Correlation between the European System for Cardiac Operative Risk Evaluation and sexual function after coronary artery bypass graft surgery.
The published studies discussing the prognostic factors for expected sexual function after coronary artery bypass graft (CABG) are still limited. Examining the correlation between the European System for Cardiac Operative Risk Evaluation (EuroSCORE) and the abridged form of International Index of Erectile Function questionnaire (IIEF-5), as a quick and inexpensive tool for the cardiologist to predict the sexual function after CABG. Validated standardized questionnaire commonly used by cardiologists in identifying appropriate weight to various risk factors related to adult cardiac operations. Preoperatively patients were evaluated as regards to the sexual function by (IIEF-5) and pharmaco-penile duplex ultrasound. Moreover all patients were evaluated bu EuroSCORE. Six months after surgery, the erectile function of all patients was revaluated according to the same preoperative procedures. The patients were categorized with EuroSCORE as follows: The low-risk group (EuroSCORE 0–2), the medium-risk group (EuroSCORE 3–5), and the high-risk group (EuroSCORE 6 plus). The EuroSCORE was negatively correlated with the IIEF-5 score (r = -0.224, P = 0.025 or rs = -0.259, P = 0.009). Moreover, low-risk patients had significantly higher IIEF-5 scores compared with medium-risk patients (mean standard deviation = 15.27 6.03 vs. 12.18 6.07, P < 0.05). There is an inverse correlation between the components of EuroSCORE and the IIEF-5 score. Patients with higher EuroSCORE had lower IIEF-5 scores and vice versa. The EuroSCORE is a useful, quick, and inexpensive tool that allows prediction of ED in those patients with coronary artery disease patients who are undergoing CABG.


Protective activity of an intravenous immune globulin (human) enriched in antibody against lipopolysaccharide antigens of Pseudomonas aeruginosa.
Human plasmas containing naturally high levels of immunoglobulin G (IgG) to lipopolysaccharide antigens of Pseudomonas aeruginosa immunotypes 1, 2, 4, and 6 were identified by an enzyme-linked immunosorbent assay. The high titered plasmas were collected, pooled, and fractionated. Cohn fraction II IgG was prepared for intravenous infusion. The antibody titers in the hyperimmune intravenous immunoglobulin preparation were approximately fivefold higher against P. aeruginosa immunotypes 1, 2, 4, 5, and 6 and approximately twofold higher against immunotypes 3 and 7 than conventional intravenous immunoglobulin G. When tested for prophylaxis in burned mice, the protective doses 50 percent of Pseudomonas-intravenous immunoglobulin G were approximately fourfold less effective against immunotypes 1, 2, 4, and 7 and International Antigenic Typing System Serotypes (IATS), 8 (= immunotype 6) than conventional intravenous immunoglobulin G. Against immunotype 3 and 5, IATS 13, 15, and 16, both immunoglobulin preparations afforded similar levels of protection. In burned mice challenged with immunotypes 1 and 2 and not treated until 18 hours after infection, Pseudomonas-intravenous immunoglobulin G and tobramycin had synergistic activity in preventing death. Pseudomonas-intravenous immunoglobulin G also afforded significant protection to immunosuppressed mice challenged with immunotype 1. These data suggest that Pseudomonas-intravenous immunoglobulin G may be useful in prevention or treatment of P. aeruginosa infections in man.


The prevalence of emotional and behavioural problems in institutionalized childcare clients.
The objective of the study was to investigate the gender-specific prevalence of emotional and behavioural problems in children and adolescents in out-of-home childcare, compared with patients in child and adolescent psychiatric institutions. The total population of clients in residential childcare institutions in Oslo, Norway, was investigated by the use of standardized questionnaires (Achenbach's Child Behavior Checklist and Youth Self Report) and compared to all same-aged patients residing in child and adolescent psychiatric institutions in the same area at the same time. Boys in residential childcare had emotional and behavioural problem levels comparable to boys in child and adolescent psychiatric institutions, as measured by the questionnaires. Girls in residential childcare did not reach problem levels as high as those found in girls in psychiatric institutions, but problem levels were still well above those found in the general population. It was concluded that institutionalized childcare clients had a high prevalence of behavioural and emotional problems, as measured by Achenbach's Child Behavior Checklist and Youth Self Report.


[Diagnosis value of nasopharyngo-fiberscope and CT for microfocal nasopharyngeal carcinoma].
To explore the value of nasopharyngo-fiberscope and CT in diagnosing microfocal Nasopharyngeal Carcinoma (NPC) and the prevalent area, the nasopharynx, where the NPC usually initially developed from. From October, 2003 to October,2005, the data of original microfocus of 36 pathologically confirmed NPC were reviewed retrospectively. These cases were examined by nasopharyngo-fiberscope and CT strengthening scanning. On clinical examination, only 2 cases (5.6%) were found to have original micro-tumor in the recess, the other 34 cases (94.4%) had developed from the other regions including 25 (69.4%) from the roof and 9 cases (25.0%) from the posterior wall, all with smooth and symmetrical mucosa in the recess. Positive rate of nasopharyngeal mass were 100% by nasopharyngo-fiberscope and by CT. The data suggested that the roof of nasopharyngeal cavity be the most possible area that the original NPC micro-focus developed from, followed by the posterior wall and the recess. Nasopharyngo-fiberscope and CT is very helpful for the correct clinical diagnosis of NPC.


Iodine-123 scintigraphy in the evaluation of pediatric thyroid disorders: a ten year experience.
Few studies have been published that describe the role of scintigraphy in the evaluation of the spectrum of pediatric thyroid disorders. Between 1978 and 1987, we studied 280 children with iodine-123 (123I) scintigraphy. Clinical information and follow-up were available in 246. We analyzed the indications for referral and determined whether the information obtained with this technique was useful in subsequent management. Indications for scintigraphy included hypothyroidism, neck masses, hyperthyroidism, and miscellaneous reasons. Scintigraphy was helpful in distinguishing anatomic from functional causes of hypothyroidism. It reliably identified the location of the thyroid gland in patients with neck masses. The functional status of thyroid nodules was readily assessed and was important in directing further treatment. Scintigraphy added little to the management of children with post-irradiation hypothyroidism without a palpable nodule, patients with Hashimoto thyroiditis or Graves disease when the clinical diagnosis was straightforward.


Nuclear and nucleolar reprogramming during the first cell cycle in bovine nuclear transfer embryos.
The immediate events of genomic reprogramming at somatic cell nuclear transfer (SCNT) are to high degree unknown. This study was designed to evaluate the nuclear and nucleolar changes during the first cell cycle. Bovine SCNT embryos were produced from starved bovine fibroblasts and fixed at 0.5, 1, 2, 3, 4, 8, 12, and 16 h postactivation (hpa). Parthenogenetic (PA) embryos were used as control. The SCNT and PA embryos were processed for lacmoid staining, autoradiography, transmission electron microscopy (TEM), and immunofluorescence localization of: upstream binding factor (UBF) and fibrillarin at 4 and 12 hpa. Likewise, starved and nonstarved fibroblasts were processed for autoradiography and TEM. The fibroblasts displayed strong transcriptional activity and active fibrillogranular nucleoli. None of the reconstructed embryos, however, displayed transcriptional activity. In conclusion, somatic cell nuclei introduced into enucleated oocytes displayed chromatin condensation, partial nuclear envelope breakdown, nucleolar desegregation and transcriptional quiescence already at 0.5 hpa. Somatic cell cytoplasm remained temporally attached to introduced nucleus and nucleolus was partially restored indicating somatic influence in the early SCNT phases. At 1-3 hpa, chromatin gradually decondensed toward the nucleus periphery and nuclear envelope reformed. From 4 hpa, the somatic cell nucleus gained a PN-like appearance and displayed NPBs suggesting ooplasmic control of development.


Direct hemoperfusion with polymyxin B-immobilized fiber for the treatment of the acute exacerbation of idiopathic pulmonary fibrosis in patients requiring invasive mechanical ventilation.
The prognosis of acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) in individuals undergoing invasive mechanical ventilation is known to be poor. We describe the cases of three men, who were former smokers and required mechanical ventilation, whose AE-IPF was treated with direct hemoperfusion with polymyxin B-immobilized fiber column (PMX-DHP). In all cases, we successfully weaned the patients from mechanical ventilation. Two of the patients survived for more than 180 days after development of AE-IPF. PMX-DHP may improve the prognosis of severe respiratory failure in patients with AE-IPF.


[Esthetic nutrition: body and beauty enhancement through nutritional care].
Nowadays, there is an increasing quest for beauty and the models proposed by fashion goods and service segments, to achieve the perfect body. The standard of beauty corresponds to a thin body, without considering health aspects. The number of women who go on diets to control weight is increasing; and taking this into consideration the objective of this study is to conduct a bibliographical review and extract data on esthetics and body image to support the practice of nutritional care. Socio-cultural aspects, which motivate the quest for the perfect body, as well as body, beauty, esthetics, nutritional counseling and cognitive behavior therapy were examined in this survey. On the basis of this work, it is possible to conclude that the continuing obsession with the body may lead the person to go on diets and other drastic methods to control weight, such as surgical procedures. In this respect, nutritional care is far more than merely recommending a standard diet or giving information, as it represents providing an effective model for nutritional reeducation, prioritizing improvement in the style and quality of life. This article provides data about enhancing esthetics and beauty by means of appropriate nutrition.


[Apoptosis of neutrophils in the patients with the high risk of peritonitis occurrence after operation for acute diseases of the abdominal organs].
The processes of apoptosis of neutrophils of peripheral blood were studied in 43 patients, who were operated on for an acute abdominal diseases on the first and fourth postoperative day. Dynamic changes of apoptotic processes in neutrophils were established postoperatively. Unfavorable course of early postoperative period in the patients owing primarily high and middle risk of postoperative peritonitis occurrence have coincided with inhibition of the apoptosis processes in neutrophils.


Group practices tie hospital, physician objectives.
Group practice arrangements can underlie a hospital's strategy to recruit physicians and ensure steady patient volumes. Because physicians largely control where their patients are treated, many hospitals are considering ways to more closely align practitioners with their programs and services. Models for developing group practices range from asking young physicians to join an established practice to helping merge the practices of a retiring physician and an established practitioner.


