Activation of c-K-ras mutations in human gastrointestinal tumors.
Ras genes are the most frequently detected oncogenes in human malignancies. Data regarding the frequency of c-K-ras mutations in esophageal, gastric, and small bowel tumors are limited and controversial. DNA was extracted from 262 formalin-fixed, paraffin-embedded sections of gastrointestinal samples and tumors, including Barrett's esophagus, esophageal squamous cell carcinomas and adenocarcinomas, and small and large bowel adenomas and adenocarcinomas. The presence of c-K-ras codon 12 mutations was determined using a nonradioactive polymerase chain reaction-based restriction fragment length polymorphism assay. c-K-ras mutations were detected in 1 of 39 (2%) patients with Barrett's esophagus, 1 of 21 (5%) adenocarcinomas, 0 of 27 squamous cell carcinomas of the esophagus, and 1 of 32 (3%) gastric adenocarcinomas. It was also present in 8 of 20 (40%) and 10 of 28 (36%) small bowel adenomas and adenocarcinomas, respectively. Similar numbers were observed in 10 of 25 (40%) large bowel adenomas and 11 of 30 adenocarcinomas (37%). Mutations were not associated with age, gender, histology, grade, stage, location, or mortality. The frequency of codon 12 c-K-ras mutations in small and large bowel tumors is approximately 10-fold higher than that of tumors in the upper gastrointestinal tract.


[The use of the perfused rat heart as a model for selecting antihypoxic compounds].
The test system for selection of antihypoxic compounds was developed and approved on the basis of the model of the perfused rat heart. It was found that the hypoxic state of the moderate degree of severity simulated on the myocardium is optimal for the assessment of the studied antihypoxic compounds. Taking into consideration the fact that at the early stages of hypoxia the electron transport is disordered at the level of the first enzymatic complex of the respiration chain, the protective actions of the agents (menadione and hydroquinone) being able of shunting the respiration chain to bypass the damaged area were studied. It was found that under hypoxia these compounds improve the energy-dependent contractile properties of the myocardium, that is, show up the antihypoxic effects.


Gene profiling analysis of the early effects of ablative fractional carbon dioxide laser treatment on human skin.
The use of carbon dioxide (CO2) laser-mediated ablative fractional resurfacing (AFR) is currently under extensive clinical investigation, but the molecular mechanisms underlying this process are unclear. To determine the early expressed genes that are upregulated in human skin after treatment using a CO2 fractional laser. Whole human skin was irradiated using an AFR CO2 laser, and changes in gene expression after 2 and 24 hours were analyzed using microarray analysis. The results were validated using reverse transcriptase polymerase chain reaction (RT-PCR). Laser scanning confocal microscopy (LSCM) was used to investigate the expression of the validated proteins after AFR CO2 laser treatment of skin that had been biopsied from seven Korean patients. Gene expression profiling showed that the most significantly upregulated genes in these skin samples were those encoding Wnt5a, cysteine-rich angiogenic inducer 61 (CYR61), and heat shock protein (HSP) 90. These results were confirmed using real-time RT-PCR and LSCM. Irradiation using an AFR laser may induce the expression of Wnt5a, CYR61, and HSP90 in human skin during the early remodeling phases, suggesting that the induction of proteins may be the preceding event that is associated with the clinical effects of laser treatment.


Purification and characterization of transcription factor IIIA from higher plants.
Transcription factor IIIA (TF IIIA) binds and specifically activates transcription of eukaryotic 5S rRNA genes. It also forms a 7S ribonucleoprotein complex with mature 5S rRNA. Here, we describe the purification and properties of pTF IIIA from higher plants. The purified protein from tulip (Tulipa whittalii) has a molecular mass of about 40 kDa and also binds 5S rRNA and 5S rRNA genes. pTF IIIA also facilitates the transcription of a 5S rRNA gene in a HeLa cell extract.


Ontogenic development of neurotensin-like immunoreactivity in the gastrointestinal tract and the influence of dietary changes in rats.
The ontogenic development of neurotensin-like immunoreactivity (NTLI) in the gastrointestinal tract was studied in three groups of male rats on different diets. Group I rats were weaned physiologically. Group II rats received only mother's milk until 25 days of age. Group III rats were fed mother's milk alone for 20 days and then switched abruptly to laboratory chow. The NTLI concentration in the gastrointestinal tract from the esophagus to the small intestine was almost the same as that in adult rats before weaning. It increased after weaning to a peak on day 20 or 25, and then decreased to the adult level. The NTLI concentration in the cecum and large intestine, however, decreased from high neonatal level, reaching the adult level on day 20 or 25, and it remained constant thereafter. Prolonged mother's milk feeding alone enhanced neurotensin production in the esophagus and postponed the physiological decrement of NTLI concentrations in the duodenum and small intestine. The sudden change from mother's milk to laboratory chow accelerated the decrement of intestinal NTLI concentrations.


Complete prosthodontic rehabilitation of a patient with Graves' disease.
Graves' disease is the most common form of hyperthyroidism. A brief summary of hyperthyroidism is given with the common symptoms that characterize a thyroid storm. This is followed by a case report of a method of restoring dental health to a patient with Graves' disease.


The sequential feeding of growing chickens.
1. Male chickens, I week old, were fed alternately for 6 or 12 h periods with diets complementary in their amino acid composition. The isonitrogenous, isoenergetic diets were based on fish meal or sunflower meal as the sole source of protein, or fish meal-sunflower (40:60, w/w); each diet contained 120 g crude protein/kg. Other groups of chickens were given these diets ad lib. 2. Net protein utilization (NPU) values obtained after a I-week experimental period indicated that sequential feeding for bot 6 and 12 h resulted in significantly improved responses compared with chickens given the same diets ad lib. These results suggested that the two protein sources, although provided at separate times, could complement each other. 3. In certain treatments there was a 6 or 12 h fasting period between feeding periods to reduce the effect of nutrients from the previous period. 4. For alternate feeding and fasting periods of 6 h with the combined diet, food intake and gain in body-weight were both significantly reduced compared with the corresponding values for the combined diet fed ad lib. The NPU value was virtually the same for both treatments. For 12 h periods of alternate feeding and fasting the gain in body-weight was only just significantly lower than that for the control group (combined diet fed ad lib.), but the NPU value was highly significantly better than that for the control group. 5. For the treatments which included 6 and 12 h fasting periods between the two single-protein diets, the food intake and gain in body-weight were significantly lower compared with the treatment groups given alternate feeding thd fasting periods of either 6 or 12 h with the combined diet. The NPU values for the two groups given 12 h alternate feeding and fasting periods differed significantly, whereas the NPU values for the two groups given 6 h feeding and fasting periods were the same.


Can CK-MB be used as a marker in benign paroxysmal positional vertigo attack?
Benign paroxysmal positional vertigo (BPPV) is one of the main causes of vertigo. More than 90% of cases of positional vertigo and nystagmus can be associated with BPPV. There is no known specific laboratory test for BPPV. Because of the possible muscle activity in BPPV (especially result of nause, vomiting and increasing heart rate) we thought the CK-MB levels may change in this situation. The purpose of this study was to investigate the relation between serum CK-MB levels and BPPV and attacks. The medical records of 35 patients with BPPV presenting to our clinic between November 2014 and November 2015 were investigated retrospectively. Thirty-two control patients with no vertigo, muscular or cardiac disease and with measured CK-MB levels were randomized into a control group. Both groups' existing CK-MB levels were obtained from the patient records. CK-MB values measured before BPPV attack from 11 patients in the patient group were also recorded. The patient and control groups were similar in terms of demographic parameters. CK-MB values at time of attack in the patient group ranged between 5.4 and 38.9 (mean: 19.67 ± 6.81), while control group values ranged between 12 and 27.9 (mean: 20.31 ± 4.54). CK-MB values in 11 patients in the patient group measured before attack ranged between 8.9 and 24 (mean: 17.02 ± 4.97), and CK-MB values during attack ranged between 9 and 34 (mean: 19.74 ± 7.64). Although CK-MB elevation at time of attack was determined in patients with BPPV, this was not statistically significant.


The use of sonication treatment to completely decellularize blood arteries: a pilot study.
We have developed a novel sonication decellularization system to prepare completely decellularized bioscaffolds in a short treatment time. The aim of the study is to investigate the sonication decellularization efficiency and its relation with ultrasonic power output and dissolved oxygen (DO) concentration in different detergent solution. In the study, we used aorta samples to evaluate sonication decellularization efficiency, which assessed treatment duration, sonication power and SDS detergent with/without saline. The treated samples were evaluated histologically by Hematoxylin Eosin (HE) staining and scanning electron microscopic (SEM) photographs. The concentration of DO was monitored to identify the effect of sonication on cavitation-related DO concentration in the solution. From histological results, the sonication decellularization efficiency was better than the other preparation methods. Decellularization efficiency was tended to increase significantly when DO value decreasing after 6 hours of treatment. In conclusion, we conclude that sonication treatment can be used to prepare the complete decellularized scaffolds in short treatment time.


Medical support of the Sinai Multinational Force and Observers: an update, 1990.
The Multinational Force and Observers in an 11-nation peacekeeping force established to monitor the 1979 Egyptian-Israeli Treaty of Peace. Provision of medical support for this force was the first employment of the U.S. Army Medical Department in an effort of this kind. This article is an update to "Medical Support of the Sinai Multinational Force and Observers, 1982," published in Military Medicine in October 1983. We compare the execution of medical support in 1982 with that of 1990 and describe medical conditions and problems encountered during our tour.


