[HIVAb, HCVAb and HBsAg seroprevalence among inmates of the prison of Bologna and the effect of counselling on the compliance of proposed tests].
The aims of the study were to evaluate the HIVAb, HCVAb and HBsAg seroprevalence among Italian and foreign inmates of the prison of Bologna, to evaluate if the extensive counselling of "new" inmates has significantly enhanced adherence to laboratory tests. The serological status was determined by a blood withdraw following the informed consent. Before asking their consent, patients were informed by cultural mediators who had been instructed about the aims of the study/exam during introductory meetings. The initial step managed by mediators was followed by further individual counselling interventions, carried out by hospital infective disease unit, prison and prison drug abuse service physicians. The laboratory tests were performed in an external structure. Prison of Bologna. The study was conducted on 433 subjects among a whole population of 900 inmates in the local prison: 390 subjects were males (90.1%) and 43 were females (9.9%). The median age of the whole population was 34.86 years (+/- 9.9). The studied population counted 147 (33.9%) intravenous drug users (IDU) and 286 not addicts (66.1%). As regards nationality, 212 subjects were Italian (48.9%) and 221 (51.1%) foreigners. Among the total 433 inmates considered, 78 (18%) were known as previous IDU with conviction history or condemned to long term sentences, while 59 (13.6%) were inmates recently convicted active IDU assisted by the internal drug abusers service. The third group was composed by 296 inmates imprisoned during the summer (103 Italians and 193 foreigners) self declared not IDU. A. 12.5% of inmates were HIV positive, 8.1% HBV positive and 31.1% HCV positive. 25 subjects were found positive both to HIV and HCV; 1 both to HIV and HBV and 5 to HIV, HBV and HCV. HIV positivity is more common among Italian vs. foreigners inmates, among IDU vs. not IDU. HCV positivity is more common among Italian vs. foreigners inmates, and among IDU vs. not IDU. The distribution of HBV seropositivity among the different groups shows no statistically significant differences. All subjects receiving multi-focal counselling reached better compliance levels: 10% vs. 1% for HIV, 16% vs. 1% for HBV and 35% vs. 0.3% for HCV, with statistically significant coefficients of contingency. In the prison of Bologna drug addiction is prevalent in italian seropositive personers and it is often associated with HIV and HCV positivity. Foreign inmates, mostly in the not-IDU group, show a lower prevalence of these two infections. Multi-focal counselling before test increased significantly the adherence of inmates to the study.


Special report. HCFA hikes conversion factor to $31.001; adopts 77 other pay policies for RVS era.
This Part B News Special Report summarizes provisions of the final Medicare resource-based relative value fee schedule, slated for publication in the Nov. 25 Federal Register. The fee schedule applies to virtually all 500,000 private practice physicians in the U.S. The Health Care Financing Administration (HCFA) issued the fee schedule after reviewing 95,000 comments on the proposed version (PBN 6/10/91).


[Genetic approaches to molecular mechanisms of programmed cell death in Dictyostelium].
Caspase-independent cell deaths have been observed in many species including the human. However, the molecular mechanisms which govern them are largely unknown. Our present work makes use of a model organism, the protist Dictyostelium discoideum, which displays a caspase-independent cell death during its development. In rich medium, Dictyostelium multiplies vegetatively as a unicellular organism, but in starvation conditions, Dictyostelium cells aggregate, differentiate and morphogenize into a multicellular structure, called sorocarp, containing a mass of spores supported by a stalk. Cells in the stalk are considered dead on the basis of non-regrowth in a rich medium and are vacuolized. This programmed cell death is therefore developmental and vacuolar, and in addition, caspase-independent since the Dictyostelium genome does not contain caspases genes. In order to study in detail this cell death without induction of development, an in vitro experimental protocol has been adopted, which enabled us to describe the cascade of morphological events during this cell death. An insertional mutagenesis approach, followed by appropriate selection or screening of mutants potentially resistant to death, attempted at establishing the cascade of molecular events leading to vacuolar death of Dictyostelium cells. A better understanding of alternative death pathways may allow to control different types of cell deaths in the cases of cancers or neurodegenerative diseases. In this short review, we will discuss briefly some generalities about the development of Dictyostelium in starvation conditions, and we will focus on the course of programmed cell death in Dictyostelium and on the genetic tools used to elucidate the corresponding molecular mechanisms.


Surgical treatment of open diaphyseal fractures of both the radius and ulna.
This study was designed to determine the effects of surgical treatment of acute, open and displaced diaphyseal fractures of both the radius and ulna by early debridement, reduction and internal fixation with a dynamic compression plate (DCP). From 1991 to 2003, data from 25 patients with acute, open and displaced diaphyseal fractures of both the radius and ulna were collected and evaluated retrospectively. Twenty-four patients were managed with early surgical debridement, open reduction and internal fixation with a DCP, and 1 fracture was reduced and fixed 3 days after the initial injury. The mean follow-up period was 74.7 months (standard deviation [SD], 38.6 months; range, 16-150 months). All patients had complete functional and radiographic assessments. Twenty-four patients (96%) achieved normal union in a mean of 20.2 weeks (SD, 3.8 weeks; range, 12-24 weeks). One patient with an open type I fracture had nonunion. Functional outcomes showed that 15 patients had excellent results, 8 had satisfactory results, 1 had an unsatisfactory result, and there was 1 failure. There was 1 delayed superficial wound infection. Early meticulous debridement, good open reduction and internal fixation with a small DCP proved very effective in the management of type I and II open fractures of both the radial and ulnar diaphyses.


Current status of surgery in colorectal metastases to the liver.
The prime role of hepatic resection in the management of colorectal cancer metastatic to the liver is firmly established. The evolution of surgical and anaesthetic techniques has dramatically reduced the morbidity and mortality of elective liver resection in the hands os specialist hepatobiliary surgical teams. At least a third of patients who undergo liver resection for colorectal metastases can expect to survive five years. Although only 10-20% of all patients presenting with colorectal liver metastases are suitable for surgery, novel strategies such as portal vein embolisation and downstaging chemotherapy promise to increase the proportion of eligible patients.


[Curative effect of decitabine combined with cytokine-induced killer cells in two elderly patients with acute myeloid leukemia].
This study was aimed to evaluate the effectiveness and safety of low methylation drug decitabine combined with autologous cytokine induced killer cells (CIK) to treat the elderly patients with acute myeloid leukemia (AML). Two AML patients aged over 80 years old were diagnosed and treated in our department from 2006 to 2012; both company with MDS history, and one case was M4-type, another case was M6-type according to FAB classification. The changes in lymphocyte subsets, hematologic response, transfusion frequency, leukemic gene expression, obtaining CR or PR, quality of life and survival time of the patients with different treatment regimen (decitabine alone; CIK alone; decitabine combined with CIK) were systematically observed. The results showed that therapy of decitabine combined with CIK cells could reduce bone marrow suppression extent, decrease the frequency and volume of blood transfusion, and prolong the duration of partial remission, compared with the single use of CIK cell infusion and single use of decitabine treatment. Meanwhile, the kinds of expressed genes associated with leukemia decreased and the survival time was prolonged obviously. The patients' life quality significantly improved. It is concluded that decitabine combined with CIK for treatment of elderly patients with AML is safe and effective.


Simultaneous determination of opiates, methadone, buprenorphine and metabolites in human urine by superficially porous liquid chromatography tandem mass spectrometry.
For monitoring compliance of methadone or buprenorphine maintenance patient, a method for the simultaneous determination of methadone, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP), buprenorphine, norbuprenorphine, opiates (morphine, codeine, 6-monoacetylmorphine) in urine by superficially porous liquid chromatography tandem mass spectrometry was developed and validated. After enzyme digestion and liquid-liquid extraction, reverse-phase separation was achieved in 5.2 min and quantification was performed by multiple reaction monitoring. Chromatographic separation was performed at 40 °C on a reversed phase Poroshell column with gradient elution. The mobile phase consisted of water and methanol, each containing 0.1% formic acid, at a flow rate of 0.32 mL/min. Intra-day and inter-day precision were less than 12.1% and accuracy was between -9.8% and 13.7%. Extraction efficiencies were more than 68%. Although ion suppression was detected, deuterated internal standards compensated for these effects. Carryover was minimal, less than 0.20%. All analytes were stable at room temperature for 16 h, 4 °C for 72 h, and after three freeze-thaw cycles. The assay also fulfilled compound identification criteria in accordance with the European Commission Decision 2002/657/EC. We analyzed 62 urine samples from patients received maintenance therapy and found that 54.8% of the patient samples tested were detected for morphine, codeine, or 6-monoacetylmorphine. This method provides a reliable and simultaneous quantification of opiates, maintenance drugs, and their metabolites in urine samples. It facilitates the routine monitoring in individuals prescribed the drug to ensure compliance and help therapeutic process.


HERSIM: a microcomputer program designed to compute the limits of conversion for real homogeneous isothermal enzymic reactors.
HERSIM is a program written in BASIC designed to aid the investigator interested in determining the substrate conversion in a real homogeneous isothermal enzymic reactor, for various kinetic equations. The program runs after tracer data relative to a Dirac impulse to the reactor have been entered, and computes the two limits of real conversion: total segregation and maximum mixedness. The kinetic constants of the reacting system are input as data, and the variation of conversion with reactor temperature between given limits is computed as accurately as requested.


Naive T cells: the crux of cellular immune aging?
When encountering foreign antigens, naïve T cells become activated and differentiate into effector and memory T cells. They represent therefore the primary source to mount an immune response against pathogens or tumors. Recent evidence of both quantitative and qualitative alterations of naïve T cells has accumulated in aged mice, indicating that the successful generation of primary T cell responses from the naïve T cell pool may be compromised with old age. However, the vast majority of the data supporting compromised naïve T cell priming efficacy with old age have been produced in animal models, and the situation is much less clear in humans. In the elderly, the involution of the thymus and the associated decline in thymic output result in a decreased number of naïve T cells, which is partially compensated by homeostatic proliferation. Emerging evidence suggest that alterations of the TCR repertoire diversity and intrinsic defects of old CD4(+) naïve T cells may impact on their responsiveness to antigenic stimulation. Increasing focus on the study of naïve T cells (in particular CD8(+)) in old humans are needed to fill the gaps in our understanding of reduced cellular immunity with aging.