[Influence of therapy with interferon inducer on the parameters of quality of life in patients with pulmonary tuberculosis].
The evaluation of quality of life using a questionnaire--Version 2 of the "SF-36 Health Survey" was performed in 144 patients with widespread pulmonary tuberculosis. The low level of "quality of life" was revealed in patients with pulmonary tuberculosis in comparison with healthy persons. It is caused by limiting physical activity, reducing the psychological component due to low vitality and mental health. By the end of the second month of chemotherapy, the changes are saved (PE, RP) and even exacerbated (RE, MN) in patients with MDR MBT. Combined therapy with Cycloferon improves physical activity of patients without MDR MBT. In this case, the mental health of the patient is perceived positively due to increasing the emotional activity, more expressed in patients without MDR MBT and minimization emotional problems related to the disease in patients with MDR MBT.


Genetic influences on bipolar EEG power spectra.
The EEG bipolar power spectra provide more localization than spectral measures obtained from monopolar referencing strategies, and have been shown to be useful endophenotypes of psychiatric disorders such as alcoholism. We estimated the additive genetic heritability of resting bipolar EEG power spectra in a large sample of non-twin sibling pairs. The corresponding heritabilities ranged between 0.220 and 0.647 and were highly significant at all 38 electrode pairs for theta (3-7 Hz), low-alpha (7-9 Hz), high-alpha (9-12 Hz), low-beta (12-16 Hz), middle-beta (16-20 Hz) and high-beta (20-28 Hz) frequency bands. The heritabilities were the highest in the high-alpha and low-beta bands at most electrode pairs. The heritabilities were most variable across the head in the three beta bands. Other heritability patterns were also identified within each frequency band. Our results suggest that substantial proportions of the variability in the bipolar EEG measures are explained by genetic factors.


The cystic renal lesion in tuberous sclerosis.
A characteristic cystic renal lesion is described in three infants with tuberous sclerosis. Large cystic kidneys were present at birth in one child. The other two patients were discovered to have cystic kidneys and hypertension at 3 months of age. Development delay and seizures were ultimately present in two infants; typical cutaneous lesions of tuberous sclerosis developed in only one child. The roentgenographic appearance of the kidneys in the two older children was similar to that of adult-type polycystic kidney disease. Cysts were lined by a distinctive, hyperplastic epithelium in each patient. The diagnosis of tuberous sclerosis may be determined by renal biopsy in infants presenting with cystic kidneys.


The effectiveness of school-based physical activity interventions for adolescent girls: A systematic review and meta-analysis.
Physical activity (PA) decreases during the transition from childhood to adolescence, with larger declines observed in girls. School-based interventions are considered the most promising approach for increasing adolescents' PA levels although, it is unclear which types of school-based interventions have the greatest impact. The objective of this systematic review is to assess the impact and design of school-based PA interventions targeting adolescent girls. A systematic search was conducted using four electronic databases (PubMed, Web of Science, SPORTDiscus and PsychInfo). This systematic review was registered with PROSPERO (Registration number: CRD42016037428) and PRISMA guidelines (2009) were followed throughout. Twenty studies were identified as meeting the inclusion criteria and were included in a narrative synthesis. Seventeen studies were eligible for inclusion in a meta-analysis. There was a significant small positive treatment effect for school-based PA interventions for adolescent girls (k=17, g=0.37, p<0.05). After an outlier was removed (residual z=7.61) the average treatment effect was significantly reduced, indicating a very small positive effect (k=16, g=0.07, p=0.05). Subgroup analysis revealed very small significant effects for multi-component interventions (k=7, g=0.09, p<0.05), interventions underpinned by theory (k=12, g=0.07, p<0.05), and studies with a higher risk of bias (k=13, g=0.09, p<0.05). Intervention effects were very small which indicates that changing PA behaviors in adolescent girls through school-based interventions is challenging. Multi-component interventions and interventions underpinned by theory may be the most effective approaches to positively change adolescent girls' PA.


Optimum onset period for training based on maximum peak velocity of height by wavelet interpolation method in Japanese high school athletes.
The Wavelet Interpolation Method (WIM) was applied to the longitudinal records of individuals' heights and weights from 6 to 17 years of age (1983 to 1994) in an athlete group (male: 45, female: 50) and a control group (male: 85, female: 85). The criterion of maturity was derived from age at Maximum Peak Velocity (MPV) of height in the control group. Ages at MPV of height and weight were compared between the athletes and control subjects. The WIM was also applied to mean heights from 6.5 to 17.5 years of all the subjects classified by maturation rate in order to derive a model of growth velocity types. Among the athletes, the males were early-maturing and the females tended to be late-maturing. The difference between the ages at MPV of height and weight in males and females was less in the athletes group than in the control group. For the growth velocity model, in the athlete group, three types could be confirmed among the males, and five among the females. By making use of the type models, it was possible to clarify the spans of adolescence as classified by maturation rates, and it was concluded that the period following the age at MPV seems appropriate for the introduction of regular athletic training for each level of maturity.


Assessing the impact of educational intervention in patients with hypertension.
It is accepted that patient education can be beneficial in the treatment of chronic diseases. We conducted an educational intervention (EI) in hypertensive patients seen at Primary Care centres (PCC) and specialised Hypertension Units (SHU). To assess patient's knowledge of hypertension and to verify the impact of this educational initiative. A multicentre quasi-experimental study with the participation of 120 patients with hypertension. EI consisted of oral and written information which included the definition of hypertension, causes, cardiovascular risk factors and means of control. A self-administered questionnaire was used to assess patient's knowledge before and after EI. Sixty-two (52%) patients were from PCC and 58 (48%) from SHU (mean age: 61 ± 13.3 years, 59% were women). There were no differences in baseline characteristics between patients attending at PCC and SHU. The definition of hypertension (blood pressure ≥140 mmHg and/or ≥90 mmHg was known by 48% and 99% of the participants before and after EI, respectively (p < 0.001). Poor baseline knowledge about the risks of hypertension was related to kidneys (54%) and eyes (58%). After EI this knowledge increased to 100% (p < 0.001 and p < 0.001, respectively). A significant improvement in knowledge about medication was observed (51% before and 87% after EI; p = 0.004). This study shows a positive impact of EI to improve patients' knowledge about hypertension. However, further studies are needed to assess if EI produces behaviour changes in the long term, as this might enhance optimal blood pressure control to prevent kidney disease or delay its progression.


Do we need pacemakers resistant to magnetic resonance imaging?
Manufacturers of pacemakers (PM) and of magnetic resonance imaging (MRI) devices state that MRI scanning of PM wearers is contraindicated. This paper tries to summarise which effects can interfere with PM, what can be hazardous, and how treatment of PM in MRI can be modified to guarantee compatibility. All PM tested were from deceased patients. Reed contact thresholds and reactions were investigated in low magnetostatic fields and compared with those in strong magnetostatic fields. Influence of gradient fields on PM and heating due to radiofrequency (RF) pulses were estimated. Thirty Legal Medicine Departments were questioned whether deaths of PM patients during MRI are known. Reed contacts are influenced above 0.7 mT. In MRI fields only 28% of the PM in magnet mode remained so in all orientations. Of synchronous PM, 76% remained synchronous in all orientations. Gradient fields can influence sensing but cannot stimulate. Power density and temperature rise produced by RF fall rapidly with distance. Our question revealed six deaths. All suffered from sick-sinus-syndrome and all were not PM dependent. In three cases ventricular fibrillation was proven as the cause of death. Asynchronous pacing due to magnetostatic and gradient fields may be problematic in patients with spontaneous rhythm. To avoid them, PM triggered MRI scan restricted to refractory period is proposed. Neither inhibition of PM nor heating of the electrode poses real risks. So far, we have examined eight patients 12 times in MRI triggered mode without problems.


[Ovarian transposition with per-celioscopy before curietherapy in stage IA and IB cancer of the uterine cervix].
Ovarian preservation is recommended for young patients with early invasive cancer of the uterine cervix. We describe the laparoscopic technique of ovariopexy we performed among seven patients before brachytherapy and Wertheim surgery and we report our functional results: menopause was avoided in four instances but three failures were observed. The laparoscopic procedure could be improved with coagulation and section of the utero-ovarian ligament, mobilization of the infundibulopelvic ligament; finally the ovary could be transposed in the paracolic gutter. According to the authors, this protocol must be applied only to patients with stage IA or IB squamous cervical cancer, aged less than 35 years.


Analysis of pork adulteration in beef meatball using Fourier transform infrared (FTIR) spectroscopy.
Meatball is one of the favorite foods in Indonesia. The adulteration of pork in beef meatball is frequently occurring. This study was aimed to develop a fast and non destructive technique for the detection and quantification of pork in beef meatball using Fourier transform infrared (FTIR) spectroscopy and partial least square (PLS) calibration. The spectral bands associated with pork fat (PF), beef fat (BF), and their mixtures in meatball formulation were scanned, interpreted, and identified by relating them to those spectroscopically representative to pure PF and BF. For quantitative analysis, PLS regression was used to develop a calibration model at the selected fingerprint regions of 1200-1000 cm(-1). The equation obtained for the relationship between actual PF value and FTIR predicted values in PLS calibration model was y = 0.999x + 0.004, with coefficient of determination (R(2)) and root mean square error of calibration are 0.999 and 0.442, respectively. The PLS calibration model was subsequently used for the prediction of independent samples using laboratory made meatball samples containing the mixtures of BF and PF. Using 4 principal components, root mean square error of prediction is 0.742. The results showed that FTIR spectroscopy can be used for the detection and quantification of pork in beef meatball formulation for Halal verification purposes.


Medial femoral condyle strength after tunnel placement for single- and double-bundle posterior cruciate ligament reconstruction.
Single-bundle posterior cruciate ligament (PCL) reconstruction can restore normal posterior laxity; double-bundle reconstruction is needed to more closely mimic normal knee kinematics. Drilling two tunnels removes additional bone from the medial femoral condyle and may interfere with its vascular supply, increasing the risk of fracture or subchondral collapse. Three groups of seven synthetic femurs were tested: no tunnels, single anterolateral 10-mm tunnel, and double tunnel (anterolateral 10-mm tunnel and posteromedial 8-mm tunnel). The distal femur was potted to rigidly hold each specimen during testing. Compressive loading was performed at 2 mm/minute using an Instron (Instron Corp, Canton, Mass). Load and displacement at failure were recorded; stiffness was calculated from those measurements. Mean failure load of the double-tunnel group (7705 N) was significantly lower than the intact group (10962 N, P < .008). No other significant differences were detected. In this model, the double-bundle technique significantly reduced failure force, increasing the potential risk of medial femoral condyle fracture compared to the intact femur. The double-bundle technique also trended toward reduced stiffness. Therefore, a period of postoperative protected weight bearing is recommended.


