The calcium-dependent phosphatidylinositol-phosphodiesterase of rat brain. Mechanisms of suppression and stimulation.
1. The activity of the soluble, calcium-dependent phosphatidylinositol-specific phosphodiesterase (EC 3.1.4.10) against [32P]phosphatidylinositol has been investigated. 2. KC1 (only at neutral pH), Mg2+, positively-charged proteins such as histone, and phospholipids containing a choline headgroup are all inhibitory to the enzyme. Choline-phospholipids cause a 90% inhibition at an equimolar ratio to phosphatidylinositol. 3. Other phospholipids (phosphatidylglycerol, phosphatidylserine, phosphatidylethanolamine and phosphatidic acid) are all potent stimulators of the enzyme: maximum stimulation being observed at a ratio of 1 mol activator/5--10 mol phosphatidylinositol. 4. Unsaturated amphiphiles such as oleic and oleoyl alcohol also stimulate the activity, maximum stimulation being observed at about an equimolar ratio to phosphatidylinositol. Saturated amphiphiles (such as stearic acid and stearoyl alcohol) are less effective. 5. The activation by acidic phospholipids and unsaturated amphiphiles appear to be independent as they are additive and, under certain conditions, synergistic. 6. Both types of stimulator (independently or together) can reverse the inhibition caused by histone or phosphatidylcholine. 7. Possible mechanisms of the suppression of the phosphatidylinositol phosphodiesterase in vivo, of its activation, and of the amplification of phosphatidylinositol breakdown are discussed.


An alpha-stable model for ultrasound speckle statistics in skin.
Characterization of biological tissues in ultrasound images is often tackled using empirical pre-Rayleigh distributions. However, the absence of a theoretical explanation to these distributions hinders their improvement and clinical interpretation. This paper presents a novel model that extends classic statistical theories to speckle in biological tissues and explains the existing pre-Rayleigh distributions. Furthermore, statistics derived from the proposed model outperform the state of the art in skin tissue characterization. Finally, promising results in characterization of skin melanoma tumors set the basis for the development of reliable ultrasound-based diagnosis techniques.


[Feasibility of predicting the dynamics of human body mass].
An original mathematical model of human energy exchange was developed and implemented on a PC. Energy exchange of healthy volunteers on a free diet and physical activity was simulated by inputting examinees' individualized parameters in the model: total body mass, fatty and lean tissue, nutritional energy capacity, power inputs. The main purpose was to study the reliability of prediction of the time course of total body mass with relation to a dietary caloric value and physical activity of an examinee, which was found to be necessary for working out an optimum metabolic diet, e.g. for patients with diabetes mellitus and adiposity. The authors propose a complete text of a computer program which can be used in research institutes and hospitals.


[Bone tissue regeneration after a gunshot fracture].
A general histological analysis of regularities of the osseous tissue reparative regeneration was performed in dops with gunshot fracture of long tubular bones. Methods of light and electron microscopy, cytophotometry of summary proteins optic density, historadioautography with 3H-thymidine were used. On the site of the osseous defect forms a complicated in tissue composition regenerate in the course of proliferative stage of regeneration and in interaction of diverse cellular differons. Viable osteogenic elements of bony fragments are the accessory source of the osseous regenerate forming. A mechanism of regenerative endosteal osteogenesis is revealed. Realization of the osseous tissue histoblastic properties, intertissue correlations and remodeling of the regenerate lead to healing of the gunshot fracture.


Consciousness in hibernation and synthetic torpor.
While human hibernation would provide many advantages for medical applications and space exploration, the intrinsic risks of the procedure itself, as well as those involved if the procedure were to be misused, need to be assessed. Moreover, the distinctive brain state that is present during a hibernation-like state raises questions regarding the state of consciousness of the subject. Since, in animal studies, the cortical activity of this state differs from that of sleep, coma, or even general anesthesia, and resembles a sort of "slowed wakefulness", it is uncertain whether residual consciousness may still be present. In this review, I will present a brief summary of the literature on hibernation and of the current state of the art in inducing a state of artificial hibernation (synthetic torpor); I will then focus on the brain changes that are observed during hibernation, on how these could modify the neural substrate of consciousness, and on the possible use of hibernation as a model for quantum biology. Finally, some ethical considerations on the use of synthetic torpor technology will be presented.


Evaluation of the Disintegration Action of Soy Polysaccharide by Image Analysis.
Here we investigated the disintegration action of the natural superdisintegrant soy polysaccharide (SP) and benchmarked it against sodium starch glycolate (SSG) and crospovidone (XPVP). Kinetics and mechanism of disintegration of various tablet formulations were monitored using a USB microscope connected to a computer, followed by image analysis. SP acts mainly by a swelling mechanism and it is most effective at concentrations of 4-8%. Its disintegration action is comparable with that of SSG and XPVP, in most cases. However, SP underperforms compared with these superdisintegrants, in extremely hard tablets containing a hydrophobic component. Moreover, it is more negatively affected by the concentration of magnesium stearate than SSG and XPVP. The disintegration action of SP is not affected by pH and ionic strength of the medium, but it is compromised by the presence of ethanol. This indicates that the concomitant administration of alcoholic beverages might hamper the disintegration of SP-containing tablets. Overall, SP is a promising tablet disintegrant for pharmaceutical and nutraceutical products.


Precise localization of sentinel lymph nodes and estimation of their depth using a prototype intraoperative mini gamma-camera in patients with breast cancer.
The aim of this study was to evaluate the ability of a prototype intraoperative mini gamma-camera, the CarolIReS, with a 50 x 50 mm field of view, to precisely localize sentinel lymph nodes (SLNs) and to determine their depth in a series of patients with infiltrative breast cancer requiring SLN excision. With the use of phantoms, the broadness of the signal of an acquired projection was shown to linearly depend on its distance from the collimator. A preclinical ex vivo study of 25 excised SLNs demonstrated that SLN size did not influence depth estimation. The minimum activity threshold for successful use of the proposed method was determined. After a preoperative radioisotope injection and lymphoscintigraphy, the SLN was localized in a series of 11 patients using both the mini gamma-camera and a gamma-probe. During surgery, a ruler was used to measure the depth of all SLNs before their excision. Using the measured linear dependence of image broadness, we found that the expected SLN anatomic depth was compatible with its measured depth during surgery. This study showed that the mini gamma-camera efficiently estimated the location of SLNs in 3 dimensions.


Dose-related effects of cycloheximide on delayed neuronal death in the gerbil hippocampus after bilateral transitory forebrain ischemia.
Degeneration of dendrites followed by punctate chromatin condensation in the CA1 area of the hippocampus is a characteristic of delayed neuronal death following bilateral forebrain ischemia. The effects of the protein synthesis inhibitor cycloheximide on delayed neuronal death following 20 min of bilateral forebrain ischemia were examined in the gerbil hippocampus at the 4th day of reperfusion. Low doses of cycloheximide beginning 10 min after ischemia (1.0 microgram/g body weight in saline followed by 1.0 microgram/g every 24 h) reduced the number of dying cells in the CA1 area, whereas high doses (2.0 micrograms/g, followed by 1.0 microgram/g every 12 h) increased the number of dying cells. No effects were seen when a single dose of cycloheximide was injected 1 h before ischemia. These results indicate that the effects of cycloheximide are dose-dependent, low doses reduce, high doses increase cell death. These findings also indirectly suggest that protein synthesis may play a role in the extent of delayed neuronal death. Some involved proteins could be heat shock proteins, which are induced after ischemia and had been correlated with increased resistance to injury. However, changes of heat shock immunoreactivity in the postischemic hippocampus were not seen in the present study following cycloheximide injection.


Correlation of condylar kinematics in children with gender, facial type and weight.
The aim of the study has been to describe the normal range of mandibular movements and condylar kinematics in children as well as to test the null hypothesis that these variables are not associated with gender, facial type and weight. The sample was comprised of 92 healthy children (7.2-10.6 years old) and 40 adult controls (18-34.7 years old). Examinations included the maximal mouth opening capacity and laterotrusion to the right and to the left. The condylar path inclination angle was calculated at 3mm and 5mm protrusion of the mandible. Kinematic variables were registered using the ultrasonic JMA system. Maximal mouth opening capacity averaged 46.73 mm for the children and 53.53 mm for the adults. The mean values of the lateral movements were 9.36 mm to the right and 9.62 mm to the left for the boys, and 9.91 mm and 9.68 mm for the girls, respectively. Mean condylar path inclination in the children was 36.5° (right) and 36.2° (left) at 3mm of protrusive movement, and 34.3° (right) and 34.0° (left) at 5mm of protrusive movement. Associations of the kinematic variables with gender, weight, or facial type were insignificant. Younger school children have not yet reached the maximum mouth-opening capacity. Correlation analysis suggests some weak, but insignificant associations of gender, facial type and weight with mouth opening, laterotrusion and the condylar path inclination angle. The null hypothesis was not rejected.


Celiac disease: diagnosis at laparoscopy.
A 27-year-old woman was found to have an abnormal small bowel at the time of an elective laparoscopic tubal ligation. Subsequent investigation revealed celiac disease to be the underlying cause. The changes identified are believed to reflect an increased intestinal blood flow, which has been identified in the diagnostic imaging literature to be associated with active celiac disease. Further study of this feature of celiac disease may provide additional insights into its pathophysiology.


Maintaining the square. How older adults with Parkinson's disease sustain quality in their lives.
In this article, the author's objective is to uncover the common practices that help sustain quality in the lives of older adults with Parkinson's disease. Interpretive phenomenology was the method used to gather and analyze the stories of six men and six women with idiopathic Parkinson's disease. The results show a constitutive pattern of Maintaining the Square. Five relational themes, including Learning How, Accepting Limitations, Seeking Knowledge, Engaging in Meaningful Experiences, and Living for Today, emerged from the participants' stories. The participants' ability to sustain continuity in their lives indicates their successful maintenance of the square. By identifying markers of continuity, they are able to maintain quality in their lives. As nurses, we can promote continuity in the lives of our patients if we take the time to learn what gives them meaning and purpose in life and then facilitate ways to help them maintain this connection.