The trouble with families: toward an ethic of accommodation.
Although some clinicians are extraordinarily sensitive to the legitimate roles of patients' families in medical crises, a persistent tendency to equate families with trouble is evident in both the literature and the practice of medicine. Some negative presumptions about families derive from western medicine's almost exclusive focus on the individual patient in codes of ethics, training, and practice. Modern bioethics has reinforced this individualistic approach. Physicians' primary responsibilities are unequivocally to their patients, but a complete understanding of the patient's personhood must include consideration of the significant persons who help define the patient's core identity. One source of tension between professionals and families lies in differing perceptions of the roles that family members should play and how they should play them. Members of a family may act as advocates, provide or manage care, serve as trusted companions on the journey through illness and death, and make decisions on behalf of an incompetent patient. Each role presents potential conflicts. Other sources of conflict include disagreement within a family; challenges to physician authority; fear of litigation; and differing religious, ethnic, or cultural traditions. An ethic of accommodation emphasizes the need to negotiate care plans that do not compromise patients' basic interests but that recognize the capacities and limitations of family members. Family caregivers want understandable and timely information, better training, compassionate recognition of their anxiety, guidance in defining their roles and responsibilities, and support for the setting of fair limits on their sacrifices. Health care professionals can better meet these needs through education and skills acquisition, the establishment of partnerships with families, and regular dialogue and communication.


Transmission ellipsometry on transparent unbacked or embedded thin films with application to soap films in air.
The ratio rho(t) = T(p)/T(s) of the complex amplitude transmission coefficients for the p and s polarizations of a transparent unbacked or embedded thin film is examined as a function of the film thickness-to-wavelength ratio d/lambda and the angle of incidence Phi for a given film refractive index N. The maximum value of the differential transmission phase shift (or retardance), Delta(t) = argrho(t), is determined, for given N and Phi, by a simple geometrical construction that involves the iso-Phi circle locus of rho(t) in the complex plane. The upper bound on this maximum equals arctan{[N - (1/N)]/2} and is attained in the limit of grazing incidence. An analytical noniterative method is developed for determining N and d of the film from rho(t) measured by transmission ellipsometry (TELL) at Phi = 45 degrees . An explicit expression for d Delta(t) of an ultrathin film, d/lambda << 1, is derived in product form that shows the dependence of Delta(t) on N, Phi, and d/lambda separately. The angular dependence is given by an obliquity factor, f(0)(Phi) = 2((1/2)) sinPhi tanPhi, which is verified experimentally by TELL measurements on a stable planar soap film in air at lambda = 633 nm. The singularity of f(0) at Phi = 90 degrees is resolved; Delta(t) is shown to have a aximum just short of grazing incidence and drops to 0 at Phi = 90 degrees . Because N and d/lambda are inseparable for an ultrathin film, N is determined by a Brewster angle measurement and d/lambdais subsequently obtained from Delta(t) Finally, the ellipsometric function in reflection rho(r) is related to that in transmission P(t).


Cascaded photo-potential in a carbon dot-hematite system driving overall water splitting under visible light.
Hematite is an earth-abundant and ubiquitous semiconductor with a suitable bandgap of 2.1 eV for solar water splitting. Unfortunately, it suffers from a low conduction band position compared to the H+/H2 potential and typically an external bias has to be applied. Here, we demonstrate carbon dot-hematite (CD-Fe2O3) nanocomposites as photocatalysts for visible-light-driven overall water splitting without any external bias or scavenger. Notably, the CD-Fe2O3 nanocomposites (carbon dots, 5 wt%) show a hydrogen evolution rate of 0.390 μmol h-1 and an oxygen evolution rate of 0.225 μmol h-1 under visible light illumination. In our system, carbon dots have been well coupled with hematite and are detected to generate a photo-induced potential. This photo-potential can be combined with hematite to meet the requirement for overall water splitting. In addition, carbon dots can significantly improve the charge separation efficiency. Our finding may greatly enhance the practical application of hematite for solar water splitting.


[Learning healthy living--health management in schools. Health promotion in schools with particular consideration of socially disadvantaged students].
"Learning to Live Healthy" is a cooperation project between the Central Association of Health Insurers and the Health Associations of Lower Saxony, Saxony-Anhalt and Rhineland-Palatinate. Our goal is to develop a healthy environment for all teachers and students in the "School Organization". Our focus lies -- more strongly than with earlier projects for school health promotion -- in the improvement of the health of teachers and non-teaching personnel. Not until their resources are strengthened and overwork/overload broken down, can resources be directed to health promotion for and with students, and health risks connected with social inequalities can be diminished. The project operates with the setting approach, and uses the principles of Workplace Health Management- Integration, Participation and Project Management. The project utilizes the instruments of project organization to jump-start the process of change in the School Organization, systematically, through goal-oriented action and sustainable development, thus improving the quality of education.


Calcium and mitosis.
Calcium signals often accompany mitosis. The most obvious example of calcium as a mitotic signal is at fertilization in vertebrate eggs, where the calcium transient induces anaphase onset. New imaging methods have demonstrated smaller calcium signals that control mitosis entry and mitosis exit in sea urchin embryos. Other experiments in mouse and frog embryos indicate that similar signals with similar function may play a part in these embryos, too. The links between these calcium control signals and mitotic kinase activation are adumbrated. It appears that calcium oscillations are a property of the mitotic state. A case is made that calcium may be a universal mitotic signal, with the possible exception of early meiotic events in oocytes.


[Supply and demand in the meetings between mental health professionals and family members of people with mental disorders].
This paper is a development of a doctoral thesis presented at the Federal University of Espírito Santo. It seeks to analyze the elucidation of needs, development of supply and demand in the provision of care and the relationship between mental health professionals and family members of people with mental disorders. A qualitative research approach was used as the method of choice to achieve the proposed objectives. Semi-structured interviews were conducted with mental health professionals from two psychosocial care centers (CAPS) in the city of Vitória, Espírito Santo, and with family members of frequenters of these institutions. After thematic analysis of content, senses, meanings and values assigned to the needs, supplies and demands present in this relationship were revealed. It highlighted the disparity between supply and demand and the lack of awareness of the needs of family members and their demands related to the routines of mental institutions. Using ethics in the philosophy of Spinoza as a benchmark, the ramifications of this process are discussed in the meetings between mental health professionals and family members of people with mental disorders and the micropolitics of the provision of care in the context of these actors.


Bilateral pseudoangiomatous stromal hyperplasia in a human immunodeficiency viral-infected patient.
Pseudoangiomatous stromal hyperplasia (PASH) is an uncommon mesenchymal neoplasm of the breast demonstrating stromal myofibroblastic proliferation and having the appearance of anastomosing slit-like pseudovascular spaces lined by spindle-shaped cells. A case of nodular PASH of the bilateral breasts in a 40-year-old woman with clinically presenting with a progressive enlarged breast lump is reported. Mammographic and ultrasonographic features of the right and left breasts showed a large solid lump with well-circumscribed border measuring 4 cm × 1.7 cm × 3.4 cm and 13.8 cm × 10.9 cm × 12.1 cm, respectively. Wide excision of the right breast and quadrantectomy of the left breast were performed. The histopathological examination of the lesion showed anastomosing slit-like pseudovascular spaces. The stromal cells were immunoreactive for muscle actin (HHF35), smooth muscle actin, and progesterone receptor. Clinical and pathological findings with briefly reviewed relevant literatures are discussed. This is the first clinicopathological and radiological report of bilateral mammary nodular PASH in a human immunodeficiency viral-infected patient.


Effect of cold storage and packaging material on the major aroma components of sweet cream butter.
The major aroma compounds of commercial sweet cream AA butter quarters were analyzed by GC-olfactometry and GC-MS combined with dynamic headspace analysis (DHA) and solvent-assisted flavor evaporation (SAFE). In addition, the effect of long-term storage (0, 6, and 12 months) and type of wrapping material (wax parchment paper vs foil) on the aroma components and sensory properties of these butters kept under refrigerated (4 degrees C) and frozen (-20 degrees C) storage was evaluated. The most intense compounds in the aroma of pasteurized AA butter were butanoic acid, delta-octalactone, delta-decalactone, 1-octen-3-one, 2-acetyl-1-pyrroline, dimethyl trisulfide, and diacetyl. The intensities of lipid oxidation volatiles and methyl ketones increased as a function of storage time. Refrigerated storage caused greater flavor deterioration compared with frozen storage. The intensity and relative abundance of styrene increased as a function of time of storage at refrigeration temperature. Butter kept frozen for 12 months exhibited lower styrene levels and a flavor profile more similar to that of fresh butter compared to butter refrigerated for 12 months. Foil wrapping material performed better than wax parchment paper in preventing styrene migration into butter and in minimizing the formation of lipid oxidation and hydroxyl acid products that contribute to the loss of fresh butter flavor.


[Modifying smoking habits at school--experiences in a town of the GDR (author's transl)].
The number of juvenile smokers in the age-group of 12-16 years is increasing. Sequels of nicotine abuse--as bronchial carcinoma, chronic bronchitis and cardiovascular diseases-are more frequent in persons who begin smoking in the younger age-group. It is our obligation to influence youth in such a way that young people do not begin to smoke at all, or as less as possible. For that reason in 1974 the Chest Clinic of Schwedt began with taking intensive influence to school children for stopping smoking or not beginning smoking. Smoking habits in the youth cannot be changed only by engagement and the possibilities of the physicians. One antismoking campaign confined in time will not result in lasting success. A deep change in the smoking habits of the youth can be achieved only by a continuous, systematic and substantial cooperation between the medical staff, the educational system and the parents. We are reporting about our approach and the experiences collected in this aimed work.


Combination of off-line two-dimensional hydrophilic interaction liquid chromatography for polar fraction and two-dimensional hydrophilic interaction liquid chromatography×reversed-phase liquid chromatography for medium-polar fraction in a traditional Chinese medicine.
Two-dimensional liquid chromatography (2-D LC) has been widely used for the analysis of complex samples owing to its great improvement in separation selectivity and peak capacity. However, one 2-D LC system may not be enough to meet the separation requirements due to the complexity of certain samples and respective limitations of two separation modes. In this work, water extract of Scutellaria barbata D. Don, a traditional Chinese medicine, was fractionated into polar fraction and medium-polar fraction by means of solid phase extraction (SPE). The fraction preparation made it easy to select the corresponding combination of 2-D LC method from hydrophilic interaction chromatography (HILIC) and reversed-phase liquid chromatography (RP-LC). An off-line 2-D HILIC×HILIC to analyze the polar fraction and an off-line 2-D HILIC×RP-LC to analyze the medium-polar fraction were developed, respectively. In total, 749 peaks were detected: 206 peaks from the polar fraction by the 2-D HILIC×HILIC and 543 from the medium-polar fraction by the 2-D HILIC×RP-LC. The practical peak capacities obtained in both systems were 2698 and 2879, and the orthogonality reached 63.18% and 90.62%, respectively. The results demonstrated that the two systems were both highly orthogonal, and the peak capacities greatly increased.


