Development of the Locking Compression Plate.
The development of the Locking Compression Plate (LCP) reflects the multilateral collaboration of clinicians, researchers, developers and industry. In retrospect, combining two completely different anchorage technologies into one implant is logical and the practical solution is simple. The clinical instructions for the new implant, which severely limited the constructive scope, proved to be critical for the project. Unlike an independent new development, compatibility with existing surgical techniques, instruments and implants had to be maintained. Industrial implementation of the LCP is only possible with the use of state-of-the-art production centres with up to five computer-controlled axes. The unlimited possibility of using the LCP as a compression plate, an internal fixator or in a specific combination allows ideal plate anchorage that is adapted to the bone. Combined with minimally invasive implant technology (MIPO), the indication spectrum of plate osteosynthesis can be expanded in a meaningful manner.


[Therapeutic bronchoscopic treatment of postintubation tracheal stenosis: 5 cases].
Benign airway obstruction is known as curable by therapeutic bronchoscopic methods. Compared by surgical therapies it is comfortable and has no risks for the patients. For five patients who applied our clinic after tracheostomy and endotracheal intubation stenosis we used therapeutic bronchoscopic methods; "laser-stenotic silicon stent". In two patients after vaporization of membranous stricture by Neodimum Yttrium Aliminum Pevroskite Laser (Nd-YAP laser) who were seen posttracheostomy and postentubation; stenotic stent was implanted mechanically and/or by means of baloon dilatation. Membranous stricture area was coagulated by Nd-YAP-laser in other three cases and anatomic airway diameter was achieved mechanically and by baloon dilatation. In the follow up period we applied stenotic silicon stent implantation after second laser resection in whom restenosis observed. In conclusion; patients who had stenotic silicon stent implantation and having no problems in the follow up this therapeutic method is found to be curative.


Intraperitoneal chemo-hyperthermia with mitomycin C for gastric cancer patients with peritoneal carcinomatosis.
This study evaluates the tolerance and efficacy of Intraperitoneal Chemo-hyperthermia (IPCH) with Mitomycin C (MMC) associated with surgery, in peritoneal carcinomatosis of gastric origin. Most patients with peritoneal carcinomatosis of gastric origin die within 6 months, and IPCH associated with surgery has been reported as a possible new therapeutic approach. A prospective non randomized trial was carried out on 42 patients with gastric cancers and peritoneal carcinomatosis. Fourty-three IPCH with MMC were used as complementary treatment after surgery (peritoneal perfusate with a 10 mg/l dose of MMC, inflow temperature 46 to 49 degrees C, use of a closed circuit, duration 90 minutes). Fourteen primary tumors were unresectable ones and 12 patients had large malignant preoperative ascites. Mortality and morbidity rates were 2/42 and 4/42 respectively. For resectable gastric cancers with stage 1 and 2 carcinomatosis (malignant granulations less than 5 mm in diameter), one, two and three year survival rates were 80, 61 and 41% respectively. For unresectable primary tumors and for stage 3 and 4 carcinomatosis (granulations larger than 5 mm in diameter), six and twelve month survival rates were 50% and 10% respectively. IPCH appears as a safe new therapeutic approach in gastric cancers with peritoneal carcinomatosis with small malignant granulations (stage 1 and 2) and randomized trials are now needed to clearly evaluate its efficacy.


Fundamental and harmonic emission from the rear side of a thin overdense foil irradiated by an intense ultrashort laser pulse.
The emission of fundamental and harmonic radiation from the rear side of thin foils in the thickness range 50-460 nm irradiated by intense frequency doubled Ti:sapphire laser pulses of the duration of 150 fs and intensities up to a few 10(18) W/cm(2) was investigated. Following up a previous study of the rear side harmonic emission [Teubner, Phys. Rev. Lett. 92, 185001 (2004)], we measured the emission efficiencies, polarization properties, and the spectral shapes of the fundamental frequency and the second harmonic. Rear side emission is only observed when the obliquely incident laser light is p -polarized. Particle-in-cell (PIC) simulations indicate that the foils remain strongly overdense during the interaction with the laser pulse and that the rear side emission is caused by energetic electron bunches which are generated at the front side by resonance absorption. They are accelerated into the foil and drive strong plasma oscillations at the fundamental and higher harmonic frequencies.


Autism in Glasgow: cumulative incidence and the effects of referral age, deprivation and geographical location.
Referrals to the Greater Glasgow Community Autism Team (CAT) made before the child's sixth birthday were analysed to obtain an estimation of the proportion of children in Greater Glasgow with childhood autism and investigate whether there were any variations in diagnosis rates, or in age at referral and diagnosis, depending on deprivation or geographical location. An analysis was made of the database recording referrals to Greater Glasgow CAT, between 2004 and 2007 inclusive, of children referred by age 6 years, comprising 584 cases. Cumulative incidence was calculated for childhood autism. Ages at referral and diagnosis were also analysed. For this subset of children, there were 246 diagnosed cases of childhood autism, a cumulative incidence from 2004 until 2007 of 11.1 per year per 10,000 children aged 0-6 years. Of children with an eventual diagnosis of autism by age 6, 72% were referred by the age of 4 years. Deprivation was found to have an association with referral and diagnostic rates, with higher rates seen in the most deprived. There was geographical variation in the cumulative incidence of autism. Given that the populations were not known to differ in any manner that would lead to a true variation, the geographical variation in the cumulative incidence of autism in children up to 6 years in Greater Glasgow observed in this study is likely to represent differences in the care pathway between areas. Such differences may also explain the observed association with deprivation. Reasons for the variation are being explored.


Arabinogalactan proteins have deep roots in eukaryotes: identification of genes and epitopes in brown algae and their role in Fucus serratus embryo development.
Arabinogalactan proteins (AGPs) are highly glycosylated, hydroxyproline-rich proteins found at the cell surface of plants, where they play key roles in developmental processes. Brown algae are marine, multicellular, photosynthetic eukaryotes. They belong to the phylum Stramenopiles, which is unrelated to land plants and green algae (Chloroplastida). Brown algae share common evolutionary features with other multicellular organisms, including a carbohydrate-rich cell wall. They differ markedly from plants in their cell wall composition, and AGPs have not been reported in brown algae. Here we investigated the presence of chimeric AGP-like core proteins in this lineage. We report that the genome sequence of the brown algal model Ectocarpus siliculosus encodes AGP protein backbone motifs, in a gene context that differs considerably from what is known in land plants. We showed the occurrence of AGP glycan epitopes in a range of brown algal cell wall extracts. We demonstrated that these chimeric AGP-like core proteins are developmentally regulated in embryos of the order Fucales and showed that AGP loss of function seriously impairs the course of early embryogenesis. Our findings shine a new light on the role of AGPs in cell wall sensing and raise questions about the origin and evolution of AGPs in eukaryotes.


Vertical transmission of nucleopolyhedrovirus in insects.
A review of the literature on transmission studies of nucleopolyhedroviruses showed that low levels of viral infection were common among studies of pupae of insects but rarer in adults. Virus could be transmitted from parent to progeny and could be found in caterpillars reared from surface-decontaminated eggs. Persistent low levels of infection were observed in many of the studies considered. These could contribute to the persistence of virus in low-density populations, but the dominant source of virus among generations is probably through environmental contamination.


Mutations in LCA5 are an uncommon cause of Leber congenital amaurosis (LCA) type II.
Leber congenital amaurosis (LCA) is the earliest and most severe form of inherited retinal dystrophy responsible for blindness or severe visual impairment at birth or within the first months of life. Up to date, ten LCA genes have been identified. Three of them account for ca. 43% of families and are responsible for a congenital severe stationary cone-rod dystrophy (Type I, 60% of LCA) while the seven remaining genes account for 32% of patients and are responsible for a progressive yet severe rod-cone dystrophy (Type II, 40% of LCA ). Recently, mutations in LCA5, encoding the ciliary protein lebercilin, were reported to be a rare cause of leber congenital amaurosis. The purpose of this study was to evaluate the involvement of this novel gene and to look for genotype-phenotype correlations. Here we report the identification of three novel LCA5 mutations (3/3 homozygous) in three families confirming the modest implication of this gene in our series (3/179; 1.7%). Besides, we suggest that the phenotype of these patients affected with a particularly severe form of LCA type II may represent a continuum with LCA type I.


[Expert assessment of tinnitus in statutory accident insurance].
Tinnitus is defined as hearing sensation without external noise source. The aetiology contains also occupational causes such as noise industrial pollution and inner ear trauma, nevertheless the origin of tinnitus is vastly unexplained. For the expert assessment in the public insurance a step-by-step procedure is recommended: Is there a tinnitus? Was the accused cause able to provoke tinnitus? How profound is the insured person hindered in his individual work ability by the tinnitus and potential psycho vegetative reactions? In this publication hints for tinnitus-matching and for expert opinion related questions are given: is there a noise-caused tinnitus in the low frequencies? Is it possible that a noise-induced tinnitus worsens after retirement? Can stress be a potential candidate to evoke tinnitus? Under which circumstances a psychiatric assessment can be necessary? In the assessment of tinnitus crucial differences between public accident insurance, civil right, public health and handicap right are explained.


Extended order parameter and conjugate field for the dynamic phase transition in a Ginzburg-Landau mean-field model in an oscillating field.
We present numerical evidence for an extended order parameter and conjugate field for the dynamic phase transition in a Ginzburg-Landau mean-field model driven by an oscillating field. The order parameter, previously taken to be the time-averaged magnetization, comprises the deviations of the Fourier components of the magnetization from their values at the critical period. The conjugate field, previously taken to be the time-averaged magnetic field, comprises the even Fourier components of the field. The scaling exponents β and δ associated with the extended order parameter and conjugate field are shown numerically to be consistent with their values in the equilibrium mean-field model.


