Gender discrimination may be worse than you think: testing ordinal interactions in power research.
The authors reanalyze the data of a study by S. M. Elias and R. J. Loomis (2004), which aimed to determine how an instructor's gender may influence his or her ability to gain student compliance. S. M. Elias and R. J. Loomis observed few significant gender effects using traditional multivariate analyses of variance. The authors reanalyze this data using the more appropriate statistical techniques for detecting ordinal interactions recommended by M. J. Strube and P. Bobko (1989) and S. M. Elias (2004). An ordinal interaction occurs when 1 cell of a 2 x 2 design is responsible for a significant interaction (e.g., female instructors suffering only when rated by male students). Reanalysis of the data resulted in more robust findings.


Surface pH and the control of intracellular pH in cardiac and skeletal muscle.
Both surface pH (pHs) and intracellular pH (pHi) were measured using single- and double-barreled pH-sensitive microelectrodes in isolated sheep cardiac Purkinje strands, rabbit and cat papillary muscle, and mouse and rat soleus muscle. Superfusion of the preparations with a relatively low buffered solution (containing 5 mM HEPES buffered to control pH) causes surface acidosis that correlates with efflux of metabolically produced acids in the unstirred layer of fluid surrounding the tissue. Acidification of the surface layer induces a slower acid change of pHi and depresses the rate of proton extrusion following an imposed intracellular acid load. In cardiac preparations, the lowering of pHi correlates with depression of twitch tension. Transient changes of pHs and pHi are seen when a weak acid or base is suddenly added to, or removed from the superfusion solution. Indirect evidence of the presence of carbonic anhydrase in the extracellular surface layer is obtained from analysis of transient pHs changes in presence and absence of acetazolamide.


[Clinical analysis of trigemino-cardiac reflex during surgery for patients with skull base tumors].
To investigate the clinical features, risky factors and outcome of the trigemino-cardiac reflex (TCR) during surgery for skull base tumors. Two hundred and sixty-two neurosurgical patients with skull base tumors underwent general anesthesia and open surgery from October 2009 to December 2011 in department of neurosurgery of Beijing Tiantan Hospital. The occurrence of TCR and the type of tumor, the surgical approach as well as the postoperative complication relative to TCR was evaluated retrospectively. Seventeen patients occurred TCR events intraoperatively (6.5%). There were 8 men and 9 women with an average age of 40.5 years. Eleven of them (64.7%) underwent schwannoma surgery. Regarding with the surgical procedure, the suboccipital retrosigmoidal approach and the middle fossa transtentorial approach were most commonly associated with TCR in this series (88.2%). The heart rate and blood pressure returned to the patient's normal baseline level after cessation of the surgical manipulation. There was no TCR-relative complication in cardiovascular system. The postoperative course is uneventful in all 17 patients. TCR may occur during surgery for skull base tumor, especially when performing schwannoma surgery and suboccipital retrosigmoidal or middle fossa transtentorial approach. Accurate recognition and management of TCR during skull base surgery often carry on favorable outcome.


[Impacted maxillary cuspid. IV. Periodontal aspects].
Treatment goal of the maxillary impacted cuspid should include health periodontal end results. This clinical and radiographic study reveals in 75% of the cases a satisfying periodontal condition.


In vitro antifungal activity of luliconazole against nondermatophytic moulds.
In vitro antifungal activity of luliconazole against nondermatophytic moulds causing superficial infections was compared with that of five classes of 12 topical and systemic drugs. The minimum inhibitory concentration (MIC) of the drugs against the genera of Neoscytalidium, Fusarium, Aspergillus, Scedosporium, and Alternaria was measured via modified microdilution method. In results, the nondermatophytic moulds were found to be less susceptible to drugs to which Neoscytalidium spp. and Fusarium spp. were typically drug resistant. However, luliconazole was effective against all the genera tested, including afore-mentioned two species, and had the lowest MICs among the drugs tested.


Measurement of trazodone in plasma and brain of rat by capillary gas chromatography with a nitrogen-selective detector.
A specific and highly sensitive method for the measurement of trazodone in plasma and brain of rat is presented. The compound and the internal standard were extracted from alkalinized samples with hexane and analysed by capillary gas chromatography with nitrogen-selective detection. The method was demonstrated to be accurate and precise. The limits of determination were 2 ng/ml for plasma and 24 ng/g for brain, which makes this procedure suitable for pharmacokinetic analysis.


[Long-term follow-up of right atrial multilinear high-frequency ablation in the treatment of recurrent paroxysmal atrial fibrillation].
To investigate the long-term follow-up after right atrial compartmentalization using radiofrequency catheter ablation to treat recurrent paroxysmal atrial fibrillation. 33 patients (eight women / 25 men, mean age 56.1+/-9.9 years) with highly symptomatic recurrent paroxysmal atrial fibrillation and mostly unresponsive to antiarrhythmic drugs were enrolled in this prospective study. All patients underwent radiofrequency catheter ablation, including right atrial compartmentalization and ablation of the right atrial isthmus region. The primary goal during follow-up was documentation of arrhythmia-related symptoms using a SF-36 quality-of-life questionnaire. During a mean follow-up of 2.1 years 21 % of patients were free of a relapse under continued antiarrhythmic medication, 79 % suffered at least from one period of atrial fibrillation. According to the underlying heart disease patients classified as "lone atrial fibrillation" (40 % without a relapse) showed improvement particularly compared to patients with coronary heart disease (10 % without a relapse). In the group of patients with a relapse of atrial fibrillation the mean of duration of an arrhythmic episode decreased significantly from 10.6 to 2.3 hours under continued administration of antiarrhythmic drugs (p = 0.01), as did the number of episodes, from 2.2 to 1.9/week. Despite of the high rate of clinical relapse, patients can profit due to an improved responsiveness to antiarrhythmic drugs after ablation. Right atrial compartmentalization should not be understood as a causal therapy but as an approach to a symptomatic form of hybrid therapy.


[The recording of ATP in the erythrocytes using luciferase injected into the cells].
The luciferase preparation obtained from fireflies Luciola mingrelica has entrapped into the human erythrocytes by means of reversible osmotic lysis. The addition of luciferin to such erythrocytes leads to the appearance of luminescence, conditioned by the entrance of luciferin into the cells. Luciferin is uniformly distributed between cells and external medium. Luciferin transport through the erythrocyte membrane is a result of simple diffusion. Values of rate constant of luciferin transport through the membrane lie between 0.009-0.021 l/s 1 cells for erythrocytes of different donors. The maximum luminescence intensity increases monotonously with rise of temperature and luciferin concentration. The dependence of the maximum luminescence intensity on luciferin concentration is described by Michaelis kinetics. Obtained in different experiments, values of luciferase Michaelis constant for luciferin inside erythrocytes lie between 4.1-21.5 microM. Luminescence intensity of the luciferase containing erythrocytes depends on the intracellular ATP concentration. Under the same luciferin concentration the correlation of luminescence intensities of control erythrocytes with normal ATP level and erythrocytes depleted without glucose is near to correlation of their ATP concentrations. After the addition of glucose to the depleted erythrocytes their ATP concentration rises and luminescence intensity approaches to the level of control erythrocytes. Luciferase entrapment permit one to control rapid ATP concentration changes in the erythrocytes.


Institutional profile: Institute of Pharmacogenetics at the University Hospital Essen.
Established in 2005, the Institute of Pharmacogenetics at the University Hospital Essen (Essen, Germany), headed by Winfried Siffert, is devoted to the discovery and validation of genetic variants that may impact upon drug responses especially in the field of cardiovascular disorders and cancer. Moreover, the institute provides pharmacogenetic testing for those drugs for which pharmacogenetic testing is recommended in order to prevent adverse drug reactions.


The Austria-Czech Republic co-operation in the field of radiation-emergency preparedness.
An overview on the long-term information exchange and co-operation between Austria and the Czech Republic in the field of radiation emergency preparedness and evaluation of radiological consequences of NPP accidents is provided. Initiated by the 'Melk Protocol' between the Czech and Austrian governments in December 2000 and its follow-up activities, the information exchange and co-operation between the Czech Republic and Austria in the field of radiation-emergency preparedness have been extended. Among others, a Working Group to compare radiological consequences of Beyond Design Basis Accident with a detailed inter-comparison program concerning atmospheric dispersion models, dose assessment methods and counter- measures was established. Based on this experience, an area for future co-operation in the field of emergency preparedness and information exchange between the Czech Republic and Austria is discussed.


14-O-Methylmorphine: A Novel Selective Mu-Opioid Receptor Agonist with High Efficacy and Affinity.
14-O-methyl (14-O-Me) group in morphine-6-O-sulfate (M6SU) or oxymorphone has been reported to be essential for enhanced affinity, potency and antinociceptive effect of these opioids. Herein we report on the pharmacological properties (potency, affinity and efficacy) of the new compound, 14-O-methylmorphine (14-O-MeM) in in vitro. Additionally, we also investigated the antinociceptive effect of the novel compound, as well as its inhibitory action on gastrointestinal transit in in vivo. The potency and efficacy of test compound were measured by [35S]GTPγS binding, isolated mouse vas deferens (MVD) and rat vas deferens (RVD) assays. The affinity of 14-O-MeM for opioid receptors was assessed by radioligand binding and MVD assays. The antinociceptive and gastrointestinal effects of the novel compound were evaluated in the rat tail-flick test and charcoal meal test, respectively. Morphine, DAMGO, Ile5,6 deltorphin II, deltorphin II and U-69593 were used as reference compounds. 14-O-MeM showed higher efficacy (Emax) and potency (EC50) than morphine in MVD, RVD or [35S]GTPγS binding. In addition, 14-O-MeM compared to morphine showed higher affinity for μ-opioid receptor (MOR). In vivo, in rat tail-flick test 14-O-MeM proved to be stronger antinociceptive agent than morphine after peripheral or central administration. Additionally, both compounds inhibited the gastrointestinal peristalsis. However, when the antinociceptive and antitransit doses for each test compound are compared, 14-O-MeM proved to have slightly more favorable pharmacological profile. Our results affirm that 14-O-MeM, an opioid of high efficacy and affinity for MOR can be considered as a novel analgesic agent of potential clinical value.


Bilateral Nonsynchronous Pacinian Corpuscle Neuroma.
Pacinian corpuscles are rapidly adapting mechanoreceptors distributed in the dermis of the fingers and palm of the hand. A neuroma of the pacinian corpuscle is rare and extremely painful, with only a few cases reported in the literature. A 71-year-old man with pain and swelling on his left index finger, initially diagnosed as tenosynovitis resistant to nonsurgical treatment, was referred to our center. During surgery, a cluster of spherical, gray lesions close to the digital nerve was found and excised. The pathological diagnosis was neuroma of the pacinian corpuscles. Two years later, he reported the same clinical findings on his right index finger with no improvement after nonsurgical treatment. During surgery, the same lesions were found and also identified as pacinian corpuscle neuromas.