Association of tumor necrosis factor-alpha gene promoter polymorphisms with acute viral hepatitis in the Indian population.
The key elements that determine the host response to either the self-limited or a severe fulminant form of liver disease are unclear. We have investigated the potential association of single nucleotide polymorphisms (SNPs) in the promoter region of tumor necrosis factor-alpha (TNFalpha) in their susceptibility to acute viral hepatitis (AVH) and fulminant hepatic failure (FHF) patients exhibiting specific viral etiology. A total of 124 individuals including 64 cases comprising 27 FHF, 37 AVH, and 60 healthy controls were recruited. SNPs at -238 (G/A), -308 (G/A), -857 (C/T), and -863 (C/A) of TNFalpha were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and confirmed by direct sequencing. Serum levels of TNFalpha were determined at admission and death or recovery. Association between the TNFalpha genotype and susceptibility to FHF was not evident; however, carrier genotypes in relation to the -308 (GA/AA) and -857 (CT/TT) loci were found to be significantly (P < or = 0.05) associated with susceptibility to AVH in relation to controls. The mean TNFalpha serum levels at admission were significantly higher (P < 0.001) in FHF than AVH patients, but no marked difference was observed between FHF-E (expired; n = 17) and FHF-S (survivors; n = 10), though the former were comparatively higher. This study suggests that SNPs at -308 and -857 of the TNFalpha promoter may represent an increased risk for the development of AVH but not for FHF in the Indian population.


Temozolomide for adult brain stem glioblastoma: case report of a long-term survivor.
Brain stem gliomas are rare intracranial tumors, especially in adults. Malignant or high-grade brain stem gliomas are usually associated with a very poor prognosis. This case report documents an adolescent harboring brain stem glioblastoma who had complete radiological response to temozolomide after partial tumor resection and survived for more than 3 years. Radiological and pathological findings are described. To the best of our knowledge, no similar cases have been reported in the literature.


[Determination of biological activity of hydrogel preparations based on ketoconazole and clotrimazole].
Biological activity of original hydrogel preparations based on ketoconazole and clotrimazole was estimated biologically with the 3-dose variant of the agar-diffusion method. The optimal concentrations of the active substances in the hydrogels were the following: 2% of ketoconazole and 1% for clotrimazole.


Bariatric surgery and the changing current scope of general surgery practice: implications for general surgery residency training.
The scope of general surgery practice has evolved tremendously in the last 20 years. However, clinical experience in general surgery residency training has undergone relatively little change. To evaluate the current scope of academic general surgery and its implications on surgical residency. The University HealthSystem Consortium and Association of American Medical Colleges established the Faculty Practice Solution Center (FPSC) to characterize physician productivity. The FPSC is a benchmarking tool for academic medical centers created from revenue data collected from more than 90,000 physicians who practice at 95 institutions across the United States. The FPSC database was queried to evaluate the annual mean procedure frequency per surgeon (PFS) in each calendar year from 2006 through 2011. The associated work relative value units (wRVUs) were also examined to measure physician effort and skill. During the 6-year period, 146 distinct Current Procedural Terminology codes were among the top 100 procedures, and 16 of these procedures ranked in the top 10 procedures in at least 1 year. The top 10 procedures accounted for more than half (range, 52.5%-57.2%) of the total 100 PFS evaluated for each year. Laparoscopic Roux-en-Y gastric bypass was consistently among the top 10 procedures in each year (PFS, 18.2-24.6). The other most frequently performed procedures included laparoscopic cholecystectomy (PFS, 30.3-43.5), upper gastrointestinal tract endoscopy (PFS, 26.5-34.3), mastectomy (PFS, 16.5-35.0), inguinal hernia repair (PFS, 15.5-22.1), and abdominal wall hernia repair (PFS, 21.6-26.1). In all years, laparoscopic Roux-en-Y gastric bypass generated the highest number of wRVUs (wRVUs, 491.0-618.2), and laparoscopic cholecystectomy was regularly the next highest (wRVUs, 335.8-498.7). A significant proportion of academic general surgery is composed of bariatric surgery, yet surgical training does not sufficiently emphasize the necessary exposure to technical expertise and clinical management of the patient undergoing bariatric surgery. As the scope of general surgery practice continues to evolve, general surgery residency training will need to better integrate the exposure to bariatric surgery.


Evaluation of Column Cleanup for Chlorobenzenes, Polychlorinated Biphenyls, Polychlorinated Dibenzo-p-dioxins, and Polychlorinated Dibenzofurans in MM5 Flue Gas Analysis.
The recoveries of chlorobenzenes (CBs), polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins (PCDDs), and polychlorinated dibenzofurans (PCDFs) from the acid-base-on-silica column (ABS), the silver nitrate-on-silica column (SNS), and the alumina column (ALM) were investigated using eluents with various concentrations of dichloromethane in hexane. PCBs recoveries from the ABS and ALM columns are generally increased with increasing number of chloro substituents. However, PCBs recoveries are also complicated by the inductive and resonance contributions due to the different conformation and electron density of the congeners. The recoveries of PCBs with lower number of chloro substituents decreased with increasing silver nitrate content coated on silica. With 2% dichloromethane in hexane (as normally used in MM5 analysis), the recoveries of all CBs and trichloro- to decachlorobiphenyls from ABS, 10% SNS, and ALM columns in series are ≥80%. However, the 2,4-dichlorobiphenyl is only 16% recovered, and monochlorobiphenyls are not recovered at all. Under these conditions, the recoveries of PCDDs/PCDFs from ABS and 10% SNS columns in series are ≥80%. With 60% dichloromethane in hexane, PCDDs/PCDFs recoveries from ALM column are ≥80%. The implication of the selective adsorption of PCBs on the fractionation of CBs/PCBs and PCDDs/PCDFs from these MM5 cleanup columns is discussed.


Dynamic MR angiography in acute aortic dissection.
To evaluate the benefit (additional flow information), image quality, and diagnostic accuracy of a dynamic magnetic resonance angiography (MRA) combining high spatial and temporal resolution for the preinterventional assessment of acute aortic dissection. Nineteen patients (12 men, 7 women; aged 32-78 years) with acute aortic dissection underwent contrast-enhanced four-dimensional (4D) MRA and 3D conventional high-resolution MRA (3D MRA) within one examination on a 1.5 Tesla MR system. Both MRA datasets for each patient were evaluated and compared for image quality and visualization of vascular details on a 5-point scale (5 = excellent image quality, 1 = nondiagnostic image quality). In addition, presence and relevance of additional hemodynamic information (flow direction and organ perfusion delay) gained by dynamic MRA were assessed. Conventional 3D MRA provided significantly higher values for image quality of the aorta and aortic side branches compared with dynamic MRA (aorta: 4.3 versus 3.3; P = 0.006 side branches: 4.2 versus 3.3; P = 0.02). However, in 10 of the 19 patients (53%) the additionally available information on flow dynamics due to dynamic MRA (e.g., delayed perfusion of parenchymal organs) led to a change in therapy planning and realization. Dynamic MRA is a technique that combines functional flow and morphological information. Thus, the combination of 3D and dynamic MRA provides all requested information for treatment planning in patients suffering from acute aortic dissection.


The ongoing pursuit of neuroprotective therapies in Parkinson disease.
Many agents developed for neuroprotective treatment of Parkinson disease (PD) have shown great promise in the laboratory, but none have translated to positive results in patients with PD. Potential neuroprotective drugs, such as ubiquinone, creatine and PYM50028, have failed to show any clinical benefits in recent high-profile clinical trials. This 'failure to translate' is likely to be related primarily to our incomplete understanding of the pathogenic mechanisms underlying PD, and excessive reliance on data from toxin-based animal models to judge which agents should be selected for clinical trials. Restricted resources inevitably mean that difficult compromises must be made in terms of trial design, and reliable estimation of efficacy is further hampered by the absence of validated biomarkers of disease progression. Drug development in PD dementia has been mostly unsuccessful; however, emerging biochemical, genetic and pathological evidence suggests a link between tau and amyloid-β deposition and cognitive decline in PD, potentially opening up new possibilities for therapeutic intervention. This Review discusses the most important 'druggable' disease mechanisms in PD, as well as the most-promising drugs that are being evaluated for their potential efficiency in treatment of motor and cognitive impairments in PD.


Scalable in Situ Synthesis of Li4Ti5O12/Carbon Nanohybrid with Supersmall Li4Ti5O12 Nanoparticles Homogeneously Embedded in Carbon Matrix.
Li4Ti5O12 (LTO) is regarded as a promising lithium-ion battery anode due to its stable cyclic performance and reliable operation safety. The moderate rate performance originated from the poor intrinsic electron and lithium-ion conductivities of the LTO has significantly limited its wide applications. A facile scalable synthesis of hierarchical Li4Ti5O12/C nanohybrids with supersmall LTO nanoparticles (ca. 17 nm in diameter) homogeneously embedded in the continuous submicrometer-sized carbon matrix is developed. Difunctional methacrylate monomers are used as solvent and carbon source to generate TiO2/C nanohybrid, which is in situ converted to LTO/C via a solid-state reaction procedure. The structure, morphology, crystallinity, composition, tap density, and electrochemical performance of the LTO/C nanohybrid are systematically investigated. Comparing to the control sample of the commercial LTO composited with carbon, the reversible specific capacity after 1000 cycles at 175 mA g-1 and rate performance at high current densities (875, 1750, and 3500 mA g-1) of the Li4Ti5O12/C nanohybrid have been significantly improved. The enhanced electrochemical performance is due to the unique structure feature, where the supersmall LTO nanoparticles are homogeneously embedded in the continuous carbon matrix. Good tap density is also achieved with the LTO/C nanohybrid due to its hierarchical micro-/nanohybrid structure, which is even higher than that of the commercial LTO powder.