Behavioral flexibility impairment with negative feedback in refractory temporal lobe epileptic patients with unilateral amygdala and hippocampal resection.
Patients with amygdala dysfunction generally have behavioral impairment. Temporal lobe surgery might be a model of study of unilateral amygdala resection. The objective of this study was to evaluate behavioral flexibility in epileptic patients who undergo amygdala resection for epilepsy surgery and evaluate its relationship with their neuropsychiatric symptoms. Ten epileptic patients who underwent amygdala and hippocampal resection (6 left and 4 right) matched by age and educational level with 10 healthy controls were tested with an extensive neuropsychological and neuropsychiatric battery. Psychiatric symptomatology was measured with the positive and negative syndrome scale (PANSS) and the Beck depression inventory. To assess behavioral flexibility the emotion-related visual reversal-learning task (O'Doherty et al., 2001) and the gambling task (Bechara et al., 1994) were used. Patient's mean scores were: Beck: 8 +/- 1.5; PANSS positive: 10 +/- 1.3, and negative: 14.4 +/- 2.2; intellectual quotient (IQ): 101.4 +/- 6.3; category number in Wisconsin card sorting test: 4.6 +/- 2.4. The emotion-related visual reversal-learning task showed significance differences in the number of reversion: healthy controls: 9.3; epileptic patients: 4.23 (p < 0.001); in the number of trials to the first reversion: healthy controls: 5; epileptic patients: 23.42 (p < 0.05). There was no correlation between reversion and depression, PANSS and IQ. Patients with epilepsy who undergo unilateral hippocampal and amygdala resection appear to have alterations in the reversion capacity with an emotional component that would explain the lack of behavior flexibility that they sometimes have and that are not related with either the isolated presence of executive alterations or low intellectual quotient.


Ethical problems arising from the use of placebo in clinical trials with drugs for migraine. Their analysis by the moral deliberation method.
Migraine is characterised as episodes of headache plus a variety of accompanying symptoms. Its pharmacological control remains unsatisfactory for some patients. The use of placebo in drug clinical trials on migraine commonly leads to numerous ethical uncertainties. The purpose of this paper is to illustrate how the deliberation method helps in analysing the issues and finding solutions to selected ethical problems. Ethical decisions that try to solve conflicts arising from placebo use in clinical trials may be adopted using the moral deliberation method. Thus, the conflict is systematically assessed by identifying the following: Relevant facts; Values in conflict; Duties, or in other words, possible courses of action. Moral duty is following the optimal course of action. To identify this, it is recommended to state extreme courses of action, then intermediate courses of action, and then to proceed to the optimal course(s) of action. In this paper, the application of this method is shown in several conflicting situations arising in two placebo-controlled clinical trials with drugs under development for the prophylaxis and acute treatment of migraine.


A homology model of Xyloglucan Xylosyltransferase 2 reveals critical amino acids involved in substrate binding.
In dicotyledonous plants, xyloglucan (XyG) is the most abundant hemicellulose of the primary cell wall. The enzymes involved in XyG biosynthesis have been identified through reverse-genetics and activity was characterized by heterologous expression. Currently, there is no information on the atomic structures or amino acids involved in activity or substrate binding of any of the Golgi-localized XyG biosynthetic enzymes. A homology model of the xyloglucan xylosyltransferase 2 (XXT2) catalytic domain was built on the basis of the crystal structure of A64Rp. Molecular dynamics simulations revealed that the homology model retains the glycosyltransferase (GT)-A fold of the template structure used to build the homology model indicating that XXT2 likely has a GT-A fold. According to the XXT2 homology model, six amino acids (Phe204, Lys207, Asp228, Ser229, Asp230, His378) were selected and their contribution in catalytic activity was investigated. Site-directed mutagenesis studies show that Asp228, Asp230 and His378 are critical for XXT2 activity and are predicted to be involved in coordination of manganese ion. Lys207 was also found to be critical for protein activity and the homology model indicates a critical role in substrate binding. Additionally, Phe204 mutants have less of an impact on XXT2 activity with the largest effect when replaced with a polar residue. This is the first study that investigates the amino acids involved in substrate binding of the XyG-synthesizing xylosyltransferases and contributes to the understanding of the mechanisms of polysaccharide-synthesizing GTs and XyG biosynthesis.


Shifting the Split Reflectors to Enhance Stone Fragmentation of Shock Wave Lithotripsy.
Shock wave lithotripsy (SWL) has been used widely in urology for about three decades to treat kidney calculi. Technical development to improve performance (i.e., stone fragmentation efficiency) is continuous. Low-pressure wide-focus lithotripters have already achieved promising results. In this study, the lithotripter field and profile of lithotripter shock waves were changed simultaneously using a cost-effective and convenient design. An intact parabolic reflector was split into four pieces, and each part was moved individually. By shifting the split reflectors, the focused acoustic beams were separated. As a result, the beam width in the focal region could be increased. Both numerical models of wave propagation using a k-wave approach and hydrophone measurements showed similar pressure waveforms at the focus and the distributions along and transverse to the lithotripter axis. The increase of the shifting distance from 0 mm to 7 mm resulted in the increase of -6 dB beam width from 7.1 mm to 13.9 mm and location of tensile peak on axis moving from z = -14 mm to 1 mm. The Lithotripters at 10 kV (intact reflector) and at 12 kV with the split reflectors shifted by 5 mm were compared with each other because of their similar peak positive pressures at the focus (8.07 MPa ± 0.05 MPa vs. 7.90 MPa ± 0.11 MPa, respectively). However, there were significant differences in their positive beam width (8.7 mm vs. 10.2 mm), peak negative pressure (-6.34 MPa ± 0.04 MPa vs. -7.13 MPa ± 0.13 MPa), the maximum tensile stress (7.55 MPa vs. 8.95 MPa) and shear stress (6.1 MPa vs. 7.76 MPa) in a 10-mm diameter spherical stone and bubble collapse time (127.6 μs ± 5.4 μs vs. 212.7 μs ± 8.2 μs). As a result, stone fragmentation efficiency was enhanced about 1.8-fold (57.9% ± 4.6% vs. 32.2% ± 5.6%, p < 0.05) when shifting the split reflectors. These results suggest that this new reflector design could change the characteristics of the lithotripter field and increase stone fragmentation efficiency.


Optimisation of DNA extraction and validation of PCR assays to detect Mycobacterium avium subsp. paratuberculosis.
The aim of this study was to investigate DNA extraction methods and PCR assays suitable for the detection of Mycobacterium paratuberculosis in bovine tissue. The majority of methods currently used to detect M. paratuberculosis have been developed using bovine samples, such as faeces, blood or tissue and, in many cases, have been based on detection from pooled samples from a herd. However most studies have not compared PCR results to culture results. In order to address this problem, four DNA extraction protocols and three PCR assays were employed to detect M. paratuberculosis in bovine tissue. Given that culture is reliable from cows, the results were then compared with the known M. paratuberculosis culture status. The following DNA extractions were included, two commercial kits, a boiling method, an in house extraction based on a published method and enrichment by sonication. The three PCR assays used included single round IS900 and f57 assays and a nested IS900 assay. In addition, another PCR assay was validated for the detection of any Mycobacterial species and a universal bacterial 16S rRNA gene assay was used to detect sample inhibition. The in-house DNA extraction was the most consistent in extracting good quality DNA compared to all other methods. The use of two PCR markers, IS900 and f57, and a universal PCR enabled the correct samples to be identified as M. paratuberculosis positive. In addition, when compared to the culture result, false-positives did not occur and PCR inhibition was readily identified. Using an in house DNA extraction coupled with the IS900 and f57 PCR markers, this study provides a reliable and simple method to detect M. paratuberculosis in both veterinary and spill over infections.


Molecular cloning of a tyrosine kinase gene from the marine sponge Geodia cydonium: a new member belonging to the receptor tyrosine kinase class II family.
We have isolated and characterized a cDNA from the marine sponge Geodia cydonium coding for a new member of the tyrosine protein kinase (TK) family. The cDNA encodes a protein of M(r) = 68,710, termed GCTK, which is homologous to class II receptor tyrosine kinases (RTKs). GCTK contains conserved amino acids (aa) characteristic of all protein kinases, and the sequences DLATRN and PIRWMATE which are highly specific for TKs. Furthermore, the sequence N-L-Y-x(3)-Y-Y-R is highly homologous to the sequence D-[LIV]-Y-x(3)-Y-Y-R found only in class II RTKs. The sponge TK, when compared with mammalian class II RTKs, shows maximum 31% homology in the TK domain indicating that this the oldest member of class II RTK started to diverge from the common ancestral protein kinase approximately 650 million years ago. Using GCTK as a probe we identified three mRNA signals ranging from 2.6 to 0.6 kb. Kinase activity was localized only in the cell membranes from G. cydonium (M(r) = 65,000), and was not detected in the cytosol of this organism. Antibodies raised against a synthetic peptide, corresponding to the aa residues within the catalytic domain of the sponge TK, recognized strongly two proteins of M(r) = 65,000; these proteins, present in membrane fractions, also bound to the antiphosphotyrosine antibody. These data suggest that the TK cloned from the sponge is a membrane-associated 65 kDa protein. Moreover these results demonstrate that RTKs are present from the lowest group of multicellular eukaryotes, sponges, to mammals, and may suggest that RTKs are involved in a signal transduction pathway.


Catastrophic failure of the polyethylene liner of uncemented acetabular components.
Ten cases are described of catastrophic failure of the polyethylene liner of three different designs of uncemented acetabular component. Failure occurred as a result of either 'wearthrough' to the metal backing, liner fracture or a combination of both, at a mean of 4.6 years after implantation (2 to 7.6). At revision there was metallosis in all hips and osteolysis of the femur or the pelvis in six. Catastrophic failure was seen only in cups with a minimum polyethylene thickness of less than 5 mm.


Clinical observation of neonatal gastrointestinal perforation.
Gastrointestinal perforation is an infrequent occurrence in neonates. Experience in its management is presented, while also attempting to analyze the factors affecting outcome. From 1983 to 1992, 31 neonates with gastrointestinal perforation were treated at Taichung Veterans General Hospital. The medical records of these patients were reviewed thoroughly. In the meantime, Mann-Whitney U and Yates' correction chi square tests were used to analyze the factors predicting the outcomes. There were 21 males and 10 females, among whom 16 were premature births. The median age at diagnosis was 5 day; half (16/31) had occurred during the first 5 days of life. Abdominal distension was the most common manifestation (87%). Hemograms at admission showed leukopenia in 32% (10/31) and thrombocytopenia in 40% (8/20) of the patients. Metabolic acidosis was present in 46% (13/28) of the patients. Peritoneal fluid and preoperative blood cultures were positive in 71% (17/24) and 50% (13/26) of the patients, and both of them had Gram-negative enterobacteriacea as the most common pathogen. The overall mortality rate was 58%. The highest mortality rate was associated with gastric perforation (100%), followed by small bowel (50%) and colon (50%) perforations. The predominant cause of perforation was necrotizing enterocolitis (14/31), with the most common site the terminal ileum (16/29). Four patients with necrotizing enterocolitis had multiple perforations. Others who underwent surgery showed single perforation. The major cause of death in those patients who received operation was sepsis (8/13). An initial arterial pH value higher than 7.25, and surgical procedure performed within two days after disease onset may predict a favorable outcome (p < 0.01). Gastrointestinal perforation is a life-threatening complication in neonates. A better survival rate can be obtained by cooperation among neonatologists, pediatric surgeons and the nursing staff taking care of these high risk babies.


