Iron status of French-Canadian children: a three year follow-up study.
Dietary iron intake and hematocrit, hemoglobin, serum iron, transferrin saturation and serum ferritin were studied longitudinally in 425 French-Canadian children from upper-middle class families at 3, 6, 9, 12, 15, 18, 24 and 36 months. At 3 to 9 months, the median iron intake exceeded the amount recommended (7 mg/d), at 12 to 36 months it was close to the amount recommended (8 mg). The proportion of anaemic children as diagnosed by low hematocrit and hemoglobin values did not exceed 5 percent except at three months of age. Transferrin saturation lower than 16 percent was detected in 12 percent of the children aged 12-18 months and 8 percent of those aged 24-36 months. Serum ferritin increased from 18 to 36 months of age; between 18 months and 3 years, the proportion of children with deficient serum ferritin (SF less than 10 ng/ml) and low iron reserves (SF 10-20 ng/ml) declined respectively from 29 to 2 percent and 55 to 26 percent. Thus, as the children grew older the iron intake still permitted the improvement of hematologic parameters of iron status in most subjects. The progressive increase of hematological values with age emphasizes the need for more specific standards for children of various ages.


The anastomosis angle does change the flow fields at vascular end-to-side anastomoses in vivo.
The purpose of this article was to study the influence of the anastomosis angle on the flow fields at end-to-side anastomoses in vivo. Polyurethane grafts of similar internal diameter to that of the abdominal aorta (8 mm) were implanted from the suprarenal to the infrarenal level in 10 pigs. Three angles of standardized distal end-to-side anastomoses (90 degrees, 45 degrees, and 15 degrees) were studied. The anatomic position of the anastomoses was constant, the proximal outflow segment was occluded, and the flow rate through the graft was controlled. Flow visualization was accomplished by a color-flow Doppler ultrasound system. The angulation was reproduced within 10%. Gross hemodynamic parameters were stable, and the similarity parameters were typical for peripheral bypasses (mean Reynold's number is 424 and Womersley's parameter is 5.9). The flow fields were clearly dependent on the anastomosis angle. A zone of recirculation (approximately 5% of the flow area), extending from the toe to one diameter downstream, was found in the 45-degree and 90-degree anastomoses. No flow disturbances were detected at the toe and one diameter downstream with an anastomosis angle of 15 degrees. At the heel different recirculating flow patterns were found in the different anastomoses. The anastomosis angle does change the flow fields at vascular end-to-side anastomoses in vivo.


[Case of advanced gastric cancer successfully treated with chemotherapy of weekly paclitaxel].
We report a case of gastric cancer with ascites treated with chemotherapy. The patient is a 67-year-old male. Combination chemotherapy of S-1 and CDDP was given as the first-line treatment. However, the symptoms did not improve with that regimen, so we decided to change the chemotherapy to paclitaxel as second-line treatment. After 4 cycles, CT scan revealed decreasing ascites and endoscopy a reduction of the primary tumor. The patient has maintained a condition of decreasing ascites with improvement of QOL for 8 months. This regimen is considered effective treatment for unresectable gastric cancer.


[Bacteriostatic and bacteriacidal activity of hydroxy-9 ellipticine in vitro].
9-Hydroxy-ellipticine shows a clear effect against bacterial development. This effect depends essentially upon the bacterial species. Two groups can be differentiated: Group I with resisting species composed by negative Gram Bacilli (Enterobacteria and Pseudomonas); Group II with sensitive species formed by Coccus, positive Gram Bacilli, Mycobacterium tuberculosis and Anaerobes.


Morphological forms of Trypanosoma evansi from blood of Arabian camel (Camelus dromedarius) in the Riyadh metropolitan areas.
Trypanosoma evansi is commonly referred to as haemoflagellate infesting camels and other vertebrates. It is causative agent of number of diseases. T. evansi has several morphological forms. We have detected three forms in the blood of camels, slender, transitional and intermediate. The present study is the first investigation on the morphological forms of T. evansi in Arabian camels in Saudi Arabia.


[The effect of alcohol on the immune system and cytokines].
Chronic alcoholism is a disease, which is known to affect individual's resistance to infections. Alcohol has a variety of short- and long-term effects on cell mediated and humoral immune response. Alcohol also affects the production, site of action and metabolism of cytokines, which are regulatory peptides of the immune and inflammatory response of lymphocytes, monocytes/macrophages and a variety of other cell types. In this review, current knowledge regarding the effect of alcohol on the immune system and the release and action of cytokines in humans and in animal models, in vivo and in vitro, is presenting. Furthermore, the role of cytokines in development of alcoholic liver disease is also discussed.


[Development of a method for the immunological measurement of aspartate aminotransferase with monoclonal antibodies].
For laboratory diagnostics in liver diseases, many enzymes have been used for the assessment of hepatocellular function. Among them, two transaminases, alanine and aspartate aminotransferase, have been regarded as the most sensitive indicators of hepatocellular damage. However, the enhanced enzyme activities of the enzymes do not exactly indicate or represent the cause and progression of diseases in the patients with liver disease. To overcome such limitations, immunological methods have been suggested as one of the alternatives for the replacement or supplement of the conventional enzymatic analysis. In the hope of developing a new assay system for measuring the AST concentration rather than its activity, we have developed a new assay using fluorescence labeled anti-AST monoclonal antibodies. Blood was obtained from a normal population of 234 patients and 43 liver disease patients. The linearity, limit of detection, and performance of the new assay system were tested and evaluated. The comparability of assay was examined with an ELISA and biochemical assays. The linearity fell in the range of 0-1 mg/L of AST (R=0.995), and the analytical detection limit was 12 microg/L of AST. The mean recovery of the control was 102.4 % in a working range. The precision of the intra- and inter-assay in a range of 50-800 microg/L was CVs < 7% and CVs < 6%, respectively. In the normal population, the mean AST concentration was 35.5 microg/L. The mean AST concentration in patients with liver disease was 266.5 microg/L. The new assay system correlated well with an ELISA and biochemical assay for quantification of AST concentration (R=0.92 and 0.88, respectively; N=43). We have developed a new immunological assay using generated monoclonal antibodies to human cytosolic AST and used them for the development of a fluorescent assay measuring the enzyme mass. Cytosolic AST mass in sera could be measured reproducibly by the immunological method. In conclusion, this study has provided us with a new type of tool for an accurate measurement of the enzyme amount in circulation.


Pharmacological characterization of the muscarinic receptors mediating contraction of canine saphenous vein.
1. The muscarinic receptor subtype mediating contraction of the canine saphenous vein has been characterized using a range of muscarinic agonists and subtype-selective antagonists. 2. Oxotremorine M and (+)-cis-dioxolane behaved as full agonists, while in comparison L-660,863 ((+/-)-3-(3-amino-1,2,4-oxadiazole-5-yl)quinuclidine) acted as a partial agonist. SDZ ENS 163 (thiopilocarpine), pilocarpine and McN-A-343 (0.1 microM-0.3 mM) did not elicit a response. The profile of agonist potencies suggests a low receptor reserve for contraction. 3. The rank order of antagonist apparent affinities was 4-DAMP (4-diphenylacetoxy-N-methylpiperidine methiodide; 8.41) > pirenzepine (8.10) > himbacine (7.34) > or = p-F-HHSiD (para-fluoro-hexahydrosiladifenidol; 7.15) > methoctramine (6.23). This antagonist apparent affinity profile is consistent with the activation of muscarinic M1 receptors.


Is God a Placebo?
Every treatment, in classical no less than in unorthodox medicine, includes a so-called 'placebo' component. Such ingredients are more accurately described as non-specific factors (NSF), for several reasons, including the fact that they are not invariably pleasing. The purpose of the title of this contribution is to provoke a discussion of NSF, leading to their classification and the description of a quantitative method (based on Judgment Analysis) of estimating the amount of 'placebo-ness', or 'non-specificity', attributable to any treatment, whether surgical or intercessory prayer.


Consecutive fecal calprotectin measurements to predict relapse in patients with ulcerative colitis receiving infliximab maintenance therapy.
This study examined whether fecal calprotectin can be used in daily practice as a marker to monitor patients with ulcerative colitis (UC) receiving infliximab maintenance therapy. This prospective multicenter study enrolled adult patients with UC in clinical remission under infliximab maintenance therapy. Fecal calprotectin levels were measured every 4 weeks. Sigmoidoscopies were performed at inclusion and at study end. Relapse was defined as a clinical need for change in treatment or an endoscopic Mayo subscore of ≥2 at week 52. Sustained deep remission was defined as a partial Mayo score <3 at all points and an endoscopic Mayo score 0 at week 52. Full analysis was possible for 87 of 113 included patients with UC (77%). Of these patients, 30 (34.4%) were considered to be in sustained deep remission and 13 (14.9%) to have relapsed. Calprotectin levels in patients with sustained deep remission remained very low (median < 40 mg/kg at all time points). Patients who flared had significantly higher calprotectin levels (median > 300 mg/kg) already 3 months before the flare. Further receiver operator curve analysis suggested that a calprotectin level >300 mg/kg had a reasonable sensitivity (58.3%) and specificity (93.3%) to model flare. Two consecutive calprotectin measurements of >300 mg/kg with 1-month interval were identified as the best predictor of flare (61.5% sensitivity and 100% specificity). Fecal calprotectin can be used in daily practice to monitor patients with UC receiving infliximab maintenance therapy. Two consecutive measurements >300 mg/kg is more specific than a single measurement for predicting relapse.


Clinical Features and Treatment Outcomes of Patients With Necrobiotic Xanthogranuloma Associated With Monoclonal Gammopathies.
Necrobiotic xanthogranuloma (NXG) is a rare chronic granulomatous disorder of the skin associated with a monoclonal gammopathy. The present report describes the findings from a single tertiary medical center retrospective study, including the clinical features of 35 patients with NXG and monoclonal gammopathy from 2000 to 2015 and their subsequent disease course and treatment response. The median age at diagnosis was 56 years (range, 26-88 years). Most patients had a plasma cell dyscrasia consisting of monoclonal gammopathy of undetermined significance in 28 patients and smoldering multiple myeloma in 5 patients; the remaining 2 patients had chronic lymphocytic leukemia. An IgG isotype of monoclonal gammopathy was present in almost all the patients (97%). The most common site of cutaneous involvement of NXG was periorbital (66%). The treatments were heterogeneous and included excision, intralesional injection, radiotherapy, and systemic chemotherapy. The median follow-up period was 46 months (range, 4 to 234 months). The median overall survival had not been reached at the analysis, and 80% of the patients were still alive. Eight patients (23%) had disease progression to multiple myeloma at a median of 67 months (range, 21 to 107 months), demonstrating that although the clinical course is generally indolent, malignant transformation is not uncommon. At the last follow-up visit, 80% had signs of either clinical improvement or stable skin disease. Cutaneous objective responses can be achieved with treatment of lymphoplasmacytic malignancies.


