Single channel planar lipid bilayer recordings of the melittin variant MelP5.
MelP5 is a 26 amino acid peptide derived from melittin, the main active constituent of bee venom, with five amino acid replacements. The pore-forming activity of MelP5 in lipid membranes is attracting attention because MelP5 forms larger pores and induces dye leakage through liposome membranes at a lower concentration than melittin. Studies of MelP5 have so far focused on ensemble measurements of membrane leakage and impedance; here we extend this characterization with an electrophysiological comparison between MelP5 and melittin using planar lipid bilayer recordings. These experiments reveal that MelP5 pores in lipid membranes composed of 3:1 phosphatidylcholine:cholesterol consist of an average of 10 to 12 monomers compared to an average of 3 to 9 monomers for melittin. Both peptides form transient pores with dynamically varying conductance values similar to previous findings for melittin, but MelP5 occasionally also forms stable, well-defined pores with single channel conductance values that vary greatly and range from 50 to 3000pS in an electrolyte solution containing 100mM KCl.


Toxicant identification by a luminescent bacterial bioreporter panel: application of pattern classification algorithms.
Genetically engineered microorganisms, tailored to respond by a dose-dependent signal to the presence of toxic chemicals, are a potentially useful tool for environmental monitoring. One manifestation of this approach is based on a panel of luminescent bacterial bioreporters, harboring fusions of the luxCDABE operon to various stress-responsive gene promoters. Such sensors can report by a dose-dependent luminescent signal on the stress sensed by the cells and thus on the presence of toxic compound(s), but they lack the ability to identify the chemicals involved. Here, we demonstrate how the use of a panel of such sensors might offer a solution to this drawback. Five selected Escherichia coli reporter strains harboring fusions of selected gene promoters (grpE, nhoA, oraA, lacZ, and mipA) to luxCDABE were exposed to five model toxicants and to a toxicant-free control in a 40-repetition format. Each of the six treatments activated different promoters to different extents, producing its own unique fingerprint. Two machine learning schemes were challenged with the obtained data set: Bayesian decision theory and the nonparametric nearest-neighbor technique. The Bayesian classifiers performed better and were able to identify the sample's contents within 30 min with an error rate estimate that did not exceed 3% at a 95% confidence level and with zero false negatives. Performance in tap water and wastewater samples was similar. Given the coming of age of whole-cell sensing devices, pattern classification algorithms such as the ones described here offer a step toward the incorporation of reporter cells into future biosensor formats, including whole-cell arrays.


Regulation of translation initiation following stress.
Recent studies suggest that genotoxic and non-genotoxic stresses appear to invoke translational checkpoints in order to inhibit protein synthesis. Depending on the stress and/or cell type, this downregulation of protein synthesis may either (i) protect against the deleterious effects of noxious agents and ensure the conservation of resources that are needed to survive under adverse conditions or (ii) activate apoptosis. In this article, we have reviewed several lines of evidence which support the notion that regulation of translation initiation is an important component of the cellular stress response. While the stress-induced post-translational regulation of translation initiation factors (eIFs) has been well documented, stress-induced regulation of eIFs at the mRNA levels, as reviewed here, is only beginning to be elucidated. Thus, the stress-mediated regulation of eIFs occurs at multiple different levels involving, transcriptional, post-transcriptional and post-translational controls.


Pulmonary and hepatic toxicity due to nitrofurantoin and fluconazole treatment.
To reemphasize potential risks associated with chronic nitrofurantoin use and to report a case of combined pulmonary and hepatic toxicity precipitated from acute use of fluconazole concomitantly with chronic nitrofurantoin. A 73-year-old white man taking nitrofurantoin 50 mg/day for 5 years developed combined hepatic and pulmonary toxicity after taking fluconazole acutely for onychomycosis. Two months after starting fluconazole, the patient's hepatic enzymes showed elevation 5 times the upper limits of normal. In addition, the patient reported fatigue, dyspnea on exertion, pleuritic pain, burning trachea pain, and a cough. Chest X-rays showed bilateral pulmonary disease consistent with nitrofurantoin toxicity. Both drugs were determined to be the cause of the patient's pulmonary and hepatic toxicity, so they were discontinued. Pulmonary function tests measured after discontinuation were abnormal and also consistent with nitrofurantoin toxicity. The patient's hepatic and pulmonary toxicity resolved upon discontinuation of both drugs and use of inhaled corticosteroids. Changes in hepatic enzyme measurement, pulmonary function measurements, and chest X-rays indicate that our patient developed hepatic and pulmonary toxicity due to his drug therapy. An objective causality assessment revealed that these adverse events were probably due to fluconazole given with nitrofurantoin. Either drug may have caused the hepatic toxicity. However, it is possible that pharmacokinetic changes induced by an interaction with fluconazole precipitated the nitrofurantoin-induced pulmonary toxicity. Our patient developed pulmonary and hepatic toxicity after starting fluconazole in combination with chronic nitrofurantoin. A potential drug interaction of unknown mechanism may have been the cause of the toxicities.


Biosafety of E. coli beta-glucuronidase (GUS) in plants.
The beta-glucuronidase (GUS) gene is to date the most frequently used reporter gene in plants. Marketing of crops containing this gene requires prior evaluation of their biosafety. To aid such evaluations of the GUS gene, irrespective of the plant into which the gene has been introduced, the ecological and toxicological aspects of the gene and gene product have been examined. GUS activity is found in many bacterial species, is common in all tissues of vertebrates and is also present in organisms of various invertebrate taxa. The transgenic GUS originates from the enterobacterial species Escherichia coli that is widespread in the vertebrate intestine, and in soil and water ecosystems. Any GUS activity added to the ecosystem through genetically modified plants will be of no or minor influence. Selective advantages to genetically modified plants that posses and express the E. coli GUS transgene are unlikely. No increase of weediness of E. coli GUS expressing crop plants, or wild relatives that might have received the transgene through outcrossing, is expected. Since E. coli GUS naturally occurs ubiquitously in the digestive tract of consumers, its presence in food and feed from genetically modified plants is unlikely to cause any harm. E. coli GUS in genetically modified plants and their products can be regarded as safe for the environment and consumers.


Conventional versus ultrasound and microwave assisted synthesis: Some new environmentally friendly functionalized picolinium-based ionic liquids with potential antibacterial activity.
A green chemistry approach has been adopted for the synthesis of thirty-four new picolinium-based ionic liquids using microwave (MW) and ultrasound (US) irradiation as well as conventional thermal heating. Their structures were confirmed by FT-IR, 1H NMR, 13C NMR, 11B NMR, 19F NMR, 31P NMR, mass spectra and elemental analyses. The antimicrobial profile of the novel ionic liquids was evaluated and the minimum inhibitory concentration (MIC) showed their moderate to low antimicrobial activity against eight types of human pathogens.


Learning Effective Molecular Models from Experimental Observables.
Coarse-grained models are an attractive tool for studying the long time scale dynamics of large macromolecules at a level that cannot be studied directly by experiment and is still out of reach for atomistic simulation. However, coarse models involve approximations that may affect their predictive power. We propose a modeling framework that allows us to design simplified models to accurately reproduce experimental observables. We demonstrate the approach on the folding mechanism of a WW domain. We show that when the correct coarsening resolution is used not only do the optimized models match the Reference model simulated experimental data accurately but additional observables not directly targeted during the optimization procedure are also reproduced. Additionally, the analysis of the results shows that localized frustration plays an important role in the folding mechanism of this protein and suggests that nontrivial aspects of the protein dynamics are evolutionary conserved.


Spirituality and Aging in Place: The Impact of Extreme Climatic Conditions on Domestic Gardening Practice.
There is limited research exploring how domestic water restrictions imposed as a result of drought conditions impact upon the lives of independently living older people. Within this age group (60 years plus), the domestic garden frequently forms an intrinsic component of ongoing health and well-being. Gardening practice offers components of both mental and physical activity and, for many older people, leads to emotional and spiritual connection on a number of levels. The capacity of older people to maintain a garden during a period of water restrictions is greatly reduced, and the resulting impact on health and well-being is considerable. A recent study, conducted in south-eastern Australia, aimed to determine the benefits to health and well-being of maintaining a domestic garden for older people and the impact of water restrictions on garden practice. This occurred at a time following a prolonged period of drought and, in central Victoria, a complete ban on outside watering. In-depth qualitative interviews were conducted with 10 gardeners aged between 60 and 83 who had tended their garden over an extended period. The lived experience of gardening was explored through hermeneutic phenomenological analysis. Clear benefits to health and well-being were established, and yet, the essence of this experience lay in the capacity of gardeners to remain connected to their garden despite change. The crisis imposed by ongoing drought and restricted use of water generated a strong impetus for adaptation, resilience and acceptance of change. The spiritual nature of gardening practice clearly emerged and appeared to intensify the experience of gardening and consolidate adaption to change on a number of levels.


[Phaeochromocytoma as an unusual aetiology of cardiogenic shock].
The authors reported a case involving a young patient with a cardiogenic shock associated to an acute pulmonary oedema. According to the seriousness of the shock, an external ventricular assist device (VAD) was initially inserted and replaced thereafter because of the cardiovascular instability, by an external pneumatic biventricular assist device. A cardiogenic shock induced by an acute adrenergic myocarditis due to a phaeochromocytoma was diagnosed. The patient was weaned from the VAD on day 84 and was scheduled for elective surgery of the phaeochromocytoma on day 93. The authors discussed the time of the surgery according to the anticoagulation therapy necessary to the VAD and the necessary caution taken if a cardiogenic shock appeared around surgery.


Replication timing properties across the pseudoautosomal region boundary and cytogenetic band boundaries on human distal Xp.
The establishment of human chromosomal regions as distinct and characteristic domains has been demonstrated by the reproducible banding patterns observed on metaphase chromosomes as a result of various staining techniques. Although the exact molecular properties responsible for the patterns are not well understood, a general correlation has been established between the time of replication of a particular region of DNA and its banding characteristics. Using a replication timing assay based on fluorescence in situ hybridization patterns, we investigated replication timing properties across chromosomal regions with potentially distinct chromatin properties. Relative replication timing values were determined using cosmid DNA probes around the pseudoautosomal region boundary in Xp22.3 and the cytogenetic band boundary regions surrounding Xp22.2. Although we observed replication timing domains that were generally consistent with cytogenetic banding patterns, we did not find sharp replication timing boundaries at either the pseudoautosomal region boundary or at the cytogenetic band boundaries.


