Kinesio taping in stroke: improving functional use of the upper extremity in hemiplegia.
The purpose of this article is to present the Kinesio taping method used to improve the upper extremity function in the adult with hemiplegia. The article discusses various therapeutic methods used in the treatment of stroke patients to achieve a functional upper extremity. The only taping technique for various upper extremity conditions that has been described in the literature is the athletic taping technique. In this article, some interpretation is offered on proper assessment of the nonfunctional upper extremity, including the emphasis on postural alignment, trunk control, and scapula alignment. The Kinesio taping method in conjunction with other therapeutic interventions may facilitate or inhibit muscle function, support joint structure, reduce pain, and provide proprioceptive feedback to achieve and maintain preferred body alignment. Restoring trunk and scapula alignment after the stroke is critical in an effective treatment program for the upper extremity in hemiplegia.


Immunohistochemical identification of the papillomavirus in uterine cervix: relationship with dysplasia, koilocytosis and evolution of the lesions.
Papillomavirus common internal capsid antigen (PV-Ag) was demonstrated using an immunoperoxidase technique in 74 out of 239 (31.0%) cases of cervical condylomata diagnosed histologically. All the positive cases but 2 (72/74) had nuclear changes compatible with dysplasia or cervical intraepithelial neoplasia (CIN). Immunocytochemically determined PV-Ag positivity was found in 54 out of 92 CIN I (58.7%), in 14 out of 32 CIN II (43.8%) and in 4 out of 18 CIN III (22.2%). The extent of koilocytosis in the epithelium had a direct correlation with the PV-Ag positivity: when koilocytosis extended to more than two thirds of the epithelium thickness, 24/41 cases (63.4%) were positive; when between one third and two thirds, 32/105 cases (30.5%) were positive; when present in less than one third 16/93 cases (17.2%) were positive. The positivity was 41.8% under 30 years of age and 20.5% over 30. Out of 16 positive cases followed with multiple biopsies for 6-20 months, 9 remained positive without change in CIN degree and 7 became negative, with CIN regression in 4 cases and progression to CIN III with disappearance of koilocytosis in 3 cases. More specific methods than histocytopathology alone are needed for epidemiologic and follow-up studies, especially in the cases in which the disappearance of antigenic and morphological expression of PV infection is not followed by dysplasia regression.


A novel link between SUMO modification and cancer metastasis.
SUMO (small ubiquitin-related modifier), a member of ubiquitin-like proteins, modifies a large number of transcription factors and coregulators. Although ubiquitin and SUMO exhibit structural similarities, the biological output of SUMOylation is somewhat distinct from protein degradation that is mainly mediated by ubiquitination. SUMOylation is involved in the regulation of the subcellular localization and stabilization of transcriptional cofactors and chromatin remodeling factors. Given the number of oncogenes and tumor suppressor genes that have been defined as targets for SUMOylation, studies on protein SUMOylation may shed light on the mechanism of tumorigenesis and metastasis. New roles of SUMOylation of a chromatin-remodeling complex have been elucidated. The SUMOylation status of the reptin chromatin-remodeling complex modulates the KAI1 metastasis suppressor gene and the invasive activity of cancer cells with metastatic potential; this revealed a novel link between SUMO modification and cancer metastasis. Here I overview these findings and discuss biological importance of protein SUMOylation in cancer metastasis.


Alkali-induced revival of Bacillus spores after inactivation by glutaraldehyde.
Spores of Bacillus subtilis 168 were apparently fully inactivated by exposure to 2% (w/v) glutaraldehyde for 20 h but a few spores could be revived by further treatment with 10-100 mM NaOH. A similar effect was found with spores from a range of Bacillus species. A minimum concentration of 5% (w/v) glutaraldehyde was required to prevent the alkali-induced reactivation. The implications of these results for the use of glutaraldehyde as a sporicidal agent are discussed.


Comparative effect of pioglitazone, quercetin and hydroxy citric acid on the status of lipid peroxidation and antioxidants in experimental non-alcoholic steatohepatitis.
Oxidative stress is one of the key mechanisms responsible for liver damage and disease progression in non-alcoholic steatohepatitis (NASH). Antioxidants try to combat the oxidative stress and minimise the oxidative stress. In this study, the comparative effect of pioglitazone, quercetin and hydroxy citric acid on lipid peroxidation and antioxidants in experimentally induced NASH has been studied. The levels of lipid peroxidation products, malondialdehyde (MDA), glutathione (GSH), catalase (CAT), superoxide dismutase (SOD), glutathione peroxidase (GPx), glutathione reductase (GR) and glutathione-S-transferase (GST) were estimated in experimental NASH. The levels of lipid peroxidation products (MDA) have been significantly increased in experimentally induced NASH group compared to the control group. The experimental NASH rats treated with pioglitazone, quercetin and with hydroxy citric acid showed significant reduction in MDA levels when compared with that of NASH induced group. Non enzymatic antioxidant such as GSH and antioxidant enzymes such as catalase, SOD, GPx, GR, and GST were decreased significantly in experimental NASH, compared to that of control group. The experimental NASH rats treated with pioglitazone showed marked increase in the levels of GSH, catalase and SOD but no significant effect on the levels of GPx, GR and GST levels when compared to the experimentally induced NASH group. Experimental NASH rats treated with hydroxy citric acid showed marked increase in the levels of GSH and catalase but no significant effect on the levels of SOD, GPx, GR and GST levels when compared to the experimentally induced NASH group. On contrary to these two drugs, the experimental NASH rats treated with quercetin showed significant increase in the levels of antioxidants as follows: GSH, catalase, SOD, GPx, GR and GST when compared with that of NASH induced group. We concluded that the levels of nonenzymatic and enzymatic antioxidants found to be decreased in experimentally induced NASH. The antioxidant property of quercetin could be more beneficial in treatment of NASH when compared to pioglitazone and hydroxy citric acid.


Levels of sexual hormones in relation with syndrome-differentiation of TCM in patients of chronic renal failure.
Determinations of plasma levels of sexual hormones in 43 male patients of chronic renal failure showed that the content of testosterone (T) decreased markedly, while estradiol (E2) and E2/T ratio were obviously higher than in normal subjects, with no significant correlation between the levels of these sexual hormones and renal function. According to syndrome-differentiation of TCM, 17 of the 43 cases belonged to deficiency of Kidney-yang, and the other 26 cases deficiency of Kidney-yin. In the patients with deficiency of Kidney-yang, the E2 level was not increased, but the T content decreased to make the E2/T ratio apparently elevated; whereas in the patients with deficiency of Kidney-yin, both E2 and E2/T were elevated. The level of E2 in deficiency of Kidney-yin was markedly higher than that in deficiency of Kidney-yang. The results indicated that patients of chronic renal failure of the type of deficiency of Kidney-yang differed in syndrome as well as in levels of the sexual hormones from the type of deficiency of Kidney-yin; however, the sexual hormones were not correlated with the renal functions in the two types of patients.


[The efficacy of integrating vaccination in primary heath care program to prevent missed opportunities of vaccination in Ivory Cost].
According to a nursing theory, a model to prevent missed opportunities of vaccination have been implemented in primary care service. The scope of the study was to experiment the efficacy of integrating vaccination in primary health care program in Bouaké (Côte d'Ivoire).


A critical review of the diagnosis and management of Barrett's esophagus: the AGA Chicago Workshop.
The diagnosis and management of Barrett's esophagus (BE) are controversial. We conducted a critical review of the literature in BE to provide guidance on clinically relevant issues. A multidisciplinary group of 18 participants evaluated the strength and the grade of evidence for 42 statements pertaining to the diagnosis, screening, surveillance, and treatment of BE. Each member anonymously voted to accept or reject statements based on the strength of evidence and his own expert opinion. There was strong consensus on most statements for acceptance or rejection. Members rejected statements that screening for BE has been shown to improve mortality from adenocarcinoma or to be cost-effective. Contrary to published clinical guidelines, they did not feel that screening should be recommended for adults over age 50, regardless of age or duration of heartburn. Members were divided on whether surveillance prolongs survival, although the majority agreed that it detects curable neoplasia and can be cost-effective in selected patients. The majority did not feel that acid-reduction therapy reduces the risk of esophageal adenocarcinoma but did agree that nonsteroidal antiinflammatory drugs are associated with a cancer risk reduction and are of promising (but unproven) value. Participants rejected the notion that mucosal ablation with acid suppression prevents adenocarcinoma in BE but agreed that this may be an appropriate strategy in a subgroup of patients with high-grade dysplasia. Based on this review of BE, the opinions of workshop members on issues pertaining to screening and surveillance are at variance with published clinical guidelines.


Prediction of in vivo drug-drug interactions from in vitro data : factors affecting prototypic drug-drug interactions involving CYP2C9, CYP2D6 and CYP3A4.
Quantitative predictions of in vivo drug-drug interactions (DDIs) resulting from metabolic inhibition are commonly made based upon the inhibitor concentration at the enzyme active site [I] and the in vitro inhibition constant (K(i)). Previous studies have involved the use of various plasma inhibitor concentrations as surrogates for [I] along with K(i) values obtained from published literature. Although this approach has resulted in a high proportion of successful predictions, a number of falsely predicted interactions are also observed. To focus on three issues that may influence the predictive value of the [I]/K(i) ratio approach: (i) the use of unbound K(i) (K(i,u)) values generated from standardised in vitro experiments compared with literature values; (ii) the selection of an appropriate [I]; and (iii) incorporation of the impact of intestinal metabolic inhibition for cytochrome P450 (CYP) 3A4 predictions. To this end we have selected eight inhibitors of CYP2C9, CYP2D6 and CYP3A4 and 18 victim drugs from a previous database analysis to allow prediction of 45 clinical DDI studies. In vitro kinetic and inhibition studies were performed in human liver microsomes using prototypic probe substrates of CYP2C9 and CYP2D6, with various inhibitors (miconazole, sulfaphenazole, fluconazole, ketoconazole, quinidine, fluoxetine, fluvoxamine). The K(i) estimates obtained were corrected for non-specific microsomal binding, and the K(i,u) was incorporated into in vivo predictions using various [I] values. Predictions for CYP3A4 were based upon in vitro data obtained from a previous publication within our laboratory, and an assessment of the impact of the interaction in the gut wall is included. Predictions were validated against 45 in vivo studies and those within 2-fold of the in vivo ratio of area under the plasma concentration-time curve of the substrate, in the presence and absence of the inhibitor (AUC(i)/AUC) were considered successful. Predictions based upon the average systemic total plasma drug concentration ([I](av)) [incorporating the effects of parallel drug elimination pathways] and the K(i,u) value resulted in 91% of studies predicted to within 2-fold of the in vivo AUC(i)/AUC. This represents a 35% improvement in prediction accuracy compared with predictions based upon total K(i) values obtained from various published literature sources. A corresponding reduction in bias and an increase in precision were also observed compared with the use of other [I] surrogates (e.g. the total and new unbound maximum hepatic input plasma concentrations). No significant improvement in prediction accuracy was observed by incorporating consideration of gut wall inhibition for CYP3A4. DDI predictions based upon the use of K(i,u) data obtained under a set of optimal standardised conditions were significantly improved compared with predictions using in vitro data collated from various sources. The use of [I](av) as the [I] surrogate generated the most successful predictions as judged by several criteria. Incorporation of either plasma protein binding of inhibitor or gut wall CYP3A4 inhibition did not result in a general improvement of DDI predictions.