Benefits of a nurse-managed wellness program. A senior center model. Using community-based sites for older adult intervention and self-care activities may promote an ability to maintain an independent lifestyle.
Recent health initiatives have encouraged the promotion of wellness and self-care among the elderly population. This research describes the effectiveness of a nurse-managed wellness program located at a multi-purpose senior center. The wellness clinic was created to provide a broad range of screening services, individual counseling services, health educational programs, and management services for chronic diseases common among older adults. Outcome measures focusing for utilization of health services, healthy behaviors, emotional well-being, and mental and physical health variables gathered from 111 older adults demonstrated significant program success. Respondents who used the wellness clinic more frequently, and in particular, those who consulted regularly with the clinical nurse, were more likely to increase their healthy behavior and subsequent health knowledge. As a result of participation in the wellness programs, respondents reported a greater psychological comfort and a more confident feeling concerning the ability to maintain an independent lifestyle.


Expression pattern of synaptic vesicle protein 2 (SV2) isoforms in patients with temporal lobe epilepsy and hippocampal sclerosis.
Synaptic vesicle proteins 2 (SV2) are neuronal vesicles membrane glycoproteins that appear as important targets in the treatment of partial and generalized epilepsies. Therefore, we analysed the expression of SV2 isoforms in the hippocampus of patients with temporal lobe epilepsy (TLE). SV2A, SV2B and SV2C immunostaining and QuantiGene branched DNA assay were performed on biopsies from 31 consecutive TLE patients with mesial temporal sclerosis (MTS) and compared with 10 autopsy controls. SV2 expression was further compared with Timm's staining, and synaptophysin, Zinc transporter 3 (ZnT3), dynorphin, vesicular glutamate transporter 1 (VGLUT1) and vesicular GABA transporter (VGAT) expression. In TLE patients, SV2A and SV2B expression was decreased in areas of synaptic loss. SV2C, which is weakly expressed or absent in the hippocampus of controls, was overexpressed in 10/11 cases with classical MTS1A and mossy fibre sprouting but not in cases with other types of MTS. SV2C staining was located in the inner molecular layer of the dentate gyrus and colocalized with dynorphin, ZnT3 and VGLUT1, suggesting selective expression in presynaptic glutamatergic Zn(2+) -rich terminals of abnormal sprouting fibres. SV2 expression patterns correlated with histological subtypes of MTS, but not with clinical features or therapeutic regimens in this patient cohort. In classical MTS1A, the expression of SV2 isoforms is altered with a marked decrease of SV2A and SV2B paralleling synaptic loss and a selective increase of SV2C in sprouting mossy fibres. These findings suggest a different physiology of sprouting synapses and the possibility to target them with SV2C-specific strategies.


Influence of preischemic short-term triiodothyronine administration on hemodynamic function and metabolism of reperfused isolated rat heart.
The "euthyroid sick syndrome" may intensify dysfunction of the heart during acute myocardial ischemia. The present research was undertaken to outline the effects of preischemic short-term triiodothyronine (T3) administration on hemodynamic function and metabolism of the myocardium during reperfusion. Thirty-six isolated working rat hearts were assigned to three experimental groups and a control group. The hearts were removed from the animals and perfused in the modified Langendorff model. They were subjected to 30 minutes of initial perfusion, 40 minutes of ischemia, and 15 minutes of reperfusion. The experimental groups received 10 extra minutes of T3 administration followed by initial perfusion (concentration of T3 was: group 1-5.4 pmol/l, group 2-27 pmol/l, and group 3-54 pmol/l). Control hearts received perfusate without T3. We evaluated the postischemic recovery of left ventricular function (aortic pressures, heart rate, cardiac output), coronary flow, and oxygen consumption. Progressive percentage of recovery of aortic systolic pressure, aortic mean pressure, and cardiac output with increasing concentration of T3 was observed. Cardiac output reached the best recovery in the group with the highest concentration of T3 (80.9+/-7.5%) and was significantly better in comparison with the control group and the other experimental groups. No significant differences in coronary flow and oxygen consumption were noted. Triiodothyronine administered before ischemia improves postischemic left ventricular function with no changes in oxygen consumption and coronary flow.


[Characteristics of liver circulation and the outflow of bile and lymph in acute carbon tetrachloride poisoning].
In acute tests set up on 13 dogs the pressure and blood flow in the portal vein and hepatic artery, the pressure in the inferior vena cava along with lymph- and bile currents were registered following intraportal introduction of CCI4. Subject to determination were also the resistance of venous and arterial hepatic vessels and of the splachnic zone, as well as the summary blood flow. The rising pressure and diminished blood flow in the portal vein were found to be the result of the growing resistance of venous vessels in the liver. Falling pressure and reduced blood flow in the hepatic artery bore witness to the general toxic effect of CCl4 on the animal organism. Increased portal pressure and disturbed permeability of biological membranes was attended by a greater lymph outflow. The inhibition of bile secretion came as a result of hypoxic and toxic damage of the liver.


Angiogenesis and platelet-derived endothelial cell growth factor/thymidine phosphorylase expression in endometrial cancer.
The object of this study was to clarify the association of angiogenic factor, platelet-derived endothelial cell growth factor (PD-ECGF)/thymidine phosphorylase (dThdPase) with clinicopathological factors including tumor angiogenesis and patient outcome in endometrial cancer. There was no correlation between the expression of PD-ECGF in cancer cells and any of the clinicopathological variables. Immunopositivity for PD-ECGF in stroma cells was significantly higher in poorly differentiated adenocarcinomas. The microvessel counts correlated with PD-ECGF positive stroma cells (p<0.0001). Disease-free survival was significantly worse in patients with marked PD-ECGF expression in stromal cells and high microvessel count. A multivariate analysis using Cox's proportional hazard model showed that high microvessel counts independently predicted disease-free survival as well as stage and myometrial invasion. The expression of PD-ECGF in stroma cells may play a crucial role in the promotion of angiogenesis. Tumor angiogenesis can be used to predict prognosis in patients with endometrial cancer.


Fatty acids: a role for Africa?
Health effects of fatty acids have been very controversial. Total mortality is inversely associated with the amount of total fat consumed. In contrast, trans fatty acids or SFA intake is positively related to mortality while the inverse is observed with consumption of MUFA or PUFA. Among PUFA, long-chain (LC) n-3 PUFA have many beneficial effects. Dietary intake of some types of fatty acids is specific to Africa. Energy from saturated fat does not exceed 14% and energy from n-6 PUFA does not exceed 8% of total energy intake. Dietary intake of LC n-3 PUFA is less than 100 mg/d whereas international recommendations promote 250-500 mg/d. Consumption of plant n-3 PUFA mainly α-linolenic acid (ALA) is highly variable depending on the country. Both fish and ALA availability are low in several African countries. The prevalence of diabetes and cardiovascular events remain very low in Africa, partly explained by the fact that the whole dietary pattern is globally the best of all continents. One objective of 'fat for Africa' could be to increase, as much as possible, the dietary intake of LC n-3 PUFA by promoting sustainable aquaculture and to maintain as much as possible traditional dietary pattern by preventing a tendency to westernisation, provided that the amount of energy and protein is sufficient to fight against wasting and stunting where it still exists.


Genomic organization of the mouse Tla locus: study of an endogenous retroviruslike locus reveals polymorphisms related to different Tla haplotypes.
A retrovirus element (TLev1) is located within the Thymus leukemia antigen (Tla) locus of the C57BL/10 mouse major histocompatibility complex. Low-copy probes have been isolated from sequences flanking the TLev1 integration site to examine the distribution of TLev1 among inbred mouse strains having genotypically determined variations in TL-antigen expression. It was found that the low-copy probes cross-hybridize to regions within the Tla locus in a genotype-specific manner. Although a strong association was found between TL mouse strains and TLev1, the presence or absence of the TLev1 locus did not exclusively correlate with expression or nonexpression of TL antigens. Analysis of different Mus subspecies indicates that TLev1 integrated into a common ancestor of the species Mus musculus. It is suggested that the loss of the TLev1 locus from certain mouse genomes reflects evolutionary rearrangements in the TL region; the resulting diversity may relate to the differential expression of TL antigens among mouse strains. The probes described here provide a useful tool for examining the genomic expansions and contractions which have occurred during the evolution of the Tla locus.


Transversely isotropic material characterization of the human anterior longitudinal ligament.
The present work represents the first study to report transversely isotropic material parameters for the human anterior longitudinal ligament (ALL) in the thoraco-lumbar spine. Force-deformation data from multi-axial testing was collected from 30 cadaveric spine test specimens using an anisotropic quarter punch test technique. The experimental data was fit to a commonly used anisotropic soft tissue material model using an FEA system identification technique. The material model correlated well with the experimental response (R(2)≥0.98). The constitutive parameter values, as well as the nonlinear anisotropic stress-strain response of the ALL specimens are reported to facilitate application to biomechanical models (including finite element models) of the spine.


Adverse effects of bisphenol A on water louse (Asellus aquaticus).
Experiments were performed to study the effects of short and long-term exposure to bisphenol A (BPA) on a freshwater crustacean isopod Asellus aquaticus (L.). Two life stages of isopods were exposed to a range of BPA concentrations, from aqueous and two dietary sources, in the form of with BPA spiked conditioned alder leaf (Alnus glutinosa) discs, or spiked formulated sediment, to determine the relative importance of each source of exposure on the uptake of this contaminant. Several lethal and sublethal endpoints were evaluated in this study to measure the potential effects of BPA on A. aquaticus, including mortality, growth and feeding rate inhibition, mobility inhibition, de-pigmentation and molting disturbances. They signify a correlation to BPA levels and a difference in BPA uptake efficiency from different uptake sources. Results of acute exposure to BPA show a greater sensitivity of test systems using juvenile specimens with a 96 h LC₅₀ of 8.6 mg L(-1) BPA in water medium and a 96 h LC₅₀ of 13.5 mg L(-1) BPA in sediment. In comparison, adult isopods show a 96 h LC₅₀ of 25.1 mg L(-1) BPA in water medium and a 96 h LC₅₀ of 65.1 mg L(-1) BPA in sediment. Observed endpoints of chronic exposures suggest the alder leave discs to be the most efficient uptake source of BPA, in contrast to uptake from water or heterogeneous sediment. Significant (p<0.05) growth inhibition, with a 21d NOEC of 0.5/2.5 mg L(-1) (for juvenile/adult organisms), and feeding rate inhibition, with a 21d NOEC of 0.5/1.0 mg L(-1) (for juvenile/adult organisms), were proven to be the most sensitive toxicity endpoints. An even more sensitive effect turned out to be molting frequency, which was significantly reduced; a 21d NOEC was 1.0 mg L(-1) of BPA for adult organisms and an even lower 21d NOEC of 0.05 mg L(-1) of BPA for juveniles. The observed endpoints are recorded at very low, non-toxic exposure concentrations, indicating that BPA acts as an endocrine disrupting compound, as well as a toxic substance. We also determined the importance of the direct dietary uptake of the pollutants, significant for juveniles as well as adult animals.