An on-line investigation of prototype and exemplar strategies in classification.
Although prototype- and exemplar-based models of categorization are very different in character, they have proved difficult to distinguish experimentally. The research described here presents a priming technique for assessing the type of information retrieved at the moment that a categorization decision is made. This technique avoids many of the problems inherent in the standard paradigms. Data from six experiments are presented that demonstrate the usefulness of the technique and also address basic questions about the categorization process. Results bolster previous suggestions that categorization strategies may be mixed within a single experimental task and highlight the need for more specific predictions about when each strategy will come into play.


Power spectra of sternocleidomastoids, splenius capitis, and upper trapezius in oblique exertions.
There is relatively little known concerning the spectral profile of the cervical muscles, despite the fact that neck injury and pain are quite prevalent. The objective of the study was to calculate and study the power spectral characteristics of the sternocleidomastoids, splenii capitis and upper trapezii in anterolateral flexion and posterolateral extension in a ramp contraction. In a laboratory setting experiments were conducted to record surface electromyographic (EMG) data from six cervical muscles and power spectral variables obtained. Forty normal and healthy young adults (21 men, 19 women). Power spectral of EMG signals. EMG data for the left and right isometric anterolateral flexion and posterolateral extension were acquired from the sternocleidomastoids, splenii capitis and upper trapezius bilaterally. The subjects were seated in an upright posture and exerted left and right anterolateral flexor and posterolateral extensor efforts from rest to their maximal voluntary contraction in a gradual linear ramp fashion using visual feedback as a guide. The force exerted and the surface EMG data were sampled at 1 kHz at every 10th percentile grade of contraction and the EMG data were subjected to the Fast-Fourier transform analysis. The median frequency (MF), mean power frequency (MPF), peak power and total power of all six cervical muscles were analyzed. In the anterolateral flexion the ipsilateral sternocleidomastoid and splenius capitis had a wider band of frequency, which further widened with increasing grade of contraction. The trapezius did not engage in the same manner or to the same magnitude. The MF of the sternocleidomastoid in the anterolateral flexion in both genders progressively increased, the splenius capitis remained relatively unchanged, and the upper trapezius declined with the increasing grades of contraction. There is no significant difference between the genders in spectral profile. There is a bilateral symmetry in spectral profile with reference to activity; however, they are significantly different in different activities for the same muscles. With increasing magnitude of contraction power, spectral density distribution increases and the median frequency decreases. These results can serve as a useful reference for painful necks. Restoration of power spectral characteristics may indicate normalcy, which cannot be gleaned by other EMG or force variables.


Bilateral femoral shortening for overgrowth in young adults.
Through 17 years ten patients were treated for psychologically unacceptable tallness by bilateral femoral shortening. All were young adults between 17 and 28 years; one was acromegalic, one had Marfans syndrome and the other were tall for unknown reasons. The amount of shortening obtained was between 6 and 16 cm. One patient was reoperated bilaterally because of insufficient stability of the pin and plate fixation. All patients healed without significant complications. For exclusive cases, which have been carefully observed over several months, bilateral shortening seems to be a safe procedure either with midshaft shortening and Küntscher nailing or subtrochanteric femoral shortening with pin and plate fixation. At review all patients were satisfied with their decision to be surgically shortened. Similar cases seem not to have been published.


Polymorphisms in the 5'-flanking region of the insulin gene and non-insulin-dependent diabetes.
DNA insertions in the 5'-flanking region of the insulin gene have been studied by Southern-blot-hybridization techniques using a cloned gene probe in 159 unrelated Caucasians. Subjects homozygous for a large DNA insertion at this locus were found to have a higher risk of concurrence of non-insulin-dependent diabetes (NIDD) than controls (P less than 0.01). Analysis of a single large NIDD pedigree (n = 67 in four generations; 11 diabetic subjects) showed no linkage between the size of DNA inserts and diabetes (Lod score = -5.7), suggesting a separate diabetogenic locus (or loci) in this family.


Using isoform-specific inhibitors to target lipid kinases.
In this issue of Cell, Knight et al. (2006) present a detailed pharmacological analysis of the PI3 kinase (PI3-K) family using small molecule inhibitors. They conclude that p110alpha, a PI3-K isoform, has a critical role in insulin signaling. In a related Cancer Cell paper, Fan et al. (2006) show that blocking activation of both p110alpha and the kinase mTOR with a small molecule inhibitor limits the growth of gliomas.


[Essential thrombocythemia--clinical course from personal material].
The article presents clinical course analysis of essential thrombocythemia in 17 patients aged 29-82. The diagnostic criteria were the same as described by Polycythemia Vera Study Group. Mean platelet level of diagnosis was 1680 x 10(9)/l. Haemorrhagic complications were observed in 42% of the patients, while thrombotic ones or embolisms in 35%. In two cases both types of complications occurred. Asymptomatic course of the disease was observed in 5 patients. The statistical analysis proved that the patients with platelet count between 900-1900 x 10(9)/l are in danger of developing thrombotic episodes and thus antiaggregation treatment should be considered. If platelet level exceeds 1900 x 10(9)/l the risk of haemorrhage increases, so antiaggregation treatment is contraindicated and thrombocytapheresis is advised instead. The patients was started on treatment when platelet count was above 1000 x 10(9)/l in asymptomatic cases or with lower platelet level in symptomatic ones. The treatment consisted of busulphan, hydroxyurea or interferon alpha (in one of the patients) until lowering platelet level below 600 x 10(9)/l.


Effect of aromatherapy massage on dysmenorrhea in Turkish students.
The purpose of this study was to investigate the effect of aromatherapy massage on dysmenorrhea. The study used a quasiexperimental design with the subjects as their own control. Every participant applied both aromatherapy massage with lavender oil and placebo massage with odorless liquid petrolatum [soft paraffin]. The population comprised 438 midwifery and nursing students. The 150 students who had declared that they had suffered from dysmenorrhea used a visual analog scale to indicate their level of pain. Higher scores reflected a greater severity of dysmenorrhea. Forty-four students volunteered to participate in the study. When the lavender massage and the placebo massage were compared, the visual analog scale score of the lavender massage was found to decrease at a statistically significant rate. This study showed that massage was effective in reducing dysmenorrhea. In addition, this study showed that the effect of aromatherapy massage on pain was higher than that of placebo massage.


Efficiencies from consumed O2 and pressure-volume area to work of in situ dog heart.
We studied the efficiencies from oxygen consumption (VO2) to external mechanical work (EW), from VO2 to the systolic pressure-volume area (PVA), and from PVA to EW, and the effects of cardiac output and contractility index (Emax) on these efficiencies in the left ventricle of open-chest, right-heart-bypassed dogs. PVA is an intermediate form of energy between VO2 and EW. PVA, EW, and Emax were determined by an abrupt occlusion of the ascending aorta. The right-heart bypass allowed us to collect all coronary venous return for VO2 measurement. The EW/VO2 efficiency ranged between 4 and 21%, the PVA/VO2 efficiency ranged between 5 and 27%, and the EW/PVA efficiency ranged between 60 and 95%. At a given Emax, EW/PVA efficiency was independent of cardiac output, but PVA/VO2 and EW/VO2 efficiencies increased with cardiac output. An increase in Emax by dobutamine increased EW/PVA efficiency, but decreased PVA/VO2 and EW/VO2 efficiencies. We could theoretically account for these changes in EW/PVA, PVA/VO2, and EW/VO2 efficiencies of the in situ heart by the VO2-PVA relation and its dependence on Emax that we had observed.


A class V chitin synthase gene, chsA is essential for conidial and hyphal wall strength in the fungus Colletotrichum graminicola (Glomerella graminicola).
The Colletotrichum graminicola tagged mutant T30 has conidia that burst and hyphal tips that swell in media with low osmotic pressure. The disrupted gene in T30 was identified as a class V chitin synthase (CSV) "chsA," which has an open reading frame of 1783 amino acids and two introns that are 52 and 54 bp. C. graminicola has one copy of chsA and no other highly homologous class V CHSs. Reverse transcriptase PCR indicated that the T30 mutant does not express the chsA transcript fragment in the conserved region in CSVs. Complementation of the mutant with chsA indicates that the encoded protein is responsible for approximately 29% of the chitin in conidial walls, is essential for conidial wall strength in media with high water potential and contributes to strength of hyphal tips. Analysis of the aligned deduced amino acid sequences of the 10 fully sequenced CSVs suggests that they are in two subgroups.


[Aging of spiked pyrene in two paddy soils and their particle-size fractions after soil incubation and changes in extractability and bio-availability to earthworm].
Effect of aging on bioavailability and extractability of persistent organic pollutants has recently been paid much attention in environmental studies. This study deals with aging of spiked pyrene, a four-ring polycyclic hydrocarbon, in two paddy soils and their particle-size fractions under laboratory incubation and change in its extractability and bioavailability. The bioavailability of aged pyrene was tested by an assay of exposure to earthworms (Eisenia foetida). The extractability of spiked pyrene was decreased by 15% to 23%, and the bioavailability to earthworm was decreased by 37% to 67% after incubation for 90 d compared to under no incubation. Meanwhile, there was no significant difference in the pyrene extractability between incubation with different size fractions of a single soil. Soil incubation resulted in lower extractability and, thus, lower environmental risk of the organic pollutants after incorporation in paddy soils and their aggregates. The different size fractions of paddy soils may exert different bioavailability when exposure to soil fauna. Thus, content and chemical extractability may not be appropriate index for assessing the potential environmental risk and bioavailability to soil fauna for persistent organic pollutants in paddy soils.