The impact of microsaccades on vision: towards a unified theory of saccadic function.
When we attempt to fix our gaze, our eyes nevertheless produce so-called 'fixational eye movements', which include microsaccades, drift and tremor. Fixational eye movements thwart neural adaptation to unchanging stimuli and thus prevent and reverse perceptual fading during fixation. Over the past 10 years, microsaccade research has become one of the most active fields in visual, oculomotor and even cognitive neuroscience. The similarities and differences between microsaccades and saccades have been a most intriguing area of study, and the results of this research are leading us towards a unified theory of saccadic and microsaccadic function.


Changes in serum eotaxin and eosinophil cationic protein levels, and eosinophil count during treatment of childhood asthma.
Increased serum levels of eotaxin are related to the severity of asthma in adults. There are limited data on the effects of oral corticosteroids and inhaled corticosteroid therapy on serum levels of eotaxin and eosinophil cationic protein (ECP) and peripheral blood eosinophil counts (ECs) in pediatric asthma patients. We investigated prospectively the changes in eotaxin and ECP serum levels and peripheral blood ECs after administering oral corticosteroids and then inhaled corticosteroids plus long-acting beta2 agonist treatment in pediatric patients. Serum samples of 20 pediatric patients with mild-to-moderate asthma were collected before treatment, after 5-7 days of oral prednisolone treatment, and after 1-2 months of inhaled fluticasone plus salmeterol treatment. Peak expiratory flow was used as the outcome index. Serum eotaxin levels remained the same after oral prednisolone treatment, but decreased after subsequent inhalation treatment compared with the end of oral steroid treatment (64.7 +/- 22.6 vs 85.7 +/- 36.8 pg/mL, p<0.001). The EC and serum ECP levels declined soon after oral steroid treatment, rebounding to initial levels during inhalation treatment. The decrease in ECP level was positively correlated with the decrease in ECs with oral steroid treatment (r(2) = 0.28, p=0.016). There was no correlation between changes in eotaxin levels and peak expiratory flow. Our data suggest that the serum eotaxin level, not peripheral blood EC or serum ECP level, declines during inhaled fluticasone plus salmeterol treatment and might serve as a surrogate marker of T helper 2 residual activity in pediatric asthma.


The ability of biological and organic synthetic materials to accumulate atmospheric particulates containing copper, lead, nickel and strontium.
This work was aimed at finding materials that could be used as alternatives to lichens as air quality monitors since the high natural variability and the large amount of lichen collected are two drawbacks of the use of these organisms. Lichen Flavoparmelia caperata(L.) Hale was exposed in three different forms (transplant, detached from the substratum and as a biomass-ground and homogeneized) and compared to the planetree bark (Platanus hybrida Brot.), exposed as a biomass, and two organic synthetic materials (Chelex(R) 100 resin and cellulose acetate). Materials were exposed for two months in the winter, spring and summer, at three Portuguese coastal cities. The results showed that the airborne accumulations of Cu, Ni, Pb and Sr were partially dependent on the meteorological conditions but mainly dependent on the nature of the exposed material. The standard deviations of the synthetic materials or homogenized biomass were the same or greater than lichen transplants or detached. The accumulation by biological materials, of the four studied elements, was comparable to the lichen transplant accumulation. The replacement of the traditional transplants by the biomass was not considered advantageous, since their preparation is time-consuming. Therefore lichens remain the most suitable in biomonitoring studies. The exposure of detached lichen allows the accurate measurement of the exposed area/volume so it can be useful to relate atmospheric deposition rates with the lichen metal content. The synthetic materials accumulated Cu and Ni and should only be used as an alternative to traditional transplants when these are the elements of interest.


Late-onset optic atrophy, ataxia, and myopathy associated with a mutation of a complex II gene.
Genetic defects affecting the mitochondrial respiratory chain are an important cause of neurological disease. Previously, we identified a family with complex II deficiency and late-onset neurodegenerative disease with progressive optic atrophy, ataxia, and myopathy. The affected family members are now shown to carry a C-to-T transition in one allele of the nuclear gene encoding the flavoprotein subunit of complex II. Mutation of the equivalent base in Escherichia coli generates an inactive enzyme unable to bind flavin adenine dinucleotide covalently. Compatible with these findings, our patients have an approximate 50% decrease in complex II and succinate dehydrogenase activity. These results suggest that genetic defects of nuclear-encoded subunits of the mitochondrial respiratory chain can result in late-onset neurodegenerative disease.


Protective effect of caffeic acid phenethyl ester (CAPE) on lipid peroxidation and antioxidant enzymes in diabetic rat liver.
The aim of this study was to examine the effect of caffeic acid phenethyl ester (CAPE) on lipid peroxidation (LPO) and the activities of antioxidant enzymes such as superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GSH-Px) in the liver of streptozotocin (STZ)-induced diabetic rats. Twenty-seven rats were randomly divided into three groups: group I, control non-diabetic rats (n = 9); group II, STZ-induced, untreated diabetic rats (n = 8); group III, STZ-induced, CAPE-treated diabetic rats (n = 10), which were intraperitoneally injected with CAPE (10 microM kg(-1) day(-1)) after 3 days followed by STZ treatment. The liver was excised after 8 weeks of CAPE treatment, the levels of malondialdehyde (MDA) and the activities of SOD, CAT, and GSH-Px in the hepatic tissues of all groups were analyzed. In the untreated diabetic rats, MDA markedly increased in the hepatic tissue compared with the control rats (p < 0.0001). However, MDA levels were reduced to the control level by CAPE. The activities of SOD, CAT, and GSH-Px in the untreated diabetic group were higher than that in the control group (p < 0.0001). The activities of SOD and GSH-Px in the CAPE-treated diabetic group were higher than that in the control group (respectively, p < 0.0001, p < 0.035). There were no significant differences in the activity of CAT between the rats of CAPE-treated diabetic and control groups. Rats in the CAPE-treated diabetic group had reduced activities of SOD and CAT in comparison with the rats of untreated diabetic group (p < 0.0001). There were no significant differences in the activity of GSH-Px between the rats of untreated diabetic and CAPE-treated groups. It is likely that STZ-induced diabetes caused liver damage. In addition, LPO may be one of the molecular mechanisms involved in STZ-induced diabetic damage. CAPE can reduce LPO caused by STZ-induced diabetes.


Appropriate goal level for 25-hydroxyvitamin D in cystic fibrosis.
Vitamin D deficiency is common in patients with cystic fibrosis (CF), and guidelines recommend 25-hydroxyvitamin D (25OHD) levels ≥ 30 ng/mL. This threshold was selected because serum parathyroid hormone (PTH) rises in healthy individuals when the 25OHD level falls below 30 ng/mL. PTH levels > 50 pg/mL are associated with an increased risk of bone loss. However, the relationship between 25OHD and PTH has not been studied in CF. We sought to determine the appropriate goal 25OHD level in patients with CF by identifying the level below which the risk of PTH > 50 pg/mL begins to increase. Levels of 25OHD and PTH in 216 individuals with CF were collected prospectively. Individuals with 25OHD < 30 ng/mL were treated with vitamin D2, and levels were reevaluated. Mean 25OHD level was 25.7 ± 12.4 ng/mL, and mean PTH level was 46.7 ± 25.9 pg/mL. In 63% of individuals, 25OHD level was < 30 ng/mL, and in 38.0% it was ≤ 20 ng/mL. Low 25OHD levels were significantly associated with elevated PTH levels, with a mean PTH of 53.1 ± 29.8 pg/mL for 25OHD level 0 to 19 ng/mL; 51.1 ± 30.7 pg/mL for 25OHD level 20 to 29 ng/mL; 38.4 ± 16.4 pg/mL for 25OHD level 30 to 39 ng/mL; and 37.2 ± 16.4 pg/mL for 25OHD level ≥ 40 ng/mL (P = .006). We assessed the sensitivity of different 25OHD thresholds to identify individuals meeting the goal of a PTH level < 50 pg/mL to reduce the risk of bone loss. To obtain 90% sensitivity, a 25OHD level ≥ 35 ng/mL was required. Strikingly, 23% of individuals with 25OHD levels 30 to 34 ng/mL still had a PTH level > 50 pg/mL. This decreased to 14% for 25OHD level ≥ 35 ng/mL. Inadequate serum 25OHD levels are common in adults with CF and are associated with elevated PTH levels. Aiming to maintain 25-OHD levels ≥ 35 ng/mL in individuals with CF decreases the risk of having a PTH level associated with secondary hyperparathyroidism and bone loss.


Effect of iron treatment on circulating cytokine levels in ESRD patients receiving recombinant human erythropoietin.
Anemia in patients with end-stage renal disease (ESRD) is treated with recombinant human erythropoietin (rhEPO) often in combination with iron. However, iron catalyzes the formation of toxic radicals, which might promote vascular damage, is a nutrient for microorganisms, and negatively affects immune pathways, thus increasing the risk for severe infections. We investigated 28 patients on chronic hemodialysis who were randomized to receive either rhEPO alone (N = 15) or rhEPO in combination with intravenous iron (N = 13) for a period of 12 weeks. We analyzed iron therapy associated changes in cytokine patterns and endogenous radical formation. Tumor necrosis factor-alpha (TNF-alpha) levels were increased in ESRD patients at study entry and then decreased significantly over time in subjects receiving additional iron, while they increased with rhEPO alone. In contrast, we found serum concentrations of the anti-inflammatory cytokine interleukin (IL)-4 to increase with iron therapy. A significant negative correlation between iron availability, as determined by transferrin saturation, and TNF-alpha levels (P = 0.008) and a positive one between transferring saturation and IL-4 (P = 0.02) pointed to the potential role of iron to induce immunologic changes. Interestingly, iron therapy resulted in a slight decrease in the amounts of endogenous peroxides, which may be referred to reduced TNF-alpha concentrations since peroxide concentrations were positively correlated to TNF-alpha levels (P = 0.046) and negatively to transferrin saturation (P = 0.02). Iron supplementation in ESRD patients down-regulates proinflammatory immune effector pathways and stimulates the expression of the anti-inflammatory cytokine IL-4. Such a condition is detrimental for host response toward invading pathogens. However, tissue damage by radicals such as endogenous peroxides may be reduced in this condition due to impaired TNF-alpha formation.