[Pulmonary lymphangioleiomyomatosis].
A clinicomorphological analysis of 41 pulmonary lymphangioleiomyomatosis (PLAM) cases has been performed. Focal (7 cases) and diffuse (34 cases) forms were identified. Expression of NMB-45, desmin, actin, vimentin prove myogenic nature of the disease and confirm combination of two morphogenesis directions - proliferation of smooth muscle cells at the active phase of the growth and fibrosis at late stages. The presence of estrogen and progesteron receptors in smooth muscle cells shows hormonal dependance of cell proliferation. Thus, LAM is multisystem disease linked with abdominal tumors (angiomyolipomas, angioleiomyomas). Prognosis in the focal form is favourable, that in the diffuse form- unfavourable.


Vaccine distribution: an operations research study.
The implementation of an immunization program in rural areas is affected by lacunae in the vaccine distribution system. A study conducted in India identified the extent to which irregular supply of vaccines has affected the immunization program. This study also identified other problem areas, such as a faulty cold chain and the need for an improved monitoring and control system and for better supervision. A model was designed to represent the immunization program and was used to assess the performance of the system under different supply conditions and operational policies. The study identified a number of improvements that could be made in the vaccine distribution system.


OsDSSR1, a novel small peptide, enhances drought tolerance in transgenic rice.
Small signaling peptides play important roles in plant development and responses to abiotic and biotic stresses. We have identified a novel small peptide gene in rice, OsDSSR1, which is expressed mainly in the root, stem, node, leaf, and panicle. OsDSSR1 expression is also induced by drought, salinity, ABA, and H2O2 treatment. OsDSSR1 is localized in the nucleus and cytoplasm. Transgenic plants overexpressing OsDSSR1 exhibited enhanced drought stress tolerance and decreased ABA sensitivity as compared to the wild type. Overexpression of OsDSSR1 promoted the accumulation of compatible osmolytes, such as free proline and soluble sugars. OsDSSR1-overexpressing plants displayed enhanced OsSodCc2 and OscAPX expression and superoxide dismutase and ascorbate peroxidase activities under drought stress. RNA-sequencing data revealed that the expression of 72 abiotic stress-responsive genes was significantly altered in homozygous transgenic plants. These stress-responsive candidate genes will aid in expanding our understanding of the mechanisms by which small peptides mediate tolerance in crop species.


Intravaginal boric acid: is it an alternative therapeutic option for vaginal trichomoniasis?
Trichomoniasis, caused by Trichomonas vaginalis (TV), is the most common curable sexually transmitted infection worldwide. Current guidance in the UK is to treat TV with a nitroimidazole antibiotic. The high prevalence of TV, high rate of antibiotic resistance and limited tolerability to nitroimidazoles suggest that alternative treatment regimens are needed. Intravaginal boric acid (BA) has been used safely for the treatment of candida vulvovaginitis and bacterial vaginosis, and in vitro studies suggest BA is active against TV. We review the evidence for the efficacy of BA in patients with TV. MEDLINE, EMBASE, CINAHL, AMED, HMIC and BNI and Grey literature databases, The Cochrane Library, Trial Registers, conference abstracts and proceedings were searched. Inclusion criteria were women aged 16 years or over with microbiological confirmation of TV infection and using BA as treatment. There were no restrictions on language, publication date or study design. The in vitro evidence for BA activity against TV was also reviewed. No randomised controlled trials or case series were found. Four case reports demonstrated TV clearance with BA using a variety of dose regimens (dose 600 mg alternate nights to 600 mg two times per day; duration 1-5 months). In vitro studies suggest that BA has activity against TV which is independent of its effect on pH. Further evaluation of BA for the treatment of uncomplicated TV is required, but it may be useful when therapeutic options are limited. If shown to be safe and effective, intravaginal BA might provide a well-tolerated alternative anti-infective treatment which reduces community exposure to systemic antibiotics.


Design and in vitro evaluation of transdermal patches based on ibuprofen-loaded electrospun fiber mats.
To improve the poor compatibility among different components of Drug-in-adhesive type patch, two novel plasters (Drug-in-fiber and Drug-in-adhesive/fiber) were developed based on ibuprofen (IBU)-loaded fiber mats. These fibrous mats were fabricated via electrospinning of cellulose acetate/poly(vinylpyrrolidone) composites in a binary solvent of N,N-dimethyl acetamide/acetone. Physical status studies suggested that Drug-in-fiber could inhibit IBU re-crystallization, but the active ingredients were released at a relatively slow rate due to the dual-resistance of fiber mat and adhesive matrix. To overcome this shortcoming, Drug-in-adhesive/fiber was designed by coupling medicated hydrophilic pressure sensitive adhesive and IBU-loaded fiber mat. This method endowed Drug-in-adhesive/fiber a fast IBU release rate and high permeated drug amount though simulative skins. This design separated enhancer from adhesive matrix, which guaranteed Drug-in-adhesive/fiber excellent adhesion forces. Hence, the plasters based on medicated fiber mats improved the compatibility among patch components.


Child sex abuse cases need more research.
Health professionals regard child sex abuse as worse than physical abuse even though the mortality in physical abuse is far higher, according Harry Zeitlin, consultant psychiatrist at Westminster Children's Hospital.


Factors to be considered in the evaluation of bioavailability and bioequivalence of topical formulations.
In this paper, an attempt is made to find functional definitions of bioavailability and bioequivalence for topical products and to examine critical factors that influence topical bioavailability and bioequivalence. A physical model approach for quantifying the problem and increasing our understanding is presented here. The key assumptions are (1) that the target site is in the lower epidermis (basal layer) or in the dermis, and (2) that it is the thermodynamic activity (i.e., the free drug concentration, C*, of the active drug species) at the target site that is the true correlate of drug effectiveness. Studies initiated to implement the physical model approach involved first validating a 'three-tiered' model for finite dose drug uptake/transport in skin with experimentally determined input parameters (partition coefficient, K, and steady-state permeability coefficients, P, for the stratum corneum, viable epidermis, and dermis). Hydrocortisone was used as the model drug with hairless guinea pig skin as the model membrane. The physical model is used to show, via the C* concept, how formulation factors may influence bioavailability and bioequivalence. Finally, a method is presented for predicting the efficacy of topical formulations employing appropriate in vitro data and physical model calculations.


Effect of peroxide concentration and brushing on whitening clinical response.
This clinical trial compared the effects of hydrogen peroxide concentration and toothbrushing on clinical response to vital bleaching. Tooth bleaching was accomplished with a flexible, polyethylene strip coated with a hydrogen peroxide bleaching gel worn for 30 minutes twice daily over a 14-day period. A total of 36 subjects were randomized to 1 of 3 treatment groups: 5.3% hydrogen peroxide strip plus prebrushing, 6.5% hydrogen peroxide strip plus prebrushing, or 6.5% hydrogen peroxide strip without prebrushing. Two groups brushed with regular anticavity toothpaste immediately before bleaching, while the other group performed ad libitum brushing only. Tooth color was measured over a 14-day period using digital images of the anterior dentition. Over the 14-day treatment period, all 3 strip groups experienced highly significant (P < 0.001) whitening as evidenced by decreased yellowness (delta b*) and increased brightness (delta L*), as well as composite color change (delta E*) relative to baseline. Keeping brushing constant, the 6.5% hydrogen peroxide strip plus prebrushing group experienced a 31% to 60% improvement in whitening relative to the 5.3% hydrogen peroxide standard. Keeping concentration constant at 6.5% hydrogen peroxide, the prebrushing group experienced a directional 5% to 33% improvement in whitening relative to no prebrushing. All treatments were generally well tolerated. This study demonstrates that for strip-based delivery, increasing hydrogen peroxide concentration to 6.5% results in a significant improvement in efficacy with few tolerability trade-offs.


Molecular signaling mechanisms underlying epileptogenesis.
Epilepsy, a disorder of recurrent seizures, is a common and frequently devastating neurological condition. Available therapy is only symptomatic and often ineffective. Understanding epileptogenesis, the process by which a normal brain becomes epileptic, may help identify molecular targets for drugs that could prevent epilepsy. A number of acquired and genetic causes of this disorder have been identified, and various in vivo and in vitro models of epileptogenesis have been established. Here, we review current insights into the molecular signaling mechanisms underlying epileptogenesis, focusing on limbic epileptogenesis. Study of different models reveals that activation of various receptors on the surface of neurons can promote epileptogenesis; these receptors include ionotropic and metabotropic glutamate receptors as well as the TrkB neurotrophin receptor. These receptors are all found in the membrane of a discrete signaling domain within a particular type of cortical neuron--the dendritic spine of principal neurons. Activation of any of these receptors results in an increase Ca2+ concentration within the spine. Various Ca2+-regulated enzymes found in spines have been implicated in epileptogenesis; these include the nonreceptor protein tyrosine kinases Src and Fyn and a serine-threonine kinase [Ca2+-calmodulin-dependent protein kinase II (CaMKII)] and phosphatase (calcineurin). Cross-talk between astrocytes and neurons promotes increased dendritic Ca2+ and synchronous firing of neurons, a hallmark of epileptiform activity. The hypothesis is proposed that limbic epilepsy is a maladaptive consequence of homeostatic responses to increases of Ca2+ concentration within dendritic spines induced by abnormal neuronal activity.


Teaching Psychotherapy to Psychiatry Residents.
The rationale, content, and teaching techniques used for a psychiatry residency psychodynamic therapy course based on Psychodynamic Therapy: A Guide to Evidence-Based Practice (Summers & Barber, 2009) are presented in the context of their evolution over the last two decades and the challenges of teaching this topic in the current environment. The central elements of an exciting and engaging psychotherapy teaching program-feelings, framework, and freedom-are explained. Specific topics such as psychodynamic formulation, using videos, self-disclosure, and resistance are discussed.


[Evapotranspiration in Pumica granatum stand in Lower Taihang Mountain].
Based on energy balance method, the daily and monthly variations of evapotranspiration are measured in Pumica granatum stand in Lower Taihang Mountain. The evapotranspiration in different phenophase is also calculated. The results indicated that Pumica granatum trees close their stoma to decrease physiological transpiration at noon when the radiation is very intense. In Pumica granatum stand, the evapotranspiration was highly linearly correlated with net radiation. The regression equation was Y = 0.0029 X--0.1449, and regression coefficient can reach 0.9. The total evapotranspiration was 424.08 mm, 64.59% of which was consumed from flowering phase to fruit maturing phase. Two essential supplementary irrigation, one in germination phase and the another before flowering phase, should be implemented to ensure the healthy growth of Pumica granatum trees.