Combination therapy of sodium-glucose co-transporter-2 inhibitors and dipeptidyl peptidase-4 inhibitors in type 2 diabetes: rationale and evidences.
No single antidiabetic agent can correct all the pathophysiologic defects manifested in type 2 diabetes mellitus (T2DM) and, therefore, multiple agents are often required to achieve optimal glycemic control. Combination therapies, having different mechanisms of action, not only have the potential to complement their action, but may possess the properties to counter the undesired compensatory response. Recent finding suggests that sodium-glucose co-transporter-2 inhibitors (SGLT2i) increase endogenous glucose production (EGP) from liver, due to the increase in glucagon which may offset its glucose-lowering potential. In contrast, dipeptidyl peptidase-4 inhibitors (DPP4i) decrease glucagon and EGP. Especially in the light of this finding, combination therapies with SGLT2i and DPP4i are particularly appealing, and are expected to produce an additive effect. Indeed, studies find no drug-drug interaction between SGLT2i and DPP4i. Moreover, significant reduction in glycated hemoglobin has also been observed. This article aims to review the efficacy and safety of combination therapy of SGLT2i and DPP4i in T2DM.


Expression of the BMP 2 gene during bone cell differentiation.
Bone morphogenetic protein 2 (BMP 2) and transforming growth factor beta (TGF beta) are actively involved in bone formation and remodeling. TGF beta, a powerful stimulant in the early stage of bone cell growth and matrix formation, inhibits differentiation and in vitro mineralized nodule formation in primary fetal rat calvarial osteoblast system. TGF beta also negatively regulates BMP 2 expression at the transcriptional level. BMP 2 gene expression is controlled by a battery of transcriptional factors, some known and some yet to be identified. Immortalized osteoblast cell lines generated from a transgenic mouse carrying BMP 2 promoter-driven SV40 large T antigen transgene are described as powerful tools for studying regulation of BMP 2 gene expression and bone cell differentiation at the molecular level.


Ureteroenteric anastomotic strictures after radical cystectomy-does operative approach matter?
Robot-assisted laparoscopic radical cystectomy has been increasingly used to decrease the morbidity of radical cystectomy. However, whether it truly lowers the complication rate compared to open radical cystectomy is not well established. We examined the benign ureteroenteric anastomotic stricture rates of open and robot-assisted laparoscopic radical cystectomy. In the 478 consecutive patients who underwent radical cystectomy at our institution from December 2007 to December 2011 we examined the proportion diagnosed with benign ureteroenteric anastomotic stricture. Clinicopathological variables were compared by treatment group. Cox multivariable analysis was performed to determine which patient or disease specific factors were independently associated with stricture diagnosis. A total of 375 patients (78.5%) underwent open radical cystectomy and 103 (21.5%) underwent robot-assisted laparoscopic radical cystectomy. Of the patients 45 (9.4%) were diagnosed with ureteroenteric anastomotic stricture a median of 5.3 months postoperatively. There was no difference in the stricture rate between the open and robot-assisted groups (8.5% vs 12.6%, p = 0.21). On adjusted Cox proportional hazards analysis no patient variable was independently associated with stricture diagnosis, including operative approach. Of the patients 9.4% were diagnosed with benign ureteroenteric anastomotic stricture after radical cystectomy with no significant difference in the risk of diagnosis by surgical approach. No patient or disease specific factor was independently associated with an increased risk of stricture diagnosis. Ureteroenteric anastomotic stricture is likely related to surgical technique. Continued efforts are needed to refine the technique of open and robot-assisted laparoscopic radical cystectomy to minimize the occurrence of this critical complication.


Oral choline decreases brain purine levels in lithium-treated subjects with rapid-cycling bipolar disorder: a double-blind trial using proton and lithium magnetic resonance spectroscopy.
Oral choline administration has been reported to increase brain phosphatidylcholine levels. As phospholipid synthesis for maintaining membrane integrity in mammalian brain cells consumes approximately 10-15% of the total adenosine triphosphate (ATP) pool, an increased availability of brain choline may lead to an increase in ATP consumption. Given reports of genetic studies, which suggest mitochondrial dysfunction, and phosphorus (31P) magnetic resonance spectroscopy (MRS) studies, which report dysfunction in high-energy phosphate metabolism in patients with bipolar disorder, the current study is designed to evaluate the role of oral choline supplementation in modifying high-energy phosphate metabolism in subjects with bipolar disorder. Eight lithium-treated patients with DSM-IV bipolar disorder, rapid cycling type were randomly assigned to 50 mg/kg/day of choline bitartrate or placebo for 12 weeks. Brain purine, choline and lithium levels were assessed using 1H- and 7Li-MRS. Patients received four to six MRS scans, at baseline and weeks 2, 3, 5, 8, 10 and 12 of treatment (n = 40 scans). Patients were assessed using the Clinical Global Impression Scale (CGIS), the Young Mania Rating Scale (YRMS) and the Hamilton Depression Rating Scale (HDRS) at each MRS scan. There were no significant differences in change-from-baseline measures of CGIS, YMRS, and HDRS, brain choline/creatine ratios, and brain lithium levels over a 12-week assessment period between the choline and placebo groups or within each group. However, the choline treatment group showed a significant decrease in purine metabolite ratios from baseline (purine/n-acetyl aspartate: coef = -0.08, z = -2.17, df = 22, p = 0.030; purine/choline: coef = -0.12, z = -1.97, df = 22, p = 0.049) compared to the placebo group, controlling for brain lithium level changes. Brain lithium level change was not a significant predictor of purine ratios. The current study reports that oral choline supplementation resulted in a significant decrease in brain purine levels over a 12-week treatment period in lithium-treated patients with DSM-IV bipolar disorder, rapid-cycling type, which may be related to the anti-manic effects of adjuvant choline. This result is consistent with mitochondrial dysfunction in bipolar disorder inadequately meeting the demand for increased ATP production as exogenous oral choline administration increases membrane phospholipid synthesis.


The 8th Supplement of the Italian Spine Society/Scoliosis Study Group (SICV&GIS).


Therapeutic potency of heat-shock protein-90 pharmacological inhibitors in the treatment of gastrointestinal cancer, current status and perspectives.
Heat-shock protein-90 (HSP90) chaperone machinery is critical to the folding, stability and activity of several client proteins including many responsible for tumour initiation, progression and metastasis. Overexpression of HSP90 is correlated with poor prognosis of GI cancer. Pharmacological inhibitors of HSP90 suppress tumorigenic effects of HSP90 by suppressing angiogenesis, survival, metastasis and drug resistance in GI cancer. This review summarizes the role of HSP90 inhibitors in the treatment of GI cancer. We have presented different antitumour mechanisms of HSP90 inhibitors in cancer treatment. Suppression of HSP90 signalling via specific and novel pharmacological inhibitors is a potentially novel therapeutic approach for patients with GI cancer for a better understanding and hence a better management of this disease.


Nail-patella syndrome and pre-eclampsia.
We present here the first described case of Nail-patella syndrome (NPS) and pregnancy. Complications occurred during the pregnancy with the onset of preeclampsia at 22 weeks, leading to intrauterine fetal death at 24 weeks. The nephropathy of the NPS began clinically during the course of gestation. Postpartum, it persisted as isolated proteinuria, which became a nephrotic syndrome 18 months later.


Short, sharp shock public health campaign had limited impact on raising awareness of laryngeal cancer.
Laryngeal cancer has poorer outcomes if diagnosed at a later stage. Improving awareness could encourage earlier presentation and improve outcomes. This study aimed to evaluate a public engagement campaign targeted at raising awareness of laryngeal cancer. An epidemiological study identified high-risk populations in the region. A target population as well as a matched control population was selected. A cancer awareness survey combined with focus groups guided the design of a 3-month multimedia campaign. The survey was repeated post-campaign to evaluate the campaign effectiveness. The study identified populations with the highest rates of laryngeal cancer and late stage disease at presentation. The surveys performed revealed a limited effect of the multimedia campaign in raising awareness of the signs and symptoms of laryngeal cancer. Recall of the campaign also faded rapidly. This is the first public awareness campaign aimed at laryngeal cancer carried out in the UK. The results suggest that short-term campaigns have a limited effect and a more prolonged approach should be considered.


Attenuation of neurotoxicity following anoxia or glutamate receptor activation in EGF- and hippocampal extract-treated neuronal cultures.
Neurotoxicity following anoxia or glutamate receptor activation was studied in primary neuronal cultures grown in serum-free, chemically defined CDM R12 medium. Exposure to 1 mM KCN, 0.5 mM kainic acid and 0.5 mM N-methyl-D-aspartate led to progressive neuronal degeneration. This damage was quantified by measuring lactate dehydrogenase released in the culture medium. The toxic effects were observed early during the development of the neuronal culture (from 4 days in vitro on) and seemed to be neuron-specific since astrocyte cultures were not affected. Chronic treatment of the neuronal cultures with epidermal growth factor at 10 ng/ml and hippocampal extract at dil. 1/833 (w/v) induced morphological alterations, increased beta-adrenergic receptor coupled adenylate cyclase activity, increased level of total lactate dehydrogenase activity in the case of epidermal growth factor-treated cultures, and attenuation of lactate dehydrogenase release following exposure to KCN or glutamate receptor agonists. The alterations observed are probably due to the proliferation and differentiation of glial cells in these treated cultures. This suggests that glial cells protect neurons in vitro from degeneration induced by anoxia or glutamate receptor activation.