Role of fluconazole in the long-term suppressive therapy of fungal infections in patients with artificial implants.
With the increased use of artificial implants the management of related infections has become an important challenge. Normally an infected implant would be removed. In many cases this might be contraindicated and drug treatment remains as the only alternative. As microbiological eradication is often impossible, especially in fungal infections at artificial implants (FIAI) long-term suppressive therapy might be required. The objective of this study was to determine the therapeutic value of fluconazole (F) in the management of FIAI. Clinical data of 56 patients (pts) with proven or suspected fungal infections and artificial implants (FIAI) subsequently treated with F were analyzed retrospectively. FIAI caused by species with intrinsic resistance to F have been excluded from the study. The following implants were involved: prosthetic valve endocarditis (PVE) 25 pts (44.6%), intraocular lenses (IL) 9 pts (16.1%), ventriculoperitoneal shunts (VPS) 6 pts (10.7%), knee prostheses (KP) 5 pts (8.9%), biliary stents (BS) 4 pts (7.1 %), venous access devices (VAS) 3 pts (5.4%), urinary stents (US) 2 pts (3.6%), breast implant and pacemaker 1 patient (1.8%) each. Underlying diseases were valve insufficiency (in PVE), cataract surgery (in IL), prematurity in newborns (in VPS), arthrosis (in KP), biliary obstruction (in BS), cystic fibrosis (in VAS), and obstructive renal calculi (in US). Candida species (C. spp.) were the most frequently detected causative agents with C. parapsilosis as the leading cause (n = 19; 33.9%). Furthermore C. albicans (n = 15; 26.8%), C. spp. and fungi not further specified (n = 8; 14.3%), C. tropicalis (n = 3; 5.4%), C. glabrata (n = 3; 5.4%), and C. lusitaniae (n = 1; 1.8%) were identified. Acremonium kiliense has been detected in 4 pts (7.1%), Cryptococcus neoformans in 2 pts (3.6 %). Histoplasma capsulatum was identified in 1 patient (1.8%). The maximum duration of treatment with F was lifelong with a maximum recorded duration of 4,5 years. The maximum dosage used was 750 mg/d or 50 mg/kg BW in premature infants. No major adverse events were observed. In conclusion, especially the excellent safety profile as well as the documented therapeutic experience justify the use of F as long-term suppressive therapy in FIAI. Higher dosages and even life-long treatment may be needed.


Towards a fully synthetic substitute of alginate: optimization of a thermal gelation/chemical cross-linking scheme ("tandem" gelation) for the production of beads and liquid-core capsules.
Fully synthetic polymers were used for the preparation of hydrogel beads and capsules, in a processing scheme that, originally designed for calcium alginate, was adapted to a "tandem" process, that is the combination a physical gelation with a chemical cross-linking. The polymers feature a Tetronic backbone (tetra armed Pluronics), which exhibits a reverse thermal gelation in water solutions within a physiological range of temperatures and pHs. The polymers bear terminal reactive groups that allow for a mild, but effective chemical cross-linking. Given an appropriate temperature jump, the thermal gelation provides a hardening kinetics similar to that of alginate. With slower kinetics, the chemical cross-linking then develops an irreversible and elastic gel structure, and determines its transport properties. In the present article this process has been optimized for the production of monodisperse, high elastic, hydrogel microbeads, and liquid-core microcapsules. We also show the feasibility of the use of liquid-core microcapsules in cell encapsulation. In preliminary experiments, CHO cells have been successfully encapsulated preserving their viability during the process and after incubation. The advantages of this process are mainly in the use of synthetic polymers, which provide great flexibility in the molecular design. This, in principle, allows for a precise tailoring of mechanical and transport properties and of bioactivity of the hydrogels, and also for a precise control in material purification.


Chemical burns: retrospective review.
The records of 51 patients with chemical burns were reviewed to identify demographics, mechanism and place of injury, cause, distribution, initial management, and outcome of treatment. Patients were classified as having received adequate (immediate dilution or neutralization of the chemical treatment--group A, or inadequate (delayed or inappropriate) treatment--group B. Inpatient mortality for chemical burns was 13% compared to 15% overall burn center mortality. Of the burns, 79% occurred in the 21-50 age group; 69% of burns were work-related in men and 17% in women. In group A, 19% required skin grafting (mortality 9.5%); in group B, 36% required grafting (mortality 21%). Alkali were the most frequent cause of burns, followed by sulfuric acid and, less often, gasoline, anhydrous ammonia, white phosphorus, and hydrofluoric acid.


Clinical presentation of deep vein thrombosis and pulmonary embolism.
In the past, the clinical diagnosis of venous thromboembolism (VTE), which comprises deep vein thrombosis (DVT) and pulmonary embolism (PE) had been very challenging, because clinical presentation is non-specific and inaccurate. To review and assess clinical signs, symptoms and risk factors of DVT and PE and identify most common differential diagnoses. Important components for the clinical diagnosis of VTE include risk factors such as immobilization, presence of cancer, confinement to bed, previous major surgery, prior VTE and - specific for DVT - whole limb enlargement, one-sided calf enlargement and dilatation of superficial veins. Additional items specific for PE include tachycardia, dyspnea chest pain and hemoptysis. Many of these clinical characteristics are included into clinical prediction rules, such as the Wells pre-test probability score for DVT or PE or the Geneva score for PE. These scores are used to determine the pre-test probability for VTE and they constitute the basis for a diagnostic algorithm. Various clinical prediction rules for DVT or PE show comparable accuracy. Even though the clinical presentation of DVT and PE varies substantially in individual patients and settings and may be misleading, diagnostic prediction rules based on clinical presentation and risk factors are very useful to assess pre-test probability, which is a very important concept for the diagnosis of DVT and PE.


Cardioprotective action of perindopril versus candesartan in renovascular hypertensive rats.
We investigated the effects of an angiotensin-converting enzyme inhibitor and an angiotensin II type 1 receptor blocker on cardiac hypertrophy in rats with renovascular hypertension. Renovascular hypertensive (Goldblatt) rats were surgically prepared from Wistar rats. Four weeks later, the rats showed a significant increase in blood pressure. At high doses, both the perindopril (1 mg/kg/day) and the candesartan (2 mg/kg/day) decreased the systolic pressure in these rats to the level of control Wistar rats. At low doses (perindopril 0.1 mg/kg/day and candesartan 0.1 mg/kg/day), these drugs lowered blood pressure to 85% of that in hypertensive rats. Echocardiographic and morphological studies revealed severe cardiac hypertrophy and fibrosis in untreated Goldblatt rats. High-dose treatment with both drugs suppressed the progression of hypertrophy and fibrosis. Also, low-dose perindopril prevented cardiac hypertrophy and fibrosis. In contrast, at the same levels of blood-pressure reduction, low-dose candesartan did not prevent cardiac fibrosis nor the upregulation of cardiac collagen types I and III mRNA observed in untreated Goldblatt rats. Atrial natriuretic peptide mRNA was up-regulated in untreated Goldblatt rats. These changes were significantly decreased by both doses of perindopril or the high dose of candesartan. Serum levels of angiotensin II and aldosterone were significantly higher in untreated Goldblatt rats. Both doses of perindopril inhibited activation of the renin-angiotensin system, whereas candesartan had weaker effects. In particular, serum aldosterone was 347 +/- 20 pg/ml in low-dose perindopril versus 1796 +/- 324 pg/ml in low-dose candesartan. These results suggest that there were no differences between the cardioprotective actions of perindopril and candesartan at high dosages. On the other hand, low-dose treatment with perindopril was more effective in preventing cardiac fibrosis than was low-dose treatment with candesartan, despite similar changes in blood pressure. It is possible that changes in aldosterone secretion are related to this difference.


MIG: Multi-Image Genome viewer.
Multi-Image Genome (MIG) viewer is a web-based application for visualizing, querying and filtering many thousands of genome browser regions as well as for exporting the data in a variety of formats. This methodology has been used successfully to analyze ChIP-Seq data and RNA-Seq data and to detect somatic mutations in genome resequencing projects. MIG is available at https://mig.molbiol.ox.ac.uk/mig/


Interpretation of the TDx-FLM fluorescence polarization assay in pregnancies complicated by diabetes mellitus.
The objective of this paper is to determine the applicability of the Abbott TDx-FLM fluorescence polarization assay in pregnancies complicated by diabetes mellitus. Retrospective review of records of women with pregnancies complicated by diabetes who underwent amniocentesis for fetal lung maturity using the Abbott TDx-FLM assay within 3 days of delivery was considered. Maternal diabetic control, neonatal birth weight, Apgar scores, umbilical cord gases, admissions to Neonatal Intensive Care Unit (NICU), development of respiratory distress syndrome (RDS) were evaluated. One hundred twenty-one patients with diabetes mellitus were identified. Thirteen (10.7%) had an FLM < or = 70 mg/g and 108 patients had > or = 70 mg/g. All obstetrical and diabetic variables were similar. RDS was not observed in neonates who had an FLM of > or = 70 mg/g. One neonate had RDS (FLM = 7.2 mg/g). The TDx-FLM > or = 70 mg/g may be interpreted as mature when obtained from transabdominal amniocentesis.


Coarctation of aorta: late aneurysm formation with Dacron onlay patch grafting.
Repair of coarctation of the aorta using Dacron onlay patch grafting performed in a 2 1/2-year-old child, with subsequent late formation of a true aneurysm on the side of the graft, is reported. Review of the literature did not reveal other cases of late formation of true aneurysm on the side of the Dacron onlay patch graft.


Rhabdomyosarcoma. A podiatric challenge.
The clinical case presented in this article demonstrates the necessity of prompt treatment of suspicious mass lesions and highlights the importance of always sending tissue specimens for proper evaluation. In this case, the prognosis was directly related to extent of the disease. Delaying treatment or improper treatment could easily mean the difference between life and death. When a highly aggressive rhabdomyosarcoma is encountered, a planned formal excision with adequate margins is mandatory to achieve optimal results. Multidisciplinary care, including oncology, radiology, pathology, and podiatry services, is preferred. A current 4-year follow-up of the patient discussed in this article has demonstrated no recurrence.