Stable expression of constitutively activated mutant h5HT6 and h5HT7 serotonin receptors: inverse agonist activity of antipsychotic drugs.
In order to determine the possible relationship between antipsychotic drug properties and inverse agonist activity at h5HT6 and h5HT7 receptors, constitutively activated forms of these receptors were created by site-specific mutagenesis. Typical and atypical antipsychotic drugs were assayed for their potencies as inverse agonists at these mutated receptors. Stable cell lines expressing constitutively activated forms of the h5HT6 and h5HT7 receptors were created. Typical and atypical antipsychotic drugs demonstrating high to moderate affinities for the h5HT6 and h5HT7 receptors were assayed for their potencies in reversing the agonist-independent activity (inverse agonist activity). The E322R h5HT6 mutant and the S267K h5HT7 mutant displayed sufficiently robust agonist-independent activity when expressed in stable cell lines to allow the detailed, concentration-dependent, investigation of the inverse agonist activity of typical and atypical antipsychotic drugs. All the drugs tested displayed inverse agonist activity at both the activated h5HT6 and h5HT7 receptors. Native forms of these receptors did not display any constitutive activity. Interestingly, atypical antipsychotic drugs displayed potent inverse agonist activity, relative to typical antipsychotic drugs, at the h5HT7 receptor. LSD displayed neutral antagonist properties at the mutant h5HT7 receptor. Site-specific mutations in the third intracellular loop of the G(s)-coupled h5HT6 and h5HT7 receptors produce constitutive activation. Antipsychotic drugs display inverse agonist activity at the activated receptors. The inverse agonist mechanism-of-action of the atypical antipsychotic drugs at the h5HT7 receptors may be different from the typical antipsychotic drugs as these drugs displayed far higher potencies as inverse agonists at the h5HT7 receptor.


A cell line from pleomorphic adenoma of the rat salivary gland.
Pleomorphic adenoma of rat salivary gland is extremely rare, and culture of cells obtained from rat salivary gland tumors has not been reported. We have established a long-term cell line from a pleomorphic adenoma of a Sprague-Dawley rat submaxillary gland. The pleomorphic adenoma was composed of oval or spindle-shaped cells occasionally forming a small duct. Alcian blue-positive intercellular matrices, consisting mainly of glycosaminoglycans, were abundant. The cultured cells showed characteristics similar to those of the original tumor. This cell line should be useful for biological and biochemical studies of glycosaminoglycan-synthesis of pleomorphic adenoma cells.


Empirically derived ability-achievement subtypes in a clinical sample.
The purpose of the present study was to identify reliable and clinically meaningful patterns of ability and achievement using the WISC-III and WIAT. Cluster analysis was used to group the 182 WISC-III and WIAT profiles (10 WISC-III subtests and 4 WIAT subtests) of children between the ages of 9 and 14 years. Theoretical and empirical considerations were used to identify a cluster solution, which involved comparison of several five-, six- and eight-cluster solutions. A five-cluster solution was selected as being representative of the data, which was well replicated across three hierarchical clustering methods (i.e., complete linkage, average linkage-within groups, and average linkage-between groups (UPGMA)). The clusters were labeled based on their most salient characteristics, which included a group of predominantly low ability and achievement, a group demonstrating a pattern of verbal processing deficits, a group demonstrating a pattern of visual spatial/processing speed deficits, a group with low ability and achievement with average processing speed, and a group with deficits consistent with an ACID pattern. The external validity of the five subtypes was assessed through an evaluation of the relationship between cluster membership and neuropsychological test data. Most predictions regarding neuropsychological performance were supported by the data, providing further evidence of the validity of the five-cluster solution. Clinical implications of the ability-achievement typology and suggestions for future research are discussed.


Circulating matrix Gla protein: a potential tool to identify minor carotid stenosis with calcification in a risk population.
Carotid calcification is an independent marker for future ischemic events, which are more frequently encountered in postmenopausal women as the prevalence of type 2 diabetes mellitus (T2DM) and hypertension (HT) increases. Matrix Gla protein (MGP) is a major inhibitor of vascular calcification. Here, we report on the prospect of serum MGP to become an identifying tool for minor carotid stenosis (minCAS) with calcification in a risk population. Based on carotid ultrasound examination, out of 72 enrolled postmenopausal women, 33 had minCAS with carotid calcification (minCAS group) and 39 were without minCAS and carotid calcification (non-minCAS group). Serum total MGP, high-sensitivity C-reactive protein (hs-CRP), bone mineral density (BMD) and carotid intima-media thickness (CIMT) were determined. We found significantly elevated serum MGP levels in the minCAS compared to the non-minCAS group (p < 0.05). MGP was independently associated with hs-CRP (unstandardized β -regression coefficient = 2.6; 95 % CI 0.007 – 5.3; p = 0.049) and CIMT ( β = – 611.3; 95 % CI – 1172.6 – – 49.9; p = 0.034) within the minCAS group, but not with BMD. Furthermore, significantly higher MGP levels were determined in two minCAS subgroups (one with HT or T2DM and second with both diseases) compared to a non-minCAS subgroup with HT or T2DM (p < 0.05 and p < 0.01, respectively). A threshold of 87.9 μ g/L serum MGP (area under the receiver operating characteristic = 0.72 } 0.06; 95 % CI 0.60 – 0.84; p = 0.001) may identify minCAS with calcification in postmenopausal women with 63 % precision. Higher circulating MGP levels could help identify minCAS with calcification in a relatively homogenous risk population (i.e., postmenopausal women), regardless of underlying cardiovascular risk factors.


The effect of mold sensitization and humidity upon allergic asthma.
Humidity is commonly associated with increased airway hyperresponsiveness in asthma. To examine mold sensitization in patients with allergic asthma or allergic rhinitis and self-reports of humidity as exacerbating factors of clinical symptoms. A retrospective, cross-sectional study at a University hospital outpatient allergy and asthma clinic was performed. A total of 106 patients with either allergic asthma or allergic rhinitis completed standard prick-puncture skin testing with 17 allergens and controls and completed standardized forms addressing trigger factors for clinical symptoms. Allergic asthmatics sensitized to Cladosporium were more likely to have a more severe asthma severity class (odds ratio = 4.26, confidence interval = 1.30-16.93). Sensitization to Alternaria, Cladosporium, Helminthosporium, Aspergillus and Dermatophagoides pteronyssinus in asthma was associated with higher likelihood for previous hospitalization, while sensitization to Cladosporium, Helminthosporium, Aspergillus, Dermatophagoides pteronyssinus and cockroach in asthma was associated with higher likelihood of having reduced pulmonary function based on forced expiratory volume in 1s. Furthermore, allergic asthmatics more commonly reported humidity as an exacerbating factor of symptoms than did patients only with allergic rhinitis (68.42% vs 42.86%, respectively; P < 0.05). Mold sensitization is highly associated with more severe asthma, while humidity is more of an exacerbating factor in patients with allergic asthma as compared with allergic rhinitis alone. Further delineation between mold sensitization and humidity is needed to determine whether these are independent factors in asthma.


The IL-10 promoter polymorphism at position -592 is correlated with susceptibility to occult HBV infection.
Occult hepatitis B infection (OBI) is characterized as a form of hepatitis in which detectable amounts of HBV-DNA can be monitored in the peripheral blood of patients whereas the hepatitis B surface antigen is undetectable. The main aim of this study was to investigate whether there is a relationship between OBI and single nucleotide polymorphisms in the -592 region of the IL-10 gene. In this study, the polymorphism at position -592 of the IL-10 promoter of 57 OBI cases was compared and correlated to that of 100 healthy controls by PCR-RFLP techniques. Our results showed that patient and control groups had significant differences regarding genotypes and alleles of the -592 polymorphism in the IL-10 gene. Based on our results, it can be concluded that the -592 polymorphism within the promoter of the IL-10 gene is associated with OBI.


Crying babies, empathic toddlers, responsive mothers and fathers: Exploring parent-toddler interactions in an empathy paradigm.
The ability to display caring responses to another child's distress is a key aspect of early empathy that is facilitated by parental socialization. However, existing studies typically involve lab settings and focus on toddlers' unsupported responses to adult simulations of distress, raising questions about their ecological validity. Framed within the New Fathers and Mothers Study, the current study involved 156 British toddlers (Mage = 24.35 months, SD = 0.73) who were filmed at home with either their mother or father (87 mothers and 69 fathers) in a novel paradigm involving a lifelike crying baby doll. Capitalizing on the inclusion of both fathers and mothers, a key question concerned effects of parent-toddler dyad gender composition on both global ratings of toddlers' displays of empathic concern and more specific indicators, including toddlers' attentional, emotional, and behavioral responses. Whereas parental responses did not differ by either child or parent gender and appeared to be closely attuned to child behavior, toddlers' responses showed effects of both (a) child gender, evident in higher rates of emotion labeling in girls than in boys (even when controlling for language ability), and (b) parent gender, evident in higher levels of empathic concern for girls observed with fathers than for those observed with mothers. These findings are discussed within the context of empathy development and parental socialization.


The role of enriched foods in infant and child nutrition.
Since the last century, fortified and enriched foods are products whose original composition has been modified-through addition of essential nutrients-to satisfy specific population needs. For the fortification of foods to have a positive impact on nutritional status, the micronutrients added must be well absorbed and utilized by the organism (bioavailability). Diverse factors affect bioavailability, such as the nutritional status of individuals, the presence in the diet of substances which facilitate or inhibit its absorption, interactions among micronutrients, illnesses, and chemical characteristics of the compound used for fortification. In countries such as Chile, Venezuela and Mexico, important effects have been demonstrated in reducing iron deficiency anaemia in children under 5 years of age. In less than a decade, the salt iodization programme has also proven its effectiveness. Other programmes have fortified foods with Zn, vitamin A and folic acid, which are deficient in infants and children of many populations. In summary, food fortification is a low-cost, relatively simple strategy that may reach a wide range of people, and contribute to reducing the high prevalence of micronutrient deficiencies affecting children, especially in poor countries. The costs due to losses of human capital and their repercussions on health and future development are very high. Building links among academic researchers, politicians, food manufacturers and consumers is essential in order for food fortification to be efficacious and effective, and therefore should be considered as part of an integral strategy to combat micronutrient deficiencies.


Origins and insertions of the triangular fibrocartilage complex: a histological study.
The origins and insertions of the triangular fibrocartilage complex (TFCC) were examined histologically in serially sectioned fresh-frozen cadaver wrists. The radioulnar ligament arose vertically through Sharpey's fibres from a broad area in the ulnar fovea and more horizontally from a narrow area at the base of the ulnar styloid. The floor of the extensor carpi ulnaris sheath also originated firmly from the dorsal side of the fovea of the ulna, through an arrangement of Sharpey's fibres. Loose ulnocarpally oriented fibres, corresponding to a thickened ulnar joint capsule, arose from the hyaline-like cartilage matrix at the tip of the ulnar styloid and inserted onto the triquetrum without Sharpey's fibres. The ulnolunate and ulnotriquetral ligaments originated not from the ulna, but from the palmar side of the TFCC. The insertion of the TFCC into the sigmoid notch of the radius demonstrated a central transition from the fibrocartilaginous disc into hyaline cartilage and a firmer fibroosseous transition of the dorsal and palmar portions of the radioulnar ligament at the periphery.