Optimized RNA extraction from non-deparaffinized, laser-microdissected material.
mRNA extraction and subsequent RT-polymerase chain reaction (PCR)-based expression analysis from laser-microdissected material is by now a well-established and reproducible method. Most routinely stored tissue samples are preserved as formalin-fixed, paraffin-embedded materials. While this allows for a convenient storage and stable preservation of nucleic acids, deparaffinization before staining for laser microdissection may result in a significant loss of mRNA quality and consequently of PCR sensitivity. We describe a method of isolating anatomic compartments from non-deparaffinized, formalin-fixed, and paraffin-embedded tissues by laser-assisted microdissection which allows for a highly efficient mRNA retrieval.


Protection afforded by pre- or post-treatment with 4-phenylbutyrate against liver injury induced by acetaminophen overdose in mice.
Acetaminophen (paracetamol, N-acetyl-p-aminophenol; APAP) is a widely used analgesic/antipyretic drug with few adverse effects at therapeutic doses; suicidal or unintentional overdose of APAP frequently induces severe hepatotoxicity. To explore a new and effective antidote for APAP hepatotoxicity, this study examined the effects of sodium 4-phenylbutyrate (4-PBA) on liver injury induced by APAP overdose in mice. Liver injury was induced in C57BL/6 male mice by intraperitoneal injection of APAP (400mg/kg). The effects of 4-PBA (100-200mg/kg) treatment at 1h before the APAP injection were evaluated with serum alanine aminotransferase (ALT) and blood ammonia levels, hepatic pathological changes, including histopathology, DNA damage, nitrotyrosine formation, and mRNA or protein expression involved in the development of hepatotoxicity, such as X-box binding protein-1 (XBP1), c-Jun N-terminal kinase (JNK), C/EBP homologous protein (CHOP) and B-cell lymphoma 2 interacting mediator of cell death (Bim). In addition, glutathione depletion and CYP2E1 protein expression, which are measures of the metabolic conversion of APAP to a toxic metabolite, were examined. Furthermore, we examined the effects of post-treatment with 4-PBA against APAP-induced hepatotoxicity in mice. When administered at 1h before APAP injection, 4-PBA significantly prevented the increase in serum ALT and blood ammonia levels, centrilobular necrosis of hepatocytes, DNA fragmentation, and nitrotyrosine formation induced by APAP in mice. 4-PBA also inhibited hepatic Xbp1 mRNA splicing and JNK phosphorylation induced by APAP, but did not suppress CHOP and Bim mRNA and protein expression. In addition, 4-PBA had little effect on hepatic glutathione depletion and CYP2E1 expression, parameters of toxic APAP metabolite production. Post-treatment with 4-PBA administration at 1 or 2h after APAP injection also attenuated the increase in serum ALT and blood ammonia levels and hepatic pathological changes in APAP-induced hepatotoxicity in mice. Although post-treatment with 4-PBA did not show any effects on hepatic Xbp1 mRNA splicing and JNK phosphorylation, it drastically attenuated the DNA fragmentation induced by APAP. The precise molecular mechanisms of the protection afforded by 4-PBA against APAP hepatotoxicity in mice are unclear, but they seem to involve inhibition of hepatocellular DNA fragmentation. We suggest that 4-PBA is a promising candidate as an antidote against APAP-induced liver injury.


Ascending flight and decelerating vertical glides in Anna's hummingbirds.
Hummingbirds are observationally well known for their capacity to vertically ascend whilst hovering, but the underlying mechanics and possible energetic limits to ascent rates are unclear. Decelerations during vertical ascent to a fixed target may also be associated with specific visual responses to regulate the body's trajectory. Here, we studied climbing flight and subsequent deceleration in male Anna's hummingbirds (Calypte anna) over an approximately 2 m vertical distance. Birds reached vertical speeds and accelerations up to ∼4 m s-1 and 10 m s-2, respectively, through the use of flapping frequencies as high as 56 Hz and stroke amplitudes slightly greater than 180 deg. Total mass-specific power at maximal ascent speed was up to 92 W kg-1 body mass. Near the end of the ascending trajectory, all individuals decelerated ballistically via cessation of flapping and folding of wings over the body without losing control, a behavior termed here a vertical glide. Visual modulation of the deceleration trajectory during ascent was indicated by a constant value (∼0.75) for the first derivative of the time-to-contact to target. Our results indicate that hummingbirds in rapid vertical ascent expended near-maximal power output during flight, but also tightly controlled their subsequent deceleration during the vertical glide.


Predictive study of charge transport in disordered semiconducting polymers.
We present a theoretical study of charge transport in disordered semiconducting polymers that relates the charge mobility to the chemical structure and the physical morphology in a novel multiscale approach. Our studies, focusing on poly(9,9-dioctylfluorene) (PFO), show that the charge mobility is dominated by pathways with the highest interchain charge-transfer rates. We also find that disorder is not always detrimental to charge transport. We find good agreement with experimental time-of-flight mobility data in highly aligned PFO films.


Conductive Gel Increases the Small Tumor Treatment With Electrochemotherapy Using Needle Electrodes.
The combination of chemotherapy drugs and high electric field treatment in local cancer is named electrochemotherapy. The European Standard Operation Procedure of Electrochemotherapy (ESOPE) provides guidelines for treatment of cutaneous and subcutaneous tumors. The electrochemotherapy of numerous tumors varying in sizes is more convenient using needle electrodes. However, ESOPE recommends that needle electrodes are applied to deeper tumors. The application of needle electrodes to treatment of superficial small tumors seems to be practical in electrochemotherapy. Plate electrodes and gel improve the electrochemotherapy efficacy. This technique provides electric field homogeneity in irregularly shaped tissue structures (bulk tumors). We propose an investigation of needle electrode and gel in electrochemotherapy of superficial tumors. In vivo experiment with squamous cell carcinoma (SCC) spontaneous nodules in dog was used to validate the mathematical tissue model. The numerical model considers the tissue conductivity dependent on local electric field. Our studies demonstrated that conductive gel is important for effective treatment of superficial tumors with needle electrodes. The needle electrodes and gel presented reduction of medium current, increased the tumor-free margin, and improved the practical application in relation to plate electrode.


Forensic Case Reports Presenting Immersion Pulmonary Edema as a Differential Diagnosis in Fatal Diving Accidents.
Immersion Pulmonary Edema (IPE) reduces the transport of gases over the respiratory membrane due to edema in the interstitium and respiratory zones. IPE has previously been described in both swimmers and divers, with a few known fatal cases. We have reviewed 42 SCUBA and snorkeling-related drowning deaths, and through a thorough analysis of each case, including both diving physiology and forensic pathology, we present IPE as a differential diagnosis to drowning in four cases. Our findings propose that; absence of watery content in the stomach and conducting airways, and liquid filled lungs without hyperexpansion, may be compatible with IPE. We suggest that IPE should be considered in cases where witness testimony reveals; no obvious signs of aspiration and rapid respiratory deterioration despite continuous breathing through an appropriate air source. The diagnosis should be based on the overall impression, including both the autopsy findings and the circumstances regarding the accident.


Apolipoprotein E4 promotes incipient Alzheimer pathology in the elderly.
To evaluate the influence of the apolipoprotein E (ApoE) epsilon4 allele on the age at which Alzheimer-like lesions appear in the brain, we analyzed the degree of cerebral beta-amyloidosis and neurofibrillary tangle formation in the hippocampal formation and adjacent cortical areas 28, 27, and 36 of persons who had died between the ages of 50 and 93 years and who had shown no signs of clinical dementia. The occurrence of the three common polymorphisms of the ApoE gene in this sample of 147 routine autopsy cases from eastern Germany was comparable to previously reported values in European and North American populations: ApoEepsilon2/2, 0.7%; ApoEepsilon2/3, 14.3%; ApoEepsilon2/4, 4.1%; ApoEepsilon3/3, 56.5%; ApoEepsilon3/4, 22.4%; and ApoEepsilon4/4, 2.0%. Nondemented persons carrying the ApoEepsilon4 allele were significantly more likely to have senile plaques, diffuse amyloid deposits, cerebrovascular amyloid, and neurofibrillary tangles than were those lacking E4. Comparing the two largest ApoE subgroups, ApoEepsilon3/3 and ApoEepsilon3/4, the relative increase in the occurrence of beta-amyloid in the epsilon3/4 group was evident by the mid-60s, with the relative increase in neurofibrillary tangles in this group emerging slightly earlier. The ApoEepsilon2 allele appears to delay the appearance of the lesions somewhat. We conclude that ApoEepsilon4 promotes the early appearance of beta-amyloid and neurofibrillary tangles in the elderly and that the increased frequency of these lesions is related to the higher risk of Alzheimer disease in persons bearing the ApoEepsilon4 allele.


Simple Approach to Improving the Amplified Spontaneous Emission Properties of Perovskite Films.
Organo-lead halide perovskite has emerged as a promising optical gain media. However, continuous efforts are needed to improve the amplified spontaneous emission (ASE) even lasing properties to evade the poor photostability and thermal instability of the perovskites. Herein, we report that simply through the coating of polymer layer, the CH3NH3PbBr3 polycrystalline films prepared by a modified sequential deposition process show remarkably enhanced photoluminescence and prolonged decay lifetime. As a result, under nanosecond pulse pumping, the ASE threshold of the perovskite films is significantly reduced from 303 to 140 μJ/cm2. Furthermore, the light exposure stability is improved greatly after the polymer coating. We confirmed that the polymer layer plays the roles of both surface passivation and symmetric waveguides. Our results may shed light upon the stable and sustained output of laser from perovskite materials.


Differential modulation of the genotoxicity of food carcinogens by naturally occurring monomeric and dimeric polyphenolics.
Naturally occurring dimeric polyphenolics and their gallate esters were isolated from grape seeds, almond fruits, and apple skin, and their ability to modulate the mutagenicity of food carcinogens was studied in the Ames test, and compared to that of the monomeric green tea flavonols, (+)-catechin and (-)-epicatechin. Neither the monomeric nor the dimeric polyphenols and their galloylated derivatives influenced the mutagenic activity elicited by the indirectly acting food carcinogens benzo[a]pyrene and 2-amino-3-methylimidazo-[4,5-f]quinoline (IQ), in the presence of a hepatic activation system derived from Aroclor 1254-treated rats; the only exception was the B7 dimer, which, at concentrations above 1 microM, suppressed the mutagenicity of IQ. None of the polyphenolics modulated the mutagenic activity elicited by the directly acting carcinogen N'-methyl-N'-nitro-nitrosoguanidine (MNNG). In contrast, all the dimeric polyphenols and the galloylated metabolites, at concentrations over 1 microM, potentiated the mutagenic activity induced by the indirectly acting carcinogen N-nitrosopyrrolidine, in the presence of an activation system derived from isoniazid-treated rats. In conclusion, dimeric polyphenols and galloylated derivatives of plant origin are unlikely to influence the initiation stage of the carcinogenicity of chemicals through mechanisms that involve inhibition of their cytochrome P450-mediated bioactivation or scavenging of the reactive, genotoxic intermediates.