[Relation between the 7-ethoxyresorufin-O-deethylase activity of the liver microsomal monooxygenase system and the level of methylcholanthrene-induced form of cytochrome P-450].
Changes in the metabolic activity of 7-ethoxyresorufin in rat liver microsomes containing different amounts of cytochrome P-450 induced by 3-methylcholanthrene and other polycyclic hydrocarbons (P-450c) were studied. Using antibodies to cytochrome P-450c for the determination of the cytochrome P-450c content and its metabolic role, it was demonstrated that 7-ethoxyresorufin O-deethylation by the liver microsomal monooxygenase system is catalyzed exclusively by cytochrome P-450c. The rate of the substrate metabolism is correlated with the cytochrome P-450c content in microsomal membranes; the cytochrome P-450c activity does not depend on the cytochrome P-450c/NADPH-cytochrome P-450 reductase ratio. The experimental results suggest that the level of 7-ethoxyresorufin metabolism in liver microsomes can be regarded as a measure of the cytochrome P-450c content, whose function is associated with the stimulation of potential carcinogenic and toxic substances.


Comparing orthodontic bond failures of light-cured composite resin with chemical-cured composite resin: A 12-month clinical trial.
In this clinical trial, we evaluated and compared bond failure rates of light-cured composite resin vs chemical-cured composite resin for 12 months. Twenty-two subjects (356 stainless steel brackets) were included in this study, and a split-mouth design was used to randomly allocate diagonally opposite quadrants to either chemical-cured (178 brackets) or light-cured (178 brackets) composite resin; the brackets came from the same manufacturer. The survival and failure rates of the brackets were evaluated by the mode of polymerization. The overall bracket survival rates were estimated using the Kaplan-Meier product limit estimate. There were no significant differences in the bond failure rates between the chemical-cured and the light-cured composites (P = 0.52). Bond failures were greater in posterior teeth (6.7%) than in anterior teeth (1.2%). The highest failure rate was observed in the second premolars (7.7%). The overall failure rate of brackets with the 2 bonding systems was 2.8%, which is acceptable for clinical use. The polymerization mode did not influence the bracket survival rate significantly.


Antifungal saponins from Paris polyphylla Smith.
Three steroidal saponins, including one new and two known compounds, were isolated from the rhizomes of Paris polyphylla Smith. One- and two-dimensional NMR, LC-MS, and interpretation of hydrolytic cleavage experiments led to the identification of the structure of the new saponin as ( 25R)-spirost-5-ene-3 beta,17 alpha-diol (pennogenin) 3- O-{ O- alpha- L-rhamnopyranosyl-(1-->2)- O-[ O- beta-xylopyranosyl-(1-->5)- alpha- L-arabinofuranosyl-(1-->4)]- beta- D-glucopyranoside}. The isolated saponins were evaluated for their antifungal activity against Cladosporium cladosporioides and Candida species and showed comparable activity to chemicals used in some commercial products.


Hemophilia and the female: considerations for the radiologist.
Hemophilia A and B are commonly considered male diseases because of their X-linked recessive inheritance, but clinical hemophilia is occasionally seen in females. This may represent an extreme example of the Lyon hypothesis in which a heterozygous female has only the one X chromosome bearing the aberrant gene in the active state.


Heterotopic ossification in cervical total disk replacement: a finite element analysis.
Heterotopic ossification is one of the possible complications following cervical total disk replacement. Although there are numerous hypotheses regarding the etiology of heterotopic ossification, the main causes of heterotopic ossification remain unknown. In this study, we hypothesize that heterotopic ossification formation is related to external loading in the cervical vertebrae after total disk replacement. A two-dimensional finite element model of a cervical vertebra treated by total disk replacement in the sagittal plane was developed. The bone adaptation process of heterotopic ossification was simulated based on strain energy density under both compressive and shear forces. Different types of heterotopic ossification formation were analyzed according to the directions of forces. Two distinct types of heterotopic ossification following cervical total disk replacement were predicted, which was consistent with previous clinical studies. Type 1 heterotopic ossification was observed in the posterior upper part of the vertebra under compressive forces, while type 2 heterotopic ossification was detected mostly in the anterior upper part under shear forces. In addition, heterotopic ossification formation enhanced the strain energy distribution, which is known to be related to bone remodeling. This article presents the effects of different mechanical loading conditions on the occurrence of heterotopic ossification following cervical total disk replacement, and the results may be useful for the design of artificial disks that minimize heterotopic ossification.


Fast high-performance liquid chromatographic purification of Saccharomyces cerevisiae phosphoenolpyruvate carboxykinase.
A procedure was established for the rapid isolation of Saccharomyces cerevisiae phosphoenolpyruvate carboxykinase (PEPCK) from an overproducing strain. Overexpression was achieved by the transformation of yeast cells with the multicopy plasmid YEp352 harbouring the PEPCK structural gene. The enzyme was purified to homogeneity using first anion-exchange chromatography on Q-Sepharose followed by hydrophobic interaction chromatography on phenyl-Sepharose and gel filtration on Sephacryl S200. The purified phosphoenolpyruvate carboxykinase was further characterized with respect to the molecular mass, displaying an apparent molecular mass corresponding to a tetrameric form.


[Synthesis of cyclic and non-cyclic tachykinin partial sequences. 2. Synthesis of the homocyclic substance P(6-11) hexapeptide].
The authors describe the synthesis of Gln-Phe-Phe-Gly-Leu-Met by cyclization of H-Leu-Met-Gln-Phe-Phe-Gly using three different methods. The linear sequence was obtained by a (2+4)-segment condensation. The resulting cyclopeptide showed only a small kinin activity on isolated guinea pig ileum compared to substance P, but it is a full agonist.


Significance of T wave abnormality in hypertension studied by spatial velocity electrocardiogram and vectorcardiogram.
The ST-T wave abnormality in hypertension has been considered to be an indicator of poor prognosis, but its precise pathophysiological significance remains unclear. The present study was aimed to correlate the electrocardiographic (ECG) change in T wave and left ventricular characteristics studied by echocardiogram. The T wave abnormality in the ECG represented hypertrophy of the left ventricle or abnormality of systolic function, but it was difficult to differentiate either of them by conventional ECG. It was shown in this study that the anterior displacement of the vectorcardiographic T loop was related to the ventricular hypertrophy and that the abnormal shape or inscription of the T loop was more closely related to the ventricular dysfunction rather than hypertrophy. These results suggested that the vectorcardiogram and spatial velocity electrocardiogram were useful for analysis of the T wave abnormality and add important information in addition to the conventional electrocardiogram.


[Government health planning in the state of Bahia, Brazil: political actors, social interaction and institutional learning].
This article analyzes the process of government planning in health in the state of Bahia in the 2007-2010 period based on the formulation of the State Health Plan. The benchmark adopted involved adaptation of the theoretical model of the cycle of public policy, including analysis of context, characterization of the actors involved, operations conducted in decision making and the strategic means used. The production of information was through the analysis of documents organized in institutional portfolios and records of the planning process in the organization studied. The analysis of results reveals that the political game included "concessions" and "negotiations" regarding changes in the management and organization of the health system, highlighting the discussion on the problems facing the state management of the Unified Health System (SUS) during the period, and the search for alternatives and solutions to these problems. It also reveals the institutional learning acquired, involving managers and technicians who broadened and reinforced their capacity to analyze and formulate proposals around the government agenda.


A small bioethical world?
This essay discusses four challenges posed to a global bioethics by articles on: divergent national policies on compensation of egg donors for IVF, efforts to advance the development of international guidelines for the management of neonates on the edge of viability, bioethics training workshops in Uganda, a bioethicist's reflection on a visit to Pakistan. The article then discusses several approaches to developing a global bioethics and how these approaches might meet the four challenges. The essay concludes with discussion of the author's development of a "navigational approach" to policymaking for "fractious" bioethical policy problems and how this compares to other approaches to developing a global bioethics.


Ileal vasoactive intestinal peptide (VIP) levels and VIP receptor/effector system in ileal epithelial cells after colectomy in the rat.
The interaction of VIP (binding to specific receptors and stimulation of cyclic AMP accumulation) with ileal epithelial cells and the levels of the neuropeptide in the ileal segment were determined after colectomy (removal of cecum and colon followed by ileorectal anastomosis) in the rat. The number of VIP receptors (but not the affinity) and the efficiency (but not the potency) of the neuropeptide upon stimulation of cyclic AMP accumulation in ileal epithelial cells increased 21 (but not 7) days after colectomy, whereas VIP ileal levels followed an inverse pattern. These changes could be interpreted in terms of a consequence or a cause of some of the phenomena that appear after colectomy, i.e., chronic watery diarrhea.


Orbital and childhood sarcoidosis.
Orbital infiltration, anterior uveitis, disc edema, choroiditis, erythema nodosum, and polyarticular arthritis due to sarcoidosis occurred in a five-year-old child who presented with unilateral proptosis. Diagnosis was enhanced by computerized tomography of the orbit, and confirmed by synovial biopsy findings. This patient's course illustrates the importance of thorough and frequent ocular examinations in childhood uveitis associated with systemic disease and demonstrates an unusual finding of orbital sarcoidosis. Childhood sarcoid arthritis may be misdiagnosed as juvenile rheumatoid arthritis. Familiarity with the ocular and systemic findings may lead to the correct diagnosis.


Computer-aided detection of breast cancer nuclei.
A computer-aided detection system for tissue cell nuclei in histological sections is introduced and validated as part of the Biopsy Analysis Support System (BASS). Cell nuclei are selectively stained with monoclonal antibodies, such as the anti-estrogen receptor antibodies, which are widely applied as part of assessing patient prognosis in breast cancer. The detection system uses a receptive field filter to enhance negatively and positively stained cell nuclei and a squashing function to label each pixel value as belonging to the background or a nucleus. In this study, the detection system assessed all biopsies in an automated fashion. Detection and classification of individual nuclei as well as biopsy grading performance was shown to be promising as compared to that of two experts. Sensitivity and positive predictive value were measured to be 83% and 67.4%, respectively. One major advantage of BASS stems from the fact that the system simulates the assessment procedures routinely employed by human experts; thus it can be used as an additional independent expert. Moreover, the system allows the efficient accumulation of data from large numbers of nuclei in a short time span. Therefore, the potential for accurate quantitative assessments is increased and a platform for more standardized evaluations is provided.


Correction to: Identification of N-arylsulfonylpyrimidones as anticancer agents.
The author would like to include conflict of interest statement of the online published article. The correct conflict of interest statement should read as: The authors declare no conflict of interest.