Fear of crime and health in residential tower blocks. A case study in Liverpool, UK.
Though it is often assumed that fear of crime erodes mental health, research evidence is limited. Our study seeks to assess the relationship between these attributes in residents of the city of Liverpool. Evidence is drawn from a sample survey of 407 adults living in 21 tower blocks. A number of social and psychosocial attributes linked with feelings of safety are compared with self-reported health status using logistic and multiple regression techniques. Possible reciprocal relationships were investigated using two-stage least squares. Fear of crime in this sample is generally much lower in the home than in Britain as a whole and much higher out on the neighbouring streets at night, but there are sub-group variations. We find significant associations between fear of crime and health status. Feelings of safety when out alone after dark is the most consistent predictor of health status. Those feeling safe score significantly higher on all five dimensions of the SF-36 measure which cover mental and social well-being. Mental health is the strongest correlate and is probably a consequence rather than cause of feelings of safety. The evidence suggests elderly residents believe tower blocks provide safe accommodation. However, feelings of safety in these 'fortresses' do not generally extend to walking in neighbouring streets. Fear of crime erodes quality of life and is associated with poorer health.


Reintervention risk and quality of life outcomes after uterine-sparing interventions for fibroids: a systematic review and meta-analysis.
To compare uterine-sparing treatment options for fibroids in terms of reintervention risk and quality of life. Systematic review and meta-analysis according to PRISMA guidelines. Not applicable. Women with uterine fibroids undergoing a uterine-sparing intervention. Not applicable. 1) Reintervention risk after uterine-sparing treatment for fibroids after 12, 36, and 60 months; and 2) quality of life outcomes, based on validated questionnaires. Two separate analyses were performed for the procedures that used an abdominal approach (myomectomy, uterine artery embolization [UAE], artery ligation, high-intensity focused ultrasound [HIFU], laparoscopic radiofrequency ablation [RFA]) and for the procedures managing intracavitary fibroids (hysteroscopic approach, including hysteroscopic myomectomy and hysteroscopic RFA). There were 85 articles included for analysis, representing 17,789 women. Stratified by treatment options, reintervention risk after 60 months was 12.2% (95% confidence interval [CI] 5.2%-21.2%) for myomectomy, 14.4% (95% CI 9.8%-19.6%) for UAE, 53.9% (95% CI 47.2%-60.4%) for HIFU, and 7% (95% CI 4.8%-9.5%) for hysteroscopy. For the other treatment options, no studies were available at 60 months. For quality of life outcomes, symptoms improved after treatment for all options. The HIFU procedure had the least favorable outcomes. Despite the substantial heterogeneity of the study population, this meta-analysis provides valuable information on relative treatment efficacy of various uterine-sparing interventions for fibroids, which is relevant when counseling patients in daily practice. Furthermore, this study demonstrates that long-term data, particularly for the newest uterine-sparing interventions, are urgently needed.


Beta 2-adrenoceptor selectivity in four series of beta-adrenoceptor agonists.
We studied the effect of two catechol and two resorcinol series of beta-adrenoceptor agonists on isolated papillary (beta 1-adrenoceptors) and soleus (beta 2-adrenoceptors) muscles preparations from the guinea-pig. One of the catechol and one of the resorcinol series were substituted by branched alkyl groups on the amino nitrogen, and the other two series were substituted by cycloalkyl groups. It was found that: the catechol derivatives were more potent than their corresponding resorcinol derivatives on both the papillary and the soleus muscle preparations, the resorcinol derivatives were more selective for the soleus muscle than their corresponding catechol derivatives, the substitution on the amino nitrogen gave compounds that were highly selective for the soleus muscle, both in the catechol and the resorcinol series. Greatest selectivity was obtained with a tertiary butyl group. the branched alkyl substitution on the amino nitrogen favoured selectivity for the soleus muscle more than cycloalkyl substitution did.


Immunohistochemical expression of glucose transporter Glut1 and cyclin D1 in breast carcinomas with negative lymph nodes.
All malignant cells appear to have increased needs for glucose in vitro as well as in vivo. The enhanced glucose uptake is mediated through transporters (Gluts), whose action and expression are regulated by oncogenes and growth factors. Cyclin D1 is a nuclear protein that plays an important role in regulating the cell cycle by promoting entry of cells from the G1 to S phase. Increased expression of Glut1 glucose transporter and cyclin D1 have been reported in several neoplasms. In the present study we examined the expression of Glut1 and cyclin D1 in breast carcinomas with negative lymph nodes. We studied 78 infiltrating ductal carcinomas (25 grade 1, 36 grade 2, and 17 grade 3) with negative lymph nodes. Glut1 was expressed in 28% of grade 1, 63.8% of grade 2 and 58.7% of grade 3 carcinomas. Nuclear expression of cyclin D1 was detected in 32% of grade 1, 44.4% of grade 2, and 41.2% of grade 3 carcinomas. From our study it appears that in breast carcinomas with negative lymph nodes Glut1 expression is better correlated to the grade of the neoplasm than cyclin D1.


A comparison between the sonochemical and thermal reaction of 5H,5Cl-dibenz[a,d]cycloheptatriene with nitrobenzene.
The reaction of 5H,5Cl-dibenzo[a,d]cycloheptatriene with nitrobenzene was investigated under both thermal (210 degrees C) and ultrasonic (50 degrees C, 40 kHz) activation. The reaction products of both procedures are similar, but their amounts depend on the activation source. To account for the products a common electron transfer reaction is postulated through the dibenzotropylium cation. The differences between the thermal and ultrasonic process is thought to arise from the role of nitrobenzene as oxidant. Under thermal conditions this occurs throughout the reaction mixture but under sonication it occurs only in the cavitation bubble and in its immediate vicinity.


[A case of leprechaunism with disorders of insulin-like growth factor-I(IGF-I)/somatomedin C(SMC) binding protein and its receptor].
Leprechaunism is a rare genetic disorder characterized by physical abnormalities, intrauterine and postnatal growth retardation, poorly developed subcutaneous fat and muscle at birth, and early death. This patient, who was a 1.5 year-old female with typical clinical features of leprechaunism, had relatively high levels of plasma GH and IGF-I/SMC but no glucose intolerance or insulin resistance. Studies were undertaken to elucidate (1) the differences among some kinds of methods for IGF-I/SMC measurement, (2) the distribution patterns of IGF-I/SMC between two kinds of its binding protein (SMBP) in plasma, and (3) the dynamics of IGF-I/SMC receptor in her erythrocytes and liver microsomal membranes. The results were as follows: (1) The level of IGF-I/SMC measured by Nichols radioimmunoassay kit was 1.33U/ml, which was higher than that of infants the same age. Conversely, it was lower than that of the control which was measured by radioimmunoassay using recombinant IGF-I/SMC after acid-ethanol or Seppak C18 extraction. (2) By Sephadex G150 gel-chromatography, immunoreactive IGF-I/SMC was eluted predominantly in 150K region, and two apparent peaks of unsaturated somatomedin binding protein (USBP) were determined in a neonatal infant (appropriate to date), a normal adult and an infant of the same age as this patient. On the other hand, immunoreactive IGF-I/SMC was located only in the fractions corresponding to 40K region, and only one peak of USBP could be estimated in the region of 40K dalton. (3) The IGF-I/SMC receptor in the patient's erythrocytes possessed significantly lower binding affinity but higher binding capacity in comparison with that of the normal neonate and adult. In addition, the receptor in liver microsomal membranes obtained from this patient at autopsy also indicated lower affinity but higher capacity than that of fetuses at more than 19 weeks of gestation. This was coincident to that of fetuses less than 19 weeks of gestation. These results suggested that this patient resembled the intrauterine fetus before midgestation not only in the co-relationship among GH, IGF-I/SMC and its binding proteins, but also in the characteristics of its receptor. The severe growth retardation existing in this patient may be, at least partly, due to the abnormality and/or immaturity of IGF-I/SMC function. It is speculated that leprechaunism could be classified in relation to fetal growth mechanism by aspects of biological functions of IGF-I/SMC during development.


Association of IL-17 and IL-23 follicular fluid concentrations and gene expression profile in cumulus cells from infertile women at risk for ovarian hyperstimulation syndrome.
This study determined the association between the levels of interleukin (IL)-17 and IL-23 in follicular fluid (FF), as well as their mRNA levels in cumulus cells from infertile women at risk for ovarian hyperstimulation syndrome (OHSS). In this case-controlled study, the control group (n = 40) was infertile women whose partners had male factor infertility, whereas the case group (n = 40) was infertile women at risk of OHSS. IL-17 and IL-23 concentrations in FF were measured using an enzyme-linked immunosorbent assay method, whereas the mRNA expression levels of IL-17 and IL-23 of cumulus cells were determined using RT-PCR. Significantly higher levels of IL-17 were seen in the case group (p = 0.04), whereas there was no significant difference in IL-23 concentrations between the two groups (p = 0.3). The mRNA levels of IL-17 and IL-23 showed no significant differences. In the case group, there was a positive significant correlation between the IL-23 concentration in FF and the oocyte maturation rates (p = 0.01). In the case group, the number of follicles, MII oocytes, immature oocytes, fertilized oocytes and number of embryos were significantly higher than the control group (p < 0.05). Our findings showed that the mRNA expressions of IL-17 and IL-23 were similar in the two groups, and IL-17 was increased in the case group.


Lasting effects of FG-7142 on anxiety, aggression and limbic physiology in the cat.
The effect of the anxiogenic β-carboline, FG-7142, on behavior and limbic physiology was investigated. A single systemic injection of FG-7142 (10 mg/kg) changed behavior for at least 43 days. Two days after drug administration, defensive response to rats was increased. In addition, predatory attack was suppressed in some, but not all, animals. Cats that were more predatory (killers, n=2) before drug administration showed suppression of predatory attack after FG-7142. The attack of less predatory cats (non-killers, n=3) was unaffected by FG-7142. Suppression of attack was not correlated with changes in defense. This finding suggests FG-7142 acts on separate substrates of defense and attack suppression to change these behaviors lastingly. FG-7142 produced long-term potentiation (LTP) in two of three limbic pathways investigated. LTP was observed in the amygdalo-ventromedial hypothalamic (AM-VMH) pathway. AM-VMH LTP depended on changes within the amygdala and not in the efferent synapses or in the VMH. LTP lasted 6 days, returning to baseline by 21 days after FG-7142. The only behavioral change correlated with AM-VMH LTP was defensive response at 2 days after FG-7142. Increased defense from 6 to 43 days after the drug was not correlated with AM-VMH LTP. Therefore, AM-VMH LTP may be necessary for the initiation, but not maintenance, of increased defensive response. LTP of the population spike of the perforant path-CA3 (PP-CA3) field potential in the ventral hippocampus was also seen. LTP appeared 6 days after drug administration, after cats had been exposed to rats. Before the appearance of PP-CA3 LTP, there was a transient failure of recurrent inhibition in area CA3. It is likely that exposure to a rat during the period of failed inhibition facilitated the PP-CA3 LTP. In addition, following FG-7142, facilitation in area CA3 increased lastingly, consistent with a lasting increase in the duration of excitatory neurotransmitter release. Changes in hippocampal inhibition and facilitation correlated with changes in attack behavior, but not with changes in defensive response. Systemic flumazenil (10 mg/kg) partially reversed the lasting changes in defense and approach-attack in a drug-dependent manner. Limbic physiology was unchanged by flumazenil. Flumazenil probably did not affect AM-VMH transmission in the present study because AM-VMH LTP had returned to baseline when flumazenil was given. These findings suggest flumazenil only acts on potentiated AM-VMH transmission.


