Preoperative evaluation of hepatic functional reserve by converted ICGR15 calculated from Tc-GSA scintigraphy.
Conversion of data from technetium 99 m diethylenetriaminepentaacetic acid galactosyl human serum albumin (99mTc-GSA) scintigraphy to ICGR15 (indocyanin green retention at 15 min) is an easy and convenient method for obtaining parameters to determine the appropriate and safe extent of liver resection. We investigated a conversion method which also accounts for LHL15 (receptor index: uptake ratio of the liver to the liver plus heart at 15 min) and HH15 (blood clearance index: uptake ratio of the heart at 15 min to that at 3 min) characteristics. Cases included 282 patients undergoing hepatic resection following 99mTc-GSA scintigraphy and an ICG tolerance test. Degree of liver dysfunction was classified as A, B, or C according to criteria of the Liver Cancer Study Group of Japan. HH15 demonstrated a larger distribution in patients with liver damage A, while LHL15 demonstrated a larger distribution in patients with liver damage B. In liver damage A, the conversion formula ICGR15 = 87.0-79.6 x LHL15 was obtained, and in liver damage B, the conversion formula ICGR15 = -23.3 + 72.4 x HH15 was obtained, and correlation with ICGR15 was higher (r = 0.61, P < 0.0001) than when the data were not segregated by liver damage severity. Furthermore, postoperative hyperbilirubinemia significantly occurred in cases where both ICGR15 and converted ICGR15 were high. Conversion models based on data segregated by severity of liver damage were more closely correlated with ICGR15 than conversion models not based on segregated data. By using this converted ICGR15, preoperative estimation of hepatic functional reserve can become more reliable.


Management of high caries risk and high caries activity patients: rampant caries control program (RCCP).
The purpose of this article is to describe the Rampant Caries Control Program established in the operative dentistry third-year clinic at the University of Iowa College of Dentistry. This program represents a new approach to the management of high caries risk and high caries activity patients who come to the school. The patients are referred initially to the third-year operative clinic only for disease control (phase I) to help them decrease the caries risk and activity. The disease control phase has three important components: 1) caries risk assessment evaluation and reevaluation throughout their treatment, in which individual risk factors are identified and recommendations are made; 2) caries removal and placement of transitional restorations using fluoride release restorative materials (glass ionomers); and 3) chemotherapeutic agents and preventive treatment in which a therapeutic regimen for prevention and nonsurgical treatment is established according to each patient's individual risk factors. About 50 percent of patients have dropped from the program, 36 percent currently are under disease control treatment, and 14 percent have finished the disease control phase of the program. After the disease is controlled through modification of risk factors and activity, the patients can be referred for reevaluation prior to beginning the rehabilitation phase.


An early history of Japanese amyotrophic lateral sclerosis (ALS) and the current significance.
The present review focuses an early history of Japanese amyotrophic lateral sclerosis (ALS) and the current significance in comparison to previously known and newly found reports on Japanese ALS. After a preliminary case report of ALS by Masamichi Hirai on 1890, 2 completed reports were simultaneously published within 2 weeks of 1891 by Momojiro Nakamura and Zenjiro Inoue, followed by Eikichi Watanabe's report on 1892. After Shonosuke Hasegawa's and Hiroshi Kawahara's case reports on 1894-1896, Aihiko Sata first reported an autopsy case of ALS on 1897. The great contribution of Kinnosuke Miura was also introduced for the naming and pathogenesis in the early stage of ALS history in Japan during 1893-1911.


Long-term survival in severe combined immune deficiency: the role of persistent maternal engraftment.
Two siblings with severe combined immune deficiency, one with maternal engraftment and detectable immunologic functions who was alive at the age of 8 years are presented. Both patients had the same JAK3 gene mutation, suggesting that maternal engraftment may result in immune competence leading to long-term survival in patients with severe combined immune deficiency.


Protoplast fusion-derived Ogura male sterile cauliflower with cold tolerance.
Cauliflower (Brassica oleracea L. ssp. botrytis) protoplasts with Ogura male sterile and fertile B. oleracea cytoplasms were fused, producing plants with an array of organellar types. Plants with Ogura mitochondria were male sterile; those with B. oleracea chloroplasts were cold tolerant. In some fusions, unfused parental protoplasts were eliminated by double inactivation with iodoacetate and gamma-irradiation; in others, fused protoplasts were physically isolated by micromanipulation or by cell sorting. Double inactivation fusions produced the most plants, including many which were male sterile, female fertile, cold tolerant and diploid.


Inter-beat changes in left ventricular function with cardiomyoplasty as measured using MUGA scanning.
Dynamic cardiomyoplasty is a new surgical technique that uses electrically stimulated skeletal muscle to partially replace or reinforce the heart muscle in the treatment of advanced heart failure. Clinical experience with cardiomyoplasty is limited, which has precluded definitive conclusions about its value. We have studied the effect of cardiomyoplasty on the heart muscle when the skeletal muscle was being stimulated to coincide with alternate natural beats. The left ventricular function was assessed using radionuclide angiography during the beat immediately following skeletal muscle stimulation and during the beat immediately before stimulation. When the supported beat is compared with the unsupported beat, the results demonstrate that cardiomyoplasty improves the global and regional ejection fraction. The regurgitation index remains unchanged. The systolic peak emptying rate improves but the diastolic peak filling rate worsens. This latter finding provides additional information regarding the diastolic function of the heart following cardiomyoplasty, which is presently not well understood.


Sibling relationships of anxiety disordered children--a research note.
There is a paucity of knowledge on the role of sibling relationships in internalizing disorders. Research in nonclinical populations suggests an association between internalizing problems in children and negative sibling interactions. Further, an association is reported between internalizing problems and actual or perceived parental differential treatment. This study examines sibling relationship qualities and perceived parental differential treatment in a clinical sample. Participants included 24 anxiety disordered children (ages 8-13 years) and 25 nondisordered control children (ages 7-13 years). Anxiety disordered and nondisordered children do not differ with regard to perceived affection or hostility from a sibling. Anxiety disordered children, however, report significantly more parental differential treatment than do nondisordered children.


The psychosocial treatment of parental alienation.
Parental alienation occurs in divorces when one parent indoctrinates the child to dislike, fear, and avoid contact with the other parent. Mental health professionals who treat children and adolescents are likely to encounter victims of parental alienation in clinical practice, and it is important to identify and treat these youngsters earlier, when the condition is mild, rather than later, when the parental alienation is almost intractable. This article presents an overview of the treatment of parental alienation, which is called reunification therapy. All the parties involved in the case have a role in the prevention and treatment of parental alienation.


Selective promotion of neuronal adhesion by target tissue-derived materials.
Chick sympathetic nerves densely innervate expansor secundariorum muscle, but not skeletal muscle. By contrast, parasympathetic ciliary nerves innervate striated muscle, but no parasympathetic innervation occurs in expansor secundariorum muscle. The present study revealed accordingly that sympathetic ganglionic neurons from chick embryos adhered firmly to a dish precoated with expansor secundariorum muscle-conditioned medium (ECM), but not to one precoated with skeletal muscle-conditioned medium (SCM), while parasympathetic ciliary ganglionic neurons adhered to a dish precoated with SCM, but not to one precoated with ECM. These results indicate that there are certain materials which mediate specific adhesion between neurons and their target cells.


Limb/trunk lean mass ratio as a risk factor for mortality in peritoneal dialysis patients.
This study was performed to determine the clinical relevance of limb/trunk lean mass ratio (LTLM) in continuous ambulatory peritoneal dialysis (CAPD) patients. This retrospective cohort study included 534 CAPD patients. Body compositions were measured using a dual-energy X-ray absorptiometry apparatus. In males, the sensitivity and specificity for the diagnosis of sarcopenia were 70.3% and 85.9%, respectively. Respective values in females were 62.3% and 83.8%. The initial low LTLM tertile was associated with mortality in male CAPD patients and in female CAPD patients. Among patients who maintained CAPD for a year, the maintenance of low LTLM tertile was associated with mortality. LTLM is associated with other lean mass indices, nutritional status, and mortality in CAPD patients. Therefore, LTLM is a novel marker that is useful for the prediction of the nutritional status and mortality in patients with CAPD.


Phospholipid species act as modulators in p97/p47-mediated fusion of Golgi membranes.
The ATPase p97 in complex with p47 participates in Golgi cisternae rebuilding after mitosis. In a Golgi-liposome assay, the complex triggered a phosphatidylethanolamine (PE)-promoted fusion. Here we show for the first time that fusion between mitotic Golgi membranes induced by adding cytosol or purified p97/p47 is modulated by PE present in Golgi membranes. Using model membranes, we demonstrate a PE-dependent recruitment of p97/p47 to membranes, causing dramatic conformational rearrangements and favoring protein-lipid interactions. Previously buried hydrophobic sites become exposed in a controlled manner, which leads to the penetration of (a) domain(s) of the complex into lipid bilayers, facilitated by a PE-dependent increase in headgroup spacing. In contrast, when facing phosphatidylcholine (PC) the complex clusters extensively. This implies that in the presence of PC protein-protein interactions rather than fusion-promoting protein-lipid interactions occur. Importantly, PE-mediated changes in secondary and tertiary structures are exclusively observed when p97 is complexed with p47, which is a prerequisite for membrane fusion. We therefore propose that at physiological conditions PE-induced conformational changes in p97/p47 are relevant in triggering this activity.


Competition and cooperation among receptor tyrosine phosphatases control motoneuron growth cone guidance in Drosophila.
The neural receptor tyrosine phosphatases DPTP69D, DPTP99A and DLAR are involved in motor axon guidance in the Drosophila embryo. Here we analyze the requirements for these three phosphatases in growth cone guidance decisions along the ISN and SNb motor pathways. Any one of the three suffices for the progression of ISN pioneer growth cones beyond their first intermediate target in the dorsal muscle field. DLAR or DPTP69D can facilitate outgrowth beyond a second intermediate target, and DLAR is uniquely required for formation of a normal terminal arbor. A different pattern of partial redundancy among the three phosphatases is observed for the SNb pathway. Any one of the three suffices to allow SNb axons to leave the common ISN pathway at the exit junction. When DLAR is not expressed, however, SNb axons sometimes bypass their ventrolateral muscle targets after leaving the common pathway, instead growing out as a separate bundle adjacent to the ISN. This abnormal guidance decision can be completely suppressed by also removing DPTP99A, suggesting that DLAR turns off or counteracts a DPTP99A signal that favors the bypass axon trajectory. Our results show that the relationships among the tyrosine phosphatases are complex and dependent on cellular context. At growth cone choice points along one nerve, two phosphatases cooperate, while along another nerve these same phosphatases can act in opposition to one another.