Observations on vesical diverticulum in childhood.
An operation was required in 78 children with vesical diverticula in the absence of bladder outlet obstruction. Virtually all diverticula were located in juxtaposition to the ureteral orifice and were associated with vesicoureteral reflux in all but 6 of 89 diverticulum-ureteral units. Upper tract changes were seen on excretory urography in 78 per cent of the refluxing units. The surgical procedure of choice was diverticulectomy and ureteroneocystostomy, which yielded a high degree of success. Diverticulectomy alone and vesical neck revision were rarely indicated.


Combined deficiency of iron and (n-3) fatty acids in male rats disrupts brain monoamine metabolism and produces greater memory deficits than iron deficiency or (n-3) fatty acid deficiency alone.
Deficiencies of iron (Fe) (ID) and (n-3) fatty acids (FA) [(n-3)FAD] may impair brain development and function through shared mechanisms. However, little is known about the potential interactions between these 2 common deficiencies. We studied the effects of ID and (n-3)FAD, alone and in combination, on brain monoamine pathways (by measuring monoamines and related gene expression) and spatial working and reference memory (by Morris water maze testing). Using a 2 × 2 design, male rats were fed an ID, (n-3)FAD, ID+(n-3)FAD, or control diet for 5 wk postweaning (postnatal d 21-56) after (n-3)FAD had been induced over 2 generations. The (n-3)FAD and ID diets decreased brain (n-3) FA by 70-76% and Fe by 20-32%, respectively. ID and (n-3)FAD significantly increased dopamine (DA) concentrations in the olfactory bulb (OB) and striatum, with an additive 1- to 2-fold increase in ID+(n-3)FAD rats compared with controls (P < 0.05). ID decreased serotonin (5-HT) levels in OB, with a significant decrease in ID+(n-3)FAD rats. Furthermore, norepinephrine concentrations were increased 2-fold in the frontal cortex (FC) of (n-3)FAD rats (P < 0.05). Dopa decarboxylase was downregulated in the hippocampus of ID and ID+(n-3)FAD rats (fold-change = -1.33; P < 0.05). ID and (n-3)FAD significantly impaired working memory performance and the impairment positively correlated with DA concentrations in FC (r = 0.39; P = 0.026). Reference memory was impaired in the ID+(n-3)FAD rats (P < 0.05) and was negatively associated with 5-HT in FC (r = -0.42; P = 0.018). These results suggest that the combined deficiencies of Fe and (n-3) FA disrupt brain monoamine metabolism and produce greater deficits in reference memory than ID or (n-3)FAD alone.


Software package for automatic microarray image analysis (MAIA).
Although various software solutions are currently available for microarray image analysis, one would still expect to develop algorithms ensuring higher level of intelligence and robustness. We present a fully functional software package for automatic processing of the two-color microarray images including spot localization, quantification and quality control. The developed algorithms aim at making ratio estimates more resistant to array contamination and offer automatic tools to evaluate spot quality. A demo version of the software can be downloaded from http://bioinfo.curie.fr/projects/maia. A full version is freely available to non-commercial users upon request from the authors.


Tumorigenic transformation of NIH 3T3 cells by the autocrine synthesis of transforming growth factor alpha.
A variety of cancer cells overexpress transforming growth factor alpha (TGF alpha), a mitogenic peptide. A cDNA sequence coding for the full-length human TGF alpha precursor protein was subcloned into a retroviral expression vector and introduced into clone 7 NIH 3T3 cells, which have low numbers of endogenous epidermal growth factor receptors (EGFRs). The autocrine synthesis of TGF alpha by these cells resulted in their focal transformation. In contrast, control NIH 3T3 cells treated in a paracrine manner with exogenous, saturating concentrations of the mature form of TGF alpha, though stimulated to divide, remained morphologically untransformed. The addition of saturating quantities of soluble, mature TGF alpha to NIH 3T3 cells expressing the transferred TGF alpha gene actually suppressed their growth and focal transformation. The transformation induced by the TGF alpha gene remained an EGFR-dependent process, since the degree of transformation was correlated with EGFR expression in NIH 3T3 cells and since NR6 cells, which are Swiss 3T3 cells devoid of endogenous EGFRs, were transformed by the TGF alpha vector only when exogenous EGFR genes were also introduced. When inoculated into nude mice, the TGF alpha-expressing cells rapidly gave rise to tumors that grew progressively, whereas control cells did not form tumors. We conclude that in certain circumstances autocrine TGF alpha can be more oncogenic than paracrine and that paracrine TGF alpha can suppress this effect.


[Correlation between the changes of surface electromyographic signals of elbow flexor and extensor and motor function in stroke patients].
To explore the correlation between the changes of surface electromyography (sEMG) signals of biceps and triceps and torques for elbow flexion and extension during maximum isometric voluntary contraction (MIVC) and motor function in convalescent stroke patients so as to provide rationale for rehabilitation. Fifteen stroke patients and 15 age and gender-matched normal controls were recruited. The sEMG signals of biceps and triceps were recorded during MIVC of elbow flexion and extension. Co-contraction ratio (CR) and torques of both groups were compared and analyzed. The motor function of upper extremity was assessed by Fugl-Meyer assessment upper extremity (FMA-UE). There were significant differences in EMG ((132 ± 65) mV×s,(124 ± 50) mV×s) and torques ((13 ± 8) N×m, (10 ± 6) N×m) at affected side with those at unaffected side and controls during MIVC of elbow flexion and extension (P < 0.05).Significant differences existed in CR ((30 ± 13)%) at affected side with unaffected side ((18 ± 8)%) and controls ((16 ± 6)%) during MIVC of elbow extension (P < 0.05). The score of FMA-UE at affected side was significantly positively correlated with iEMG on biceps during MIVC of elbow flexion (r = 0.579, P = 0.024) and on triceps during MIVC of elbow extension (r = 0.618, P = 0.014). The score of FMA-UE at affected side was significantly positively correlated with torques during MIVC of elbow flexion and extension (rflexion = 0.518, P = 0.048; rextension = 0.679, P = 0.005). The score of FMA-UE at affected side was significantly negatively correlated with CR during MIVC of elbow flexion and extension (rflexion = -0.579, P = 0.024; rextension = -0.693, P = 0.004). The strength of flexor and extensor of bilateral elbow decreases in convalescent stroke patients. The spasticity of elbow flexor still exists. Besides increasing the strength of bilateral upper extremities, particularly affected side, rehabilitation should also focus upon reducing spasticity of flexor to enhance elbow joint stability and improve motor function.


A survey about the usefulness of computerized systems to support illness management in clinical practice.
This survey among an interdisciplinary group of clinicians was conducted to obtain their opinions about the usefulness of decision support systems (DSS) for evidence- and patient preference-based illness management, factors important to their implementation, and criteria for evaluating their effectiveness. A questionnaire was sent by mail or electronically to a convenience sample of 184 nurses, physicians and other health care professionals. The DSS ability to provide information about potential benefits and harms of intervention options and reports on patient outcomes of symptom relief, functional status and preference achievement was considered most useful among DSS features. Nurses rated the usefulness of the DSS higher than physicians did. Ease of use, no increase in workload, and timely, precise information were rated as the most important factors for successful implementation. The most frequently selected patient, care process/provider and system outcomes rated as indicators for DSS effectiveness were: patient satisfaction, health-related quality of life, symptom relief, functional status, and alignment of patient preferences with realistic expectations; congruence between patient preferences and patient care; clinician time use; quality of patient documentation and cost-effectiveness. This survey provided crucial information to successfully develop DSS for evidence- and patient preference-based illness management that are perceived helpful by their potential users.


Inhibition of DNA synthesis and tube morphogenesis of cultured vascular endothelial cells by chondromodulin-I.
Cartilage is an avascular tissue, and exhibits anti-angiogenic properties. Cartilage extracts have been shown to contain an inhibitor for DNA synthesis in vascular endothelial cells in vitro. Here we purified the inhibitory activity in the 10-50 kDa fraction of guanidine extracts from fetal bovine epiphyseal cartilage, and found that the inhibitor was identical with chondromodulin-I (ChM-I). Purified ChM-I inhibited tube morphogenesis of cultured vascular endothelial cells, as well as DNA synthesis. These results indicate that cartilage-specific glycoprotein ChM-I may participate in the maintenance of avascularity and anti-angiogenic properties of cartilage.


Kinetic study of the complex reaction between copper(II) and 2-(2'-hydroxy-3'-methoxyphenyl)benzothiazole.
2-(2'-Hydroxy-3'-methoxyphenyl)benzothiazole reacts with copper(II) in an ethanol/water mixture to form an O,S chelate which exhibits the remarkable property of changing the chelation site above a pH of ca. 5.0, to the O,N site. The detailed kinetics of this reaction in an ethanol/water mixture (3:1) at a temperature of 25 degrees C was investigated using a stopped-flow spectrophotometric technique employing a wavelength of 400 nm. The initial complex, Cu(O,S), is formed via a fast, reversible second-order complex formation step whereupon the formation of the Cu (O,N) follows first order kinetics. The Cu(O,N) complex is, however, unstable towards internal electron exchange and after the reaction is complete, a black polymeric material very slowly precipitates out of solution. Rate and equilibrium constants for the postulated reactions are presented and discussed.


Doppler echocardiography. Role in emergency diagnosis of cardiac valve disease.
Doppler echocardiography provides crucial information in the evaluation of a patient with suspected significant heart valve dysfunction. Doppler studies can provide quantitative data on the gradients across the stenotic valves and in many cases derive the actual valve area (with use of the pressure half-time method for stenotic atrioventricular valves or the continuity equation for semilunar valves). When combined with two-dimensional echocardiographic studies, Doppler studies may discern the cause of valve dysfunction. In valvular regurgitation, semi-quantitative estimation of the severity of the problem can be obtained by pulsed Doppler flow mapping or color Doppler echocardiography. These methods show great value for rapid evaluation of valve dysfunction in the emergency setting.


Coding Exon-Structure Aware Realigner (CESAR): Utilizing Genome Alignments for Comparative Gene Annotation.
Alignment-based gene identification methods utilize sequence conservation between orthologous protein-coding genes to annotate genes in newly sequenced genomes. CESAR is an approach that makes use of existing genome alignments to transfer genes from one genome to other aligned genomes, and thus generates comparative gene annotations. To accurately detect conserved exons that exhibit an intact reading frame and consensus splice sites, CESAR produces a new alignment between orthologous exons, taking information about the exon's reading frame and splice site positions into account. Furthermore, CESAR is able to detect most evolutionary splice site shifts, which helps to annotate exon boundaries at high precision. Here, we describe how to apply CESAR to generate comparative gene annotations for one or many species, and discuss the strengths and limitations of this approach. CESAR is available at https://github.com/hillerlab/CESAR2.0 .