Incidence and Risk Factors for Isolated Esophageal Cancer Recurrence to the Brain.
Recurrence of esophageal cancer in the brain is rare but associated with poor prognosis. Identification of risk factors for isolated brain metastasis after surgical treatment (iBMEC) may guide surveillance recommendations to enable early identification and intervention prior to widespread metastasis. Patients with iBMEC (n=38) were identified from a prospective database of patients with esophageal cancer that underwent esophagectomy. Risk factors for iBMEC were identified using competing risk regression analysis. In a cohort of 1760 patients, 39% recurred and 2% developed iBMEC by the end of the study. Patients with iBMEC had similar survival to patients with distant recurrence (median OS: 0.95 years, 95%CI 0.6-1.5). Over half of patients with iBMEC were diagnosed within 1 year postoperatively. All 38 patients with iBMEC had received neoadjuvant therapy prior to surgery. Pathologic Complete Response (PCR) to neoadjuvant therapy was associated with improved survival after brain recurrence (median OS:1.56 years versus 0.66, p=0.019). In patients with PCR, iBMEC may represent true isolated recurrence while in those with residual nodal disease, iBMEC may actually be the first observed site of widespread metastasis. Patients that received neoadjuvant therapy, especially with PCR, may benefit from brain imaging, both preoperatively and with routine surveillance.


Formaldehyde and hexamethylenetetramine in Styles' cell transformation assay.
A dose-dependent increase in the transformation rate in Styles' cell transformation assay using BHK-21/cl.13 cells was observed after exposure to formaldehyde and hexamethylenetetramine. The toxic and transforming effect was equal after exposure to 20 micrograms/ml of formaldehyde or 1000 micrograms/ml of hexamethylenetetramine which is slowly hydrolysed in aqueous solution to form ammonia and formaldehyde.


TRBV kinetics and its association with HLA disparity and aGVHD following allogeneic hematopoietic stem cell transplantation.
The relative expression of T cell receptor (TCR) beta variable (TRBV) and TCR diversity was compared between recipients receiving human leukocyte antigen (HLA)-mismatched transplants and those receiving HLA-matched transplants, using granulocyte colony-stimulating factor (G-CSF)-mobilized peripheral blood stem cells and bone marrow as grafts. The kinetics of the relative expression of TRBV family members were analyzed using real-time quantitative PCR. Additionally, the association of TRBV clonotype with acute graft-versus-host disease (aGVHD) was determined by cloning and sequence analysis of the CDR3 region. The TCR diversity in recipients receiving HLA-mismatched transplants was significantly lower than in those receiving HLA-matched transplants at 1 month and 2 months after hematopoietic stem cell transplantation (HSCT) (both P < 0.05). However, these differences disappeared 3 months after transplantation. The relative expression of TRBV27 (n = 7 recipients) at the onset of aGVHD was higher than in corresponding donors (P = 0.025), but no significant differences were observed between recipients lacking aGVHD and their donors at serial time points after HSCT. Our results suggest that HLA disparity may affect the relative expression of TRBV in the early phase after transplantation, and TRBV27 may be associated with the onset of aGVHD.


[Imaging methods in breast diagnosis--value and choice of methods in general practice].
X-ray mammography continues to represent the most efficient imaging method for the diagnosis of breast disease and ultimately reduce mortality from breast cancer. Ultrasound is the most valuable supplementary method and is particularly useful to differentiate cystic from solid lesions. Today it is used mostly in the dense breast, as e.g. in young patients. All other imaging methods as thermography, diaphanoscopy, computed tomography and magnetic resonance imaging have not gained any importance and are particularly not useful for screening a large number of patients. In this paper all these imaging methods and our personal experience with them are briefly discussed. The importance of implementing mammographic screening programs to detect breast cancer is stressed, particularly considering the high incidence of breast cancer in all industrialized countries.


Development of a Pde6b Gene Knockout Rat Model for Studies of Degenerative Retinal Diseases.
To describe the phenotypes of a newly developed Pde6b-deficient rat model of retinal degeneration. Pde6b knockout rats were produced by CRISPR-Cpf1 technology. Pde6b knockout rats were evaluated for ocular abnormalities by comparison with wild-type eyes. Eyes were imaged using fundus photography and optical coherence tomography (OCT), stained by hematoxylin and eosin (H&E), and examined by TUNEL assay. Finally, eyes were functionally assessed by electroretinograms (ERGs). Pde6b knockout rats exhibited visible photoreceptor degeneration at 3 weeks of postnatal age. The fundus appearance of mutants was notable for pigmentary changes, vascular attenuation with an irregular vascular pattern, and outer retinal thinning, which resembled retinitis pigmentosa (RP) in humans. OCT showed profound retinal thinning in Pde6b knockout rats; the outer nuclear layer (ONL) was significantly thinner in Pde6b knockout rats, with relative preservation of the inner retina at 3 weeks of postnatal age. H&E staining confirmed extensive degeneration of the ONL, beginning at 3 weeks of postnatal age; no ONL remained in the retina by 16 weeks of postnatal age. Retinal sections of Pde6b knockout rats were highly positive for TUNEL, specifically in the ONL. In ERGs, Pde6b knockout rats showed no detectable a- or b-waves at 8 weeks of postnatal age. The Pde6b knockout rat exhibits photoreceptor degeneration. It may provide a better model for experimental therapy for RP because of its slower progression and larger anatomic architecture than the corresponding mouse model. Further studies in this rat model may yield insights into effective therapies for human RP.


Pediatric asthma management within Latino and non-Latino White families.
Pediatric asthma disparities exist with Latino children, especially from Island Puerto Rico (PR), experiencing greater asthma prevalence and morbidity than non-Latino White (NLW) children. Families must balance attention to child asthma with other child and family needs, defined as the "balanced integration of asthma." This study examined the impact of culturally related factors on the balanced integration of asthma in NLW and Latino families in Rhode Island (RI) and PR, as well as associations between balanced integration and asthma morbidity. Participants included 601 caregivers and their children with asthma (7-16 years) from NLW and Latino backgrounds in RI and PR. Caregivers and children completed interview-administered assessments and a semistructured interview related to family asthma management. Balanced integration of asthma differed significantly by ethnic group/site (p < .001), with Island PR families having the lowest levels of balanced integration. Higher balanced integration was associated with fewer concerns about asthma medications, higher levels of Spanish proficiency in RI Latino families, lower levels of functional limitation, and no emergency department visits in the last year (all ps < .05). Findings suggest that Latino families may experience more difficulty adjusting to child asthma in the context of other child and family demands. Medication beliefs and language proficiency may begin to explain these differences. Our study suggests the importance of continuing to understand how families balance asthma with other aspects of daily life, as culturally appropriate interventions to improve family adjustment to asthma may serve to reduce child asthma morbidity.


High levels of interleukin 13 in rheumatoid arthritis sera are modulated by tumor necrosis factor antagonist therapy: association with dendritic cell growth activity.
To investigate the physiology of interleukin 13 (IL-13) in rheumatoid arthritis (RA) and the effects of tumor necrosis factor (TNF) antagonists (etanercept) on the distribution of IL-13 in patients with RA. We measured cytokine levels in RA sera (pre/post etanercept), RA synovial fluid (SF), osteoarthritis (OA) SF, and normal human sera by ELISA. Detection of IL-13 was not influenced by rheumatoid factor, as revealed in spike recovery and isotype antibody control studies. Biologically active IL-13 in RA SF was studied using dendritic cell (DC) progenitors that develop into mature DC with IL-13 and with neutralizing antibodies to IL-13. The modulation of IL-13 by etanercept was compared to that of IL-6 and monocyte colony stimulating factor (M-CSF). The effect of etanercept on the ability of RA sera to promote DC growth was studied using DC progenitors. IL-13 was increased in RA sera versus normal sera, OA SF, and RA SF. Relative to OA SF and normal sera, RA SF was enriched in IL-13. The IL-13 contained in RA samples was biologically active, prompting DC growth from progenitors. Circulating DC growth activity was strongly reduced by anti-TNF therapy. Whereas decreases in DC growth factors including IL-13 and IL-6 occurred with etanercept therapy and were associated with clinical improvement, concurrent increases in circulating M-CSF (a non-DC, monocyte-specific growth factor) were noted. The increase of biologically active IL-13 in RA supports the concept that IL-13 regulates immune cell (including dendritic cell) activity and indicates how the varied anatomical distribution of cytokines may play a role in the RA disease process. The differential regulation of circulating IL-13 and M-CSF levels by TNF antagonists further implies discrete roles in the TNF-cytokine network in RA.


Radiommunological measurement of leptin in plasma of obese and diabetic human subjects.
Studies in mice have identified the ob gene product, leptin, as a signaling factor regulating body weight homeostasis and energy balance. Defective production of the encoded protein may be one of the causes for the development of obesity. Using a high affinity antibody, that in immunohistochemical studies specifically stained human adipocytes, a radioimmunoassay was established and leptin immunoreactivity was quantified in plasma of lean and obese human subjects. Chromatographic analysis suggested that the immunoreactive material in plasma is identical to that found in extracts from human fat and represent a protein with a molecular size of approximately 16 kD. Fasting levels were measured in plasma of 75 lean and obese human subjects (body mass index (BMI) 17.7 - 87.3). The mean concentration of leptin in plasma of lean subjects (BMI < or = 28) was 69.3 +/- 36.9 fmol/ml plasma (mean +/- SD, n=27). The highest concentration measured in obese was 533.3 fmol/ml plasma. The levels showed a strong positive correlation with BMI (r=0.77, p<0.001). A subgroup of diabetic patients did not significantly differ in their leptin plasma levels from non-diabetic subjects with similar BMI.


Remote substituent effects on the photooxygenation of 9,10-diarylanthracenes: strong evidence for polar intermediates.
Two different reaction pathways in the photooxygenation of 9,10-diarylanthracenes are identified, with strong evidence for polar (forward, singlet oxygen addition) and radical (backward, thermolysis) intermediates.