Polymerase chain reaction in pediatric post-traumatic fungal endophthalmitis among Egyptian children.
The aim of this study was to evaluate the effectiveness of polymerase chain reaction (PCR) in accurate and rapid diagnosis of fungal endophthalmitis in comparison with conventional Gram stain and culture in pediatric fungal endophthalmitis. This study included 26 cases with endophthalmitis. Age was less than 16 years old, and all were males with history of ocular trauma and with clinical picture suggestive of fungal endophthalmitis. A prospective nonrandomized study was done. For all cases pars plana vitrectomy was done and sample of vitreous wash was collected from the vitrectomy cassette and was sent for laboratory diagnosis. At the end of surgery, intravitreal injection of 1.0 mg/0.1 mL vancomycin was given. PCR, culture sensitivity and ultrasound were done for all cases. Follow-up of cases by visual acuity, full ophthalmological examination, ultrasound, PCR, and other laboratory investigation. The schedule for follow-up was daily for 1 week, weekly for 1 month, and monthly for 1 year than all data collected and analysed. The ages ranged from 7 to 16 years old. All cases were males. Seventeen cases had central corneal ulcer, 5 of them with penetration full thickness, and 9 cases had peripheral corneal ulcer, 2 of them with penetration. Ophthalmological examination revealed a marked drop of vision ranging from HM to PL in the affected eye. Although Gram stain gave negative results in 20 cases (was positive in only 6 cases), KOH wet mount preparation revealed septate hyphae in only 4 cases, and culture on blood agar was negative in all samples, suggestive of Aspergillus niger and showing Candida albicans colonies in 8 samples. PCR assay was positive for the universal as well as for the Aspergillus-specific primers, but it was negative for Candida-specific primer in 4 samples. No recurrence of infection was noticed for the following 1 year The mean follow-up period was 10.3 months (range, 5-24 months), but with trivial improvement in visual acuity. The sensitivity of PCR assay was found to be highly significant, p < .0001, much superior to that of microscopy and culture in detecting fungal endophthalmitis. PCR assay was found to be a highly sensitive and specific test that allows rapid and accurate diagnosis of pediatric fungal endophthalmitis. PCR was found to give a much more sensitive and more rapid result than Gram stain and culture technique with comparable high specificity. Thus, we recommend the use of conventional methods as culture and stained smears as they are useful if positive, inexpensive, and available in all laboratories. This is in addition to PCR assay, which must be added to the protocol of management of cases of pediatric fungal endophthalmitis.


Adsorption characteristics of selected hydrophilic and hydrophobic micropollutants in water using activated carbon.
In this study, we investigated adsorption characteristics of nine selected micropollutants (six pharmaceuticals, two pesticides, and one endocrine disruptor) in water using an activated carbon. The effects of carbon dosage, contact time, pH, DOM (dissolved organic matter), and temperature on the adsorption removal of micropollutants were examined. Increasing carbon dosage and contact time enhanced the removal of micropollutants. Sorption coefficients of hydrophilic compounds (caffeine, acetaminophen, sulfamethoxazole, and sulfamethazine) fit a linear isotherm and hydrophobic compounds (naproxen, diclofenac, 2, 4-D, triclocarban, and atrazine) fit a Freundlich isotherm. The removal of hydrophobic pollutants and caffeine were independent of pH changes, but acetaminophen, sulfamethazine, and sulfamethoxazole were adsorbed by mainly electrostatic interaction with activated carbon and so were affected by pH. The decrease in adsorption removal in surface water samples was observed and this decrease was more significant for hydrophobic than hydrophilic compounds. The decline in the adsorption capacity in surface water samples is caused by the competitive inhibition of DOM with micropollutants onto activated carbon. Low temperature (5°C) also decreased the adsorption removal of micropollutants, and affected hydrophobic compounds more than hydrophilic compounds. The results obtained in this study can be applied to optimize the adsorption capacities of micropollutants using activated carbon in water treatment process.


Diagnosis of urethral strictures: is retrograde urethrography still necessary?
Different methods are available in the diagnosis and treatment of urethral strictures. True diagnosis is necessary for choosing the most suitable method of treatment and to inform the patient about the method, complications, recurrence rate and costs. In this study we aimed to compare the efficiency, complications and reproducibility of retrograde urethrography with urethroscopy. The retrograde urethrographic (RGU) and urethroscopic findings of 38 male patients were evaluated. Thirty had the same findings with either technique. In 8 patients the RGU was misdiagnosing (p < 0.01). In conclusion, it has been shown that the results of RGU are misleading when it is not combined with urethroscopy and we think that it must not be a routine method in the diagnosis of urethral strictures.


[Evaluation of interferences in electronic platelet count].
A platelets count was performed on 100 subjects using both the electronic counter and a manual method; the results obtained concerning healthy subjects are overlapping. In subjects with structural alterations regarding platelets and red blood cells, the electronic counter method has overestimated the number, yet making note of it.


GAD immunoreactivity in pretectal and accessory optic nuclei of the frog mesencephalon.
By an immunocytochemical technique using anti-GAD antibodies, we found a high density of GAD-immunoreactive puncta in the 5 pretectal nuclei and in the nucleus of the basal optic root. These results back up the suggestion that GABAergic modulation of the output of the visual pretectal relay nuclei might underlie the directional asymmetry of the horizontal optokinetic nystagmus and the directional selectivity of pretectal neurons.


Transitions in American hospitals: the necessary reshaping is taking place. "Turnaround" processes in organizations.
American hospitals are reshaping and redefining the way they are managed and the way they provide care. More American healthcare organizations are stating that they are in a turnaround situation. Although there are no definite guidelines or criteria that place an organization in a turnaround situation, there are certain circumstances that are frequently present. These circumstances most often include a somewhat sudden change from a financially favorable situation. This may include revenue lost and/or increases in cost from operations, decreases in volumes that are most positive and favorable to the organization, sudden changes in key management or board representation, and sudden loss of key managers and staff needed for the successful operation of the organization. Any one of these factors or several can place an organization in such jeopardy that quick and decisive actions must be taken to ensure survival and future success. The specific conditions of a turnaround and the effectiveness of quick and decisive actions are critical for the survival of an organization or a system.


1-(N-trifluoroacetylamino)alkylphosphonic acids: synthesis and properties.
The 1-(N-trifluoroacetylamino)alkylphosphonic acids (TFA-AA(P)) - sub-products in the synthesis of O,O-dialkyl 1-(N-trifluoroacetylamino)alkylphosphonates and O,O-diethyl 1-aminoalkylphosphonates, were synthesized in two-stage transformations of 1-aminoalkylphosphonic acids including: trifluoroacetylation of 1-aminoalkylphosphonic acids (AA(P)) using a trifluoroacetic anhydride/trifluoroacetic acid reagent (AA(P) + TFAA/TFA-->2) and subsequent hydrolysis of the intermediary compounds 2 into desired TFA-AA(P) (2-->TFA-AA(P)). These intermediates 2 presented mixtures of the type of mixed anhydrides of TFAA and 1-(N-trifluoroacetylamino)alkylphosphonic, pyrophosphonic and polyphosphonic acids, which underwent rapid and quantitative conversion to corresponding TFA-AA(P) during treatment with an excess of water. The title acids were isolated by direct evaporation of the corresponding post-reaction mixtures, and their physicochemical proprieties, including deacylation abilities, were determined. TFA-AA(P) compounds can be re-converted into the starting amino acids AA(P) under respectively mild conditions (AA(P)-->TFA-AA(P)-->AA(P)).


Value of reagent strips in the rapid diagnosis of spontaneous bacterial peritonitis.
Spontaneous bacterial peritonitis is a severe complication in cirrhotic patients with ascites. Early antibiotics are essential to improve the prognosis. An ascites neutrophil count >250/mm3 is an indication for antibiotic therapy. However this procedure requires intensive labor and is not available in all hospitals on emergency setting. The aim of this study was to assess the utility of Human-Test Combina strips for the rapid diagnosis of spontaneous bacterial peritonitis. The interobserver variability in the result reading was also evaluated. A prospective study of 109 consecutive ascitic fluid samples colected from 55 patients was carried out. The results of the reagent strips were compared with the neutrophil count by conventional optical microscopy. Interobserver agreement was tested in 37 cases. The prevalence of infection was 8.3%. Reagent strips had sensitivity, specificity, positive and negative predictive values of 78%, 88%, 37% and 98% for a cut-off level > or =2 and 67%, 98%, 75% and 97% for > or =3, respectively. Concordance between investigators was 100%. Reagent strips are a rapid, simple and easily available method for the diagnosis of spontaneous bacterial peritonitis. A positive result should be an indication to start antibiotics and a negative result can be useful to exclude the possibility of infection.


The provision of neuropsychological services in rural/regional settings: professional and ethical issues.
Despite rapid growth of the discipline of clinical neuropsychology during recent times, there is limited information regarding the identification and management of professional and ethical issues associated with the practice of neuropsychology within rural settings. The aim of this article is to outline the characteristics unique to practicing neuropsychology in rural communities and to describe the potential professional and ethical dilemmas that might arise. Issues are illustrated using examples from neuropsychological practice in a rural/regional setting in Victoria, Australia. Relative to urban regions, there is an inequality in the distribution of psychologists, including neuropsychologists, in rural areas. The unique characteristics of rural and regional communities that impact on neuropsychological practice are: 1) limited resources in expertise, technology, and community services, 2) greater travel distances and costs, 3) professional isolation, and 4) beliefs about psychological services. These characteristics lower the threshold for particular ethical issues. The ethical issues that require anticipation and careful management include: 1) professional competence, 2) multiple relationships, and 3) confidentiality. Through increased awareness and management of rural-specific professional and ethical issues, rural neuropsychologists can experience their work as rewarding and enjoyable. Specific guidelines for identifying, managing, and resolving ethically and professionally challenging situations that may arise during rural practice are provided.


A joint effort to affect lives. The COPD Wellness Program.
Health care providers can work toward the goal of maintaining quality, dignity, and independence in the elderly when they combine resources with the community to promote wellness and help manage chronic problems. The Chronic Obstructive Pulmonary Disease (COPD) Wellness Program was undertaken for this purpose. The target participants were elderly individuals and their care partners who met the program qualifications: a diagnosis or symptoms of COPD and residency in a certain independent housing facility. The program was designed to help the participants maximize their independence through knowledge and improved management of their disease process.