Morin attenuates doxorubicin-induced heart and brain damage by reducing oxidative stress, inflammation and apoptosis.
Doxorubicin (DOX) is an effective antineoplastic agent of the anthracycline group. However, as with most anticancer drugs, they cause some toxic effects, including major cardiotoxicity and cognitive impairment. In this study, protective effects of morin against DOX-induced cardiotoxicity and neurotoxicity in rats were investigated. Morin was orally administered to rats at a dose of 50 and 100 mg/kg body weight for 10 days. DOX was administered 40 mg/kg body weight by single dose intraperitoneal injection on the 8th day of the study. Both the levels of glutathione (GSH) and malondialdehyde (MDA) were assessed and enzyme activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) were assessed to determine the protective effect of morin against oxidative stress. To determine the anti-inflammatory effect, the levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), nuclear factor kappa B (NF-κB) were assessed in the heart and brain tissues. Lactate dehydrogenase (LDH) and creatine kinase isoenzyme-MB (CKMB) activities, which are cardiac function markers, and cardiac troponin-I (cTn-I) levels were also determined. Anti-apoptotic effect was determined by anti-apoptotic protein B-cell lymphoma-2 (Bcl-2) and pro-apoptotic protein cysteine aspartate specific protease-3 (caspase-3) changes. The regulatory role of morin in signal transduction in the brain tissue was assigned with the determination of amount of acetylcholinesterase (AChE), and its healing effect on the central nervous system was determined with imuinohistochemical detection of glial fibrillar acidic protein (GFAP) level. Histopathological evaluation of heart and brain tissues was performed in all groups.


Analysis of anthocyanins in powdered berry extracts by planar chromatography linked with bioassay and mass spectrometry.
Major anthocyanins were extracted with acidified methanol and characterised in powdered berry extracts of bilberry, blueberry, chokeberry, açai berry and cranberry by HPTLC-Vis-MS for the first time. A combined 2-step normal phase separation was applied, first for separation of anthocyanins and secondly of anthocyanidins. Documentation was performed under white light illumination (transmission mode). In the powdered berry extracts, especially the 3-glucosides of delphinidin, cyanidin, malvidin and peonidin, further cyanidin glycosides and respective anthocyanidins were found. Calibration data revealed a good correlation, with r between 0.9988 and 0.9999. The repeatability of the sample analysis (n=3) was ⩽3.6%. Based on the results obtained, this method can be used for rapid routine quality control of powdered berry extracts. For confirmation of the results or characterisation of unknown anthocyanin zones, mass spectra were recorded. Chromatography was directly linked to the effect using DPPH(∗) reagent and luminescent Aliivibrio fischeri bioassay.


Immunocytochemical and enzyme histochemical localization of Na+,K(+)-ATPase in normal and ischemic porcine myocardium.
Na+,K(+)-ATPase is involved in generating transmembrane ion gradients and the associated potential difference necessary for contraction of cardiac myocytes. It is possible that changes in the activity or membrane content of this enzyme may occur under ischemic conditions. To investigate this question, right ventricular (RV) ischemia was produced in closed chest pigs and the RV ejection fraction was measured using a fast response thermistor in the pulmonary artery. Sections of RV collected at 15, 30, 45, and 60 min of ischemia were assayed for changes in sarcolemmal Na+,K(+)-ATPase activity using an enzyme coupled histochemical reaction as well as a biochemical assay. Similar sections were examined for changes in the distribution and content of Na+,K(+)-ATPase using an immunocytochemical procedure. The RV ejection fraction fell significantly from baseline after 15 min of ischemia (62 +/- 3% vs 39 +/- 3% respectively, P less than 0.05, n = 10). A decrease in sarcolemmal Na+,K(+)-ATPase activity was first detected after 30 min of occlusion and a significant reduction in enzyme activity was present at 45 min of ischemia. In contrast no changes were detected in the distribution or content of immunoreactive Na+,K(+)-ATPase in the sarcolemma at any time point. In addition, the amount of Na+,K(+)-ATPase in tissue homogenates showed no significant changes after 45 min of ischemia. These findings show that acute ischemia results in the disruption of sarcolemmal Na+,K(+)-ATPase activity and suggests that the decrease in enzyme activity is not due to the loss or redistribution of sarcolemmal Na+,K(+)-ATPase.


Magnet Resonance Angiography versus Conventional Angiography for the Planning of Reconstructive Surgeries.
Assessing the vascular status and anatomy of the lower extremity is of crucial importance when planning the coverage of a tissue defect with a free flap. The standard techniques comprise the clinical examination, Doppler ultrasound and Doppler sonography for healthy patients without suspected direct trauma to the vascular system, and conventional digital subtraction angiography (DSA), respectively, in case of traumatized vessels or patients with peripheral arterial obstructive disease. We have conducted a prospective study for the comparison of the magnetic resonance angiography (MRA) to the conventional DSA. Fourteen patients were examined presurgically by means of both a conventional DSA and an MRA before undergoing planned microvascular coverage of tissue defects of the lower extremity. The surgeon, based on a questionnaire, assessed and compared both examination results according to their information content. Furthermore, the presurgically planned level and localization of the vascular anastomoses and the intraoperative findings were compared postoperatively. The MRA examination yielded sufficient information on the vascular anatomy to enable the surgeon to carry out a detailed presurgical planning. Additionally, the use of MRA showed clear advantages with regard to both patient and user comfort. Taking into account the advantages for the assessment of vessels using MRA, in particular when considering the impact of the frequently varying vascular anatomy of the lower leg on reconstructive surgery, as well as the significantly lower morbidity rate of the examination itself, then the MRA must be regarded as a safe alternative to the DSA.


Sexual mosaics induced by tetracycline treatment in the Wolbachia-infected adzuki bean borer, Ostrinia scapulalis.
Wolbachia-infected Ostrinia scapulalis (Lepidoptera: Crambidae) females generate all-female or nearly all-female broods. Curing the infection by tetracycline treatment during larval stages results in the generation of all-male broods in the next generation. Here we show that sexually mosaic offspring are produced by Wolbachia-infected females treated with tetracycline at the adult stage. The sexual mosaics had wings that were composed of distinctive female and male sectors. Besides wings, the sexually dimorphic mid tibiae displayed an intermediate morphology in some of the mosaics. Many of the mosaic individuals had an abnormal structure of the external genitalia as well, a combination of the male uncus and the female ovipositor. We assume that Wolbachia has a feminizing effect on O. scapulalis genetic males and, hence, incomplete curing of the Wolbachia infection results in the generation of sexually mosaic individuals.


The structurally effect of surface coated rhamnogalacturonan I on response of the osteoblast-like cell line SaOS-2.
Osseointegration is important when implants are inserted into the bone and can be improved by biochemical surface coating of the implant. In this paper enzymatically modified rhamnogalacturonan I (RG-I) from apple and lupin was used for biochemical coating of aminated surfaces and the importance of the quality of RG-I, the nature of the binding, the fine structure of RG-I, and its effect on SaOS-2 cell line cultured on coated surfaces was investigated. SaOS-2 cells are osteoblast-like cells and a well-established in vitro model of bone-matrix forming osteoblasts. Purification by gel filtration could remove small fragments of galacturonic acid (GalA) and binding studies showed that the purity of the RG-I molecules was important for the quality of the coating. The structure of RG-I and osteoblast-like cells' viability were positively correlated so that high content of 1,4-linked galactose (Gal) and a low content of arabinose in the RG-I molecules favored cell viability. These results indicate that coating of implants with RG-I affect osseointegration positively.


A survey of Japanese patients with mitochondrial fatty acid beta-oxidation and related disorders as detected from 1985 to 2000.
A clinical survey of Japanese patients with mitochondrial fatty acid beta-oxidation and related disorders (FAODs) was performed with questionnaires sent to 187 institutions, where inborn errors of metabolism could be managed in Japan, including a search of related literature published between 1985 and 2000. Sixty-four patients with ten types of FAODs were found. Carnitine palmitoyltransferase 2 deficiency and glutaric aciduria type 2 were most common (17 and 14 patients, respectively). As of 2000, there were no patients with medium-chain acyl-CoA dehydrogenase deficiency, which is common in Caucasians. Age at onset was under 2 years in 38 (59%) of the patients. Eight (13%) patients had neonatal onset. Twenty-one (55%) of the 38 children with an initial attack under 2 years of age had acute encephalopathy or a Reye syndrome-like illness. Half of the patients presented within 2 years of birth died or were handicapped. On the other hand, 19 (79%) of the 24 with onset after 2 years of age had muscle symptoms and 23 (96%) of the 24 grew and developed normally. Though the precise incidence of FAODs in Japan is still unknown, as a consequence of the development of diagnostic procedures the number of FAOD cases being diagnosed appears to have increased. Mass screening for FAODs during the neonatal period will greatly aid in prevention of attacks and related effects.


[Reference values of prostate specific antigen (PSA) in 63926 workers without prostatic symptoms who participated in prostate screening cancer developed by the Ibermutuamur Prevention Society in 2006].
To determine the values of PSA in Spanish workers without history of prostate problems and compare them with other geographical latitudes. Observational, retrospective, multicenter and population-based study, conducted between January 1 and December 31, 2006. A total of 65303 workers participated in the Programme of prostate cancer screening conducted by the Ibermutuamur Prevention Society in different Spanish regions. Of these, were selected for this report, 63926: 149 were excluded by personal history of prostate problems and 1328 for being over 64 years. PSA determinations were performed using the Abbott test. Were specified PSA values for each age and for the following age ranges: younger than 40 years, 40-49 years, 50-59 years and 60-64 years. Also calculated the mean PSA values by Autonomous Communities. The data were expressed as mean (+/-SD), confidence intervals 95%, standard error of the mean (SEM) and in the percentiles 5, 25, 50, 75 and 95. The results obtained were compared with those in other areas of the world. All data were analysed using the statistical software GraphPad Quick Calcs. Mean PSA value: for all cases was 1.06 ng/ml (95% CI: +/-1,18) and age groups: under 40 years, 0.67 ng/ml (95% CI: +/-0.49), 40-49 years, 0, 77 ng/ml (95% CI: +/-0.66), 50-59 years, 1.11 ng/ml (95% CI: +/-1.22) and 60-64 years, 1.57 ng/ml (95% CI: +/-1.72). Depending on the age ranged between 0.67 ng/ml under age 40 and 1.70 in the 64 years. According to region, the lowest value was recorded in the País Vasco with 0.98 ng/ml (95% CI: 1.02) and higher in Asturias with 1.28 ng/ml (95% CI: 1.32). Percentile value PSA: the upper normal limit (95th percentile) was 1.40 ng/ml in those younger than 40 years, 1.70 ng/ml in 40-49 years, 3.30 ng/ml in 50-59 years and 5.18 ng/ml in the group 60-64 years. PSA values collected in this study may serve as a reference for the Spanish working population, using the range described for decades, or even better, those relating to each age.