Yeast sterols: yeast mutants as tools for the study of sterol metabolism.
Yeast mutants defective in ergosterol synthesis are valuable tools for investigating sterol metabolism. Both sterol mutants and sterol auxotrophs have been utilized in determining what sterol structural features are required for yeast cell viability. Both types of mutants can also be studied to ascertain how changes in sterol structure affect membrane properties. Other aspects of sterol metabolism, such as the specificity of sterol esterification, have been elucidated by the sterol auxotrophs. In broader applications, interrelationships between sterol metabolism and other cellular functions (e.g., heme metabolism) may also be examined with these mutants. By analyzing the lipid composition of the sterol mutants, on the other hand, much of the ergosterol biosynthetic pathway has been delineated. The unusual sterols of the mutants can also be obtained to develop assays for the enzymes involved in ergosterol synthesis. Thus, by utilizing mutants, the simple eukaryotic system of yeast may be extended to explore the entire field of sterol metabolism and its relationship to cellular physiology.


Difference thresholds for the perception of whole-body vertical vibration: dependence on the frequency and magnitude of vibration.
When seeking to reduce vibration in transport it is useful to know how much reduction is needed for the improvement to be noticeable. This experimental study investigated whether relative difference thresholds for the perception of whole-body vertical vibration by seated persons depend on the frequency or magnitude of vibration. Relative difference thresholds for sinusoidal seat vibration were determined for 12 males at three vibration magnitudes and eight frequencies (2.5, 5, 10, 20, 40, 80, 160, 315 Hz) using the three-down-one-up method in conjunction with a two-interval-forced-choice procedure. The median relative difference thresholds were in the range 9.5% to 20.3%. There appeared to be a frequency-dependence at the lowest vibration magnitude, such that higher frequencies had higher difference thresholds. The relative difference thresholds depended on the vibration magnitude only at 2.5 and 315 Hz. The influence of both vibration frequency and vibration magnitude on the measured difference thresholds suggests that vision (at 2.5 Hz) and hearing (at 315 Hz) contributed to the perception of changes in vibration magnitude.


Awake microlaryngoscopy and serial balloon dilation in a third trimester multigravida with subglottic tracheal stenosis: anesthetic implications.
Tracheal stenosis in pregnancy is a relatively rare occurrence and there are limited data regarding the perioperative management of these patients. Various surgical treatment options are available to include open repair, long-term tracheostomy, or endoscopic repair (rigid versus balloon dilation). We report the case of a woman in her third trimester of pregnancy, with known recurrent and worsening history of subglottic tracheal stenosis, who underwent awake microlaryngoscopy with potassium titanyl phosphate laser radial incision and serial tracheal balloon dilation under topical anesthesia with sedation. We further discuss her perioperative multidisciplinary management.


Occupational types and antenatal care attendance among women in Ghana.
Improving antenatal care is considered a priority and has been relevant toward achieving the Millennium Development Goals (MDGs), yet antenatal care attendance remains relatively low in Ghana. Guided by the Andersen and Newman framework and employing logit models, we examine associations between occupational types and antenatal care among Ghanaian women aged 15-49. Type of occupation, conceptualized as a predisposing factor, has a significant impact on the frequency and timing of antenatal care attendance at the bivariate level. The effect of occupational type was considerably mediated, however, when other socioeconomic variables such as wealth status were controlled in the multivariate models.


The evolution of vertebral fractures after surgical stabilization treatment.
In vertebral fractures, the size of the reductions in the anterior height and the deformity of the body are directly correlated to the intensity of the pain. Among the various therapeutic options, mini-invasive stabilization has been shown to obtain effective antalgic results in the short term, allowing a reduction in hospitalization time, the use of a corset, the employment of analgesic drugs and improvement of quality of life. Clinical improvement can be consequent to re-balancing the biomechanics and the physiological resistance of the vertebrae.


Osteoid osteoma in the differential diagnosis of persistent joint pain.
We report 20 cases (13 male and 7 female), mean age 21 years) of juxta-articular osteoid osteoma. The distribution of affected joints was as follows: hip joint (7 cases), knee joint (2 cases), ankle joint (2 cases); iliosacral joint (2 cases), lumbar spine (2 cases), carpus (2 cases), shoulder (1 case), second metacarpal (MCP; 1 case) and first metatarsal (MTP; 1 case). The duration between the onset of symptoms and diagnosis varied from 8 months to approximately 4 years. In juxta-articular osteoid osteoma, the clinical picture and the radiographic findings are often atypical, and this may lead to misdiagnosis and delayed definitive treatment. In young patients with persistent undiagnosed pain, the possibility of an osteoid osteoma should be considered. When the clinical picture is suggestive but radiological findings are negative, we must proceed to further investigation with bone scintigraphy and computed tomography. These examinations should be repeated 1 year after the onset of symptoms because initially negative findings may become positive at a later date. When the diagnosis of an osteoid osteoma is confirmed, surgical excision leads to complete relief of the symptoms.


Immunophenotyping of classic murine myeloma cell lines used for monoclonal antibody production.
Murine myeloma cell lines play an important role in different areas of scientific research and are essential tools for monoclonal antibody production technology. Thus, it is important to understand the biology of these cell lines in order to provide useful information to various research fronts. The present study aims to perform detailed analyses of surface antigens expressed on three major murine myeloma cell lines extensively used for MAb production. The P3X63Ag8.653 cell line expresses molecules associated with T cell interaction (CD40(low), CD80(low)), as well as antigens related to plasma cell phenotype (CD138(high), CD184(low)). The Sp2/0-Ag14 cell line presents molecules associated with BCR activation and regulation (CD79b(low), CD22(low), CD72(med)), molecules related to T cell interaction (CD40(low), CD80(low)), and markers of plasma cell phenotype (CD138(high), CD184(low)). The NS1 cell line presents all molecules of plasma cell phenotype evaluated in this study (CD184(low), CD138(high), CD38(med)) with low expression of CD72 (CD72(low)), a molecule related to BCR activation. Molecules associated with immune response modulation such as CD23 and CD25, as well as CD117, a marker related to undifferentiated cell phenotype, were not observed in any of the three murine myeloma cell lines evaluated. These data show that in spite of their common origin and function, the immunological profiles differ between P3X63Ag8.653, Sp2/0-Ag14, and NS1 cell lines.


Assessment of ventricular tachycardia scar substrate by intracardiac echocardiography.
Intracardiac echocardiography (ICE) is increasingly used to guide complex ablation procedures. This study aimed to assess the scar substrate of ventricular tachycardia (VT) by ICE in patients undergoing VT ablation. In 22 patients undergoing VT ablation (10 ischemic, 12 nonischemic), the Biosense CARTOSOUND module (Biosense Webster, Diamond Bar, CA, USA) was used for three-dimensional reconstruction of the ventricles. The characteristics and appearance with ICE imaging of voltage-defined scar zones (bipolar voltage <0.5 mV), border zones (0.5-1.5 mV), and normal myocardium (>1.5 mV) on electroanatomic maps were evaluated. The standard image analysis software Image J (National Institutes of Health, Bethesda, MD, USA) was used to analyze signal intensity (mean pixel signal intensity unit [SIU]) and heterogeneity (standard deviation of signal intensity in analyzed area) on ICE images. A total of 83 myocardial areas were analyzed from two-dimensional ICE images (15 scars, 31 border zones, and 37 normal). Voltage-defined scar zones had increased signal intensities compared to border zones (149 SIU vs 104 SIU, P < 0.0001) and normal myocardium (88 SIU, P < 0.0001). Border zones were more likely to have heterogeneous densities compared to normal myocardium (standard deviation of signal intensity 20 SIU vs 12 SIU, P < 0.0001). In receiver-operator characteristic analyses, signal intensity ≥ 137 SIU differentiated scar from nonscar zones (area under curve 0.91, P < 0.0001). Software-based color enhancement of areas with signal intensity ≥ 137 SIU allowed identification of the VT substrate in all 15 patients with voltage-defined scar zones. ICE provides important information about the VT anatomical substrate and may have potential to identify areas of scarred myocardium.


Meniscectomy operation as a surgical treatment for internal derangement of the temporomandibular joint in our department.
This paper describes the surgical treatment of six patients with internal derangement of the temporomandibular joint (nine joints). Meniscectomy was performed on all the patients, because severely advanced cases in which the articular disk could not be preserved or replaced were chosen. Our surgical technique and the results of short-term follow up are presented. Indications of meniscectomy and the criteria for postoperative evaluation are also described. The postoperative outcomes were assessed as "good" for seven joints in five patients and as "acceptable" for two joints in one patient.


[Study of the pathogenic qualities of 4 celo-virus strains isolated in Bulgaria].
Four CELO virus strains, isolated in this country, were used to infect 3-day-old chicks via the trachea, muscularly, orally, subcutaneously, and cerebrally. The chicks were killed on the 2nd, 4th, 6th, 9th and 16th day following inoculation. Material was taken from each chick for morphologic, virologic, and serologic examination. The clinical course of the disease was also followed up. Prior to killing some birds showed infirmity, difficult breathing, slightly expressed diarrhia, going off food, and more sporadically there was fecal mass around the cloaca matting the plumage. Some manifested nervous symptoms similar to those observed in cases of Newcastle disease and encephalitis of birds. In some of the chicks there were hyperemia of the lungs, trachea, and intestins as well as necrotic foci in the liver.


A Case of Sclerosing Lymphocytic Lobulitis of the Breast Associated with Diabetes Mellitus.
BACKGROUND: The benign breast disease sclerosing lymphocytic lobulitis is thought to result from autoimmune diseases causing insulin-dependent diabetes mellitus (IDDM) due to insulinitis. In cases of sclerosing lymphocytic lobulitis accompanied by IDDM, the clinical term gdiabetic fibrous breast disease hhas been proposed. METHODS: A case of sclerosing lymphocytic lobulitis of the breast is described RESULTS: The patient was a 43-year-old woman diagnosed with non insulin-dependent diabetes mellitus (NIDDM) 8 years previously. Insulin therapy was thought to be necessary because treatment with glibenclamide was not effective. She visited our facility complaining of a lump in her right breast that was 5 cm in diameter, painless, rock-hard, discrete, and irregularly outlined. Biopsy was performed because breast cancer was strongly suggested by its hardness and its irregular internal echo on ultrasonography. Histopathological findings demonstrated marked stromal sclerosis and lymphocyte infiltration in the perivascular and perilobular areas. Sclerosing lymphocytic lobulitis was diagnosed. CONCLUSION: Referring physicians should avoid performing unnecessary repeated biopsies by recognizing this disease entity, which often occurs bilaterally.