The pseudo-receiver domain of CikA regulates the cyanobacterial circadian input pathway.
CikA (circadian input kinase) is a component of the cyanobacterial circadian clock that aids in synchronizing the endogenous oscillator with the external environment. cikA mutants of the prokaryotic circadian model organism Synechococcus elongatus PCC 7942 fail to reset the phase of the circadian rhythm of gene expression after an environmental time cue, and also exhibit reduced amplitude and shortened period of circadian oscillation. CikA has histidine protein kinase (HPK) activity that is modulated in vitro by GAF and pseudo-receiver (PsR) domains. Here we show that the PsR domain negatively regulates HPK activity in vivo and also serves as an interaction module to dock CikA at a specific subcellular location. Phenotypes conferred by alleles that encode CikA variants showed that all domains except the featureless N-terminus are required for CikA function. Overexpression of all alleles that encode the PsR domain, whether or not the HPK is functional, caused a dominant arrhythmic phenotype, whereas overexpressed variants that lack PsR did not. Subcellular localization of intact CikA identified a polar focus whereas a variant without PsR showed uniform distribution in the cell, consistent with a model in which PsR mediates interaction with other input pathway components.


Assessment of psychopathy as a function of age.
The assessment of psychopathy was examined as a function of age in 889 male prison inmates between the ages of 16 and 69. Ratings of psychopathy were made with the Psychopathy Checklist (PCL), which measures 2 correlated factors. Factor 1 describes a cluster of affective-interpersonal traits central to psychopathy. Factor 2 describes traits and behaviors associated with an unstable, unsocialized lifestyle, or social deviance. Cross-sectional analyses revealed that mean scores on Factor 1 were stable across the age-span; mean scores on Factor 2 declined with age. The prevalence of antisocial personality disorder, and, to a lesser extent of PCL-defined psychopathy, also declined with age. The results are consistent with a conceptualization of psychopathy as encompassing 2 correlated but distinct constructs. They also suggest that age-related differences in traits related to impulsivity, social deviance, and antisocial behavior are not necessarily paralleled by differences in the egocentric, manipulative, and callous traits fundamental to psychopathy.


[Closure of the patent ductus arteriosus by means of cardiac catheterization].
Authors report their results with transcatheter closure of patent arterial duct during a period of 1 year. Thirty patients underwent the procedure at the mean age of 5.22 yrs (range 5 mos-22.3 yrs) and mean bodyweight of 19.1 kg (range 5.8-73 kg). There were 9 males and 21 females. The diagnosis of the patent arterial duct was established by physical examination and noninvasive techniques. The procedures were attempted in all patients above 5 kg bodyweight with patent arterial duct and normal pulmonary artery pressure, irrespective of the shunt-size. All procedures were performed under general anesthesia in one session with the diagnostic cardiac catheterisation. Transcatheter closure was successful in 29 patients. In one patient the device embolized into the left pulmonary artery, snaring was unsuccessful, surgical closure of the patent duct and removal of the device took place uneventfully. Control aortography 15 minutes after the coil placement showed insignificant residual shunt through the patent duct in 8 patients (27%), while echocardiography at 1 month proved complete closure in all. The patients were followed by noninvasive methods. No mortality was observed. Authors emphasize the low risk and cost-effectiveness of the procedure. They stress the importance of the patients selection. Authors applied the technique for the first time and introduced it to the regular patient-care practice in Hungary.


The variable morphological coexistence of apoptosis and necrosis in human myocardial infarction: significance for understanding its pathogenesis, clinical course, diagnosis and prognosis.
Myocardial infarction includes both apoptosis and necrosis, but little is known of the morphological relationship of these two different forms of cell death in the human heart, despite the possibility that this may have clinical importance. Hearts from 77 cases of fatal myocardial infarction were examined. Twelve morphologically representative hearts were selected for immunohistochemical staining to define in detail the histology and cytology of apoptotic areas. Both apoptosis and necrosis were present in every heart. Necrotic myocytes quickly disintegrate and evoke acute inflammation. Apoptotic myocytes retain their membrane integrity and do not evoke acute inflammation. Phagocytosis of apoptotic cells and apoptotic bodies occurred with engulfment by either neighboring myocytes or macrophages, but predominantly the latter. In many apoptotic areas, the phagocytic capacity was overwhelmed, resulting in large pools of apoptotic bodies lying free in the extracellular space. Because apoptotic cells retain their membrane integrity, enzymatic diagnosis of myocardial infarction that is due to necrosis. Measurement of any intracellular enzyme consequently always underestimates the extent of myocardial infarction, often by a large margin. Morphological progression of cell death in myocardial infarction, from apoptosis to necrosis, may depend upon exceeding the local capacity for phagocytosis of apoptotic cells. However, cells dying by either apoptosis or necrosis are equally dead. There is a need for better definition of the role of apoptosis in myocardial hibernation (or stunning), in ischemic preconditioning and in the pathogenesis of silent angina, and post-myocardial infarction remodeling.


Tactile Toe Agnosia and Percept of a "Missing Toe" in Healthy Humans.
A disturbance of body representation is central to many neurological and psychiatric conditions, but the mechanisms by which body representations are constructed by the brain are not fully understood. We demonstrate a directional disturbance in tactile identification of the toes in healthy humans. Nineteen young adult participants underwent tactile stimulation of the digits with the eyes closed and verbally reported the identity of the stimulated digit. In the majority of individuals, responses to the second and third toes were significantly biased toward the laterally neighboring digit. The directional bias was greater for the nondominant foot and was affected by the identity of the immediately preceding stimulated toe. Unexpectedly, 9/19 participants reported the subjective experience of a "missing toe" or "missing space" during the protocol. These findings challenge current models of somatosensory localization, as they cannot be explained simply by a lack of distinct representations for toes compared with fingers, or by overt toe-finger correspondences. We present a novel theory of equal spatial representations of digit width combined with a "preceding neighbor" effect to explain the observed phenomena. The diagnostic implications for neurological disorders that involve "digit agnosia" are discussed.


Comparison of a healing touch, coaching, and a combined intervention on comfort and stress in younger college students.
Three nursing interventions to increase total comfort and reduce stress-related events in young college students experiencing stress were compared. Healing Touch, coaching, and a combination of both, were compared to a waitlist. On comfort and stress, Healing Touch had better immediate results, while coaching had better carryover effects.


[Indications, contraindications and differential therapeutic alternatives in heart transplantation. Current status and results of a survey by the German Transplantation Programs. Thoracic Organ Transplantation Study Group of the German Society of Cardiology--Heart and Lung Research].
In conjunction with the report on "Posttransplant care and rehabilitation", the consensus paper on "Indications, contraindications, and therapeutic alternatives to cardiac transplantation" reflects the current practice in German cardiac transplant centers. This paper is based on a survey organized in 1994 by the Working Group on Thoracic Organ Transplantation of the German Society of Cardiology in which all German transplant centers participated.


Nitric oxide in the treatment of fulminant pulmonary failure in a young pregnant woman with varicella pneumonia.
Extracorporeal membrane oxygenation is the recommended treatment for fulminant pulmonary failure due to varicella pneumonia. However, in pregnancy fetal viability during extracorporeal membrane oxygenation is generally poor resulting in either therapeutic or spontaneous abortion. The present case is to our knowledge the first report on the treatment with nitric oxide to improve oxygenation in a pregnant woman with fulminant pulmonary failure due to varicella pneumonia. Adding 20 parts per million nitric oxide to the inspiratory gas increased arterial oxygen saturation from 75 to 88%, and it could be kept at this level. Due to a vaginal bleeding, an emergency Caesarean section was performed with successful outcome for the fetus. The mother started to improve after delivery and could be weaned from nitric oxide after 5 days. We conclude that inhalation of nitric oxide may be a good alternative to extracorporeal membrane oxygenation in the treatment of fulminant pulmonary failure due to varicella pneumonia in pregnancy.


An approach to nasal tip remodeling.
The luxation (cartilage delivery) technique may be used to achieve a predictable, individualized result in nasal tip rhinoplasty. The author describes how this technique, using a bipedicle flap with an intercartilaginous and rim incision, allows superior visualization of the domal region without structural disruption of the cartilaginous arch. (Aesthetic Surg J 2001;21:345-348.).


Subungual chondroblastoma in a 9-year-old girl.
Chondroblastoma is an uncommon primary bone tumor, mainly found in the epiphyses of long bones. We describe a 9-year-old girl who presented with a chondroblastoma as a subungual mass in the fifth toe. Radiographs showed an expansive, calcified tumor of the distal phalanx. Histologic examination after excision revealed chondroid differentiation, active mitosis, multinucleated giant cells, calcification, and necrosis. There was no recurrence of the lesion after surgical excision. The purpose of this report is to document this unusual event that occurred in such a short bone as the distal phalanx of the fifth toe, mimicking a dermatologic entity.


Celecoxib anti-aromatase neoadjuvant (CAAN) trial for locally advanced breast cancer: preliminary report.
Anti-aromatase therapy is important in the treatment of breast cancer in postmenopausal women. Cyclooxygenase-2 (COX-2) inhibitors have been shown to be effective in chemoprevention in animal and clinical studies. A proof of principle study was performed to investigate the efficacy of combing anti-aromatase therapy (exemestane) and COX-2 inhibitors neoadjuvantly in hormone-sensitive postmenopausal breast cancers. The initial results are reported. The patients were randomly assigned to receive exemestane 25 mg daily and celecoxib 400 mg twice daily (group A), exemestane 25 mg daily (group B) and letrozole 2.5 mg daily (group C). The analysis was based on 20 patients who received at least one cycle of treatment. Fourteen patients completed two cycles and 12 patients three cycles. All groups showed clinical response and there was decrease in tumor area in each group. However, complete clinical response was only observed for group A patients. There was also progressive decline in blood CEA and CA15.3 levels but the differences between the three groups were not significant. The results of the preliminary analysis are encouraging but definitive conclusion could only be drawn after the completion of the study.