Enhanced vulnerability to oxidative stress by alpha-synuclein mutations and C-terminal truncation.
alpha-Synuclein is a key component of Lewy bodies found in the brains of patients with Parkinson's disease and two point mutations in this protein, Ala53Thr and Ala30Pro, are associated with rare familial forms of the disease. Several lines of evidence suggest the involvement of oxidative stress in the pathogenesis of nigral neuronal death in Parkinson's disease. In the present work we studied the effects of changes in the alpha-synuclein sequence on the susceptibility of cells to reactive oxygen species. Human dopaminergic neuroblastoma SH-SY5Y cells were stably transduced with various isoforms of alpha-synuclein and their survival following exposure to hydrogen peroxide or to the dopaminergic neurotoxin MPP(+) was assessed. Cells expressing the two point mutant isoforms of alpha-synuclein were significantly more vulnerable to oxidative stress, with the Ala53Thr engineered cells faring the worst. In addition, cells expressing C-terminally truncated alpha-synuclein, particularly the 1-120 residue protein, were more susceptible than control beta-galactosidase engineered cells. The present experiments indicate that point mutations and C-terminal truncation of alpha-synuclein exaggerate the susceptibility of dopaminergic cells to oxidative damage. Thus, these observations provide a pathogenetic link between alpha-synuclein aberrations and a putative cell death mechanism in Parkinson's disease.


Sexual function in ICU survivors more than 3 years after major trauma.
To study sexual function in trauma patients 3-8 years after discharge from an ICU and to assess determinants of poor sex life. A postal questionnaire survey was conducted in 2006 on a cohort of 325 consecutive adult ICU trauma patients admitted to a university hospital during 1998-2003. Of 210 eligible patients 156 (74%) answered the questionnaires. Mean age was 46 years, and 124 were males. Sexual function was assessed by a self-report measure, and patients were asked to describe sexual life both currently and prior to trauma. The International Index of Erectile Function evaluated erectile function in males. At follow-up 50% reported sexual function to be unchanged, 41% impaired, and 9% to be better than preinjury status; 34% reported that the trauma impaired current sex life. Erectile dysfunction was found in 27% of men younger than 40 years and 51% of men 40 years or older. Age, being single, Injury Severity Score, and depression were associated with poor sexual function. Of 17 patients experiencing breakdown of a regular relationship 71% reported the trauma to be a significant contributor. At follow-up more than 3 years after injury one-third of our ICU trauma patients reported that the trauma impaired sexual function. Erectile dysfunction was significantly more frequent among men younger than 40 years than found in studies of the normal population. Evaluation of sexual function should be part of long-term outcome assessment after major trauma.


Current knowledge on Parmelia genus: Ecological interest, phytochemistry, biological activities and therapeutic potential.
Parmelia Acharius is one of the most representative genera within Parmeliaceae family which is the largest and the most widespread family of lichen-forming fungi. Parmelia lichens present a medium to large foliose thallus and they are distributed from the Artic to the Antartic continents, being more concentrated in temperate regions. According to its current description, the genus encompasses up to 41 different species and it is phylogenetically located within the Parmelioid clade (the largest group in the family). Interestingly, some of its species are among the most common epiphytic lichens in Europe such as Parmelia sulcata Taylor and Parmelia saxatilis (L.) Ach. The present work aims at providing a complete overview of the existing knowledge on the genus, from general concepts such as taxonomy and phylogeny, to their ecological relevance and biological interest for pharmaceutical uses. As reported, Parmelia lichens arise as valuable tools for biomonitoring environmental pollution due to their capacity to bioaccumulate metal elements and its response to acid rain. Moreover, they produce a wide array of specialized products/metabolites including depsides, depsidones, triterpenes and dibenzofurans, which have been suggested to exert promising pharmacological activities, mainly antimicrobial, antioxidant and cytotoxic activities. Herein, we discuss past and recent data regarding to the phytochemical characterization of more than 15 species. Even though the knowledge is still scarce in comparsion to other groups of organisms such as higher plants and other non-lichenized fungi. Reviewed works suggest that Parmelia lichens are worthy of further research for determining their actual possibilities as sources of bioactive compounds with potential therapeutic applications.


Nonphosphorylated peptide ligands for the Grb2 Src homology 2 domain.
Critical intracellular signals in normal and malignant cells are transmitted by the adaptor protein Grb2 by means of its Src homology 2 (SH2) domain, which binds to phosphotyrosyl (pTyr) residues generated by the activation of tyrosine kinases. To understand this important control point and to design inhibitors, previous investigations have focused on the molecular mechanisms by which the Grb2 SH2 domain selectively binds pTyr containing peptides. In the current study, we demonstrate that the Grb2 SH2 domain can also bind in a pTyr independent manner. Using phage display, an 11-amino acid cyclic peptide, G1, has been identified that binds to the Grb2 SH2 domain but not the src SH2 domain. Synthetic G1 peptide blocks Grb2 SH2 domain association (IC50 10-25 microM) with a 9-amino acid pTyr-containing peptide derived from the SHC protein (pTyr317). These data and amino acid substitution analysis indicate that G1 interacts in the phosphopeptide binding site. G1 peptide requires a YXN sequence similar to that found in natural pTyr-containing ligands, and phosphorylation of the tyrosine increases G1 inhibitory activity. G1 also requires an internal disulfide bond to maintain the active binding conformation. Since the G1 peptide does not contain pTyr, it defines a new type of SH2 domain binding motif that may advance the design of Grb2 antagonists.


Mechanical assistance of the pulmonary circulation after right ventricular exclusion.
The Fontan procedure is often associated with elevated right-sided pressures and low cardiac output during the early postoperative period. A dog model was established to test the effect of pulmonary artery counterpulsation after atriopulmonary anastomosis. After exclusion of the right ventricle by a purse-string suture at the right AV orifice, placed during inflow occlusion, a valved conduit was inserted between the right atrial appendage and the pulmonary artery. This created a circulatory pattern comparable to a Fontan procedure. Counterpulsation was achieved by inserting a cannula into the conduit distal to the valve in eight dogs; alternatively, in four, counterpulsation could be achieved through a 10 mm side-arm graft connected to the conduit distal to the valve. Twenty-four observations were made. Without counterpulsation the circulatory status of the dog deteriorated rapidly. Counterpulsation resulted in a mean increase in cardiac output of 48% (p less than 0.0001). Right atrial pressure fell significantly with a mean drop of 4 mm Hg (p less than 0.003). This allowed for a further increase in right-sided filling pressure by transfusion, with a subsequent further increase in cardiac output. Left atrial pressure did not change significantly unless altered by transfusion. Counterpulsation instituted through the 10 mm side-arm graft gave similar results. Pulmonary vascular resistance decreased with counterpulsation (mean decrease 35%; p less than 0.002). The use of a side-arm graft connected to the conduit after a Fontan procedure affords a clinical method of circulatory support without the need for additional surgical intervention for decannulation. These data suggest that mechanical assistance of the failing right atrium after atriopulmonary anastomosis is both feasible and effective.


Molecular subtypes in patients with inflammatory breast cancer; a single center experience.
The purpose of this study was to investigate the frequency and prognosis of inflammatory breast cancer (IBC) according to molecular subtypes. Demographic data were examined for 78 patients diagnosed with IBC among breast cancer patients monitored in our clinic. Patients were staged according to the 2010 AJCC guidelines. Physical examination and radiographic findings classified on the basis of Response Evaluation Criteria in Solid Tumors (RECIST) guidelines were employed in the evaluation of clinical response to systemic therapy. Subtype analysis was performed in patients with IBC and subtypes were compared. Patients were divided on the basis of metastatic or non metastatic status and survival analysis was performed on the basis of molecular subtypes. Distribution analysis of molecular subtypes revealed a lower incidence of luminal A and a higher incidence of both HER 2 (+) and triple negative breast cancer in IBC. Molecular subtypes had no effect on survival in the non metastatic (p=0.61) and metastatic patient group (p=0.08). This study showed that IBC frequency is higher in HER2 overexpressing and triple negative subtypes. No survival differences were noticed in relation to molecular subtypes in IBC patients.


Outcomes in acute ischemic strokes presenting with disabling neurologic deficits without intracranial vascular occlusion.
Patients with moderate to severe acute ischemic stroke without intracranial vessel occlusion are an intriguing subset of stroke patients. They pose diagnostic and therapeutic challenges to the physician. We sought to study these patients with an emphasis on their radiological and clinical outcomes. This is a retrospective cohort study of ischemic stroke patients (NIHSS≥6), with no intracranial vessel occlusion on computed tomography angiography within six-hours of symptom onset. Follow-up imaging - either computed tomography brain or magnetic resonance imaging - was performed within one- to seven-days. The primary outcome was modified Rankin Scale score≤2 at three-months. In a database of 1308 patients, we identified 99 (7·6%) patients with NIHSS≥6 and no intracranial vessel occlusion on computed tomography angiography. The mean age was 67·8 ± 15·4 years and 60 (60·6%) were men. The median baseline NIHSS was nine (6-28). The initial computed tomography head was normal in 79 (79·8%) patients. Dramatic early clinical improvement at 24 h (NIHSS score ≤2 at 24 h or change between baseline and 24 h NIHSS score ≥15 points) was seen in 38 (38·4%) patients. Follow-up scans showed infarcts in 66 (66·7%) patients. Fifty (50·5%) patients received tissue plasminogen activator; one (2%) tissue plasminogen activator-treated patient developed symptomatic intracranial hemorrhage. At three-months; 59 (59·6%) patients were independent (modified Rankin Scale≤2), 34 (34·3%) patients were dependent (modified Rankin Scale 3-5), and six (6·1%) were dead. The factors associated with the unlikelihood of good outcome were higher initial NIHSS (odds ratio 0·86 per additional point, 95% confidence interval 0·77-0·95, P=0·003), and older age (odds ratio 0·95 per additional year, 95% confidence interval 0·92-0·98, P=0·004). Stroke without intracranial occlusions are not a benign entity. Factors that are independently associated with decreased likelihood of a good outcome are higher baseline NIHSS, and older age. Treatment with tissue plasminogen activator is not a predictor of outcome.