[Comparison of latex agglutination and bacitracin-SXT methods used for the identification of 142 beta-hemolytic streptococci].
We compared the latex agglutination and bacitracin-SXT methods to identify Group A Streptococci (GAS) from throat cultures. In our study all 118 GAS strains identified by latex agglutination method were found susceptible to bacitracin, 115 were found resistant and 3 were susceptible to SXT. All beta hemolytic streptococci rather than GAS were found resistant to bacitracin. As a result bacitracin method is found valuable in rutin studies in GAS identification.


Forecasting instead of reacting to educational needs.
As healthcare resources become increasingly scarce, professional development educators will be expected to provide cost-effective education to meet the organization's mission and strategic goals. This can only happen when educators collaborate with organizational leaders to identify actual educational needs in a proactive way. Rather than reacting to educational needs, educators must use a proactive and collaborative approach in forecasting these needs in a consistent and timely manner. This is best accomplished when the mission of staff development is clear; the stakeholders are identified; and tools and processes are in place to assess, plan, implement, and evaluate educational offerings.


Kinetics of Borrelia burgdorferi infection in larvae of refractory and competent tick vectors.
The acquisition of Borrelia burgdorferi by the larvae of competent and refractory ixodid ticks was assessed by quantitative polymerase chain reaction (PCR). Larvae were fed on infected mice, and the spirochete loads were determined during feeding and up to 93 d postfeeding. Amblyomma americanum (L.) was refractory to B. burgdorferi infection, with almost no detection of spirochete DNA during or postfeeding. In contrast, Ixodes scapularis Say supported high loads of spirochetes (10(3)-10(4) per larva). In Dermacentor variabilis (Say), B. burgdorferi uptake was reduced, with an average of 16 spirochetes per larvae acquired after 4 d of feeding, representing 1/195 of the counts in I. scapularis. However, during the first day postfeeding, the spirochete growth rate in D. variabilis reached 0.076 generations per hour, 7.7 times greater than the highest growth rate detected in I. scapularis. D. variabilis supported intense spirochete growth up to the fourth day postinfection, when the counts increased to an average of 282 spirochetes per larvae or 1/8.5 of the I. scapularis counts 4 d postfeeding. The kinetics of spirochete growth was unstable in D. variabilis compared with I. scapularis, and transmission of B. burgdorferi by D. variabilis could not be demonstrated. A cofeeding experiment indicated that I. scapularis feeding increased A. americanum spirochete uptake. These collective results indicate suboptimal conditions for B. burgdorferi uptake and colonization within A. americanum or the presence of anti-Borrelia factor(s) in this nonpermissive tick species.


Preeclampsia associated focal and segmental glomerulosclerosis and glomerular hypertrophy: a morphometric analysis.
Renal biopsies from hypertensive pregnant women performed 8 to 10 days postpartum were processed by morphometric analysis. We allocated the 74 patients into four groups according to the respective forms of pregnancy hypertension, i.e. preeclampsia and gestational hypertension. Groups I and II included preeclamptic women, with (group I) or without (group II) de novo FSGS. Groups III and IV included biopsies of women with isolated gestational hypertension, appeared during the third trimester (group III) or earlier (group IV). The control group included 17 biopsies from age-matched nonpregnant women presenting with isolated hematuria. Glomerular lesions of typical preeclampsia were seen in all the biopsies of groups I and II, and in some of women with gestational hypertension of groups III and IV. Our morphometric analysis of these renal biopsies showed a progressive increase in glomerular size from early gestational hypertension, gestational hypertension of the 3rd trimester, isolated preeclampsia, and finally preeclamptic nephropathy associated with FSGS. The largest glomeruli were seen in preeclamptic women with severe hypertension and histologic lesions of preeclampsia with FSGS. Thus, both systemic hypertension and glomerular hypertrophy seem necessary to induce FSGS in this type of pathology.


Expiratory washout versus optimization of mechanical ventilation during permissive hypercapnia in patients with severe acute respiratory distress syndrome.
The aim of this study was to compare three ventilatory techniques for reducing PaCO2 in patients with severe acute respiratory distress syndrome treated with permissive hypercapnia: (1) expiratory washout alone at a flow of 15 L/min, (2) optimized mechanical ventilation defined as an increase in the respiratory frequency to the maximal rate possible without development of intrinsic positive end- expiratory pressure (PEEP) combined with a reduction of the instrumental dead space, and (3) the combination of both methods. Tidal volume was set according to the pressure-volume curve in order to obtain an inspiratory plateau airway pressure equal to the upper inflection point minus 2 cm H2O after setting the PEEP at 2 cm H2O above the lower inflection point and was kept constant throughout the study. The three modalities were compared at the same inspiratory plateau airway pressure through an adjustment of the extrinsic PEEP. During conventional mechanical ventilation using a respiratory frequency of 18 breaths/min, respiratory acidosis (PaCO2 = 84 +/- 24 mm Hg and pH = 7.21 +/- 0.12) was observed. Expiratory washout and optimized mechanical ventilation (respiratory frequency of 30 +/- 4 breaths/min) had similar effects on CO2 elimination (DeltaPaCO2 = -28 +/- 11% versus -27 +/- 12%). A further decrease in PaCO2 was observed when both methods were combined (DeltaPaCO2 = -46 +/- 7%). Extrinsic PEEP had to be reduced by 5.3 +/- 2.1 cm H2O during expiratory washout and by 7.3 +/- 1.3 cm H2O during the combination of the two modes, whereas it remained unchanged during optimized mechanical ventilation alone. In conclusion, increasing respiratory rate and reducing instrumental dead space during conventional mechanical ventilation is as efficient as expiratory washout to reduce PaCO2 in patients with severe ARDS and permissive hypercapnia. When used in combination, both techniques have additive effects and result in PaCO2 levels close to normal values.


The Haight Ashbury Free Medical Clinic.
The article highlights the philosophy, history, growth and current dimensions of the Haight Ashbury Free Medical Clinic. Started in the spring of 1967, the clinic was the first of more than 600 free clinics that appeared nationwide over the next decade. With a philosophy that health care is a right, not a privilege, and should be free, humane, demystified and nonjudgemental, the clinic has continued to fill a need among the medically indigent and drug abusing clients it serves in San Francisco. In the last 17 years, it has logged over 600,000 patient visits, and today has grown into a nationally renowned research and treatment center, providing a wide spectrum of services.


Dose-dependent responses in insulin-like growth factors, insulin-like growth factor-binding protein-3 and parameters of bone metabolism to growth hormone therapy in young adults with growth hormone deficiency.
There is increasing awareness that growth hormone (GH) replacement therapy is also essential in adult patients with growth hormone deficiency (GHD). There are little data available on the dose requirements for replacement therapy in this age group. In childhood, the growth response to GH therapy can serve as an indicator for correct replacement dose. Because this indicator does not exist in adults, we analyzed growth factors and biochemical markers of bone metabolism by specific radioimmunoassays in a group (n = 12) of adult patients (age, 20.0-31.6 years) with GHD with childhood onset before and after a 4-week treatment period (daily, s.c.) with recombinant, human GH at different doses (0.125, 0.25 and 0.5 IU/kg body weight/week). Comparing the basal levels to those on low-dose GH (0.125 IU/kg/week) and on a high dose (0.5 IU/kg/week), the following results were obtained. Insulin-like growth factor-I (IGF-I) in serum: basal, 68.6 +/- 37 ng/ml; low dose, 176.9 +/- 65 ng/ml (p < or = 0.05); high dose, 380.6 +/- 200 ng/ml (p < or = 0.01). IGF-binding protein-3 in serum: basal, 2.13 +/- 0.58 mg/l; low dose, 3.23 +/- 0.84 mg/l (p < or = 0.01); high dose, 3.97 +/- 0.82 mg/l. Osteocalcin in serum: basal, 3.88 +/- 1.27 ng/ml; low dose, 7.01 +/- 2.20 ng/ml (p < or = 0.01); no further increase. Procollagen-I peptide in serum: basal, 113.6 +/- 36.7 microgram/l; low dose, 211.6 +/- 90.4 microgram/l (p < or = 0.01); no further increase.(ABSTRACT TRUNCATED AT 250 WORDS)


[Potential impact of water transfer project from Yangtze River to Huaihe River on snail spread and schistosomiasis transmission].
To investigate the possibility of spread of snails and transmission of schistosomiasis japonica due to the construction of water transfer project from Yangtze River to Huaihe River. In order to understand the current endemic situation of schistosomiasis in the project area, the distribution of snails was surveyed by routine methods, level of anti-schistosome antibody in human sera was detected by indirect haemagglutination test (IHA), and the prevalence of schistosomiasis in cattle was detected by egg hatching method. The snail survival and reproduction were observed in Chaohu Lake area(experimental area) and a control area for one year. Snail density was high in two starting points, from where the water in Yangtze River will be directed to Huaihe River. In counties of Wuwei and Hexian, through which the project will be built, the positive rate of anti-schistosome antibody in residents was 22.11% (168/760) and 18.59% (37/199), schistosomiasis prevalence in cattle was 2.42% (9/371) and 0.2% (2/997), respectively. Schistosomiasis was also endemic in Juchao District of Chaohu City. Snails respectively from grassland and hilly area were collected and put in Chaohu Lake for breed and newborn snails were found one year later. During the egg-laying season, the survival rate of snails from grassland in 2 experiment areas and a control area was 11.3%-16.7%, 3.0%-20.8% and 4.7%-14.7% respectively (chi2 = 0.093, 0.760, P > 0.05; chi2 = 0.647, 0, P > 0.05), and that of snails from hilly area was 24.1%-44.4%, 37.8%-67.3% and 86.3%-93.1% respectively (chi2 = 9.575, 5.302, P < 0.05; chi2 = 56.863, 36.218, P < 0.05). There was no significant difference between the experimental area and the control area on the number of eggs in the ovaries of the same type female snails. The one-year observation reveals that the construction of the project might result in spread of snails and transmission of schistosomiasis japonica in the relevant areas.


Optical properties of mammalian tissue: introduction by the feature editors.
This issue of Applied Optics features twenty-two papers on the optical character of tissue, a topic of growing importance in the life sciences. The papers deal with theory and experiment and are contributed by a core of researchers active in the current development of this relatively new field. The complete description of the tissue's optical properties is fraught with problems due to the extraordinary nature of this difficult, varied, turbid, highly scattering medium. The solution of these optical problems promises important dividends in practical areas, such as cancer treatment and diagnosis.