Flexible active-matrix displays and shift registers based on solution-processed organic transistors.
At present, flexible displays are an important focus of research. Further development of large, flexible displays requires a cost-effective manufacturing process for the active-matrix backplane, which contains one transistor per pixel. One way to further reduce costs is to integrate (part of) the display drive circuitry, such as row shift registers, directly on the display substrate. Here, we demonstrate flexible active-matrix monochrome electrophoretic displays based on solution-processed organic transistors on 25-microm-thick polyimide substrates. The displays can be bent to a radius of 1 cm without significant loss in performance. Using the same process flow we prepared row shift registers. With 1,888 transistors, these are the largest organic integrated circuits reported to date. More importantly, the operating frequency of 5 kHz is sufficiently high to allow integration with the display operating at video speed. This work therefore represents a major step towards 'system-on-plastic'.


Adipokine expression in systemic sclerosis lung and gastrointestinal organ involvement.
The immunomodulatory properties of adipokines have previously been reported in autoimmune disorders. Less is known about the role of adipokines in systemic sclerosis (SSc). Lung and gastrointestinal tract are frequently involved in SSc; therefore, these organs were analyzed for adipokine expression as well as pulmonary samples of patients suffering from idiopathic pulmonary fibrosis (IPF) as comparison. Gastric samples (antrum, corpus) of SSc were analyzed immunohistochemically for adiponectin, resistin and visfatin compared with non-SSc related gastritis. Inflammatory cells were quantified in gastric samples and correlated with adipokine expression. Lung samples of SSc, IPF and healthy controls were also analyzed. Protein levels of lung tissue lysates and bronchoalveolar lavages (BAL) in minor fibrotic stages were measured by ELISA. Lung sections of donor parenchyma showed significantly stronger adiponectin signals as IPF and SSc (donor vs. IPF: p < 0.0001). In SSc and IPF, resistin and visfatin were increased within immune cell infiltrates, but overall no difference in expression for resistin or visfatin compared to controls was observed. In BAL and lung protein lysates of early stages of fibrosis, adiponectin and visfatin were not reduced in IPF and SSc compared to controls. In gastric samples collected by standard endoscopic gastric biopsy, adiponectin was also significantly reduced in SSc- compared to non-SSc gastritis (p = 0.049) while resistin and visfatin were comparable although deeper fibrotic layers were not included in the respective samples. Adiponectin-positive tissues showed higher amounts of CD4+ but not CD8+ T cells. Controls showed no correlation between CD4+ T cells and resistin, whereas SSc showed significantly more CD4+ T cells in resistin-negative tissues. Adipokines are expressed in gastric and lung samples of patients with SSc and in lung samples affected by IPF. Prominently, adiponectin levels were reduced in fibrotic SSc gastritic tissue as well as in IPF and SSc lung tissue. Consequently, adiponectin expression seems to be associated with fibrotic progression in the context of SSc and IPF.


Conceptual framework for analysing farm-specific economic effects of helminth infections in ruminants and control strategies.
Helminth infections are considered to be an important constraint on livestock productivity worldwide. The economic impact of these infections or their control strategies has traditionally been assessed by their effect on animal performance indicators or traditional economic calculation methods (e.g. budgeting and cost-benefit analysis). Because the impact of helminth infections has become more subtle and is farm-specific, one needs more refined economic evaluations of actions meant to increase or maintain the health of livestock on individual farms. This paper proposes an interdisciplinary framework that combines the developments in the veterinary control of helminth infections with economic performance measurements to identify farm-specific and profitable anthelmintic management decisions. Our framework positions individual farms' performance against performance benchmarks and is based on the farms' efficiency in transforming input(s) into output(s). We show how this positioning makes it possible to establish a linkage between input and output transformation, helminth infection levels and effects of control strategies. Furthermore, the framework allows for the identification of improvement paths that are not necessarily related to the helminth infection, but which may lead to other management improvements. We discuss the epidemiological information required and which complementary methods (e.g. efficiency analysis and budgeting techniques) can be used to make the framework operational.


Atrial fibrillation and alcoholic beverages.


[Certain difficulties of diagnosis and treatment of patent ductus arteriosus].
The diagnosis of patent arterial duct (PAD) is not felt to be difficult in the presence of systolic-diastolic murmur, and in 91.7% of cases it would be established on general clinical investigations. In 8.3% of cases the main ausculatatory sign of this defect was distorted or utterly absent. In such cases the correct diagnosis was somewhat difficult. The absence of systolic-diastolic murmur in patients with PAD with conditioned by pulmonary hypertension, insufficiency of pulmonary artery valves, mitral defect, a small diameter of the duct, aneurysm-like changes in the aorta and pulmonary artery, decreased elastic properties of the latter walls, as well. In the absence of PAD pathognomonic signs catheterization of heart cavities and aortography should be employed. Surgical therapy for the lesion concerned in complicated cases shows some specificity. Utilization of the posterolateral approach, controlled hypotension, provisional application of holders to the aorta and below the duct, its being ligated on synthetic pads made it possible to improve the results of treatment of the lesion involved.


Variations in hospice use among cancer patients.
Previous studies have documented that hospice enrollment by terminally ill cancer patients varies substantially by patient characteristics and across broad geographic regions, but little is known about how local practice patterns and individual physicians contribute to these variations. We examined hospice use within a regional integrated health care delivery system that provides consistent insurance coverage and hospice availability for its members to evaluate the relative importance of patient characteristics, physician characteristics, individual physicians, and local health centers in explaining variations in hospice enrollment. We examined data for 3805 Kaiser Permanente of Northern California health plan enrollees who were diagnosed with and died of lung, colorectal, breast, or prostate cancer from January 1, 1996, through June 30, 2001. We used a random-effects linear probability hierarchical model to estimate adjusted hospice enrollment rates and identify factors associated with hospice enrollment. All P values are two-sided. Overall, 65.4% of patients enrolled in hospice care before death. In adjusted analyses, hospice enrollment did not vary by patients' race/ethnicity or marital status (all P>.2) but varied substantially among the 11 health centers where patients were treated (standard deviation [SD] of random effect = 10.0 percentage points, corresponding to an estimated adjusted hospice enrollment rate for two-thirds of centers (2 SDs) ranging from 55% to 75%, P = .02). Hospice enrollment varied less among the 675 individual physicians (SD = 4.6 percentage points; P = .09). Health care within a large integrated delivery system has the potential to eliminate racial and ethnic disparities in hospice use, but substantial variation in hospice use persists among local health centers. Focused efforts to understand how patients, physicians, and hospices interact at the local level are important to ensure equal access to hospice care for all terminally ill cancer patients.


Conformational, steric and electronic effects on the site- and chemoselectivity of the metal-catalyzed reaction of N-bis(trimethylsilyl)methyl, N-(2-indolyl)methyl α-diazoamides.
The Rh(II)- and Cu(II)-catalyzed reactions of N-bis(trimethylsilyl)methyl, N-(2-indolyl)methyl α-diazoamides are investigated to delineate how conformational, steric and electronic factors influence the site- and chemoselectivity of the metallocarbenoid reaction. The N-bis(trimethylsilyl)methyl (N-BTMSM) group is found to be essential in promoting the metallocarbenoid reaction at the N-(2-indolyl)methyl moiety as well as providing subtle but effective conformational influence about the amide N-C(α) sigma bond in diazoamides carrying an N-C(α) alkoxymethyl side-chain, to afford excellent site- and chemoselectivity. In general, the metal-catalyzed reactions are found to favor metallocarbenoid addition to the indole C(2)-C(3) double bond over C-H insertion to give cyclopropanated products (tetracyclic γ-lactams); however, chemoselectivity is also affected by steric effects, as revealed in the N-[2-(3-methylindolyl)]methyl diazoamides, and to some extent by the nature of the catalyst employed, as seen in the N-C(α)-alkoxymethyl diazoamides. The tetracyclic γ-lactams are found to rearrange to give good to high yields of the tricyclic indole derivatives under the metallocarbenoid reaction conditions or under acidic conditions. The propensity of the tetracyclic γ-lactams to undergo rearrangement is found to be dependent on the nature of the α-substituent on the original diazo carbon and the indole N-substituent.


Disclosing the Parameters Leading to High Productivity of Retroviral Producer Cells Lines: Evaluating Random Versus Targeted Integration.
Gammaretrovirus and lentivirus are the preferred viral vectors to genetically modify T and natural killer cells to be used in immune cell therapies. The transduction efficiency of hematopoietic and T cells is more efficient using gibbon ape leukemia virus (GaLV) pseudotyping. In this context gammaretroviral vector producer cells offer competitive higher titers than transient lentiviral vectors productions. The main aim of this work was to identify the key parameters governing GaLV-pseudotyped gammaretroviral vector productivity in stable producer cells, using a retroviral vector expression cassette enabling positive (facilitating cell enrichment) and negative cell selection (allowing cell elimination). The retroviral vector contains a thymidine kinase suicide gene fused with a ouabain-resistant Na+,K+-ATPase gene, a potential safer and faster marker. The establishment of retroviral vector producer cells is traditionally performed by randomly integrating the retroviral vector expression cassette codifying the transgene. More recently, recombinase-mediated cassette exchange methodologies have been introduced to achieve targeted integration. Herein we compared random and targeted integration of the retroviral vector transgene construct. Two retroviral producer cell lines, 293 OuaS and 293 FlexOuaS, were generated by random and targeted integration, respectively, producing high titers (on the order of 107 infectious particles·ml-1). Results showed that the retroviral vector transgene cassette is the key retroviral vector component determining the viral titers notwithstanding, single-copy integration is sufficient to provide high titers. The expression levels of the three retroviral constructs (gag-pol, GaLV env, and retroviral vector transgene) were analyzed. Although gag-pol and GaLV env gene expression levels should surpass a minimal threshold, we found that relatively modest expression levels of these two expression cassettes are required. Their levels of expression should not be maximized. We concluded, to establish a high producer retroviral vector cell line only the expression level of the genomic retroviral RNA, that is, the retroviral vector transgene cassette, should be maximized, both through (1) the optimization of its design (i.e., genetic elements composition) and (2) the selection of high expressing chromosomal locus for its integration. The use of methodologies identifying and promoting integration into high-expression loci, as targeted integration or high-throughput screening are in this perspective highly valuable.