Interaction of peanut root lectin (PRA II) with rhizobial lipopolysaccharides.
Sugar specific binding of peanut root lectin (PRA II) to peanut specific bradyrhizobial lipopolysaccharides (LPS) was demonstrated by gel retardation assay and lectin based ELISA. Sephadex G-50 gel purified high molecular weight polysaccharides from NC 92 LPS bind PRA II most efficiently. Binding of NC 92 LPS only to PRA II and not to PNA, SBA and PSL by Western blot analysis suggests that this lectin-LPS interaction is tissue as well as species specific.


Serotypes of carriage and invasive isolates of Streptococcus pneumoniae in Brazilian children in the era of pneumococcal vaccines.
Nasopharyngeal carriage of Streptococcus pneumoniae is a key factor in the development of invasive disease and the spread of resistant strains within the community. A single nasopharyngeal swab was obtained from 648 unvaccinated children aged <5 years, either healthy or with acute respiratory tract infection or meningitis, during the winters of 2000 and 2001. The overall pneumococcal carriage rate was 35.8% (95% CI 32.1-39.6). The pneumococcal serotypes found most frequently in the nasopharynx were 14, 6B, 6A, 19F, 10A, 23F and 18C, which included five of the seven serotypes in the currently licensed seven-valent conjugate vaccine (PCV7); serotypes 4 and 9V were less common. Serotypes 1 and 5 were isolated rarely from the nasopharynx. A comparison of 222 nasopharyngeal isolates with 125 invasive isolates, matched for age and time to the carrier isolates, showed a similar prevalence of penicillin non-susceptible pneumococci (PNSp) (19.8% and 19.2%, respectively). PNSp serotypes were similar (6B, 14, 19F, 19 A, 23B and 23F) for carriage and invasive disease isolates. The coverage of PCV7 for carriage isolates (52.2%) and invasive isolates (62.4%) did not differ significantly (p 0.06); similarly, there was no significant difference in PCV7 coverage for carriage isolates (34.5%) and invasive isolates (28.2%) of PNSp. These data suggest that PCV7 has the potential to reduce pneumococcal carriage and the number of carriers of PNSp belonging to vaccine serotypes.


Firefighting Induces Acute Inflammatory Responses that are not Relieved by Aspirin in Older Firefighters.
Sudden cardiac events account for 40% to 50% of firefighter line-of-duty deaths. Inflammatory proteins are strong biomarkers of cardiovascular inflammation. The present study investigated the effects of aspirin supplementation on inflammatory biomarkers following firefighting. Using a randomized, placebo-controlled, double-blind crossover design, 24 male firefighters (48.2 ± 5.9 years) were allocated into four conditions: acute (81 mg; single-dose) aspirin and placebo supplementation, and chronic (81 mg; 14 days) aspirin and placebo supplementation. Inflammatory proteins [interleukin (IL)-6, C-reactive protein (CRP), intracellular adhesion molecule (ICAM)-1, P-selectin, matrix metalloproteinase-9 (MMP-9)] and antioxidant potential [total antioxidant capacity (TAC)] were measured pre- and post-structural firefighting drills. Firefighting activities significantly increased IL-6, MMP-9, and P-Selectin; however, no changes in TAC and ICAM-1 were detected. Neither acute nor chronic aspirin supplementation attenuated this inflammatory response. Firefighting significantly increases inflammatory biomarkers and neither acute nor chronic low-dose aspirin mitigates this response.


Incidence of pleural mesothelioma in New Caledonia: a 10-year survey (1978-1987).
All cases of primary pleural cancers that were reported during a 10-y period (i.e., 1978-1987) in New Caledonia were recorded and compared with five cancer registers. There was an excess of primary pleural cancers in the area of New Caledonia, and it was particularly evident among the Melanesian ethnic group. Neither geographical nor occupational factors accounted for these results, but an environmental factor could not be excluded.


Female and male lifestyle habits and IVF: what is known and unknown.
There is no greater tribute to the importance and efficacy of IVF than the fact that >1 x 10(6) babies have been born to infertile couples since its clinical introduction in 1978. Despite enormous advances regarding the technical aspects of the IVF procedure, the parents' contribution has virtually been ignored when considering aspects that influence success rates. This systematic review focuses on the effects of female and male lifestyle habits (specifically: smoking, alcohol and caffeine use, and psychological stress) on the reproductive endpoints of IVF (i.e. oocyte aspiration, fertilization, embryo transfer, achievement of a pregnancy, live birth delivery, and perinatal outcomes, e.g. low birthweight, multiple gestations). What is currently known in the field of lifestyle habits and IVF? There is compelling evidence that smoking has a negative influence on IVF outcomes, whereas for stress, the evidence is suggestive but insufficient due to the heterogeneity of studies. The evidence for the effects of alcohol and caffeine on IVF is inadequate, and therefore unknown, due to the scarcity of studies.


Effect of acetaldehyde on binding of prostaglandins by receptors of liver plasma membranes.
Rat liver plasma membranes possess a single class of high affinity binding sites for the carbonyl-containing prostaglandins PGE2 and PGE1. The specificity of the binding sites is confirmed by the effective competition of the corresponding unlabeled PGs with 3H-PGs for binding sites on receptors. The modification of liver plasma membranes by acetaldehyde drastically decreases the density of the binding sites, leaving unaffected the affinity of receptors. To bind PGF2 alpha, liver plasma membranes have two types of binding sites, strong and weak ones. The alkylation of membranes by acetaldehyde does not essentially change the PGF2 alpha binding parameters. It is suggested that the protective effect of PGs in alcoholic liver injury occurs by their competition with acetaldehyde for binding sites on specific PG-binding receptors of liver plasma membranes.


Enzyme-Free Immunosorbent Assay of Prostate Specific Antigen Amplified by Releasing pH Indicator Molecules Entrapped in Mesoporous Silica Nanoparticles.
An enzyme-free titer plate-based colorimetric assay utilizing functionalized mesoporous silica nanoparticles (MSNs) entrapping pH-indicator molecules has been developed. Pores in the silica nanoparticles were functionalized with phenyltrimethyloxysilane so that pH indicator molecules (thymolphthalein or TP in the present case) can be tightly entrapped through π-π conjugation. To detect prostate specific antigen (PSA), the TP-containing MSNs were coated with polyethylenimine (PEI), which favors the attachment of the negatively charged secondary anti-PSA antibody. The entrapped thymolphthalein molecules can be readily released from the pores with a simple addition of alkaline solution. The resultant bifunctional MSNs were used for signal-amplified detection of PSA captured by the primary antibody preimmobilized in the wells of a plate. Our method possesses a wide dynamic range (0.5 to 8000 pg/mL) wherein the adsorption of the bifunctional MSNs obeys a modified Langmuir isotherm. A detection limit (LOD) down to as low as 0.36 pg/mL can be attained. Owing to the size uniformity of the MSNs and the obviation of enzyme molecules employed in the enzyme-linked immunosorbent assay (ELISA), excellent reproducibility (RSD = 1.12%) was achieved. The selective detection of PSA in human serum samples demonstrates the amenability of our method to detect important biomarkers in complex biological samples, whereas the performance of the assay in a titer plate ensures high throughput and obviates the use of expensive instruments. Both of these features are prerequisites for clinical settings wherein a great number of samples need to be analyzed in a timely fashion.


An attempt to characterize by immunocytochemical methods the enkephalin-like material in oxytocin endings of the rat neurohypophysis.
An antibody raised against dynorphin 1-8 was immunoreactive in the rat neurohypophysis in vasopressin but not in oxytocin endings. Oxytocin but not vasopressin terminals were immunostained when a Met5-enkephalin, a N-terminally directed monoclonal beta-endorphin antibody and an enkephalin-Met5-Arg6-Phe7 antibody were applied. The immunocytochemical reactions indicate that oxytocin terminals and their granules store pro-enkephalin-A derived opioid peptide fragments.


[Association of the meaning of life with satisfaction, the occurrence of subjective complaints and the family's economic status in the population of lower secondary school students].
Feeling of meaning in life is extremely crucial factor of mental health. The lack of it can result in various disorders. Many authors, especially those connected with current of humanistic psychology underline the teenagers' life sense. The aim of the paper was to examine the level of satisfaction with life, the frequency of psychosomatic complaints by junior high school students as well as the estimation of economical status of family and the analysis of meaning in life with above mentioned factors. The research was carried out in 2015 at 70 schools from all over the country, in group of 3695 lower secondary school students of I-III classes at the age of 13-17 (M=14,9; SD=0,87). The analysis connected with meaning in life using the shorten version of Purpose in Life Test (PIL) as well as analysis of life satisfaction using Cantril scale were taken up. What is more, the subjective physical complaints using single-factor shorten scale and economic status of family with the usage of material resources FAS scale (Family Affluence Scale) were examined. The statistical analysis included a one-way analysis of variance (ANOVA), t-student test post-hoc test as well as multivariate logistic regression model. The average level of meaning in life among the examined students was 24,7 points (the summary scale 0-36 points), the boys achieved higher score than girls. The students satisfied with life (t=28,0; p<0,001), with rare physical complaints (F=124,8; p<0,001) and from affluent families (F=15,4; p<0,001) were significantly characterized by higher average level of meaning in life than students who were dissatisfied with their life, often or fairly suffer from health complaints and live in families of at most average level of affluence. The meaning in life is positively connected with satisfaction with life, lack of subjective complaints and family affluence. Because there is a lack of analysis linked with school teenagers' meaning in life in Polish literature, another research involved not only shorten but also full version of this tool should be conducted.


Comparison of the motor-stimulating action of EM523, an erythromycin derivative, and prostaglandin F2 alpha in conscious dogs.
The effect of EM523 [de(N-methyl)-N-ethyl-8,9-anhydroerythromycin A 6,9-hemiacetal], an erythromycin derivative, on gastrointestinal motility was investigated using conscious dogs in the fasting state, and it was compared with those of motilin and prostaglandin F2 alpha (PGF2 alpha). EM523 and motilin given as i.v. infusions induced strong contractions in the stomach that migrated along the intestine. On the other hand, PGF2 alpha stimulated intestinal contractions, but its effect on gastric motility was weak. EM523 had 1/50 the potency of motilin and 6 times the potency of PGF2 alpha for stimulation of intestinal motility. Atropine at 0.1 mg/kg, i.v. strongly inhibited gastrointestinal contractions induced by EM52 EM523 or motilin and partly inhibited PGF2 alpha-induced intestinal motility. ICS-205-930, a 5HT3-receptor antagonist, at a dose of 1 mg/kg, i.v. strongly inhibited EM523 or motilin-induced gastric contractions but did not affect the action of PGF2 alpha. Infusion of EM523 at 100 micrograms/kg/hr induced strong migrating contractions even when motility was depressed by dopamine infusion or laparotomy. Infusion of PGF2 alpha at 300 micrograms/kg/hr stimulated intestinal but not gastric motility under these conditions. The results of this study indicate that the cholinergic pathway and 5HT3 receptors are involved in EM523 and motilin-induced migrating gastrointestinal contractions, whereas the cholinergic pathway seems to be only partly involved in PGF2 alpha-induced intestinal contractions.