Health services research into postnatal depression: results from a preliminary cross-cultural study.
Little is known about the availability and uptake of health and welfare services by women with postnatal depression in different countries. Within the context of a cross-cultural research study, to develop and test methods for undertaking quantitative health services research in postnatal depression. Interviews with service planners and the collation of key health indicators were used to obtain a profile of service availability and provision. A service use questionnaire was developed and administered to a pilot sample in a number of European study centres. Marked differences in service access and use were observed between the centres, including postnatal nursing care and contacts with primary care services. Rates of use of specialist services were generally low. Common barriers to access to care included perceived service quality and responsiveness. On the basis of the pilot work, a postnatal depression version of the Service Receipt Inventory was revised and finalised. This preliminary study demonstrated the methodological feasibility of describing and quantifying service use, highlighted the varied and often limited use of care in this population, and indicated the need for an improved understanding of the resource needs and implications of postnatal depression.


Not all boronic acids with a five-membered cycle induce tremor, neuronal damage and decreased dopamine.
Several striatal toxins can be used to induce motor disruption. One example is MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine), whose toxicity is accepted as a murine model of parkinsonism. Recently, 3-Thienylboronic acid (3TB) was found to produce motor disruption and biased neuronal damage to basal ganglia in mice. The aim of this study was to examine the toxic effects of four boronic acids with a close structural relationship to 3TB (all having a five-membered cycle), as well as boric acid and 3TB. These boron-containing compounds were compared to MPTP regarding brain access, morphological disruption of the CNS, and behavioral manifestations of such disruption. Data was collected through acute toxicity evaluations, motor behavior tests, necropsies, determination of neuronal survival by immunohistochemistry, Raman spectroscopic analysis of brain tissue, and HPLC measurement of dopamine in substantia nigra and striatum tissue. Each compound showed a distinct profile for motor disruption. For example, motor activity was not disrupted by boric acid, but was decreased by two boronic acids (caused by a sedative effect). 3TB, 2-Thienyl and 2-furanyl boronic acid gave rise to shaking behavior. The various manifestations generated by these compounds can be linked, in part, to different levels of dopamine (measured by HPLC) and degrees of neuronal damage in the basal ganglia and cerebellum. Clearly, motor disruption is not induced by all boronic acids with a five-membered cycle as substituent. Possible explanations are given for the diverse chemico-morphological changes and degrees of disruption of the motor system, considering the role of boron and the structure-toxicity relationship.


Supportive, palliative, and end-of-life care for patients with cancer in Asia: resource-stratified guidelines from the Asian Oncology Summit 2012.
The burden of cancer in Asia is high; 6·1 million new cases were diagnosed in the continent in 2008, which accounted for 48% of new cases worldwide. Deaths from cancer are expected to continue to rise because of ageing populations and modifiable risk factors such as tobacco and alcohol use, diet, and obesity. Most patients who are diagnosed with cancer in Asia have advanced disease that is not amenable to curative treatment, which means that they are likely to have pain and other symptoms and psychosocial concerns. These burdens vary with the economic and political situation of the different countries and are affected by such factors as an absence of screening programmes, insufficient cancer diagnostic and treatment services (especially in sparsely populated and rural areas), legal restrictions on access to drugs to relieve pain, and a medical culture in which quality-of-life considerations are undervalued in relation to imperatives to treat. These issues could be ameliorated by increased investment in cancer screening, removal of restrictions on prescription of opioids, and improvements in medical education to increase recognition of treatment futility. Supportive, palliative, and end-of-life care offer the potential to enhance quality of life, improve pain control, and reduce suffering for patients with cancer and their families, and to give patients a dignified death. All patients should have access to such care-in resource-rich regions these services should be integrated into oncology services, whereas in resource-poor regions they should be the main focus of treatment. The form of care should depend on the economic circumstances within and across countries, and recommendations are made across four resource classifications (basic to maximal) to take account of the diversity of settings in Asia.


A tale of three genomes: the kinetoplastids have arrived.
July 2005 marked a milestone in kinetoplastid biology research. A tour de force effort led by the Tri-Trypanosomatidae "Tritryp" genome consortium yielded the publication of three prominent kinetoplastid parasite genome sequences: Trypanosoma brucei, Trypanosoma cruzi and Leishmania major. The individual and combined comparative analyses of these three genome sequences, combined with proteomic analyses, have yielded insights into topics ranging from genome evolution and horizontal gene transfer to potential new therapeutic and vaccine targets.


Novel biological transformations of 15-Ls-hydroperoxy-5,8,11,13-eicosatetraenoic acid.
[1-14C]Arachidonic acid was incubated with homogenates of the fungus, Saprolegnia parasitica. The products consisted of comparable amounts of two epoxy alcohols, 15-Ls-hydroxy-11,12-epoxy-5cis,8cis,13trans- eicosatrienoic acid and 15-hydroxy-13,14-epoxy-5cis,8cis,11cis-eicosatrienoic acid. Results of incubations carried out in the presence of nordihydroguaiaretic acid, 5,8,11,14-eicosatetraynoic acid, p-hydroxymercuribenzoate as well as glutathione peroxidase plus reduced glutathione demonstrated that transformation of arachidonic acid into epoxy alcohols occurred with the formation of 15-Ls-hydroperoxy-5cis,8cis,11cis,13trans- eicosatetraenoic acid (15-HPETE) as an intermediate. The pathway involved a lipoxygenase catalyzing the oxygenation of arachidonic acid at the 15L position to produce 15-HPETE, and a hydroperoxide isomerase activity which catalyzed conversion of 15-HPETE into the two epoxy alcohols. Studies with 15-[18O2]HPETE demonstrated that both oxygens of 15-HPETE were retained in the epoxy alcohols. Furthermore, experiments with mixtures of 15-[18O2]-and 15-[16O2]HPETE showed that conversion of 15-HPETE into epoxy alcohols occurred by an intramolecular transfer of hydroperoxide oxygen.


Patients' Attitudes and Physicians' Perceptions Toward Maintenance Therapy for Advanced Non-Small-cell Lung Cancer: A Multicenter Italian Survey.
Pemetrexed maintenance therapy (MT) after induction with platinum-based chemotherapy has recently become a common treatment strategy for advanced nonsquamous non-small-cell lung cancer (NSCLC). However, the benefits of MT should be weighed with consideration of the patients' perceptions and preferences. The aim of the present study was to evaluate patients' attitudes toward MT and to describe physicians' awareness of their patients' inclinations. We administered a 12-question anonymous survey and the Distress Thermometer Questionnaire to patients with advanced or recurrent nonsquamous NSCLC. The survey was also distributed to the referring physicians. From December 2014 to July 2015, 92 patients and 37 physicians were enrolled. All 92 patients completed the questionnaire at T0 (before starting chemotherapy) and 56.5% also did so at T1 (after completion of induction). The physicians completed the survey only at T0. Most patients had a positive attitude toward MT at both T0 (78.9%) and T1 (86.5%), and 100% of the physicians thought their patients would be in favor of MT. The physicians believed that their patients' attitudes toward MT would decrease proportionally with the reduction in the magnitude of the overall survival increase and expected benefits. The decrease expected by the physicians was much greater than that reported by the patients. This was especially true for an overall survival increase as small as 1 month (51.9% of patients accepting MT vs. 13.5% supposed by physicians) or when the only treatment benefit was radiologic tumor stabilization (69.3% of patients accepting MT vs. 37.8% supposed by physicians). NSCLC patients have a generally positive attitude toward MT, which is not directly proportional to the expected benefits and greater than the attitude expected by physicians.


Interface fluid syndrome after bioptics.
To report an unusual case of interface fluid syndrome after refractive surgery. A 37-year-old man with high myopia underwent a planned bioptics procedure including creation of a corneal flap using a mechanical microkeratome and concurrent anterior chamber phakic intraocular lens implantation; excimer laser ablation was not performed at this time. Postoperatively, the patient developed corneal edema and was referred to our department. Interface fluid syndrome was confirmed using optical coherence tomography; the mechanism was due to endothelial cell pump dysfunction. This is the first report to document interface fluid syndrome following a planned bioptics procedure.


Pattern of macular diseases in Nigerians: a preliminary report.
This study indicates the need for a population survey to determine the prevalence of macular diseases in an African population. An attempt should then be made to prevent those that can be prevented especially since there is a progressively increasing literacy rate in our population.


Mutagenesis of mouse embryonic stem cells with ethylmethanesulfonate.
Unraveling the function of the mammalian genome relies heavily on analyses of the laboratory mouse. Because of its powerful genetics and available technologies to manipulate the genome, plus its developmental and physiological similarities to humans, it has become a goal to generate mutations in all mouse genes and analyze the phenotypic consequences. Gene targeting in embryonic stem (ES) cells is the method of choice for making null mutations in known genes of interest. However, forward genetics approaches, in which mutations are produced randomly throughout the genome, has the advantage of producing alleles of varying severity both within known genes, in non-coding regulatory elements, or in other unannotated functional elements. Such forward genetic mutation screens in mice have typically involved treating male mice with N-ethyl-N-nitrosourea (ENU), followed by three generations of breeding to render potential recessive mutations homozygous, at which time phenotype screens can be performed. An alternative strategy for randomly mutagenizing the mouse genome is by chemical treatment of ES cells. This enables the use of multiple alternative chemicals with different mutational spectra, can reduce breeding to two generations, and impart a higher mutational load. Furthermore, ES cell mutagenesis can be used to create banks of clones that can be screened for point mutations in genes of interest, and to conduct forward genetic screens in vitro to detect potential phenotypes prior to generation of mice. In this chapter, we provide a detailed protocol for mutagenizing ES cells with the point mutagen ethylmethanesulfonate (EMS).


Detection of a 46,XX,der(3)t(3;4)(p25;p16.1) by using chromosome microdissection.
We performed chromosome microdissection in order to define the "de novo" rearrangement observed in a female patient affected by: frontal microgyria, mild psychomotor retardation, thoracic scoliosis, XIIth rib asymmetry and facial dysmorphisms. Through the use of the micro-FISH we evidenced a deletion of the 3p25pter region and a 4p16.1 duplication. We performed a karyotype-phenotype correlation in our patient and in the ones previously reported in literature which had a 3p25pter deletion or the 4p16 duplication.