Relation between nursing procedures, other local characteristics and transmission of enteric bacteria in neonatal wards.
Faecal colonization patterns were studied in 22 neonatal special care units (N = 953 babies) using a novel method for typing of Escherichia coli, Klebsiella spp. and Enterobacter spp. isolates. Sporadic strains of E. coli (found in only one infant in a ward) were taken to indicate natural colonization, whereas local spread of E. coli strains or colonization with sporadic or spreading strains of Klebsiella spp. and Enterobacter spp. was regarded as abnormal (non-maternal) colonization. All apparent risk factors for abnormal neonatal colonization with enteric bacteria identified were modifiable (ward size, staff work load, antibiotic policy, hygienic precautions). Another encouraging finding was that variables harder to modify (crowding, intensity of care) appeared to be unimportant in influencing neonatal colonization patterns with such bacteria.


Selective growth-inhibiting effects of compounds identified in Tabebuia impetiginosa inner bark on human intestinal bacteria.
The growth-inhibiting activity of anthraquinone-2-carboxylic acid and lapachol identified in the inner bark of taheebo, Tabebuia impetiginosa, toward 10 human intestinal bacteria was evaluated by using a paper disk diffusion bioassay and compared to those of seven lapachol congeners (1,4-naphthoquinone, naphthazarin, menadione, lawsone, plumbagin, juglone, and dichlone) as well as two commercially available antibiotics, chloramphenicol and tetracycline. Anthraquinone-2-carboxylic acid exhibited very strong growth inhibition of Clostridium paraputrificum at 1 microg/disk while 100 microg/disk of lapachol was needed for moderate growth inhibition of the same organism. These two isolates exhibited weak inhibition of Clostridium perfringens and Escherichia coli at 100 microg/disk while no adverse effects were observed on the growth of Bifidobacterium adolescentis, Bifidobacterium bifidum, Bifidobacterium infantis, Lactobacillus acidophilus, and Lactobacillus casei at 1000 microg/disk. Structure-activity relationships indicate that a methyl group in the C-2 position of 1,4-naphthoquinone derivatives might play an important role in antibacterial activity.


Types of pain treatment facilities and referral selection criteria. A review.
Family physicians often come in contact with patients who suffer from chronic pain. These patients present a treatment challenge and may require referral to a pain treatment facility. The purpose of this review is to define and clarify the current concept of a pain treatment facility and delineate the different types of treatment facilities available. Possible selection criteria for referral to such facilities are suggested, with the rationale for the selection of these criteria. The role of the family physician in the treatment by a by a special facility of a patient with chronic pain is discussed. By definition, pain treatment facilities differ. The family physician should be aware of these differences and selection criteria for referral to such facilities.


Objective grading of the pivot shift phenomenon using a support vector machine approach.
The pivot shift test is the only clinical test that has been shown to correlate with subjective criteria of knee joint function following rupture of the anterior cruciate ligament. The grade of the pivot shift is important in predicting short- and long-term outcome. However, because this grade is established by a clinician in a subjective manner, the pivot shift's value as a clinical tool is reduced. The purpose of this study was to develop a system that will objectively grade the pivot shift test based on recorded knee joint kinematics. Fifty-six subjects with different degrees of knee joint stability had the pivot shift test performed by one of eight different orthopaedic surgeons while their knee joint kinematics were recorded. A support vector machine based algorithm was used to objectively classify these recordings according to a clinical grade. The grades established by the surgeons were used as the gold standard for the development of the classifier. There was substantial agreement between our classifier and the surgeons in establishing the grade (weighted kappa=0.68). Seventy-one of 107 recordings (66%) were given the same grade and 96% of the time our classifier was within one grade of that given by the surgeons. Moreover, grades 0 and 1 were distinguished from grade 2 to 3 with 86% sensitivity and 90% specificity. Our results show the feasibility of automatically grading the pivot shift in a manner similar to that of an experienced clinician, based on knee joint kinematics.


Diffusion tensor MR imaging of white matter integrity in HIV-positive patients with planning deficit.
The aim of this study was to evaluate whether normal controls and human immunodeficiency virus (HIV) patients with and without planning deficits differ on white matter integrity. A total of 34 HIV-positive patients with planning deficits were compared with 13 HIV-positive patients without planning deficits and 19 gender-, age-, and education-matched control subjects. Diffusion tensor imaging (DTI) was performed along 30 noncolinear directions in a 1.5-T scanner. For tract-based spatial statistics analysis, a white matter skeleton was created, and a permutation-based inference with 5000 permutations with a threshold of p < 0.05 was used to identify abnormalities in fractional anisotropy (FA). The median, radial, and axial diffusivities were also projected onto the mean FA skeleton. Compared with controls, HIV-positive patients with planning deficits had decreased FA in bilateral anterior thalamic radiations, bilateral inferior fronto-occiptal fasciculi, genu and splenium of the corpus callosum, bilateral superior longitudinal fascicule, and bilateral uncinate fasciculi. Compared to HIV-positive patients without planning deficits, patients with planning deficits had decreased FA in bilateral anterior thalamic radiations, bilateral inferior fronto-occiptal fasciculi, genu of the corpus callosum, bilateral superior longitudinal fascicule, and right uncinate fascicule. DTI can detect extensive white matter abnormalities in the normal-appearing white matter of HIV-positive patients with planning deficits compared with controls and HIV-positive patients without planning deficits.


Techniques and complications of esophageal foreign body extraction in children and adults.
To assess the success rates and complications of esophageal foreign body extraction in adult and pediatric patients, the charts of 76 adults and 116 children with endoscopically or radiographically documented esophageal foreign body impaction were retrospectively reviewed. Success rates for rigid esophagoscopy (100%) and flexible endoscopy (96.2%) were not significantly different (p > 0.05). Overall, rigid esophagoscopy had a higher complication rate than flexible endoscopy (10% versus 5.1%, p > 0.05), but this trend did not reach statistical significance. The Foley catheter technique was used predominantly in children with proximally located blunt objects. Our study shows that flexible and rigid esophagoscopy are both safe and effective methods of removing esophageal foreign bodies, but rigid esophagoscopy carries a higher complication rate and therefore should be reserved for patients in whom flexible endoscopy is unsuccessful. The Foley catheter technique is suited only for proximally located blunt objects, and its routine use is not recommended.


Embryo development after successful somatic cell nuclear transfer to in vitro matured human germinal vesicle oocytes.
Somatic cell nuclear transfer (SCNT) involves the transfer of somatic cell nuclei into enucleated oocytes. Because human in vivo matured oocytes are scarcely available, we investigated whether in vitro matured (IVM) germinal vesicle (GV) oocytes could also support preimplantation development of human cloned embryos. Three groups were used for SCNT: in vitro matured GV oocytes (IVM oocytes), 'in vivo' matured oocytes (in vivo oocytes) and 'failed fertilized' oocytes after routine-ICSI (FF oocytes). After removal of the chromosome-spindle complex, cumulus cell nuclei were injected, and oocytes were artificially activated and cultured. In total 61, 54 and 45 metaphase II oocytes were used for SCNT in the three groups, respectively. Survival and pronuclear rates were 59, 78 and 58% and 61, 64 and 50%, respectively. Of the 22 activated IVM oocytes, 13 cleaved to the 2-cell stage, whereby 2 morulae were formed. For the in vivo oocytes, 17 of 27 activated oocytes cleaved to the 2-cell stage and 1 morula was observed. Cleavage to the 2-cell stage in the group of FF oocytes was compromised. To our knowledge, this is the first report describing development of cloned human embryos using IVM oocytes and non-autologous transfer using a conventional method of SCNT.


De novo vertebral artery-posterior inferior cerebellar artery aneurysm: a case report.
There have been few reports of de novo aneurysms in the posterior circulation since most de novo aneurysms occur in the anterior circulation. At the age of 46 years, the patient suffered a subarachnoid hemorrhage due to a ruptured right middle cerebral artery aneurysm, which was subsequently clipped. Eight years later, the patient experienced another subarachnoid hemorrhage of the posterior fossa predominance. A cerebral angiogram demonstrated a right vertebral artery-posterior inferior cerebellar artery (VA-PICA) aneurysm that had not been noted on the previous study. The first case of a subarachnoid hemorrhage from a right de novo VA-PICA aneurysm is presented. The characteristics of de novo aneurysms in the posterior circulation are discussed.


Subcellular effects of drought stress in Rosmarinus officinalis.
The use of Rosmarinus officinalis, and other wild plant species, in the Mediterranean area is an interesting solution in order to avoid the desertification and rapid soil erosion, because of their good resistance to environmental conditions. Previous articles have described experiments designed to determine the impact of water stress at the plant level in this species, but more knowledge is required at the subcellular and ultrastructural levels. An anatomic and ultrastructural study of the leaves was conducted on Rosmarinus officinalis plants growing under different water treatments. In the leaves of water-stressed plants, the leaf water potential and turgor decreased, and leaf osmotic potential became more negative with respect to control plants. The anatomic investigations showed that both the mesophyll intercellular spaces and the epidermal cell size were reduced significantly under the more intense drought stress conditions. At the subcellular level, chloroplasts accumulated plastoglobuli and lipid bodies, and cuticle thickness was increased under water stress. In our experiment, the anatomic and ultrastructural modifications of Rosmarinus officinalis could be considered an additional adaptation to drought stress together with physiological and biochemical modifications as antioxidant accumulation.


Awan's syndrome (primary orbital hypertelorism, narrow-angle glaucoma and lean physique) in two women.
Awan's syndrome, characterized by a lean physique, orbital hypertelorism and angle-closure glaucoma, is a distinct clinical entity which should be more widely recognized. The patients, usually women in their sixth decade, may suffer several self-limiting and misdiagnosed episodes of angle-closure before a definite diagnosis is made. The general physical appearance and hypertelorism in two women, one aged 56 and the other 59 years, with Awan's syndrome aroused the suspicion of angle-closure glaucoma. The timely confirmation of diagnosis and proper management prevented further visual loss in both patients. Some patients with Awan's syndrome may show advanced damage to the optic nerve without ever having had an acute attack of glaucoma or any other symptoms, which makes it important that all patients with orbital hypertelorism and suspected glaucomatous optic discs should undergo gonioscopic evaluation to rule out glaucoma.