Molecular Genetic Analysis of Ethanol Intoxication in Drosophila melanogaster.
Recently, the fruit fly Drosophila melanogaster has been introduced as a model system to study the molecular bases of a variety of ethanol-induced behaviors. It became immediately apparent that the behavioral changes elicited by acute ethanol exposure are remarkably similar in flies and mammals. Flies show signs of acute intoxication, which range from locomotor stimulation at low doses to complete sedation at higher doses and they develop tolerance upon intermittent ethanol exposure. Genetic screens for mutants with altered responsiveness to ethanol have been carried out and a few of the disrupted genes have been identified. This analysis, while still in its early stages, has already revealed some surprising molecular parallels with mammals. The availability of powerful tools for genetic manipulation in Drosophila, together with the high degree of conservation at the genomic level, make Drosophila a promising model organism to study the mechanism by which ethanol regulates behavior and the mechanisms underlying the organism's adaptation to long-term ethanol exposure.


Narcotrend and Bispectral Index monitor are superior to classic electroencephalographic parameters for the assessment of anesthetic states during propofol-remifentanil anesthesia.
A new electroencephalogram monitor, the Narcotrend, was developed to measure anesthetic depth. The authors compared the Narcotrend, the Bispectral Index, and classic electroencephalographic and hemodynamic parameters during anesthesia with propofol and remifentanil. The authors investigated 25 patients undergoing laminectomy at different anesthetic states: awake, steady state anesthesia, first reaction during emergence, and extubation. Narcotrend value; BIS; relative power (percent) in delta, theta, alpha, and beta; median frequency; spectral edge frequency; and hemodynamic parameters were recorded simultaneously. The ability of the classic and processed electroencephalographic and hemodynamic parameters to predict the clinically relevant anesthetic states of awake, steady state anesthesia, first reaction, and extubation was tested using prediction probability. Only the Narcotrend was able to differentiate between awake versus steady state anesthesia and steady state anesthesia versus first reaction/extubation with a prediction probability value of more than 0.90. Modern electroencephalographic parameters, especially Narcotrend, are more reliable indicators for the clinical assessment of anesthetic states than classic parameters.


[DICOM in radiotherapy].
Digital Image Communication in Medicine (DICOM) defines a standard method to store and transmit digital medical image information, in which there is a piece of implemented protocol named DICOM-RT that specially addresses both the transmission of radiation therapy image data and the ancillary data. In this paper, we firstly introduce the DICOM-RT with the emphases on its components, relationship with radiotherapy and how to produce the DICOM-RT object that refer to some certain radiotherapy information. Then we expatiate on the impact that benefits from applying DICOM-RT to radiotherapy, with an aid to accelerate its application in China.


Meta-analysis of association between ALDH2 rs671 polymorphism and essential hypertension in Asian populations.
Mitochondrial aldehyde dehydrogenase-2 (ALDH2) is an enzyme that oxidizes acetaldehyde into acetic acid during alcohol metabolism. Many studies indicate that the rs671 GG genotype in the ALDH2 gene may play a critical role in increasing the risk of essential hypertension (EH) associated with alcohol consumption, which predominantly occurs in men. However, the literature is inconclusive in this regard. This meta-analysis aims to derive a more precise estimation of the relationship between the rs671 polymorphism and EH for both male and female drinkers and nondrinkers. Ten cohort and case-control studies were included in the analysis with a total of 12,161 subjects; 7,062 patients and 5,099 healthy controls. Our results show that the rs671 GG genotype was associated with an increased risk of EH compared with the AG+AA genotype (OR = 1.27, 95 % CI = 1.17-1.37, p < 0.00001). When comparing male and female subjects, only among male individuals was a higher risk of EH found in the GG genotype compared with the AG+ AA genotype (OR = 1.59, 95 % CI = 1.40-1.80, p < 0.00001). By contrast, among female subjects, the risk of EH in the rs671 GG genotype did not differ from that detected in the AA + GG genotype. The proportion of patients with EH was significantly higher for the GG genotype carriers than for the AG+AA genotype carriers, both in the subset of drinkers (OR = 1.51, 95 % CI = 1.23-1.86, p < 0.0001) and in that of nondrinkers (OR = 1.22, 95 % CI = 1.01-1.47, p = 0.03). In addition, among carriers of the GG genotype, the risk of EH among the drinkers was similar to that found in the nondrinkers' subset (OR = 1.12, 95 %CI = 0.89-1.41, p = 0.34). Our meta-analysis demonstrates that the rs671 GG genotype increases the risks of EH, especially in men, and is independent of alcohol consumption.


Cesarean myomectomy and possible risk factors for admission to intensive care unit - a retrospective study.
Cesarean myomectomy (CM) allows to remove fibroids and to restore uterine anatomy during delivery combining two operations in one. It was opposed in the past due to surgical risks, although many reports showed that CM was not associated with increased morbidity The risk for admission to an intensive care unit (ICU) following CM - as an objective indicator of maternal morbidity potentially resulting in greater morbidity for patients, increased length of hospital stay and higher hospital costs - has been poorly evaluated in the literature. The aim of our investigation is to estimate risk factors for ICU admission after CM. The patients were subdivided into two groups: 57 women who were postoperatively admitted to the ICU (study group), and 45 women not treated in the ICU (control group). The p-value of <0.05 was considered as statistically significant. Data showed no statistically significant differences with regard to demographic factors, comorbidity and indications for cesarean section, as well as experience of the surgeon, number of hysterotomies, and incidence of emergency CS between the two groups. The most common reason for admission to the ICU was intraoperative hemorrhage (61.40%). As for the surgical characteristics, the study group showed significant increase in the rates of intraoperative transfusion (p=0.000) and intraoperative hemorrhage (p=0.000), as well as prolongation of surgical time (p=0.002). Myoma type and size were also significantly different between the groups (p=0.003 and p=0.000, respectively). The most important factor contributing to ICU admission after CM is intraoperative hemorrhage in case of bigger myomas and prolonged surgeries.


Feasibility of laparoscopic adrenalectomy for metastatic adrenal tumors in selected patients: a retrospective multicenter study of Japanese populations.
Because of the small numbers of cases in single centers, the indications for and survival benefits of adrenalectomy for adrenal metastasis remain unclear. We evaluated the outcomes of laparoscopic adrenalectomy for patients with adrenal metastasis. We retrospectively analyzed the records of 67 patients who underwent laparoscopic adrenalectomy for metastatic disease from 2003 to 2017 at 11 hospitals. Associations of clinical, surgical, and pathologic features with overall survival (OS) and positive surgical margins were evaluated using univariate and multivariate Cox regression analyses and univariate logistic regression analysis. Lung cancer (30%) and renal cell carcinoma (30%) were the most common primary tumor types. Intraoperative complications were observed in seven patients (10%) and postoperative complications in seven (10%). The surgical margin was positive in 10 patients (15%). The median OS was 3.8 years. Univariate analysis showed that the tumor size, episodes of extra-adrenal metastasis before adrenalectomy, extra-adrenal metastasis at the time of adrenalectomy, and positive surgical margins were significantly associated with shorter OS (p = 0.022, p = 0.005, p < 0.001, and p = 0.022, respectively). Multivariate analysis showed that extra-adrenal metastasis at the time of adrenalectomy and positive surgical margins remained statistically significant (p = 0.022 and p = 0.049, respectively). In the univariate analysis, the tumor size was significantly associated with positive surgical margins (p = 0.039). Laparoscopic adrenalectomy for adrenal metastasis can be safely performed in selected patients, and patients with isolated adrenal metastasis and negative surgical margins seem to have more favorable outcomes.


Technical note. Optimal computed tomography technique for bone evaluation.
Various combinations of window settings and displays were evaluated to determine the optimal photographic reproduction of images obtained from the Ohio-Nuclear Delta scanner to best demonstrate bony structure by computed tomography. A combination of wide window and negative images will produce better bony structure detail than various other settings. The physical basis of this technique will be described along with several cases to illustrate the conclusion. Although no one combination was universally adequate, the best in our experience was a wide window with negative images.


Prediction of metabolism by cytochrome P450 2C9: alignment and docking studies of a validated database of substrates.
A validated database of 70 molecules known to undergo biotransformation by CYP2C9 was collated. The molecular alignment program ROCS was used with the query molecule flurbiprofen as a basis for predicting the correct active site orientation of the CYP2C9 database molecules. The quality of the results obtained was excellent, with 39 of the first 44 molecules (89%) sorted by ROCS combination score having alignments that accounted for the experimentally observed site of oxidation. Transposition of the first 39 correctly aligned molecules into the CYP2C9 active site yielded an average site of metabolism to iron heme distance of 5.21 A, in good agreement with previous experimental observations. Molecular docking studies were also undertaken, but the results were less successful than the ROCS-based alignment method, indicating that ligand-based approaches with chemical typing are important in the prediction of metabolism by CYP2C9.


Influence of Metarhizium anisopliae (IMI330189) and Mad1 protein on enzymatic activities and Toll-related genes of migratory locust.
Efficacy of Metarhizium anisopliae strain (IMI330189) and Mad1 protein alone or in combination by feeding method to overcome immune-related enzymes and Toll-like pathway genes was investigated in migratory locust. M. anisopliae (IMI330189) is a potent and entomopathogenic fungal strain could be effectively used against insect pests. Similarly, Mad1 protein adheres to insect cuticle, causing virulence to insects. We confirmed maximum 55% of mortality when M. anisopliae (IMI330189) and Mad1 was applied in combination. Similarly, increased PO activity was observed in locust with combined dose of Mad1 + IMI330189 whereas PO, POD, and SOD activities reduced using Mad1 independently. Four Toll-like signaling pathway genes (MyD88, Cactus, Pelle, and CaN) were investigated from midgut and body of the migratory locust after 72 h of treatments. Subsequently, the expression of MyD88 in the midgut and body significantly decreased with the application of Mad1 and Mad1 + IMI330189. Performance of these treatments was absolutely non-consistent in both parts of insects. Meanwhile, IMI330189 significantly raised the expression of Cactus in both midgut and body. However, the combined treatment (Mad1 + IMI330189) significantly reduced the Cactus expression in both body parts. Pelle expression was significantly increased in the midgut with the application of independent treatment of Mad1 and IMI330189 whereas the combined treatment (Mad1 + IMI330189) suppressed the Pelle expression in midgut. Its expression level was absolutely higher in body with the application of IMI330189 and Mad1 + IMI330189 only. On the other hand, Mad1 significantly increased the expression of CaN in midgut. However, all three treatments significantly affected and suppressed the expression of CaN gene in body of locust. This shows that the applications of M. anisopliae and Mad1 protein significantly affected Toll signaling pathway genes, which ultimately increased level of susceptibility of locust. However, their effect was significantly different in both parts of locust which recommends that the Toll-related genes are conserved in midgut instead of locust body.