No association with risk for colorectal cancer of the insertion/deletion polymorphism which affects levels of angiotensin-converting enzyme.
In the light of the established association of angiotensin-converting enzyme (ACE) with several types of cancer, the possible contribution of the insertion/deletion (I/D) polymorphism that affects ACE gene expression, in the development of colorectal cancer was investigated. DNA samples of 92 patients with colorectal cancer (adenocarcinomas) and 102 healthy controls were examined by allele-specific polymerase chain reaction followed by electrophoretic analysis. The resulting allele and genotype frequencies of the patients were compared to those of the controls by Fischer's exact test and odds ratios. No statistical differences were observed between healthy controls and patients with colorectal cancer regarding either genotype distribution or low expression I allele frequency. The ACE I/D polymorphism is not a genetic predisposing factor concerning the risk for colorectal cancer.


Changes in caecal microbiota and mucosal morphology of weaned pigs.
An experiment was designed to monitor the changes in caecal microbiota associated with early weaning. Twelve piglets (20+/-2 days) from six different litters were selected from a commercial source. For the two experimental groups, one animal from each litter was weaned onto a post-weaning diet (W) and the other remained with the sow (S). After 1 week, animals were sacrificed and caecal samples taken. Microbial counts for total bacteria, enterobacteria and lactobacilli populations were determined by quantitative PCR using SYBR Green dye. Microbial profiles were assessed by terminal restriction fragment length polymorphism (t-RFLP). Weaning promoted an increase in the enterobacteria:lactobacilli ratio (0.27 versus 1.67 log/log 16S rRNA gene copy number, P=0.05). Total bacteria and richness of the caecal microbial ecosystem (number of peaks) were similar in both experimental groups (49.3 for S and 53.4 for W, respectively, P=0.22), although the band patterns were clearly grouped in two different clusters by dendogram analysis. Weaning was also associated with a decrease in crypt density, an increase in mytotic index and a decrease in the number of goblet cells. A reduced immunological response was also observed and was manifested by an increase in intraepithelial lymphocytes and lymphocyte density in the lamina propria. Weaning appears to be critical in the establishment of the caecal microbiota in pigs with important changes, particularly in microbial groups and in caecal mucosal architecture.


Assessment of target-organ damage in adolescent white-coat and sustained hypertensives.
The aim of the present study was to assess whether a difference exists between intima-media thickness and the left ventricular mass index in healthy nonhypertensive, white-coat hypertensive and sustained hypertensive adolescents. Fifty-nine normotensive and 120 hypertensive adolescents were enrolled in our study. Hypertensive patients were classified into white-coat hypertension (WCH) and sustained hypertension groups based on 24-h ambulatory blood pressure measurements. Both normotensive and hypertensive individuals underwent routine laboratory tests, intima-media thickness measurements on the common carotid arteries and transthoracic echocardiography to measure the left ventricular mass index (LVMI). Intima-media thickness was higher both in WCH and sustained hypertension compared with healthy normotensive individuals (controls: 0.048 ± 0.01 cm, WCH: 0.056 ± 0.01 cm, sustained hypertension: 0.054 ± 0.012 cm, both P < 0.001 compared with controls, nonsignificant difference between the two hypertensive groups). There was no difference between the LVMI of control individuals and WCH (LVMI: 35.5 ± 10.3 g/m and 37.7 ± 11.2 g/m respectively, P = 0.87). LVMI in sustained hypertension group (LVMI: 44.1 ± 14.1 g/m) was significantly higher both compared with WCH (P < 0.05), and healthy adolescents (P < 0.001). Target-organ damage develops in a stepwise fashion in adolescent hypertension. An increased intima-media thickness can be demonstrated not only in the sustained but also in the white-coat form of adolescent hypertension.


Anatomical and developmental bases for the ventral arc of the human pubis.
The ventral arc of the pubis is frequently used for sexing adult human hip bones. This study addresses the issues of the anatomical and developmental bases for the ventral arc. Dissection of seven adult pelves (four females and three males) demonstrates that the sexes are identical in the muscular and ligamentous attachments to this ridge of bone. The tendons of gracilis and adductor brevis, which are fused for a variable extent, arise from the ridge of bone, and the fibers of the ventral pubic ligament attach to its medial border. Lateral placement of the ventral arc is defined in terms of the minimum distance between the ridge of bone and the inferior border of the symphyseal face of the pubis. The hypothesis that lateral placement of the ventral arc is positively correlated with pubic length was tested using two random samples of adult female hip bones (N = 50 for both whites and blacks) from the Hamann-Todd collection. The correlation between these variables is significant. The results support the argument that lateral placement of the ventral arc is related to the amount of postadolescent growth occurring at the symphyseal border of the pubis. Therefore, the ventral arc should not be considered as an independent criterion from pubic length in sexing adult hip bones.


Ultrasound features of suture granulomas in the thyroid bed after thyroidectomy for papillary thyroid carcinoma with an emphasis on their differentiation from locally recurrent thyroid carcinomas.
The purpose of our study was to evaluate the ultrasound features of suture granulomas at the thyroid bed after thyroidectomy for papillary thyroid carcinoma with an emphasis on their differentiation from locally recurrent thyroid carcinomas. We enrolled 14 suture granulomas in 10 patients and 20 locally recurrent carcinomas in 18 patients after thyroidectomy, confirmed by surgery (15 out of 20 recurrent carcinomas), or ultrasound-guided fine needle aspiration cytology (14 suture granulomas and 5 recurrent carcinomas). The ultrasound findings, including presence of internal echogenic foci suggesting calcification or suture material, were compared between the two groups. In the cases with internal echogenic foci, the size, number, distribution pattern, and the presence of a paired appearance were also evaluated. In result, most of the suture granulomas were irregular (n=13) and heterogeneous (n=9) (p<0.05). The incidence of internal echogenic foci was higher in suture granulomas (n=12) than in recurrent carcinomas (n=7) (p<0.05). The internal echogenic foci in all suture granulomas were clustered centrally or paracentrally, unlike those in recurrent carcinomas (p<0.05). Most of the echogenic foci in suture granulomas were larger than 1 mm in diameter (p<0.05) and had a paired appearance (p<0.05). Shape, heterogeneity, and the presence of central or paracentral internal echogenic foci are helpful criteria for differentiating suture granulomas from locally recurrent tumors in the thyroid bed.


Altered mRNA Levels of Glucocorticoid Receptor, Mineralocorticoid Receptor, and Co-Chaperones (FKBP5 and PTGES3) in the Middle Frontal Gyrus of Autism Spectrum Disorder Subjects.
Although stress has been implicated in the pathophysiology of autistic spectrum disorder (ASD), it is not known whether glucocorticoid receptor (GR) levels are altered in the brain of subjects with ASD. The messenger RNA (mRNA) levels of GR isoforms (GRα, GRβ, GRγ, and GRP), mineralocorticoid receptor (MR), GR co-chaperones (FKBP5, PTGES3, and BAG1), and inflammatory cytokines (IL-6, IL-1β, and IFN-γ) were examined in the postmortem middle frontal gyrus tissues of 13 ASD and 13 age-matched controls by qRT-PCR. The protein levels were examined by Western blotting. We found significant decreases in GRα (64%), GRγ (48%), GRP (20%) and MR (46%) mRNA levels in ASD subjects as compared to controls. However, significant increases in FKBP5 (42%) and PTGES3 (35%) mRNA levels were observed in ASD subjects. There were no differences in the mRNA levels of GRβ and BAG1 in ASD subjects as compared to controls. MR mRNA was found to be negatively correlated with the diagnostic score for abnormality of development. On the protein level, significant reductions in GR and MR, but no change in FKBP5 and PTGES3 were found in ASD subjects as compared to controls. Moreover, we observed significant increases in IL-1β and IFN-γ mRNA levels in ASD subjects, and these cytokines were negatively associated with GR levels. Our data, for the first time, reports dysregulation of GR, MR, FKBP5, and PTGES3 in ASD and suggest a possible role of inflammation in altered GR function in ASD.


Mass-analyzed threshold ionization spectroscopy of 2-phenylethanol: probing of conformational changes caused by ionization.
The vibrational structure of the ionic ground state of different conformers of the biologically relevant molecule 2-phenylethanol has been investigated by combination of two-photon two-color mass-analyzed threshold ionization spectroscopy (MATI) and quantum chemical calculations at M05, MP2, and coupled cluster (CC) levels of theory with extended basis sets. MATI spectra recorded via gauche vibronic bands are with poor structure and increasing background, whereas the ones measured via vibronic bands of the anti conformers feature well-resolved vibronic structure in the cation. Ab initio computations predict three stable conformers for the 2-phenylethanol cation out of five initial neutral structures. None of the theoretical structures in the cation features a nonclassical OH...pi hydrogen bond in conjunction with the analysis of the MATI spectra. This provides clear evidence that the OH...pi hydrogen bond stabilizing the lowest-energy gauche conformer in the neutral breaks upon ionization.


Representation and identity - convergence of brain research and mind-brain philosophy.
The localization or representation of mental abilities in the brain have always been considered as key questions for understanding the organization of the human nervous system. Particularly with the advent of modern electrophysiological and imaging techniques that provide maps of electromagnetic fields and metabolic processes on the living central nervous system, the representation theory is experiencing a scientific renaissance in neurology, but is only one theory, however, in the succession of a long philosophical tradition dealing with the possible identification of mental phenomena and brain processes. This dichotomy was formulated at the latest in the Cartesian dualism of res cogitans and res extensa of the mind-body problem. Nowadays philosophical discussion, on the contrary, is dominated by monistic concepts that attempt to explain the mental realm on an organic foundation in order not to succumb to the problem of a psychophysical dualism. Of these, the identity theory offers a philosophically plausible concept postulating that the identity of brain conditions and mental phenomena is based on organic foundations. In this theory, the efforts of brain research converge on the representations of mental phenomena in the human nervous system. In a comprehensive approach, both concepts could complement each other.