Topoisomerase 1 Promoter Variants and Benefit from Irinotecan in Metastatic Colorectal Cancer Patients.
Topoisomerase 1 (topo-1) is an important target for the treatment of metastatic colorectal cancer (CRC). The aim of the present study was to evaluate the correlation between topo-1 single-nucleotide polymorphisms (SNPs) and clinical outcome in metastatic CRC (mCRC) patients. With the use of specific software (PROMO 3.0), we performed an in silico analysis of topo-1 promoter SNPs; the rs6072249 and rs34282819 SNPs were included in the study. DNA was extracted from 105 mCRC patients treated with FOLFIRI ± bevacizumab in the first line. SNP genotyping was performed by real-time PCR. Genotypes were correlated with clinical parameters (objective response rate, progression-free survival, and overall survival). No single genotype was significantly associated with clinical variables. The G allelic variant of rs6072249 topo-1 SNP is responsible for GC factor and X-box-binding protein transcription factor binding. The same allelic variant showed a nonsignificant trend toward a shorter progression-free survival (GG, 7.5 months; other genotypes, 9.3 months; HR 1.823, 95% CI 0.8904-3.734; p = 0.1). Further analyses are needed to confirm that the topo-1 SNP rs6072249 and transcription factor interaction could be a part of tools to predict clinical outcome in mCRC patients treated with irinotecan-based regimens.


The effect of sphingosine on the release of fibronectin from human lung fibroblasts.
Previous work from our laboratory (Scheidl et al. (1992) Biochim. Biophys. Acta 1135, 295-300) has shown that sphingosine (Sph), a known inhibitor of protein kinase C (PKC) inhibited the release of fibronectin (FN) into the media of fibroblast cells in culture and that this effect was independent of PKC. We now report that the action of Sph was time dependent (maximum inhibition in 2 h), concentration dependent (0.5-10 microM, at which concentration Sph was not toxic), and rapidly reversible after removal of Sph. Incubating with [35S]methionine, we found Sph reduced FN release either by inhibition of FN synthesis or FN secretion. To distinguish between these two possibilities, cells were treated with monensin, an inhibitor of FN secretion, which together with Sph showed no additive effect on FN release. Cycloheximide also inhibited FN release, but this inhibition was additive to that with monensin. We concluded that Sph inhibited secretion of FN, not synthesis. Furthermore, intracellular FN declined less in Sph-treated than in untreated control cells. By cell-surface iodination with Na125I and lactoperoxidase, followed by immunoprecipitation with antibodies to FN and alpha 5 beta 1-integrin, we showed that labeled multimeric and dimeric cell-surface FN declined, whereas integrins remained unchanged upon Sph treatment. This result suggested that though the number of cell-surface receptors for FN was not affected by Sph, their affinity may be reduced. In addition, we found that either pre- or co-treatment for 30 min with Sph caused a robust inhibition of cell adhesion to FN-coated plastic. We conclude that Sph rapidly inhibits FN secretion, lowers cell-surface FN, and greatly reduces cell adhesion to a FN substratum.


A closed-form solution for steady-state coupled phloem/xylem flow using the Lambert-W function.
A closed-form solution for steady-state coupled phloem/xylem flow is presented. This incorporates the basic Münch flow model of phloem transport, the cohesion model of xylem flow, and local variation in the xylem water potential and lateral water flow along the transport pathway. Use of the Lambert-W function allows this solution to be obtained under much more general and realistic conditions than has previously been possible. Variation in phloem resistance (i.e. viscosity) with solute concentration, and deviations from the Van't Hoff expression for osmotic potential are included. It is shown that the model predictions match those of the equilibrium solution of a numerical time-dependent model based upon the same mechanistic assumptions. The effect of xylem flow upon phloem flow can readily be calculated, which has not been possible in any previous analytical model. It is also shown how this new analytical solution can handle multiple sources and sinks within a complex architecture, and can describe competition between sinks. The model provides new insights into Münch flow by explicitly including interactions with xylem flow and water potential in the closed-form solution, and is expected to be useful as a component part of larger numerical models of entire plants.


Commercial enzyme immunoassay adapted for the detection of antibodies to hepatitis C virus in dried blood spots.
Dried blood spots (DBS) provide a convenient method for blood sample collection in many settings where the prevalence of infection with hepatitis C virus (HCV) is increasing. Consequently, HCV assays are required that produce reliable results using samples derived from DBS. The optimum buffer for the elution of samples from DBS was selected and the performance of a commercial enzyme immunoassay (EIA) was evaluated using these DBS eluates and paired plasma samples. DBS with paired plasma samples were compared using this modified commercial EIA, which was found to have an estimated sensitivity and specificity of approximately 100% for detecting anti-HCV antibodies in DBS. A DBS-based assay for the detection of antibodies to HCV will prove valuable for collecting epidemiological data in the field or in under resourced settings.


Congenital chylothorax: lymphopenia and high risk of neonatal infections.
To describe the clinical course of patients with congenital chylothorax focusing on infectious complications. Congenital chylothorax is a common manifestation of non-immune hydrops fetalis (NIHF). The drainage of chyle leads to loss of cellular and plasmatic factors that influence the patient's immune response and increase the risk of infections. In a retrospective analysis of 24 preterm infants with NIHF treated between 1998 and 2002, congenital chylothorax was diagnosed in 7 patients. All 7 patients were treated conservatively with pleural drainage over a median period of 22 d (range 10-36 d). Lymphopenia was found in all patients (median of minimal lymphocyte counts 285/microl, range 80-770). The nadir was on day 5 (2-6 d). Lymphopenia lasted for 12 d median (range 4-39 d) and was significantly correlated with the duration of lymph drainage (p = 0.001). Cell-surface analysis of peripheral blood lymphocytes was performed in two patients. Both patients had a decreased number of total T cells. Four out of seven (57%) patients developed nosocomial infections. This incidence of nosocomial infections in patients with congenital chylothorax is about three times higher than that in other neonatal patients. None of the children suffered from fungal or viral infection. Although there was a very high incidence of infections, no correlation between lymphopenia and the occurrence of infections could be shown. Drainage of congenital chylothorax results in the loss of lymphocytes and bears a high risk of infections.


A leishmanin skin test survey in the human population of l'Alacantí region (Spain): implications for the epidemiology of Leishmania infantum infection in southern Europe.
A study of leishmanin skin test reactors was carried out in 1997 and 1998 in an endemic region in southeast Spain, to estimate the magnitude of and the factors related to subclinical Leishmania infantum infection. In the main focus of leishmaniasis in the region, 11.5% of the children and 52.8% of the adults reacted to the skin test. Among the adults, the response was significantly greater for males and for those who had resided in the area for > or = 15 years. In the whole region, 3.7% 14-year-old students reacted to the skin test, with no gender differences. The main factors related to a positive skin test result were having a parent or sibling recovered from leishmaniasis (relative risk = 14) and living in the rural periphery of the region as opposed to the metropolitan area (relative risk = 4). These results indicate a high frequency of subclinical leishmaniasis in the region. We postulate that the decline in childhood visceral leishmaniasis in southern Europe in the second half of the 20th century is related to social changes, which gave rise to a less frequent exposure at a young age as well as a lowered susceptibility to disease through nutritional and immune improvements.


Evaluation of exercise capacity using submaximal exercise at a constant work rate in patients with cardiovascular disease.
Symptom-limited incremental exercise tests are used to estimate the severity of cardiovascular disease and the patient's daily activity. However, there is a need for objective parameters for submaximal exercise. To test the hypothesis that a decrease in maximal exercise capacity can be estimated by oxygen uptake (VO2) kinetics, we measured the time constant of VO2 both during the onset of constant work rate exercise at 50 W and during recovery from this exercise and compared it with data obtained during maximal exercise in patients with cardiovascular disease and in normal subjects. A total of 34 patients with cardiovascular disease and 14 normal subjects performed 6 minutes of 50-W constant work rate exercise and an incremental exercise test to the symptom-limited maximum on a cycle ergometer. VO2 was calculated from respiratory gas analysis on a breath-by-breath basis. The time constant of VO2 during the onset of 50-W exercise was 61.4 +/- 15.2 seconds in patients with cardiovascular disease, significantly longer (the kinetics of VO2 were slower) than that in normal subjects (48.8 +/- 10.4 seconds, P = .008). The time constant of VO2 during the onset of exercise was significantly negatively correlated with peak VO2 (r = -.67) and maximal work rate (r = -.66). The time constant during recovery, which did not differ significantly from that of exercise, was also prolonged in patients with cardiovascular disease; it showed a negative correlation with peak VO2 (r = -.63) and maximum work rate (r = -.54). The time constant of VO2 during and after recovery from 50 W of constant work rate exercise, which does not require the subject's maximal effort, is a useful and objective measure of exercise capacity in patients with mild to moderate cardiovascular disease.


Is chronic tension-type headache a vascular headache? The relation between chronic tension-type headache and cranial hemodynamics.
Twenty-seven patients with chronic tension-type headache were studied as to end-tidal PCO2, heart rate, mean blood pressure, diameter and blood flow of the common carotid arteries, cranial vascular resistance, and headache intensity at supine rest, after administration of nitroglycerin, and at head down tilt. The results were compared to the results of nitroglycerin and head down tilt provocations in age- and sex-matched controls. During supine rest, no change in chronic tension-type headache occurred. Nitroglycerin and tilting induced significant increase of the headache intensity compared to baseline in patients with chronic tension-type headache (P=0.01 and P<0.05, respectively) in contradistinction to controls who did not develop significant headache. Common carotid artery blood flow changes were similar during nitroglycerin provocations in the two groups, but greater (P<0.05) during head down tilt in patients than in controls. Lumbar cerebrospinal fluid pressure was found to be greater than 20 but less than 26 cm H2O in 45% of the 22 patients studied with chronic tension-type headache. The results indicate that the pain in chronic tension-type headache is related to cranial hemodynamics, presumably to distention of intracranial veins.


