E. coli. pSE211 att site integration and excision were not affected by a deletion in himA, the gene encoding a subunit of integration host factor.


The use of umbilical artery Doppler ultrasonography in modern obstetrics.
In contrast to the reduction in perinatal mortality in high-risk pregnancies, screening of low-risk pregnancies with umbilical artery Doppler ultrasonography has shown no benefit. Advances in pathophysiology question the assumption that the placenta is hypoxic in fetal growth restriction, with absent end-diastolic frequencies in the umbilical artery. The timing of delivery in relation to Doppler findings is uncertain, and so trials that relate Doppler findings to neurodevelopmental outcome are necessary to refine the role of this technique in obstetric practice.


Agreement between the index of complexity, outcome, and need and the dental and aesthetic components of the index of orthodontic treatment need.
This was a cross-sectional study to investigate the agreement between assessments of orthodontic treatment need of the index of complexity, outcome, and need (ICON) and the index of orthodontic treatment need (IOTN). Five hundred two subjects (253 girls, 249 boys; ages, 11-14 years) participated in this study, including a few who were wearing an orthodontic appliance (1 girl, 5 boys). ICON scores and the aesthetic (AC) and dental health components (DHC) of the IOTN were recorded in those not undergoing treatment. The percentages of subjects needing treatment (ICON score >43) and the different complexity components of ICON were compared between the sexes. Observed percentages of agreement and kappa statistics were used to analyze the agreement between the AC and DHC of the IOTN and also the ICON, and the DHC and AC of the IOTN dichotomized into a yes or no categories of orthodontic treatment need. No sex differences were found between male and female subjects for treatment need (ICON score >43; P >0.05) and treatment complexity (P >0.05). The kappa statistic for diagnostic agreement between the DHC and AC of the IOTN was 0.55 (95% CI, 0.48-0.63). The kappa statistics for diagnostic agreement between the ICON and the AC and the DHC of the IOTN were 0.40 (95% CI, 0.33-0.46) and 0.78 (95% CI, 0.73-0.83), respectively. The observed agreement between the DHC and the AC of the IOTN was 81.8%. The observed agreement between the ICON and AC and DHC of the IOTN were 71.3% and 89.5%, respectively. In terms of orthodontic treatment need, there was moderate agreement between the ICON and the AC (IOTN), and between the DHC and the AC. There was good agreement between the ICON and the DHC of the IOTN. The ICON is a good substitute for the DHC of the IOTN.


Effect of whole-body microwave hyperthermia on delayed cutaneous hypersensitivity in tumor-bearing mice.
Tumor-bearing and normal BALB/c mice were examined for their responsiveness to contact-sensitizing agent oxazolone after whole-body microwave hyperthermia treatment. The effective therapy with hyperthermia prolonging mean survival time of the animals and causing tumors regression resulted in strongly pronounced hyporeactivity to oxazolone. The impaired responsiveness remained unchanged until death of the tumor-bearing animals. In the case of tumor-free animals delayed cutaneous response returned to normal values within 8-12 days after hyperthermia treatment. It is documented that the longer exposure to hyperthermia sessions the more pronounced depression of reactivity to oxazolone occurs.


Establishing a chromium-reactor design for measuring delta2H values of solid polyhalogenated compounds using direct elemental analysis and stable isotope ratio mass spectrometry.
2H/1H isotope ratios of polyhalogenated compounds were determined by elemental analysis and isotope ratio mass spectrometry (EA-IRMS). Initial measurements with standard EA-IRMS equipment, which used high-temperature pyrolysis to convert the organic compounds into hydrogen, did not achieve significant signals for polychlorinated pesticides and related compounds, presumably due to the formation of HCl instead of hydrogen. To reverse this problematic reaction, a chromium reactor was incorporated into the element analyzer system, which scavenged Cl, forming chromium chloride and releasing hydrogen again in the form of H2. The optimized system therefore allowed the delta2H values of polyhalogenated compounds to be determined. A quality assurance program was developed based on several parameters. (i) Each compound was analyzed using a sequence of five injections, where the first measurement was discarded. (ii) Recovery of H (when calculated relative to acetanilide) had to be >90% for all replicates in a sequence. (iii) All delta-values within a sequence had to vary by less than 10/1000. (iv) Results had to be reproducible on another day with a different sample scheme. Once this reproducibility had been established, variabilities in the delta2H values of organohalogen standards were investigated using the technique. The highest delta2H value of +75/1000 was found for o,p'-DDD, whereas the strongest depletion in deuterium was found for Melipax (-181/1000). The most important results for comparable compounds were as follows. DDT-related compounds gave delta2H values of between +59 and +75/1000 (technical DDT, o,p'- and p,p'-DDD) or in the range of approximately -1/1000, indicative of the different sources/methods of producing this compound. Four HCH isomers from the same supplier showed relatively similar hydrogen isotope distributions, whereas two lindane (gamma-HCH) standards from other sources had 39/1000 less deuterium. This difference is likely due to different purification steps during the isolation of pure lindane from the technical HCH mixture. An even greater difference was observed between the delta2H values of Toxaphene (US product dating from 1978) and Melipax (product from the former East Germany, dating from 1979), which gave delta2H values of -101/1000 and -181/1000, respectively, meaning that both products were easily distinguished via delta2H-IRMS. Fractioning of hydrogen isotopes in the atmospheric water cycle was suggested as one reason for the different values. In this theory, the water (which had different delta2H values depending on where it was taken from) was incorporated during the biosynthesis of camphene, which is the natural product used to produce both products. These results indicate that hydrogen isotope-specific analysis can be a valuable tool for tracing the origins of a compound in certain cases.


Two new species and key to four species of the genus Humphaplotropis from China (Orthoptera: Pamphagidae, Pamphaginae).
Two new species i.e.: Humphaplotropis xiai sp. nov. and Humphaplotropis hebeiensis sp. nov. of the genus Humphaplotropis Xiao, Yin et Yin, 2013, are described from Hebei and Jiangsu, China in this paper. The new species Humphaplotropis xiai sp. nov. differs all known species of the genus by the abdomen like sawtooth in lateral view. The new species Humphaplotropis hebeiensis sp. nov. is similar to Humphaplotropis culaishanensis Lin, Cao et Yin, 2014, but differs from the latter by: lateral carinae of frontal ridge parallel; anterior margin of pronotum with acute angular in the middle, the apex reaching the hind margin of eyes; tegmina wider, cover 4/5 tympanum. Hind tibia yellow brown on upper side; epiphallus with 44 spikes, ancorae oblique inward distinctly, both posterior projections shorter than median projection. Type specimens are deposited in the Shanghai Entomological Museum, C.A.S., Shanghai and Natural Museum of Hebei University, Baoding, Hebei China respectively.


Inferior rectus muscle restriction after retrobulbar anesthesia for cataract extraction.
Among the recognized complications of retrobulbar anesthesia, postoperative permanent diplopia has rarely been reported. We describe two patients with inferior rectus muscle restriction after retrobulbar anesthesia for cataract extraction and intraocular lens implantation. Both did well after inferior rectus recession with placement of an adjustable suture.