The role of serum adipocyte fatty acid-binding protein on the development of metabolic syndrome is independent of pro-inflammatory cytokines.
Adipocyte fatty acid-binding protein (FABP4) is abundantly expressed in adipocytes and plays a role in glucose homeostasis. We analysed the relationship between serum FABP4 levels and the progression of metabolic syndrome in healthy adults. A total of 465 subjects were selected from participants in a medical check-up programme at a Health Promotion Center. Baseline serum FABP4 levels were measured, and the subjects were evaluated for the presence of metabolic syndrome (MetS) according to the recommendations of the American Heart Association/National Heart, Lung, and Blood Institute. The subjects were re-evaluated 4 years later. Baseline FABP4 concentrations were significantly higher in subjects with MetS than in those without MetS (P<0.001). At the 4-year follow-up, subjects in the highest FABP4 tertile at baseline exhibited higher values for body mass index, fat mass and percent body fat, as well as blood pressure, fasting glucose, total cholesterol, triglycerides, low-density lipoprotein (LDL)-cholesterol, insulin, homeostasis model assessment of insulin resistance, monocyte chemoattractant protein-1 and tumor necrosis factor-α levels (all P<0.05). The subjects with higher FABP4 levels had lower HDL-cholesterol concentrations (P<0.05). After adjustment for age, sex, change in percent body fat and baseline values for other metabolic and inflammatory parameters, FABP4 levels at baseline were shown to be strongly associated with the development of MetS by year 4 (odds ratio (OR), 5.75; 95% confidence interval (CI), 2.71-12.23 for highest tertile vs. lowest tertile, P<0.001) Baseline serum FABP4 levels appear to be a significant predictor for the future development of MetS, independent of pro-inflammatory cytokines.


Peroxynitrite formation from the simultaneous reduction of nitrite and oxygen by xanthine oxidase.
One electron reductions of oxygen and nitrite by xanthine oxidase form peroxynitrite. The nitrite and oxygen reducing activities of xanthine oxidase are regulated by oxygen with K(oxygen) 26 and 100 microM and K(nitrite) 1.0 and 1.1 mM with xanthine and NADH as donor substrates. Optimal peroxynitrite formation occurs at 70 microM oxygen with purine substrates. Kinetic parameters: V(max) approximately 50 nmol/min/mg and K(m) of 22, 36 and 70 microM for hypoxanthine, pterin and nitrite respectively. Peroxynitrite generation is inhibited by allopurinol, superoxide dismutase and diphenylene iodonium. A role for this enzyme activity can be found in the antibacterial activity of milk and circulating xanthine oxidase activity.


Aspartate aminotransferase to platelet ratio can reduce the need for transient elastography in Chinese patients with chronic hepatitis B.
In the absence of liver biopsy and transient elastography (TE), aspartate aminotransferase to platelet ratio (APRI), fibrosis-4 score (FIB-4), and gammaglutamyl transpeptidase to platelet ratio (GPR) are simple and inexpensive methods for the detection of liver fibrosis. We compared the performance of APRI, FIB-4, and GPR scores against TE in predicting the presence of liver fibrosis and cirrhosis, determined the optimal cut-off values for fibrosis and cirrhosis prediction, and reviewed the need for further TE assessment in resource-limited areas in China. TE and basic laboratory tests were performed in 2014 consecutive patients with chronic hepatitis B (CHB), and then compared to APRI, FIB-4, and GPR. For the detection of significant fibrosis, the areas under the receiver operating characteristic (AUROC) curves for APRI, FIB-4, and GPR were 0.83, 0.75, and 0.77, respectively. For the detection of cirrhosis, the AUROC curves for APRI, FIB-4, and GPR were 0.90, 0.84, and 0.84, respectively. The cutoff of APRI was 0.35, with 78% sensitivity and 63% negative predictive value (NPV), to exclude significant fibrosis (F ≥ 2). At an APRI of 0.6, results showed a 94% specificity, 100% positive predictive value (PPV) and 7.9 positive likelihood ratio (PLR) in detecting significant fibrosis. Thus, patients with an APRI of <0.35 or >0.6 demonstrated correct prediction of liver fibrosis. These results translated to 1250 out of the 2014 patients avoiding the need for TE with a diagnostic accuracy of >80%. The APRI score accurately assessed fibrosis and reduced the need for TE in almost two-thirds of Chinese patients with CHB.


Translabyrinthine repair for cerebrospinal fluid otorhinorrhea.
Cerebrospinal fluid (CSF) otorhinorrhea may occur as a complication of surgery for removal of acoustic neurinomas. The CSF leak usually appears within the first 2 weeks after surgery, and the diagnosis is obvious. The fistulous site is frequently inaccessible and may be difficult to repair by reexploring the suboccipital craniectomy. Successful closure of the fistula is accomplished by obliterating the space between the posterior fossa dura and the eustachian tube orifice with homograft muscle, using a radical translabyrinthine approach.


Quantification of pulmonary vascular occlusion in dogs by use of the diffusing capacity.
The purpose of these experiments was to quantify stagnant intrapulmonary blood caused by a pulmonary arterial occlusion (PAO). The hypothesis was that the diffusing capacity of the lung for CO (DLCO) would be altered little by PAO when measured with the usual inspired concentrations (0.3%) of CO, since stagnant blood distal to the occlusion takes up CO for 20 s or more before significant CO backpressure would develop. However, higher levels of CO (i.e., greater than or equal to 3%) would equilibrate faster with capillary blood (within 5-10 s), and DLCO measured 10-20 s subsequent to the high CO exposure would reflect only the DLCO in the unoccluded regions. Thus the fractional reduction in DLCO measured with 3% CO, with respect to that measured with 0.3% CO, should be related to the fractional occlusion of the pulmonary artery in a predictable way. We occluded the right pulmonary artery (RPAO), the left pulmonary artery (LPAO), or the left lower lobar artery (LLPAO) and found that DLCO measured during rebreathing a 0.3% CO mixture was 80, 87, and 94%, respectively, of the preocclusion value, whereas the DLCO measured during rebreathing a 3.3% CO mixture was 59, 73, and 87% of the preocclusion value. A computer model was developed to predict the reduction in DLCO at different levels of CO exposure that would be caused by varying fractions of PAO. Our data indicated that RPAO corresponded to a 42% vascular occlusion, LPAO a 35% occlusion, and LLPAO a 20% occlusion. Measurement of DLCO using low and high concentrations of CO might be useful in assessing the fraction of vascular bed occluded and in following noninvasively the course of vascular occlusion in a variety of pulmonary diseases.


Suprachoroidal hemorrhage as an intraoperative complication of 25-gauge pars plana vitrectomy.
To describe a case of suprachoroidal hemorrhage occurring during 25-gauge vitrectomy. Retrospective case review. An 80-year old pseudophakic man developed intraoperative suprachoroidal hemorrhage during a vitreous biopsy procedure for chronic intraocular inflammation. Despite drainage of the choroidals, visual outcome was poor. 25-gauge vitrectomy is often referred to as a "less-invasive" procedure than 20-gauge vitrectomy, but it is not necessarily less risky and probably carries a similar risk profile.


Dynamics of the nuclear lamina as monitored by GFP-tagged A-type lamins.
The behavior of chimeric proteins consisting of A-type lamins and green fluorescent protein (GFP) was studied to investigate the localization and dynamics of nuclear lamins in living cells. Cell line CHO-K1 was transfected with cDNA constructs encoding fusion proteins of lamin A-GFP, lamin Adelta10-GFP, or lamin C-GFP. In the interphase nucleus lamin-GFP fluorescence showed a perinuclear localization and incorporation into the lamina for all three constructs. Our findings show for the first time that the newly discovered lamin A 10 protein is localized to the nuclear membrane. The GFP-tagged lamins were processed and behaved similarly to the endogenous lamin molecules, at least in cells that expressed physiological levels of the GFP-lamins. In addition to the typical perinuclear localization, in the majority of transfected cells each individual A-type lamin-GFP revealed an extensive collection of branching intra- and trans-nuclear tubular structures, which showed a clear preference for a vertical orientation. Time-lapse studies of 3-D reconstructed interphase cells showed a remarkable stability in both number and location of these structures over time, while the lamina showed considerable dynamic movements, consisting of folding and indentation of large parts of the lamina. Fluorescence recovery after bleaching studies revealed a low protein turnover of both tubular and lamina-associated lamins. Repetitive bleaching of intranuclear areas revealed the presence of an insoluble intranuclear fraction of A-type lamins. Time-lapse studies of mitotic cells showed that reformation of the lamina and the tubular structures consisting of A-type lamins did not occur until after cytokinesis was completed.


[Neonatal apnea]
OBJECTIVE: To review medical literature related to apnea of prematurity. SOURCES: Extensive literature search and clinical practice-oriented concepts. SUMMARY OF THE FINDINGS: Apnea is one of the most common respiratory disorders in the neonatal period. Immaturity of the central nervous system is associated with instability of respiration. Therefore, apnea manifests itself in other systems, causing problems such as hypoglycemia, hypothermia, infection, or patent ductus arteriosus. Apnea may be central, obstructive or mixed depending on the presence of air flow through the upper airways. Diagnosis should involve careful observation by unit personnel and the monitoring of heart rate, respiratory frequency or arterial oxygen saturation. Initially, the treatment consists of xanthines (caffeine and aminophylline). If respiratory failure occurs, then continuous positive airway pressure (CPAP), and mechanical ventilation should be used. CONCLUSIONS: Preterm newborns are susceptible to respiratory problems, having apnea as a clinical manifestation of disorders in many organs and systems.


An exact surface-integral approach for accurate interferometric microscopy of single nanoparticles.
We present a half-plane surface-integral equation (SIE) approach for modeling the optical phase response of a single nanowire under phase-stepping interferometric (PSI) microscopy. This approach calculates scattered fields exactly from the Helmholtz equation in this 2D problem, obviating the need for ray-optic approximations. It is demonstrated that refractive index metrology is enabled by this method, with precision as low as 7 × 10(-5) possible for current state-of-the-art PSI microscopes. For nanowires of known refractive index, radii as small as 0.001λ are shown to yield a measurable phase signal and are therefore potentially measurable by this approach. Measurements are also demonstrated to be relatively insensitive to the spectral and coherence characteristics of the light source, the illumination conditions, and variations in nanowire cross-section shape. Prospects for measuring both the radius and refractive index simultaneously, and scope for generalizing this approach to arbitrary nanoparticle shapes are discussed.


Tracheal reconstruction with a prosthesis of marlex mesh and pericardium.
Tracheal reconstruction with a new type of prosthesis made of heavy Marlex mesh and pericardium is described in 13 patients suffering from malignancy. Two patients had circumferential excision of the trachea, and the remaining 11 had partial circumferential excision and a patch graft. In 10 of them, tracheal excision was a part of block pulmonary resection. The early results are good enough to allow us to continue using the prosthesis in suitable cases.