[Disorders of zinc transport through the ileal epithelium in vitamin A deficiency and ischemia].
By means of histochemical revealing of zinc and applying radioactive isotope 65Zn accumulation, absorption and distribution of cations of this metal in the mucous membrane of the iliac intestine have been studied in chicken, normal, at ischemia and at A-avitaminosis. An essential zinc-depositing ability is peculiar to coverings of mucus upon the intestine epithelium, and among intracellular components--to smooth endoplasmic reticulum. A-avitaminosis and especially ischemia result in increasing permeability of the apical part of the external membrane of epitheliocytes, in overloading of the latter with zinc cations, when they are introduced into the intestine, as well as in decreasing transepithelial transport of zinc. The changes mentioned are accompanied with certain disturbances in the barrier function of the intestinal epithelium.


Capillary affinity electrophoresis and ab initio calculation studies of valinomycin complexation with Na+ ion.
In a combined experimental and theoretical approach, the interactions of valinomycin (Val), macrocyclic depsipeptide antibiotic ionophore, with sodium cation Na(+ )have been investigated. The strength of the Val-Na(+ )complex was evaluated experimentally by means of capillary affinity electrophoresis. From the dependence of valinomycin effective electrophoretic mobility on the sodium ion concentration in the BGE (methanolic solution of 20 mM chloroacetic acid, 10 mM Tris, 0-40 mM NaCl), the apparent binding (stability) constant (K(b)) of the Val-Na(+ )complex in methanol was evaluated as log K(b) = 1.71 +/- 0.16. Besides, using quantum mechanical density functional theory (DFT) calculations, the most probable structures of the nonhydrated Val-Na(+) as well as hydrated Val-Na(+).H(2)O complex species were proposed. Compared to Val-Na(+), the optimized structure of Val-Na(+).H(2)O complex appears to be more realistic as follows from the substantially higher binding energy (118.4 kcal/mol) of the hydrated complex than that of the nonhydrated complex (102.8 kcal/mol). In the hydrated complex, the central Na(+) cation is bound by strong bonds to one oxygen atom of the respective water molecule and to four oxygens of the corresponding C=O groups of the parent valinomycin ligand.


Prospective two-year followup of recombinant interferon-gamma in rheumatoid arthritis.
Seventy patients with rheumatoid arthritis (RA) completing a 12-week multicenter double blind trial comparing recombinant human interferon-gamma (r-IFN-gamma) with placebo were enrolled in a longterm prospective protocol evaluating r-IFN-gamma in RA. Forty (57%) patients after 1 year and 26 (37%) patients after 2 years continued the drug with sustained clinical benefit. Over 2 years, r-IFN-gamma was discontinued in 44 patients (lack of efficacy--25, withdrawn consent--7, noncompliant--4, suspected adverse drug reactions--2, concurrent illness--6). Two years of treatment with r-IFN-gamma were well tolerated with sustained clinical benefit in some patients with few significant adverse drug reactions.


Trunk and center of mass movements during gait in children with juvenile idiopathic arthritis.
Motion of the body center of mass (CoM) can often indicate the overall effect of the strategy of forward progression used. In the present study, focus is placed on trunk movements in the sagittal, coronal, and transverse/rotation plane, as well as placement of the CoM, during gait in children with juvenile idiopathic arthritis (JIA). Seventeen children with JIA, all with polyarticular lower extremity involvement were examined before and approximately two weeks after treatment with intra-articular cortico-steroid injections. Movement was recorded with a 6-camera 3D motion analysis system in both the children with JIA and in 21 healthy controls. Trunk and center of mass movements were compared between JIA and controls, and effects of intra-articular cortico-steroid treatment were evaluated. Children with JIA were more posteriorly tilted in the trunk, contrary to the common clinical impression, and had their CoM placed more posterior and off-centred, which may have been a result of pain. With such knowledge, it might be possible to better understand the effects of their pain and involvement, and ultimately to plan a treatment strategy for improving their gait patterns.


'Memory' of the stratum corneum: exploration of the epidermis' past.
The stratum corneum (SC) is the final product of the process of epidermal differentiation. Besides its crucial protective role as a physical permeability barrier, this composite structure made of cornified keratinocytes embedded in a layered lipid matrix is also, by nature, a tissue that keeps track of past events occurring in the outermost living layers. In normal human epidermis, formation of the SC is very rapid, and during this cornification process several structures expressed by the last granular layer of keratinocytes become entrapped and immobilized at the cells' periphery. Cell-cell junctions are obvious targets of transglutaminases that cross-link junctions' components within the corneocyte envelopes. Thus, desmosomes and tight junctions (TJs) in living cells become fixed at the corneocyte periphery and cannot be recycled anymore. We have quantified the TJ-like structures residing in the SC of human skin explants subjected to environmental stress and compared these results with fresh skin controls. Significant overexpression of TJ-like cell-cell envelope fusions has been observed in the stressed epidermis and in two different hereditary skin diseases characterized by increased SC cohesion. Quantitation of TJ-like structures has contributed to the interpretation of the diseases' physiopathology. Other examples of information retrieved from the SC concern fluctuating lipid expression in the course of atopic dermatitis and patterns of corneodesmosome breakdown influencing SC desquamation. It is, therefore, possible to analyse and quantify the traces left in the SC and to draw conclusions on the dynamics of living tissue over the past several days.


Single nucleotide polymorphisms in the anti-Müllerian hormone signalling pathway do not determine high or low response to ovarian stimulation.
There is substantial variability in ovarian response to exogenous gonadotrophins in women undergoing ovarian stimulation for IVF. Genetic variation in signalling pathways of the ovary could influence ovarian stimulation outcome. Studies have shown a correlation between the serum concentration of anti-Müllerian hormone (AMH) and ovarian stimulation outcome. This paper present a retrospective case-controlled genetic association study designed to test the association between single nucleotide polymorphisms (SNP) in the AMH signalling pathway and two clinically important outcomes of ovarian stimulation: low and high response. Blood samples from 53 high responders, 38 low responders and 100 controls were analysed for eight SNP of interest. Odds ratios and 95% confidence intervals were estimated by a binary logistic regression model adjusting for age and body mass index. As far as is known, this is the first report on the influence of these SNP, present in approximately 19% of women, on ovarian stimulation outcome. No statistically significant association was found between any of the SNP studied and high or low response to ovarian stimulation. It seems unnecessary to detect these SNP when applying the serum concentration of AMH as a predictor of ovarian response to stimulation. Many infertile couples are treated by IVF. Part of this treatment is to pharmacologically stimulate the ovaries to develop many oocytes simultaneously. This process is called ovarian stimulation. Some women respond either too little (low responders) or too much (high responders) to ovarian stimulation. Both these situations are unfavourable to the woman. This study evaluates whether these chances of having one of these two outcomes of ovarian stimulationare influenced by variation in the gene for anti-Müllerian hormone (AMH) or its receptor. This is done by taking blood samples from three groups of patients: low responders, high responders and controls with a normal response. These blood samples were analysed to see if the variation in the genes for AMH or its receptor were different in the three groups. They were not, and so we conclude that the genetic variation that exists in the AMH and receptor signalling pathway is not a major determinant of ovarian stimulation outcome.


Determination of substrate binding energies in individual subsites of a family 18 chitinase.
Thermodynamic parameters for binding of N-acetylglucosamine (GlcNAc) oligomers to a family 18 chitinase, ChiB of Serratia marcescens, have been determined using isothermal titration calorimetry. Binding studies with oligomers of different lengths showed that binding to subsites -2 and +1 is driven by a favorable enthalpy change, while binding to the two other most important subsites, +2 and +3, is driven by entropy with unfavorable enthalpy. These remarkable unfavorable enthalpy changes are most likely due to favorable enzyme-substrate interactions being offset by unfavorable enthalpic effects of the conformational changes that accompany substrate-binding.


[Primary ultrasonic diagnosis of congenital hip dysplasia in neonates at the Senta Hospital].
Congenital hip dislocation is an abnormality which has not been managed in the period of early infantile period. However, clinical and ultrasound screening performed in the first days of life after birth at the Labor and Delivery Departments, provide prompt application of certain preventive and therapeutic measures which are painless, nonaggressive and highly efficient at this age. That is why primary sonoscreening of congenital hip dislocation of newborn infants in the first three days of life has been introduced at the Labor and Delivery Department of the Hospital in Senta. Methodology after Graf using a 5 Mhz linear probe is applied. Examinations are performed in the lateral position, giving a morphological finding, whereas morphodynamic data are processed after Graf classification. In clinically unstable and sonographically critical hips a dynamic hip examination is performed after Harcke. This is a teamwork of a neonatologist, ultrasonographist and child orthopedist and management of pathological hips starts at our department. Depending on indications therapeutic panties. Pavlik harness or Von Rosen band are used. Mothers are instructed how to use these appliances and take care of their newborn infants in these circumstances which helps in accepting the necessary therapeutic procedures. In the period 1991-1998, 14,378 hips were examined at the Labor and Delivery Department of the Hospital in Senta. A normal sonographic finding of Ia type was found in 45.87% of hips, while Ib type was found in 18.58% of hips. There were 31.16% of sonographically immature hips of IIa plus type, whereas a pathological finding was found in 1.39% of hips. In this group of pathological hips there were 0.98% of sonographically critical hips of IIg type. 0.26% of sonographically decentered hips of IID type. 0.09% of decentered hips of IIIa type and 0.06% excentric hips of type IV after Graf. In pathologic hips, check-ups were performed every 3 weeks and every 6 weeks in sonographically immature hips. Considering the fact that the first three months are the period of the most intensive maturation, that is the phase of absolute reduction of excentric and decentered hip in newborn infants, check-ups for infants with normal hip clinical and ultrasonographic findings were obligatory after the third month. Results of early nontraumatic and dynamic treatment proved successful on the basis of control clinical, functional, ultrasonographic and radiographic parameters. During the studied period at our territory there were no cases with aseptic necrosis of femoral head, nor necessity for surgical correction of the congenital hip dislocation.