Role Stress, Job Anxiety, Job Involvement, and Job Satisfaction Among Three Groups of Organizational Employees: A Factor Analytic Study.
This study is an attempt to compare organizational role stress, job involvement, job anxiety, and job satisfaction among three groups of employees in a private sector organization. The sample consisted of 50 top managers, 50 middle managers, and 50 workers. The Organizational Role Stress developed by Pareek (1983), the Job Involvement scale by Lodhal and Kejner (1965), the Job Anxiety scale by Srivastava and Sinha (1977), and the Job Descriptive Index developed by Smith, Yulin, and Kendall (1969) were administered to all three groups of employees. The results were analyzed both by the factor analytic technique and by discriminant function analysis. The factor analysis yielded three important factors that are discussed. The discriminant function analysis separated the three groups on 10 out of the 23 variables considered in the study. The findings are discussed in the light of other relevant studies.


Lipid peroxidative damage on malathion exposure in rats.
Lipid peroxidation is one of the major outcomes of free radical-mediated injury to tissue in vivo, including the central nervous system (CNS). The aim of this study was to examine whether malathion, a commonly used organophosphorus (OP), might induce oxidative stress in cerebrospinal fluid, blood serum and brain structures in male Wistar rats. Malathion was administered intraperitoneally in the doses of 25, 50, 100 and 150 mg/kg for 28 days. Oxidative damage was determined by measuring the thiobarbituric acid reactive species (TBARS) content, as an index of lipid peroxidation. TBARS concentration in the cerebrospinal fluid (CSF) and brain structures were increased, but a decrease in TBARS concentration in serum was observed. The results of the present study suggest the usefulness of TBARS measurement as a good biomarker in the estimation of malathion-induced oxidative stress affecting CSF and brain structures.


Prevalence and correlates of lifetime smokeless tobacco use in female military recruits.
Although considerable research has been conducted on smokeless tobacco (ST) use in males, much less is known about the characteristics of female ST users. The present study examined the prevalence and correlates of lifetime ST use among female Air Force recruits (N=9,087). Participants were surveyed during Basic Military Training regarding their history of tobacco use and other health risk behaviors. Although the prevalence of current ST use was low (<1%; n=34), 6.6% (n=599) had tried ST. Multivariate logistic regression analysis indicated that lifetime ST use was related to ethnicity, with Native Americans and Whites being most likely to have tried ST. Additional correlates of lifetime ST use included post-high-school education (OR=1.26, 95% CI=1.03-1.55); weekly acts of road rage (OR=1.48, 95% CI=1.06-2.06); frequent arguing (OR=1.71, 95% CI=1.18-2.48); daily or near-daily alcohol consumption (OR=1.71, 95% CI=1.03-2.82); current cigarette use (OR=3.80, 95% CI=2.42-5.94); and experimental use of cigars (OR=4.01, 95% CI=3.22-5.01), pipes (OR=2.23, 95% CI=1.64-3.03), and clove cigarettes (OR=1.23, 95% CI=1.01-1.49), all of which were associated with an increased likelihood of ST use. Results suggest that female recruits who have ever used ST engage in a variety of risk behaviors including use of other tobacco products and alcohol, as well as additional harmful behaviors.


Sleep and Metabolism: Eaat-ing Your Way to ZZZs.
A new study in fruit flies identifies a molecule, Eaat2, that regulates both sleep and metabolic rate. Surprisingly, Eaat2 acts in a specific glial subtype to modulate both processes, suggesting a cellular link in the brain between sleep and metabolism.


Diagnosis and treatment of recurrent laryngeal cancer following initial nonsurgical therapy.
Surgery is the preferred modality for curative treatment of recurrent laryngeal cancer after failure of nonsurgical treatments. Patients with initial early-stage cancer experiencing recurrence following radiotherapy often have more advanced-stage tumors by the time the recurrence is recognized. About one third of such recurrent cancers are suitable for conservation surgery. Endoscopic resection with the CO(2) laser or open partial laryngectomy (partial vertical, supracricoid, or supraglottic laryngectomies) have been used. The outcomes of conservation surgery appear better than those after total laryngectomy, because of selection bias. Transoral laser surgery is currently used more frequently than open partial laryngectomy for treatment of early-stage recurrence, with outcomes equivalent to open surgery but with less associated morbidity. Laser surgery has also been employed for selective cases of advanced recurrent disease, but patient selection and expertise are required for application of this modality to rT3 tumors. In general, conservation laryngeal surgery is a safe and effective treatment for localized recurrences after radiotherapy for early-stage glottic cancer. Recurrent advanced-stage cancers should generally be treated by total laryngectomy.


Differential expression of HER2 and downstream proteins in prediction of advanced tumor phenotypes and overall survival of patients with Epstein-Barr virus-positive vs. negative gastric cancers.
This study evaluated the associations of HER2 protein, HER2 gene amplification, and positivity for p-AKT, p-ERK, and p-PLCγ proteins with clinicopathological status and overall survival (OS) of patients who had Epstein-Barr virus-associated gastric cancer (EBVaGC; n = 58) or EBV-negative GC (EBVnGC; n = 329). Tissue samples were subjected to immunohistochemistry and fluorescence in situ hybridization (FISH). Results showed that EBVaGC less expressed HER2 and amplified HER2 gene. p-AKT (p = 0.035) and p-ERK (p = 0.001) were inhibited in EBVaGC than in EBVnGC, while p-PLCγ (p = 0.034) was upregulated. Among EBVaGC patients, p-ERK positivity was associated with Lauren classification (p = 0.023), and p-PLCγ positivity was inversely associated with TNM stage (p = 0.041) and lymph node metastasis (p = 0.041). In contrast, among EBVnGC patients, HER2 expression was associated with distant metastasis (p = 0.043) and p-AKT positivity was associated with intestinal subtype (p < 0.004), lymph node metastasis (p = 0.031), distant metastasis (p < 0.001), and elder age (>60y, p < 0.004). Overall analysis showed that EBVaGC patients presented better OS than EBVnGC patients (p = 0.044). Among EBVaGC patients, p-AKT positivity (p = 0.008) was associated with worse OS; as well as, HER2 high expression (p < 0.001), p-AKT positivity (p = 0.010), and p-PLCγ (p < 0.001) were associated with worse OS in EBVnGC patients. Multivariate analysis showed that distant metastasis (95% CI: 1.559 to 4.028, p < 0.001), HER2 high expression (95% CI: 1.058 to 2.454, p = 0.026), and p-PLCγ positivity (95% CI: 1.056 to 2.435, p = 0.027) were independent prognostic predictors of OS in EBVnGC patients. Our results indicated that p-AKT positive patients presented worse OS than p-AKT negative ones in EBVaGC, as well as, HER2, p-AKT, and p-PLCγ are prognostic biomarkers for OS in EBVnGC patients.


Development of a mental health smartphone app: perspectives of mental health service users.
Current mental health policy emphasises the importance of service user involvement in the delivery of care. Information Technology can have an effect on quality and efficiency of care. The aim of this study is to gain the viewpoint of service users from a local mental health service in developing a mental health app. A qualitative descriptive approach was used. Eight volunteers aged 18-49 years were interviewed with the aid of a semi-structured questionnaire. Interviewees defined a good app by its ease of use. Common themes included availability of contact information, identifying triggers, the ability to rate mood/anxiety levels on a scale, guided relaxation techniques, and the option to personalise the app. The researchers will aim to produce an app that is easily accessible, highly personalisable and will include functions highlighted as important (i.e. contact information, etc.). This research will assist in the development of an easy-to-use app that could increase access to services, and allow service users to take an active role in their care. In previous studies, apps were developed without the involvement of service users. This study recognises the important role of service users in this area.


Relation between coupled map lattices and kinetic ising models
A spatially one-dimensional coupled map lattice possessing the same symmetries as the Miller-Huse model is introduced. Our model is studied analytically by means of a formal perturbation expansion which uses weak coupling and the vicinity to a symmetry breaking bifurcation point. In parameter space four phases with different ergodic behavior are observed. Although the coupling in the map lattice is diffusive, antiferromagnetic ordering is predominant. Via coarse graining the deterministic model is mapped to a master equation which establishes an equivalence between our system and a kinetic Ising model. Such an approach sheds some light on the dependence of the transient behavior on the system size and the nature of the phase transitions.


Invasive and metastatic potential of a v-Ha-ras-transformed human bronchial epithelial cell line.
The in vivo growth behavior and invasive potential of normal and "immortalized" human bronchial epithelial cells were studied by xenotransplantation procedures, an in vitro assay of invasiveness, and determinations of type IV collagenase activity and mRNA expression. BEAS-2B cells, immortalized after hybrid virus infection (adenovirus 12-simian virus 40), reconstituted a columnar epithelium when xenotransplanted into de-epithelialized rat tracheas transplanted sc into athymic BALB/c mice. A few adenomatous growths could be seen 16 weeks after transplantation. BZR cells, obtained by transfer of the v-Ha-ras oncogene into BEAS-2B cells, were tumorigenic in this xenotransplantation model. BZR-T33 cells, obtained from a tumor produced after injection of BZR cells, were also tumorigenic; however, they exhibited a shorter latent period. When these same cell lines were injected sc and iv into athymic BALB/c mice, BEAS-2B cells were not tumorigenic, and the BZR-T33 cells were more tumorigenic than the BZR cells. The incidence of spontaneous metastases after sc inoculation was zero for BEAS-2B cells, 33% for BZR cells, and 100% for BZR-T33 cells. Similar increasing values that correlated well with the data on in vivo growth were noted in the in vitro invasion assay, the collagenolytic ability, and the mRNA expression of type IV collagenase. Normal human bronchial epithelial cells showed the lowest values in all the assays. These progressive changes occurring in cells derived from the same parental line indicate that the presence of the v-Ha-ras oncogene in immortalized bronchial cells is associated with a full-fledged malignant phenotype, which is further enhanced by in vivo passaging.