Electrochemical Polymerization of Iron(III) Polypyridyl Complexes through C-C Coupling of Redox Non-innocent Phenolato Ligands.
Phenolato moieties impart redox flexibility to metal complexes due their accessible (oxidative) redox chemistry and have been proposed as functional ligand moieties in redox non-innocent ligand based transition metal catalysis. Here, the electro- and spectroelectrochemistry of phenolato based μ-oxo-diiron(III) complexes [(L1)Fe(μ-O)Fe(L1)]2+ (1) and [(L2)Fe(μ-O)Fe(L2)]2+ (2), where L1 = 2-(((di(pyridin-2-yl)methyl)(pyridin-2-ylmethyl)amino)methyl)phenol and L2 = 3,5-di-tert-butyl-2-(((di(pyridin-2-yl)methyl)(pyridin-2-ylmethyl)amino)methyl)phenol, is described. The electrochemical oxidation of 1 in dichloromethane results in aryl C-C coupling of phenoxyl radical ligand moieties to form tetra nuclear complexes, which undergo subsequent oxidation to form iron(III) phenolato based polymers (poly-1). The coupling is blocked by placing tert-butyl groups at para and ortho positions of phenol units (i.e., 2). Poly-1 shows two fully reversible redox processes in monomer free solution. Assignment of species observed during the electrochemical and chemical {(NH4)2[CeIV(NO3)6]} oxidation of 1 in acetonitrile is made by comparison with the UV-vis-NIR absorption and resonance micro-Raman spectroelectrochemistry of poly-1, and by DFT calculations, which confirms that oxidative coupling occurs in acetonitrile also. However, in contrast to that observed in dichloromethane, in acetonitrile, the oligomers formed are degraded in terms of a loss of the Fe(III)-O-Fe(III) bridge by protonation. The oxidative redox behavior of 1 and 2 is, therefore, dominated by the formation and reactivity of Fe(III) bound phenoxyl radicals, which considerably holds implications in regard to the design of phenolato based complexes for oxidation catalysis.


Catecholamine activity in paraventricular hypothalamus after hemorrhage in cats.
Temporal changes in catecholamine activity within the paraventricular nucleus (PVN) of the hypothalamus were assessed using in vivo voltammetry after moderate hemorrhage in chloralose-anesthetized cats. Oxidation current was measured with carbon microelectrodes, and the change at +250 mV was used as an estimate of catecholamine activity. The magnitude and directional change in catecholamine activity was assessed for each site during the initial 3 min of blood loss. Of 62 recording sites, 45 sites were located along the rostrocaudal extent of the medial PVN. Fifteen of these 45 sites exhibited an increase, 15 others exhibited a decrease, and the remaining 15 sites exhibited no change in catecholamine activity. The magnitude of change in oxidation current was independent of the magnitude of the decrease in arterial pressure after hemorrhage. Twelve of the 15 sites that exhibited increases in catecholamine activity were located in the caudal PVN along its dorsomedial aspect, whereas the location of sites that exhibited decreases in catecholamine activity were more widely distributed throughout the nucleus. These data are consistent with the hypothesis that an increase in the release of catecholamines within the caudal PVN in response to hemorrhage is facilitatory for the release of adrenocorticotropin and/or vasopressin.


Hospital characteristics associated with success in a pay-for-performance program in orthopaedic surgery.
Pay-for-performance programs are designed to link payments to clinical outcomes. We investigated the characteristics of hospitals in the United States, such as size and volume, that were associated with the receipt of a clinical performance bonus in a nationwide pay-for-performance program involving hip and knee replacement. We obtained hospital-level outcomes data from a nationwide pay-for-performance demonstration project on hip and knee replacement. We obtained data on the hospital's size, procedure volume, and case-mix index as well as whether it was a teaching hospital and then performed a multivariate analysis to determine which factors were associated with the receipt of a performance bonus. Hospital size and revenue were not associated with the receipt of a performance bonus. Top-performance hospitals tended to be those specialized in orthopaedics (p < 0.002). Multivariate analysis revealed that high-performance hospitals tended to perform a high volume of hip and knee replacements (p < 0.008), to be teaching hospitals (p < 0.037), and to be located in the Midwestern United States (p < 0.001). Teaching hospitals that perform a high volume of hip and knee replacements will tend to succeed should pay-for-performance programs be enacted nationwide.


Lack of muscle fibre hypertrophy, myonuclear addition, and satellite cell pool expansion with resistance training in 83-94-year-old men and women.
To examine satellite cell and myonuclear content in very old (≥83 years) individuals, and the response to heavy resistance training. A group of very old men and women (Old, 83-94 years, n = 29) was randomized to 12 weeks of heavy resistance training or untrained controls. A group of young men who did not resistance train (Young, 19-27 years, n = 9) were included for comparison. Compared to young men, prior to training the old men had smaller type II fibres (-38%, P < 0.001), lower satellite cell content (-52%, P < 0.001), smaller myonuclear domain (-30%, P < 0.001), and a trend for lower myonuclear content (-13%, P = 0.09). Old women were significantly different from old men for these parameters, except for satellite cell content. Resistance training had no effect on these parameters in these old men and women. Fibre-size specific analysis showed strong correlations between fibre size and myonuclei per fibre and between fibre size and myonuclear domain for both fibre types (r = 0.94-0.99, P < 0.0001). In contrast, muscle fibre perimeter per myonucleus seemed to be constant across the range in fibre size, particularly in type I fibres (r = -0.31, P = 0.17). The present data demonstrate that type II fibre size, satellite cell content and myonuclear domain is significantly smaller in very old men compared to young men, while myonuclear content is less affected. These parameters were not improved with heavy resistance training at the most advanced stage of ageing.


[Bioelectrical activity of the brain in patients with craniocerebral injuries and irritation of brain stem structures].
Affection of the stem structures in craniocerebral injury causes their irritation at different levels and of different degree, which determines the severity of the patient's clinical condition with the corresponding EEG changes. Irritation of a high degree induces functional block of the stem structures which hinders the clinical and EEG manifestations of the local symptoms. The therapeutic measures should be aimed at removing the causes of brain stem affection and at reducing the degree of irritation of the median structures. The EEG facilitates the application of purposeful pathogenetic treatment of patients with cranial and cerebral trauma.


Assessing postpartum adjustment. A pilot study.
Utilizing crisis theory, the stages of growth and development, and a theory of role transition and enactment, a series of questionnaires was developed as a clinical tool to study women's adaptation to motherhood during six weeks postpartum. The tool was tested on six women. Results suggest that the postpartum is indeed a critical period of identity reformation and role transition. Theories are developed for a framework, and a timetable for nursing intervention is given.


Near-field mediated plexcitonic coupling and giant Rabi splitting in individual metallic dimers.
Strong coupling between resonantly matched localized surface plasmons and molecular excitons results in the formation of new hybridized energy states called plexcitons. Understanding the nature and tunability of these hybrid nanostructures is important for both fundamental studies and the development of new applications. We investigate the interactions between J-aggregate excitons and single plasmonic dimers and report for the first time a unique strong coupling regime in individual plexcitonic nanostructures. Dark-field scattering measurements and finite-difference time-domain simulations of the hybrid nanostructures show strong plexcitonic coupling mediated by the near-field inside each dimer gap, which can be actively controlled by rotating the polarization of the optical excitation. The plexciton dispersion curves, obtained from coupled harmonic oscillator models, show anticrossing behavior at the exciton transition energy and giant Rabi splitting ranging between 230 and 400 meV. These energies are, to the best of our knowledge, the largest obtained on individual hybrid nanostructures.


Psychiatric disorders in an Arctic community.
To determine the rates of depression, anxiety, and alcohol abuse, using modern nosology, in a random sample of residents aged 14 to 85 years living in an Arctic community. A cross-sectional 2-step survey of randomly selected households was undertaken, using a self-report questionnaire to screen for anxiety, depression, and alcohol abuse. The survey included the Hospital Anxiety and Depression Scale (HADS) and Ewing and Roose's 4-question alcohol screening instrument (the CAGE questionnaire). Cut-off scores for the HADS and CAGE were found by comparing HADS and CAGE scores with scores on the Structured Clinical Interview for the DSM-III-R (SCID) in a stratified subsample. Estimated rates of depression and anxiety were 26.5% and 19.0% respectively within the past week, and estimated rates of lifetime alcohol abuse were 30.5%. The estimated prevalence of psychiatric disorders in this Arctic community is higher than that indicated in previous findings on Native mental health.


Seizure occurrence and the circadian rhythm of cortisol: a systematic review.
Stress is the seizure precipitant most often reported by patients with epilepsy or their caregivers. The relation between stress and seizures is presumably mediated by stress hormones such as cortisol, affecting neuronal excitability. Endogenous cortisol is released in a circadian pattern. To gain insight into the relation between the circadian rhythm of cortisol and seizure occurrence, we systematically reviewed studies on the diurnal distribution of epileptic seizures in children and adults and linked the results to the circadian rhythm of cortisol. A structured literature search was conducted to identify relevant articles, combining the terms 'epilepsy' and 'circadian seizure distribution', plus synonyms. Articles were screened using predefined selection criteria. Data on 24-hour seizure occurrence were extracted, combined, and related to a standard circadian rhythm of cortisol. Fifteen relevant articles were identified of which twelve could be used for data aggregation. Overall, seizure occurrence showed a sharp rise in the early morning, followed by a gradual decline, similar to cortisol rhythmicity. The occurrence of generalized seizures and focal seizures originating from the parietal lobe in particular followed the circadian rhythm of cortisol. The diurnal occurrence of epileptic seizures shows similarities to the circadian rhythm of cortisol. These results support the hypothesis that circadian fluctuations in stress hormone level influence the occurrence of epileptic seizures.


Complement components as uremic toxins and their potential role as mediators of microinflammation.
Cardiovascular disease is the major cause of death in end-stage renal disease (ESRD) patients. There is growing evidence that atherogenesis is an inflammatory rather than a purely degenerative process leading to a state of microinflammation. This raises the issue of whether treatment modalities of ESRD contribute to the microinflammatory state. One potential candidate in this context is the complement system. Here we consider three potential pathways linking complement activation to progression of atherosclerosis: (1) complement activation on artificial surfaces depends on their physicochemical characteristics, the effect of which is amplified because of the accumulation of complement factor D; (2) the exposure of ESRD patients to endotoxin creates a microinflammatory state, and this may amplify complement-induced damage; exposure to endotoxin may result from frequent infections because of the impairment of host-defense mechanisms or from transfer of bacterial contaminants across dialysis membranes into the blood stream; and (3) direct transduction of proinflammatory signals from blood-material interactions to the vascular system. We conclude that the complement system is an important candidate system in the genesis of microinflammation and accelerated atherogenesis in ESRD. We advance the hypothesis that the generation of proinflammatory signals, in which the complement system appears to be involved--both through systemic and local activation--plays a role in the development of late complications of uremia, including coronary heart disease. This hypothesis provides a rationale to maximize the biocompatibility of the dialysis procedure, that is, selection of nonactivating materials, use of ultrapure dialysis fluid, and--still theoretical--high-flux dialysis to remove factor D.