Mechanisms and medical management of exercise intolerance in hypertrophic cardiomyopathy.
Hypertrophic cardiomyopathy (HCM) is an inherited disorder of cardiac sarcomeric proteins characterised by the presence of myocardial hypertrophy in the absence of abnormal loading conditions. Individuals with HCM can remain asymptomatic throughout their lives but many experience chest pain, symptoms of heart failure, syncope and sudden ventricular arrhythmias. Cardiopulmonary exercise testing is an important part of the assessment of patients with HCM who often have reduced peak oxygen consumption and a lower anaerobic threshold compared with healthy age-matched controls. This review will focus on mechanisms of exercise limitation, which are complex and multifactorial, and the options for medical management.


Discrimination of intracellular and extracellular proteins using amino acid composition and residue-pair frequencies.
Sequences of intracellular and extracellular soluble proteins were analyzed statistically in terms of amino acid composition and residue-pair frequencies. Residue-pair frequencies were calculated for sequential separations from (n, n + 1) to (n, n + 5), and converted into scoring parameters. Then, for each test protein, the single-residue and residue-pair parameters were applied to calculate a total score. According to our definition, a protein which yields a positive score is indicative of an intracellular protein, whereas a negative score implies an extracellular one. The parameter set was derived from 894 sequences constituting different protein families in the PIR database, and assessed by application to a test of 379 proteins. The results showed that 88% of intracellular and 84% of extracellular proteins were correctly assigned. The discrimination power was improved by about 8% in comparison with the previous study, which used composition data alone. Segregation of intra/extracellular proteins is also observed by other criteria, such as structural class (intracellular proteins prefer alpha and alpha/beta types and extracellular proteins prefer beta and alpha + beta types). Segregation by sequence was found to be a more reliable procedure for distinguishing intra/extracellular proteins than methods using structural class. Possible causes for this segregation by sequence are discussed.


Rapid modulation of P-glycoprotein-mediated transport at the blood-brain barrier by tumor necrosis factor-alpha and lipopolysaccharide.
At the blood-brain barrier, P-glycoprotein, an ATP-driven drug efflux pump, selectively limits drug access to the brain parenchyma, impeding pharmacotherapy of a number of central nervous system (CNS) disorders. We previously used confocal imaging to demonstrate in isolated rat brain capillaries that endothelin-1 (ET-1), acting through an ET(B) receptor, NO synthase, and protein kinase C, rapidly and reversibly reduces P-glycoprotein transport function. In this study, we define a link between the brain's innate immune response and functional regulation of P-glycoprotein. We show that exposing brain capillaries to the inflammatory cytokine tumor necrosis factor-alpha (TNF-alpha), activated a TNF-R1 receptor, released ET-1, activated ET(B) receptor signaling, and essentially abolished P-glycoprotein-mediated transport. Bacterial lipopolysaccharide, a potent activator of the brain's innate immune response, reduced P-glycoprotein activity through TNF-alpha release, ET-1 release, and ET(B) receptor signaling. TNF-alpha and LPS effects had a rapid onset (minutes), were reversible, and did not involve changes in tight junctional permeability. These findings define a signaling pathway through which P-glycoprotein activity is acutely modulated. They show that this key component of the selective/active blood-brain barrier is an early target of cytokine signaling during the innate immune response and suggest ways to manipulate the barrier for improved CNS pharmacotherapy.


Alcohol intake, hypertension development and mortality in black South Africans.
Excessive alcohol intake is a risk factor for cardiovascular disease (CVD) and predicts cardiovascular and all-cause mortality. We determined which alcohol marker (self-reported alcohol intake, gamma-glutamyltransferase (GGT) or percentage carbohydrate deficient transferrin (%CDT)) relates best with mortality and predicts hypertension development over five years in black South Africans. This was a longitudinal study as part of the PURE (Prospective Urban and Rural Epidemiology) study in the North West Province, South Africa. We included 2010 participants and followed 1471 participants. Over five years, 230 deaths occurred, of which 66 were cardiovascular-related. At enrolment, participants completed questionnaires on alcohol intake (yes, for former and current use; no, for alcohol never used). We measured blood pressure, collected blood samples and measured GGT and %CDT. When comparing hazard ratios (HRs) of self-report, GGT and %CDT, we found that only GGT predicted cardiovascular (HR = 2.76 (1.49-5.12)) and all-cause mortality (HR = 2.47 (1.75-3.47)) and hypertension development ((HR = 1.31 (1.06-1.62)). Participants self-reporting yes for alcohol intake had a 30% increased risk of developing hypertension (HR = 1.30 (1.07-1.60)) but not an increased risk for mortality. When adding both GGT and self-report in the prediction model for hypertension, only self-reporting of alcohol was significant (HR = 1.24 (1.01-1.53)). The alcohol marker, %CDT, did not show any significant association with mortality or hypertension development. GGT independently predicted cardiovascular and all-cause mortality, as well as hypertension development in black South Africans. Despite non-specificity to excessive alcohol consumption, GGT may be a useful general marker for hypertension development and mortality, also due to its significant association with self-reported alcohol intake.


[Sports hernia is not a hernia].
This review summarises aetiology, diagnostic approach, and treatment of longstanding groin pain, which can be divided in adductor-related, pubis-related, iliopsoas-related, and inguinal-related pain. Among the diagnoses included in the inguinal-related entity is the so-called sports hernia. However, the terminology is a misnomer since sports hernia is characterised by not being a hernia. Both athletes and non-athletes are affected, and the condition may cause long sick leaves. The treatment is primarily exercise treatment. If this treatment is unsuccessful after 2-6 months, surgery is an option.


Engaging with culturally and linguistically diverse communities to reduce the impact of depression and anxiety: a narrative review.
Culturally and linguistically diverse (CALD) communities in Australia face significant challenges in terms of reducing barriers to information and support for depression and anxiety. Increased stigma surrounding mental ill-health in some cultures and related concerns about trust and confidentiality all impact upon timely access to information, services and support for consumers and carers from CALD backgrounds. For health services, there is a need to understand how to better engage CALD communities in mental healthcare. The objective of this narrative review was to identify examples of evidence-based, best practice for what works effectively for engaging with CALD communities to reduce the impact of depression and anxiety. In January 2014, we searched Academic Search Premier, CINAHL, Health-Source Consumer Edition, PsycARTICLES, PsycINFO (all databases within the EbscoHost platform) and PubMed for peer-reviewed articles published between 1994 and 2014. The search revealed a total of 706 records contained within the EbscoHost platform and 689 records in PubMed; 15 matched the inclusion criteria. Six key themes were identified: (i) setting the scene for engagement; (ii) cultural values and preferences; (iii) language considerations; (iv) 'engagers' in the therapeutic process; (v) opening out engagement to include others; and (vi) engaging through the use of technology and alternative mediums. The literature obtained provides a small body of evidence regarding approaches to engaging CALD communities, with findings highlighting the importance of processes which are tailored to the CALD community of interest and which take into account different cultural explanatory models of mental ill-health. Review findings are also discussed within the framework of intersectionality, in which broader structural inequalities and power imbalances - in areas such as gender and social class - collectively impact on help-seeking and mental health outcomes. This review supports further enquiry into how such societal issues influence engagement - and disengagement - in mental health services for CALD communities.


The role of health care technology in support of perinatal nurse staffing.
Health care technology can generate massive amounts of data. However, when data are generated from disparate, uncoordinated systems, using them to make decisions related to staffing can be a challenge. In this article, I describe the importance of data standardization, system interoperability, standard terminologies that support nursing practice, and nursing informatics expertise as tools for improving the usefulness of electronic systems for informing staffing decisions.


Emerging Biofabrication Strategies for Engineering Complex Tissue Constructs.
The demand for organ transplantation and repair, coupled with a shortage of available donors, poses an urgent clinical need for the development of innovative treatment strategies for long-term repair and regeneration of injured or diseased tissues and organs. Bioengineering organs, by growing patient-derived cells in biomaterial scaffolds in the presence of pertinent physicochemical signals, provides a promising solution to meet this demand. However, recapitulating the structural and cytoarchitectural complexities of native tissues in vitro remains a significant challenge to be addressed. Through tremendous efforts over the past decade, several innovative biofabrication strategies have been developed to overcome these challenges. This review highlights recent work on emerging three-dimensional bioprinting and textile techniques, compares the advantages and shortcomings of these approaches, outlines the use of common biomaterials and advanced hybrid scaffolds, and describes several design considerations including the structural, physical, biological, and economical parameters that are crucial for the fabrication of functional, complex, engineered tissues. Finally, the applications of these biofabrication strategies in neural, skin, connective, and muscle tissue engineering are explored.


Home antibiotic therapy for brain abscesses.
Patients with brain abscesses now have the option of receiving intravenous antibiotic therapy at home. However, before discharge from the hospital, these patients require significant education in aseptic technique, general catheter care, medication administration, and troubleshooting. Also provided is a review of the pathology, signs, symptoms, diagnosis, and treatment of adult brain abscesses.


Bone histomorphometric reference values in 88 normal Italian subjects.
The study deals with bone histomorphometric results obtained from 88 normal subjects (38 women and 50 men; range: 20-89 years), in order to establish control values in an Italian population. Bone specimens were obtained at autopsy from a standardized area of the iliac crest. The following indicators were measured: bone volume (BV/TV), osteoid volume, osteoid surface, osteoblast surface, eroded surface, osteoclast surface, osteoid thickness. Dependence of histomorphometric indicators on sex and age was evaluated by multiple regression analysis, including sex, age, and also a quadratic term (age2) and two interaction terms (sex x age, sex x age2). BV/TV was mainly affected by age. In fact, a decrease in the amount of bone was found with increasing age in both males and females. The reduction appeared rather regular, with negligible differences between males and females. The other indicators were found to be age- and sex-independent. As a consequence, they did not give information on the possible changes of bone apposition and resorption processes due to aging. On the whole, histomorphometric indicators of trabecular bone of the normal Italian population do not greatly differ from those reported for most other caucasian people.


Successful System, Incomplete Data: Caveats in Reusing Activity Data from Emergency Department Whiteboards.
During the daily treatment of patients large quantities of data are recorded in electronic health records (EHRs). Compared to data in paper records, these EHR data are easily available for reuse in research and quality improvement. However, the opportunities for reuse depend on the quality of the data. In this study we analyze the completeness with which main treatment activities are recorded on emergency department (ED) whiteboards and whether completeness varies with the severity of the patients' condition. Data from 381,231 ED visits show that after the whiteboard had been in successful use for several years the clinicians recorded four of the five main treatment activities with a completeness of less than 50%. Completeness tended to increase with three indicators of the severity of the patient's condition: triage level, length of stay, and patient age. We conclude that the low completeness of the activity data probably prevents most types of reuse.