ISO 31000:2009--Setting a new standard for risk management.
Last year saw the publication of IS0 31000:2009, a new globally accepted standard for risk management together with a new, associated vocabulary in ISO Guide 73:2009. These were developed through a consensus-driven process over four years, through seven drafts, and involving the input of hundreds of risk management professionals around the world. The new standard supports a new, simple way of thinking about risk and risk management and is intended to begin the process of resolving the many inconsistencies and ambiguities that exist between many different approaches and definitions. While most decisionmakers seem to welcome the new standard and it has so far received very good reviews, it does create challenges for those who use language and approaches that are unique to their area of work but different from the new standard and guide. The need for compromise and change is the inevitable consequence of standardization.


Temporary epicardial pacing wire placement in totally endoscopic cardiac surgery.
Temporary epicardial pacing wire placement is a common procedure in cardiac surgery. However, it is difficult to perform in totally endoscopic cardiac surgery. We describe a simple new technique to place temporary epicardial pacing wires quickly and safely.


Differential expression of transforming growth factors-beta1, -beta2 and -beta3 in human colon carcinoma.
Transforming growth factor (TGF)-beta is a protein family which affects multiple cellular functions including survival, proliferation, differentiation and adhesion. Among the three known isoforms, TGF-beta1 is commonly overexpressed in solid malignancies. Recent studies in knock-out mice demonstrated non-redundant roles of different TGF-beta isoforms in development. The present study was performed to assess tumour-associated expression of the three TGF-beta isoforms in colon carcinoma. We report that colon carcinoma progression is associated with gradual and significant increases in expression of TGF-beta1 and TGF-beta2 mRNA and proteins. By contrast, TGF-beta3 expression was detected in normal colonic mucosa and, at slightly higher levels, in tumour tissues. In addition, plasma levels of both TGF-beta1 and TGF-beta2 were significantly higher in cancer patients when compared with unaffected individuals. Taken together, our results indicate distinct expression patterns of the three TGF-beta isoforms in colon carcinoma cells and possible systemic effects of TGF-beta1 and TGF-beta2 in tumour patients.


Physically consistent data assimilation method based on feedback control for patient-specific blood flow analysis.
This paper presents a novel data assimilation method for patient-specific blood flow analysis based on feedback control theory called the physically consistent feedback control-based data assimilation (PFC-DA) method. In the PFC-DA method, the signal, which is the residual error term of the velocity when comparing the numerical and reference measurement data, is cast as a source term in a Poisson equation for the scalar potential field that induces flow in a closed system. The pressure values at the inlet and outlet boundaries are recursively calculated by this scalar potential field. Hence, the flow field is physically consistent because it is driven by the calculated inlet and outlet pressures, without any artificial body forces. As compared with existing variational approaches, although this PFC-DA method does not guarantee the optimal solution, only one additional Poisson equation for the scalar potential field is required, providing a remarkable improvement for such a small additional computational cost at every iteration. Through numerical examples for 2D and 3D exact flow fields, with both noise-free and noisy reference data as well as a blood flow analysis on a cerebral aneurysm using actual patient data, the robustness and accuracy of this approach is shown. Moreover, the feasibility of a patient-specific practical blood flow analysis is demonstrated.


Ribonucleotide reductase activity and deoxyribonucleoside triphosphate metabolism during the cell cycle of S49 wild-type and mutant mouse T-lymphoma cells.
We investigated deoxyribonucleoside triphosphate metabolism in S49 mouse T-lymphoma cells synchronized in different phases of the cell cycle. S49 wild-type cultures enriched for G1 phase cells by exposure to dibutyryl cyclic AMP (Bt2cAMP) for 24 h had lower dCTP and dTTP pools but equivalent or increased pools of dATP and dGTP when compared with exponentially growing wild-type cells. Release from Bt2cAMP arrest resulted in a maximum enrichment of S phase occurring 24 h after removal of the Bt2cAMP, and was accompanied by an increase in dCTP and dTTP levels that persisted in colcemid-treated (G2/M phase enriched) cultures. Ribonucleotide reductase activity in permeabilized cells was low in G1 arrested cells, increased in S phase enriched cultures and further increased in G2/M enriched cultures. In cell lines heterozygous for mutations in the allosteric binding sites on the M1 subunit of ribonucleotide reductase, the deoxyribonucleotide pools in S phase enriched cultures were larger than in wild-type S49 cells, suggesting that feedback inhibition of ribonucleotide reductase is an important mechanism limiting the size of deoxyribonucleoside triphosphate pools. The M1 and M2 subunits of ribonucleotide reductase from wild-type S49 cells were identified on two-dimensional polyacrylamide gels, but showed no significant change in intensity during the cell cycle. These data are consistent with allosteric inhibition of ribonucleotide reductase during the G1 phase of the cycle and release of this inhibition during S phase. They suggest that the increase in ribonucleotide reductase activity observed in permeabilized S phase-enriched cultures may not be the result of increased synthesis of either the M1 or M2 subunit of the enzyme.


Differentiation between restrictive cardiomyopathy and constrictive pericarditis by early diastolic doppler myocardial velocity gradient at the posterior wall.
The differential diagnosis between restrictive cardiomyopathy (RCM) and constrictive pericarditis (CP) is challenging and, despite combined information from different diagnostic tests, surgical exploration is often necessary. A group of 55 subjects (mean age, 63+/-11 years; 36 men and 19 women) were enrolled in the study; 15 had RCM, 10 had CP, and 30 were age-matched, normal controls. The diagnosis of RCM was supported by a biopsy; in the CP group, the diagnosis was confirmed either surgically or at autopsy. All patients underwent a transthoracic echocardiogram that included the assessment of Doppler myocardial velocity gradient (MVG), as measured from the left ventricular posterior wall during the predetermined phases of the cardiac cycle. MVG was lower (P<0.01) in RCM patients compared with both CP patients and normal controls during ventricular ejection (2. 8+/-1.2 versus 4.4+/-1.0 and 4.7+/-0.8 s(-1), respectively) and rapid ventricular filling (1.9+/-0.8 versus 8.7+/-1.7 and 3.7+/-1.4 s(-1), respectively). Additionally, during isovolumic relaxation, MVG was positive in RCM patients and negative in both CP patients and normal controls (0.7+/-0.4 versus -1.0+/-0.6 and -0.4+/-0.3 s(-1), respectively; P<0.01). During atrial contraction, MVG was similarly low (P<0.01) in both RCM and CP patients compared with normal controls (1.6+/-1.7 and 1.7+/-1.8 versus 3.8+/-0.9 s(-1), respectively). Doppler myocardial imaging-derived MVG, as measured from the left ventricular posterior wall in early diastole during both isovolumic relaxation and rapid ventricular filling, allows for the discrimination of RCM from CP.


An exploratory study of the association between physical activity, cardiovascular fitness and body size in children with Down syndrome.
To explore the association between physical activity, cardiovascular fitness and body size among children with Down syndrome. Physical activity, cardiovascular fitness and body size were measured by accelerometry, maximal fitness test and anthropometric measurements (BMI, waist circumference), respectively. Fourteen children with Down syndrome (8 boys, 6 girls; mean age 12.9 years) participated. There was no significant correlation between physical activity and cardiovascular fitness or physical activity and body size. Children with Down syndrome who were fitter, had lower BMIs (r = -0.77, 95% confidence interval (CI) -0.41 to -0.93) and smaller waist circumference (r = -0.75, 95% CI -0.36 to -0.92). Preliminary evidence suggests physical activity may not be associated with either body size or fitness in children with Down syndrome. Body size appears to be inversely related to fitness in children with Down syndrome.


Detection and measurement of alternative splicing using splicing-sensitive microarrays.
Splicing and alternative splicing are major processes in the interpretation and expression of genetic information for metazoan organisms. The study of splicing is moving from focused attention on the regulatory mechanisms of a selected set of paradigmatic alternative splicing events to questions of global integration of splicing regulation with genome and cell function. For this reason, parallel methods for detecting and measuring alternative splicing are necessary. We have adapted the splicing-sensitive oligonucleotide microarrays used to estimate splicing efficiency in yeast to the study of alternative splicing in vertebrate cells and tissues. We use gene models incorporating knowledge about splicing to design oligonucleotides specific for discriminating alternatively spliced mRNAs from each other. Here we present the main strategies for design, application, and analysis of spotted oligonucleotide arrays for detection and measurement of alternative splicing. We demonstrate these strategies using a two-intron yeast gene that has been altered to produce different amounts of alternatively spliced RNAs, as well as by profiling alternative splicing in NCI 60 cancer cell lines.


Hypokalaemic metabolic alkalosis, hypertension and diabetes: what is the link.
Two years after diagnosis of a metastatic neuroendocrine gastrin-secreting tumour and after several cycles of chemotherapy and peptide receptor radionuclide therapy, a 56-year-old woman presented with hypokalaemic metabolic alkalosis, hypertension, leg oedema and new-onset diabetes mellitus. Further investigations revealed renal potassium loss confirmed by a transtubular potassium gradient of 16, fully suppressed serum aldosterone, but instead highly elevated blood levels of morning cortisol and adrenocorticotropic hormone as well as increased urinary excretion of glucocorticoid and mineralocorticoid metabolites. Ruling out other causes, paraneoplastic hypercortisolism was diagnosed. Pharmacological inhibition of the steroid 11β-hydroxylase with metyrapone resulted in complete resolution of metabolic alkalosis, hypokalaemia, hypertension, hyperglycaemia and leg oedema within 1 week.


[Evaluation of intraperitoneal chemotherapy using CDDP combined with MMC in gastric carcinomatous peritonitis].
Based on the experimental studies using Meth A and L 1210 transplantable mouse, which indicated that simultaneous combined administration of MMC and CDDP prolonged life span more significantly than individual administration, clinical application was performed on 14 cases with carcinomatous peritonitis in gastric cancer. One hundred mg of CDDP was administered before the closure of abdomen and drainage tubes were opened 2 hours later. Then, repeated administration of 10 mg/body of MMC and 40-50 mg/body of CDDP was continued once a month via the drug delivery system. Negative change of cytology was observed in seven out of 14 cases, and the prognosis of these patients was better than in the unchanged cytology group. Side effects such as severe gastro-intestinal symptoms and bone marrow toxicities were not recognized. Further studies should be done to confirm the efficacy of the intraperitoneal chemotherapy for carcinomatous peritonitis.


Beneficial influence of matching for D/DR antigens and treatment with cyclosporin-A on kidney graft survival in transfused rhesus monkeys.
The influence of matching for D/DR antigens and treatment with Cyclosporin-A (Cy-A) was investigated in rhesus monkeys given pretransplant blood transfusions. It was observed that the combination of D/DR matching and transfusions led to a higher percentage of animals with prolonged graft survival as well as a better kidney function in the early post-transplant period than was achieved with transfusions alone. Regarding the possible interference of Cy-A with the beneficial blood transfusion effect, it was found that transfused animals given Cy-A had survival times which were as good as those of transfused recipients without Cy-A or, sometimes, even slightly better.