Ethical issues in gynecology: adolescent confidentiality, provider conscience and abortion, and patient choice of provider gender.
All medical specialists struggle with problems that cannot be solved with medical knowledge alone. The field of gynecology is not unique in medicine for the presence of ethical dilemmas, but the nature of the dilemmas are unique. Gynecologists commonly confront complex ethical questions in their practices that can be answered only through thoughtful consideration of the values, interests, rights, goals, and obligations of those involved. In this paper, three ethical issues that commonly arise in the practice of gynecology are presented: adolescent confidentiality regarding reproductive health services, physician conscience and provision of abortion services, and the question of accommodating patient choice of provider gender. Each topic is introduced with a case vignette followed by an analysis of the issues involved and recommendations for resolution.


The correlated evolution of three-dimensional reproductive structures between male and female damselflies.
For many taxa, species are defined by the morphologies of reproductive structures. In many odonates, these structures are the cerci of males (used to hold females during mating) and the thoracic plates of females where the male cerci contact the females' bodies. A previous study showed that the shapes of cerci of Enallagma males (Zygoptera: Coenagrionidae) are best explained by an evolutionary model of punctuated change at the time of speciation, with a homogeneous rate of change across the entire phylogeny of the genus. In the present study, we examine the evolution of shape change in the corresponding female plates. We found that, like male cerci, the shapes of Enallagma female thoracic plates could best be explained by an evolutionary model of punctuated change at the time of speciation, with a homogeneous rate of change across the clade. Moreover, the evolutionary contrasts quantifying the rates of change in male cerci and female thoracic plates were positively related across the history of the clade, demonstrating that these male and female structures evolve in a correlated fashion. This pattern of evolution suggests that these structures are primary signals of species identity during mating.


Studies of the antidiarrheal action of clonidine. Effects on motility and intestinal absorption.
Clonidine, an alpha 2-adrenergic agonist, has been reported to stimulate the rate of electrolyte absorption in vitro, to alter intestinal motility in vivo, and to have antidiarrheal effects in animals. Experiments were performed in 8 healthy volunteers in order to evaluate the antidiarrheal effect of clonidine in humans. When diarrhea was induced by intragastric infusion of 2700 ml of balanced electrolyte solution over 90 min, oral administration of 0.3 mg of clonidine reduced the volume of rectal effluent by 48% (from 1233 +/- 62 to 640 +/- 77 ml, p less than 0.001), a clear-cut antidiarrheal effect. Clonidine increased total gut volume significantly (from 987 +/- 91 to 1830 +/- 142 ml, p less than 0.001), suggesting that clonidine exerted its antidiarrheal effect by altering gut motility, i.e., increasing the capacity of the gut and slowing the transit of fluid through the intestine. In other experiments, the net absorption rate of the whole gut during steady state total gut perfusion was measured. The rate of absorption of fluid was transiently stimulated by clonidine by 15% (from 696 +/- 77 to 799 +/- 55 ml/h, p less than 0.02), indicating an additional effect on mucosal cell function. These studies indicate that in this experimental diarrhea model, clonidine has antidiarrheal properties that are due largely to effects on motility of the gut but that clonidine also modestly stimulates the net rate of absorption by intestinal mucosa.


Drug-seeking behavior and its mediation: effects of aversion therapy with narcotic addicts on methadone.
The effectiveness of aversion therapy was tested in the modification of drug-seeking behavior in addicts maintained on methadone. Covert imagery was paired with electric shock, and treatment sessions were randomized sequences of classical and avoidance learning trials. A significant decrease in positive ratings of drug stimuli was found immediately after treatment. However, there was no significant difference found between mean percent drug urines for experimental and control groups immediately after treatment, and at 3 and 6 months posttreatment for experiment volunteers and for eligible nonvolunteers, suggesting that motivational and expectancy variables may have interacted systematically with treatment. Implications for further research are discussed.


Crossed inhibition in the human motor system.
We used transcranial magnetic stimulation in humans to investigate the effect of focal unilateral stimulation of the motor cortex on the function of the contralateral motor cortex. Surface-recorded, rectified, averaged electromyography (EMG) showed relative silent periods in small hand muscles at 35-64 and 123-158 ms following ipsilateral cortical stimulation over the hand area. The first inhibitory phase started 11 ms after the minimum corticospinal conduction time from the contralateral cortex, appropriate for transcallosal conduction. Foot muscles (with focal stimulation over the ipsilateral hand area) also showed silent periods at 61-104 ms, indicating a marked spread of the inhibitory effect throughout the opposite motor cortex. H-reflex studies in the upper limb showed that this inhibitory effect was not mediated at the level of the alpha motoneuron. Single motor unit peristimulus time histogram studies in upper limb muscles showed inhibition similar to that seen in the surface recordings and no evidence of excitation following ipsilateral motor cortex stimulation. Transcranial magnetic stimulation performed with large circular coils centered at the vertex activates both excitatory and inhibitory processes bilaterally so that focal unilateral stimulation is preferable in detailed studies of motor system physiology.


Are the responses generated during a psychophysical task independent of previously presented stimuli or do they depend on earlier stimulus presentations?
Quinn and Watt (2006 Perception 35 267-280) showed that the optimal tempi for pieces of music (ie the appropriate speed for a melody) vary from melody to melody. The current study tested if such tempi responses depend on previous stimulus presentations. To do this, we ran a many-participants single-presentation version of the Quinn and Watt experiment. 616 visitors to the Glasgow Science Centre participated. We found that the results substantially matched those obtained earlier, and demonstrate that participants' responses are essentially independent of previously presented stimuli.


Effect of sunlight-exposure on antioxidants and antioxidant enzyme activities in 'd'Anjou' pear in relation to superficial scald development.
Influence of preharvest sunlight exposure on superficial scald development in 'd'Anjou' pears during cold storage was investigated. The biochemical changes related to scald including α-farnesene, conjugated trienols (CTols), antioxidants, antioxidant enzyme activities were monitored among separated blushed and shaded peels of unbagged fruit as well as the whole peel of bagged fruit. In unbagged fruit, scald symptom was restricted to shaded peel; while there was no difference in α-farnesene between blushed and shaded peels, CTols increased significantly in shaded peel along with scald development after 3months storage. Bagging treatment increased both α-farnesene and CTols significantly and enhanced scald. Preharvest sunlight exposure significantly increased certain antioxidant contents and antioxidant enzyme activities in blushed peel at harvest and during storage. These results reveal a direct role of CTols during development of scald, however, antioxidant systems may play an important role in α-farnesene oxidation to CTols and scald susceptibility in 'd'Anjou pears.


[Effect of leptin on long-term spatial memory of rats with white matter damage in developing brain].
To investigate the neuroprotective effect of leptin by observing its effect on spatial memory of rats with white matter damage in developing brain. A total of 80 neonatal rats were randomly divided into 3 groups: sham-operation (n=27), model (n=27) and leptin intervention (n=27). The rats in the model and leptin intervention groups were used to prepare a model of white matter damage in developing brain, and the rats in the leptin intervention group were given leptin (100 μg/kg) diluted with normal saline immediately after modelling for 4 consecutive days. The survival rate of the rats was observed and the change in body weight was monitored. When the rats reached the age of 21 days, the Morris water maze test was used to evaluate spatial memory. There was no significant difference in the survival rate of rats between the three groups (P>0.05). Within 10 days after birth, the leptin intervention group had similar body weight as the sham-operation group and significantly lower body weight than the model group (P<0.05); more than 10 days after birth, the leptin intervention group had rapid growth with higher body weight than the model and sham-operation groups (P>0.05). The results of place navigation showed that from the second day of experiment, there was a significant difference in the latency period between the three groups (P<0.05); from the fourth day of experiment, the leptin intervention group had a similar latency period as the sham-operation and a significantly shorter latency period than the model group (P<0.05). The results of space search experiment showed that compared with the sham-operation group, the model group had a significant reduction in the number of platform crossings and a significantly longer latency period (P<0.05); compared with the model group, the leptin intervention group had a significantly increased number of platform crossings and a significantly shortened latency period (P<0.05), while there was no significant difference between the leptin intervention and sham-operation groups. Leptin can alleviate spatial memory impairment of rats with white matter damage in developing brain. It thus exerts a neuroprotective effect, and is worthy of further research.


High-density lipoprotein cholesterol and cardiovascular disease in Spanish hypertensive women. The RIMHA study.
To determine the prevalence of a low high-density lipoprotein cholesterol (HDL-C) concentration in 11,042 hypertensive Spanish women aged >or=55 years, to identify factors associated with a low concentration, and to evaluate its relationship with cardiovascular disease (CVD). Analysis of RIMHA cross-sectional study findings. Data on demographic, biochemical and clinical variables were obtained. Relationships between a low HDL-C concentration (<46 mg/dL) and CVD and between the HDL-C concentration (in quintiles) and CVD were studied by multivariate logistic regression modeling. The prevalence of a low HDL-C concentration was 24.3% (95% confidence interval [CI], 23.5-25.1%), and was higher in women with diabetes or CVD. A low HDL-C concentration was independently associated with excess weight, smoking, diabetes and the presence of CVD, and inversely with age. The prevalence of CVD was higher in women with a low HDL-C concentration (24.7% vs. 18.4% in those with a normal concentration; P< .001). There was an independent association between a low HDL-C concentration and CVD after adjustment for other risk factors (odds ratio [OR]=1.42; 95% CI, 1.26-1.60; P< .001) and with silent target organ damage (OR=1.31; 95% CI, 1.15-1.49; P< .001). Similarly, there was an independent inverse association between the HDL-C concentration (in quintiles) and the prevalence of CVD, particularly for HDL-C concentrations <58 mg/dL. One in four hypertensive women aged >or=55 years had a low HDL-C concentration, which was independently associated with the presence of CVD. Moreover, there was an inverse association between the HDL-C concentration and the prevalence of CVD, even at normal HDL-C concentrations.