Enhancement of cellular binding efficiency and cytotoxicity using polyethylene glycol base triblock copolymeric nanoparticles for targeted drug delivery.
Folate (FA) conjugated tri-block copolymers were prepared by bioconjugation of poly epsilon-caprolactonediol and various molecular weights of diamine polyethylene glycol. The synthetic tri-block copolymers were characterized by 1H-NMR. Three types of nanoparticles were prepared by nanoprecipitation. Their size and morphology were verified by laser scattering and transmission electron microscopy, respectively. The colloidal stability of the nanoparticles was evaluated by turbidity test. The anticancer drug doxorubicin (DOX) was encapsulated in the nanoparticles during preparation. Drug loading amounts and release behavior from prepared nanoparticles were investigated. Fluorescent-activated cell sorting analysis and epi-fluorescencic microscopic imaging of prepared nanoparticles exhibited good cellular uptake against target cells. FA receptor expressed OVCAR3 cells that showed higher mean fluorescence intensity than FA receptor defect A549 cells at specific polyethylene glycol chain lengths. The cell cytotoxicity of prepared nanoparticles was evaluated for receptor mediated drug delivery.


The herpes simplex virus 1 origin binding protein: a DNA helicase.
A recombinant herpes simplex 1 origin binding protein, the product of the herpes UL9 gene, has been overexpressed in mammalian cells and purified to near homogeneity. The origin binding protein shows DNA-dependent nucleoside 5'-triphosphatase and DNA helicase activities in addition to its origin binding activity. The ability to hydrolyze nucleoside 5'-triphosphates is influenced strongly by the structure and sequence of the DNA cofactor. The properties of the recombinant origin binding protein are identical to those of the protein synthesized in herpes simplex 1-infected mammalian cells.


Genome organization and phylogenetic relationship of Pineapple mealybug wilt associated virus-3 with family Closteroviridae members.
The nucleotide sequence of Pineapple mealybug wilt associated virus-3 (PMWaV-3) (Closteroviridae: Ampelovirus), spanning seven open reading frames (ORFs) and the untranslatable region of the 3' end was determined. Based on the amino acid identities with orthologous ORFs of PMWaV-1 (54%-73%) and PMWaV-2 (13%-35%), we propose PMWaV-3 is a new species in the PMWaV complex. PMWaV-3 lacks an intergenic region between ORF1b and ORF2, encodes a relatively small, 28.8 kDa, coat protein, and lacks a coat protein duplicate. Phylogenetic analyses were used to analyze seven different domains and ORFs from members of the family Closteroviridae. Two distinct clades within the recognized genus Ampelovirus were observed; one that includes PMWaV-3 and PMWaV-1 and several GLRaVs and another that includes PMWaV-2 and GLRaV-3, the type member of the genus Ampelovirus.


DNA repair pathway profiling and microsatellite instability in colorectal cancer.
The ability to maintain DNA integrity is a critical cellular function. DNA repair is conducted by distinct pathways of genes, many of which are thought to be altered in colorectal cancer. However, there has been little characterization of these pathways in colorectal cancer. By using the TaqMan real-time quantitative PCR, RNA expression profiling of 20 DNA repair pathway genes was done in matched tumor and normal tissues from 52 patients with Dukes' C colorectal cancer. The relative mRNA expression level across the 20 DNA repair pathway genes varied considerably, and the individual variability was also quite large, with an 85.4 median fold change in the tumor tissue genes and a 127.2 median fold change in the normal tissue genes. Tumor-normal differential expression was found in 13 of 20 DNA repair pathway genes (only XPA had a lower RNA level in the tumor samples; the other 12 genes had significantly higher tumor levels, all P<0.01). Coordinated expression of ERCC6, HMG1, MSH2, and POLB (RS>or=0.60) was observed in the tumor tissues (all P<0.001). Apoptosis index was not correlated with expression of the 20 DNA repair pathway genes. MLH1 and XRCC1 RNA expression was correlated with microsatellite instability status (P=0.045 and 0.020, respectively). An inverse correlation was found between tumor MLH1 RNA expression and MLH1 DNA methylation (P=0.003). Our study provides an initial characterization of the DNA repair pathways for understanding the cellular DNA damage/repair system in human colorectal cancer.


Leadership in a Private Nephrology Practice: Autonomy Is More Than a Dream!
Private practice is entering an era of diminishing reimbursement and increasing overhead associated with federally mandated payment reforms resulting in a need to move from the traditional fee-for-service to a value-based model, changes that place financial and organizational strain on nephrology practices. In addition, the changing geopolitical scene is one of mergers and consolidation of health care networks, which in turn are developing their own insurance plans or partnering with commercial payers. The new landscape will require the leadership of a private nephrology practice to vigilantly monitor and adapt to these changes for success. Our leaders must be mindful of the impact of these changes to foster the successful growth of an autonomous private nephrology practice in which there is opportunity for personal and professional growth of its members in their quest to provide quality and safe patient care.


Work flow analysis of around-the-clock processing of blood culture samples and integrated MALDI-TOF mass spectrometry analysis for the diagnosis of bloodstream infections.
Because sepsis has a high mortality rate, rapid microbiological diagnosis is required to enable efficient therapy. The effectiveness of MALDI-TOF mass spectrometry (MALDI-TOF MS) analysis in reducing turnaround times (TATs) for blood culture (BC) pathogen identification when available in a 24-h hospital setting has not been determined. On the basis of data from a total number of 912 positive BCs collected within 140 consecutive days and work flow analyses of laboratory diagnostics, we evaluated different models to assess the TATs for batch-wise and for immediate response (real-time) MALDI-TOF MS pathogen identification of positive BC results during the night shifts. The results were compared to TATs from routine BC processing and biochemical identification performed during regular working hours. Continuous BC incubation together with batch-wise MALDI-TOF MS analysis enabled significant reductions of up to 58.7 h in the mean TATs for the reporting of the bacterial species. The TAT of batch-wise MALDI-TOF MS analysis was inferior by a mean of 4.9 h when compared to the model of the immediate work flow under ideal conditions with no constraints in staff availability. Together with continuous cultivation of BC, the 24-h availability of MALDI-TOF MS can reduce the TAT for microbial pathogen identification within a routine clinical laboratory setting. Batch-wise testing of positive BC loses a few hours compared to real-time identification but is still far superior to classical BC processing. Larger prospective studies are required to evaluate the contribution of rapid around-the-clock pathogen identification to medical decision-making for septicemic patients.


Contemporary evaluation of mitral regurgitation - 3D echocardiography, cardiac magnetic resonance, and procedural planning.
Mitral regurgitation is one of the more common forms of valvular heart disease. Given the expansion of therapies for structural heart disease, new therapies for mitral regurgitation are emerging. An accurate description and classification of mitral disease is important to understand pathology and provide recommendations for therapy. Areas covered: In the modern evaluation of mitral regurgitation, 3-dimensional echocardiography (3DE) and cardiac magnetic resonance imaging (CMR) play important roles which overcome the prior limitations of 2-dimensional echocardiography. Specifically, an advanced evaluation with these techniques allows accurate characterization of the anatomic etiology of mitral regurgitation and quantification of severity. Furthermore, the role of 3DE during intraprocedural guidance, 'interventional echocardiography,' is expanding. Expert commentary: In our review, we demonstrate a complete diagnostic evaluation of mitral valve dysfunction by 3DE and CMR and describe current implications for invasive therapy and procedural guidance.


Prevention of renal insufficiency after abdominal aortic aneurysm resection by optimal volume loading.
A retrospective case review of 34 men was undertaken to evaluate the relationship between preoperative volume loading and renal function before, during, and after abdominal aortic aneurysm surgery. Volume expansion was guided by either central venous pressure (CVP) in 12 patients or pulmonary artery wedge pressure (PAWP) measurements in 22 patients. Statistically significant differences (P less than .05) were noted between the two groups where greater preoperative volume loading and urine output were associated with lower postoperative serum creatinine and renal function indices in the PAWP group. The age range, vascular risk factors, aneurysm size, and preoperative renal function were similar. The data indicate that (1) PAWP is a more accurate monitor for volume expansion than CVP and (2) when volume replacement is optimal, abdominal aortic aneurysm surgery is not associated with postoperative renal insufficiency.


Alphafetoprotein: the genesis.
A historical account of the finding of alphafetoprotein is presented. The problems in its initial isolation, purification and source are described. Some interesting potential future studies are also discussed.


Novel stannatranes of the type N(CH2CMe2O)3SnX (X = OR, SR, OC(O)R, SP(S)Ph2, halogen). Synthesis, molecular structures, and electrochemical properties.
The syntheses of the stannatrane derivatives of the type N(CH(2)CMe(2)O)(3)SnX (1, X = Ot-Bu; 2, X = Oi-Pr; 3, X = 2,6-Me(2)C(6)H(3)O; 4, X = p-t-BuC(6)H(4)O; 5, X = p-NO(2)C(6)H(4)O; 6, X = p-FC(6)H(4)O; 7, X = p-PPh(2)C(6)H(4)O; 8, X = p-MeC(6)H(4)S; 9, X = o-NH(2)C(6)H(4)O; 10, X = OCPh(2)CH(2)NMe(2); 11, X = Ph(2)P(S)S; 12, X = p-t-BuC(6)H(4)C(O)O; 13, X = Cl; 14, X = Br; 15, X = I; 16, X = p-N(CH(2)CMe(2)O)(3)SnOSiMe(2)C(6)H(4)SiMe(2)O) are reported. The compounds are characterized by X-ray diffraction analyses (3-8, 11-16), multinuclear NMR spectroscopy, (13)C CP MAS (14) and (119)Sn CP MAS NMR (13, 14) spectroscopy, mass spectrometry and osmometric molecular weight determination (13). Electrochemical measurements show that anodic oxidation of the stannatranes 4 and 8 occurs via electrochemically reversible electron transfer resulting in the corresponding cation radicals. The latter were detected by cyclic voltammetry (CV) and real-time electron paramagnetic resonance spectroscopy (EPR). DFT calculations were performed to compare the stannatranes 4, 8, and 13 with the corresponding cation radicals 4(+•), 8(+•), and 13(+•), respectively.


[Mechanisms of the inhibitory effect of clonidine on the reproductive system of female rats].
It has been demonstrated in experiments on puberal and infantile female rats that a single subcutaneous injection of clonidine (0.03 mg/kg) disturbed whereas in a dose of 1 mg/kg completely inhibited spontaneous or induced ovulation as well as sexual receptivity. When injected in a daily dose of 0.03 mg/kg to puberal rats for 8 days clonidine potentiated the total gonadotropic activity of the pituitaries. When injected in a daily dose of 0.5 mg/kg for 10 days the drug induced the disorders of the estrous cycle during diestrus.