Cardiovascular and renal action of platelet-activating factor in anesthetized dogs.
Platelet-activating factor (PAF) has hypotensive effects similar to those of antihypertensive polar renomedullary lipid (APRL), a potent endogenous hypotensive lipid. In this study the cardiovascular and renal effects of PAF were characterized in anesthetized dogs. Intravenous infusion of PAF at 0.1 micrograms/kg/min for 1 hour caused marked reduction in arterial blood pressure and cardiac output and was accompanied by minimal changes in heart rate. Concomitantly, renal blood flow, glomerular filtration rate, urine flow, and fractional excretion of Na+ and K+ fell significantly. Plasma renin activity was greatly stimulated (11.9 +/- 1.66 vs 3.26 +/- 0.45 ng/angiotensin I/ml/hr for the placebo group). There were no significant alterations in any of these parameters following PAF at a lower dose (0.03 micrograms/kg/min for 1 hour). In a separate study, PAF at 0.1 micrograms/kg/min for 20 minutes produced a decrease in left ventricular myocardial contractile force, concomitant with bradycardia and hypotension, which indicated the presence of a negative inotropic activity. It is concluded that systemic administration of PAF has a deleterious effect on kidney function due to arterial hypotension and diminished cardiac output.


[An analysis of the myocardial contractile function of the left ventricle in patients with ischemic heart disease and isolated involvement of the anterior descending artery based on data from x-ray contrast ventriculography].
Coronaroventriculography was performed in 36 patients with an isolated injury to the anterior, descending artery (ADA) and in 32 patients with concomitant injury to the ADA and the right coronary artery (RCA) or to the circumflex artery. Associated injury to the ADA and RCA resulted in greater disorders of left ventricular function than an isolated injury to the ADA. Dysfunction of the left ventricle was less pronounced in patients with an isolated injury to the ADA in the presence of postinfarction angina pectoris whereas in ADA occlusion, in proper collateral filling of the vessel.


Natural course of postsurgical adhesions.
To evaluate the natural course of postsurgical adhesion formation, a descriptive animal study was performed in a standardized rat adhesion model, involving the uterine horn and peritoneal side wall. Extent and type of postsurgical adhesion formation was evaluated at increasing postoperative time intervals up to 1 year, both through inter- and intra-animal observations (laparotomy and repeated-laparotomy group). The extent of the adhesions was found to be similar while the type of the adhesions changed markedly, especially during the early observation periods. From day 1 until 1 month post- operatively, the adhesions became increasingly more organized and vascular and were separable with sharp dissection only. From the present study it was concluded that spontaneous lysis of postsurgical adhesions, once they are established, does not seem to occur. The most optimum time for surgical intervention when scheduled to lyse newly formed adhesions will be between 8 days and 1 month after the initial procedure.


The non-refluxing gastrostomy: an evaluation.
A gastrostomy is often essential to deliver adequate and safe nutrition. Various types are now available such that the technique can be tailored to the specific needs of the patient. This paper explores the non-refluxing gastrostomy for long-term intermittent gastrostomy feeding, avoiding the need for a permanent indwelling appliance. A full-thickness vascularized flap based on the right gastroepiploic vessels is raised from the greater curve of the stomach. The proximal half of the tubularized flap is buried in a submucosal tunnel and the free distal end is brought to the skin surface as a catheterizable stoma. Fifteen children with varied mental and physical disabilities formed the cohort of the study. There were 3 stomal stenoses and 3 mild mucosal eversions requiring minor surgical adjustments. One child had a wound dehiscence 10 days postoperatively. Once the stoma had healed, the majority fed by intermittent catheterization and bolus feeds at conventional feed times during the day. Intermittent catheterization was painless and easy and was well accepted by caregivers and patients. Perhaps the most important advantages were the increased patient and caregiver confidence and independence, as well as the reduction in anxiety and hospital attendance.


Assessing Mn, Fe, Cu, Zn, and Cd pollution in bottom sediments of Wadi Al-Arab Dam, Jordan.
Thirty five bottom sediment samples were collected in a grid pattern from Wadi Al-Arab Dam. The present study focuses on the levels of Mn, Fe, Cu, Zn, Cd, total organic matter (TOM) and carbonate content (CO(3)(-2)) in order to assess the extent of environmental pollution and to discuss the origin of these contaminants in sediments of the dam. Concentration data were processed using correlation analysis and factor analysis. The results of correlation analysis and factor analysis show low positive and negative correlations among Mn, Fe, Cu, Zn, Cd, TOM, and CO(3)(-2) and indicate that heavy metals in sediments of Wadi Al-Arab have different anthropogenic and natural sources. The results also confirm the complicated behavior of these pollutants, that can be influenced by many factors. Sediments pollution assessment was carried out using enrichment factor and the geoaccumulation index. The calculation of enrichment factors showed that Mn and Cu are depleted by 0.76, and 1.33, respectively, whereas Cu, Zn, and Cd are enriched by 3.6, and 30, respectively. The results of geoaccumulation index reveal that sediments of Wadi Al-Arab are uncontaminated with Mn, Fe, and Cu, moderately contaminated with Zn, and strongly to extremely contaminated with Cd. Some of the elevated concentration of Zn and Cd are probably due to anthropogenic sources nearby the dam site. These sources mainly include fertilizers and pesticides used in agricultural activities, and the effluent of Irbid City treatment plant. Environmental risks of Cd and Zn were evaluated using the risk assessment code (RAC) and sequential extraction method. Zn poses a low environmental risk, whereas Cd poses a medium environmental risk.


Reform. A change is coming.
The attitude of managers to change, and the way they support staff, is crucial to effective NHS reform. Effective communication and taking staff opinions into account is also key. Concerns over the fitness for purpose programme, and the drive to encourage PCTs to commission from private providers, have added to fears about change management.


Management of nonalcoholic fatty liver disease: a 60-year-old man with probable nonalcoholic fatty liver disease: weight reduction, liver biopsy, or both?
Nonalcoholic fatty liver disease (NAFLD) is one of the most common hepatic disorders in the United States, but uncertainty remains as to the optimal way to manage it. Using the case of Mr T, a 60-year-old man with obesity, diabetes mellitus, and increased serum transaminase levels, an evidence-based approach to diagnosis and treatment is discussed. Diagnosis of NAFLD is based on patient clinical profile and risk factors for metabolic syndrome, the exclusion of other liver diseases, radiologic imaging and sometimes biopsy. At this point in Mr T's disease, the most important step is differentiation between simple steatosis and nonalcoholic steatohepatitis (NASH). Simple steatosis has a benign natural history, but NASH is progressive and may lead to cirrhosis, liver failure, and liver cancer. An evidence-based approach to treatment is limited by lack of large randomized trials, particularly of combinations of therapies, but weight loss, exercise, and medical therapies targeted at the mechanism of liver injury in NASH are recommended. Improved noninvasive diagnostic tests, a clearer understanding of the natural history of NAFLD, and large, well-designed clinical trials are needed.


Electrophysiologic effects of a new antiarrhythmic agent, recainam, on isolated canine and rabbit myocardial fibers.
Recainam (Wy 42,362) is a new antiarrhythmic agent undergoing clinical evaluation, but its electrophysiologic effects in cardiac muscle are poorly defined. With microelectrode techniques, its profile in isolated preparations of dog and rabbit hearts was determined using drug concentrations of 10 to 300 microM. Recainam induced a concentration- and frequency-dependent decrease in the maximal rate of rise of the phase 0 of the action potential (Vmax), action potential amplitude and overshoot potential, with little or no change in the effective refractory period except in Purkinje fibers, in which it was markedly reduced. At a 300 microM concentration, Vmax was reduced 51% (p less than 0.001) in ventricular muscle and 44% (p less than 0.001) in atrial muscle, with no change in action potential duration or effective refractory period. At the same drug concentration in Purkinje fibers, Vmax was decreased by 41% (p less than 0.01), action potential duration at 90% repolarization by 36% (p less than 0.01) and effective refractory period by 34% (p less than 0.01). Recainam had no significant effect on the sinoatrial node, but it depressed phase 4 depolarization in isoproterenol-induced automaticity in Purkinje fibers. The drug had no effect on slow channel potentials induced by high concentrations of potassium and isoproterenol. The data indicate that the electrophysiologic profile of recainam in isolated cardiac muscle is consistent with the overall effects of class IC agents without having an effect on the slow calcium channel. Its major action is to depress Vmax, with little effect on refractoriness.(ABSTRACT TRUNCATED AT 250 WORDS)


Different patterns of lymphoscintigraphic findings in patients with intestinal lymphangiectasia.
Technetium-99m antimony sulfide colloid lymphoscintigraphy conveniently demonstrates intestinal leakage of lymph in patients with intestinal lymphangiectasia. However, we found no intestinal radioactivity in some patients. We evaluated lymphoscintigraphic findings and compared them with clinical data. Technetium-99m antimony colloid lymphoscintigraphy was performed in 12 patients (age, 8.9+/-6.4 years; male:female=8:4) with histologically proven intestinal lymphangiectasia. After subcutaneous injection of 103.6 MBq of technetium-99m antimony colloid into the webs of both feet, sequential abdominal images were obtained up to 24 h post-injection. Four patients underwent technetium-99m methylene diphosphonate bone scintigraphy. Patients were divided into two groups according to the presence or absence of intestinal radioactivity. Five showed intestinal activity (Group 1), but seven did not (Group 2). No Group 1 patient had a history of ascites, while all Group 2 patients had ascites as the initial manifestation. Serum total protein and albumin levels were significantly lower in Group 1 patients than in Group 2 patients. In three Group 1 patients, technetium-99m methylene diphosphonate bone scintigraphy revealed intestinal radioactivity, while in one Group 2 patient this was not found. We observed two types of lymphoscintigraphic pattern in patients with intestinal lymphangiectasia. To clarify the exact pathophysiology, further study is required.