Pulse sequence optimization for MR imaging using a paramagnetic hepatobiliary contrast agent.
Paramagnetic agents enhance contrast between tissues in magnetic resonance (MR) imaging by altering tissue relaxation times. The effect of these changes on MR image intensity depends in part on the choice of operator-controlled pulse sequence parameters. With the newly described paramagnetic hepatobiliary contrast agent, iron(III) ethylenebis-(2-hydroxyphenylglycine), Fe(EHPG)-, an in vivo experimental analysis of pulse sequence optimization was performed on the rat. We compared the enhancement of the liver divided by background noise, EL/N, of standard inversion-recovery (IR) and spin-echo (SE) T1-weighted pulse sequences and several pulse sequences theoretically predicted to have improved EL/N. Optimization of the echo time (TE = TEmin) gave a substantial (greater than 60%) increase in EL/N over the standard IR and SE pulse sequences. Images obtained with optimized repetition rate and inversion time gave only a slight additional improvement. Within the uncertainties of our relaxation measurements, the measured changes in EL/N with pulse sequence optimization corresponded well with theoretical predictions. With the experimental and theoretical data, the importance of using a short echo time to obtain maximal T1 contrast in contrast-enhanced MR imaging and the relative merits of optimized SE versus IR pulse sequences for contrast-enhanced MR imaging are discussed.


Independent CPI masculinity and femininity scales: psychological correlates and a sex-role typology.
The meanings of masculinity and femininity as measured by independent scales (MSC and FMN) on the CPi are explored, and a sex-role typology is constructed. The CPI and ACL were administered to 287 college students. Correlations of MSC and FMN with 18 CPI measures showed both masculinity and femininity to be positive traits. Masculinity included self-confidence, mental alertness, assertiveness, leadership, and poise; femininity included socialization, self-control, development of ethical standards, and emotional sensitivity. A sex-role typology was formed, based on joint MSC and FMN scores, and each sex-role type was described, based on its relationship with 18 measures on the CPI and 300 adjectives on the ACL. The typology showed that the high MSC/high FMN group described themselves in favorable terms. The low MSC/low FMN group appeared unhappy, somewhat withdrawn, and distrustful. The self-description of high MSC/low FMN and low MSC/high FMN groups corresponded to stereotypic views of masculinity and femininity, respectively. The similarity of these findings with research using different approaches suggests that consistent pictures of masculinity, femininity, and sex-role types are emerging.


New Insights of Ustilago maydis as Yeast Model for Genetic and Biotechnological Research: A Review.
The basidiomycete Ustilago maydis is a biotrophic organism responsible for corn smut disease. In recent years, it has become one of the most promising models for biochemical and biotechnological research due to advantages, such as rapid growth, and easy genetic manipulation. In some aspects, this yeast is more similar to complex eukaryotes, such as humans, compared to standard laboratory yeast models. U. maydis can be employed as a tool to explore physiological processes with more versatility than other fungi. Previously, U. maydis was only considered as a phytopathogenic fungus, but different studies have shown its potential as a research model. Therefore, numerous promising studies have focused on deepening our understanding of the natural interactions, enzyme production, and biotechnological capacity. In this review, we explore general characteristics of U. maydis, both as pathogenic and "innocuous" basidiomycete. Additionally, a comparison with other yeast models focusing on genetic, biochemical, and biotechnological research are analyzed, to emphasize the versatility, dynamism, and novelty that U. maydis has as a research model. In this review, we highlight the applications of the yeast form of the fungus; however, since the filamentous form is also of relevance, it is addressed in the present work, as well.


Influence of hormones on platelet intracellular calcium.
The pathophysiology of thromboembolic disease associated with estrogen therapy is poorly understood. There are innumerable calcium-dependent activities involved in platelet function. To determine whether platelet calcium levels are affected by exogenous hormones, intracellular calcium and release were studied in platelets in various hormonal environments and findings were correlated with platelet adhesion and aggregation. Platelet intracellular calcium concentration and release was significantly decreased in women ingesting tamoxifen compared to controls and significantly increased, as was platelet adhesion, in oral contraceptive users. Platelets incubated ex vivo with estradiol had increased intracellular calcium and release but there was decreased adhesion to fibronectin. Intracellular calcium concentration and release were not affected when platelets were incubated with tamoxifen. Adhesion to collagen III was increased in tamoxifen-incubated platelets. Only oral contraceptive users had increased sensitivity to aggregating agents. This data suggests that 17 beta estradiol, progesterone, and tamoxifen likely have a nongenomic effect on platelet intracellular calcium and calcium release and that platelet calcium levels are closely related to the degree of platelet adhesion and aggregation in vivo.


Chemistry of the superheavy elements.
The quest for superheavy elements (SHEs) is driven by the desire to find and explore one of the extreme limits of existence of matter. These elements exist solely due to their nuclear shell stabilization. All 15 presently 'known' SHEs (11 are officially 'discovered' and named) up to element 118 are short-lived and are man-made atom-at-a-time in heavy ion induced nuclear reactions. They are identical to the transactinide elements located in the seventh period of the periodic table beginning with rutherfordium (element 104), dubnium (element 105) and seaborgium (element 106) in groups 4, 5 and 6, respectively. Their chemical properties are often surprising and unexpected from simple extrapolations. After hassium (element 108), chemistry has now reached copernicium (element 112) and flerovium (element 114). For the later ones, the focus is on questions of their metallic or possibly noble gas-like character originating from interplay of most pronounced relativistic effects and electron-shell effects. SHEs provide unique opportunities to get insights into the influence of strong relativistic effects on the atomic electrons and to probe 'relativistically' influenced chemical properties and the architecture of the periodic table at its farthest reach. In addition, they establish a test bench to challenge the validity and predictive power of modern fully relativistic quantum chemical models.


[Dynamic observation of alpha-granule membrane protein 140 during the treatment of thrombolytic and anticoagulant therapy in patients with acute myocardial infarction].
The degree of platelet activation and damage in 15 cases with acute myocardial infarction (AMI) receiving thrombolytic therapy and 15 cases with AMI receiving anticoagulant therapy were studied in vivo and in vitro by using specific monoclonal antibodies (SZ-51 & S12) against alpha-granule membrane protein 140 (GMP-140). Clinical indexes and myocardial enzyme changes in the two groups of patients were also observed. The results showed that the number of GMP-140 molecules on platelet surface and the concentration of GMP-140 in plasma were increased before treatment. The number of GMP-140 molecules on platelet surface began to decrease on the 1st day and returned to baseline on the 7th day after treatment. The concentration of GMP-140 in plasma reached a peak on the 1st day, began to fall on the 2nd day and returned to baseline on the 3rd day after treatment. There were no significant differences in the dynamic changes of number of GMP-140 molecules on platelet surface and the concentration of GMP-140 in plasma between groups of thrombolytic therapy and anticoagulant therapy. In vitro experiment showed that the thrombolytic medicine urokinase neither activated platelets nor inhibited platelet activation induced by thrombin. Significantly greater reperfusion rate and earlier appearance of CK and CK-MB peaks were found in the thrombolytic than in the anticoagulant group. LVEF determined by echocardiography, rate of return of ST segments to baseline and alleviation rate of chest pain were significantly greater and complications of AMI (ventricular fibrillation, left ventricular failure and angina) were less in the group receiving thrombolytic therapy.(ABSTRACT TRUNCATED AT 250 WORDS)


Evaluation of antifungal efficacy of erbium, chromium: yttrium-scandium-gallium-garnet laser against Candida albicans.
The purpose of this in vitro study was to investigate the ability of Er,Cr:YSGG laser irradiation at different energy settings to eliminate Candida albicans, either with or without 5.25% sodium hypochlorite (NaOCl) treatment. In total, 90 extracted human single-rooted teeth were shaped by using a crown-down technique with HERO Shaper rotary instruments and irrigated with 1 mL of 2.5% NaOCl between each instrument. The specimens were autoclaved and incubated with a suspension of C. albicans (ATCC 90028). Then the specimens were divided into six treatment groups (n = 15 per group): group 1, NaOCl + 1-W laser; group 2, 1-W laser; group 3, NaOCl + 0.75-W laser; group 4, 0.75-W laser, group 5, NaOCl; and group 6, no treatment. Aliquots of the experimental teeth were transferred onto Sabouraud's dextrose agar plates with paper points, and colony-forming units (CFUs) were counted as a measure of antifungal activity. One root from each group, which was not submitted to the sampling procedure, was fixed in glutaraldehyde, split into two halves, and evaluated with scanning electron microscopy (SEM). Statistical analysis was performed by using analysis of variance (ANOVA) and the Dunnett t test. Significance was set at alpha = 0.05. All the treatment groups resulted in a significant reduction of C. albicans, but no sterilization, and all the groups were significantly different from each other (p < 0.0001). Group 1 (NaOCl and 1-W laser combination) exhibited the greatest reduction, whereas group 5 (NaOCl) resulted in a minimal reduction in CFUs of C. albicans. The SEM observations were in accordance with the microbiologic analysis. The 5.25% NaOCl and 1-W laser treatment combination may be a valuable cleaning tool for root canals infected with C. albicans.


[The dynamics of lipid peroxidation in patients with ischemic heart disease and hypertension during anaprilin treatment].
Results are reported of a study of the lipid peroxidation (LP) in 33 patients with ischemic heart disease (IHD), hypertensive disease (HD) and their associations during anaprilin treatment. During deterioration of the course of HD and IHD there occurs initiation of LP of membranes most pronounced in association of these diseases. Anaprilin reduces the activity of LP products.


Prevalence of azole-resistant Aspergillus fumigatus in the environment of Thailand.
Occurrence of azole-resistant Aspergillus fumigatus (ARAF) in the environment is an emerging problem worldwide, likely impacting on patient treatment. Several resistance mutations are thought to have initially arisen through triazole-based fungicide use in agriculture and subsequently being propagated in a similar manner. Here we investigated the prevalence of ARAF in the environment of Thailand and characterized their susceptibility profiles toward clinically used azole compounds along with underlying resistance mutations. Three hundred and eight soil samples were collected and analyzed, out of which 3.25% (n = 10) were positive for ARAF. All isolates obtained were resistant to itraconazole (MIC ≥ 8 μg/ml), two showed additional increased MIC values toward posaconazole (MIC = 0.5 μg/ml), and one other toward voriconazole (MIC = 2 μg/ml). Sequencing of the respective cyp51A genes revealed that eight of the isolates carried the TR34/L98H allele and those two with elevated MIC values to posaconazole the G54R substitution. Although a clear correlation between the use of triazole-based fungicides and isolation of ARAF strains from agricultural lands could not be established for Thailand, but this study clearly demonstrates the spread of globally observed ARAF strains to the environment of South East Asia.