Toxic epidermal necrolysis (TEN): Acute complications and long-term sequelae management in a multidisciplinary follow-up.
Toxic epidermal necrolysis (TEN) is a devastating exfoliative disorder with life-changing complications. This study aimed to identify acute complications and long-term sequelae of TEN and to highlight the importance of a multidisciplinary management follow-up. A 19-year (1998-2016) retrospective review of all patients with TEN admitted to Cruces University Hospital´s Burns Unit was performed. Demographic and admission data were collected. Survivors were contacted for a follow-up multidisciplinary assessment involving dermatological, ocular, ENT, urological, gynecological, and psychological examination. Within the total cohort of patients analyzed (22), 6 survivors agreed to be interviewed. The patients presented with both physical and psychological sequelae, including dermatological (100%), oropharyngeal (50%), and ophthalmologic sequelae (50%), with corneal damage and severe dry eye as the most frequent. The only male patient underwent phimosis surgery due to mucosal adhesions. Psychometric scales captured symptoms of post-traumatic stress disorder (33.33%), and quality of life was affected in 66.67% of the patients by skin sequelae. Quality of life can be severely impaired by multiple long-term complications. It is important to emphasize the need for multidisciplinary awareness during their acute stay at Burns Unit. Furthermore, long-term follow-up might prevent or limit the progression of the chronic sequelae.


An update on natural occurrence and biological activity of chromones.
The chemistry of chromones is very well known. This system is widely used in organic chemistry as an intermediate compound for the synthesis of numerous hetrocycles. On the other hand, chromones were extensively studied as bioactive compounds. They possess remarkable biological activities, such as antimicrobial, antiviral, anticancer, anti-inflammatory, antioxidant, etc. This comprehensive review describes the current status and knowledge of natural occurrence, and biological activities of chromones. Recent advances made over the last decade i.e. January 1999 to December 2009 are critically discussed and we have covered about 176 references and more than 350 compounds reported during this period.


[12-lead ECG teletransmission in emergency medicine teams' actions].
Sudden health-threatening conditions with cardiovascular aetiology constitute a great number of all interventions of emergency medicine teams. Diagnostic and therapeutic abilities of modern cardiology lead to the necessity of introducing diagnostic methods which enable effective pre-hospital diagnostics in patients with circulatory system diseases also in emergency medicine. The ECG teletransmissions performed by emergency medicine teams prior to hospitalization increase the accuracy of the diagnosis and thus improve the organization of medical transport of patients to the medical centres appropriate to their medical condition. A 12-lead ECG teletransmission system and a system of teleconsultations was set up in September 2009 at the Voivodship Emergency Service and Medical Transport Station (WSPRiTS) "Meditrans" in Warsaw. The system consists of: emergency medicine teams and the Teletransmission Centre located in the Cardiac Department of WSPRiTS "Meditrans. The WSPRiTS "Meditrans" emergency medicine teams and helicopter emergency medicine teams performed standard ECGs at the place of the incident, sending them then via telephone to the Teletransmission Centre. Performing an ECG is recommended in the following cases: a pain in the chest, collapse and syncope, perceptible cardiac arrhythmia, dyspnoea and in any case when the head of the emergency medicine team (ZRM) took the decision to perform an ECG. The ECG record as well as the information about the patient supplied by the head of the team were analyzed by a consulting doctor on 24-hour duty at the receiving station. On basis of the received information the doctor from the Teletransmission Centre instructed the ZRM as to further procedure with the patient. There were 20117 ECG teletransmissions performed within the analyzed period. In the period between September 2009 and September 30th, 2012 there were 20 117 12-lead ECG teletransmissions performed, where 18139 (90.2%) were successful. 1978 (9.8%) were unsuccessful. 19 997 ECG transmissions were sent from WSPRiTS "Meditrans"ambulances and 120 by helicopter emergency teams. Women constituted 55% and men 45% of the investigated population of patients. The average age was 61 years. The average ECG transmission time was 7 minutes 10 seconds and did not extend the time of emergency medicine actions. The analysis of collected data revealed that ZRMs applied the teletransmission system particularly in cases others than acute coronary syndromes - 16 998 (93.7%) cases. The most frequent reasons to perform an ECG and consultation were pains in the chest - 23% cases, cardiac arrhythmias (18%) and collapses and syncope (13%). Among cardiac arrhythmias, arterial fibrillations (11%) were most often stated and in this group 79% cases were paroxysmal arrhythmias. During the 3 years 1141 cases of acute coronary syndromes were diagnosed in the pre-hospital period, what constituted only 6.3% of all teletransmissions. During a 9-month period 389 transports were carried out to primary health care centres from where the ECG records were then transferred to the Teletransmission Centre. In 117 cases (30%) the consultant changed the initial decision and patients were transported to other medical centres withour interventional cardiology departments. The system of ECG teletransmissions and consultations was appreciated by ZRMs and significantly supported their actions. The system should be supervised and coordinated by emergency medicine centres such as the Teletransmission Centre, Emergency Departments or Emergency Rooms. ECG teletransmissions make it possible to extend the paramedics and nurses' competences as regards emergency medical actions with patients with circulatory system diseases. The introduction of ECG teletransmissions from the place of the incident and the doctor's consultation have led to the optimization of transport of patients to appropriate in respect to their condition medical centres.


Experimental chronic Trypanosoma brucei rhodesiense infection in Microtus montanus.
Adult Microtus montanus were inoculated with a recently isolated strain of Trypanosoma brucei rhodesiense of human origin. The animals developed subacute to chronic infection and low-grade parasitemia. Histopathological examination of the heart revealed a severe pancarditis resulting in pronounced weight loss, and survival times of 5-8 weeks, preventing development of meningoencephalitis. In the brain a moderate meningitis was found, usually associated with moderate numbers of parasites in the choroid plexus and leptomeninges; however, trypanosomes were also found without tissue inflammation. Meningoencephalitis was found after 7 weeks, with parasites in the cerebral parenchyma. Chronic inflammation was present in lungs and kidney, often associated with trypanosomes; in one animal glomerulonephritis was found. Spleen and lymph glands showed a variable degree of lymphoid hyperplasia but no extravascular parasites. In the liver of all animals plasmolymphoid infiltrates were observed in the periportal connective tissue; no extravascular parasites were observed. A variable degree of lymphoplasmohistiocytic infiltrate in the connective tissue and occasional rare trypanosomes were seen in mesenterium, pancreas, epididymis, striated muscle, and skin. Experimental infection in M. montanus appears to be a suitable model for study of the acute trypanosomiasis of T. b. rhodesiense, but not for chronic African sleeping sickness with cerebral involvement.


Ionizing radiation induces iNOS-mediated epithelial dysfunction in the absence of an inflammatory response.
Ionizing radiation induces intestinal epithelial hyporesponsiveness to secretagogues through an unknown mechanism. We investigated the role of the inducible isoform of nitric oxide (NO) synthase (iNOS)-derived NO in radiation-induced hyporesponsiveness. C57BL/6 mice were sham treated or exposed to 10-Gy gamma-radiation and were studied 3 days later. Tissues were mounted in Ussing-type diffusion chambers to assess chloride secretion in response to electrical field stimulation (EFS) and forskolin (10 microM). Transport studies were also repeated in iNOS-deficient mice. White blood cell counts were significantly lower in irradiated mice, and there was no inflammatory response as shown by myeloperoxidase activity and histological assessment. iNOS mRNA levels and nitrate/nitrite concentrations were significantly elevated in irradiated colons. iNOS immunoreactivity localized to the epithelium. Colons from irradiated wild-type, but not iNOS-deficient, mice exhibited a significant reduction in the responsiveness of the tissue to EFS and forskolin. The hyporesponsiveness was reversed by L-N(6)-(1-iminoethyl)lysine, 1400W, and dexamethasone treatments. iNOS-derived NO mediates colonic hyporesponsiveness 3 days after irradiation in the mouse in the absence of an inflammatory response.


[Stimulants].
The authors present a comprehensive account of stimulants from chemical structure to clinical use. They analyze in detail the function and pharmacokinetic properties of stimulants but also their clinical and undesirable side-effects. The section on the interaction of stimulants and other drugs and other types of treatment is very important. The second part of the paper deals with indications and contraindications of stimulants, incl. the possible risk of the development of dependence. There are many indications for stimulants in clinical (in particular paedopsychiatric) practice.


[Effects of contextual changes between class and intermission on episodic memory].
Three naturalistic experiments were conducted to investigate the context-dependent memory induced by contextual changes between class and intermission. In all the experiments, junior college students served as subjects. The experimenter in a class session was their teacher, and the experimenters in an intermission session were other students with whom the subjects were acquainted. In Experiment 1, one group of subjects was tested in the same class as encoding, and another group was tested in the intermission at a different place, 60 seconds after their encoding of to-be-remembered items in class. In Experiment 2, the place factor (types of the room) and the non-place factor (class vs. intermission) were orthogonally manipulated. The retention interval was one week. In Experiments 1 and 2, the results revealed clear context-dependent memory. Furthermore, the context-dependent memory was produced by the changes in the non-place component of the context but not by those in the place component. Experiment 3 confirmed that the results were due to the context-dependent memory rather than to any other factors of experimental design.


Is there evidence that cerebral protection is beneficial? Clinical data.
Advances in angioplasty techniques and the development of low-profile, flexible, tapered nitinol stents designed specifically for carotid applications have made carotid artery stenting a viable alternative to carotid endarterectomy for treatment of occlusive disease of the carotid arteries. During the stenting process, however, debris may be released and cause distal embolization that can lead to stroke or death. Thus, several embolic protection devices have been developed for use in carotid stenting, two of which are available in the United States. In the past 5 years, data from several large trials, series, and registries of carotid artery stenting-reflecting the experience in thousands of patients-have become available. These investigations include the CAVATAS study, the Global Carotid Artery Stent Registry, the SAPPHIRE study, the ARCHeR trials, the CABERNET registry, the BEACH registry, the SECuRITY registry, the German Registry, and the EVA-3S trial. The studies have provided considerable evidence that use of an embolic protection device decreases the incidence of cerebral embolic events during carotid stenting in both symptomatic and asymptomatic patients. They have also shown that increased experience with angioplasty in the carotid artery decreases complication rates associated with the procedure, even when a protection device is not employed. Although the benefits of routine use of cerebral protection have not been confirmed by level 1 evidence, a consensus supports such use.