The cytokinin trans-zeatine riboside increased resistance to heavy metals in the halophyte plant species Kosteletzkya pentacarpos in the absence but not in the presence of NaCl.
Heavy metals such as cadmium and zinc constitute major pollutants in coastal areas and frequently accumulate in salt marshes. The wetland halophyte plant species Kosteletzkya pentacarpos is a promising species for phytostabilization of contaminated areas. In order to assess the role of the antisenescing phytohormone cytokinin in heavy metal resistance in this species, seedlings were exposed for two weeks to Cd (10 μM), Zn (100 μM) or Cd + Zn (10 μM + 100 μM) in the presence or absence of 50 mM NaCl and half of the plants were sprayed every two days with the cytokinin trans-zeatine riboside (10 μM). Zinc reduced the endogenous cytokinin concentration. Exogenous cytokinin increased plant growth, stomatal conductance, net photosynthesis and total ascorbate and reduced oxidative stress estimated by malondialdehyde in Zn-treated plants maintained in the absence of NaCl. Heavy metal induced an increase in the senescing hormone ethylene which was reduced by cytokinin treatment. Plants exposed to the mixed treatment (Cd + Zn) exhibited a specific hormonal status in relation to accumulation of abscisic acid and depletion of salicylic acid. Non-protein thiols (glutathione and phytochelatins) accumulated in response to Cd and Cd + Zn. It is concluded that toxic doses of Cd and Zn have different impacts on the plant behavior and that the simultaneous presence of the two elements induces a specific physiological constraint at the plant level. Salinity helps the plant to cope with heavy metal toxicities and the plant hormone cytokinin assumes key function in Zn resistance but its efficiency is lower in the presence of NaCl.


Implementation of a Nurse-Led Family Meeting in a Neuroscience Intensive Care Unit.
The aims of this study were to develop, implement, and evaluate the impact of early intensive care unit (ICU) nurse-led family meetings on nurse-family communication, family decision making, and satisfaction of family members. Intensive care unit nurses are in an ideal position to meet family needs, and family members may cope better with the crisis of an ICU admission if consistent honest information is provided by nurses; however, there are no early ICU family meetings led by bedside nurses. This quality improvement project was implemented in a 10-bed neuroscience ICU over a 3-month period. A convenience sample of 23 nurses participated in the project. Following development of a communication protocol to facilitate nurse-led meetings, the nurses received education and then implemented the protocol. Thirty-one family members participated in the project. Family members were surveyed before and after the meetings. Mean meeting time was 26 (SD, 14) minutes. Following implementation of the meetings, findings demonstrated that families felt that communication improved (P = .02 and P = .008), they had appropriate information for decision making allowing them to feel in control (P = .002), and there was an increase in family satisfaction (P = .001). Early ICU nurse-led family meetings were feasible, improved communication between ICU nurses and family members, facilitated decision making in ICU families, and increased satisfaction of family members.


Effects of transforming growth factor-beta on the production of parathyroid hormone-related peptide in a human ovarian cancer cell line in vitro.
We examined the effects of transforming growth factor-beta 1 (TGF-beta 1) on intracellular parathyroid hormone-related peptide (PTHrP) production in a human ovarian cancer cell line (HOC-21). Various concentrations of TGF-beta 1 were added to a culture medium, and the numbers of cells were counted. HOC-21 cells were cultured with or without TGF-beta 1, and intracellular PTHrP was measured by a radioimmunoassay kit that recognized the carboxy-terminal protein while counting the number of cells. Furthermore, a 125I-TGF-beta 1 binding assay was carried out. Values were analyzed statistically using an analysis of variance followed by an unpaired t-test. Five ng/ml of TGF-beta 1 inhibited the cell growth on Day 1 after plating. The TGF-beta 1 significantly (p < 0.05) stimulated intracellular PTHrP production in a time-dependent manner, also by Day 1. A 125I-TGF-beta 1 binding study revealed that HOC-21 cells expressed a high affinity for the TGF-beta 1 receptor. The suppression of human ovarian cancer cell proliferation by TGF-beta 1 might be involved in the production of PTHrP.


Incorporating multi-leaf collimator leaf sequencing into iterative IMRT optimization.
Intensity modulated radiation therapy (IMRT) treatment planning typically considers beam optimization and beam delivery as separate tasks. Following optimization, a multi-leaf collimator (MLC) or other beam delivery device is used to generate fluence patterns for patient treatment delivery. Due to limitations and characteristics of the MLC, the deliverable intensity distributions often differ from those produced by the optimizer, leading to differences between the delivered and the optimized doses. Objective function parameters are then adjusted empirically, and the plan is reoptimized to achieve a desired deliverable dose distribution. The resulting plan, though usually acceptable, may not be the best achievable. A method has been developed to incorporate the MLC restrictions into the optimization process. Our in-house IMRT system has been modified to include the calculation of the deliverable intensity into the optimizer. In this process, prior to dose calculation, the MLC leaf sequencer is used to convert intensities to dynamic MLC sequences, from which the deliverable intensities are then determined. All other optimization steps remain the same. To evaluate the effectiveness of deliverable-based optimization, 17 patient cases have been studied. Compared with standard optimization plus conversion to deliverable beams, deliverable-based optimization results show improved isodose coverage and a reduced dose to critical structures. Deliverable-based optimization results are close to the original nondeliverable optimization results, suggesting that IMRT can overcome the MLC limitations by adjusting individual beamlets. The use of deliverable-based optimization may reduce the need for empirical adjustment of objective function parameters and reoptimization of a plan to achieve desired results.


Sulforaphane activates the cerebral vascular Nrf2-ARE pathway and suppresses inflammation to attenuate cerebral vasospasm in rat with subarachnoid hemorrhage.
Nrf2-ARE pathway reportedly plays a protective role in several central nervous system diseases. No study has explored the role of the Nrf2-ARE pathway in cerebral vasospasm(CVS) after subarachnoid hemorrhage(SAH). The purpose of the present study was to investigate the activation of the cerebral vascular Nrf2-ARE pathway and to determine the potential role of this pathway in the development of CVS following SAH. We investigated whether the administration of sulforaphane (SFN, a specific Nrf2 activator) modulated vascular caliber, Nrf2-ARE pathway activity, proinflammatory cytokine expression, and clinical behavior in a rat model of SAH. A two-hemorrhage protocol was used to generate an animal model of SAH in male Sprague-Dawley rats. Administration of SFN to these rats following SAH enhanced the activity of the Nrf2-ARE pathway and suppressed the release of proinflammatory cytokines. Vasospasm was markedly attenuated in the basilar arteries after SFN therapy. Additionally, SFN administration significantly ameliorated two behavioral functions disrupted by SAH. These results suggest that SFN has a therapeutic benefit in post-SAH, and this may be due to elevated Nrf2-ARE pathway activity and inhibition of cerebral vascular proinflammatory cytokine expression.


Synthesis, photoluminescence properties and theoretical insights on 1,3-diphenyl-5-(9-anthryl)-2-pyrazoline and -1H-pyrazole.
1,3-Diphenyl-5-(9-anthryl)-2-pyrazoline and 1,3-diphenyl-5-(9-anthryl)-1H-pyrazole with an anthryl chromophore were synthesized and characterized using (1) H NMR, (13) C NMR, FT-IR, mass spectrometry and elemental analysis. Their optical properties were characterized by UV-vis absorption and fluorescence spectroscopy. It was observed that the absorption and fluorescence spectra of the two compounds showed a red shift with respect to that of anthracene. Pyrazole exhibited high fluorescent quantum yields (Φf = 0.90 in toluene) while pyrazoline showed nearly no fluorescence in solution. The significant fluorescence divergence of the two similar compounds was investigated theoretically through density functional theory (DFT) calculations. The energetically lowest-lying state S1 in the pyrazoline exhibited both characteristics of locally excited and electron-transfer states that resulted in the fluorescence quenching of anthryl chromophore whereas the S1 state in the pyrazole corresponded to an optically allowed state that led to high fluorescence quantum yields in solutions.


Multiple idiopathic arterial aneurysms in children: a case report and review of the literature.
A 6-year-old boy from China presented initially at 2 years of age with a pulsatile mass in his right antecubital fossa. He was not fully evaluated until the age of six years, when pan-angiography and computed axial tomography scan revealed multiple aneurysms of his right brachial artery, right radial artery aneurysms, an infrarenal aortic aneurysm, and a right internal carotid artery aneurysm in the region of the cavernous sinus. The patient underwent uneventful repairs of both the abdominal aortic aneurysm and the multiple aneurysms of the right arm. Pathologic evaluation was significant for medial fibrosis of the arterial wall with decreased and disordered elastin fibers. Review of the previously reported cases in children indicate the upper extremity arteries are involved in 92% of patients, the aortoiliac region in 92% of patients, and the renal/mesenteric vessels in 77% of cases. Lower extremity and cerebrovascular arteries are involved to a lesser extent. Children with peripheral aneurysms should have pan-angiography performed before treatment is begun. Surgical repair in these cases has been excellent.


Default mode network coherence in treatment-resistant major depressive disorder during electroconvulsive therapy.
Functional connectivity in the "default mode network" (DMN) is changed in depression, and evidence suggests depression also affects the DMN's spatial topography and might cause a dissociation between its anterior and posterior regions. As antidepressive treatment affects anterior and posterior regions of the network differently, how depression and treatment change DMN-organization is crucial for understanding their mechanisms. We present a novel way of assessing the coherence of a network's regions to the network as a whole, and apply this to investigate treatment-resistant depression and the effects of electroconvulsive therapy (ECT). Resting-state functional MRI was collected from 16 patients with treatment-resistant depression before and after ECT and 16 healthy controls matched for age and sex. For each subject, the mean time series of the DMN was used as a regressor for each voxel within the DMN, creating a map of "network coherence" (NC). The obtained maps were compared across groups using permutation testing. NC was significantly decreased in depressed subjects in the precuneus and the angular gyrus. With ECT the NC normalized in responders (n=8), but not in non-responders (n=8). We present a novel method of investigating within-network coherence and apply this to show that in depression, a large area of the DMN shows a decrease in coherence to the network as a whole. Although tentative due to the small sample size, we find that this effect is not present after ECT in those improving clinically, but persists in patients not responding to ECT.


[The undetected brain lesion in sports. Minor traumatic brain injury and its sequelae].
The minor traumatic brain injury (mTBI) in sports is often looked at as a bagatelle. The treating physician underestimates the severity of the injury suspecting that a mTBI is a nonstructural lesion with an overall excellent prognosis in the majority of the cases. This paper shows that the minor traumatic brain injury may be a structural brain lesion with potentially life-threatening dangers. The therapy should follow exactly defined guidelines, e.g., stepwise protocol of the Concussion in Sports (CIS-) Group. Return to sports activities should happen only when all physical but also cognitive symptoms have subsided. All mTBIs that have been sustained prior to the actual injury have to be recorded properly because repeated mTBIs may cause chronic degenerative brain damage. Neuropsychological testing will aid in the correct diagnosis of a mTBI and is a useful parameter in the course of the injury. In the future biochemical markers may serve as indicators of the severity of the brain injury and may also aid in predicting the outcome after TBI. Today biochemical markers do not serve as a substitute for neuroimaging.