Industrial shift systems.
This technical report describes the identification of shift systems worked by industrial shiftworkers in England, Scotland and Wales. A diverse range of shift systems were reported to be in operation across 27 industrial sectors. Companies employed up to 14 different shift systems at a particular site. The numbers of shiftworkers on a given shift schedule ranged from 1 to 2977. Most systems employed fewer than 100 people. The majority of rotas were regular, rotating systems. The most common shift durations were 8 or 12 h. Compared to earlier surveys of shiftwork prevalence in certain industries there appeared to be a substantial increase over the past 3 decades in the proportion of the workforce who work shifts. Information about the average numbers of hours worked per week on major system types is given. In addition, data for the range of shifts per cycle, the distribution of shifts and distributions of their start and end times are presented.


Two distinct cone-opponent processes in the L+M luminance pathway.
We measured phase shifts between Long-wavelength cone (L-cone) and Middle-wavelength cone (M-cone) signals as well as sensitivity in the luminance pathway either following a cone-silent substitution of colored background or on a steady colored background. In background substitution, the phase shifts between L- and M-cone signals varied only slightly depending on the substituted color, whereas marked elevation of the threshold following the substitution of colored background was found. In contrast, the phase shifts, as well as threshold, varied largely, depending on the background color in the steady background. These facts suggest that suppression by the cone-opponent process for background color substitution is different from the one for a steady colored background.


Fast separations by capillary electrophoresis hyphenated to electrospray ionization time-of-flight mass spectrometry as a tool for arsenic speciation analysis.
Fast capillary electrophoresis (CE) hyphenated to time-of-flight mass spectrometry (TOF-MS) of four organoarsenic species (glycerol oxoarsenosugar, sulfate oxoarsenosugar, arsenobetaine, arsenocholine) are presented using short length CE capillaries under high electric field strengths of up to 1.3 kV cm(-1) with small inner diameter (ID). The separation of arsenosugars by CE is demonstrated for the first time. An aqueous formic acid solution was employed as the background electrolyte (BGE) for the separation. Various acid concentrations were evaluated for their influence on migration times, separation efficiency as well as with regard to controlling the charge of the arsenic species. A 0.1 M formic acid/ammonium formate buffer (pH 2.8) proved to be suitable for the separation of the four species. A non-aqueous BGE was tested as an alternative buffer system for fast speciation analysis. Separation of arsenobetaine and arsenocholine could even be achieved within 10 s by pressure-assisted CE. Application of the optimized method for the analysis of extracts of a seagrass and a Wakame algae sample as well as the brown algae homogenate reference material IAEA-140/TM revealed a clear signal for the glycerol arsenosugar.


Low frequency of clonotypic Ig and T-cell receptor gene rearrangements in t(4;11) infant acute lymphoblastic leukaemia and its implication for the detection of minimal residual disease.
Infant t(4;11) acute lymphoblastic leukaemia (ALL) is a rare but cytogenetically well defined subgroup of immature B-cell precursor (BCP) ALL. To date, the configuration of their antigen receptor genes has not been studied in a large group of patients so far. In this study on 27 t(4;11) infant ALL, we have used standardized primer sets for the detection of all incomplete and complete immunoglobulin (Ig) heavy chain (IGH) rearrangements, as well as for the Ig light chain kappa (IGK), T-cell receptor delta (TCRD) and gamma (TCRG) rearrangements that are most common in childhood BCP ALL. Only 52% of cases displayed clonotypic antigen receptor gene rearrangements (IGH in 48%, IGK, TCRD and TCRG in 12%, 41% and 6% respectively). This low frequency suggests, together with the findings of predominantly incomplete DJh joins and monoallelic IGH rearrangements, that they are derived from an immature progenitor cell. As 48% of the t(4;11) infant ALL cases had no detectable antigen receptor gene rearrangements that could be used for minimal residual disease (MRD) analysis, we established an expression-independent, leukaemia-specific polymerase chain reaction (PCR) using the genomic sequence of the MLL-AF4 fusion genes. This method had high sensitivity and specificity and resulted in identical estimations of tumour loads when compared with IGH targets. Thus, genomic MLL-AF4 fusion genes are a good alternative target for the analysis of MRD in patients with t(4;11) leukaemias.


Selective serotonin reuptake inhibitors and tricyclic antidepressants in the acute treatment of chronic depression and dysthymia: a systematic review and meta-analysis.
Chronic depression represents a substantial portion of depressive disorders and is associated with severe consequences. This review examined the efficacy and acceptability of selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) in the treatment of chronic depression. Additionally, the comparative effectiveness of the two types of antidepressants has been examined. A systematic search was conducted in the following databases: CENTRAL, MEDLINE, EMBASE, ISI Web of Science, BIOSIS, PsycINFO, and CINAHL. Primary efficacy outcome was a response to treatment; primary acceptance outcome was dropping out of the study. Only randomized controlled trials were considered. We identified 20 studies with 22 relevant comparisons. 19 studies focused on samples with a majority of dysthymic patients. Both SSRIs and TCAs are efficacious in terms of response rates when compared to placebo (Benefit Ratio [BR]=1.49; p<0.001 for SSRIs and BR=1.74; p<0.001 for TCAs) and no statistically significant differences between the active drugs and placebo in terms of dropout rates could be found. No differences in effectiveness were found between SSRIs and TCAs in terms of response rates (BR=1.01; p=0.91), yet, SSRIs showed statistically better acceptability in terms of dropout rates than TCAs (Odds Ratio [OR]=0.41; p=0.02). The methodological quality of the primary studies was evaluated as unclear in many cases and more evidence is needed to assess the efficacy of SSRIs and TCAs in patients suffering from chronic forms of depression other than dysthymia. This systematic review provides evidence for the efficacy of both SSRIs and TCAs in the treatment of chronic depression and showed a better acceptability of SSRIs.


Strabismus after endoscopic third ventriculostomy.
Until recently, the treatment of choice for noncommunicating hydrocephalus included the use of valve-regulated shunts such as the ventriculoperitoneal shunt. High failure rates and multiple complications have led neurosurgeons to use other techniques. Endoscopic third ventriculostomy (ETV) is becoming popular as treatment for noncommunicating hydrocephalus when standard shunts have failed.(1) We present 2 adolescents who developed exotropia, hypertropia, and diplopia after endoscopic third ventricle surgery.


Hg2+-mediated stabilization of G-triplex based molecular beacon for label-free fluorescence detection of Hg2+, reduced glutathione, and glutathione reductase activity.
G-triplexes have been reported recently with the similar function to G-quadruplex that can combine with thioflavin T (ThT) and emit strong fluorescence but easier to be controlled and excited. In this work, we report an Hg2+-mediated stabilization of G-triplex based functional molecular beacon (G3TMB) sensing system for the label-free detection of Hg2+, reduced glutathione (GSH), and glutathione reductase (GR) activity. In the presence of Hg2+, the extended G-triplex sequence containing the "T" bases can form a stable hairpin structure due to the strong interactions of "T-Hg2+-T", resulting in the locking of G-tracts in the stem of the G3TMB effectively. However, the hairpin structure of the G3TMB can be opened by the introduction of GSH through the stronger "GSH-Hg2+" interaction. Therefore, by employing the fact that GR can catalyze the reduction of oxidized glutathione (GSSG) into GSH, this concept can be applied to fluorescence "off-on" detection of GR activity, with a linear range of 0.02-30 mU/mL and detection limit of 0.01 mU/mL. This work may expand a new perspective of G-triplex based functional molecular beacon as the label-free fluorescent probes in the detection of small biomolecule and enzyme activity.


M2 muscarinic receptor of spinal cord mediated increase of nNOS expression in locus coeruleus during morphine withdrawal.
To investigate the effects of different muscarinic receptor (M) subtypes in the spinal cord on the scores of naloxone-precipitated morphine-withdrawal symptoms and the changes of nNOS expression in locus coeruleus (LC). nNOS immunohistochemistry, intrathecal injection (it), and antisense oligonucleotides (AS-ONs) techniques were used. Intrathecal injection of M2-antisense oligonucleotides (M2-AS) decreased the scores of morphine withdrawal symptoms. M1-AS attenuated morphine-withdrawal symptoms, but the effect was less than that of M2-AS. The expression of nNOS positive neurons in the LC increased in morphine-dependent rats and increased to a greater extent during morphine withdrawal. Intrathecal injection of M2-AS inhibited the increase of nNOS expression in LC during morphine-withdrawal, but there was no effect in case of M1-AS. M2 muscarinic receptor of spinal cord mediated the increase of nNOS expression in LC during morphine withdrawal.


A purpose-built simulator for percutaneous ultrasound-guided renal biopsy.
To construct a simple and affordable simulator for ultrasoundguided percutaneous renal biopsy. The kidney biopsy phantom was constructed by embedding a porcine kidney in gelatine. Silicon carbide and aluminium oxide were used as scattering particles in order to mimic the ultrasound appearance of human tissues. Two porcine ribs were also embedded. A latex sheet was placed over the top of the gel layer to resemble skin. The simulator was used and feedback from participants obtained during a renal ultrasound course with an international audience of middle-grade trainees from adult and pediatric nephrology, many of whom had never done a renal biopsy. Biopsy was carried out a single-use biopsy gun. All participants were able to perform a biopsy and obtain a satisfactory sample. All trainees felt that our simulator was very realistic. 94% of participants agreed that the simulator would help to allay their fears in relation to renal biopsy The total cost of the simulator was around £ 50,- for consumables per simulator. We describe a purpose-built and affordable simulator for percutaneous ultrasound-guided renal biopsy. We suggest that others evaluate our simulator used as part of a structured approach to teach this important procedure.


Professional identity formation in medical education for humanistic, resilient physicians: pedagogic strategies for bridging theory to practice.
Recent calls for an expanded perspective on medical education and training include focusing on complexities of professional identity formation (PIF). Medical educators are challenged to facilitate the active constructive, integrative developmental process of PIF within standardized and personalized and/or formal and informal curricular approaches. How can we best support the complex iterative PIF process for a humanistic, resilient health care professional? How can we effectively scaffold the necessary critical reflective learning and practice skill set for our learners to support the shaping of a professional identity?The authors present three pedagogic innovations contributing to the PIF process within undergraduate and graduate medical education (GME) at their institutions. These are (1) interactive reflective writing fostering reflective capacity, emotional awareness, and resiliency (as complexities within physician-patient interactions are explored) for personal and professional development; (2) synergistic teaching modules about mindful clinical practice and resilient responses to difficult interactions, to foster clinician resilience and enhanced well-being for effective professional functioning; and (3) strategies for effective use of a professional development e-portfolio and faculty development of reflective coaching skills in GME.These strategies as "bridges from theory to practice" embody and integrate key elements of promoting and enriching PIF, including guided reflection, the significant role of relationships (faculty and peers), mindfulness, adequate feedback, and creating collaborative learning environments. Ideally, such pedagogic innovations can make a significant contribution toward enhancing quality of care and caring with resilience for the being, relating, and doing of a humanistic health care professional.