Augmented Likelihood Image Reconstruction.
The presence of high-density objects remains an open problem in medical CT imaging. Data of projections passing through objects of high density, such as metal implants, are dominated by noise and are highly affected by beam hardening and scatter. Reconstructed images become less diagnostically conclusive because of pronounced artifacts that manifest as dark and bright streaks. A new reconstruction algorithm is proposed with the aim to reduce these artifacts by incorporating information about shape and known attenuation coefficients of a metal implant. Image reconstruction is considered as a variational optimization problem. The afore-mentioned prior knowledge is introduced in terms of equality constraints. An augmented Lagrangian approach is adapted in order to minimize the associated log-likelihood function for transmission CT. During iterations, temporally appearing artifacts are reduced with a bilateral filter and new projection values are calculated, which are used later on for the reconstruction. A detailed evaluation in cooperation with radiologists is performed on software and hardware phantoms, as well as on clinically relevant patient data of subjects with various metal implants. Results show that the proposed reconstruction algorithm is able to outperform contemporary metal artifact reduction methods such as normalized metal artifact reduction.


Electroencephalographic parameters in assessing the cognitive function of children with epilepsy.
Many biological and psychological possibilities have to be considered when attempting to explain cognitive dysfunction in the individual child with epilepsy. Electroencephalographic (EEG) information, which may be particularly relevant in some children, has mainly been studied in relation to the possible direct effects of seizure discharges on learning and behavior. Such discharges can be divided into transient, brief or prolonged. Prolonged seizure discharges includes nonconvulsive status epilepticus during wakefulness and status epilepticus during slow-wave sleep. In addition to the influence of seizure discharges, preliminary findings suggest that some children with epilepsy might have a subtle disorder of arousal mechanisms in sleep, possibly associated with impaired daytime performance.


Gingival crevicular fluid prostaglandins and gingival phospholipids in experimentally-induced periodontitis in the dog.
Prostaglandins are known to be mediators of inflammation in many tissues. Their fluctuations in gingival crevicular fluid during experimentally induced periodontitis were investigated, together with the possible role of phospholipids, which were measured in normal gingiva and gingiva associated with the chronic periodontitis. Periodontitis was induced in 5 dogs in the lower premolar quadrant; the opposite quadrant was used as a control. A small amount of inter-radicular bone was removed and then a cotton-wrapped stainless steel ligature was placed around each of 3 premolar teeth below the gingival margin to provide an inflammatory irritant. Pocket depth was measured by periodontal probe; crevicular fluid was collected on absorbent paper points. PGs were analysed by HPLC and the results expressed as ng PG/microliter crevicular fluid. Measurements were taken in both quadrants at 1, 3 and 6 weeks after placement of the ligatures; PGI2, 6 keto-F1 alpha, F2 alpha, E2, E1 and D2 were detected in the crevicular fluid. At 1 week, there was no difference in PG levels between experimental and control sides. During week 3, PGI2 and PGE2 increased in the experimental crevicular fluid [214.1 +/- 49.3 (SEM) vs control 87.0 +/- 39.7; p less than 0.05 and 350.0 +/- 115 vs 162.0 +/- 14.7; p less than 0.05, respectively]. At week 6, only PGE2 was elevated in crevicular fluid (207.7 +/- 68.1 vs 99.2 +/- 45; p less than 0.025).(ABSTRACT TRUNCATED AT 250 WORDS)


The association of protease activated receptor 1 gene -506 I/D polymorphism with disease-free survival in breast cancer patients.
Recent data have shown that tumor development and dissemination may be regulated by procoagulant/anticoagulant axis. The aim of the present study was to search for an association of the protease activated receptor (PAR)1 gene -506 insertion/deletion (I/D), factor V Leiden (FVL), prothrombin (PT) G20210A, and methylenetetrahydrofolate reductase (MTHFR) C677T polymorphisms with disease-free survival (DFS) in breast cancer. Genotyping of -506 I/D in the promoter region of PAR1 gene was performed by single-strand conformation polymorphism analysis and sequencing. FVL, PT G20210A, and MTHFR C677T were also determined by the method of polymerase chain reaction-based DNA analysis. Data regarding patient's age, menopausal status, tumor size, lymph node status, disease stage, tumor grade, estrogen and progesterone receptor, c-erb B2 expression, PAR1 -506 I/D, MTHFR C677T, FVL, and PT G20210A polymorphisms were examined by the univariate and multivariate analyses. Recurrent disease occurred in 29 patients (19.6 %) within a median of 20 months. It was found that tumor size, lymph node status, tumor stage, tumor grade, c-erbB2 expression, and PAR1 -506 I/D polymorphism were associated with DFS when Kaplan-Meier method was applied (P<.05). By Cox proportional hazards model, the presence of allele D at -506 locus (P=.0249) and small tumor size (P=.0001) were significant favorable prognostic factor, but c-erbB2 expression was an adverse prognostic factor (P=.0049). Our study suggested the protective effect of the allele D at -506 locus of PAR1 gene on the recurrence of breast cancer.


A Novel Tool for Deformity Surgery Planning: Determining the Magnitude of Lordotic Correction Required to Achieve a Desired Sagittal Vertical Axis.
We sought to create a model capable of predicting the magnitude of pelvic incidence-lumbar lordosis (PI-LL) correction necessary to achieve a desired change in sagittal vertical axis (SVA). A retrospective review was conducted of a prospectively maintained multicenter adult spinal deformity database collected by the International Spine Study Group between 2009 and 2014. The independent variable of interest was the degree of correction achieved in the PI-LL mismatch 6 weeks after surgery. Primary outcome was the change in global sagittal alignment 6 weeks and 1 year after surgery. We used a linear mixed-effects model to determine the extent to which corrections in the PI-LL relationship affected postoperative changes in SVA. A total of 1053 adult patients were identified. Of these patients, 590 were managed surgically. Eighty-seven surgically managed patients were excluded because of incomplete or missing PI-LL measurements on follow-up; the remaining 503 patients were selected for inclusion. For each degree of improvement in the PI-LL mismatch at 6 weeks, the SVA decreased by 2.18 mm (95% confidence interval, -2.56, -1.79; P < 0.01) and 1.67 mm (95% confidence interval, -2.07, -1.27; P < 0.01) at 6 weeks and 12 months, respectively. A high SVA measurement (>50 mm) 1 year after surgery was negatively associated with health-related quality of life as measured by the Scoliosis Research Society 22 outcomes assessment. We describe a novel model that shows how surgical correction of the PI-LL relationship affects postoperative changes in SVA. This model may enable surgeons to determine preoperatively the amount of LL necessary to achieve a desired change in SVA.


Epoxyeicosatrienoic acids attenuate cigarette smoke extract-induced interleukin-8 production in bronchial epithelial cells.
In response to endothelial cell activation, arachidonic acid can be converted by cytochrome P450 (CYP) epoxygenases to epoxyeicosatrienoic acids (EETs), which have potent vasodilator and anti-inflammatory properties. In this study, we investigated the effects of exogenous EETs on cigarette smoke extract (CSE)-induced inflammation in human bronchial epithelial cells (NCI-H292). We found that CSE inhibited the expression of CYP2C8 and mildly stimulated the expression of epoxide hydrolase 2 (EPHX2) but did not change the expression of CYP2J2. Treatment with 11,12-EET or 14,15-EET attenuated the CSE-induced release of interleukin (IL)-8 by inhibiting the phosphorylation of p38 mitogen-activated protein kinases (MAPKs). Our results demonstrated that CSE may reduce the anti-inflammatory ability of epithelial cells themselves by lowering the EET level. EETs from pulmonary epithelial cells may play a critical protective role on epithelial cell injury.


A mark of silence in malaria parasites.
Gene families in malaria parasites that encode hypervariable surface antigens display mutually exclusive expression that is controlled epigenetically. In this issue, Lopez-Rubio et al. (2009) show that the histone mark H3K9me3 is specifically associated with regulation of expression of these gene families within repressive centers located at the nuclear periphery.


Cortisol cut-points for the glucagon stimulation test in the evaluation of hypothalamic pituitary adrenal axis.
Diagnosis of adrenal insufficiency requires evaluation by dynamic stimulation tests. The insulin tolerance test (ITT) is accepted as the gold-standard test for the evaluation of hypothalamo-pituitary-adrenal (HPA) axis but the test is unpleasant and dangerous. Although it takes more time, glucagon stimulation test (GST) is a good alternative to ITT. The primary aim of this study was to compare the ITT and GSTs in the evaluation of HPA axe in patients with pituitary disorders. We conducted a prospective study in which ITT and GST were performed within 7 days in 81 patients. Serum cortisol was measured. We divided our population in Group 1 (G1): Adrenal Insufficiency (Peak cortisol under ITT <200 ng/mL) and Group 2 (G2): normal response (Peak cortisol under ITT >200 ng/mL). Receiver-operating characteristic (ROC) analysis was performed to identify the thresholds for GST. The mean peak of cortisol under GST was not significantly different from that obtained after ITT in the whole cohort (182.67 ± 89.07 ng/mL vs. 179.75 ± 79.01 ng/mL), and it was significantly reduced in patients of G1 (p < 10-3). ROC curve analysis showed that the best diagnostic accuracy was obtained with a peak cortisol cut-off to GST of 167 ng/mL (sensitivity, 89%; specificity, 79%). Using this cut-off, 86.4% of the patients were correctly classified. In our prospective series, GST is a potential accurate and safe alternative test for the assessment HPA. Test-specific cut-offs should be applied to avoid misinterpretation.


Three new <i>Batillipes</i> species (Arthrotardigrada: Batillipedidae) from the Brazilian coast.
Three new tardigrade species, Batillipes brasiliensis sp. nov., Batillipes dandarae sp. nov. and Batillipes potiguarensis sp. nov., are described from shallow subtidal sediments of the Brazilian coast. B. brasiliensis sp. nov. and B. dandarae sp. nov. have toes 3 and 4 on leg IV different in length, so they can be included in the D group of species, while B. potiguarensis sp. nov., with toes 3 and 4 on leg IV equal in length belong to the A group. Batillipes brasiliensis sp. nov. is characterized by having an ala-like caudal expansion; cuticular projections on the coxal region of legs I-III, and lateral projections. The lateral projection located between the third and fourth legs is fringed with digit-shaped expansions. Batillipes dandarae sp. nov. has a dorsal blunt enlargement in the scapular region; a pointed triangular caudal appendage, and no lateral projections. The new species exhibits a sensorial spine on legs I inserted posteriorly and turning forward, and anus surrounded by a peculiar cuticular structure constituted by six platelets. Batillipes potiguarensis sp. nov. is characterized by a unique combination of characters: scapular region well developed, protruding laterally at the level of the first pair of legs; lateral blunt processes between legs, and prominent roundish caudal protrusion. In addition, the new species exhibits cephalic appendages with swollen tips, evident secondary clavae, and very short sense organs on the legs IV.