Manipulating Simple Reactive Chemical Units: Fishing for Alkaloids from Complex Mixtures.
This Concept article describes how key C10 molecular scaffolds, too reactive to be obtained through classical multistep synthesis, were targeted in the most simple reaction conditions, reproducing those that may be encountered in living cells. The rationale was that small amounts of these reactive intermediates might be formed in situ from cheap and abundant reactants (i.e., glutaraldehyde and tetrahydropyridine) resulting, upon further rearrangement in "complex mixtures" from which natural substances would arise. From five types of mixtures, at least six full carbon skeletons of known natural substances were formed spontaneously. This work also led to the discovery of new plausible biosynthetic achiral precursors in the Nitraria metabolism.


Validity of SMART-COP score in prognosis and severity of community acquired pneumonia in the emergency department.
Determining prognosis in community acquired pneumonia (CAP), is very important. Many scores are introduced up to now for prediction of pneumonia prognosis like SMART-COP. To evaluate validity of SMART-COP score in prognosis and severity of CAP in emergency department (ED). All patients older than 18 years old with clinical suspicion of CAP (meeting the inclusion criteria), were enrolled in our study. In this prospective study, patients were admitted to the ED of a tertiary referral center. Hospital length of stay, rate of intensive care unit (ICU) admission, mortality rate, number of intensive respiratory or vasopressor support (IRVS) use, patients' SMART-COP scores and all demographic data were recorded. Validity of SMART-COP in the prediction of IRVS rate and its correlation with other variables were determined. In this study, 47.6% and 52.4% of patients were females and males respectively. The mean age of patients was 68.13 ± 16.60 years old. The mean hospital length of stay was 13.49 ± 5.62 days. Of all patients entered in our study, 55 cases (38.5%) needed ICU admission, 29 cases (20.3%) were expired within 1 month and 44 cases (30.8%) needed IRVS during their treatment. SMART-COP ≥5 (high risk CAP) accurately predicted the rate of ICU admission, one-month mortality and IRVS need (p-value = 0.001). SMART-COP≥5 had a high sensitivity and specificity in the prediction of patients' prognosis with severe CAP in the ED.


Somatostatin inhibits secretin-induced ductal hypercholeresis and exocytosis by cholangiocytes.
Previous work from our laboratory has implicated hormone-induced plasma membrane movement (i.e., endo- and exocytosis) in water and electrolyte transport by the epithelial cells that line the ducts in the liver (i.e., cholangiocytes). To further explore the cellular mechanisms regulating ductal bile secretion, we infused somatostatin and/or secretin intravenously into rats 2 wk after either bile duct ligation (BDL), a procedure that induces selective proliferation of cholangiocytes, or sham surgery and measured bile flow and biliary constituents. We also determined the effect of somatostatin on basal and secretin-induced exocytosis by purified cholangiocytes isolated from rat liver after BDL. Finally, we studied the expression of the somatostatin receptor gene by both ribonuclease (RNase) protection and nuclear run-on assays using cDNA encoding for two subtypes of the somatostatin receptor gene (i.e., SSTR1 and SSTR2). In vivo, somatostatin infusion caused a dose-dependent bicarbonate-poor decrease (57% maximal decrease below baseline; P < 0.05) in bile flow in BDL but not in sham-operated rats; in contrast, secretin caused a dose-dependent bicarbonate-rich choleresis (228% maximal increase above baseline; P < 0.05) in BDL but not in sham-operated rats. Simultaneous or prior infusion of somatostatin inhibited the secretin-induced hypercholeresis in BDL rats. In vitro, somatostatin had no effect on basal exocytosis by cholangiocytes isolated from BDL rats; however, somatostatin inhitibed (88% maximal inhibition; P < 0.05) secretin-induced exocytosis by cholangiocytes in a dose-dependent fashion. In addition, somatostatin inhibited secretin-induced increases in levels of adenosine 3',5'-cyclic monophosphate (cAMP) in cholangiocytes isolated from BDL rats.(ABSTRACT TRUNCATED AT 250 WORDS)


Mitochondrial DNA mutations in mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS).
The total sequences of mitochondrial DNA were determined in two patients with juvenile-onset mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) due to Complex I deficiency. Patients 1 and 2 had three and two unique point mutations, respectively, causing replacement of phylogenically conserved amino acids. A transition from G to A was found at nucleotide position 5601 in the alanine tRNA gene of Patient 2, and a transition from A to G was found at 3243 in the leucine (UUR) tRNA gene of both patients. The latter mutation located at the phylogenically conserved 5' end of the dihydrouridine loop of the tRNA molecule, and was present in two patients with adult-onset MELAS and absent in controls. These results indicate that a mass of mtDNA mutations including the A-to-G transition in the tRNA(Leu) gene is a genetic cause of MELAS.


Superporous hydrogels containing poly(acrylic acid-co-acrylamide)/O-carboxymethyl chitosan interpenetrating polymer networks.
Superporous hydrogels containing poly(acrylic acid-co-acrylamide)/O-carboxymethyl chitosan interpenetrating polymer networks (SPH-IPNs) were prepared by cross-linking O-carboxymethyl chitosan (O-CMC) with glutaraldehyde (GA) after superporous hydrogel (SPH) was synthesized. The structures of the SPH-IPNs were characterized with FT-IR, 13C-NMR and DSC. SEM, CLSM and light images revealed that the SPH-IPNs possessed both the IPN network and large numbers of pores and the cross-linked O-CMC molecules were located on the peripheries of these pores. The swelling behavior of SPH-IPNs was dependent on the O-CMC content, GA amount and cross-linking time. Due to the cross-linked O-CMC network, in vitro muco-adhesive force and mechanical properties, including compression and tensile modulus, of the SPH-IPN were greatly improved when compared with the CSPH. An enhanced loading capacity for insulin could be obtained by the SPH-IPNs as compared to non-porous hydrogel and CSPH, and more than 90% of the insulin was released within 1 h. With the improved mechanical properties, in vitro muco-adhesive force and loading capacities, the SPH-IPN may be used as a potential muco-adhesive system for peroral delivery of peptide and protein drugs.


New-generation portable tonometers: comparison of the Keta and Goldmann tonometers.
The Keta Smart-001 is a recently introduced portable battery-operated tonometer with a digital readout. To determine the reliability of the Keta tonometer, intraocular pressure (IOP) measurements were taken in a masked fashion with the Keta tonometer and the Goldmann tonometer in both eyes of 60 patients (20 with and 40 without glaucoma) recruited from general ophthalmology and glaucoma clinics. The results were analysed with an F-test analysis of variance. The Keta tonometer significantly underread the IOP and was totally unreliable in patients with glaucoma. Our results indicate that Keta tonometry should not be used for the screening and management of glaucoma.


Differential suppression of T-cell subpopulations by thc (delta-9-tetrahydrocannabinol).
THC (delta-9-tetrahydrocannabinol), the major psychoactive component of marijuana, has been shown to suppress various immune functions in vivo and in vitro. THC suppresses murine T-lymphocyte proliferation; however, the effects on T-cell subsets remain unclear. We have stimulated cultured murine splenocytes with the mitogens concanavalin A (Con A) or phytohemagglutinin (PHA) while exposing them to varying concentrations of THC. After three days, the cells were analyzed by the fluorescent activated cell sorter for the following T-cell markers--Thy1, L3T4 and Ly2. The Ly2 cells represent the suppressor/effector T-cells while L3T4 cells represent the helper T-cell subpopulations. The results show that the dose response suppressive effect of THC on T-cell proliferation reflects a preferential inhibition of Ly2 vs L3T4 cells. The effects of THC on other functional parameters are in the process of investigation.


A consensus cAMP-dependent protein kinase (PK-A) site in place of the CcN motif casein kinase II site simian virus 40 large T-antigen confers PK-A-mediated regulation of nuclear import.
The regulation of nuclear protein transport by phosphorylation plays a central role in gene expression in eukaryotic cells. We previously showed that nuclear import of SV40 large tumor antigen (T-ag) fusion proteins is regulated by the CcN motif, comprising phosphorylation sites for casein kinase II and the cyclin-dependent kinase cdc2, together with the nuclear localization signal. Regulation of nuclear uptake by CcN motif kinase sites also holds true for the yeast transcription factor SWI5 and the Xenopus nuclear phosphoprotein nucleoplasmin. To test directly whether a kinase site other than those of the CcN motif could regulate nuclear import of T-ag, the CcN motif casein kinase II site, which markedly increases the rate of T-ag nuclear import, was replaced by a consensus site for the cAMP-dependent protein kinase (PK-A) using site-directed mutagenesis. The resultant fusion protein could be specifically phosphorylated by PK-A in vitro and in cell extracts. Nuclear import of the fluorescently labeled protein was analyzed in the HTC rat hepatoma cell line both in vivo (microinjected cells) and in vitro (mechanically perforated cells) in the presence and the absence of cAMP and/or PK-A catalytic subunit using confocal laser scanning microscopy. In vitro PK-A-prephosphorylated protein was also tested. All results indicated that the rate of nuclear import was increased by phosphorylation at the PK-A site (2-5-fold), demonstrating that kinases other than those of the CcN motif can regulate nuclear import in response to stimulatory signals. The phosphorylation-regulated nuclear localization signal derived here represents an important first step toward developing a signal conferring inducible nuclear targeting of molecules of interest.


Are vascular abnormalities a primary cause or secondary consequence of hypertension?
This paper reviews the evidence that the resistance vasculature is altered in hypertension and the role that the vasculature may play in the pathogenesis of the disease. Although functional changes (i.e., increased vascular smooth muscle sensitivity) have been found to be associated with some models of hypertension (e.g., spontaneously hypertensive rat), in human essential hypertension it appears that the abnormalities that predominate in the resistance vasculature are structural in nature. These changes result in an increased media/lumen ratio of the more proximal resistance vessels (i.d. 100-300 microns), and the changes are such that they could account for many of the altered hemodynamic characteristics seen in patients with essential hypertension (e.g., increased minimum vascular resistance, increased pressor response). However, evidence that the abnormal structure of the peripheral vasculature is a prime determinant of blood pressure is still lacking, and much of the available evidence suggests that the altered structure is a secondary adaptation. Nevertheless, the abnormal vascular structure may play an important pathological role concerning the morbid consequences of the hypertensive disease, suggesting that normalization of vascular structure is a desirable aim for antihypertensive treatment. At present it seems that treatment must be continued for long periods, maybe many years, before vascular structure is normalized.