Use of three-dimensional, CAD/CAM-assisted, virtual surgical simulation and planning in the pediatric craniofacial population.
Virtual Surgical Planning (VSP) and computer-aided design/computer-aided manufacturing (CAD/CAM) have recently helped improve efficiency and accuracy in many different craniofacial surgeries. Research has mainly focused on the use in the adult population with the exception of the use for mandibular distractions and cranial vault remodeling in the pediatric population. This study aims to elucidate the role of VSP and CAD/CAM in complex pediatric craniofacial cases by exploring its use in the correction of midface hypoplasia, orbital dystopia, mandibular reconstruction, and posterior cranial vault expansion. A retrospective analysis of thirteen patients who underwent 3d, CAD/CAM- assisted preoperative surgical planning between 2012 and 2016 was performed. All CAD/CAM assisted surgical planning was done in conjunction with a third party vendor (either 3D Systems or Materialise). Cutting and positioning guides as well as models were produced based on the virtual plan. Surgeries included free fibula mandible reconstruction (n = 4), lefort I osteotomy and distraction (n = 2), lefort II osteotomy with monobloc distraction (n = 1), expansion of the posterior vault for correction of chiari malformation (n = 3), and secondary orbital and midface reconstruction for facial trauma (n = 3). The patient's age, diagnosis, previous surgeries, length of operating time, complications, and post-surgery satisfaction were determined. In all cases we found presurgical planning was helpful to improve accuracy and significantly decrease intra-operative time. In cases where distraction was used, the planned and actual vectors were found to be accurate with excellent clinical outcomes. There were no complications except for one patient who experienced a wound infection post-operatively which did not alter the ultimate reconstruction. All patients experienced high satisfaction with their outcomes and excellent subjective aesthetic results were achieved. Preoperative planning using CAD/CAM and VSP allows for safe and precise craniofacial reconstruction in complex pediatric cases with a reduction of operative time.


Intra-specific association between carbon isotope composition and productivity in woody plants: A meta-analysis.
The study of intra-specific variations in growth and plant physiological response to drought is crucial to understand the potential for plant adaptation to global change. Carbon isotope composition (δ(13)C) in plant tissues offers an integrated measure of intrinsic water-use efficiency (WUEi). The intra-specific association between δ(13)C and productivity has been extensively studied in herbaceous crops, but species-specific information on woody plants is still limited and has so far provided contradictory results. In this work we explored the general patterns of the relationship between δ(13)C and growth traits (height, diameter and biomass) using a meta-analysis. We compiled information from 49 articles, including 176 studies performed on 34 species from 16 genera. We found a positive global intra-specific correlation between δ(13)C and growth (Gr=0.28, P<0.0001), stronger for biomass than for height, and non-significant for diameter. The extent of this intra-specific association increased from Mediterranean to subtropical, temperate and boreal biomes, i.e. from water-limited to energy-limited environments. Conifers and shrubs, but not broadleaves, showed consistent positive intra-specific correlations. The meta-analysis also revealed that the relationship between δ(13)C and growth is better characterized at juvenile stages, under near-optimal and controlled conditions, and by analyzing δ(13)C in leaves rather than in wood.


A comparison of two doses of nizatidine versus placebo in the treatment of reflux oesophagitis.
Three-hundred and twenty-five patients with endoscopically verified oesophagitis entered a double-blind, randomized multicentre study that compared 300 mg nizatidine b.d., 300 mg nocte and placebo. The 6- and 12-week treatment responses were studied. Healing was defined as complete epithelialization of all oesophageal lesions. The healing rates were 40% in the 300 mg nizatidine b.d. group, 30% in the 300 mg nocte group and 26% in the placebo group at 6 weeks. The corresponding figures after 12 weeks of treatment were 50%, 44% and 34%, respectively. The healing rates were significantly different (P less than 0.05) between the high-dose nizatidine group and placebo only, both at 6 and 12 weeks. Despite a trend at both 6 and 12 weeks in favour of 300 mg nizatidine nocte compared to placebo, this was not significantly different. The most important factor for the outcome, apart from the treatment group, was the pre-entry severity of oesophagitis. The differences observed between treatment groups in healing rates, symptomatic relief, and antacid consumption appear to result mainly from the patients with moderate and severe oesophagitis upon entry. Nizatidine (300 mg) b.d. appeared to be safe and effective in the treatment of reflux oesophagitis.


IGFBP-rP1 acts as a potential tumor suppressor via the suppression of ERK signaling pathway in endometrial cancer cells.
Insulin-like growth factor binding protein-related protein 1 (IGFBP-rP1) is a potential tumor‑suppressor gene in various cancers. However, its biological role and underlying mechanism has not been well investigated in endometrial cancer yet. The aim of the present study aimed to investigate the role and underlying molecular mechanisms of IGFBP‑rP1 in endometrial cancer cells in vitro. The authors used transfection of IGFBP‑rP1 or small interfering (si)RNA in endometrial cancer HEC‑1A or Ishikawa cells, respectively. Biological functional alterations, such as cell growth and cell cycle were analyzed in endometrial cancer cells, combined with the use of PD98059. A panel of proteins including phospho‑retinoblastoma (p‑RB) and p‑extracellular signal‑regulated kinase (ERK)/ERK were detected by western blot analysis. It was observed that IGFBP‑rP1 transfection inhibited cell growth, and induced G1 phase arrest and cellular senescence in HEC‑1A cells while gene silencing presented the adverse functional changes. Moreover, p‑RB and p‑ERK were significantly downregulated or upregulated in HEC‑1A‑IGFBP‑rP1 cells or Ishikawa‑siRNA (IGFBP‑rP1) compared with control cells, respectively. These observations were reinforced in endometrial cancer cells by PD98059 treatment. The authors conclude that IGFBP‑rP1 acts as a potential tumor suppressor via the suppression of the ERK signaling pathway in endometrial cancer cells. These findings suggested that IGFBP‑rP1 may serve as a potential therapeutic target for cancer intervention in the future.


[Felice Fontana precursor of neurosciences (author's transl)].
The A.A. insert the life and work of the naturalist and chemist Felice Fontana, born in Pomarolo (Trentino), in the frame of 18th century sciences, beside other great names of that century like Carolus Linnaeus, Réaumur, von Haller, Spallanzani, Morgagni, Priestley and Lavoisier. In the field of general biology, the discovery of nucleus and nucleolus and consequently the discovery of the eukaryotic cell, as we say in our days, in his, as well as the one of anabiosis. The A.A. enucleate and analyse the contributions of Fontana to the neurosciences; he has discovered the axon and the myelinic sheath half century before Remak and Purknije; he found out that the white matter of the brain is made of fibres alike those of nerves and the grey matter is made of globules (i.e. cells) mixed up with fibres; he discovered in the retina a part of coming out from the brain; he described the transversal bands of fibres of the skeletal muscles; he was the first to introduce into physiology the law of "all and nothing"; he attributed the irritability to the whole animal life; he identified the pupillar reflexes to the light, the reflex of accommodation, the consensual reflex, the psycho-emotive mydriasis and at last the myosis of sleep. He made experimental searches about nerves and recognised their regeneration, he enumerated various pathological intracranial masses, he made an important anatomopathological research about hydatid cyst in the brain of the sheep affected by "capostorno" and madness, he demonstrated their parasitical nature (he said that the hydated cysts were covered inside by small animals), he come out to formulate the hypothesis that some neuropsychiatric diseases of man can depend from similar aetiology. He declared that passions may have pathological effects (psyco-somatic aetiology), but he has also drawned the attention against the danager of aprioristical generalisation of neurogenical causes in all diseases. The A.A. give to Fontana the palm of precursor of modern neurosciences and of neurology intended as synthesis and unified corpus of these sciences.


Gestational changes in concentrations of selenium and zinc in the porcine fetus and the effects of maternal intake of selenium.
The effect of maternal dietary selenium (Se) and gestation on the concentrations of Se and zinc (Zn) in the porcine fetus were determined. Mature gilts were randomly assigned to treatments of either adequate (0.39 ppm Se) or low (0.05 ppm Se) dietary Se. Gilts were bred and fetuses were collected throughout gestation. Concentrations of Se in maternal whole blood and liver decreased during gestation in sows fed the low-Se diet compared to sows fed the Se-supplemented diet. Maternal intake of Se did not affect the concentration of Se in the whole fetus; however, the concentration of Se in fetal liver was decreased in fetuses of sows fed the low-Se diet. Although fetal liver Se decreased in both treatments as gestation progressed, the decrease was greater in liver of fetuses from sows fed the low- Se diet. Dietary Se did not affect concentrations of Zn in maternal whole blood or liver or in the whole fetus and fetal liver. The concentration of Se in fetal liver was lower but the concentration of Zn was greater than in maternal liver when sows were fed the adequate Se diet. These results indicate that maternal intake of Se affects fetal liver Se and newborn piglets have lower liver Se concentrations compared to their dams, regardless of the Se intake of sows during gestation. Thus, the piglet is more susceptible Se deficiency than the sow.


Unexpected link between anaphase promoting complex and the toxicity of expanded polyglutamines expressed in yeast.
Protein aggregation is intimately linked to a number of neurodegenerative diseases. Expansion of the huntingtin polyglutamine-rich domain causes protein aggregation and neuronal degeneration. Recently we found that, similar to neurons, yeast expressing the expanded domain show markers of programmed cell death. Here we showed that deletion of yeast metacaspase gene YCA1 partly rescues the toxic effect of the domain overexpression. We also performed genetic screen for other genes deletions alleviating the toxic effect and found ASE1. Ase1 is a substrate of the Cdh1 form of anaphase promoting complex, APC/Cdh1. We tested Cdh1 overexpression and the deletion of CLB2 (mitotic cyclin, substrate of APC/Cdh1) and found that both mutations had a rescuing effect on the expanded polyglutamine toxicity. Our data suggest that the toxic effect of aggregated proteins is partly indirect. We speculate that cellular attempt to degrade the aggregates overloads the proteasome, and this leads to pathological accumulation of APC substrates.


Directed three-dimensional patterning of self-assembled peptide fibrils.
Molecular self-assembly is emerging as a viable "bottom-up" approach for fabricating nanostructures. Self-assembled biomolecular structures are particularly attractive, due to their versatile chemistry, molecular recognition properties, and biocompatibility. Among them, amyloid protein and peptide fibrils are self-assembled nanostructures with unique physical and chemical stability, formed from quite simple building blocks; their ability to work as a template for the fabrication of low resistance, conducting nanowires has already been demonstrated. The precise positioning of peptide-based nanostructures is an essential part of their use in technological applications, and their controlled assembly, positioning, and integration into microsystems is a problem of considerable current interest. To date, their positioning has been limited to their placement on flat surfaces or to the fabrication of peptide arrays. Here, we propose a new method for the precise, three-dimensional patterning of amyloid fibrils. The technique, which combines femtosecond laser technology and biotin-avidin mediated assembly on a polymeric matrix, can be applied in a wide variety of fields, from molecular electronics to tissue engineering.