A null mutation in the human peripherin/RDS gene in a family with autosomal dominant retinitis punctata albescens.
The murine rds (retinal degeneration slow) allele is a semidominant null allele that causes photoreceptor degeneration. The wild-type sequence at the rds locus encodes a photoreceptor disc membrane protein named peripherin/RDS. Mutations in the homologous human peripherin/RDS gene can cause autosomal dominant retinitis pigmentosa, but these are missense mutations or deletions of single codons. No obvious null alleles have been reported in humans, so that the human phenotype corresponding to rds is as yet unknown. Here we report a 2-basepair deletion in codon 25 of the human gene in a family with autosomal dominant retinitis punctata albescens, suggesting that this disease, rather than retinitis pigmentosa, is the comparable human phenotype.


Prolactin as a marker of dopaminergic activity at different levels of thyroid function in man.
To investigate the hypothesis of an altered dopaminergic activity in hypothyroidism, seven patients without thyroid tissue were studied by means of three consecutive tests: an iv bolus of TRH (200 micrograms); a continuous iv infusion (5 mg during 30 min) of metoclopramide (MCP); and a second, post-MCP, iv bolus of TRH (200 micrograms). The study was performed three times: (A) without treatment; (B) on the 15th day while on L-T4 (150 micrograms i.d.); and (C) on the 30th day with the same treatment. Each time was a different situation of thyroid function; on the basis of basal serum TSH (P less than 0.001, A vs B vs C). The response of PRL to the first (non-primed) TRH, expressed as the sum of increments in ng/ml (mean +/- SE), was significantly higher in A (659 +/- 155) than in C (185 +/- 61). Individual PRL responses correlated with circulating T3 (P less than 0.02), but not with T4. A significant increase of PRL occurred after MCP in the three situations, but there were no differences among them. Likewise, the responses to the second (MCP-primed) TRH showed no differences. Although there was an expected high correlation (P less than 0.001) between basal TSH and circulating thyroid hormones, the maximal response of TSH to both non-primed and MCP-primed TRH was in B. After MCP, no measurable increase of TSH could be demonstrated at any of the three levels of thyroid function. These results do not support the hypothesis of an altered dopaminergic activity in hypothyroidism.(ABSTRACT TRUNCATED AT 250 WORDS)


The persistence of engineered Agrobacterium tumefaciens in agroinfected plants.
Several plant species, including tomato (Lycopersicon esculentum), Gynura aurantiaca, avocado (Persea americana), and grapefruit (Citrus paradisi) grafted on Troyer citrange (Poncirus trifoliata x C. sinensis) were "agro-infected" with Agrobacterium tumefaciens strain LBA-4404, carrying a mini-Ti plasmid with a dimeric cDNA of citrus exocortis viroid (CEVd). Extracts prepared from tissues of the agroinfected plants 38-90 days after inoculation were plated on selective media and found to contain large amounts of the engineered bacteria. These observations suggest the need for more stringent quarantine measures when handling A. tumefaciens cells harboring constructs for "agroinoculation" with plant viruses or viroids.


Molecular electrocatalysis at soft interfaces.
The fundamental aspects of electrochemistry at liquid-liquid interfaces are introduced to present the concept of molecular electrocatalysis. Here, a molecular catalyst is adsorbed at the interface to promote a proton coupled electron transfer reaction such as hydrogen evolution or oxygen reduction using lipophilic electron donors.


Coriander anaphylaxis in a spice grinder with undetected occupational allergy.
Anaphylaxis after ingestion of spices as a result from occupational sensitization remains anecdotal. We describe a patient, working in a spice factory, with anaphylaxis from coriander in a meal. He also demonstrated urticaria, angio-edema, rhinoconjunctivitis and bronchospasm during handling coriander and fenugreek. To determine the mechanism of the anaphylactic reaction and to evaluate cross-reactivity between both botanically unrelated spices. Investigations comprised quantification of total and specific IgE by Immuno-CAP FEIA, skin testing, basophil activation experiments by flow-assisted determination of CD63 expression in the patient and 3 healthy controls. Immuno-CAP inhibition experiments were applied to investigate cross-reactivity. Specific IgE, skin tests and basophil activation tests were clearly positive in the patient, whereas they remained negative in controls. No cross-reactivity between fenugreek and coriander was demonstrable by inhibition experiments. The clinical manifestations in temporal relationship to ingestion of coriander and handling of coriander and/or fenugreek, the positive specific IgE results, skin tests and basophil activation assays support the diagnosis of allergy to both spices. History suggests sensitization by occupational exposure.


Short-term wear of Japanese highly cross-linked polyethylene in cementless THA.
Production of polyethylene wear from acetabular liners is thought, in part, to mediate the periprosthetic osteolysis. This study examined the in vivo wear performance of Japanese highly cross-linked polyethylene (Aeonian) in cementless total hip arthroplasty. Ninety-five hips received a highly cross-linked polyethylene liner, while 20 hips were implanted with conventional polyethylene. Two-dimensional linear wear was measured on radiographs and volumetric wear was then calculated. Both linear and volumetric wear rates were examined for the 1-year postoperative period as well as for the time frame beginning after 1 year ending with the final follow-up. The amount of linear wear was significantly lower in the cross-linked group at 3 and 5 years postoperatively (P < 0.01 and < 0.001, respectively). Linear and volumetric wear rates after 1 year postoperatively for hips with the cross-linked polyethylene were significantly reduced by 57 and 59%, respectively, when compared to rates for those who received conventional polyethylene (P < 0.01). A multiple logistic regression analysis revealed that cross-linking was a significant factor influencing linear wear rate after 1 year postoperatively with an odds ratio, exp(ss) = 10.033 (P < 0.001). These results suggest that the highly cross-linked polyethylene reduces penetration of the femoral head and may be an optimal bearing surface for patients receiving total hip arthroplasty.


Do separated instruments affect pH levels when using calcium hydroxide as intracanal dressing?
The aim of this study was to evaluate the effect of intracanal separated instruments with different lenghts on periapical pH levels using calcium hydroxide (CH) as an intracanal medicament. In total, 60 teeth were used. Following root canal preparation, teeth were divided into four groups (n = 15). In Group 1, 2 mm and in Group 2, 4 mm weakened from the tip of Revo-S NiTi SC2 (Micro-Mega, Besancon, France) instruments were separated in the apical portion of root canals. In Group 3, there was no separated instrument. CH paste was placed in the first three groups. In Group 4, there was no separated instrument or CH paste. Teeth were placed in containers with deionized distilled water. After 1 h and 1, 2, 7, 15, and 30 days, the pH of the solution was measured. At 1 h, Group 3 showed a significantly higher pH than Groups 1 (2 mm) and 2 (4 mm; P < 0.05). At the same time point, Group 1 (2 mm) showed a higher pH than Group 2 (4 mm) without significance. At 1, 2, 7, 15, and 30 days, Group 2 (4 mm) showed a significantly lower pH than Groups 1 (2 mm) and 3 (P < 0.05). At the same time points, Group 1 (2 mm) showed a lower pH than Group 3 without significance. Separated instrument may affect the rise in periapical pH level when using CH as the intracanal dressing. Therefore, 4 mm of separated instrument in the apical third showed a significant effect.


Repair of rabbit duodenal mucosa after acid injury in vivo and in vitro.
Epithelial repair after luminal acid exposure was studied in the rabbit duodenum in vivo and in vitro. Hydrochloric acid (200 mM, 30 min in vivo; 10 mM, 10 min in vitro) caused a uniform damage of the mucosa confined to the villi. After demarcation and detachment of the necrotic tissue the defect was bridged by the remaining viable epithelial cells, resulting in a reduction of villus height. This process of mucosal repair proceeded continuously, so that 9 h after acid damage only 33% of villi in the proximal duodenum and 41% in the distal duodenum remained not fully restored, at both luminal pH 7 and luminal pH 3. The difference is due to the higher acid susceptibility of the distal duodenum. In vitro, most of the mucosal surface was reconstituted 5 h after acid injury, at both luminal pH 7.4 and luminal pH 3. The potential difference declined and reversed after mucosal damage; restitution to original values was only observed at luminal pH 7 in vivo and luminal pH 7.4 in vitro.


Association of hematuria and mycobacterial infection.
Hematuria has been noted to be a presenting symptom of urinary tuberculosis. In the last few decades because of the decreasing incidence of tuberculosis in the United States, the association of tuberculosis and hematuria has been neglected. Now that the incidence of tuberculosis is again on the rise, it is timely to remind the medical community of this association. We present 3 children with hematuria associated with positive tuberculin tests. Mycobacterium tuberculosis was cultured from the urine of one patient. Mycobacterium avium-intracellulare was cultured from a second patient. All 3 patients showed clearing of their hematuria with antituberculosis therapy. A tuberculin test should once again be considered part of the standard work-up of hematuria.


Serological survey of salmonellosis in grey duiker (Sylvicapra grimmia) in Asejire, Irewole Local Government Area, Osun State, Nigeria.
A serological survey of salmonellosis in grey duiker was carried out in Asejire, Irewole Local Government Area (LGA), Osun State, between August and September, 1996. The sera of 50 animals were screened for antibodies to salmonella flagella (H) and/or somatic (O) antigens. Ten "bushmeat" hawkers/processors were interviewed on their state of health. Twenty-two (44%) and 3 (6%) had antibodies to the H and O antigens, respectively. Nine (18%) had antibodies to both the H and O antigens. Antibody titres of 1/320 were detected against Salmonella paratyphi serotypes B (12%) and C (2%) and S. typhi serotype D (8%). Four (40%) of the interviewed hawkers/processors had had 'fever' in the recent past, and 80% of them usually take traditional herbal medicines for most fever-related ailments. A human typhoid epidemiological surveillance carried out within the LGA between 15th March and 4th April, 1995 revealed 64 cases of tentatively diagnosed salmonellosis. Eleven (17.2%) cases were conclusively diagnosed as typhoid fever by laboratory examination. High antibody titres against H and O antigens of S. paratyphi serotype B and S. typhi serotype were detected. Two (3.1%) of the patients died. The public health importance of these findings is discussed.