Perfusion cells for studying regional variation in oral mucosal permeability in humans. 2. A specialized transport mechanism in D-glucose absorption exists in dorsum of tongue.
To clarify the site of d-glucose absorption in human oral cavity, newly designed perfusion cells were applied to five different sites in the human oral cavity, i.e., the dorsum of the tongue, the ventral surface of the tongue, the labial mucosa, the floor of the mouth, and the buccal mucosa. The solution of D-glucose was perfused for 1 h and the rate of absorption was calculated from the amount that disappeared from the perfusate. D-Glucose was absorbed rapidly from the dorsum of the tongue and the absorption was saturable. The saturable absorption was also observed in the ventral surface of the tongue, but not in the other three sites. The rate of D-glucose absorption in the dorsum and the ventral surface of the tongue was significantly larger than that of L-glucose, while in the other sites they were not significantly different. The presence of a specialized transport system for D-glucose absorption in the dorsum of human tongue was suggested.


Comparison of dose-escalated, image-guided radiotherapy vs. dose-escalated, high-dose-rate brachytherapy boost in a modern cohort of intermediate-risk prostate cancer patients.
We compared outcomes in intermediate-risk prostate cancer patients treated with dose-escalated adaptive image-guided radiation therapy (IGRT) or dose-escalated high-dose-rate brachytherapy boost (HDR-B). Patients with intermediate-risk prostate cancer by National Comprehensive Cancer Network criteria were treated with either CT-based off-line adaptive IGRT (n = 734) or HDR-B (n = 282). IGRT was delivered with 3D-conformal or intensity-modulated radiation therapy with a median dose of 77.4 Gy. For HDR-B, the whole pelvis received a median 46 Gy, and the prostate 2 implants of 9.5 Gy (n = 71), 10.5 Gy (n = 155), or 11.5 Gy (n = 56). Median followup was 3.7 years for IGRT and 8.0 years for HDR-B (p < 0.001). Eight-year biochemical control was 86% for IGRT and 91% for HDR-B (p = 0.22), disease-free survival 67% for IGRT and 79% for HDR-B (p = 0.006), and overall survival 75% for IGRT and 86% for HDR-B (p = 0.009). Cause-specific survival (8-year, 100% vs. 99%), freedom from distant metastases (98% vs. 97%), and freedom from local recurrence (98% vs. 98%) did not differ (p > 0.50 each). A worse prognosis group was defined by percent positive prostate biopsy cores >50%, perineural invasion, or stage T2b-c, encompassing 260 (35%) IGRT and 171 (61%) HDR-B patients. These patients evidenced a 5-year biochemical control of 96% for HDR-B and 87% for IGRT (p = 0.002). Dose-escalated IGRT and HDR-B both yield excellent clinical outcomes for patients with intermediate-risk prostate cancer. Improved biochemical control with HDR-B for patients with worse pretreatment characteristics suggests that a subgroup of intermediate-risk prostate cancer patients may benefit from dual-modality treatment.


Effects of exposure to cold and catecholamines on the respiratory quotient and plasma levels of free fatty acids, glucose and urea in rats acclimated to 15 degrees C.
The reported experiments were carried out on 95 male Wistar rats weighing 300 to 360 g kept for 3 weeks in separate cages in a room at an ambient temperature of 15 degrees C. The rats normally fed or fasted for 24 hours were injected at 24-26 degrees C with adrenaline or noradrenaline (400 micrograms/kg s.c.) or injected at 15 degrees C with propranolol (1 mg/kg s.c.). The metabolic rate (MR), respiratory quotient (RQ) and plasma levels of free fatty acids (FFA), glucose (G) and urea (U) were determined. Similarly as in the non-acclimated rats, the determined parameters considered separately were insufficient for estimating the changes in the catabolism of lipids, carbohydrates and proteins, but a simultaneous determination of the RQ and plasma levels of FFA, G or U with MR measurement indicated the degree of lipid, carbohydrate or protein participation in cold-induced thermogenesis.


Science in hand: how art and craft can boost reproducibility.


Mapping patients' experiences after stroke onto a patient-focused intervention framework.
Stroke patients' involvement in the rehabilitation process including decision making has made significant advances clinically over the past two decades. However, development of patient-focused interventions in stroke rehabilitation is a relatively under developed area of research. The aim of this study was to interpret the explanations that patients gave of their experience after stroke and how these may validate an already established patient-focused intervention framework - the Quest for quality and improved performance (QQUIP) (2006) that includes seven quality improvement goals. A random purposive sample of eight stroke patients was interviewed between 3 and 6 months following discharge. Patients' reports of their experience after stroke were obtained using in-dept semi-structured interviews and analysed using Qualitative Content Analysis. Explanations given by patients included both positive and negative reports of the stroke experience. Regardless of consequences as a result of physical, psychological and social impairments, there were other life style disruptions that were reported by all patients such as taking new medication and adverse effects of these, experiencing increasing fatigue, difficulties with social activities and situations and having to make changes in health behaviours and lifestyle. Some of the core themes that emerged reflected the aims of QQUIP improvement goals that include improving health literacy, clinical decision-making, self-care, patient safety, access to health advice, care experience and service development. Further recommendations based on the findings from this study would be to consider using the QQUIP framework for developing intervention studies in stroke rehabilitation care that are person-centred. This framework provides a template that is equipped to address some of the main concerns that people have following the experience of stroke and also focuses on improving quality of care.


Photoreflectance and contactless electroreflectance measurements of semiconductor structures by using bright and dark configurations.
Experimental setup for measurements of photoreflectance (PR) and contactless electroreflectance (CER) spectra in bright and dark configurations is described in this work and applied to study various semiconductor structures. The innovative solution in this setup is the possibility to measure PR and CER spectra in both experimental configurations with the same halogen lamp, monochromator, detector, and only very small modification in the optical path. In this setup the measurement conditions for the two experimental configurations are very similar, and the obtained PR and CER spectra can be compared and discussed in the context of the unwanted constant photovoltaic (PV) effect, which appears in the bright configuration when the sample is illuminated by the spectrum of white light instead of the monochromatic light. It has been clearly shown that for (i) epitaxial layers, (ii) quantum wells, and (iii) quantum dots, exactly the same spectral features are observed in both configurations at room temperature. It means that from the viewpoint of the detection of optical transitions, it is not important what configuration is used since the white light-induced PV effect does not influence the energy of optical transitions in these structures.


Patterns of genetic diversity and biogeographical history of the tropical wetland tree, Pterocarpus officinalis (Jacq.), in the Caribbean basin.
Studies examining intraspecific variation in plant species with widespread distributions and disjunct populations have mainly concentrated on temperate species. Here, we determined the genetic structure of a broadly distributed wetland tropical tree, Pterocarpus officinalis (Jacq.), from eight Neotropical populations using amplified length fragment polymorphisms (AFLP). AFLPs proved highly variable with almost half (48%) of the genetic variation at these loci occurring among individuals within populations. Nonetheless, there was a strong geographical pattern in the distribution of AFLP variation within P. officinalis. Caribbean and continental populations fell into two well-defined genetic clusters supported by the presence of a number of unique AFLP bands. Within these two regions, there were also strong genetic differences among populations, caused mainly by frequency differences in AFLP bands, making it difficult to determine the evolutionary relationships among populations. In addition, our analysis of P. officinalis revealed striking differences in the levels of AFLP variation among the eight populations sampled. In general, Caribbean populations had lower genetic diversity than continental populations. Moreover, there was a clear loss in AFLP diversity with distance from the continent among Caribbean populations. The overall genetic pattern within P. officinalis suggests that past colonization history, coupled with genetic drift within local populations, rather than contemporary gene flow are the major forces shaping variation within this species.


Effects of purified oxygenated water on exercise performance during acute hypoxic exposure.
The purpose of this study was to assess the effects of purified oxygenated water on exercise performance under hypoxic conditions. Nine recreational male cyclists (age = 26.6 +/- 5.2 y, weight = 87.6 +/- 19.5 kg, VO2peak = 46.5 +/- 5.9 mL x kg(-1) x min(-1)) completed two 600 kJ cycling time trials under hypoxic conditions (FIO2 = 13.6% O2, Pbar = 641 mmHg) separated by 2 wk. Trials were completed following 3 d ingestion of 35 mL x kg(-1) x d(-1) of control (CON) or experimental (EXP) water. Time to completion, heart rate (HR), rate of perceived exertion (RPE), pulse oximetry (SaO2), blood gases (PcO2 and PcCO2), and lactate were measured during the trials. Hydration was assessed with pre- and post-exercise body weight and 24-h urine specific gravity. Performance, hydration, and blood oxygenation were unaffected by EXP water. Results of this study suggest that purified oxygenated water does not improve exercise performance in moderately active males.


Degradation of surfactant protein D by alveolar macrophages.
Surfactant protein (SP) D is a pulmonary surfactant-associated protein that may function in lung host defense. SP-D is produced by alveolar type II cells and nonciliated bronchiolar epithelial (Clara) cells of the airway and is secreted into the air space. Here we investigated whether alveolar macrophages degraded SP-D in vitro. We also examined the effects of SP-A and lipids on SP-D metabolism. The results showed that alveolar macrophages bound and degraded SP-D in a time- and temperature-dependent fashion. After 100 min of incubation, the formation of trichloroacetic acid-soluble degradation products increased 4-fold in the medium and 30-fold in the cells. The degradation of SP-D was via a cell-associated process because SP-D was not degraded when incubated in medium previously conditioned by alveolar macrophages. Gel autoradiography of cell lysate samples after incubation with 125I-labeled SP-D demonstrated an increase in degradation products, further confirming the degradation of SP-D by alveolar macrophages. In addition, the degradation of SP-D was not affected by coincubation with SP-A or surfactant-like liposomes containing either phosphatidylglycerol or phosphatidylinositol. In conclusion, alveolar macrophages rapidly degrade SP-D and may play an important role in SP-D turnover and clearance.