Moving forward with capecitabine: a glimpse of the future.
Oral capecitabine is a useful chemotherapy for metastatic breast cancer, both as monotherapy and in combination with other cytotoxic drugs. The proven activity of capecitabine has provided the rationale to explore its use earlier in the course of the disease and in combination with other agents, particularly those known to further upregulate thymidine phosphorylase (TP) concentrations in tumor tissue. The efficacy and safety of capecitabine monotherapy compares favorably with cyclophosphamide/methotrexate/5-fluorouracil in chemotherapy-naïve patients and with paclitaxel in anthracycline-pretreated patients. Therefore, for patients whose disease has progressed during or following anthracycline treatment, but for whom capecitabine/docetaxel combination therapy or taxane monotherapy is not appropriate, capecitabine monotherapy is an attractive alternative to established i.v. treatments. In combination, capecitabine plus paclitaxel, which further upregulates TP in tumor tissue, has demonstrated high activity in two phase II studies in advanced/metastatic breast cancer. Similarly, combination with vinorelbine showed promising activity in pretreated metastatic breast cancer patients, and triple combinations with an anthracycline and a taxane or cyclophosphamide have proven to be highly active. In the future, capecitabine may be combined with novel biologic agents, such as trastuzumab and bevacizumab; the former combination has already shown encouraging results in a pilot trial. Confirmatory studies for many of these combinations and phase III trials versus standard therapy are now warranted.


Remobilization of polycyclic aromatic hydrocarbons and organic matter in seawater during sediment resuspension experiments from a polluted coastal environment: Insights from Toulon Bay (France).
Polycyclic aromatic hydrocarbons (PAHs) and organic matter contents were measured in seawater during resuspension experiments using sediments collected from Toulon Bay (Northwestern Mediterranean Sea, France). The studied sediments were very highly contaminated in PAHs, especially in 4-ring compounds emitted from combustion processes. The sediments used for resuspension experiments were collected at 0-2 cm (diagenetically new organic matter, OM) and 30-32 cm depths (diagenetically transformed OM). They were both mostly composed of fine particles (<63 μm), enriched in organic carbon (8.2 and 6.3%, respectively) and in PAHs (concentration of Σ34 PAHs: 38.2 and 35.7 × 103 ng g-1, respectively). The resuspension of these sediments led to an increase in concentrations of dissolved Σ34 PAHs, dissolved organic carbon (DOC) and dissolved humic- and tryptophan-like fluorophores in seawater up to 10-, 1.3-, 4.4- and 5.7-fold, respectively. The remobilization in seawater was higher for 4-6 ring PAHs, especially benzo(g,h,i)perylene, whose concentration exceeded the threshold values of the European Water Framework Directive. This noted the potential harmful effects of sediment resuspension on marine biota. From these sediment resuspension experiments, we determined OC-normalized partition coefficients of PAHs between sediment and water (Koc) and found that during such events, the transfer of PAHs from sediment particles to seawater was lower than that predicted from octanol-water partition coefficients (Kow) (i.e., measured Koc > Koc predicted from Kow). The results confirmed the sequestration role of sedimentary OC quality and grain size on PAHs; the OM diagenetic state seemed to impact the partition process but in a relatively minor way. Furthermore, differences were observed between 2-4 ring and 5-6 ring PAHs, with the latter displaying a relatively higher mobility towards seawater. These differences may be explained by the distribution of these two PAH pools within different OM moieties, such as humic substances and black carbon.


Skin immune systems and inflammation: protector of the skin or promoter of aging?
The immune system may either have a protective role against sunburn and skin cancer or, conversely, promote solar damage. The skin is poised to react to infections and injury, such as sunburn, with rapidly acting mechanisms (innate immunity) that precede the development of acquired immunity and serve as an immediate defense system. Some of these mechanisms, including activation of defensins and complement, modify subsequent acquired immunity. An array of induced immune-regulatory and pro-inflammatory mediators is evident, at the gene expression level, from the microarray analysis of both intrinsically aged and photoaged skin. Thus, inflammatory mechanisms may accentuate the effect of UV radiation to amplify direct damaging effects on molecules and cells, including DNA, proteins, and lipids, which cause immunosuppression, cancer, and photoaging. A greater understanding of the cutaneous immune system's response to photo-skin interactions is essential to comprehensively protect the skin from adverse solar effects. Sunscreen product protection measured only as reduction in redness (current "sun" protection factor) may no longer be sufficient, as it is becoming clear that protection against UV-induced immune changes is of equal if not of greater importance. Greater knowledge of these processes will also enable the development of improved strategies to repair photodamaged skin.


Ultralow fouling and functionalizable surface chemistry based on a zwitterionic polymer enabling sensitive and specific protein detection in undiluted blood plasma.
A crucial step in the development of implanted medical devices, in vivo diagnostics, and microarrays is the effective prevention of nonspecific protein adsorption from real-world complex media such as blood plasma or serum. In this work, a zwitterionic poly(carboxybetaine acrylamide) (polyCBAA) biomimetic material was employed to create a unique biorecognition coating with an ultralow fouling background, enabling the sensitive and specific detection of proteins in blood plasma. Conditions for surface activation, protein immobilization, and surface deactivation of the carboxylate groups in the polyCBAA coating were determined. An antibody-functionalized polyCBAA surface platform was used to detect a target protein in blood plasma using a sensitive surface plasmon resonance (SPR) sensor. A selective protein was directly detected from 100% human blood plasma with extraordinary specificity and sensitivity. The total nonspecific protein adsorption on the functionalized polyCBAA surface was very low (<3 ng/cm (2) for undiluted blood plasma). Because of the significant reduction of nonspecific protein adsorption, it was possible to monitor the kinetics of antigen-antibody interactions in undiluted blood plasma. The functionalization effectiveness and detection characteristics using a cancer protein marker candidate of polyCBAA were compared with those of the conventional nonfouling oligo(ethylene glycol)-based surface chemistry.


Growth inhibition of human pancreatic cancer cell lines by anti-sense oligonucleotides specific to mutated K-ras genes.
About 90% of human pancreatic cancers carry K-ras point mutation, which may play an important role in tumorigenesis. We investigated the inhibitory effects of anti-sense oligonucleotides targeting K-ras point mutation on the growth of cultured human pancreatic cancer cells. Eight human pancreatic cancer cell lines were screened for K-ras codon 12 point mutations by PCR-RFLP analysis and direct sequencing. Then, 3 cell lines with the major types of K-ras point mutation, i.e.,HuP-T1, HuP-T3 and PANC-1, and 1 without mutation, BxPC-3, were used for the experiments. Seventeen mer anti-sense oligonucleotides were designed, targeting the point mutation of K-ras codon 12, and transfected into the cells by the liposome-mediated method. Cell-growth activities were estimated by MTT assay. Levels of K-ras mRNA expression were determined using quantitative RT-PCR, and K-ras p21 protein synthesis was evaluated with Western blotting. Mutation-matched anti-sense oligonucleotides effectively inhibited the growth of these pancreatic cancer cell lines, except for BxPC-3, by suppressing K-ras mRNA expression and K-ras p21 protein synthesis. Moreover, mutation-matched anti-sense oligonucleotides showed stronger anti-proliferative effects than did mutation-mismatched ones. Our results suggest that anti-sense therapy specific to point mutations of K-ras mRNA is a practical approach to selective suppression of tumor growth, with little effect on normal cells.


Does Parent Stress Predict the Quality of Life of Children With a Diagnosis of ADHD? A Comparison of Parent and Child Perspectives.
There are indicators that parental psychological factors may affect how parents evaluate their child's quality of life (QoL) when the child has a health condition. This study examined the impact of parents' perceived stress on parent and child ratings of the QoL of children with ADHD. A cross-sectional sample of 45 matched parent-child dyads completed parallel versions of the KIDSCREEN-27. Children were 8 to 14 years with clinician diagnosed ADHD. Parents who rated their child's QoL lower than their child had higher perceived stress scores. Parent stress was a unique predictor of child QoL from parent proxy-rated but not child-rated QoL scores. Parents' perceived stress may play an important role in their assessments of their child's QoL, suggesting both parent and child perspectives of QoL should be utilized wherever possible. Interventions that target parent stress may contribute to improvements in the child's QoL.


Psychosocial risk factors for the onset of abdominal pain. Results from a large prospective population-based study.
To determine the psychosocial risk factors for the development of abdominal pain and to determine whether, in those people who consulted, symptoms had been attributed to an organic cause. Prospective population-based postal survey with follow-up survey at 12 months. A mixed sociodemographic suburban area of Manchester, UK. Subjects aged 18-65 years were randomly selected from a population-based primary care register who had responded to a detailed pain questionnaire, which included a pain manikin drawing. They also completed the following psychosocial instruments: General Health Questionnaire, Somatic Symptom Checklist, Fatigue Questionnaire and the Illness Attitude Scales (including the 'health anxiety' and 'illness behaviour' sub-scales). The onset of new abdominal pain. Of the 1953 participants at baseline, 1763 were free of abdominal pain: 1551 were followed up at 12 months (adjusted follow-up rate of 92%) of which 69 subjects reported new abdominal pain (new onset rate 4.6%). New abdominal pain was similar in females (4.9%) and males (4.2%), and did not vary by age group. Baseline factors which predicted onset were high levels of fatigue (odds ratio [OR] = 3.3, 95% CI: 1.9-5.8), psychological distress (OR = 3.4, 95% CI: 1.9-6.0), high scores on the illness behaviour scale (OR = 3.3, 95% CI: 1.7-6.7) and high levels of health anxiety (OR = 2.1, 95% CI: 1.1-3.9). Reporting low back pain at baseline was also associated with an increased risk of reporting abdominal pain (OR = 2.0, 95% CI: 1.2-3.3). On multivariate analysis, high levels of psychological distress and aspects of prior illness behaviour were the major independent predictors of outcome. Of those who sought health care, only one consultation led to a definite diagnosis. In subjects free of abdominal pain, psychological distress, fatigue, health anxiety and illness behaviour are predictors of future onset rather than merely a consequence of symptoms. These results suggest that abdominal pain shares some common features of onset with pain at other sites thought not to be primarily organic in origin.