A limited plasma cell flow cytometry panel with reflex CD138 immunohistochemistry is an optimal workflow process for evaluating plasma cell neoplasms in bone marrow specimens.
To determine the optimal workflow combination of flow cytometry (FC) and immunohistochemistry tests for efficient and cost-effective evaluation of plasma cell (PC) neoplasms (PCNs) in bone marrow (BM) specimens. Various workflow combinations of immunohistochemistry and FC for 4,031 BM specimens worked up for PCNs were compared. Turnaround time (TAT), immunohistochemistry usage, technical charges, and addendum/amendment rates were compared between periods to determine the optimal workflow combination. Five distinct workflow periods were identified, with varying combinations of full or limited FC panels for assessing PC clonality and CD138/κ/λ immunohistochemistry for PC quantification. Replacement of full FC with limited FC was associated with significant reductions in TAT and number of immunostains performed per case. Elimination of immunohistochemistry on cases determined to be polyclonal by FC also resulted in significant reductions in immunohistochemistry usage and significant cost savings. Assessment of PC clonality using a limited FC panel followed by reflex CD138 immunohistochemistry on cases that are monoclonal by FC provides an optimal and cost-effective workflow for evaluating PCNs in BM samples.


Physiological responses of king penguins during simulated diving to 136 m depth
To evaluate blood N(2) uptake and the role of the respiratory volume (air sacs/lungs) as a N(2) and O(2) reservoir in deep-diving penguins, diving respiratory volume (Vdr), heart rate (fh), venous P(N)(sum), blood volume (V(b)) and hemoglobin (Hb) concentration were measured in king penguins (Aptenodytes patagonicus) during forced submersions and compressions equivalent to depths up to 136 m. Vdr was 69+/-18 ml kg(-)(1) (mean +/- s.d.) in 62 submersions ranging from 4.4 atmospheres absolute (ATA; 1 ATA=101 kPa) (34 m) to 14.6 ATA (136 m). Submersion fh averaged 30+/-7 beats min(-)(1) (N=18), approximately 20 % of pre- and post-submersion values. Venous P(N)(sum) values during and after submersions as deep as 11.2 ATA (102 m) were all less than 2.8 atmospheres N(2) (283 kPa) above ambient pressure, a previously measured threshold for symptomatic bubble formation. Mean V(b) was 83+/-8 ml kg(-)(1) (N=6); [Hb] was 17.6+/-0.7 g dl(-)(1) (N=7). On a mass-specific basis, mean Vdr, and therefore total available N(2), is 41 % of that in shallow-diving penguin species. Total body O(2) stores, calculated from measured Vdr, V(b), [Hb], muscle mass and myoglobin concentration, are 45 ml kg(-)(1), with 23 % in the respiratory system. This small respiratory fraction in comparison with that in shallow-diving penguins suggests a lesser reliance on the respiratory oxygen store for extended breath-holding and also a reduced uptake of nitrogen at depth.


Production and localization of hydrogen peroxide and nitric oxide in grapevine cells elicited with cyclodextrins and methyl jasmonate.
The use of methyl jasmonate, alone or in combination with cyclic oligosaccharides such as cyclodextrins, has proved to be a successful strategy for increasing the production of trans-resveratrol in Vitis vinifera cell cultures. However, understanding the intracellular signalling pathways involved in its production would improve the management of grapevine cells as biofactories of this high-value natural product. The results obtained herein confirm the involvement of hydrogen peroxide and nitric oxide in cyclodextrins and methyl jasmonate-induced trans-resveratrol production in grapevine cell cultures. In fact, methyl jasmonate led to maximal intracellular levels of hydrogen peroxide and nitric oxide after 24 h of treatment, but extracellular hydrogen peroxide was only detected in the culture medium when grapevine cells were treated with cyclodextrins. The results derived from the cytochemical detection of H2O2 in elicited grapevine cell cultures also suggested that the combined treatment with cyclodextrins and methyl jasmonate not only increased the production of H2O2 but also released cell wall fragments with electron-dense deposits. Moreover, nitric oxide was localized in all the cellular compartments, particularly in the nucleus and cytoplasmic organelles, whereas hydrogen peroxide was mainly found in cytoplasmic areas close to the cell wall, and in the nucleoplasm.


Neonatology and emerging trends in health insurance.
As the cost of healthcare rises, the employers who finance health insurance benefits plans are demanding increased accountability and effectiveness in the management of costly care, such as that delivered in the neonatal intensive care unit. Neonatologists are under increased scrutiny by third-party payors. They should also expect to see closer case management, downgraded reimbursement according to standardized tools for assessing level of care, and closer evaluation of reimbursement for novel and expensive drugs and technologies. Neonatologists need to become more knowledgeable about how the current crisis in cost for employer-funded health plans may affect their practice.


[Periodic EEG discharges of stereotyped morphology].
Clinical course of disease and results of EEG examinations of 6 patients with severe brain disturbances of various aetiology provided grounds for discussion on the phenomenon of periodic stereotyped EEG discharges (PSD) which is of considerable diagnostic value in some cases. The variability in appearance of these discharges, in their form and duration of intervals between them are stressed--the last parameter varied in own material from 0.5 to 8 sec. The appearance of PSD may indicate increased convulsive excitability of the cortical and subcortical structures of the gray matter. The prognostic value of PSD was not always the same and it could be established only basing upon a comparison of EEG findings during successive examinations.


Lessons learned from the failure of several recent trials with biologic treatment in systemic lupus erythematosus.
Treatment of systemic lupus erythematosus (SLE) represents a challenge due to variable disease manifestations, clinical course, and outcome. Long-term outcome in SLE remain unsatisfactory and a search for new therapeutic options is definitely warranted. Despite expectations, most clinical trials performed in SLE and lupus nephritis in the last decade did not reach primary outcome, and the only drug that has been licensed is belimumab. Results of negative trials testing monoclonal antibodies and other biologic agents in SLE are briefly summarized. Reasons for the failure of the trials are listed and discussed. Future studies should recruit patients with similar organ involvement, better defined disease manifestations, higher activity, and similar severity. In addition to testing higher efficacy if given as add-on treatment to standard-of-care, the trials should be aimed at reducing dosing, or completely eliminating some parts of the current standard treatment, especially corticosteroids. Median follow-up of the patients should be longer. Moreover, specific biomarkers are needed to help to identify eligible patients and to better define response to treatment. An urgent unmet need is testing these new drugs in patients with severe SLE (including those refractory to current treatment).


[Update of diabetic retinopathy for Primary Care physicians: Towards an improvement of telematic medicine].
Diabetic retinopathy (DR) is considered the most common cause of blindness in the working-age population in industrialised countries, with diabetic macular oedema being the most common reason of decreased visual acuity in diabetics. According to the results of large multicentre studies, blindness prevention for RD involves conducting periodic check-ups, which include examinations of the back of the eye, so they can be treated in time. The use of non-mydriatic cameras and telemedicine have been shown to be useful in this regard (sensitivity>80% and specificity>90%). If this procedure is followed, the first retinography should be performed 5 years from diagnosis in type 1 diabetics and immediately after diagnosis in type 2 diabetics. Therefore the role of the Primary Care physician is crucial to enable early diagnosis of this disease.


On the influence of baseline startle reactivity on the indexation of prepulse inhibition.
Prepulse inhibition (PPI) of the startle reflex refers to the reduction of the reflexive startle response to an intense pulse stimulus when its presentation is shortly preceded by a weak prepulse stimulus. PPI is considered as a cross-species translational model of sensorimotor gating, and deficient PPI has been reported in a number of neuropsychiatric disorders. Although a part of the literature is based on the assumption that PPI is independent of the baseline startle reaction, there is accumulating evidence (Csomor et al., 2006; Sandner & Canal, 2007; Yee, Chang, Pietropaolo, & Feldon, 2005) that argues against such an independency. The authors systematically investigated whether PPI indexed as percentage or difference score is dependent on the magnitude of baseline startle reactivity in healthy human volunteers and in C57BL/6 mice. The results revealed that both indexations of PPI were affected by the magnitude of the baseline startle. The authors highlight the pitfalls of different methods to index PPI, especially when startle reactivity differs considerably between groups under comparison, and offer practical recommendations to satisfactorily deal with such baseline differences.


Quality of life of low-vision patients and outcomes of low-vision rehabilitation.
The impact of low vision on self-reported quality of life and changes after low-vision intervention are investigated. Literature reports from 1990 to 2000 are reviewed. Low vision is associated with increased risk for depression and decreased functional status and quality of life. Decreased visual acuity, visual field loss, and occasional blurred vision are also associated with decreased quality of life. Improvements in both functional status and quality of life occur after low-vision service delivery. Self-reported quality of life is a significant outcome measure for low-vision rehabilitation. Questionnaires that are more sensitive to rehabilitation services provided as well as patient needs and goals are required to facilitate development of rehabilitation plans and to compare techniques, devices, and programs. Attention should be given to measurement properties, validity, and reliability of instruments used currently and in development of new instruments.


Amino-terminal heterogeneity of E. coli TEM-beta-lactamase secreted from Bacillus subtilis.
E. coli TEM-beta-lactamase, secreted from Bacillus subtilis after transformation with three different hybrid plasmids, was purified and subjected to direct amino-terminal sequence analysis. The results show that the signal sequence cleavage site varies depending on the hybrid plasmid construction and cannot be exactly predicted from the DNA sequences. The results are of general interest if recombinant DNA technology is used to synthesize, e.g. pharmaceutical products where the preservation of the authentic amino-terminal structure is highly desirable.