Effects of protein concentration and heat treatment on concentration of digestible and metabolizable energy and on amino acid digestibility in four sources of canola meal fed to growing pigs.
Two experiments were conducted to determine DE and ME and the apparent ileal digestibility (AID) and the standardized ileal digestibility (SID) of CP and AA in 4 sources of canola meal (high-protein [CM-HP], high-temperature-processed [CM-HT], low-temperature-processed [CM-LT], and conventional [CM-CV] canola meal) and in conventional soybean meal (SBM) fed to growing pigs. In Exp. 1, 48 growing barrows (initial BW: 39.7 ± 1.58 kg) were individually housed in metabolism cages and randomly assigned to 6 treatments in a randomized complete block design with 2 blocks of 24 pigs and 8 replicate pigs per treatment. The 6 diets included a corn-based basal diet and 5 diets that were formulated by mixing corn and 1 of the sources of canola meal (39.0% inclusion) or SBM (28.5% inclusion). Feces and urine were collected for 5 d following a 5-d adaptation period. The DE and ME in each source of canola meal and in SBM were calculated using the difference procedure. The DE and ME in the 4 sources of canola meal were less (P < 0.05) than in corn and SBM (DE: 2,854, 2,680, 2,892, and 2,883 vs. 3,324 and 3,784 kcal/kg, respectively; ME: 2,540, 2,251, 2,681, and 2,637 vs. 3,213 and 3,523 kcal/kg, respectively). No differences in the concentrations of DE and ME were observed among the 4 sources of canola meal. In Exp. 2, 12 growing barrows (initial BW: 34.0 ± 1.41 kg) that had a T-cannula installed in the distal ileum were randomly allotted to a repeated 6 × 6 Latin square design with 6 diets and 6 periods in each square. Five diets that contained 35% SBM or 45% of 1 of the 4 sources of canola meal as the sole source of CP and AA were formulated, and a N-free diet was also used. Each period lasted 7 d and ileal digesta were collected on d 6 and 7 of each period. The AID and SID of CP and all AA in SBM were greater (P < 0.05) than in the 4 sources of canola meal. Compared with CM-CV, CM-HP had greater (P < 0.05) AID of Ile, Lys, Asp, Cys, and Pro and greater (P < 0.05) SID of Lys and Cys. However, no differences between CM-HT and CM-LT were observed. In conclusion, regardless of the concentration of CP and the processing used, canola meal provides less DE and ME to pigs than corn and SBM, and the SID of AA in canola meal is less than in SBM. The processing temperature used in this experiment did not affect DE and ME or SID of AA in canola meal. The SID of Lys and Cys was greater in CM-HP than in CM-CV.


[Chronic diseases, coping with illness and complementary medicine].
The increasing demands for complementary medical practises by patients with chronic diseases is seen in the context of a global model of contending with disease. The author assumes that only few variables of this model may influence "supply and demand" in the "marketplace of complementary medical methods" and that the importance of these methods may fade. Finally the encounter with patients asking for complementary medical methods is considered.


Biodiesel production from hydrolysate of Cyperus esculentus waste by Chlorella vulgaris.
To reduce the cost of algal-based biodiesel, a waste material from oil industry, Cyperus esculentus waste, was used as the carbon source of the oleaginous microalgae Chlorella vulgaris. It demonstrated that C. vulgaris grew better in C. esculentus waste hydrolysate (CEWH(1)) than in glucose medium under the same reducing sugar concentration. CEWH concentration influenced the cell growth and lipid production significantly. The maximum lipid productivity 438.85 mg l(-1) d(-1) was achieved at 40 g l(-1). Fed-batch culture was performed to further enhance lipid production. The maximum biomass, lipid content and lipid productivity were 20.75 g l(-1), 36.52%, and 621.53 mg l(-1) d(-1), respectively. The produced biodiesel was analyzed by GC-MS and the results suggested that lipids produced from CEWH could be a potential feedstock for biodiesel production.


[Primary rectal lymphoma: value of rectal endosonography].
The authors report a case of primary rectal lymphoma characterized by dyspareunias and a raised erythematous rectal mucosa visible at rectoscopy. They stress the difficulty of the diagnosis, requiring deep biopsies, and the advantage of endorectal sonography. Its efficacy in defining the parietal and depth spread is evaluated between 90-95 p. cent, while it is lower (72%) regarding node invasion.


The impact of the SARS outbreak on an urban emergency department in Taiwan.
Emergency departments (ED) were on the front lines for possible cases of transmission during the severe acute respiratory syndrome (SARS) epidemic. The purpose of this study was to investigate the impact of the SARS catastrophe on an urban ED. The patients' characteristics in an urban ED were collected from March to May 2003 during the SARS outbreak in Taiwan. The crisis period was divided into 2 periods: 30 days before (period 1) and after (period 2) April 21, the date of the first hospital-associated transmission. Problem severity in the ED and stress levels of ED staff during the SARS catastrophe were rated from mild (1 point) to severe (5 points). The number of ED patients declined 33.4% in period 2. There was a 2.1% (95%CI, 0.4-3.8) increase in the percentage of male patients, a 2.5% (95% CI, 1.5-3.7) increase in percentage of fever (>38 degrees C), and a 4.0% (95% CI, 2.6-5.4%) increase in chief complaint of fever in period 2. The number of nontrauma patients younger than 18 years had declined by 44.5% in period 2. The total charge for reimbursement from an insurance institution declined 21.7%. During the SARS outbreak, the most severe stress experienced by either physicians or nurses occurred during emergency resuscitation (median stress rating point, 4; interquartile range, 1). The SARS catastrophe affected the ED visit volume, finances, various patient characteristics, and stress levels in the ED physicians and nurses. EDs must be fully prepared to face the challenges of the next outbreak of SARS or other infectious disease.


A method for determining Am-241 activity for large area contamination.
Airborne gamma-ray spectrometry system HELINUC™ is used for different missions. Although well-developed for estimation of high energy emitters' activity, it is rarely used for low energy emitters. A new method for the determination of Am-241 activity over extended sites based both on statistical analysis of spectra and deconvolution of Am-241 signal with a reference library is presented. Results show a lowering of the detection threshold and a good agreement with ground level measurements.


[Kinetic modeling of enzyme-catalysed reactions with participation of activators applied to ATP hydrolysis by Mg2+- ATPase].
Theoretical investigation of the model of reaction of ATP hydrolysis by "basal" Mg2+-ATPase has been carried out. It has been assumed that during the reaction each of three reacting substances (Mg2+, ATP, enzyme) can combine into complexes in couples with other participants of this process. Then the third component can associate with formed complexes producing the ternary complex of enzyme-activator-substrate. Such approach allowed to take into account all possible interactions in the chosen system, to investigate overall process in detail avoiding any simplifications and to find such peculiar properties of the process which will allow to understand the reaction mechanism and to explain observed experimental data. All possible pathways of the ATP hydrolysis process have been examined separately and as a whole. It is shown that if the reaction proceeds via two or three possible pathways then maximums are observed on plots of initial reaction rate on concentration ATP or magnesium. In addition maximums are also observed when enzyme concentration is increased. It is qualitatively new result that does not follow from the existing theories. The obtained results permit to explain some experimental data of ATP hydrolysis, active ion transport and some other reactions in a new fashion. The studied model and obtained results may be applied to another enzyme-catalysed reactions which proceed in the activator presence.


[A case of acquired occlusion of the upper ureter by ampullary hernia of the renal hilus].
The authors report the documented observation of a 59 year old woman admitted to hospital for recent pains in the left flank caused by acute hydronephrosis. Surgical exploration revealed a surprising loss of continuity in the ureter resulting from an ischemic occlusion of the upper ureter. The occlusion was in turn due to compression from a hernia of the renal hilum. The authors conclude with a brief physiopathologic study.


Tonogenetic mechanisms in northern Mon-Khmer.
In this paper, tonogenesis in the four languages Northern Kammu, Blang, Hu and U is analyzed. For comparison, register development in Lamet is treated as well. All these languages belong to the Palaungic and Kammuic branches of the Mon-Khmer division of the Austroasiatic language family and are fairly closely related, but they have developed tone or register systems independently of each other. These developments can be explained by universal microprosodic properties of segments, which are used in different ways by the different languages. Tone (or register) development is connected with merger of voiced and voiceless initial consonants in Kammu, Blang and Lamet, with merger of long and short vowels in Hu, and with merger of long and short vowels combined with both initial and final consonant changes and vowel quality changes in U. Thus, the range of microprosodic properties used for tonogenesis is extremely wide in this language group.


Vitreous fluorophotometry: identification of sources of variability.
Slit-lamp vitreous fluorophotometry (VF) has been used by several investigators to document the early breakdown of the blood-ocular barrier. After an injection of fluorescein, levels of fluorescein in the vitreous humor are reported to be elevated in diabetic patients compared with controls even when there is no retinal pathologic condition discernible by angiography or ophthalmoscopy. We have examined the technique of VF in normal persons and have identified several potential sources of error in the determination of vitreous fluorescein levels. Fluorescein in the choroidal circulation significantly influences VF readings taken at the retinal surface and in the posterior vitreous. This effect is modulated by ocular pigmentation, with heavy pigmentation of dark-eyed normals more effectively screening out choroidal fluorescence than the light pigmentation of blue-eyed subjects. Influence of choroidal fluorescein extends toward the midvitreous, and the range of influence is directly related to the slit width of the exciting light. At narrow slit widths the effect is diminished but can never be completely eliminated. Blood fluorescein levels decrease with time, and since choroidal fluorescein contributes to VF values, the time after injection that VF reading are taken is a critical parameter.


Stage of primary infection with lymphocytic choriomeningitis virus determines predisposition or resistance of mice to secondary bacterial infections.
We investigated the effect of a primary non-lethal infection with lymphocytic choriomeningitis virus (LCMV) on the course and outcome of a secondary infection with the Gram-negative Salmonella enterica serovar Typhimurium or the Gram-positive Listeria monocytogenes in mice. We found that at each stage of the viral infection the susceptibility of mice to bacterial super-infections changes dramatically and depends also on whether the secondary infection is a Gram-positive or Gram-negative one. The study shows that the outcome of the secondary infection is determined by a delicate balance between the overproduction of and the hypersensitivity to inflammatory cytokines (TNF-alpha and IFN-gamma), as well as by the changes in blood leukocytes occurring in mice in the course of viral infection.