[Transcription regulation by histone-modifying enzymes].
During gene transcription, it needs to recruit many histone-modifying enzymes to modify histone. These chemical modification contains methylation, acetylation, phosphorylation, ubiquitylation, sumoylation of histone and so on. Most of histone-modifying enzymes can form a complex with various transcriptional factors, they can change the interaction between histone and DNA, which regulate gene transcription. This review is focused on recent findings regarding the composition, the structure and the function of the histone-modifying enzyme complexes.


Rightsizing Your Board.
What's the ideal size for a hospital board of trustees? Here are several factors to consider before deciding if your own board needs to be right-sized.


Effects of Group Counseling Transmitted Through Videoconferencing on Changes in Eating Behaviors.
To compare the effects of constructivism-based dietary group counseling transmitted through videoconferencing (VC) and face-to-face (FF) counseling on changes in eating behaviors. Altogether, 74 participants with high risk of type 2 diabetes were divided into FF and VC groups based on their place of residence in northern Finland. Constructivism-based dietary group counseling, a nonrandomized intervention, was performed (evaluations at 0, 6, and 21 months). The Three-Factor Eating Questionnaire-18 was used to evaluate cognitive restraint eating (CR), emotional eating (EE), and uncontrolled eating (UE). Data were analyzed using ANOVA and ANCOVA (significance level of 0.05). Cognitive restraint eating increased and UE decreased between baseline and 6 months in both groups, but between baseline and 21 months only in the FF group (P = .005 and P = .021, respectively). Emotional eating decreased only in the VC group (P = .016). There were no differences between groups at 6 or 21 months. Constructivism-based counseling delivered through videoconferencing was effective at improving eating behaviors.


Behavioral health assessments and interventions of residents and psychology trainees during dual interviewing: a descriptive study.
Family medicine residents increasingly work collaboratively with psychology trainees. One type of collaborative experience involves dual interviewing of clinic patients. The goal of this observational study was to provide an initial description of what occurs during dual interviews as it relates to behavioral health assessments and interventions. Psychology trainees provided detailed descriptions of 550 collaborative patient encounters involving 348 patients from the Wayne State University/Crittenton Family Medicine Residency clinic. Psychology trainees coded the frequency of behavioral health assessments and interventions by the resident, psychology trainee, or both. Eighty percent of the encounters contained a behavioral health assessment, and 29% contained a behavioral health intervention. Most of these clinical activities were collaboratively done. Interestingly, residents and psychology trainees tended to provide different behavioral health interventions. Moreover, residents provided different behavioral health interventions in repeat dual interviews (n=202) as opposed to first-time visits (n=348), while psychology trainees did not. Little is known about the process of dual interviewing, and this study is an important first step in describing how residents and psychology trainees actually interact during these encounters. More research is needed about the impact of dual interviewing on residents' behavior.


Cytochrome 3A and 2E1 in human liver tissue: Individual variations among normal Japanese subjects.
The metabolism of drugs, xenobiotic compounds, and other endogenous/exogenous substrates generally begins with their oxidation through cytochrome P450 (CYP). The results of recent pharmacogenetic analyses have demonstrated CYP's polymorphisms to be related to individual differences in metabolism, but only a limited number of CYP3A4 and CYP2E1 variant alleles influence enzymatic activities. Therefore, CYP gene expression profiling of both normal and pathological human livers should provide critical information for an evaluation of the biological significance of CYPs. In our present study, we first characterized the individual differences in CYP3A4 and CYP2E1 expression levels among Japanese normal or non-pathological liver tissue obtained from autopsy or surgery using immunohistochemistry and quantitative RT-PCR array of phase I metabolic enzymes with combined laser capture microscopy and qPCR analysis. Both CYP3A4 and CYP2E1 mRNA and proteins were predominantly detected in hepatocytes surrounding central veins in normal liver, but there were marked individual differences in both CYP3A4 and CYP2E1 mRNA and proteins among the 23 Japanese subjects examined. Individual differences in CYP3A and CYP2E1 subtypes were also detected in the livers obtained from monozygotic neonatal Japanese female twins with different survival periods. CYP3A and CYP2E1-positive cells were decreased in number in non-pathological hepatocytes of diseased livers compared to those in disease-free livers from autopsy. The above results suggest that individual differences in CYP3A4 and CYP2E1 exist among normal human liver tissues and in non-pathological hepatocytes between diseased and normal liver, and these differences may be important in evaluating the pharmacodynamics of various substances.


Association of asthma education with asthma control evaluated by asthma control test, FEV1, and fractional exhaled nitric oxide.
Asthma education is an important adjunct for asthma control although the way asthma education affects asthma outcomes is poorly understood. The asthma control test (ACT), forced expiratory volume in 1 s (FEV(1)), and fractional exhaled nitric oxide (FeNO) have all been used as markers of asthma control. However, the use of FeNO as a surrogate marker remains controversial. (i) To examine whether asthma education is associated with asthma control; (ii) to compare absolute levels and changes of ACT, FEV(1), and FeNO over a year; and (iii) to evaluate whether FeNO can be used as an additional marker of asthma control. Fifty asthmatics with poor adherence (12 mild, 21 moderate, and 17 severe) received asthma education at study entry. Medications were unchanged for the first 3 months, and ACT, FEV(1), and FeNO measurements were recorded at entry, 3, 6, and 12 months. Asthma control was assessed at each visit and patients were categorized as either "stable" or "unstable" asthmatics according to the global initiative for asthma (GINA) guidelines. A significant decrease in FeNO and increase in ACT score were noted in the stable asthmatic group at 3 months (p < .001), and this persisted over 12 months. Significant correlations were seen between changes (Δ) in FeNO, ACT, and FEV(1) over time. However, significant correlations between the absolute levels were not maintained over 12 months. A decrease of ≥18.6% in FeNO and a ≥3-point increase in ACT score (sensitivity: 80% and 73.3% and specificity: 83.3% and 87.5%, respectively) were associated with stable asthma control although the absolute levels were not. Asthma education may be useful to achieve stable control. In addition, changes rather than absolute levels of FeNO and ACT may be better markers of asthma control.


Microscale purification of proteins exhibiting anomalous electrophoretic migration: application to the analysis of GAP-43 phosphorylation.
Quite often, in vivo analysis of posttranslational protein modifications is complicated by the lack of specific antibodies or unsatisfactory immunoprecipitation efficiency. Here, we present an alternative method to immunoprecipitation that takes advantage of the anomalous electrophoretic behavior exhibited by GAP-43. This method can be applied to other proteins which show similar characteristics, such as myristoylated alanine-rich C kinase, NAP-22, and Neurogranin, among others. All these proteins display relative mobility values that depend on the concentration of polyacrylamide used in the resolving gel. Cell extracts or tissue homogenates are first separated by SDS-PAGE in 15% polyacrylamide gels, and the bands containing GAP-43 are identified, excised from the gel, and rerun on a second SDS-PAGE in 7.5% polyacrylamide/6 M urea gels. To quickly identify the position of GAP-43 in the first gel, a small amount of fluorescein-labeled recombinant GAP-43 was added to the initial extracts. The method, applied to the analysis of GAP-43 phosphorylation in rat hippocampal slices, can be typically completed in less than 4 h. The excellent yields of purification obtained contributed to a greater accuracy and increased reliability of the radioactivity measurements. It also allowed further processing of the samples, including the analysis of the different phosphorylation sites by proteolytic digestion and peptide mapping.


A regio- and diastereoselective intramolecular nitrone cycloaddition for practical 3- and 2,3-disubstituted piperidine synthesis from gamma-butyrolactone.
A fast and efficient route for diversity-oriented synthesis of 3- and 2,3-disubstituted piperidines, featuring an intramolecular nitrone cycloaddition with high regio- and diastereoselectivity, was achieved in six steps and 36-66% overall yield from commercially available gamma-butyrolactone or 1,4-butanediol. A new N-alkenyl nitrone enoate was used in this intramolecular nitrone cycloaddition, and the regioselectivity, diastereoselectivity, and reversibility of this cycloaddition were investigated.


[Pollutions of indoor fine particles in four types of public places and the influencing factors].
To study the levels of pollutions caused by fine particulate matter (PM(2.5)) in the public places and investigate the possible influencing factors. A total of 20 public places in four types such as rest room in bath center, restaurant, karaoke bars and cyber cafe in Tongzhou district in Beijing were chosen in this study; indoor and outdoor PM(2.5) was monitored by TSI sidepak AM510. Data under varying conditions were collected and analyzed, such as doors or windows or mechanical ventilation devices being opened, rooms cramped with people and smoking. The average concentration of indoor PM(2.5) in 20 public places was (334.6 +/- 386.3) microg/m(3), ranging from 6 microg/m(3) to 1956 microg/m(3); while in bath center, restaurant, karaoke bars and cyber cafe were (116.9 +/- 100.1)microg/m(3), (317.9 +/- 235.3) microg/m(3), (750.6 +/- 521.6)microg/m(3) and (157.5 +/- 98.5) microg/m(3) respectively. The concentrations of PM(2.5) in restaurant (compared with bath center: Z = -10.785, P < 0.01; compared with karaoke bars: Z = -10.488, P < 0.01; compared with cyber cafe: Z = -7.547, P < 0.01) and karaoke bars (compared with bath center: Z = -16.670, P < 0.01; compared with cyber cafe: Z = -15.682, P < 0.01) were much higher than those in other two places. Single-factor analysis revealed that the average concentration of indoor PM(2.5) in 20 public places was associated with the number of smokers per cube meters(9.13 x 10(-3); r = 0.772, F = 26.579, P < 0.01) and ventilation score [(2.5 +/- 1.5) points; r = 0.667, F = 14.442, P < 0.01], and there were significant correlation between the average indoor and outdoor levels in restaurant [(317.9 +/- 235.3) microg/m(3), (67.8 +/- 78.9) microg/m(3); r = 0.918, F = 16.013, P = 0.028] and cyber cafe [(157.5 +/- 98.5) microg/m(3), (67.7 +/- 43.7) microg/m(3); r = 0.955, F = 30.785, P = 0.012]. Furthermore, significant correlation was observed between the average concentration of indoor PM(2.5) [(157.5 +/- 98.5) microg/m(3)]and the number of people per cube meters (288.7 x 10(-3)) in cyber cafe (r = 0.891, F = 11.615, P = 0.042). Multiple regression analysis showed that smoking (b' = 0.581, t = 3.542, P = 0.003) and ventilation (b' = -0.348, t = -2.122, P = 0.049) were the major factors that may influence the concentration of indoor PM(2.5) in four public places. With cluster analysis, the results showed that the major factors that influence the concentration of indoor PM(2.5) was the outdoor PM(2.5) levels [(49.6 +/- 39.5) microg/m(3); b = 1.556, t = 3.760, P = 0.007] when ventilation (score > 2) was relatively good. The number of smokers per cube meters (14.7 x 10(-3)) became the major influence factor when the ventilation score </= 2 (b = 140.957, t = 3.108, P = 0.013) and 51.8% increases of indoor PM(2.5) was attributed to smoking. This study indicated that smoking was the main source of indoor PM(2.5) in public places. Outdoor PM(2.5) should be correlated with indoor PM(2.5) concentration under drafty situation.