Role of renin angiotensin aldosterone on minimal change nephrotic syndrome.
Plasma volume (PV), plasma renin activity (PRA) and plasma aldosterone (PA) were examined serially at the edema forming stage, the stage of diuresis, and the stage of remission in 11 patients. These patients were steroid responsive, minimal change nephrotic syndrome with normal kidney function. PV was expressed as a percentage of the normal reference value, which was obtained from PV and body height in 44 normal volunteers. PV decreased significantly at the edema-forming stage and increased at the stage of the diuresis. A significant inverse correlation was obtained between PV and PRA. PRA correlated significantly with PA. The amount of 24 hour urinary sodium excretion severely reduced at the edema-forming stage and increased at the stage of diuresis: thus showing a significant inverse correlation with PA. In conclusion, renin-angiotensin-aldosterone system plays a role as a compensatory mechanism to the intravascular volume status in minimal change nephrotic syndrome, but, its' contribution to the genesis of edema is unsusceptible.


Peri-tumor interleukin-2 causes systemic therapeutic effect via interferon-gamma induction.
This study compares the direct local therapeutic effects of multiple peri-tumor injections of interleukin-2 (IL-2) and interferon gamma (IFN-gamma), also the associated systemic therapeutic effects on distant untreated tumors resulting from the peritumor injections. The therapeutic effects were tested against intramammary implants of an immunogenic, syngeneic C3H mammary carcinoma. Peritumor IL-2 and IFN-gamma had nearly equal local and systemic therapeutic effects. In a comparison of the therapeutic effects of IL-2 and IFN-gamma injected systemically, only the IFN-gamma injections resulted in a significant number of cures. IL-2 and IFN-gamma did not have an additive effect when used in combination, suggesting that they have connected, rather than separate, paths of action in the anti-tumor immune response. The injection of anti-IFN-gamma-MAb abrogated the systemic therapeutic effect of peri-tumor IL-2, indicating that the systemic therapeutic effect was the result of IFN-gamma induction at the IL-2 injection site.


Nulliparous pregnant women's narratives of imminent childbirth before and after internet-based cognitive behavioural therapy for severe fear of childbirth: a qualitative study.
To describe the expectations concerning imminent childbirth before and after 8 weeks of internet-based cognitive behavioural therapy (ICBT) among nulliparous pregnant women with severe fear of childbirth. Qualitative study of nulliparous pregnant women's narratives before and after CBT. The first ICBT programme for treating severe fear of childbirth. Fifteen nulliparous pregnant Swedish women with severe fear of childbirth participating in an ICBT self-help programme. Semi-structured open-ended questions over the internet before and after 8 weeks of ICBT. The data were analysed using thematic analysis. The participants' narratives pertaining to five different situations during labour and delivery before and after ICBT. After therapy, participants described a more realistic attitude towards imminent childbirth, more self-confidence and more active coping strategies. They perceived their partners and the staff as more supportive. They were more aware of the approaching meeting with their baby when giving birth. Following the ICBT programme, participants changed their attitude towards imminent childbirth from negative to more positive. This was manifested in positive and more realistic expectations regarding themselves, their partner and the staff that would look after them.


Long term glycaemic control by alternative regimens in a feasibility study of continuous subcutaneous insulin infusion.
Of 382 insulin-treated diabetic patients participating in a feasibility study of continuous subcutaneous insulin infusion (CSII) and alternative regimens in a large British clinic, 63 used CSII for a 2-yr period. Additionally 74 patients persisted with an intensified injection regimen and 85 continued on non-intensified therapy. There was no significant difference in mean glycosylated haemoglobin between the 3 groups at the study onset. At month 24 only the CSII group had significantly reduced mean glycosylated haemoglobin (11.0 +/- 1.8 (SD) at month 0; 9.8 +/- 1.9 month 24, p less than 0.001) although the intensified injection group experienced a significant reduction in mean glycosylated haemoglobin until month 18 (11.0 +/- 1.8 month 0; 10.1 +/- 1.4, p less than 0.001). Serious hypoglycaemia was not increased in the CSII-treated group compared with the intensified injection group. Thus it proved feasible to achieve sustained, improved glycaemic control in a large group of patients by the use of insulin pump therapy and the level of control was superior to that achieved by an intensified injection regimen.


Antelopes (Bovidae) kept in European zoological gardens as intermediate hosts of Sarcocystis species.
Four different forms of sarcocysts from the zoo-kept antelopes Addax nasomaculatus. Antilope cervicapra, Taurotragus oryx and Boselaphus tragocamelus (Bovidae) were investigated by light and transmission electron microscopy, in special consideration of the cyst wall. The sarcocysts found in Addax (born in a zoo) were not distinguishable from Sarcocystis medusiformis of Australasian sheep by their morphology and would be the first indication for the occurrence of this species in Europe. Sarcocysts from Antilope (born in a zoo) resembled the tenella/capracanis type of sheep/goats and were, therefore, designated as Sarcocystis sp. (? cf. capracanis) in this paper. Sarcocysts from Taurotragus were similar to a zoonotic species of cattle and hence provisionally designated as S. sp. (? cf. hominis). A sarcocyst form with hair-like villar protrusions of the cyst wall was found in Taurotragus. Boselaphus and Antilope and compared with a common species of cattle: S (? cf. cruzi).


Parental attitudes to health of children in child-care centres and options when children are ill.
To determine parental attitudes regarding the health of children attending child-care centres, to explore concerns when children who normally attend child care are ill, and to investigate options in these circumstances. Focus groups conducted with parents whose children attended child-care centres. Ten focus groups were conducted. Many parents encountered difficulty when children who normally attend child care were ill and there was a lack of options for care. Parents were concerned about the spread of infections among children but considered that there were also many health and other advantages for their children in attending child care. Child-care centres were perceived as providing a valuable support role for families. Many parents lack adequate options for care when their children are ill. Parents' concerns regarding health in child care are important in policy decisions regarding the health of children in child care, and the development of alternative care services for children.


Brassinosteroid nuclear signaling recruits HSP90 activity.
Heat shock protein 90 (HSP90) controls a number of developmental circuits, and serves a sophisticated and highly regulatory function in signaling pathways. Brassinosteroids (BRs) control many aspects of plant development. Genetic, physiological, cytological, gene expression, live cell imaging, and pharmacological approaches provide conclusive evidence for HSP90 involvement in Arabidopsis thalianaBR signaling. Nuclear-localized HSP90s translocate to cytoplasm when their activity is blocked by the HSP90 inhibitor geldanamycin (GDA). GDA treatment promoted the export of BIN2, a regulator of BR signaling, from the nucleus into the cytoplasm, indicating that active HSP90 is required to sustain BIN2 in the nucleus. HSP90 nuclear localization was inhibited by brassinolide (BL). HSP90s interact with BIN2 in the nucleus of untreated cells and in the cytoplasm of BL-treated cells, showing that the site-specific action of HSP90 on BIN2 is controlled by BRs. GDA and BL treatments change the expression of a common set of previously identified BR-responsive genes. This highlights the effect of active HSP90s on the regulation of BR-responsive genes. Our observations reveal that HSP90s have a central role in sustaining BIN2 nuclear function. We propose that BR signaling is mediated by HSP90 activity and via trafficking of BIN2-HSP90 complexes into the cytoplasm.


The influence of different registration techniques on condyle displacement and electromyographic activity in stomatognathically healthy subjects: a prospective study.
It is unclear whether different intermaxillary registration techniques are related to a physiological condylar position that permits neuromuscular equilibrium. This study analyzes and quantifies the effects of different registration techniques on the condyle position and how the registration technique modulates bilateral masseter and anterior temporalis muscle electromyographic activity. Three-dimensional electronic condylar position analysis (EPA) with an ultrasound-based jaw-tracking system and surface electromyographic activity (sEMG) was recorded during the registration of a manually guided centric relation (CR), maximal intercuspation (MI), and Gothic arch tracing guided centric relation (DIR method). Participants were 26 stomatognathically healthy volunteers (mean age, 30.6 ±9.5 years). Data were analyzed by 1-way ANOVA and post hoc Bonferroni correction (α=.05). EPA showed significant differences (P<.001) for CR, MI, and DIR in the vertical, sagittal, and horizontal axes. The condyle position during DIR was found to be significantly more anteriorly and inferiorly located than with CR (P<.001) and MI (P<.04). There were no significant differences in the mean muscle activity among CR, MI, and DIR. Muscular symmetry ranged from 63.87 to 81.47%. Significantly higher symmetry for the anterior temporalis (P=.03) and the masseter (P=.03) was found during the DIR than with CR. Torque coefficients (potential laterodeviating effect) were between 88.02% (CR) and 89.94% (MI). Registration technique significantly influenced the condyle position, while mean muscular activity was minimally affected. With respect to muscular balance and activation, the DIR position proved to be capable of inducing the greatest motor unit activity when compared with manually guided CR and MI.


The undervaluation of evaluation and management professional services: the lasting impact of current procedural terminology code deficiencies on physician payment.
The Resource-Based Relative Value Scale (RBRVS) is fundamentally undermined by the following foundational errors: (1) The full range of office-based evaluation and management (E/M) activities are not captured by the Current Procedural Terminology (CPT) code choices, (2) it places relatively high values on procedural services, (3) there is no measure of intensity for complex outpatient E/M care, and (4) its maintenance and update have been delegated to select professional societies. Limitations imposed on the development of the RBRVS dating back to the early 1980s have not been corrected. The repertoire of codes for physician office-based E/M work must be expanded to create a new topology of choices with new outpatient code families with discrete service code levels, such as comprehensive outpatient consultation care, comprehensive outpatient primary care, and limited outpatient consultation care. Service code relative values must be based on representative samples and reliable survey data, draw from the broader literature on work intensity, and be developed with accountable and representative professional engagement.


Response to symptoms in healthy, low utilizers of the health care system.
From the literature, it is clear that a small proportion of people account for an inordinately high number of health care visits. Conversely, there exists a group of individuals who rarely seek professional medical intervention and, yet, who remain healthy. This study examines a sample of adults who have not received remedial treatment for any symptom in the previous year, who consider themselves as healthy and who pass a comprehensive physical examination. A gender and age balanced group of healthy low utilizers was administered the Symptom Response Questionnaire, an instrument designed to elicit response tendencies to thirteen standardized symptoms. There were significant differences between age groups in response to symptoms with the older individuals more likely to seek professional help. There were few gender differences within the healthy sample. This sample of healthy low-utilizers was not without symptoms, reporting an average of 20 symptoms occurring in the previous week as measured by the SCL-90. A clinical headache group was also administered the SRQ to provide information about their response tendencies to symptoms. This preliminary study suggests that response to illness may be significantly influenced by age and patient status and that reported gender differences in health care utilization may need to be examined more carefully. It is proposed that behavior patterns of healthy, low utilizers may have direct implications for intervention with high utilizers of the health care system.