Expression and secretion of malarial parasite beta-tubulin in Bacillus brevis.
Microtubule inhibitors are active against the human malarial parasite Plasmodium falciparum, but whether these drugs actually interact with parasite tubulins is not known. It has not previously been possible to produce mg quantities of isolated, soluble tubulin subunits for drug-binding experiments. A cDNA encoding P falciparum beta-tubulin was expressed and the protein secreted in Bacillus brevis. With the addition of EGTA to the culture medium, which increases shedding of proteins from the cell surface, up to 2 mg/l recombinant beta-tubulin was obtained in supernatants. It is not clear why B brevis is able to secrete this normally cytoplasmic protein, but the secretion levels of recombinant proteins may be related to the net charge of the first few residues of the mature polypeptide.


Loss of TRIM29 Alters Keratin Distribution to Promote Cell Invasion in Squamous Cell Carcinoma.
: TRIM29 (tripartite motif-containing protein 29) is a TRIM family protein that has been implicated in breast, colorectal, and pancreatic cancers. However, its role in stratified squamous epithelial cells and tumors has not been elucidated. Here, we investigate the expression of TRIM29 in cutaneous head and neck squamous cell carcinomas (SCC) and its functions in the tumorigenesis of such cancers. TRIM29 expression was lower in malignant SCC lesions than in adjacent normal epithelial tissue or benign tumors. Lower expression of TRIM29 was associated with higher SCC invasiveness. Primary tumors of cutaneous SCC showed aberrant hypermethylation of TRIM29. Depletion of TRIM29 increased cancer cell migration and invasion; conversely, overexpression of TRIM29 suppressed these. Comprehensive proteomics and immunoprecipitation analyses identified keratins and keratin-interacting protein FAM83H as TRIM29 interactors. Knockdown of TRIM29 led to ectopic keratin localization of keratinocytes. In primary tumors, lower TRIM29 expression correlated with the altered expression of keratins. Our findings reveal an unexpected role for TRIM29 in regulating the distribution of keratins, as well as in the migration and invasion of SCC. They also suggest that the TRIM29-keratin axis could serve as a diagnostic and prognostic marker in stratified epithelial tumors and may provide a target for SCC therapeutics. SIGNIFICANCE: These findings identify TRIM29 as a novel diagnostic and prognostic marker in stratified epithelial tissues.


Magnetic resonance imaging study on temporomandibular joint morphology.
Magnetic resonance imaging (MRI) has enabled the accomplishment of a more effective diagnostics of temporomandibular disorders (TMD). The sample included 40 patients with clinical symptoms of disc displacement (DD) of temporomandibular joint (TMJ) and 25 subjects included in our study were asymptomatic. DD were diagnosed by clinical examinations which were subsequently confirmed by MRI. DD was found in 18% of the TMJs of the asymptomatic patients. The highest prevalence of total DD without reduction was found in 44.1% of the patients' joints subsequently followed by total DD with reduction comprising 34.9% of the TMJs and by partial DD with reduction comprising 21% of the TMJs. This study may help us clarify the complicated relationship which exists between the radiographic and clinical findings of TMJ disorders.


In vitro susceptibility of six isolates of equine herpesvirus 1 to acyclovir, ganciclovir, cidofovir, adefovir, PMEDAP and foscarnet.
Equine herpesvirus 1 (EHV-1) is an important equine pathogen that causes respiratory disease, abortion, neonatal death and paralysis. Although vaccines are available, they are not fully protective and outbreaks of disease may occur in vaccinated herds. Therefore, there is an urgent need for effective antiviral treatment. For three abortigenic (94P247, 97P70 and 99P96) and three neuropathogenic isolates (97P82, 99P136 and 03P37), the effect of acyclovir, ganciclovir, cidofovir, adefovir, 9-(2-phosphonylmethoxyethyl)-2,6-diaminopurine (PMEDAP) and foscarnet on plaque number was studied. Additionally, for isolate 97P70, the effect on plaque size was investigated. Ganciclovir was most potent in reducing plaque number, followed by PMEDAP and acyclovir. Adefovir and cidofovir were less effective and foscarnet was the least effective compound. There were no differences detected for acyclovir, ganciclovir, adefovir and PMEDAP between the abortigenic and neuropathogenic isolates. One abortigenic isolate (99P96) was more susceptible to cidofovir and two neuropathogenic isolates (99P136 and 03P37) were less susceptible to foscarnet. For isolate 97P70, all compounds resulted in a significant reduction of plaque size. The most remarkable effect was observed for cidofovir. It was 40-fold more effective in reducing plaque size than in reducing plaque number. In conclusion, ganciclovir was the most potent compound and therefore, may be a valuable candidate for the treatment of EHV-1 infections in horses. The antiviral effect of foscarnet on plaque number was highly dependent on the viral isolate tested. Therefore, it is no valuable antiviral for the treatment of herpesvirus-infections. Cidofovir, although less effective in reducing plaque number, had a strong effect on plaque size.


Movement encoding by a stretch receptor in the soft-bodied caterpillar, Manduca sexta.
In a wide variety of animals, stretch receptors provide proprioceptive feedback for motion control. However, for animals that lack a stiff skeleton, it is unclear what information is being detected and how this is incorporated into behavior. Because such animals can change their body shape from moment-to-moment, information about body configuration could be particularly important for coordination. This study uses larval stage Lepidoptera (Manduca sexta) to examine how the longitudinal stretch receptor organ (SRO) responds to behaviorally appropriate movements. We characterized the responses of the SRO to changes in strain using magnitudes and velocities matching those seen physiologically. We found that the SRO response characteristics are compatible with the regulation of stance and with the defensive response to noxious stimuli. However, we also found that movements during crawling produce SRO responses that are dominated by the interdependence of phasic, tonic and slowly adaptive components. Ablation of stretch receptors in the proleg-bearing, fourth abdominal segment did not have any observable effect on behaviors, which suggests that the SROs are not essential for coordinating overt movements. We discuss the implications of these findings in the context of specific behaviors, and explore how the SRO response might be utilized during animal behavior.


Potential biomarkers for esophageal carcinoma detected by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry.
Currently, no satisfactory biomarkers are available to screen for esophageal squamous cell carcinoma (ESCC). The goal of this study was to find biomarkers and establish a serum protein fingerprint model for early diagnosis of ESCC using the ClinProt protocol of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Serum samples were collected from 62 patients with ESCC, nine patients with esophageal adenocarcinoma (EA) and 38 healthy individuals. Proteomic spectra of mass to charge ratio (m/z) were generated following the application of plasma to weak cationic-exchanger magnetic beads (WCX-MB). The spectral data were analyzed using a support vector machine, and potential biomarkers were chosen for system training and used to construct diagnostic models. Three differential patterns were established using MALDI-TOF MS. Pattern 1, consisting of 11 protein peaks, separated ESCC patients from the healthy individuals with a sensitivity of 90.0% and a specificity of 88.4%. Pattern 2, consisting of eight protein peaks, separated ESCC in stage I and stage II from stage III and stage IV with a sensitivity of 92.9% and a specificity of 82.3%. Pattern 3, consisting of seven protein peaks, separated ESCC from EA with a sensitivity of 91.3% and a specificity of 80.0%. These results suggested that MALDI-TOF MS combined with MB separation yields significantly higher sensitivity and specificity for the detection of serum protein in patients with ESCC.


The response of fibroblasts to hexagonal nanotopography fabricated by electron beam lithography.
It has been known for many years that cells will react to the shape of their microenvironment. It is more recently becoming clear that cells can alter their morphology, adhesions, and cytoskeleton in response to their nanoenvironment. A few studies have gone further and measured cellular response to high-adhesion nanomaterials. There have, however, been practical difficulties associated with genomic studies focusing on low-adhesion nanotopographies. Because of advancement in fabrication techniques allowing the production of large area of structure and the ability to amplify mRNA prior to microarray hybridization, these difficulties can be overcome. Here, electron beam lithography has been used to fabricate arrays of pits with 120 nm diameters, 100 nm depth and 300 nm center to center spacing in hexagonal arrangement. Electron and fluorescent microscopies have been used to observe morphological changes in fibroblasts cultured on the pits. 1.7k gene microarray was used to gauge genomic response to the pits. The results show reduction in cellular adhesion, decrease in spreading, and a broad genomic down-regulation. Also noted was an increase in endocytotic activity in cells on the pits.


Policies to promote use of generic medicines in low and middle income countries: a review of published literature, 2000-2010.
Review the literature on the impact of policies designed to enhance uptake of generic medicines in low and middle income countries (LMICs). We searched for publications related to generic medicines policies (January 2000-March 2010) and did a bibliometric, descriptive analysis of the dataset in addition to an analysis of studies evaluating the impact of pro-generic policies. We repeated a subset of this larger search in January 2012. Of the 4994 articles screened, 315 (6.3%) full-text publications were related to generic medicines policies. Of these 315, 236 (75%) dealt with generic medicine policies in high-income countries, and 79 (25%) with policies in LMICs. In total, we found only 10 evaluation studies looking at the impact of competition, trade, pricing and prescribing policies on generic medicine price and/or volume. Key barriers to implementing generic medicine policies in LMICs are negative perceptions of stakeholders (e.g., generics are of lower quality) plus perverse private sector financial incentives to sell products with the highest profit margin. Other relevant barriers are legal/regulatory, such as the absence of generic substitution regulations. There also exists a general difficulty in promoting generics due to a lack of transparency in the pharmaceutical supply and distribution system, for example, a lack of price information provided by health care provider organizations to physicians. There is little policy evaluation to determine which pro-generic policies increase generic medicines utilization in LMICs. Ensuring a functioning medicines regulation authority, creating a reasonably robust market of generic medicines and aligning incentives for physicians, consumers and drug sellers are necessary prerequisites for increasing the uptake and use of generic medicines.


Care for dying patients--German legislation.
Caring for dying patients appears to be one of the most difficult challenges in modern medicine. Apart from respective medical standards, such care is influenced by legal stipulations, economic resources, societal values, and ethical principles. In Germany, legal provisions prohibit actively hastening a patient's death. Although passive and indirect means of assistance to die are permitted for terminally ill patients, they appear to be implemented only with hesitation. Probably, the authority of advance directives needs further clarification. More importantly, however, physicians' deficits in knowledge as well as their conceptual and psycho-emotional barriers need comprehensive improvement in order to foster end-of-life care.