Hydrogen peroxide sensor based on coimmobilized methylene green and horseradish peroxidase in the same montmorillonite-modified bovine serum albumin-glutaraldehyde matrix on a glassy carbon electrode surface.
A new approach to construct a second-generation amperometric biosensor is described. The classical dye methylene green as a probing-needle mediator and horseradish peroxidase as a base enzyme were coimmobilized in the same montmorillonite-modified bovine serum albumin (BSA)-glutaraldehyde matrix to construct a H2O2 sensor. The immobilization matrix was formed from the pretreated sodium montmorillonite colloid in which the enzyme and the cross-linker were dissolved. Immobilization of methylene green from the dye mother solution was attributed to the adsorption function of the montmorillonite, whereas immobilization of horseradish peroxidase was attributed to the cross-linking function of the BSA-glutaraldehyde as usual. Cyclic voltammetry and potentiostatic measurements indicated that methylene green efficiently mediated electrons from the base electrode to the enzyme in the matrix. The sensor responded rapidly to low H2O2 concentration and achieved 95% of the steady-state current in less than 20 s, with a detection limit of 4.0 x 10(-7) M H2O2.


A study into the views of intensive care nurses on the psychological needs of their patients.
This small scale study examined the way in which ICU nurses perceived the psychological needs of their patients. Data was collected through the use of semi-structured interviews, and was then analysed using a modified grounded theory approach. Two overall themes were developed from the data, one being the way in which ICU nurses make choices about the organisation of their work and the other nurse-project relationship. Secondly the theme of the nurse-patient relationship was developed, in which ICU nurses experience difficulty in communicating with their patients. Paradoxically it would appear that the quality of this communication becomes poorer when the patient is more able to participate in the communication process. This problem in communication is substantiated by research into other areas of nurse-patient communication.


Enzyme-linked bridging assay method for the quantification of oligonucleotide-based drugs in biological matrices.
With ongoing efforts to develop oligonucleotide-based (ODN-based) therapeutics, there is a need for a sensitive, high-throughput method of quantification of ODN-based drugs in biological matrices. To overcome the insufficient sensitivity and time-consuming sample extraction procedures involved in conventional capillary gel electrophoresis (CGE) and high-performance liquid chromatography (HPLC), we developed a nucleic acid hybridization-based enzyme-linked bridging assay (ELBA), which shows significant advantages over CGE methods in evaluating ODN-based drugs in plasma and tissue: (1) It has higher sensitivity; (2) it involves easier sample extraction procedures; (3) it is suitable for many ODN-based drugs, even those with different secondary structures and modifications, including phosphorothioate oligonucleotide (PSODN), mixed backbones with 2'-O-Me (MBO), locked nucleic acid (LNA) modifications, and B- and C-type CpG sequences; and (4) it is highly selective, even during simultaneous quantification, with regard to intact ODNs and their 3'-metabolites. This universal design produces a rapid, sensitive, specific assay with minimal method development time. It is well suited to high-throughput analysis of various ODN-based drugs.


Telemedicine: an innovative way of managing patients with leg ulcers.
The optimal management of patients with leg ulcers requires a multidisciplinary approach, with contributions from both community and hospital specialists to identify, investigate and treat the underlying causes, provide patient education, assess healing and dress the wounds, monitor outcome and prevent recurrence. However, current practice is impaired by the limited communication between community and hospital specialists. There are inconsistencies in methods of transferring and updating patient records between the hospital and the community, and this can lead to confusion over the diagnosis and appropriate management. Telemedicine, the electronic exchange of medical information at a distance, would appear to offer a way to establish an efficient and effective communication link between hospital and community specialists involved in the care of patients with leg ulcers. The authors of this article believe that modern information technology and the existing NHSnet information infrastructure could be employed to create such a link via electronic patient records.


Planar and 3D fibrous polyaniline-based materials for memristive elements.
The memristive elements constructed using polymers - polyaniline (PANI) and polyethyleneoxide (PEO) - could be assembled on planar thin films or on 3D fibrous materials. Planar conductive PANI-based materials were made using the Langmuir-Schaefer (LS) method, and the 3D materials - using the electrospinning method which is a scalable technique. We have analyzed the influence of PANI molar mass, natures of solvent and subphase on the crystalline structure, thickness and conductivity of planar LS films, and the influence of PANI molar mass and the PANI-PEO ratio on the morphological and structural characteristics of 3D fibrous materials.


Cause-specific mortality among a cohort of U.S. flight attendants.
We evaluated mortality among 11,311 former U.S. flight attendants. The primary a priori outcomes of interest were breast cancer and melanoma. Vital status was ascertained through 2007, and life table analyses was conducted. Cumulative exposure to cosmic radiation and circadian rhythm disruption were estimated from work history data and historical published flight schedules. All-cause mortality was less than expected among women but was elevated among men, primarily due to elevated HIV-related disease mortality. Mortality from breast cancer among women and melanoma was neither significantly elevated nor related to metrics of exposure. Mortality was elevated for non-Hodgkin's lymphoma among men; for alcoholism, drowning, and intentional self-harm among women; and for railway, water, and air transportation accidents. We found no evidence of increased breast cancer or melanoma mortality. Limitations include reliance on mortality data and limited power resulting from few melanoma deaths and relatively short employment durations.


Human milk mineral intake and serum concentrations of calcium and phosphorus in newborn term infants: influence of intrauterine growth restriction.
A prospective case-control study was performed to test the hypothesis that the milk Ca and P contents of term, small-for-gestational-age (SGA) newborns' mothers differs from that of term, adequate-for-gestational-age (AGA) newborns' mothers. We studied 71 pairs of mothers and newborns, divided into two groups: I (control): 41 pairs of mothers and term AGA newborns and II (study): 30 pairs of mothers and term SGA newborns. This latter group was subdivided according to type (symmetric: birthweight, length and head circumference <10th percentile; asymmetric: birthweight <10th percentile) and severity (<P3: birthweight <3rd percentile and >P3 - <P10: birthweight between 3rd and 10th percentiles) of intrauterine growth restriction (IUGR). Mothers' milk and blood samples were collected for Ca and P analysis using standard techniques (milk on days 3, 15 and 30 postpartum and blood from both the umbilical cord and the newborn on days 15 and 30 of life). There were no differences in blood and human milk Ca and P contents between the two groups. In the study group, milk (p=0.001) and serum (p=0.002) P levels and milk Ca (p=0.002) levels increased during the first month of life. Regarding type and severity of IUGR, milk P levels increased in the IUGR asymmetric and <P3 groups; serum Ca levels increased in the IUGR >P3 - <P10 group. These findings suggest a tendency towards differences in human milk between AGA and SGA newborns regarding longitudinal variations.


Proper restorative material selection, digital processes allow highly esthetic shade match combined with layered porcelain.
Today's digital technologies are affording dentists and laboratory technicians more control over material choices for creating restorations and fabricating dental prostheses. Digital processes can potentially enable technicians to create ideal marginal areas and account for the thickness and support of layering porcelain over substructures in the design process. In this case report of a restoration of a single central incisor, a number of issues are addressed that are central to using the newest digital technology. As demonstrated, shade selection is a crucial early step in any restorative case preparation.


Topological Phase Buried in a Chalcogenide Superlattice Monitored by Helicity-Dependent Kerr Measurement.
Chalcogenide superlattices (SLs), formed by the alternate stacking of GeTe and Sb2Te3 layers, also referred to as interfacial phase-change memory (iPCM), are a leading candidate for spin-based memory device applications. Theoretically, the iPCM structure has been predicted to form a three-dimensional topological insulator or Dirac semimetal phase depending on the constituent layer thicknesses. Here, we experimentally investigate the topological insulating nature of chalcogenide SLs using a helicity-dependent time-resolved Kerr measurement. The helicity-dependent Kerr signal is observed to exhibit a four-cycle oscillation with π/2 periodicity, suggesting the existence of a Dirac-like cone in some chalcogenide SLs. Furthermore, we found that increasing the thickness of the GeTe layer dramatically changed the periodicity, indicating a phase transition from a Dirac semimetal into a trivial insulator. Our results demonstrate that thickness-tuned chalcogenide SLs can play an important role in the manipulation of topological states, which may open up new possibilities for spintronic devices based on chalcogenide SLs.


Controlled release morphine tablets: a double-blind trial in patients with advanced cancer.
Eighteen of 27 patients with pain due to advanced cancer, completed a randomised crossover comparison of 4-hourly aqueous morphine sulphate and twice daily controlled release morphine tablets. There was no difference between the two regimens in analgesic efficacy or adverse effects, but there was an apparent improvement in quality of sleep on the controlled release tablets. After completion of the study, 17 patients continued with the latter medication for periods that ranged from 2 days to 94 weeks (median 6.5 weeks). Controlled release morphine tablets given twice daily provide a simpler and more convenient treatment regimen than a 4-hourly opioid for patients with cancer pain, once they have been stabilised.


A national survey of how acupuncture is currently used in midwifery care at Swedish maternity units.
it is not known how acupuncture is used in midwifery care in Sweden and what kind of requirements health-care providers have for midwives and acupuncture training programmes. The aims of this study were to survey indications for the use of acupuncture in midwifery care in Sweden, and to examine the criteria and requirements used for purchase of acupuncture education programmes. a postal survey using a structured questionnaire. 45 maternity units in Sweden. the midwife-in-charge of the units. the most common indications for the use of acupuncture were relaxation, pain relief, retained placenta, after pains, milk stasis during lactation, hyperemesis and pelvic instability. Specific requirement for acupuncture education were provision of a short course during weekdays including a follow-up course. acupuncture is widely used for many indications in Swedish maternity units despite weak or no evidence to support effectiveness in midwifery care. Requirements for acupuncture education did not seem to be in accordance with what might be expected for this type of qualified intervention. the use of acupuncture in midwifery care should not persist until systematic evaluation of the effect of this method is carried through.