A novel mutation in the JH4 domain of JAK3 causing severe combined immunodeficiency complicated by vertebral osteomyelitis.
JAK3 is a tyrosine kinase essential for signaling downstream of the common gamma chain subunit shared by multiple cytokine receptors. JAK3 deficiency results in T-B+NK- severe combined immune deficiency (SCID). We report a patient with SCID due to a novel mutation in the JAK3 JH4 domain. The function of the JH4 domain remains unknown. This is the first report of a missense mutation in the JAK3 JH4 domain, thereby demonstrating the importance of the JH4 domain of JAK3 in host immunity.


[Claude Bernard-Horner syndrome and lumbar epidural analgesia].
Lumbar epidural analgesia was performed in a 28 year old primigravida through a L2-L3 catheter. The first dose induced satisfactory analgesia for 1 h. After the second dose of 8 ml of 0.25 bupivacaine, the patient's systolic blood pressure fell from 110 to 80 mmHg. As vena caval compression can contribute to hypotension, the patient was immediately placed in the left lateral position and oxygen was administered through a mask. Rapid infusion of 250 ml of modified gelatin resulted in a prompt and lasting restoration of blood pressure to its initial level. The third dose of 8 ml of 0.25% bupivacaine produced satisfactory analgesia without any adverse effect. The last dose (4 ml of 0.50% bupivacaine administered with the patient in half sitting) gave a left-sided Horner's syndrome and weakness in the left arm. An epidurogram, performed through the catheter 2 h after delivery, with the patient lying supine, showed unilateral left spread ascending to upper thoracic levels with delayed spread toward the right lumbar epidural space. The troubles persisted 6 h after the final bupivacaine dose, then resolving completely.


Similar effect of caerulein on intracranial self-stimulation in vagotomized and non-vagotomized rats.
Electrical stimulation eliciting self-stimulation behavior from postero-lateral hypothalamic implanted electrode was controlled by factors that control normal feeding. In this idea, lateral hypothalamic stimulation possessed an appetite whetting property and this is experienced as rewarding. The octapeptide cholecystokinin, a gut hormone, has been experimented upon to produce the complete behavioral sequence of satiety in rats. We observed that an i.p. injection of caerulein (an analog of cholecystokinin) did decrease, in a dose-related manner, the rate for brain self-stimulation. However, a similar effect on the rate of ICSS was measured after a bilateral cut of the vagus nerve at a subdiaphragmatic level. This result suggests that the decreasing effect on ICSS after an i.p. injection of caerulein is not strictly related to feeding. We interpret the decrease of reinforcement induced by caerulein as the action of a general satiety for any object presenting a rewarding value for behavior.


Varied clinical presentations of Vibrio vulnificus infections: a report of four unusual cases and review of the literature.
Vibrio vulnificus is a Gram-negative, motile, curved bacillus of the family Vibrionaceae that is a rare cause of gastroenteritis, septicemia, and wound infections in humans. V. vulnificus is halophilic, flourishes in warm temperatures, and is part of the bacterial flora of the marine environment. The location of our health care setting, on the Gulf of Mexico, has given us the opportunity to observe a wide variety of clinical presentations of infections caused by this organism. In the first case, a 27-year-old man struck by lightning while windsurfing was found pulseless in the water and was resuscitated. The patient subsequently developed cardiac arrhythmias, respiratory failure, and necrotizing fasciitis, blood cultures yielded V. vulnificus. After antibiotic therapy and several fasciotomies, the patient recovered. The second case was that of a 43-year-old Asian man employed as an oyster shucker who presented with complaints of redness, tearing, and photophobia of the right eye. The diagnosis of corneal ulcer secondary to V. vulnificus was made after culture of the right eye revealed the organism. The third case involved a 46-year-old man who presented with complaints of abdominal pain, nausea, chills, and bullous lesions on the lower extremities. He developed disseminated intravascular coagulation, and cultures of the lesions on his lower extremities showed V. vulnificus. Initially, the patient denied any exposure to raw seafood or seawater, but he eventually remembered eating raw oysters 3 days before his illness. The fourth case is that of a 32-year-old, human immunodeficiency virus-positive, hepatitis C-positive woman with cirrhosis who presented with productive cough, chills, fever, and red spots on her extremities and buttocks. Blood cultures revealed V. vulnificus and the patient was treated with antibiotics and improved clinically. These four cases illustrate the wide range of clinical presentations associated with this organism.


Secondary Tumors Arising in Patients Undergoing BRAF Inhibitor Therapy Exhibit Increased BRAF-CRAF Heterodimerization.
BRAF inhibitors (BRAFi) elicit therapeutic responses in metastatic melanoma, but alarmingly, also induce the formation of secondary benign and malignant skin tumors. Here, we report the emergence and molecular characterization of 73 skin and extracutaneous tumors in 31 patients who underwent BRAFi therapy. The majority of patients presented with classic epidermal tumors such as verrucous papillomas, keratoacanthomas, and squamous cell carcinomas (SCC). However, 15 patients exhibited new or rapidly progressing tumors distinct from these classic subtypes, such as lymph node metastasis, new melanomas, and genital and oral mucosal SCCs. Genotyping of the tumors revealed that oncogenic RAS mutations were found in 58% of the evaluable tumor samples (38/66) and 49% of the control tumors from patients not treated with BRAFi (30/62). Notably, proximity ligation assays demonstrated that BRAF-CRAF heterodimerization was increased in fixed tumor samples from BRAFi-treated patients compared with untreated patients. Our findings reveal that BRAF-CRAF complex formation is significantly associated with BRAFi treatment, and may therefore serve as a useful biomarker of BRAFi-induced cutaneous and extracutaneous tumor formation.


Intimate partner violence and mental health effects: a population-based study among married women in Karachi, Pakistan.
Intimate partner violence (IPV) is recognized all over the world for its association with mental health problems in women. In Pakistan, such violence occurs commonly, but detailed information on mental health effects is scarce. The purpose of this study is to focused on married couples in urban Karachi to investigate mental health effects associated with physical, sexual and psychological violence perpetrated by husbands towards wives. Disclosure rates and health care-seeking behaviour were also investigated. This cross-sectional study involved 759 women between the ages of 25 and 60 years, selected using a multi-stage random sampling technique. The women were interviewed by trained community midwives using a structured questionnaire. In the total population of women, mental symptoms were prevalent. Women subjected to any form of violence reported, however, considerably poorer mental health than unexposed women. A statistically significant difference for almost all of the studied health parameters persisted even after controlling for socio-demographic factors. The strongest associations were found for suicidal thoughts and physical violence (OR 4.41; 3.18-6.12), sexual abuse (OR 4.39; 3.17-6.07) and psychological abuse (OR 5.17; 3.28-8.15). The interviews revealed that only 27% of the women subjected to violence had disclosed this to anyone, in most cases to their parents. The findings in this study highlight that the violence women have to face contributes to the development of multiple forms of psychological stress and serious mental health problems. Women's restrictive life circumstances seriously hamper women's empowerment. Reliable health surveillance system and health care services are needed to serve abused women. Policy initiatives focused on IPV and gender inequality in Pakistan should be initiated.


Bivalent ligands for G protein-coupled receptors.
Bivalent ligands have been developed for a variety of G protein-coupled receptor targets, including opioid, dopamine, serotonin and muscarinic receptors. The most successful application of the bivalent ligand approach has been in the development of selective opioid antagonists, such as norbinaltorphimine. Several important principles have emerged from the study of norbinaltorphimine and related compounds, including the utility of bivalent ligands for targeting particular receptor classes and serving as a scaffold for specific interactions with unique amino acid residues that render receptor subtype selectivity. In recent years, several novel bivalent compounds were synthesized and characterized for activity at muscarinic receptors. The compounds display an interesting profile of high binding affinity, strong agonist potency and receptor subtype selectivity. Bivalent ligands represent an important starting point for the development of selective muscarinic agonists with potential utility in treating a variety of neurological disorders, including Alzheimer's disease and schizophrenia. The bivalent ligand approach may be generally applicable to other G protein-coupled receptors.


Nanoparticle scanning and detection on flat and structured surfaces using fluorescence microscopy.
A new technique is proposed for the scanning and detection of nanoparticles on flat substrates and three-dimensional structures using fluorescence microscopy. This technique is utilized for particle removal measurements especially in semiconductor and hard disk manufacturing. This fluorescent particle scanning technique enables nanoscale particle detection. The technique shows that single particles down to 63 nm could be detected and counted. The technique is also capable of detecting particles in trenches that are as deep as 500 microm.


The use of misoprostol for early pregnancy failure.
This paper reviews the current management of early pregnancy failure with particular emphasis on the use of misoprostol. Medical management using misoprostol is effective for the management of miscarriages. The success rate ranged from 84 to 93% depending on the regimen of misoprostol, the duration of waiting period and the types of miscarriage. Miscarriages occur in 10 to 20% of all pregnancies. Surgical evacuation has been used to empty the uterus. Recently, medical treatment using misoprostol has been studied for the management of miscarriage. It avoids surgery and its associated complications. Compared to expectant management, the success rate is higher. Nonsurgical management takes a longer period to reach the endpoint and medical management is associated with side effect of medication. Studies have shown that medical management is safe and acceptable to women. The optimal regimen of medical management, however, is yet to be determined.


[Gastric metastases of breast cancer].
Breast cancer is the most frequently encountered cancer in women and the first cause of death in the female population. Metastasis may occur ubiquitously depending on the histological type and the presence or absence of oestroprogesterone receptors. We report three cases with gastric metastasis. Signs of gastric involvement are often non-specific and should not be mistaken for simple side reactions to treatment. Hormone chemotherapy is indicated in most situations but surgery may be needed. It should be noted that gastrointestinal metastasis predominates in lobular breast cancers positive for progesterone receptors.