Systematic review and two new cases of primary upper urinary tract neuroendocrine carcinomas.
Upper urinary tract neuroendocrine carcinoma (UUT-NEC) is extremely rare and has a poor prognosis. Although a few cases of successful treatment have been reported, no treatment has shown established efficacy. We analyzed 70 UUT-NEC patients, including 68 with small cell neuroendocrine carcinoma (SCNEC) and large cell neuroendocrine carcinoma (LCNEC) reported between 1985 and 2017 and 2 treated at our hospital. Median patient age was 66 years, 58.6% were men, and 60% were of Asian descent. Most UUT-NECs were SCNEC (68; 95.7%), whereas LCNEC was very rare (2; 2.9%). More than half of the patients had accompanying other histological components, the most common being urothelial carcinoma (51.5%), whereas 41.4% had NEC alone. Of the 70 patients, 27 underwent additional therapy (e.g., chemotherapy and radiotherapy) along with surgery. Median survival was 15 months. In univariate analysis, stages T1-2 disease showed better prognosis than stages T3-4 (P < 0.001). Additional treatment (e.g., chemotherapy and radiotherapy) significantly improved prognosis (P = 0.014). Moreover, platinum-based chemotherapy also was associated with improved prognosis (P = 0.017). For platinum-based chemotherapy, multicollinearity with additional treatments was strong, and, thus, these data were not included in the analysis. Multivariate analysis revealed pathological stage (T1-2 vs. T3-4; P = 0.003) and additional treatment (P = 0.028) to be independent predictors of improved prognosis. Although UUT-NEC has a poor prognosis, additional treatment along with surgery and therapeutic intervention and stage T1-2 disease are independent factors to improve prognosis.


Best supportive care in lung cancer trials is inadequately described: a systematic review.
The objective of the paper was to identify and discuss clinical terms associated with the availability and delivery of best supportive care for patients with lung cancer in randomised controlled clinical trials. Systematic review was carried out of relevant studies without language restrictions identified through Medline, EMBASE, Science Citation Index (Web of Science and ISI Proceedings) and Cochrane Library. Reference lists of retrieved articles were also searched to identify further studies. Articles describing randomised controlled trials or systematic reviews with a comparator arm of best supportive care for patients with lung cancer were studied. Definitions of best supportive care and elements of best supportive care were reported. Included clinical studies (n = 40) did not adequately describe or outline either the components or the delivery of best supportive care for patients in lung cancer trials. None of the identified studies provided a clear definition of a patient pathway in relation to best supportive care, or a clear list of components. Clinical studies are being conducted without a clear definition of the best supportive care provided in the comparator arms of trials. Inadequate definitions mean that all direct and indirect comparisons in trials comparing active treatments with best supportive care must be interpreted with caution.


Renal denervation significantly attenuates cardiorenal fibrosis in rats with sustained pressure overload.
To investigate the effects of renal denervation (RDN) on comprehensive cardiac and renal fibrosis in cardiomyopathy. Five weeks after successful transverse aortic constriction (TAC)-induced cardiomyopathy model building, Sprague-Dawley rats were randomly assigned to three groups: (1) RDN, (2) sham, and (3) losartan. Sham TAC rats served as control group. Compared with control, TAC groups showed a significant decrease in left ventricle ejection fraction and increase in ventricular septum thickness and left atrium diameter on echocardiography after 5 weeks. At 10 weeks post-TAC, venous blood samples were collected for fibrosis biochemical assay. Heart and kidney samples were also harvested for fibrosis pathophysiological detection. Cardiac and renal fibrosis quantity results showed that, compared with sham group, collagen volume fraction was significantly decreased in RDN group more than in losartan group. Biochemical parameters such as tumor necrosis factor α, aldosterone, and B-type natriuretic peptide levels as well as biomarkers for fibrosis such as procollagen type I N-terminal propeptide and procollagen type III N-terminal propeptide concentrations were significantly decreased in RDN group in comparison with sham. In addition, compared with sham group, left ventricle tissue protein expression of transforming growth factor-β1 and angiotensin II type I receptor was downregulated, and angiotensin-converting enzyme 2 was upregulated in RDN but not in losartan group. RDN significantly attenuates cardiac and renal fibrosis in cardiomyopathy. Differing from losartan, which only has angiotensin II type I receptor inhibition effects, RDN comprehensively suppresses cardiac and renal fibrogenesis through multiple pathways.


A review of evidence on the discriminant validity of outcome measures in rheumatoid arthritis.
We have assessed the discriminant validity of functional status measures and measures that are part of the core set for rheumatoid arthritis. Papers were identified by a systematic literature search in MEDLINE and hand searching of references.


Enantioselective Total Syntheses of Kuwanon X, Kuwanon Y, and Kuwanol A.
The first enantioselective total syntheses of (-)-kuwanon X, (+)-kuwanon Y, and (+)-kuwanol A have been accomplished by using asymmetric Diels-Alder cycloaddition promoted by chiral VANOL or VAPOL/boron Lewis acid. The biosynthesis-inspired asymmetric Diels-Alder cycloaddition shows high exo selectivity (exo/endo = 13/1), which was unprecedented in the previous total syntheses of related prenylflavonoid Diels-Alder natural products. An acid catalyzed intramolecular ketalization process enabled a biomimetic transformation to construct the polycyclic skeleton of kuwanol A efficiently.


Spontaneous splenic rupture in infectious mononucleosis: case report and review of the literature.
A 15-year-old previously healthy girl presented in full arrest after 1 week of flu-like symptoms, recent diagnosis of infectious mononucleosis, and 1 day of abdominal pain. There was no history of trauma. Focused assessment with sonography for trauma examination showed free fluid in the abdomen. The patient died despite aggressive resuscitative management and emergency laparotomy with splenectomy, which showed grade V splenic laceration. Infectious mononucleosis is a common viral illness of adolescence. Spontaneous splenic rupture is a rare but potentially fatal complication. Anticipatory guidance about the importance of seeking medical care if abdominal pain develops during infectious mononucleosis is crucial to early diagnosis and intervention in the case of rupture. We discuss the current literature surrounding the outpatient follow-up of splenomegaly associated with infectious mononucleosis, as well as current practice and treatment options when rupture occurs.


[Quantitative measurement of prefrontal lobe volume on three dimensional magnetic resonance imaging scan].
This article describes the measurement of the frontal and prefrontal lobe volumes on three dimensional (3-D) MRI in 13 children aged 5 months to 14 years and in 3 adults aged 27 to 39 years. The 3-D MRI data were acquired by the fast spoiled gradient recalled (SPGR) sequence using a 1.5 T MR imager. The frontal and prefrontal lobe volumes were measured by the volume measurement function of the Workstation. We confirmed that this technique to analyze segmental brain volumes achieved acceptable levels of reliability and accuracy. There was an increase in the frontal and prefrontal lobe volumes with advancing age, being rapid between 8 and 15 years of age. The prefrontal to frontal lobe volume ratio also increased gradually, with spurts between 8 and 15 years of age. This approach may be particularly useful for studies on patients with frontal and prefrontal lobe dysfunctions.


Vascular endothelial growth factor and neovascularization in astrocytic tumors.
It has been widely recognized that the vascular structure is an important factor when making a histopathological diagnosis and assessing the malignancy potential, especially of astrocytic tumors. The vascular endothelial growth factor (VEGF), which is thought to be regulated by the p53 gene, is a regulation factor for tumor neovascularization. The relationship between VEGF distribution and neovasculature was studied in 42 cases of astrocytic tumors (grades 1-4), which were obtained from surgical material, and the St Anne-Mayo grading system was applied. The relationship between the labeling indices (LI) of VEGF and LI of p53 protein in tumor cells was also studied using immunohistochemistry. The VEGF LI in high-grade malignancy potential tumors, such as grade 3 and grade 4 tumors, was significantly higher than those that were low grade. In grade 4 tumors, a significant correlation between the VEGF LI and the proliferation indices of endothelial cells of neovasculatures was observed. No significant correlation was noted between p53 LI and VEGF LI, as well as p53 LI and histopathological grade. In astrocytic tumors, expression of VEGF may be correlated to tumor neovascularization, and can be considered as an indicator of malignancy potential in astrocytic tumors.


Legal considerations in a nuclear detonation.
This article summarizes public health legal issues that need to be considered in preparing for and responding to nuclear detonation. Laws at the federal, state, territorial, local, tribal, and community levels can have a significant impact on the response to an emergency involving a nuclear detonation and the allocation of scarce resources for affected populations. An understanding of the breadth of these laws, the application of federal, state, and local law, and how each may change in an emergency, is critical to an effective response. Laws can vary from 1 geographic area to the next and may vary in an emergency, affording waivers or other extraordinary actions under federal, state, or local emergency powers. Public health legal requirements that are commonly of concern and should be examined for flexibility, reciprocity, and emergency exceptions include liability protections for providers; licensing and credentialing of providers; consent and privacy protections for patients; occupational safety and employment protections for providers; procedures for obtaining and distributing medical countermeasures and supplies; property use, condemnation, and protection; restrictions on movement of individuals in an emergency area; law enforcement; and reimbursement for care.