Potentiating AZT activation: structures of wild-type and mutant human thymidylate kinase suggest reasons for the mutants' improved kinetics with the HIV prodrug metabolite AZTMP.
The 60-fold reduced phosphorylation rate of azidothymidine (AZT) monophosphate (AZTMP), the partially activated AZT metabolite, by human thymidylate kinase (TMPK) severely limits the efficacy of this anti-HIV prodrug. Crystal structures of different TMPK nucleotide complexes indicate that steric hindrance by the azido group of AZTMP prevents formation of the catalytically active closed conformation of the P-loop of TMPK. The F105Y mutant and a chimeric mutant that contains sequences of the human and Escherichia coli enzyme phosphorylate AZTMP 20-fold faster than the wild-type enzyme. The structural basis of the increased activity is assigned to stabilization of the closed P-loop conformation.


An ELISA using recombinant TmHSP70 for the diagnosis of Taenia multiceps infections in goats.
Infections with the tapeworm Taenia multiceps are problematic for ruminant farming worldwide. Here we develop a novel and rapid method for serodiagnosis of T. multiceps infections via an indirect ELISA (iELISA) that uses a heat shock protein, namely, TmHSP70. We extracted the total RNA of T. multiceps from the protoscoleces of cysts dissected from the brains of infected goats. Subsequently, we successfully amplified, cloned and expressed the TmHSP70 gene in Escherichia coli BL21 (DE3). Western blot analysis showed that the recombinant protein (∼34 kDa molecular weight) was recognized by the coenurosis positive serum. Given these initial, robust immunogenic properties for recombinant TmHSP protein, we assessed the ELISA-based serodiagnostic potential of this gene. The indirect ELISA was then optimized to 2.70 μg/well dilution for antigen and 1:80 dilution for serum,while the cut-off value is 0.446. We report that our novel TmHSP ELISA detected T. multiceps sera with a sensitivity of 1:10240 and a specificity of 83.3% (5/6). In a preliminary application, this assay correctly confirmed T. multiceps infection in 30 infected goats, consistent with the clinical examination. This study has revealed that our novel iELISA, which uses the rTmHSP protein, provides a rapid test for diagnosing coenurosis.


The Milan Project: a newborn hearing screening programme.
Since 1997 a newborn hearing screening programme has been implemented by the U.O. Neurologia-Neurofisiopatologia and Dipartimento di Neonatologia of the Istituti Clinici di Perfezionamento ICP in Milan for both babies with no risk and those at risk of hearing impairment. This programme was named the Milan Project. The protocol for no-risk babies consisted of three stages: in the first two stages, newborns were tested with transient click-evoked otoacoustic emissions (TEOAE), in the third one with conventional auditory brainstem responses (ABR). The first TEOAE test was performed by 36 h of age, before discharge, the second one after 15-30 d in case of referral, and the third one, by ABR, for those babies who failed the second TEOAE stage. Newborns at audiological risk were submitted to conventional ABR before the third month of corrected age. Some of this latter population was also submitted to the TEOAE test. The entire tested population (no-risk babies and newborns at audiological risk) consisted of 19 777 babies: 19 290 without risk ("no risk") and 487 at risk ("at risk"). During the course of the Milan Project, hearing impairment (ABR threshold equal to or greater than 40 dB nHL) was identified in 63 newborns (19 from the no-risk and 44 from the at-risk population), with a prevalence of 0.32%. Bilateral hearing impairment (BHI) was found in 33 newborns (10 from the no-risk and 23 from the at-risk population), corresponding to 0.17%. Among infants with bilateral hearing impairment, 30.3% had no risk factors. The prevalence of hearing impairment was determined on days 15-30 after birth. The results show that the implementation of a hospital-based, universal neonatal hearing screening programme for babies with and without audiological risk is feasible and effective. The effectiveness of the programme has increased as a function of the years since its inception, with a strong decrease in the referral rate. Further improvement is obtained if the TEOAE measurements are repeated in cases of referral scoring before discharge.


Full cost accounting as a tool for the financial assessment of Pay-As-You-Throw schemes: a case study for the Panorama municipality, Greece.
In the present paper, implementation scenarios of a Pay-As-You-Throw program were developed and analyzed for the first time in Greece. Firstly, the necessary steps for implementing a Pay-As-You-Throw program were determined. A database was developed for the needs of the full cost accounting method, where all financial and waste-production data were inserted, in order to calculate the unit price of charging for four different implementation scenarios of the "polluter-pays" principle. For each scenario, the input in waste management cost was estimated, as well as the total waste charges for households. Finally, a comparative analysis of the results was performed.


Ring chromosome 21 and monosomy 21 mosaicism in a patient with azoospermia.
In this report, we describe a patient with azoospermia in conjection with de novo ring chromosome 21 and monosomy 21 mosaicism. Inter-phase fluorescence in situ hybridisation (FISH) studies on uncultured peripheral blood and epithelial cells obtained by buccal smear revealed that 25% of the uncultured blood cells and 11% of the epithelial cells were monosomic for chromosome 21. Y chromosome microdeletion analysis ruled out the presence of any genomic deletions in the azoospermic factor a,b,c regions on the long arm of chromosome Y. Additionally, through subtelomeric FISH analysis, it was found that there was no deletion in the subtelomeric region of ring chromosome 21. Our results indicate that ring chromosome 21 is a rare, but recurrent chromosomal abnormality in male factor infertility. Furthermore, in individuals with ring chromosome 21, defective spermatogenesis is not associated with the deletion of any gene or genes located in the subtelomeric region of chromosome 21.


Race and ethnicity are not primary determinants in utilizing veterinary services in underserved communities in the United States.
A retrospective database analysis (2011-2015) evaluated associations between race and ethnicity and veterinary service utilization by sampling 83,260 companion animals whose guardians (owners) self-identified as White, Black, or Latino/a from 39 Humane Society of the United States Pets for Life (PFL) sites across the United States. Controlling for socioeconomic status, the percentage of nonhuman animals sterilized through PFL whose owners were Latino/a or Black was substantially higher than in previously reported findings. While Latinos/as had the highest mean number of days from first contact with the program to consent, they also had the highest percentage of owners accepting the voucher during initial contact. Logistic regression models suggested that although meaningful, race and ethnicity were not primary determinants of veterinary service utilization. When veterinary and animal welfare organizations deliberately remove structural barriers embedded with racial inequalities, individuals, regardless of race and ethnicity, proceed with companion-animal sterilization. Therefore, service providers must use unbiased, informed, and culturally competent practices to improve companion-animal welfare through the optimization of veterinary services, including spay and neuter.


Correlation of in vitro azole susceptibility with in vivo response in a murine model of cryptococcal meningitis.
Correlations between in vitro susceptibility and in vivo responses to fluconazole were sought in a mouse model of cryptococcal meningitis. Twenty clinical isolates were used. Two distinct populations were noted. Eight high-virulence isolates had an LD50 of < or = 252 cfu of Cryptococcus neoformans. Twelve low-virulence isolates had an LD50 of > 252 cfu. For 7 low-virulence isolates, the LD50 was > 20,000 cfu. C. neoformans also had a broad range of in vitro susceptibilities (MICs of 1.25 to > 80 micrograms/mL) at 24 h. A correlation was found between the MIC and the minimum effective dose of fluconazole in mice. This was observed with both survival and tissue counts as parameters of efficacy. This study documents for the first time the in vivo relevance of in vitro susceptibility to an azole antifungal for C. neoformans.


Brief exposure to aversive stimuli impairs visual selective attention.
Although it is well established that stress can disrupt complex cognitive functions, relatively little is known about how it influences visual processing, especially in terms of visual selective attention. In the current study, we used highly aversive images, taken from the International Affective Picture System, to induce acute, low-intensity stress while participants performed a visual discrimination task. Consistent with prior research, we found that anticipation of aversive stimuli increased overall amplitude of the N170, suggesting an increase in early sensory gain. More importantly, we found that stress disrupted visual selective attention. While in no-stress blocks, the amplitude of the face-sensitive N170 was higher when participants attended to faces rather than scenes in face-scene overlay images; this effect was absent under stress. This was because of an increase in N170 amplitude in the scene-attend condition under stress. We interpret these findings as suggesting that even low-intensity acute stress can impair participants' ability to filter out task-irrelevant information. We discuss our findings in relation to how even brief exposure to low-intensity stress may adversely impact both healthy and clinical populations.


Health and behavioral consequences of binge drinking in college. A national survey of students at 140 campuses.
To examine the extent of binge drinking by college students and the ensuing health and behavioral problems that binge drinkers create for themselves and others on their campus. Self-administered survey mailed to a national representative sample of US 4-year college students. One hundred forty US 4-year colleges in 1993. A total of 17,592 college students. Self-reports of drinking behavior, alcohol-related health problems, and other problems. Almost half (44%) of college students responding to the survey were binge drinkers, including almost one fifth (19%) of the students who were frequent binge drinkers. Frequent binge drinkers are more likely to experience serious health and other consequences of their drinking behavior than other students. Almost half (47%) of the frequent binge drinkers experienced five or more different drinking-related problems, including injuries and engaging in unplanned sex, since the beginning of the school year. Most binge drinkers do not consider themselves to be problem drinkers and have not sought treatment for an alcohol problem. Binge drinkers create problems for classmates who are not binge drinkers. Students who are not binge drinkers at schools with higher binge rates were more likely than students at schools with lower binge rates to experience problems such as being pushed, hit, or assaulted or experiencing an unwanted sexual advance. Binge drinking is widespread on college campuses. Programs aimed at reducing this problem should focus on frequent binge drinkers, refer them to treatment or educational programs, and emphasize the harm they cause for students who are not binge drinkers.


[Use development of sedatives/hypnotics and psychopharmaceuticals in the DDR with international comparisons using defined daily doses (DDD)].
For the period from 1965 to 1978, the development of the use of sedatives/hypnotics, tranquilizers, neuroleptics and antidepressives within one territory of the GDR is presented in a detailed manner. Besides this information about the trend the present stage of the consumption of centrally active pharmaceuticals, their DDD-values (defined daily doses) are given and international comparison with the development in Scandinavian countries are made.


A comparison of unwed pregnant teenagers and nulligravid sexually active adolescents seeking contraception.
Unwed pregnant adolescents were contrasted with nulligravid teenagers seeking contraception. Pregnant subjects were less likely to employ or plan to use contraceptives. Gravid subjects more often described their boyfriends as happy about the pregnancy and expressed a desire for a pregnancy. Nulligravid youngsters described their parents as more disapproving of their premarital sexual activity. There is a need for counseling programs, including adolescents of both sexes, and aimed at the modification of attitudes toward contraception.