[Clinical and neuroimaging signs of cardioembolic stroke laboratory in children].
To study clinical and neuroimaging signs of cardioembolic stroke (CES) in children. Ten children (mean age 3.5±3.5 years) were examined. Eight children met the diagnostic criteria of CES CASCADE, two children were diagnosed with CES based on the complex of symptoms. A comparison group consisted of 90 children with other subtypes of ischemic stroke (IS). The diagnosis was confirmed by MRI and magnetic-resonance angiography; symptom severity was assessed with PedNIHSS and PSOM. The PedNIHSS score in the acute stage of CES was higher (18.4±9.34) compared to patients with other subtypes of IS (12.6±6.2; p=0.0065). Six patients had large cerebral infarctions with the involvement of basal ganglia, internal capsule, white matter and cerebral cortex. In two patients, the infarction affected the cerebral cortex and underlying white matter, in one patient it affected the cortex from one side and the basal ganglia from the other. A damage of the cortex was noted in one patient. The frequency of recurrent CES was 30%, of fatal cases 20%. Recurrent IS and severe residual neurological deficit were more frequent in CES. Early disease onset, acute development and progression of neurological deficit up to the maximal level in the first 5 min, marked severity of the acute stage (PedNIHSS score >15), early onset of neurological function recovery, marked residual neurological deficit (PSOM score >2) are the additional signs of CES.


[Determination of dosage and effectiveness of propofol and ketamine for TIVA in adults].
To evaluate the effectiveness of combined use of propofol and ketamine for total intravenous anesthesia (TIVA) in adults and to determine their optimal doses. 100 adults with general anesthesia were randomly divided into five groups [K0, K0.5, K1, K1.5 and K2, with 0, 0.5, 1, 1.5 and 2 mg/ (kg x h) ketamine, respectively]. The dose of propofol administered during surgery and hemodynamics, respiratory recovery time, awakening time, steward score of recovery and adverse reactions of the patients were recorded. Ten patients from each group were randomly chosen to have plasma concentrations of propofol and ketamine examined. The dose of propofol and total price of the two drugs decreased with the increase of dosage of ketamine (P < 0.05). Better outcomes in recovery indexes and adverse reactions were observed in Group K1 compared with those in Group K1.5 and K2 (P < 0.05). Plasma concentrations of ketamine in Group K1, K1. 5 and K2 were higher than those in Group K0.5 (P < 0.05). Regression analyses showed a positive correlation between 'dose of ketamine and operation time' and 'respiratory recovery time and awakening time' and a negative correlation between 'dose of ketamine and operation time' and 'steward score of recovery'. 'Dose of ketamine' was also associated with dreams, asleep after awakening, nystagmus and visual changes. The dose ratio of ketamine and propofol was associated with dizzy and adverse reactions. Continuous pump infusion of 1 mg/(kg x h) ketamine for TIVA in adults can reduce dosage of propofol and minimize adverse effects of ketamine.


Population and vital statistics, 1981.
"For various reasons some of the data relating to population estimates, vital statistics and causes of death in 1981 were not included in the Statistical Abstract of Israel No. 33, 1982. The purpose of this [article] is to complete the missing data and to revise and update some other data." Statistics are included on population by age, sex, marital status, population group, origin, continent of birth, period of immigration, and religion; marriages, divorces, live births, deaths, natural increase, infant deaths, and stillbirths by religion; characteristics of persons marrying and divorcing, including place of residence, religion, age, previous marital status, and year and duration of marriage; live births, deaths, and infant deaths by district, sub-district, and type of locality of residence; deaths by age, sex, and continent of birth; infant deaths by age, sex, and population group; and selected life table values by population group and sex.


The transition of human estrogen sulfotransferase from generalist to specialist using directed enzyme evolution.
Broad specificity is believed to be a property of primordial enzymes that diverged during natural protein evolution to produce highly specific and efficient enzymes. Human estrogen sulfotransferase (SULT1E1) is a broad-specificity enzyme that detoxifies a variety of chemicals, including estrogens, by the transfer of sulfate. To study the molecular basis for the broad specificity of this enzyme and to investigate the process of SULT1E1 specialization, we have adopted a directed enzyme evolution approach. Using two iterative rounds of evolution, we generated SULT1E1 mutants with increased thermostability and narrower specificity from the broadly specific wild-type enzyme. To identify mutants with enhanced specificity, we developed an unbiased screening assay to assess sulfate transfer to three different acceptors in parallel. Such an assay enabled the isolation of SULT1E1 mutants with enhanced or wild-type activity toward an estrogen acceptor and significantly reduced activity for phenol or coumarin type of acceptors, leading to up to 3 orders of magnitude increase in specificity. We found that mutations conferring novel specificity are located in the vicinity of the active site and thus may play a direct role in reshaping the acceptor-binding site. Finally, such mutations resulted in reduced SULT1E1 thermostability, revealing a trade-off between SULT1E1 thermostability and acquisition of novel function.


Allergen-specific immunotherapy in childhood asthma.
Immunotherapy has been shown to prevent rhinitis symptoms in seasonal allergic rhinitis, and to prevent anaphylaxis to hymenoptera and fire ant stings. The evidence supporting its effectiveness in the treatment of asthma is much more limited; it appears that clinical trials, until the past year, have only tested therapy for single allergens such as house dust mite, cats, pollen, and mold. In the past year, a double-blind placebo-controlled clinical trial was completed that tested immunotherapy with a mixture of multiple allergen extracts in 121 perennial asthmatic children. This was the first test of treatment with allergen mixtures. The trial showed that over 30% of children underwent a complete or partial remission during the 2.5 years of therapy, but the changes were almost identical in both treatment and placebo control groups. Other trials were reported that examined injection therapy using synthetic fragments of the major allergen responsible for allergic reactions to cats. In this trial, acute rhinitis and asthma during exposure to naturally occurring airborne particles of cat allergen were reduced significantly.


Factors influencing treatment time in orthodontic patients.
The purpose of this retrospective study was to identify (and quantify the effect of) factors that influence orthodontic treatment time. The sample consisted of 366 consecutive orthodontic patients (220 female, 146 male, aged 10-20 years, treated by 1 orthodontist) who completed treatment in a single stage with fixed appliances. Four categories of data (sociodemographic characteristics, malocclusion characteristics, treatment methods, and patient cooperation) were collected from treatment records and analyzed. Average treatment time was 23.5 months (range, 12-37; SD, 4.7). A multiple regression model explained 38% of the variance and identified 9 significant variables. Five were pretreatment characteristics: male sex, maxillary crowding of 3 mm or more, Class II molar relationships, proposed treatment plan involving extractions, and delayed extractions. The remaining variables (3 of which were associated with patient cooperation) were poor oral hygiene, poor elastic wear, bracket breakages, and brackets rebonded for repositioning. Orthodontic treatment time is influenced by a number of patient characteristics and clinical decisions. It is possible to predict estimated treatment time for a patient by using a small number of personal characteristics and treatment decisions.


Optimizing survival of large fibula osteocutaneous flaps for extensive full-thickness oromandibular defects: A two-stage approach with temporary orocutaneous fistula.
Composite and large head and neck defects requiring extensive skin-mucosa coverage are often reconstructed by combining flaps. Herein, we present a simple and reliable two-stage fibula osteocutaneous (FOC) flap technique to improve the survival of a large skin paddle for oromandibular reconstructions. From October 2011 to September 2016, 47 patients with through-and-through oromandibular defects were reconstructed using FOC flaps with large skin paddles. To ensure optimum survival of skin paddles, temporary orocutaneous fistula were left in place and closed during the second stage operation via de-epithelialization of the skin paddle and suturing of mucosa. Demographic data, operative details, and postoperative complications were recorded. The skin paddle dimensions ranged from 20 to 31.5 cm in length and 12 to 17 cm in width with an average area of 430.4 cm2 (range 300-504). The average time between the two stages and hospital stay were 10 days and 14 days, respectively. Complications at the donor site included wound dehiscence (n = 3, 6.4%), partial skin graft loss (n = 3, 6.4%) and hematoma (n = 2, 4.3%). Recipient site complications included two (4.3%) early postoperative venous congestions that resolved after elevation and three (6.4%) partial skin flap necrosis (less than 5% surface area). All complications resolved with bedside conservative management. There was only one take-back for evacuation of recipient site hematoma (2.1%) but no flap loss. Two-staged large skin paddle FOC flaps can simplify reconstruction of extensive oromandibular defects by improving the reliability of the sizable skin paddle and negating the need for a second flap.


Pattern of Near Transfer Effects Following Working Memory Training With a Dual N-Back Task.
In a randomized controlled trial, we investigated the pattern of near transfer effects of working memory (WM) training with an adaptive auditory-visuospatial dual n-back training task in healthy young adults. The results revealed significant task-specific transfer to an untrained single n-back task, and more general near transfer to a WM updating composite score plus a nearly significant effect on a composite score measuring interference control in WM. No transfer effects were seen on Active or Passive WM composites. The results are discussed in the light of cognitive versus strategy-related overlap between training and transfer tasks.


Smooth muscle tumours of the vulva in Jamaica.
Smooth muscle tumours of the vulva are uncommon and their behaviour is unpredictable. A 30-year retrospective analysis of the pathology files and patient records revealed 10 cases diagnosed at the University Hospital of the West Indies, Kingston, Jamaica, with one malignant and one recurrent tumour. Size, infiltrating margins and mitotic count are important parameters to determine prognosis. Although these tumours are of low malignancy, mitotic count may be mandatory in determining their potential for recurrence.


Caudal bupivacaine vs bupivacaine plus tramadol in post-operative analgesia in children.
Caudal analgesia with bupivacaine is used commonly for pain relief in children and extradural administration of tramadol seemed to be a safe method of analgesia. The aim of the study is to compare the analgesic efficacy of caudal bupivacaine and bupivacaine and tramadol mixture for postoperative analgesia and to observe for side effects. Forty children, aged between 1- 6 years undergoing infra umbilical surgeries were selected for this randomized, control trial. They were randomly divided into two groups. Group A (n = 20) received 0.5 ml/kg of 0.25 % bupivacaine and Group B (n = 20) received 0.5 ml/kg of 0.25 % bupivacaine with 1 mg/kg of tramadol as a single shot caudal block. In the postoperative period heart rate, respiratory rate, pain score, recovery to first analgesic time, total number of analgesics required in 24 hours and side effects were noted and analyzed. It was observed that the mean duration of pain relief was significantly longer in Group B (8.8 hrs Vs 7 hrs). Nausea and vomiting was observed in 25% of the patients in group B and 20 % of the patients in group A. None of the patients in both the groups had complication like motor weakness, urinary retention in the postoperative period. The addition of tramadol to bupivacaine in the caudal analgesic technique provides longer analgesia and lesser need for rescue analgesic in the postoperative period compared to bupivacaine.