[Attempt at a mathematical definition of pachycurare dosage. Application for pancuronium and AH 8165].
Correlations among the elements indispensable to the choice of an average dose of pachycurare are established for surgical needs. Weight and duration of the surgery jointly allow to foresee with approximately 80 p. 100 accuracy the effective dose required for a surgical curarization controlled according to clinical and electromyographical criteria. After calculation of the average consumption of pachycurare per unit of time, a group of curves is established by successive integrations of additional doses representing a family of parabolae corresponding to a second-degree equation: P = alpha + beta t + gamma t2 where P: the cumulative dose for a determined period of time, per kg of body weight and thus total dose if t: the duration of the surgery, t: the time variable, alpha, beta and gamma: significant calculated coefficients. This analytical function established for the use of Pancuronium - bromide in surgery, is also being tried for the curarizing substance: AH.8165.


[Mortality of a group of psychiatric patients under ambulatory care in Geneva].
It is known from former studies that psychiatric patients have a mortality rate higher than that of the general population. This cannot be explained by causes of death that may be specific of psychiatric illness (as suicide for example). The objective of our project is to find if there is such an over mortality in our population, to evaluate to what factors it is related and specially what are the causes of death.


[Functional disorders of the immune system].
In common with other organ systems in the body the immune system demonstrates functional disturbances which may lead to numerous immunological disorders with grave consequences for the health of the patient. Whenever the complex network of regulation and counter-regulation mechanisms within the defence system is impaired, by hereditary or acquired defects, immunological defect syndromes occur. One of the disorders that has been the object of intensive discussion in this context over the past few years is the acquired immune deficiency syndrome AIDS, a dangerous viral infection that mostly affects the T4 cells, whose helper and inductor function is absolutely essential for successful immunological defence. Furthermore, functional impairment of the antibody-producing plasma cells leads to the heterogeneous group of gammopathies which are characterized by an uncontrolled and excessive proliferation of structurally uniform antibody molecules in the blood. Overreactions of the immune system which wrongly attack endogenous tissue are accredited with causing the so-called auto-immune diseases. The clinical pictures within this group are exceptionally varied, and depend both on the self-antigen that the attack is aimed at as well as the erroneously triggered effector function that is affected. Whenever the immune system reacts disproportionately strongly against otherwise harmless foreign antigens, allergic clinical picture emerge.


Dual role of layered double hydroxide nanocomposites on antibacterial activity and degradation of tetracycline and oxytetracyline.
The antibiotic intercalation inside the layered double hydroxide (LDH) layers was usually considered for water decontamination but rarely for drug delivery. Here, tetracycline (TCH) and oxytetracycline (OXY) were immobilized in Zn2Al-Cl LDH following two methods: co-precipitation and anionic exchange. The interfacial concentration of antibiotic varies from 0.04 to 0.5 depending the method of immobilization. The antibiotics are not intercalated in the interlayer space allowing their release in 10 Hours. The antibacterial activity against both E. coli and S. epidermidis revealed that the loaded antibiotics are still active but less efficient compared to the free ones. After exposition to UV light or to high temperature storage (30, 60 and 120 °C), their antibacterial activity significantly decreases due to their degradation especially when antibiotic is loaded on material by co-precipitation. These results are promise to reduce antibiotic contamination in waters.


[Ginsenoside Rb1 attenuates beta-amyloid peptide(25-35) -induced hyperphosphorylation of tau protein through CDK5 signal pathway].
This study is to explore the effect of ginsenoside Rb1 on the process of beta-amyloid peptide(25-35) (Abeta(25-35)) -induced hyperphosphorylation of tau protein, and on the level of cyclin-dependent kinase 5 activator, p25/p35. Western blotting and/or immunocytochemical staining were used to detect the levels of phosphorylation of tau protein at the sites of Thr205, Ser396, Ser404 in hippocampal neurons, cdk5 and p25/p35. After exposure to Abeta(25-35) (20 micromol x L(-1)) for 12 h, the levels of tau protein phosphorylation at the sites of Thr205, Ser396, Ser404 were enhanced, the level of p25 was increased, but the level of protein cdk5 was not changed markedly. Pretreatment with ginsenoside Rb1 reduced Abeta(25-35) -induced hyperphosphorylation of tau protein and decreased the lever of p25, but had no effect on cdk5. Ginsenoside Rb1 can attenuate Abeta(25-35) -induced hyperphosphorylation of tau protein through CDK5 signal pathway.


Genetic analysis of fluvastatin response and dyslipidemia in renal transplant recipients.
The Assessment of Lescol in Renal Transplantation clinical trial demonstrated the efficacy of fluvastatin in reducing cardiovascular (CV) disease in renal transplant recipients. The study included a voluntary pharmacogenetic component, enrolling 1,404 patients, which allowed association testing of baseline measures and longitudinal analysis of the 707 fluvastatin-treated and 697 placebo-treated individuals. A candidate gene approach, examining 42 polymorphisms in 18 genes, was used to test for association between selected polymorphisms and major adverse cardiac events, graft failure, change in LDL and HDL cholesterol, and baseline LDL and HDL cholesterol. Reported associations between cholesteryl ester transfer protein (CETP) and baseline HDL cholesterol were replicated, with four previously implicated single nucleotide polymorphisms significantly associated in males and one in females; tests of reported associations between CETP and CV disease yielded varying results. We found no evidence for genetic factors affecting fluvastatin response. Polymorphisms in 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) previously reported to affect the efficacy of pravastatin did not show a similar effect on the reduction of LDL cholesterol by fluvastatin.


Effect of chronic administration of alprazolam and adinazolam on clonidine- or apomorphine-induced aggression in laboratory rodents.
The activity of chronic (3 weeks) treatment with the triazolobenzodiazepines, alprazolam and adinazolam, on clonidine- and apomorphine-induced aggression were studied. Adinazolam, like desipramine, potentiated aggression induced by clonidine while diazepam and alprazolam completely abolished it. In the apomorphine-induced aggression, adinazolam suppressed both aggressivity and stereotypy, while diazepam slightly potentiated it. Alprazolam did not modify the effect of aggression induced by apomorphine. On the whole, while adinazolam seemed to develop an activity closer to that of a classical antidepressant like desipramine, alprazolam appeared to be more similar to the benzodiazepines on clonidine-induced aggression in mice. Compared to desipramine and diazepam, adinazolam left these two effects induced by apomorphine almost unchanged. The experiments performed showed differences between the profiles of action of the two triazolobenzodiazepines studied.


The role of enhanced mitochondrial phosphorylation in rat liver transplantation.
The effects of organ preservation on mitochondrial oxidative phosphorylation activity, adenylate hepatic energy charge, cytochrome content, and redox state of NAD+/NADH couple in rat liver transplantation were compared between a nonpreservation group and a preservation group with grafts preserved for 12 hr in Euro-Collin's solution. At 3 hr after transplantation, the energy charge in the preservation group decreased to 0.60 +/- 0.02 from the control value of 0.86 +/- 0.01, accompanied by a reduction of intramitochondrial redox state of NAD+/NADH couple. In contrast, in the nonpreservation group, the decrease in energy charge was minimally decreased to 0.79 +/- 0.04 due to the compensatory enhancement of mitochondrial oxidative phosphorylation activity. These results suggest that an enhanced mitochondrial ATP synthesis and a reduced intramitochondrial redox state are important factors affecting survival following rat liver transplantation.


Asbestos, asbestosis, pleural plaques and lung cancer.
Inhalation of asbestos fibers increases the risk of bronchial carcinoma. It has been claimed that asbestosis is a necessary prerequisite for the malignancy, but epidemiologic studies usually do not have enough statistical strength to prove that asbestos-exposed patients without asbestosis are without risk. Several recent studies do actually indicate that there is a risk for such patients. In addition, case-referent studies of patients with lung cancer show an attributable risk for asbestos of 6% to 23%, which is much higher than the actual occurrence of asbestosis among these patients. Thus there is an increasing body of evidence that, at low exposure levels, asbestos produces a slight increase in the relative risk of lung cancer even in the absence of asbestosis. Consequently, all exposure to asbestos must be minimized.


Glucocerebrosidase deficiency and mitochondrial impairment in experimental Parkinson disease.
Gaucher disease is an autosomal recessive disease, caused by a lack or functional deficiency of the lysosomal enzyme, glucocerebrosidase (GCase). Recently, mutations in the glucocerebrosidase gene (GBA) have been associated with Parkinson's disease (PD) and GBA mutations are now considered the most important genetic vulnerability factor for PD. In this study, we have investigated (i) in vivo whether inhibition of the enzyme glucosylceramide synthase by miglustat may protect C57Bl/6 mice against subchronic 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) intoxication and (ii) in vitro whether a decrease of GCase activity may render dopaminergic neurons susceptible to MPP(+) (1-methyl-4-phenylpyridinium) or alpha-synuclein (α-Syn) toxicity and amenable to miglustat treatment. We could demonstrate that reduction of glucocerebroside by inhibition of glucosylceramide synthase partially protects mice against MPTP-induced toxicity. Conversely, we could show that inhibition of GCase activity with conduritol-B-epoxide (CBE) enhances both α-Syn and MPP(+) induced toxicity in vitro. However, only CBE-induced enhancement of MPP(+) toxicity could be reversed by miglustat. Moreover, we were unable to reveal any alterations of complex I activity or cell respiration upon treatment with either CBE or miglustat. Our findings suggest that the reduction of GCase activity rather than an accumulation of glucocerebroside increases aSyn toxicity.