Inflammatory microcrystals alter the functional phenotype of human osteoblast-like cells in vitro: synergism with IL-1 to overexpress cyclooxygenase-2.
Chronic crystal-associated arthropathies such as gout and pseudogout can lead to local bone destruction. Because osteoblasts, which orchestrate bone remodeling via soluble factors and cell-to-cell interactions, have been described in contact with microcrystals, particularly in uratic foci of gout, we hypothesized that microcrystals of monosodium urate monohydrate (MSUM) and of calcium pyrophosphate dihydrate (CPPD) could alter osteoblastic functions. MSUM and CPPD adhered to human osteoblastic cells (hOB) in vitro and were partly phagocytized as shown by scanning electron microscopy. MSUM and CPPD dose-dependently stimulated the production of PGE(2) in hOB as assessed by enzyme immunoassay, a response that was synergistically enhanced in the presence of IL-1. The mechanism of this synergism was, at least in part, at the level of the expression of cyclooxygenase-2 as evaluated by immunoblot analysis. MSUM and CPPD also stimulated the expression of IL-6 and IL-8 and reduced the 1,25-dihydroxyvitamin D(3)-induced activity of alkaline phosphatase and osteocalcin in hOB (with no synergism with IL-1). MSUM- or CPPD-stimulated expression of IL-6 in hOB pretreated with the selective cyclooxygenase-2 inhibitor NS-398 was increased, unlike that induced by IL-1 alone which was partially reduced. MSUM-, CPPD- or IL-1-induced expression of IL-8 was unchanged by pretreating hOB with NS-398. These results suggest that inflammatory microcrystals alter the normal phenotype of hOB, redirecting them toward reduced bone formation and amplified osteoblast-mediated bone resorption, abnormalities that could play a role in the bone destruction associated with chronic crystal-induced arthritis.


Cancer risk associated with germline DNA mismatch repair gene mutations.
The autosomal dominant syndrome of Hereditary Nonpolyposis Colorectal Cancer (HNPCC) is due to germline DNA mismatch repair gene mutations in most cases. However, the penetrance of such mutations outwith classical HNPCC kindreds is unknown because families studied to date have been specifically selected for research purposes. Using a population-based strategy, we have calculated the lifetime cancer risk associated with germline DNA mismatch repair gene mutations, irrespective of their family history. We identified 67 gene carriers whose risk to age 70 for all cancers was 91% for males and 69% for females. The risk of developing colorectal cancer was significantly greater for males than for females (74% versus 30%, P= 0.006). The risk of uterine cancer (42%) exceeded that for colorectal cancer in females, emphasising the need for uterine screening. Our findings give further insight into the biological effect of defective DNA mismatch repair. We have demonstrated a systematic approach to identifying individuals at high risk of cancer but who may not be part of classical HNPCC families. The risk estimates derived from these analyses provide a rational basis on which to guide genetic counselling and to tailor clinical surveillance.


Rapid automatized naming in a developmental perspective between ages 4 and 10.
During the last decades, rapid automatized naming (RAN) has been widely examined as a predictor of reading ability, but very few studies have examined the development of RAN itself. The present study followed children from ages 4 until 10, focusing on RAN performance in a developmental perspective. Relations within and between alphanumeric and nonalphanumeric RAN were investigated both concurrently and over time. The result shows that individual differences in RAN objects are stable between ages 4 and 10, with the most rapid growth of mean performance between ages 4 and 6. Early performance on RAN objects predicts both performance on RAN digits and RAN letters at age 8 and the further development between ages 8 and 10. Further, low-performing children at age 4 develop their performance on RAN digits and RAN letters later compared with high-performing children, and RAN digits performance reaches a plateau earlier than RAN letters performance.


Electroporation dynamics in biological cells subjected to ultrafast electrical pulses: a numerical simulation study.
A model analysis of electroporation dynamics in biological cells has been carried out based on the Smoluchowski equation. Results of the cellular response to short, electric pulses are presented, taking account of the growth and resealing dynamics of transient aqueous pores. It is shown that the application of large voltages alone may not be sufficient to cause irreversible breakdown, if the time duration is too short. Failure to cause irreversible damage at small pulse widths could be attributed to the time inadequacy for pores to grow and expand beyond a critical threshold radius. In agreement with earlier studies, it is shown that irreversible breakdown would lead to the formation of a few large pores, while a large number of smaller pores would appear in the case of reversible breakdown. Finally, a pulse width dependence of the applied voltage for irreversible breakdown has been obtained. It is shown that in the absence of dissipation, the associated energy input necessary reduces with decreasing pulse width to a limiting value. However, with circuit effects taken into account, a local minima in the pulse dependent energy function is predicted, in keeping with previously published experimental reports.


Fatal variceal rupture after sildenafil use: report of a case.
Sildenafil may increase the risk of variceal bleeding in portal hyptertension by increasing splanchnic blood flow. We report herein the second case of variceal rupture after sildenafil use.


A comprehensive clinical research database based on CDISC ODM and i2b2.
We present a working approach for a clinical research database as part of an archival information system. The CDISC ODM standard is target for clinical study and research relevant routine data, thus decoupling the data ingest process from the access layer. The presented research database is comprehensive as it covers annotating, mapping and curation of poorly annotated source data. Besides a conventional relational database the medical data warehouse i2b2 serves as main frontend for end-users. The system we developed is suitable to support patient recruitment, cohort identification and quality assurance in daily routine.


Motivation of plateletpheresis donors.
Twenty randomly chosen voluntary plateletpheresis donors were interviewed in depth. Information on their family histories, past histories, present psychosocial adjustment, and history of blood donation was elicited. Most donors had a high level of commitment and drive to achieve, frequently related to low self-image dating from childhood. The act of platelet donation had several important meanings for the subjects. It improved their self-esteem, making them feel more worthy and responsible persons. It provided them with an opportunity to establish relationships with others. The data obtained in this survey suggest that the altruistic behavior of the voluntary donors should be seen both as an act of giving and also one of receiving emotional gratification which fulfills one's important psychological needs. Utilization of these data in recruitment of plateletpheresis donors is suggested.


Preparation of an Aroma Fraction from Dried Bonito by Steam Distillation and Its Effect on Modification of Salty and Umami Taste Qualities.
To study the effects of dried bonito aroma on taste perception, dried bonito aroma fraction (DBAF) as a steam distillate in liquid was added to the salt solutions containing 5 different salt concentrations (0.68% to 1.5% [w/v]) before sensory evaluations. Perception of the taste qualities of salt solutions with added DBAF varied depending on the salt concentration. At low salt concentrations (0.68% to 0.83%), after-taste intensity of saltiness and overall taste intensity were significantly enhanced by the addition of DBAF. This suggests that DBAF can be applied to a low-salt seasoning at these salt concentrations. Umami taste intensity was significantly enhanced by the addition of DBAF at all salt concentrations (0.68% to 1.5%). The addition of heat-treated DBAF, which no longer had the dried bonito odor, exerted no significant influences on any taste descriptors. As the result of gas chromatography-mass spectrometry analysis, sulfur-containing compounds, pyrazines, alcohols, and phenols were contained in DBAF and not detected in heat-treated DBAF. Because these compounds contributed to the dried bonito odor, the taste modifications were thought to be induced by these compounds. The effects of the DBAF on Japanese noodle soup (mentsuyu) were also examined. The saltiness intensity of 1.2% salt concentration of mentsuyu containing both DBAF and DBS (dried bonito stock) as a hot water extract of dried bonito was not significantly differ from that of 1.5% salt concentration of mentsuyu not containing any of them. It will thus be possible to develop a reduced salt seasoning by combining DBAF and DBS.


Internet user profile in the field of parasitology.
This study determined a profile of current Internet users in parasitology, their use patterns on the Internet for parasitologic purposes, and the Web sites they would recommend. In a European survey, 689 parasitologically engaged scientists were asked to fill out a questionnaire about Internet access, current problems, current and future use, and which Web sites they would recommend as well as about the use of e-mail. In all, 153 (22.2%) of the interviewees returned the questionnaire. Only one participant had no access to the Internet. Time expenditure was considered the main problem involved in use of the Internet. The Internet was mainly used for e-mail (96.1%); for literature research (93.5%); for reading of electronic journals (51.6%); and for gathering of information, e.g., about institutes and colleagues (58.2%) and about congresses (49.7%). In the future, 71.9% of the respondents would like to read electronic journals more often and 49.7% would like to use the web more intensively for acquisition of information about congresses, universities, and institutions. Requests for the future included an easier application of the browser software (33%) and a shorter response time (47.7%). The survey demonstrates that the Internet has assumed a definite place in the lives of researchers in the field of parasitology. Survey responses indicate a need for electronic journals. In our opinion, universities and parasitology societies should be urged to publish journals electronically on the Web. To diminish current problems involved in the finding of relevant information on the Internet, we strongly recommend careful reading of the instructions regarding the search engines used. Web pages with clear structures, small file sizes, precise HTML (hypertext markup language) key-word editing, and page titles would facilitate more accurate discovery of specific sites. In addition, there seems to be a need for regular publication of reviewed parasitology-link collections.


[Clinical study of symptomatic Rathke cleft cyst].
The clinical, radiographic findings in 12 patients with symptomatic Rathke cleft cysts (RCC) are presented. The mean age of these patients was 52 years, and 9 of the patients were female. Visual disturbance was the most common symptom, followed by headache. Magnetic resonance images (MRIs) were reviewed in 11 cases. In two cases, the cyst fluid had low signal intensity on T1-weighted images and high intensity on T2-weighted images. In eight cases the cyst fluid had iso-to-high intensity on both T1 and T2-weighted images. On dynamic MRI study using Gd-DTPA, normal anterior pituitary gland was seen superior to the RCC in 4 cases, anterior in 4, and inferior in 2 cases. In accordance with the MRI findings, transcranial approach was chosen in 4 cases and the transsphenoidal route was used in eight cases. Most symptoms and signs improved or resolved following surgery with the exception of those cases with a long-standing history of hypopituitarism. We experienced two cases of recurrence at 7 months, and 65 months respectively requiring a second operation, and the mean follow-up period for all cases was 78 months. Differential diagnosis between RCC and craniopharyngioma should be carefully made in the recurrent cases by surgical specimens of the cyst wall. Partial resection of the cyst wall and drainage of the contents via the transsphenoidal route is a safe and effective procedure in the majority of cases, but the transcranial approach is the treatment of choice in cases in which the cyst is entirely located in the suprasellar region.