Estimating predictive stimulus features from psychophysical data: The decision image technique applied to human faces.
One major challenge in the sensory sciences is to identify the stimulus features on which sensory systems base their computations, and which are predictive of a behavioral decision: they are a prerequisite for computational models of perception. We describe a technique (decision images) for extracting predictive stimulus features using logistic regression. A decision image not only defines a region of interest within a stimulus but is a quantitative template which defines a direction in stimulus space. Decision images thus enable the development of predictive models, as well as the generation of optimized stimuli for subsequent psychophysical investigations. Here we describe our method and apply it to data from a human face classification experiment. We show that decision images are able to predict human responses not only in terms of overall percent correct but also in terms of the probabilities with which individual faces are (mis-) classified by individual observers. We show that the most predictive dimension for gender categorization is neither aligned with the axis defined by the two class-means, nor with the first principal component of all faces-two hypotheses frequently entertained in the literature. Our method can be applied to a wide range of binary classification tasks in vision or other psychophysical contexts.


Identification of a new reciprocal translocation in an AI bull by synaptonemal complex analysis, followed by chromosome painting.
An AI Ayrshire bull was subjected to cytogenetic examination due to lowered fertility. Preliminary Giemsa staining revealed a normal chromosome complement (60,XY) and G-banding did not allow us to draw a clear conclusion concerning an occurrence of chromosome rearrangement. Testicles were collected at slaughter and synaptonemal complex (SC) analysis revealed a large cross-shaped tetravalent configuration in pachytene spreads. No association between the tetravalent and XY bivalent was observed. Chromosome painting, with the use of bovine whole chromosome painting probes, conjugated with DAPI staining, facilitated a detailed description of the translocation rcp(2;4)(q45;q34). This study shows that post mortem analysis of synaptonemal complexes is a simple and useful tool for the preliminary detection of reciprocal translocation carriers.


[Morphologic effect of adrenaline and insulin on bone capillaries after receptor blockade. Functional transmission electron microscopy analysis].
In three groups of six mice each, the alpha- and beta-receptors were blocked by phentolamine and propranolol. The mice in the three groups then received an intravenous bolus injection of saline solution, epinephrine, and insulin, respectively. Cortical bone capillaries from the tibia diaphysis were submitted to transmission electron microscopy (TEM). The lumen and endothelium were measured and the results compared. Significant changes were only noted in the endothelium after the administration of insulin. These findings suggest that there are also insulin receptors in bone. Furthermore, they support previous findings in similar studies with epinephrine.


Tobacco and alcohol use outcomes of a school-based intervention in New Delhi.
To reduce tobacco use among adolescents. Thirty schools in New Delhi, India, were randomly assigned to 3 conditions: school-based and family-based intervention, school-based intervention only, or control group. Students were in the seventh grade at pretest (N = 4,776). The smoking intervention included posters, booklets, classroom activities, debates, and a signature campaign. The family intervention involved home activities. The survey measured tobacco knowledge, attitudes, offers, use, and intentions. Intervention students were significantly less likely than controls to have been offered, received, experimented with, or have intentions to use tobacco. The project had a significant impact on tobacco use.


Paradoxical modulation of tendon tap reflex during voluntary contraction in Parkinson's disease.
Inadequate supraspinal modulation of spinal motor control mechanisms such as alpha-gamma coactivation is supposed to cause difficulty in maintaining proper voluntary contraction in Parkinson's disease (PD). Subjects were 42 patients with PD and 20 normal volunteers. Soleus H-reflex and tendon tap reflex (T-reflex) were recorded. The maximal reflexes (H(max) and T(max)) at rest were recorded first. Next, the stimulus intensities were fixed to obtain a reflex size of around 25% of M(max) at rest for both H- and T-reflexes, and the reflexes were recorded at rest, during tonic plantarflexion (TPF), and at the onset of plantarflexion. H(max) at rest was 55% and T(max) 30% in normal subjects, while they were 36 and 31%, respectively, in PD. The size ratio of T(max) and H(max) at rest in PD was larger than normal. In PD, the size of H-reflex increased with TPF as in normal subjects, but T-reflex decreased. These changes in T-reflex were correlated with the grade of rigidity, bradykinesia, and time for 10 m gait. H-reflex had no such correlations. T-reflex was abnormally modulated in PD especially during tonic contraction. Inappropriate supraspinal modulation of the spinal reflex pathways disturbs motor performance in PD.


Endomyocardial biopsy detection of acute rejection in cardiac allograft recipients.
Endomyocardial biopsy provides a safe, reliable, morphologic index of acute rejection and has an important role to play in the management of patients in whom acute rejection occurs. Repeated endomyocardial biopsies are well tolerated, permitting monitoring of acute rejection in cardiac recipients. Some patients have undergone over 30 serial biopsies. Adequate sampling requires at least four pieces of tissue. The biopsies are graded in the following manner: Mild acute rejection is characterized by a perivascular and mild interstitial infiltrate of pyroninophilic lymphoblasts without myocyte necrosis. Moderate acute rejection has an increased infiltrate extending into the interstitium and causing focal myocyte necrosis. This requires augmentation of immunosuppression. Severe acute rejection, which is more difficult to reverse, includes a more prolific infiltrate with the addition of neutrophils, hemorrhage, and increased myocyte necrosis. Ongoing acute rejection implies that the degree of acute rejection is the same, or worse, than the previous biopsy. Resolving or resolved acute rejection shows reparative changes with diminishing or absent inflammatory infiltrate following treatment. Recipients treated with Cyclosporin-A develop rejection and respond to treatment more slowly than with conventional treatment. This group also develops endocardial infiltrates and a dose-related fine perimyocytic cardiac fibrosis. The endomyocardial biopsy is also useful in identifying infectious agents, for example, toxoplasmosis in cardiac recipients.


The influence of CRF and alpha-helical CRF(9-41) on rat fear responses, c-Fos and CRF expression, and concentration of amino acids in brain structures.
In the present study we have examined the influence of intracerebroventricullary administered CRF, and a non-selective CRF receptor antagonist, alpha-helical CRF((9-41)), on rat conditioned fear response, serum corticosterone, c-Fos and CRF expression, and concentration of amino acids (in vitro), in several brain structures. Pretreatment of rats with CRF in a dose of 1 microg/rat, enhanced rat-freezing response, and further increased conditioned fear-elevated concentration of serum corticosterone. Moreover, exogenous CRF increased aversive context-induced expression of c-Fos in the parvocellular neurons of the paraventricular hypothalamic nucleus (pPVN), CA1 area of the hippocampus, and M1 area of the frontal cortex. A different pattern of behavioral and biochemical changes was present after pre-test administration of alpha-helical CRF((9-41)) (10 microg/rat): a decrease in rat fear response and serum corticosterone concentration; an attenuation of fear-induced c-Fos expression in the dentate gyrus, CA1, Cg1, Cg2, and M1 areas of the frontal cortex; a complete reversal of the rise in the number of CRF immunoreactive complexes in the M2 cortical area, induced by conditioned fear. Moreover, alpha-helical CRF((9-41)) increased the concentration of GABA in the amygdala of fear-conditioned rats. Altogether, the present data confirm and extend previous data on the integrative role of CRF in the central, anxiety-related, behavioral and biochemical processes. The obtained results underline also the role of frontal cortex and amygdala in mediating the effects of CRF on the conditioned fear response.


Tissue distribution of [14C]ethambutol in mice.
Fifteen male mice were given oral doses of 32 mg [14C]ethambutol/kg in a study of the tissue distribution of the drug. Animals were killed 1, 2, 4, 7, and 24 h after dosage and radioactivity in various tissues was measured. Peak concentrations were seen at 2 h after dosage. With the exception of brain, all tissues examined (liver, kidney, heart, spleen, lung, and muscle) developed tissue-to-plasma concentration ratios greater than 2. Highest values were seen in liver, kidney, and lung. High lung values were viewed as a favorable attribute for a drug used in the treatment of tuberculosis.


Allergome: a unifying platform.
The approaches used in both basic research and clinical work in allergology must be reconsidered in the light of information technology. Internet resources are further amplified by the parallel development of other new tools, such as molecular biology and nanotechnology. Information technology, molecular biology and nanotechnology are tightly related entities that fully express their power once applied to biomedical fields. Bioinformatics applied to allergological research simplifies the approach to the increasing wealth of knowledge.


Preliminary results in mitral valve replacement with St. Jude medical prosthesis: comparison with the Björk-Shiley valve.
The clinical improvement and the hemodynamic performance at rest and during bicycle exercise in 22 patients 1 year after implantation of a St. Jude Medical mitral valve (SJMM) were compared with the results of 40 patients after implantation of a Björk-Shiley mitral valve (BSM). In both subjective and functional improvement were significant. In the SJMM group no thromboembolic event occurred, while five patients in the BSM group suffered from embolism during the first year postoperative year (12.5%). Hemolysis was significantly lower in the BSM group but remained subclinical in the SJMM group. This may be explained by a premature backward movement of the posterior leaflet of the SJMM prosthesis in the late diastole, which resulted in a change of flow pattern. Low resistance to blood flow in the SJMM prosthesis could be verified by a small diastolic transvalvular gradient. In valves with equal tissue annulus diameters (29 mm), the calculated effective valve orifices were significantly different (3.07 +/- 1.36 cm2 in SJMM, 1.85 +/- 0.53 cm2 in BSM). In both groups, the mean pulmonary artery pressure was significantly reduced at the time of reinvestigation but increased during exercise. Durability may become a problem because of the two moving parts of SJMM, but we have observed no malfunction. The SJMM appears to be a good alternative in mitral valve replacement.


The effects of space travel on the nervous system.
The translation of man from terrestrial to an extra terrestrial environment is accompanied by an upset in the servo-control of movement engendered by the removal of the normal gravitational signal. Unfortunately the "natural" response of the nervous system, to ocular and vestibular confusion, is to cause varying degrees of sickness which can only be avoided by choice of suitable space travellers i.e., those who are least upset by gravitational chaos. This will remain so until much more is learned about the fundamental physiological mechanisms whereby man maintains a correct head/trunk, head/eye, trunk/limb and eye/limb positional coordination and why if these are upset man's natural response is to vomit.