[Investigation of clinical characteristics and surgical treatment for conjunctival epithelial inclusion cyst].
To investigate the clinical characteristics and surgical treatment in eyes with conjunctival epithelial inclusion cysts (CEIC). This study involved the retrospective, medical-record-based investigation of 37 eyes of 34 patients diagnosed with CEIC by slit-lamp biomicroscopy and anterior segment optical coherence tomography (AS-OCT). CEIC were found most commonly in the nasal area of the conjunctiva (64.9%). Thirteen eyes (35.1%) had more than 1 cyst, and 10 eyes (27.0%) had a past history of punctures. Adhesion (9 eyes) between cyst and surrounding connective tissues was found to be significantly more in eyes with a puncture history (5 eyes; p = 0.0234, Fisher's exact test). Complete excision of cysts through a small conjunctival incision could be performed significantly more often among the 28 eyes without adhesion than in the 9 eyes with adhesion (p = 0.002). Pathological examination of the cysts indicated that they involved goblet cells in 16 eyes and mild inflammation in 4 eyes, consistent with the findings in previous reports. CEIC are predominantly found in the nasal area of the conjunctiva. In eyes without puncture history, adhesion of cysts to the surrounding tissues was rarely observed and cysts were successfully excised "en bloc" via minimally invasive surgery.


Co-composting of oil-based drilling cuttings by bagasse.
The feasibility of using a locally abundant bulking material (sugarcane bagasse) in Khuzestan province, Iran, to remove petroleum hydrocarbons from oil-based drill cuttings (OBDCs), using composting process, was investigated. OBDCs were collected from the discharge point of a drilling rig and bagasse was collected from a sugarcane agro-industry near Ahwaz. Experiments were performed in the dark and at room temperature, using different bagasse to OBDCs ratios. Degradation extent and kinetics of total petroleum hydrocarbons (TPHs) and poly aromatic hydrocarbons (PAHs), as well as dehydrogenase and urease enzymes activities and number of heterotroph bacteria during the co-composting of OBDCs and bagasse were studied and measured. Highest PAHs and TPH removals were observed when OBDCs were composted with 15% bagasse. After 70 days of incubation, PAHs and TPH were removed up to 24.8% and 67.5%, respectively. Studying the enzymes activities and number of heterotrophs with TPH and PAHs concentrations over time suggests that biodegradation is the main mechanism in the degradation process. The first-order kinetic model was fitted to the TPH and PAHs degradation data and contaminants half-lives were estimated to be in the range of 40-80 and 170-240 days respectively. DT90 values for TPH and PAHs were in the range of 120-260 and 560-1260 days, depending on the bagasse content.


[Single high-dose and fractionated low dose cisplatin in the EP protocol for advanced NSCLC--a prospective randomized trial on 72 patients].
A prospective randomized trial on 72 patients (12 cases in stage III and 60 cases in stage IV) suffering from non-small cell lung cancer (NSCLC) was carried out from January 1993 to March 1994 to assess the immediate results of single high dose DDP and fractionated low doses DDP in the EP (Etoposide and Cisplatin, DDP) protocol. The response rate to the former regimen was 47.1% (16/34) as compared with 39.5% (15/38) of the latter. The difference between these two regimens were not statistically significant (P > 0.10). The former regimen had higher incedence of delayed vomiting (P < 0.01), but the latter had more severe bone marrow suppression (P < 0.05). Without significant difference in renal toxicity (P > 0.10). The authors suggest that, the EP protocol consisting of fractionated doses of DDP, may be more preferrable due to its mild gastro-intestinal toxic reaction and less expensive in the treatment of advanced NSCLC patients. Yet, it is necessary to guard against its renal toxicity and myelosuppression.


Temperature effects on drift of suspended single-domain particles induced by the Magnus force.
We study the temperature dependence of the drift velocity of single-domain ferromagnetic particles induced by the Magnus force in a dilute suspension. A set of stochastic equations describing the translational and rotational dynamics of particles is derived, and the particle drift velocity that depends on components of the average particle magnetization is introduced. The Fokker-Planck equation for the probability density of magnetization orientations is solved analytically in the limit of strong thermal fluctuations for both the planar rotor and general models. Using these solutions, we calculate the drift velocity and show that the out-of-plane fluctuations of magnetization, which are not accounted for in the planar rotor model, play an important role. In the general case of arbitrary fluctuations, we investigate the temperature dependence of the drift velocity by numerically simulating a set of effective stochastic differential equations for the magnetization dynamics.


Analog electromagnetically induced transparency for circularly polarized wave using three-dimensional chiral metamaterials.
In this paper, we theoretically and experimentally demonstrate a three-dimensional metamaterial that can motivate electromagnetic induced transparency (EIT) by using circular polarized wave as stimulations. The unit cell consists of a pair of metallic strips printed on both sides of the printed circuit board (PCB), where a conductive cylinder junction is used to connect the metal strips by drilling a hole inside the substrate. When a right circularly polarized wave is incident, destructive interference is excited between meta-atoms of the 3D structure, the transmission spectrum demonstrates a sharp transparency window. A coupled oscillator model and an electrical equivalent circuit model are applied to quantitatively and qualitatively analyze the coupling mechanism in the EIT-like metamaterial. Analysis in detail shows the EIT window's amplitude and frequency are modulated by changing the degree of symmetry breaking. The proposed metamaterial may achieve potential applications in developing chiral slow light devices.


Warming 0.5% bupivacaine to 37 degrees C increases duration of spinal anesthesia.
The effect of warming glucose-free 0.5% bupivacaine to 37 degrees C before injection for spinal anesthesia was studied in 20 patients having total knee replacement. Twenty additional patients having spinal anesthesia for the same procedure were given glucose-free 0.5% bupivacaine at room temperature (approximately 20 degrees C). Onset, maximum cephalad spread, quality of sensory anesthesia, and duration and degree of motor blockade were the same in both groups. However, the duration of sensory anesthesia was significantly prolonged in patients who received bupivacaine at 37 degrees C. The mechanism by which warming bupivacaine prolongs the duration of sensory spinal anesthesia is uncertain. However, a decrease in the dissociation constant (pKa) of bupivacaine owing to increasing the temperature to 37 degrees C may account for some of this effect.


Synthesis and antiproliferative activity of D-ring substituted steroidal benzamidothiazoles.
Using progesterone as the starting material, we synthesized a series of steroidal derivatives possessing a D-ring substituted benzamidothiazole. All of the final structures were reported and identified by NMR and HRMS spectrometry for the first time. The antiproliferative activity of the synthesized compounds against PC-3 (human prostate cancer cell line) and SKOV-3 (ovarian cancer cells) were investigated. The preliminary results showed that compounds 8b, 8d and 8g possessed moderate antiproliferative activities.


High-Throughput Differential Scanning Fluorimetry of GFP-Tagged Proteins.
Differential scanning fluorimetry is useful for a wide variety of applications including characterization of protein function, structure-activity relationships, drug screening, and optimization of buffer conditions for protein purification, enzyme activity, and crystallization. A limitation of classic differential scanning fluorimetry is its reliance on highly purified protein samples. This limitation is overcome through differential scanning fluorimetry of GFP-tagged proteins (DSF-GTP). DSF-GTP specifically measures the unfolding and aggregation of a target protein fused to GFP through its proximal perturbation effects on GFP fluorescence. As a result of this unique principle, DSF-GTP can specifically measure the thermal stability of a target protein in the presence of other proteins. Additionally, the GFP provides a unique in-assay quality control measure. Here, we describe the workflow, steps, and important considerations for executing a DSF-GTP experiment in a 96-well plate format.


Chiropractic Integration into Private Sector Medical Facilities: A Multisite Qualitative Case Study.
Chiropractic care may have value in improving patient outcomes and decreasing opioid use, but little is known about the impetus for or process of incorporating these services into conventional medical settings. The purpose of this qualitative study was to describe organizational structures, care processes, and perceived value of chiropractic integration within U.S. private sector medical facilities. Multisite, comparative organizational case study. Nine U.S. private sector medical facilities with on-site chiropractic care, including five hospitals and four clinics. One hundred and thirty-five key facility stakeholders including doctors of chiropractic (DCs), non-DC clinicians, support staff, administrators, and patients. Researchers conducted 2-day site visits to all settings. Qualitative data were collected from audio-recorded, semi-structured, role-specified, individual interviews; standardized organizational data tables; and archival document review. A three-member, interdisciplinary team conducted thematic content analysis of verbatim transcripts using an existing conceptual framework and emergent codes. These nine medical facilities had unique organizational structures and reasons for initiating chiropractic care in their settings. Across sites, DCs were sought to take an evidence-based approach to patient care, work collaboratively within a multidisciplinary team, engage in interprofessional case management, and adopt organizational mission and values. Chiropractic clinics were implemented within existing human resources, physical plant, information technology, and administrative support systems, and often expanded over time to address patient demand. DCs usually were co-located with medical providers and integrated into the collaborative management of patients with musculoskeletal and co-morbid conditions. Delivery of chiropractic services was perceived to have high value among patients, medical providers, and administration. Patient clinical outcomes, patient satisfaction, provider productivity, and cost offset were identified as markers of clinic success. A diverse group of U.S. private sector medical facilities have implemented chiropractic clinics, and a wide variety of facility stakeholders report high satisfaction with the care provided.


[Clinical evaluation of living donor].
When possible, living donor transplantation represents the best therapeutic strategy for patients suffering from chronic renal failure. Studying the donor allows a complete and thorough clinical, laboratory and instrumental assessment that guarantees good organ function whilst protecting the health of the donor. The main parameters considered within this framework are age, renal function, nephrological complications, comorbidities (diabetes, hypertension, obesity, etc.), malignancies, and infection. Moreover, particular attention is paid to the sociopsychological aspects of the donation, particularly related to the donor, the recipient, and the entire family situation.