In vitro evaluation of biomarkers of nephrotoxicity through gene expression using gentamicin.
Acute renal failure is one of the most frequent effects observed after taking medicine. Such situations have been tardily discovered, given that existing methods for assessing toxicity are not predictive. In this light, the present work evaluated the effects of gentamicin, a form of nephrotoxic drug, on HK-2 and HEK-293 cells. By using MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) and flow cytometry, both cells demonstrated that cytotoxicity occurs in a dose-dependent manner through the processes of apoptosis and cell necrosis. Gene expression analysis showed a relative increase of expression for genes related to cell processes and classic biomarkers, such as TP53, CASP3, CASP8, CASP9, ICAM-1, EXOC3, KIM-1, and CST3. A decrease in expression for genes BCL2L1 and EGF was observed. This study, therefore, indicates that, when the methods are used together, gene expression analysis is able to evaluate the nephrotoxic potential of a substance.


MRI blood-brain barrier permeability measurements to predict hemorrhagic transformation in a rat model of ischemic stroke.
Permeability imaging might add valuable information in the risk assessment of hemorrhagic transformation. This study evaluates the predictive value of blood-brain barrier permeability (BBBP) measurements extracted from dynamic contrast-enhanced MRI for hemorrhagic transformation in ischemic stroke. Spontaneously hypertensive and Wistar rats with 2 h filament occlusion of the right MCA underwent MRI during occlusion, at 4 and 24 h post reperfusion. BBBP was imaged by DCE imaging and quantified by Patlak analysis. Cresyl-violet staining was used to characterize hemorrhage in sacrificed rats at 24 h, immediately following the last imaging study. BBBP changes were evaluated at baseline, 4 and 24 h after reperfusion. Receiver-operating characteristic (ROC) analysis was performed to determine the most accurate BBBP threshold to predict hemorrhagic transformation. In animals showing macroscopic hemorrhage at 24 h, 95th BBBP percentile values ipsilateral were 0.323 [0.260, 0.387], 0.685 [0.385, 0.985], and 0.412 [0.210, 0.613] ml/min·100 g (marginal mean [95%CI]) during occlusion, at 4 and 24 h post reperfusion, respectively. The BBBP values on the infarcted and contralateral side were significantly different at 4 (p = 0.034) and 24 h post reperfusion (p = 0.031). The predictive value of BBBP in terms of macroscopic hemorrhage was highest 4 h after reperfusion (ROC area under the curve = 84 %) with a high negative predictive value (98.3 %) and limited positive predictive value (14.9 %) for a threshold of 0.35 ml/min·100g. Altered BBBP is a necessary but not sufficient condition to cause hemorrhagic transformation in rats with an infarct. Further research is needed to identify those additional risk factors that are required for hemorrhagic transformation to develop in the setting of ischemic stroke.


Aluminum chloride induced splenic lymphocytes apoptosis through NF-κB inhibition.
This research investigated the relationship between lymphocytes apoptosis, hypothalamic-pituitary-adrenal (HPA) axis and NF-κB in AlCl3-treated rats. Eighty Wistar rats were orally exposed to 0 (control group, CG), 0.4 mg/mL (low-dose group, LG), 0.8 mg/mL (mid-dose group, MG) and 1.6 mg/mL (high-dose group, HG) AlCl3 for 90 days, respectively. A variety of measurements were taken including lymphocyte apoptosis index, serum corticotropin-releasing hormone (CRH), adrenocorticotrophic hormone (ACTH) and glucocorticoids (GCs) contents, GC receptors (GCR) and NF-κB mRNA and nuclear protein expressions, caspase 3 and 9 mRNA expressions and activities. The results showed that in the AlCl3-treated rats serum CRH, ACTH and GCs contents, lymphocyte GC receptors (GCR) mRNA and nuclear protein expressions, caspase 3 and 9 mRNA expressions and activities increased, while Bcl-2/Bax ratio and NF-κB mRNA and nuclear protein expressions decreased compared with the CG. Furthermore GCR and NF-κB nuclear protein expressions were negatively correlated. And NF-κB mRNA expression was positively correlated with that of Bcl-2, but negatively correlated with that of Bax in AlCl3-treated rats. These findings indicated that AlCl3 activated HPA axis, then induced splenic lymphocytes apoptosis through NF-κB inhibition.


Thermodynamics-structure relationship of single mismatches in RNA/DNA duplexes.
Thermodynamics of 66 RNA/DNA duplexes containing single mismatches were measured by UV melting methods. Stability enhancements for rG. dT mismatches were the largest of all mismatches examined here, while rU.dG mismatches were not as stable. The methyl group on C5 of thymine enhanced the stability by 0.12 approximately 0.53 kcal mol(-)(1) depending on the identity of adjacent Watson-Crick base pairs, whereas the 2'-hydroxyl group in ribouridine stabilized the duplex by approximately 0.6 kcal mol(-)(1) regardless of the adjacent base pairs. Stabilities induced by the methyl group in thymine, the 2'-hydroxyl group of ribouridine, and an nucleotide exchange at rG.dT and rU.dG mismatches were found to be independent of each other. The order for the mismatch stabilities is rG.dT >> rU. dG approximately rG.dG > rA.dG approximately rG.dA approximately rA. dC > rA.dA approximately rU.dT approximately rU.dC > rC.dA approximately rC.dT, although the identity of the adjacent base pairs slightly altered the order. The pH dependence stability and structural changes were suggested for the rA.dG but not for rG.dA mismatches. Comparisons of trinucleotide stabilities for G.T and G.U pairs in RNA, DNA, and RNA/DNA duplexes indicate that stable RNA/DNA mismatches exhibit a stability similar to RNA mismatches while unstable RNA/DNA mismatches show a stability similar to that of DNA mismatches. These results would be useful for the design of antisense oligonucleotides.


Quantitative analysis of the difference between an intact complete discoid lateral meniscus and a torn complete discoid meniscus on MR imaging: a feasibility study for a new classification.
To determine the quantitative difference between an intact complete discoid lateral meniscus (CDLM) and a torn CDLM on MR imaging. Between May 2005 to November 2009, 137 patients with a CDLM (107 intact CDLM and 30 torn CDLM) and 92 patients with a normal meniscus were included in this study. The evaluated parameters were the height of the posterior horn of the lateral and medial menisci on the sagittal images and their ratio as assessed by two observers twice at an interval of 1 month. Each parameter was analyzed based on the Kruskal Wallis test, and the analysis using the mixed model. Intraclass correlation coefficient (ICC) was used to determine the interobserver reliabilities at session 2. The mean heights of the posterior horn of the lateral and medial menisci on the sagittal images for an intact CDLM, a torn CLDM, and a normal meniscus were 6.5, 7.3, 5.7 and 6.6, 6.4, 6.7 mm at session 1, respectively. The mean heights of the posterior horn of the lateral and medial menisci on the sagittal images for an intact CDLM, a torn CDLM, and a normal meniscus for both observers were 6.5, 7.2, 5.7 and 6.6, 6.3, 6.8 mm at session 2, respectively. The ratio of the height of the lateral to the height of the medial meniscus for an intact CDLM at both sessions for both observers was 1.0. The ratios were 1.2 and 0.8 for a torn CDLM and for a normal meniscus, respectively, at both sessions for observer 1. The ratios were 1.2 and 0.9 for a torn CDLM and for a normal meniscus, respectively, at session 2 for observer 2. The heights of the posterior horn of the lateral meniscus on the sagittal images and the ratios of the heights of the lateral to the medial menisci in all three groups were statistically significantly different for both sessions (p < 0.0001). The interobserver ICCs for each parameter of both an intact CDLM and a torn CDLM at session 2 showed high correlations (p < 0.0001). The height of the lateral meniscus and the ratio of the height of the lateral to the height of the medial meniscus for a torn CDLM were significantly higher than those for an intact CDLM.


Clozapine treatment in patients with prior substance abuse.
This study examined outcomes following discharge on clozapine for treatment-resistant schizophrenia patients with and without diagnosed substance abuse histories. Those discharged on clozapine from a research unit between April 1991 and March 1996 were followed with respect to hospitalization status. Of the treatment-resistant patients with schizophrenia, 19 were diagnosed as individuals with substance abuse, while 26 patients had no history of abuse. Patients were openly treated with clozapine and were included in the study if they were stabilized and discharged on the medication. Patients who had histories of abuse exhibited a better treatment response and a lower total Brief Psychiatric Rating Scale (BPRS) score at discharge, compared with the non-substance abuse group. One-year readmission rates were 21% and 23% in patients with and without prior substance abuse histories, respectively (P = ns). Clozapine may be a therapeutic option for the dually diagnosed population and may offer benefits to patients with schizophrenia who have a history of substance abuse.


Hartford Hospital surgeons share publicity with robot 'assistants.'.
Hartford Hospital, Hartford, Conn. finds some patients gravitate to Boston or New York City for high-tech procedures. Being the first Connecticut hospital with the daVinci Robotic Surgery System, it developed an advertising campaign emphasizing high-tech surgery with the human touch. Hartford also broadcast a robotic prostatectomy on its popular live webcast series.


Pharmacotherapy of Parkinson's disease.
The pathophysiology, anticholinergic therapy and dopaminergic therapy of Parkinson's disease are reviewed; an emphasis is placed on the structure and function of the basal ganglia because of their importance in understanding the pharmacotherapy of parkinsonism. The pharmacologic management of Parkinson's disease is limited primarily to manipulation of the dopamine-acetylcholine system. Levodopa, with or without a peripheral dopa decarboxylase inhibitor, is the current drug of choice in the management of idiopathic and postencephalitic Parkinson's disease. Modification of the serotonin-histamine system via the use of antihistamines may be useful in some patients. There are also many adjunctive agents which may be employed in combination with or in place of levodopa. Levodopa clearly has no place in the treatment of neuroleptic-induced Parkinson's disease; anticholinergics and antihistamines are the agents of choice.


Heart transplantation for congenital heart disease.
Congenital heart disease affects 0.8% of all live-born infants. Some of the malformed hearts can at best be palliated by conventional surgical or catheter interventions from the start. Others fail slowly from chronic overloading. Patients with congenital heart disease have been among the first transplant recipients since 1967. Primary therapy with infant heart transplant is a convincing concept from an immunological perspective but large-scale implementation is limited by donor organ shortages. Another growing area is rescue therapy for older patients with end-stage heart failure after palliative procedures, particularly those with single-ventricle hearts, systemic right ventricles, and associated arrhythmias.