Does preoperative tethering symmetry affect left ventricular reverse remodeling after restrictive annuloplasty?
We hypothesized that a preoperative symmetric pattern with anterior mitral leaflet (AML) tethering predominance is related to lack of LVRR after restrictive annuloplasty. In 300 patients with surgical annuloplasty for chronic ischemic mitral regurgitation the AML and posterior mitral leaflet (PML) tethering angles were quantified and patients were divided on the basis of the preoperative anterior/posterior tethering angle ratio: there were 144 patients with symmetric (Group 1) and 156 with asymmetric (Group 2) preoperative tethering pattern patients underwent echocardiography preoperatively, at discharge and at follow-up appointments (6 months [IQR 5-8 months]; late, 48 months [15-63 months]). Reverse remodeling was defined as a reduction in left ventricular end systolic volume index >15%. LVRR was higher in the asymmetric group at discharge (69.2% vs. 9.7%, p<0.001), early (70.55% vs. 10.45%, p<0.001 and late follow up (81.4% vs. 4.8%, p<0.001). At multivariable regression analysis corrected by significant key factors of LVRR, symmetric leaflet tethering (OR, 4.8 [95% CI 2.9-5.6], p<0.001), anterior tethering angle alpha'<39.5 degrees (OR, 5.0 [95% CI 2.0-6.6], p<0.001), coaptation height<11 mm (OR, 2.5 [95% CI 1.1-3.3], p=0.006) and coaptation length > or =8 mm at the end of procedure (OR, 2.0 [CI 0.8-3.0], p=0.01) were independent predictors of LVRR. Compared with patients with asymmetric pattern (adjusted OR 0.2 [95% CI 0.03-1.6), those with symmetric pattern had >4-fold odds for lack of LVRR. The preoperative symmetric pattern with AML prevalence was strongly associated with lack of reverse remodeling after annuloplasty. An accurate echocardiographic evaluation of the tethering mechanisms should be incorporated into clinical risk assessment and prediction models.


Neurofibromas of digital nerves.
We report four cases of neurofibromas affecting the digital nerves. Diagnosis and management are both difficult and demanding. Excision of the tumour while preserving the nerve was achieved by meticulous dissection in three out of four cases, resulting in normal sensation in two. The risk of recurrence is outweighed by the risk to sensation.


Search for Heavy Higgs Bosons A/H Decaying to a Top Quark Pair in pp Collisions at sqrt[s]=8 TeV with the ATLAS Detector.
A search for heavy pseudoscalar (A) and scalar (H) Higgs bosons decaying into a top quark pair (tt[over ¯]) has been performed with 20.3 fb^{-1} of proton-proton collision data collected by the ATLAS experiment at the Large Hadron Collider at a center-of-mass energy sqrt[s]=8 TeV. Interference effects between the signal process and standard model tt[over ¯] production, which are expected to distort the signal shape from a single peak to a peak-dip structure, are taken into account. No significant deviation from the standard model prediction is observed in the tt[over ¯] invariant mass spectrum in final states with an electron or muon, large missing transverse momentum, and at least four jets. The results are interpreted within the context of a type-II two-Higgs-doublet model. Exclusion limits on the signal strength are derived as a function of the mass m_{A/H} and the ratio of the vacuum expectation values of the two Higgs fields, tanβ, for m_{A/H}>500 GeV.


Transient unilateral vision loss in a dog following inadvertent intravitreal injection of bupivacaine during a dental procedure.
A 4-year-old castrated male Chihuahua was evaluated because of unilateral vision loss following extraoral administration of a caudal maxillary nerve block during a dental procedure. The menace response was absent in the left eye, but the pupillary light reflex was intact. Vitreal hemorrhages and opacities were present on ophthalmic examination of the left eye. Ultrasonographic findings were supportive of the clinical findings. The posterior lens capsule and retina appeared to be undisturbed. Treatment consisted of administration of carprofen and prophylactic administration of amoxicillin-clavulanate. Vision was clinically normal with an intact menace response 1 week later. Findings indicated that intravitreal injection of the local anesthetic agent should be considered as a potential complication when performing nerve blocks prior to dental procedures in dogs.


Postnatal phencyclidine treatment differentially regulates N-methyl-D-aspartate receptor subunit mRNA expression in developing rat cerebral cortex.
The present study was designed to determine the effects of chronic neonatal exposure to the NMDA receptor antagonist phencyclidine (PCP) on [3H]MK-801 binding and on gene expression of NMDA receptor subunits in juvenile male rats. Rat pups were injected daily with PCP from day 5 to 15 and killed on day 21. [3H]MK-801 binding was measured by quantitative autoradiography. A sensitive RNase protection assay was employed to determine simultaneously the mRNA levels of NR1 subunit (comprising all different splice variants) and three NR2 subunits (NR2A-NR2C). The relative distribution profile of NMDA receptor subunits in the cerebral cortex was NR2B > NR1 > NR2A > NR2C and in the cerebellum NR2C = NR1 > NR2A = NR2B. Chronic PCP administration in postnatal rats produced significant reduction in both [3H]MK-801 binding and mRNA level of the NR2B subunit in the cerebral cortex. Expression of the other NMDA receptor subunits in the cerebral cortex did not change following the drug treatment. In the cerebellum, neither [3H]MK-801 binding nor any of the NMDA receptor subunit expression levels showed any alteration. Together, these data provide a molecular correlate for chronic postnatal PCP-induced down-regulation of [3H]MK-801 binding in rat cerebral cortex and suggest that the NR2B subunit plays an important role in developmental plasticity.


The association of frailty with serum 25-hydroxyvitamin D and parathyroid hormone levels in older European men.
the link between the vitamin D endocrine axis and frailty remains undefined, with few studies examining the joint effect of vitamin D and parathyroid hormone (PTH) levels. Our objective was to determine the association of frailty with serum 25-hydroxyvitamin D (25(OH)D) and PTH. cross-sectional analysis within the European Male Ageing Study (EMAS). a total of 1,504 community-dwelling men aged 60-79 years. frailty was classified using a frailty phenotype (FP) and frailty index (FI). The association of frailty with 25(OH)D and PTH was examined using multinomial logistic regression; individual FP criteria with 25(OH)D and PTH using binary logistic regression. Results were expressed as relative odds ratios (ROR) and 95% confidence intervals (CIs) for multinomial; odds ratios (OR) and 95% CIs for binary models. using the FP, 5.0% of subjects were classified as frail and 36.6% as prefrail. Lower levels of 25(OH)D were associated with being prefrail (per 1 SD decrease: ROR = 1.45; 95% CI: 1.26-1.67) and frail (ROR = 1.89; 95% CI: 1.30-2.76), after adjusting for age, centre and health and lifestyle confounders (robust group = base category). Higher levels of PTH were associated with being frail after adjustment for confounders (per 1 SD increase: ROR = 1.24; 95% CI: 1.01-1.52). Comparable results were found using the FI. Among the five FP criteria only sarcopenia was not associated with 25(OH)D levels, while only weakness was associated with PTH. lower 25(OH)D and higher PTH levels were positively associated with frailty in older men. Prospective data would enable the temporal nature of this relationship to be explored further.


Are baby hammocks safe for sleeping babies? A randomised controlled trial.
Two reports of infants found dead after sleeping in baby hammocks have raised international concern about the safety of infant hammocks. We therefore tested whether hammock sleep affected oxygenation in infants, when they were at an age of high risk of sudden, unexpected infant death. Healthy, full-term 4- to 8-week-old infants were randomised to sleep either in a commercially available hammock (n = 14) or a standard bassinet (n = 9), and sleep state, oxygen desaturation (a fall in peripheral haemoglobin oxygen saturation (SpO2 ) ≥ 4%, for ≥ 4 sec from baseline to nadir), apnoea and hypopnoea, and mean SpO2 were analysed. There was no significant difference in mean SpO2 (both 98.5%) or rate of oxygen desaturation events between the hammock and the bassinet cot (mean ± SD, 24 ± 20 vs. 28 ± 23 events per hour), but infants slept less in the hammock (59 ± 31 vs. 81 ± 34 min, p < 0.02). When correctly used, the hammock sleep position did not compromise the upper airway of sleeping infants. The significance of shorter duration of sleep in the hammocks is unclear. These findings should not be applied to all baby hammocks, nor to older babies, particularly once the infant can roll. Given that it is not possible to predict when an infant will be able to roll, we strongly recommend that hammocks should not be used for unsupervised sleep.


Common variants in the G protein beta3 subunit gene and thyroid disorders in a formerly iodine-deficient population.
Heterotrimeric G proteins are key mediators of signals from membrane receptors-including the thyroid-stimulating hormone (TSH) receptor-to cellular effectors. Gain-of-function mutations in the TSH receptor and the Galpha(S) subunit occur frequently in hyperfunctioning thyroid nodules and differentiated thyroid carcinomas, whereby the T allele of a common polymorphism (825C>T, rs5443) in the G protein beta3 subunit gene (GNB3) is associated with increased G protein-mediated signal transduction and a complex phenotype. The aim of this study was to investigate whether this common polymorphism affects key parameters of thyroid function and morphology and influences the pathogenesis of thyroid diseases in the general population. The population-based cross-sectional Study of Health in Pomerania is a general health survey with focus on thyroid diseases in northeast Germany, a formerly iodine-deficient area. Data from 3428 subjects (1800 men and 1628 women) were analyzed for an association of the GNB3 genotype with TSH, free triiodothyronine and thyroxine levels, urine iodine and thiocyanate excretion, and thyroid ultrasound morphology including thyroid volume, presence of goiter, and thyroid nodules. There was no association between GNB3 genotype status and the functional or morphological thyroid parameters investigated, neither in crude analyses nor upon multivariable analyses including known confounders of thyroid disorders. Based on the data from this large population-based survey, we conclude that the GNB3 825C>T polymorphism does not affect key parameters of thyroid function and morphology in the general population of a formerly iodine-deficient area.


A noncomputerized count-based technique for the determination of resting left ventricular ejection fraction.
A noncomputerized, count-based technique for the determination of left ventricular ejection fraction (LVEF), which does not use geometric assumptions of left ventricular shape, was developed. The noncomputerized technique and computerized multigated ventriculography using both fixed and variable region-of-interest (ROI) methods were performed on 16 patients. The LVEFs obtained with the noncomputerized technique correlated well with both the fixed ROI computerized technique (r = .87) and the variable ROI computerized technique (r = .86). It is concluded that when a computer is not available, the noncomputerized technique is a valid alternative for the determination of LVEF in resting patients in stable sinus rhythm.