Vocational Rehabilitation of Transition-Age Youth with Disabilities: A Propensity-Score Matched Study.
Objective To investigate the employment outcomes of vocational rehabilitation (VR) services for youth with disabilities in a targeted, enhanced, and contract-based secondary transition program as compared to the traditional VR transition services. Methods A population-based study was conducted on 4422 youth with physical, intellectual, learning, mental and hearing disabilities aged 14-21 at application and whose case was closed after receiving VR transition services in a Midwestern state. Selected youth were classified into either targeted secondary transition program (START) or non-START treatment group. The employment outcomes of the groups were compared using propensity-score matching procedures. Results 2211 youth with disabilities in each treatment group were successfully matched based on demographic characteristics, types of disabilities, existence of severe functional limitations, and year of referral. The overall rehabilitation rate was 57 % [95 % confidence interval (CI) 56-59 %], where the START group rate was 61 % (95 % CI 59-63 %) and the non-START group 53 % (95 % CI 51-55 %). The propensity-score matched odds ratio (OR) was 1.40 (95 % CI 1.24-1.58; p < 0.001). Subgroup analyses showed that the odds of rehabilitation in youth with disabilities were consistently higher when they were in START as compared to non-START (OR ranged from 1.27 to 1.92 with p < 0.05 except for the Hispanic subgroup). Conclusion The results suggest that VR services in a targeted, enhanced, and contract-based secondary transition program are more effective in transitioning youth with disabilities to employment than the regular VR transition services.


The multicomponent AM-FM image representation.
We compute AM-FM representations for multicomponent, nonstationary images using a statistical component model. Components are isolated with a filterbank comprising frequency and orientation selective channels. The modulating functions for each component are estimated from the channel responses using localized nonlinear operators followed by optimal MMSE estimators. We also demonstrate reconstruction from the representation.


Psoriasis and psoriasiform lesions induced by TNFα antagonists: the experience of a tertiary care hospital from northern Spain.
The aim of this study was to investigate the cumulated incidence and clinical characteristics of the psoriasiform lesions seen in a wide cohort of rheumatic patients exposed to anti-TNFα drugs in a tertiary care hospital from northern Spain. The study population included 450 patients exposed to anti-TNFα agents from 2001 to 2007 and treated in a university hospital in northern Spain. Two hundred patients were exposed to infliximab (44%), 129 (29%) to etanercept, and 121 (27%) to adalimumab. The cumulated incidence (CI) of this skin reaction was calculated for each of the three agents studied. Psoriasis and psoriasiform lesions were documented in 7 patients diagnosed with different rheumatic inflammatory conditions (1.56%). Cases of this adverse effect were identified with all three anti-TNFα agents available at that time, but less frequently with infliximab (CI: 0.5%) compared with etanercept (CI: 2.3%) or adalimumab (CI: 2.5%). The most common lesion was palmoplantar pustulosis (71.3% of the cases), and the latency period to the development of the lesions ranged from 4 to 38 months (mean 9 months). In four of the 7 patients, treatment was suspended, while in the remaining three patients treatment was continued. The CI of this skin reaction in our setting is similar to that published by others. Infliximab was found to be less frequently associated with this adverse event. In our experience, it is not always necessary to stop anti-TNFα therapy for the skin lesions to improve.


The relationship between patient object relations and the therapeutic alliance in a naturalistic psychotherapy sample.
This study examined the relationship between patients' object relations and interpersonal process in psychotherapy. Namely, we tested the hypothesis that the quality of patients' object relations is positively associated with both patient- and therapist-rated alliance quality. Psychotherapy was administered naturalistically, with quantitative data collection before and during treatment. Participants included 73 adult outpatients and 23 therapists at two mental health clinics. Using the Bell Object Relations and Reality Testing Inventory, we measured four dimensions of patients' object relations at baseline-alienation, insecure attachment, egocentricity, and social incompetence. Using the Working Alliance Inventory, we measured alliance from patient and therapist perspectives. Control variables included time, patient demographics, symptom severity, and clinic. We employed hierarchical linear modelling to analyse data with a nested structure, with 138 sessions at Level 1, 73 patients at Level 2, and 23 therapists at Level 3. Patient alienation and insecure attachment were associated with lower patient-rated alliance, while egocentricity was associated with higher patient-rated alliance. Patients' object relations were not significantly associated with therapist-rated alliance. On average, patients perceived the alliance more positively than their therapists, with a weak positive correlation between the alliance perspectives. The results suggest that object relation dimensions may be important patient characteristics for forecasting therapeutic relationship quality. They also call for more attention to differences between alliance rating perspectives. Treatment may benefit from more attention to the quality of patients' object relations. If patients present with high levels of alienation and insecure attachment, therapists may need to pay especially close attention to the therapeutic alliance, and prudently address any ruptures in its quality. When monitoring the alliance quality, it is important to consider that patients and therapists may have different perspectives. Therapists relying solely on their own perceptions are at risk of missing alliance difficulties, and patients' object relations may be uniquely predictive of their own sense of the alliance. Therefore, it may be helpful to ask patients in session and through standardized measures for feedback on how they perceive the goals and tasks of treatment and the emotional bond with their therapist. Again, any alliance tensions could then be addressed directly as a means to maintaining engagement in the service of better outcome.


Preparation of silica thin films by novel wet process and study of their optical properties.
Silicon dioxide (SiO2) thin films have gained considerable attention because of their various industrial applications. For example, SiO2 thin films are used in superhydrophilic self-cleaning surface glass, UV protection films, anti-reflection coatings, and insulating materials. Recently, many processes such as vacuum evaporation, sputtering, chemical vapor deposition, and spin coating have been widely applied to prepare thin films of functionally graded materials. However, these processes suffer from several engineering problems. For example, a special apparatus is required for the deposition of films, and conventional wet processes are not suitable for coating the surfaces of substrates with a large surface area and complex morphology. In this study, we investigated the film morphology and optical properties of SiO2 films prepared by a novel technique, namely, liquid phase deposition (LPD). Images of the SiO2 films were obtained by scanning electron microscopy (SEM) and atomic force microscopy (AFM) in order to study the surface morphology of these films: these images indicate that films deposited with different reaction times were uniform and dense and were composed of pure silica. Optical properties such as refractive index and transmittance were estimated by UV-vis spectroscopy and ellipsometry. SiO2 films with porous structures at the nanometer scale (100-250 nm) were successfully produced by LPD. The deposited film had excellent transmittance in the visible wavelength region.


[Intraosseous infusions in children].
The authors submit a review on th intraosseous approach to infusions and their possible application in emergency medicine.


Disruption of the transforming growth factor-β pathway by tolfenamic acid via the ERK MAP kinase pathway.
Transforming growth factor-β (TGF-β) modulates diverse cell physiological processes and plays a complicated role in tumor development. It has been well established that TGF-β inhibits cell proliferation in normal and early stage carcinoma and facilitates tumor metastasis in late-stage carcinoma. Therefore, blocking TGF-β signaling in advanced stage carcinogenesis provides a potentially interesting chemotherapeutic strategy. We aimed to determine the effect of tolfenamic acid (TA) on TGF-β-induced protumorigenic activity. Here, we demonstrate that TA attenuates tumor-promoting effects of TGF-β in cancer cells. Further observation indicates TA blocks the TGF-β/Smad pathway, and this blockage is mainly attributed to the interference of TGF-β1-driven phosphorylation of Smad2/3. We also show that TA could exert this effect on cancer cell lines from several different origins and that TA is much better than other non-steroidal anti-inflammatory drugs with respect to inhibition of TGF-β1-induced Smad2 phosphorylation. Finally, extracellular signal-regulated kinase mitogen-activated protein kinase plays a role in TA-induced suppression of Smad2/3 phosphorylation and subsequent nuclear accumulation of Smad2/3 in response to TGF-β1. Our study provides a possible mechanism by which TA affects anticancer activity by inhibiting the TGF-β pathway and sheds light on the application of TA for cancer patients.


Lithiophilic Ag Nanoparticle Layer on Cu Current Collector toward Stable Li Metal Anode.
Intractable hurdles of low Coulombic efficiency and dendritic Li formation during a repeated deposition/stripping process hinder the commercial use of Li metal anode for next-generation battery systems. Achieving uniform Li nucleation is one of the effective strategies to address these issues, and it is of practical importance to realize this on a commercial Cu current collector that is lithiophobic. Herein, we design a nanostructured Ag lithiophilic layer on a Cu foil via an electroless plating process for a Li metal current collector. The deposition of lithiophilic Ag particles that are homogeneously distributed on the Cu foil can reduce the nucleation overpotential, realizing uniform Li nucleation and subsequently flat Li plating. As a result, a stable cycle stability of up to 360 h (1 mA cm-2) and an average Columbic efficiency of 94.5% for 100 cycles (1 mA cm-2) are achieved. Furthermore, CuAg full cells with LiFePO4 as a cathode exhibit good cycle performances and low polarization voltage. This approach provides another facile way for a stable lithium metal anode.


Granulomatous slack skin presenting as acquired ichthyosis and muscle masses.
We describe a case of granulomatous slack skin in a 31-year-old woman with an unusual presentation of acquired ichthyosis and muscular masses involving four limbs over 3 years. Vesicles and ulcerative skin nodules first appeared only 3 months prior to diagnosis. The diagnosis was confirmed after sequential biopsies of muscle, skin lesions, and lymph nodes, together with molecular genetic studies. The patient responded poorly to various therapies, including thalidomide, and died of doxorubicin-related cardiomyopathy.


More harm than good? Diagnostic codes for child and adult abuse.
This study sought to understand the reasons for the lack of use of ICD diagnostic codes for child and adult abuse. New Jersey professionals were recruited to participate in three focus groups on child abuse, adult or primarily woman abuse, and elder abuse. Participants included health care providers, advocates from the community, and representatives of state agencies and the insurance industry. Concerns about coding abuse included further jeopardizing victims/patients, diagnostic uncertainty, and lack of resources. Members of the child abuse group were somewhat more receptive to coding abuse. Reasons to code, such as for documentation and reimbursement were discussed and rebutted. Most participants concluded that use of the abuse codes should be judicious because they have the potential to do more harm than good. More research is needed on the implications of coding for victims/patients along with medical education in the identification of abuse in general and coding abuse in particular.