Serologically detected lymphocyte antigens in Holstein cattle.
Lymphocytes from 103 Holstein cattle were tested with 11 antilymphocytotoxic sera. Four of these sera were produced by whole blood immunization; these generally yielded lymphocytotoxicity against a large number of animals in each test panel. The majority of the sera were collected from parous cows which had never been immunized. Observations about this latter group of sera are (1) lymphocyte antibodies, may occur by alloimmunization in foetal-maternal interaction, (2) normal sera from non-immunized parous cows generally had a narrower specificity of antibodies than from parous cows immunized with blood from unrelated animals and in some cases these antisera may be monospecific, and (3) these sera from parous cows are easy to obtain without the need for laborious immunizations. Analysis of these lymphocytotoxic sera indicate several reagents were obtained which possessed different antibodies; these were useful in detecting polymorphism of cattle lymphocyte antigens. Using these 11 sera, an analysis of the reactions patterns among 103 Holsteins, including parent-offspring data resulted in the postulation of several alleles. These data suggest that cattle lymphocyte antigens are very polymorphic and inherited.


Evaluation of early pelvic floor physiotherapy on the duration and degree of urinary incontinence after radical retropubic prostatectomy in a non-teaching hospital.
The objective of this study was to study the effect of early pelvic floor re-education on the degree and duration of incontinence and to evaluate the results of radical retropubic prostatectomy (RRP) performed in a non-teaching hospital. This is a non-randomised study. From March 2000 to November 2003, 57 consecutive men, who underwent RRP for localized prostate cancer, participated in a pelvic floor re-educating program. Continence was defined as a loss of no more than 2-g urine on the 24-h pad test and no use of pads. The 24-h pad test was performed once in every 4 weeks until the patient indicated that he was continent. Diurnal and nocturnal continence was achieved after 1, 2, 3, 6 and 12 months post catheter removal in 40, 49, 70, 86 and 88% of all men, respectively. Comparison of our results with current literature suggest that the time period towards continence after a RRP can be shortened relevantly if pelvic floor re-education is started directly after catheter removal.


EH and UIM: endocytosis and more.
Exogenously and endogenously originated signals are propagated within the cell by functional and physical networks of proteins, leading to numerous biological outcomes. Many protein-protein interactions take place between binding domains and short peptide motifs. Frequently, these interactions are inducible by upstream signaling events, in which case one of the two binding surfaces may be created by a posttranslational modification. Here, we discuss two protein networks. One, the EH-network, is based on the Eps15 homology (EH) domain, which binds to peptides containing the sequence Asp-Pro-Phe (NPF). The other, which we define as the monoubiquitin (mUb) network, relies on monoubiquitination, which is emerging as an important posttranslational modification that regulates protein function. Both networks were initially implicated in the control of plasma membrane receptor endocytosis and in the regulation of intracellular trafficking routes. The ramifications of these two networks, however, appear to extend into many other aspects of cell physiology as well, such as transcriptional regulation, actin cytoskeleton remodeling, and DNA repair. The focus of this review is to integrate available knowledge of the EH- and mUb networks with predictions of genetic and physical interactions stemming from functional genomics approaches.


How I do it: cervical lateral mass screw fixation.
Cervical lateral mass screw fixation is indicated for the treatment of cervical subaxial C3-C7 lesions associated with instability. The authors first describe the surgical anatomy of the subaxial cervical posterior approach. Then the Magerl technique is detailed. In particular, tricks to avoid complications are presented. The ideal screw entry point, direction, size and exit point are mentioned. A surgical video, artist's drawings and a radiological case report are included. The Magerl technique is a safe and effective lateral mass fixation technique. Respecting anatomical landmarks is crucial to avoid nerve root, vertebral artery and facet joint injury.


Conditional Singlet Oxygen Generation through a Bioorthogonal DNA-targeted Tetrazine Reaction.
We report the use of bioorthogonal reactions as an original strategy in photodynamic therapy to achieve conditional phototoxicity and specific subcellular localization simultaneously. Our novel halogenated BODIPY-tetrazine probes only become efficient photosensitizers (ΦΔ ≈0.50) through an intracellular inverse-electron-demand Diels-Alder reaction with a suitable dienophile. Ab initio computations reveal an activation-dependent change in decay channels that controls 1 O2 generation. Our bioorthogonal approach also enables spatial control. As a proof-of-concept, we demonstrate the feasibility of the selective activation of our dormant photosensitizer in cellular nuclei, causing cancer cell death upon irradiation. Thus, our dual biorthogonal, activatable photosensitizers open new venues to combat current limitations of photodynamic therapy.


[Quantitative assessment of allospecific interleukin-2-secreting helper T lymphocyte in cord blood with limiting dilution assay].
In order to investigate whether cord blood transplantation could induce severe graft versus host disease (GVHD) similar to that in bone marrow transplantation. The frequency of allospecific IL-2-secreting helper T lymphocyte (AIHTL) in 17 cord blood and 14 adult peripherial blood samples were detected by limiting dilution assay. No statistically significant difference between the cord blood and adult peripheral blood AIHTLs was revealed. Alloreactivity of cord blood was the same as that of adult blood. HLA typing and powerful immunosuppressive therapy should be adopted to reduce the incidence of GVHD in cord blood transplantation.


[Value-based health care (VbHC): Whence and wither].
Since about 2005 VbHC has become a prominent movement on the border between population medicine and health economics. The "value" it is aiming at is defined as health care "outcomes per dollar spent". The text focuses on the work of two prominent proponents: M.E. Porter and J.A.M. Gray. It considers background and central elements of VbHC and discusses similarities and differences between the two authors. Especially the differences raise questions that will hopefully play a role in the German discussion that is still in its infancy. Three complex topics seem to be particularly relevant: the relationship between VbHC and evidence-based health care, the question of who is to benefit from VbHC (total, diseased, patient population?), and the role of moral values especially the value of solidarity with the severely ill and socially deprived.


[Pneumocystis carinii pneumonia in AIDS. New concepts for an old problem].
Pneumocystis carinii (PC) is an ubiquitous pathogen phylogenetically considered a fungus. In individuals with T-cell deficiency, PC produces typically an interstitial pneumonia. The primary infection is, perhaps, transmitted airborne, and is acquired during early infancy. PC was a rare cause of disease until the advent of AIDS. In susceptible patients infected with HIV it remains a major cause of morbidity and mortality despite appropriate prophylaxis and treatment. Mutations in the gene that encodes the enzyme dihydropteroate synthase are seemingly accountable for the failure of prophylaxis in some individuals. The incidence of new cases of PC pneumonia (PCP) in patients with infection with HIV has dropped substantially since the advent of highly active antiretroviral therapy (HAART). Ongoing trials are designed to study the effect of withdrawing prophylaxis for PCP in patients whose T-cell count has risen over 200/mm3 in response to HAART.


Separate assessment of forearm cortical and trabecular bone density from standard densitometry data.
Cortical and trabecular bone are different bone components. Their mineral density cannot be measured directly by areal bone densitometry. To introduce a method for assessment of pure radial cortical and trabecular bone density based on standard densitometry data. The study included 418 healthy females (aged 20-83 years, body mass index between 19 and 30) free of previous fractures and conditions or drugs affecting bone metabolism; as well as a group of 64 age-matched females with early menopause. Forearm bone density was measured by single X-ray absorptiometry and calculated separately for cortical and trabecular bone. Age-adjusted bone density curves were built. Peak bone density was found to occur between 30 and 34 years of age and was 0.561 g/cm2 for cortical and 0.281 g/cm2 for trabecular bone. In comparison, lowest values were registered between 70 and 74 years of age; cortical bone density reduced by 26% and trabecular density by 44%. Both bone density profiles through life reflected the earlier peri- and postmenopausal (mainly trabecular) and later senile (cortical bone also involved) changes in bone mass. A step-wise pattern of trabecular bone reduction was registered with acceleration around 45, 55 and 65 years. The effects of early menopause on trabecular and cortical bone were tested in the prematurely menopausal women. The ability of our model to discriminate between natural and premature menopause was moderate. Although hypothetical (based on calculations from integral densitometry data rather than on direct measurements), our method could differentiate between cortical and trabecular osteopenia and may prove helpful in assessing the type of osteoporosis, in making therapy choices and monitoring response to therapy based on forearm bone density.


Laterality influences cognitive performance in rainbowfish Melanotaenia duboulayi.
Cerebral lateralization has been suggested to convey a selective advantage to individuals by enhancing their cognitive abilities. Few, however, have explicitly compared the cognitive ability of animals with strongly contrasting laterality. Here, we examined the influence of laterality on learning performance in the crimson spotted rainbowfish, Melanotaenia duboulayi, using a classical conditioning paradigm. We also compared the learning ability of wild caught and captive-reared fish to examine the influence of rearing environment on cognitive performance. Laterality was established by observing which eye fish preferred to use while viewing their mirror image. Subjects were then conditioned to associate the appearance of a red light with a food reward over 7 days. Our results revealed that left-lateralized fish learned the conditioning task faster than right-lateralized. These results provide further evidence that cerebral lateralization can play important roles in cognitive function which likely have diverse fitness consequences for animals in their natural environments.


Use of an orthogonal design method to study two-stage chemical carcinogenesis in BALB/3T3 cells.
An orthogonal design method was used to study two-stage chemical carcinogenesis in BALB/3T3 cells. Four factors were studied: different concentrations of the initiator N-methyl-N-nitro-N'-nitrosoguanidine (MNNG); different concentrations of the promoter 12-O-tetradecanoyl-phorbol-13-acetate (TPA); different concentrations of fetal calf serum (FCS) and different times at which TPA was added after cell initiation. From the results of three experiments designed by Table L9(3(4)), L8(2(7)) and L16(4(5)), 0.3 microgram/ml MNNG was the highest possible initiating concentration and 0.25 microgram/ml TPA was the minimum effective concentration for promoting activity. There is synergy between MNNG and TPA, the optimum combination in sequential treatment being 0.3 microgram/ml MNNG and 0.25 microgram/ml TPA. The 10% FCS standard concentration was the optimal one; however, below 5% few foci appeared. The time at which TPA was added had little effect on cloning efficiency and transformation frequency. So the use of this orthogonal design in cell culture has many advantages: several factors can be tested simultaneously; it is easy to find the optimal protocol conditions and the dose-response relationship is stable, which enables the reproducibility to be improved. In addition, the different tables proposed may help to reveal unexpected problems.