Specialization of rabbit reticulocyte transfer RNA content for hemoglobin synthesis.
The amount of acceptance of each amino acid per absorbancy unit of rabbit reticulocyte transfer RNA was determined. The results were compared with the amino acid composition of rabbit hemoglobin and with a similar determination of the transfer RNA content of rabbit liver. The histidine and isoleucine transfer RNA content of reticulocytes is specialized for the synthesis of hemoglobin, in which histidine is unusually common and isoleucine unusually scarce compared to most proteins.


Presence of family member during upper endoscopy. What do patients and escorts think?
We evaluated what effect an escort present during upper endoscopy had on the attitude and anxiety level of patients and on the escorts. The study consisted of 206 patients (ages 15-85, 47% male) and their escorts. Both patients and escorts were interviewed before the procedure. Escorts were then randomly divided into two groups-on-the-spot escorts, who present throughout the procedure, as opposed to waiting-room escorts. Both groups were reinterviewed following the procedure. Before the procedure, 80% of the patients understood the nature of endoscopy. Thirteen percent believed the procedure to be dangerous, and only 33% were totally worry-free. Fifty percent preferred to be escorted during the procedure, while 17% refused. Following the procedure, 89% of the patients who were escorted in the endoscopy room expressed satisfaction. Fifty-two percent of the patients found the procedure to be mild, with a higher proportion among escorted patients. Among the escorts, 63% felt that their close presence had lessened their own fears and anxiety regarding the procedure, and 72% believed their presence to have been supportive to the patient. Having an escort present throughout endoscopy appears to be a promising approach.


Development and progression of secondary hyperparathyroidism in chronic kidney disease: lessons from molecular genetics.
The identification of the calcium-sensing receptor (CaSR) and the clarification of its role as the major regulator of parathyroid gland function have important implications for understanding the pathogenesis and evolution of secondary hyperthyroidism in chronic kidney disease (CKD). Signaling through the CaSR has direct effects on three discrete components of parathyroid gland function, which include parathyroid hormone (PTH) secretion, PTH synthesis, and parathyroid gland hyperplasia. Disturbances in calcium and vitamin D metabolism that arise owing to CKD diminish the level of activation of the CaSR, leading to increases in PTH secretion, PTH synthesis, and parathyroid gland hyperplasia. Each represents a physiological adaptive response by the parathyroid glands to maintain plasma calcium homeostasis. Studies of genetically modified mice indicate that signal transduction via the CaSR is a key determinant of parathyroid cell proliferation and parathyroid gland hyperplasia. Because enlargement of the parathyroid glands has important implications for disease progression and disease severity, it is possible that clinical management strategies that maintain adequate calcium-dependent signaling through the CaSR will ultimately prove useful in diminishing parathyroid gland hyperplasia and in modifying disease progression.


A selective reversible monoamine oxidase B inhibitor in smoking cessation: effects on its own and in association with transdermal nicotine patch.
Monoamine oxidase B (MAO-B) activity is reduced in smokers. A MAO-B inhibitor alone or co-administered with nicotine may mimic the effects of smoking and be a candidate drug for smoking cessation. This study aims to determine the efficacy and safety of EVT302, a selective reversible MAO-B inhibitor, alone and on top of nicotine patch (NP) in smoking cessation. This was a randomised, double blind, placebo-controlled phase II, multicentre trial. Smokers (≥10 cigarettes/day) received either EVT302 (N = 145) or placebo (N = 145), or EVT302 (N = 61) or placebo (N = 61) on top of open label NP 21 mg/day for 8 weeks. The main comparison was between EVT302 and placebo without NP. The primary outcome measure was end-of-treatment 4-week continuous abstinence rate (CAR). point prevalence abstinence rate, saliva cotinine concentrations in the groups without NP, urge to smoke, nicotine withdrawal symptoms and assessment of subjective effects of cigarettes. The 4-week CAR was 15.2 % in the placebo, 17.2 % in the EVT302, 26.8 % in the NP + placebo and 32.8 % in the NP + EVT302 groups, respectively. There was no difference between EVT302 and placebo either alone (adjusted OR: 1.45, 95 % CI: 0.65-3.26) or when co-administered with NP. No statistically significant difference occurred for the secondary outcome measures. The selective, reversible MAO-B inhibitor EVT302 was not superior to placebo in helping smokers quit, in line with data with selegiline and confirms that MAO-B inhibitors are not effective in smoking cessation. Co-administration of NP does not provide a supplementary benefit.


Management information systems--green light for better info.
An EIS gathers financial and non-financial data from a variety of sources, both internal and external to an organisation, and presents them accessibly and understandably. It should facilitate the presentation of data so that it is timely and relevant to senior managers' needs. Generally, there are three categories of EIS: Front-end tools, which enhance the presentation of output from existing systems. For example, they can take the output from a general ledger system and enhance its appearance but do not change the content. Internal consolidation tools, which take data from a number of internal sources (such as the general ledger), store it in a central database, and present it to users. This is often done in report book format to which all EIS style functions may be applied. Integrators of information, which integrate data from internal and external sources. Much of the data is non-financial and a major emphasis is on the users' ability to communicate with each other. The key functions that may be included within an EIS are: Drill down. The facility to explore increasingly detailed levels of data. Trends and variances against pre-set targets, such as financial budgets. Graphics and tabular reporting. Data integrity checking. Analysis of the data, modelling and the production of forecasts using time series analysis techniques. Exception reporting through the use of some form of alert. Incorporation of text into the output.


The von Hippel-Lindau tumor suppressor stabilizes novel plant homeodomain protein Jade-1.
The von Hippel-Lindau disease gene (VHL) is the causative gene for most adult renal cancers. However, the mechanism by which VHL protein functions as a renal tumor suppressor remains largely unknown. To identify low occupancy VHL protein partners with potential relevance to renal cancer, we screened a human kidney library against human VHL p30 using a yeast two-hybrid approach. Jade-1 (gene for Apoptosis and Differentiation in Epithelia) encodes a previously uncharacterized 64-kDa protein that interacts strongly with VHL protein and is most highly expressed in kidney. Jade-1 protein is short-lived and contains a candidate destabilizing (PEST) motif and plant homeodomains that are not required for the VHL interaction. Jade-1 is abundant in proximal tubule cells, which are clear-cell renal cancer precursors, and expression increases with differentiation. Jade-1 is expressed in cytoplasm and the nucleus diffusely and in speckles, where it partly colocalizes with VHL. VHL reintroduction into renal cancer cells increases endogenous Jade-1 protein abundance up to 10-fold. Furthermore, VHL increases Jade-1 protein half-life up to 3-fold. Thus, direct protein stabilization is identified as a new VHL function. Moreover, Jade-1 protein represents a novel candidate regulatory factor in VHL-mediated renal tumor suppression.


Comparison of pegvisomant and long-acting octreotide in patients with acromegaly naïve to radiation and medical therapy.
Normalization of IGF-I in patients with acromegaly is associated with a decrease in mortality. Pegvisomant may be more effective in lowering IGF-I than octreotide. The efficacy and safety of pegvisomant and octreotide long-acting release (LAR) were compared in 118 patients with acromegaly in this 52-week, multicenter, open-label, randomized study. The primary endpoint was IGF-I normalization at week 52. Secondary endpoints included mean changes from baseline in IGF-I, IGF binding protein 3, acromegaly signs and symptom scores, ring size, acromegaly quality of life questionnaire scores, and safety. Fifty-six patients received pegvisomant and 57 received octreotide LAR. IGF-I normalized in 51% of pegvisomant patients and 34% treated with octreotide LAR (p=0.09, ns). Patients with baseline IGF-I > or = 2x upper limit of normal had a higher rate of IGF-I normalization with pegvisomant vs octreotide LAR (p=0.05). Among the patients who did not achieve a normalized IGF-I, pegvisomant-treated patients were more likely to be receiving < 30 mg of study drug (71% vs 16%). Treatment-related adverse events were mild-to-moderate in both groups. Mean fasting glucose decreased in diabetic and non-diabetic patients on pegvisomant whereas octreotide LAR was associated with an increase at week 52 (p=0.005 and p=0.003 between groups, respectively). Mean change in tumor volume during treatment was similar between groups. Pegvisomant and octreotide LAR were equally effective in normalizing IGF-I in the overall population, and pegvisomant was more effective in patients with higher baseline IGF-I levels. Pegvisomant had a more favorable effect on parameters of glycemic control.


Aspartic acid as a trap for gamma-radiation energy in the amorphous Al5(OH)15(Asp)3.3H2O.
Paramagnetic molecular centers produced by gamma irradiation at 77 K and at room temperature in the novel compound Al5(OH)15(Asp)3.3H2O were studied by ESR spectroscopy. The g value of 2.0034 and the lack of such lines in pure aluminum hydroxide suggested that all the paramagnetic centers observed are related to the aspartic acid molecule. However, none of the paramagnetic centers gave an ESR spectrum characteristic for gamma-irradiated pure aspartic acid powder. The influence of the oxygen on the formation of the paramagnetic centers was noticed. The extreme stability of the paramagnetic molecular centers formed in Al5(OH)15(Asp)3.3H2O suggests that aspartic acid complexed in aluminum hydroxide is a good trap for gamma-radiation energy.


Life cycle environmental impacts of biogas production and utilisation substituting for grid electricity, natural gas grid and transport fuels.
In this study, life cycle analysis (LCA) has been applied to evaluate the environmental impacts of biogas production and utilisation substituting for grid electricity, natural gas grid and transport fuels, with a focus on Greenhouse Gas (GHG) emissions. The results demonstrate significant reductions in greenhouse gas emissions for the biogas as a fuel scenario due to the displacement of fossil petrol and diesel fuels (scenario 3), with savings of between 524 and 477 kg of CO2 equivalent (per MWh of energy provided by the fuels). The utilisation of biogas for electricity generation saves around 300 kg of CO2 equivalent per MWh of electricity injected into the grid (scenario 1), while Scenario 2, the upgrading of biogas to biomethane and its injection into the gas grid for heating saves 191 kg of CO2 equivalent (per MWh of energy generated by the biomethane). The results emphasise the benefits of using life cycle analysis to provide an evidence based for bioenergy policy. The limitations of the research are identified and recommendations made for future research priorities to further the use of LCA in the evaluation of bioenergy systems.