Back pain after photodynamic therapy with verteporfin.
To report the incidence of back pain after photodynamic therapy, which suggests methods for prevention that are related to its pathogenesis. Retrospective case series. We retrospectively observed 548 patients who had undergone photodynamic therapy with verteporfin. Of 548 patients at the first treatment, 14 patients (2.6%) experienced pain during the infusion. Eleven patients were being treated for age-related macular degeneration; their mean age was 81 years, which significantly differed from the mean age of the overall age-related macular degeneration group (P = .003). The pain was mild in eight patients, moderate in four patients, and severe in two patients, with dyspnea and precordial pain. Five of the 14 patients had further courses of photodynamic therapy. After being treated prophylactically 60 minutes before photodynamic therapy, only one patient reported further mild pain. The biologic mechanisms of back pain may involve a high level of circulating thromboxanes that are induced by the liposomal composition of verteporfin. Prevention may include hydration, nonsteroidal anti-inflammatory drugs, and halving the infusion rate.


Results of a technique of pancreaticojejunostomy that optimizes blood supply to the pancreas.
Anastomotic failure after pancreaticojejunostomy is still a common problem. Failure rates have not decreased perceptibly in the past 3 decades. The neck of the pancreas is a vascular watershed between celiac and superior mesenteric arterial systems. Prior attempts to reduce anastomotic failure at pancreaticojejunostomy have not focused on issues related to blood supply of the pancreas. The aim of this study was to determine whether pancreaticojejunostomy performed using a technique that included optimization of blood supply to the pancreas, would result in a low anastomotic failure rate. The technique was prospectively evaluated in 40 patients having pancreaticojejunostomy, 39 during pancreaticoduodenectomy and 1 after traumatic transection of the neck of the pancreas. Blood supply to the pancreatic neck was evaluated clinically and by Doppler techniques. When blood supply was considered marginal, the pancreas was re-resected 1.5-2.0 cm to the left, away from the vascular watershed. Blood supply at the cut margin of pancreas was judged as brisk in 24 patients and marginal in 16 patients. Resecting a segment of pancreas in these 16 patients resulted in brisk bleeding from the new cut margin in all but 1 patient who had an anomalous artery that had to be sacrificed for oncologic reasons. The only fistula in the series occurred in this patient. There were no intraabdominal abscesses. A technique that includes ensuring adequate blood supply to the pancreas can result in a very low rate of anastomotic failure.


Crystal structure, matrix-isolation FTIR, and UV-induced conformational isomerization of 3-quinolinecarboxaldehyde.
The crystal structure of 3-quinolinecarboxaldehyde (3QC) has been solved, and the compound has been shown to crystallize in the space group P21/c (monoclinic) with a = 6.306(4), b = 18.551(11), c = 6.999(4) Å, β = 106.111(13)°, and Z = 4. The crystals were found to exhibit pseudomerohedral twinning with a twin law corresponding to a two-fold rotation around the monoclinic (100) reciprocal lattice axis (or [4 0 1] in direct space). Individual molecules adopt the syn conformation in the crystal, with the oxygen atom of the aldehyde substituent directed toward the same side of the ring nitrogen atom. In the gas phase, the compound exists in two nearly isoenergetic conformers (syn and anti), which could be successfully trapped in solid argon at 10 K, and their infrared spectra are registered and interpreted. Upon in situ irradiation of matrix-isolated 3QC with UV light (λ > 315 nm), significant reduction of the population of the less stable anti conformer was observed, while that of the conformational ground state (syn conformer) increased, indicating occurrence of the anti → syn isomerization. Upon irradiation at higher energy (λ > 235 nm), the syn → anti reverse photoreaction was observed. Interpretation of the structural, spectroscopic, and photochemical experimental data received support from quantum chemical theoretical results obtained at both DFT/B3LYP (including TD-DFT investigation of excited states) and MP2 levels, using the 6-311++G(d,p) basis set.


Threshold and suprathreshold temporal integration effects in the crossed and uncrossed human acoustic stapedius reflex.
Threshold and suprathreshold temporal integration (TI) effects were studied in the crossed and uncrossed human acoustic stapedius reflex. Changes in reflex threshold were compared at four stimulus durations and for six threshold response criteria; suprathreshold effects were similarly compared at four stimulus durations and at five stimulus sound-pressure levels. Our results showed that reflex thresholds were significantly lower for the uncrossed condition and for longer duration stimuli. Both effects were dependent on threshold response criteria. Threshold TI measurements in both crossed and uncrossed conditions were equivalent at low criterion levels (0%-4%, p greater than 0.05) but were significantly larger in the crossed condition at higher criterion levels (5%-6%, p less than 0.05). Prominent suprathreshold effects also occurred. The main effect was characterized by significantly larger reflex magnitudes in the uncrossed condition. Duration dependent slope differences in magnitude intensity functions (MIFs) were also observed and were characterized by steeper slopes for longer duration stimuli. Saturation effects and/or intensity-dependent slope decelerations in MIFs were predominant in the uncrossed condition and for stimulus durations exceeding 20 ms. These data provide further quantitative evidence for asymmetric threshold and suprathreshold response properties of the crossed and uncrossed human acoustic stapedius reflex and demonstrate the dependence of these effects on stimuli of different durations.


Establishment and characterisation of ovine blood monocyte-derived cell lines.
Studies of the important functions in host defense assured by macrophages, both as functional elements and as potential targets for intracellular pathogens, are often inhibited by the lack of a source of large numbers of uniform, well-characterised cells. To address this lack for ovine studies, we have established cell lines from spontaneously-proliferating adherent mononuclear cells from sheep blood. Eight such lines which have been continuously cultured for over 400 passages have phagocytic activities and cytochemical characteristics indicating that they retain the nature of mononuclear phagocytes. They display typical functional membrane proteins such as CD14, Fc receptors and MHC class II. Such cells can facilitate in vitro studies of pathogen-monocyte interactions and can furnish copious amounts of cells for transfer experiments.


Endothelial cell tube formation depends on cadherin 5 and CD31 interactions with filamentous actin.
Capillary tube formation represents a specialized endothelial cell function and is a prerequisite for the establishment of a continuous vessel lumen. Tube formation is thought to depend on cell-cell adhesion molecules, but whereas cadherins, Ig superfamily proteins, and integrins have been considered as potential candidates, the specific proteins subserving this function are unknown. We identified cadherin 5 and CD31 as two molecules critical for endothelial cell tube formation. Using human dermal microvascular endothelial cells or human umbilical vein endothelial cells for an in vitro capillary tube formation assay or, for comparison, an in vivo wound healing model in SCID mice, we show that tube formation in vivo and in vitro were prevented by adhesion-blocking mAbs to both proteins when used in conjunction but not by either mAb alone. In addition, both mAbs but not each individual mAb blocked cytoplasmic filamentous actin (F-actin) reorganization that resulted in cytoplasmic F-actin clumps similar to those induced by cytochalasin D, suggesting that cadherin 5 and CD31 tune tube formation in concert with F-actin. Indeed, cytochalasin D blocked capillary tube formation but colchicine did not, the latter inhibiting microtubule but not F-actin assembly. Using immunoprecipitation methods, we show for the first time that not only cadherin 5 but also a portion of CD31 connects to beta-catenin, which is part of the adherens junction complex known to be linked to F-actin. In conclusion, we provide evidence that cadherin 5, CD31, beta-catenin, and F-actin shape a functional complex that controls endothelial cell tube formation.


Asymptotic solution for the problem of sound propagation in a shallow sea with the bathymetry described by a parametric quadratic function.
A wide class of three-dimensional sound propagation problems in shallow water where the bathymetry can be locally approximated by a parametric quadratic function is considered. Relevant examples of such bathymetry functions include underwater canyons and ridges. Asymptotic solution for this class of problems is derived under the adiabaticity assumption. The solution is based on mode parabolic equation theory and group-theoretical disentanglement formulas for operator exponentials. Two examples are considered (a ridge and a bottom with quadratic slope), and respective wavefront geometry is studied.


Nucleation and cavitation of spherical, cylindrical, and slablike droplets and bubbles in small systems.
Computer simulations are employed to obtain subcritical isotherms of small finite sized systems inside the coexistence region. For all temperatures considered, ranging from the triple point up to the critical point, the isotherms gradually developed a sequence of sharp discontinuities as the system size increased from approximately 8 to approximately 21 molecular diameters. For the smallest system sizes, and more so close to the critical point, the isotherms appeared smooth, resembling the continuous van der Waals loop obtained from extrapolation of an analytic equation of state outside the coexistence region. As the system size was increased, isotherms in the chemical potential-density plane developed first two, then four, and finally six discontinuities. Visual inspection of selected snapshots revealed that the observed discontinuities are related to structural transitions between droplets (on the vapor side) and bubbles (on the liquid side) of spherical, cylindrical, and tetragonal shapes. A capillary drop model was developed to qualitatively rationalize these observations. Analytic results were obtained and found to be in full agreement with the computer simulation results. The analysis shows that the shape of the subcritical isotherms is dictated by a single characteristic volume (or length scale), which depends on the surface tension, compressibility, and coexistence densities. For small reduced system volumes, the model predicts that a homogeneous fluid is stable across the whole coexistence region, thus explaining the continuous van der Waals isotherms observed in the simulations. When the liquid and vapor free energies are described by means of an accurate mean-field equation of state and surface tensions from simulation are employed, the capillary model is found to describe the simulated isotherms accurately, especially for large systems (i.e., larger than about 15 molecular diameters) at low temperature (lower than about 0.85 times the critical temperature). This implies that the Laplace pressure differences can be predicted for drops as small as five molecular diameters, and as few as about 500 molecules. The theoretical study also shows that the extrema or apparent spinodal points of the finite size loops are more closely related to (finite system size) bubble and dew points than to classical spinodals. Our results are of relevance to phase transitions in nanopores and show that first order corrections to nucleation energies in finite closed systems are power laws of the inverse volume.


Aging and sexuality.
Sexuality, although only one aspect of one's being, plays an integral role during the aging process. This role has physical and psychologic ramifications. A healthy sexual attitude combined with addressing physical health needs provides a greater potential for enjoying a more fulfilled lifestyle as one ages. With aging come significant potential medical problems and associated psychologic disturbances. These issues present a challenge to those in the medical profession who treat this age group. It is important to those physicians accepting this responsibility to become extremely familiar with all the nuances affecting those in the golden years of their lives. This enormous responsibility requires knowledge, caring, compassion, understanding, and sensitivity. With luck, we will all reach those golden years and receive the freedom to experience and express sexuality that is most certainly deserved.