Transient expression of tenascin in experimentally induced cholestatic fibrosis in rat liver: an immunohistochemical study.
This study describes the sequential changes in tenascin expression in hepatic fibrosis induced by bile duct ligation (BDL) in the rat. Two days after BDL, tenascin was strongly expressed in the matrix surrounding interlobular bile ducts and also between proliferating ductules. From day 7 onwards, its distribution was restricted to the connective tissue-parenchymal interfaces where ductular proliferation was still active. A markedly increased number of desmin- and alpha-smooth muscle actin (alpha-smA)-positive cells, considered myofibroblasts, was noted around interlobular bile ducts and between proliferating ductules during periductal fibrogenesis. Type IV collagen and laminin were strongly expressed on the basement membranes of proliferating ductules, and contributed to the development of newly formed fibrous septa. The transient expression of tenascin around interlobular bile ducts in the early phase of BDL may be related to the onset of periductal fibrosis or to the mitogenic response of the biliary epithelium. The expression of tenascin between 'proliferating' ductules in contrast to its absence from 'mature' fibrous areas suggests a transient role in early matrix organization. Furthermore, alpha-smA-positive cells may modulate the synthesis of extracellular matrix components.


Gestational Weight Gain and Maternal and Neonatal Outcomes in Underweight Pregnant Women: A Population-Based Historical Cohort Study.
Objective Limited data are available that estimate the effect of gestational weight gain on maternal and neonatal outcomes in underweight women according to revised 2009 Institute of Medicine (IOM) guidelines. Methods A population-based historical cohort study of 21,674 underweight women in Missouri delivering liveborn, singleton, term infants in 2002-2008 was conducted. Adjusted odds ratios were calculated for gestational weight gain categories with multiple logistic regression, using the 2009 IOM recommended 28-40 pounds as the reference group. Results Women gaining >40 pounds compared to women gaining 28-40 pounds had significantly higher odds for preeclampsia (aOR 1.94, 95% CI 1.56-2.42, p < 0.001), cesarean delivery (aOR 1.40, 95% CI 1.28-1.53, p < 0.001), large-for-gestational-age (LGA) infant (aOR 2.32, 95% CI 2.00-2.70, p < 0.001), and 1 min APGAR score <4 (aOR 1.36, 95% CI 1.01-1.83, p < 0.05) and significantly lower odds for small-for-gestational-age (SGA) infant (aOR 0.53, 95% CI 0.48-0.59, p < 0.001). Women gaining <28 pounds compared to women gaining 28-40 pounds had significantly higher odds for SGA infant (aOR 1.85, 95% CI 1.69-2.03, p < 0.001) and significantly lower odds for preeclampsia (aOR 0.72, 95% CI 0.53-0.96, p < 0.05) and LGA infant (aOR 0.50, 95% CI 0.39-0.63, p < 0.001). Conclusion Women gaining more than the IOM recommendation were at higher risk for many adverse outcomes, but at lower risk for SGA infants. Women gaining less than the IOM recommendation were at higher risk for SGA infants but were protective for preeclampsia and LGA infants. Prospective studies of other short- and long-term maternal/infant outcomes are needed to evaluate the efficacy of the IOM guideline.


Improved efficacy of warm-white light-emitting diode luminaires.
We present a novel approach to address one of the technical hurdles the current light-emitting diode (LED) lighting field faces: the packaged efficacy of warm-white LEDs is 20%-30% lower than that of cool-white LEDs depending on the color rendering index. With a differentiated luminaire design in combination with a new class of nano materials, we have greatly improved the efficacy of warm white by 15% at the luminaire system level, which translates to less energy being required to achieve the same light output, and thus offers a more energy-efficient solution. Reliability test of the luminaire shows no performance degradation within the tested period of more than 3000 h. A modeling has been developed to predict the optical performance of luminaires incorporating the nano materials, which agrees well with the experimental data and serves as a powerful tool for designing luminaires with targeted performance.


Genetic linkage of the Marfan syndrome, ectopia lentis, and congenital contractural arachnodactyly to the fibrillin genes on chromosomes 15 and 5. The International Marfan Syndrome Collaborative Study.
The large glycoprotein fibrillin is a structural component of elastin-containing microfibrils found in many tissues. The Marfan syndrome has been linked to the fibrillin gene on chromosome 15, but congenital contractural arachnodactyly, which shares some of the physical features of the syndrome, has been linked to the fibrillin gene on chromosome 5. Using specific markers for the fibrillin genes, we performed genetic linkage analysis in 28 families with the Marfan syndrome and 8 families with four phenotypically related disorders--congenital contractural arachnodactyly (3 families), ectopia lentis (2), mitral-valve prolapse syndrome (2), and annuloaortic ectasia (1). Genetic linkage was established between the Marfan syndrome and only the fibrillin gene on chromosome 15, with a maximum lod score of 25.6 (odds for linkage, 10(25.6):1). Ectopia lentis was also linked to the fibrillin gene on chromosome 15, whereas congenital contractural arachnodactyly was linked to the fibrillin gene on chromosome 5. There was no linkage of mitral-valve prolapse to the fibrillin gene on chromosome 5; studies of chromosome 15 were not informative. Annuloaortic ectasia was not linked to either fibrillin gene. The Marfan syndrome appears to be caused by mutations in a single fibrillin gene on chromosome 15. Diagnosis of the Marfan syndrome by genetic linkage and analysis is now feasible in many families.


Hyperfine coupling constants of β-phosphorylated nitroxides: a tool to probe the cybotactic effect by electron paramagnetic resonance.
Nitrogen hyperfine coupling constants (hcc) a(N) of nitroxides measured by electron paramagnetic resonance are used to probe the cybotactic effect of solvents. A few articles (Janzen et al., Can. J. Chem. in 1982 for a(Hβ) and Deng et al., J. Fluorine Chem. in 2002, both for a(Hβ) and a(Fβ)) dealt with the cybotactic effect on the hcc of atoms (hydrogen H, fluorine F, and phosphorus P) in β positions of nitroxides. They show either no significant change or an increase in a(β) with a(N) . However, an early report by Il'Yasov et al. (Theor. Exp. Chem. 1976, 656) described a dramatic change in a(Pβ) with the solvent and an anti-correlation of a(Pβ) with a(N) . We decided to reinvestigate that work using the N-(2-methylpropyl)-N-(1-diethylphosphono-2,2-dimethylpropyl)-N-oxyl radical that carries both hydrogen and phosphorus atoms on the same carbon attached to the nitroxy moiety and that is highly persistent, in contrast to the nitroxide used by Il'Yasov. We observe the same trends as those observed by Il'Yasov, except that the solvent cybotactic effect on a(N) and a(Pβ) is dramatically weaker in our case. We showed that a(Pβ) is correlated to both the cohesive pressure c and the normalized Reichardt polar constant E(T)(N), and that hydrogen-bonding donor solvents exhibit a specific behavior.


Epidermal growth factor and sex steroids dynamically regulate a marker of endometrial receptivity in Ishikawa cells.
The factors regulating human endometrial receptivity remain poorly understood. The alpha v beta 3 integrin cell adhesion molecule appears to be regulated in the human endometrium, appearing on postovulatory days 5-6, corresponding to the time of initial embryo attachment. This integrin has been extensively studied as a potential marker of endometrial receptivity and is aberrantly expressed in the endometrial epithelium of some infertile women. Ishikawa cells are a well differentiated endometrial adenocarcinoma cell line that maintain functional estrogen and progesterone receptors and are a useful model to study steroid-mediated events in human endometrial epithelium. This cell line expresses most of the normal endometrial epithelial integrins, including the alpha v beta 3 vitronectin receptor. The regulation of this integrin was studied with fluorescence immunocytochemistry, flow cytometry, and Northern blot analysis. Estrogen with or without progesterone treatment down-regulates alpha v beta 3 in this cell line. Several growth factors, including epidermal growth factor and the closely related transforming growth factor-alpha significantly increase the expression of this integrin. We conclude that endometrial differentiation is influenced by both steroid hormones and growth factors. The alpha v beta 3 integrin appears to be an excellent marker to study the molecular events leading to the establishment of uterine receptivity and successful implantation.


The effect of bleaching agents on the color stability of ceromer and porcelain restorative materials in vitro.
The aim of this in vitro study was to determine the color changes of five different restorative materials after exposing these materials to two different home bleaching agents. This study applied bleaching agents to an ultralow-fusing porcelain, a low-fusing porcelain, two types of heat-pressed glass ceramics, and a ceromer. A total of 24 disc-shaped specimens were fabricated (with a diameter of 10 mm and a thickness of 2 mm) from each material (n=12). The initial color measurements were taken with a spectrophotometer. The first set of specimens were bleached with 10% hydrogen peroxide (HP) for one hour daily for 10 days. The other set of specimens were bleached with 10% carbamide peroxide (CP) bleaching gel for eight hours daily for 14 days. Data were analyzed with the one-way analysis of variance and Kruskal-Wallis statistical test. The difference in the prebleaching and postbleaching color of each material was considered to be statistically significant at p < 0.05. The study found a statistically significant difference among the color changes of the test groups after exposing them to both bleaching agents (p<0.05). Appreciable color change was observed in the Estenia (ΔE=3.99) specimens that were bleached with the HP, and noticeable color changes were observed in the Estenia (ΔE=1.89) and IPS Empress 2 (ΔE=1.66) groups when they were treated with the CP. Restorations (especially polymer-containing restorative materials) should be protected before any bleaching procedure due to the high risk of color change.


[A new general orthopedic universal intramedullary nail for the tibia. Clinical development and experiences].
The new AO-Universal-Nail was developed through intensive cooperation between fundamental research, technicians and clinical application. We are now able to transfer the concept of a Universal-Nail (initially for the femur) to the tibia as well. The existing technique of the medullary nail was maintained as far as possible. Special features to be highlighted: The new AO-bend obtains better impact behavior and a more anatomical stabilization of the bone cavity. The tapered tip eases the gliding of the tip of the nail along the inner wall of the dorsal corticalis and past the fracture. Proximal locking is obtained through three transverse extending holes. They offer many choices for optimal placement of the locking bolts. Interlocking from anterior to posterior has been logically abandoned, due to danger for nerves and vessels. Distal looking offers a large selection for stabilization through one a.p.-hole and two transverse holes for the locking bolts. The design from anterior to posterior entables the protection of the soft tissue. The Universal-nail can either be inserted with or without interlocking. A free decision is possible during the operation. The new AO-Universal-Nail for the tibia (as for the femur) maintained reliable aspects and was consequently converted to meet new demands and findings. The basic fundamentals of the AO, namely the observance and application of biomechanical principles and safe operation procedure were attained through simple instrumentation and have been proved successful for clinical application.