Reinfection of Somali children with Trichuris trichiura after chemotherapy: relevance of immunostimulation.
The intestinal helminth status of an age-stratified sample (6 to 20 years old) from a Somalian community has been assessed and the typical pattern of highly aggregated parasite distribution found. A reinfection study on a sample of 40 children (treated and untreated with a pentapeptide identical to the active site of the thymic hormone thymopoietin) seemed to indicate that immunological factors play a significant role in modulating the population dynamics of infection in endemic communities.


Effects of propofol and pentobarbital on ligand binding to GABAA receptors suggest a similar mechanism of action.
The GABAA receptor is allosterically modulated by a number of anesthetics and barbiturates. We have examined the effects of propofol and pentobarbital on the binding of the receptor agonist [3H]muscimol and the benzodiazepine modulators [3H]flunitrazepam and [3H]Ro15-4513 to bovine brain membranes. Both agents potentiated the binding of [3H]muscimol (5 nM), with EC50 values of 18.7 and 276 microM, respectively. The binding of [3H]muscimol is heterogeneous, suggesting the presence of both high (Kd approximately 10 nM) and low (Kd approximately 0.1-1.0 microM) affinity sites. The major effect of both propofol and pentobarbital was to increase the affinity of the lower affinity sites without changing the total binding capacity. In contrast, the steroid anesthetic alphaxalone did not affect the affinity of these sites, suggesting that this drug has distinct effects on the GABAA receptor. Propofol and pentobarbital also increased the binding of the benzodiazepine agonist [3H]flunitrazepam and decreased the binding of the inverse agonist [3H]Ro15-4513. The results of these studies demonstrate that propofol and pentobarbital modulate the binding of ligands to the GABAA receptor in a similar manner, suggesting that these drugs may have a common mechanism of action.


Management of malignant atlanto-axial tumours.
To review the management and outcomes of patients with malignant tumours of the atlanto-axial spine treated over a 4-year period at a tertiary hospital. A total of 12 patients (9 female and 3 male) with a mean age of 56.5 years (range, 35-71 years) were consecutively enrolled. At the time of presentation, 7 patients had received treatment for a known primary malignancy of the lung (n=4), colon (n=1), nasopharynx (n=1), or breast (n=1). The atlanto-axial spine was the first presentation of malignant disease in the remaining 5 patients, whose subsequent diagnoses were multiple myeloma (n=1), carcinoma of the thyroid (n=1), malignant fibrous histiocytoma (n=2), and adenocarcinoma of unknown origin (n=1). Preoperative, postoperative, and follow-up radiographs and computed tomographic and magnetic resonance imaging scans were analysed with regard to the extent of tumour involvement, other spinal metastases, instability, and evidence of cord compression. Surgeries were performed for surgically fit patients with a life expectancy of more than 3 months. All patients presented with severe suboccipital neck pain. Two had mild neurological deficits (Frankel grade D). Two patients were treated conservatively with rigid neck collars and survived for 3 and 11 months. Surgical stabilisation with posterior instrumentation was performed in 10 patients. One patient received additional anterior surgery for tumour debulking and bone grafting. No neurological complications were recorded in the series. Excellent relief of pain was achieved, and the mean visual analogue scale pain score of the operated patients improved from 9.3 to 1.9. The mean survival of 9 patients after surgery was 13.1 months, while one patient was still living at the time of review (at postoperative 11 months). Surgical stabilisation in selected patients provided pain relief and preserved ambulatory status before the deterioration of overall function.


Ultrathin β-tellurium layers grown on highly oriented pyrolytic graphite by molecular-beam epitaxy.
Monolayer tellurium (Te) or tellurene has been suggested by a recent theory as a new two-dimensional (2D) system with great electronic and optoelectronic promises. Here we present an experimental study of epitaxial Te deposited on highly oriented pyrolytic graphite (HOPG) by molecular-beam epitaxy. Scanning tunneling microscopy of ultrathin layers of Te reveals rectangular surface cells with the cell size consistent with the theoretically predicted β-tellurene, whereas for thicker films, the cell size is more consistent with that of the [101[combining macron]0] surface of the bulk Te crystal. Scanning tunneling spectroscopy measurements show that the films are semiconductors with the energy band gaps decreasing with increasing film thickness, and the gap narrowing occurs predominantly at the valence-band maximum (VBM). The latter is understood by strong coupling of states at the VBM but a weak coupling at conduction band minimum (CBM) as revealed by density functional theory calculations.


Association between socioeconomic status, surgical treatment and mortality in patients with colorectal cancer.
High socioeconomic status is associated with better survival in colorectal cancer (CRC). This study investigated whether socioeconomic status is associated with differences in surgical treatment and mortality in patients with CRC. Patients diagnosed with stage I-III CRC between 2005 and 2010 in the Eindhoven Cancer Registry area in the Netherlands were included. Socioeconomic status was determined at a neighbourhood level by combining the mean household income and the mean value of the housing. Some 4422 patients with colonic cancer and 2314 with rectal cancer were included. Patients with colonic cancer and high socioeconomic status were operated on with laparotomy (70·7 versus 77·6 per cent; P = 0·017), had laparoscopy converted to laparotomy (15·7 versus 29·5 per cent; P = 0·008) and developed anastomotic leakage or abscess (9·6 versus 12·6 per cent; P = 0·049) less frequently than patients with low socioeconomic status. These differences remained significant after adjustment for patient and tumour characteristics. In rectal cancer, patients with high socioeconomic status were more likely to undergo resection (96·3 versus 93·7 per cent; P = 0·083), but this was not significant in multivariable analysis (odds ratio (OR) 1·44, 95 per cent confidence interval 0·84 to 2·46). The difference in 30-day postoperative mortality in patients with colonic cancer and high and low socioeconomic status (3·6 versus 6·8 per cent; P < 0·001) was not significant after adjusting for age, co-morbidities, emergency surgery, and anastomotic leakage or abscess formation (OR 0·90, 0·51 to 1·57). Patients with CRC and high socioeconomic status have more favourable surgical treatment characteristics than patients with low socioeconomic status. The lower 30-day postoperative mortality found in patients with colonic cancer and high socioeconomic status is largely explained by patient and surgical factors.


Polyclinidae (Ascidiacea: Aplousobranchia) from the Gulf of Mexico, collected during the "Hourglass" cruises (1965-1967).
This paper presents the ascidians from the Family Polyclinidae collected in the Gulf of Mexico during the Hourglass Cruises between August 1965 and November 1967. The analysis of the collected material revealed the presence of eight polyclinid ascidians from three different genera, with two new species and two new records for the Gulf of Mexico.


Care of epidermolysis bullosa patients: a nursing challenge.
Epidermolysis bullosa is a complex set of diseases occurring at birth or infancy and characterized by severe blistering and in some cases dystrophy. This article describes those diseases and the nurse's role in coordinating patient care.


Endoscopic sinus surgery or Caldwell-Luc operation in the treatment of chronic and recurrent maxillary sinusitis.
The treatment of chronic and recurrent maxillary sinusitis has been changed in recent years. The radical Caldwell-Luc approach has increasingly been replaced by more conservative functional endoscopic sinus surgery (FESS). In the central hospital of Central Finland between 1991 and 1992, 260 patients (424 sinuses) suffering from chronic or recurrent maxillary sinusitis were operated on. Patients were classed into three groups according to the patient history of sinusitis. The plain sinus films (occipitomental projections) were evaluated. Complication rate and the need for reoperations were evaluated retrospectively after a mean follow-up time of 3.8 years. Patients in the Caldwell-Luc group had more serious disease than in the FESS or antrostomy group. The plain sinus films taken preoperatively showed more opacification in maxillary sinuses in the Caldwell-Luc group than in the FESS or antrostomy group. Complication rate was 4.4% in the Caldwell-Luc group and 2.6% in the FESS group. No serious complications existed in the whole material. Patients treated with Caldwell-Luc operation in 1991 and 1992 needed reoperation in 7/96 cases (7.3%) and 3/63 cases (4.8%), respectively. In the FESS group, patients operated 1991 and 1992 needed reoperation in 3/11 cases (27%) and 13/72 cases (18%), respectively.


Study of oxidative DNA damage in TK6 human lymphoblastoid cells by use of the thymidine kinase gene-mutation assay and the in vitro modified comet assay: determination of No-Observed-Genotoxic-Effect-Levels.
Nowadays, there is clear progress in using the threshold concept in genetic toxicology, but its demonstration and acceptance in risk assessment is still under debate. Although it has been accepted for some non-DNA-reactive agents for which mechanisms of action were demonstrated, there is a growing weight of evidence to also support the existence of thresholded dose-responses for DNA-reactive agents. In this context, we have recently shown in human TK6 lymphoblastoid cells, that DNA-oxidizing agents [potassium bromate, bleomycin and hydrogen peroxide (via glucose oxidase)] produced non-linear dose-responses in the in vitro micronucleus test, thus allowing the determination of No-Observed-Genotoxic-Effect-Levels (NOGELs). Therefore, the aim of the present study was to focus on the analysis of thresholded dose-response curves in order to further investigate the existence of NOGELs for these same directly DNA-damaging agents, by use of other genotoxicity endpoints. Mutation frequency was determined after a 1-h treatment in the thymidine kinase (TK) gene-mutation assay. Primary DNA damage, especially oxidative DNA damage, was also assessed after 1h of treatment, followed - or not - by a 23-h recovery period, with the modified version of the comet assay (i.e. with the glycosylases Fpg and hOgg1). Overall, our analysis demonstrates that there is convincing evidence to support the existence of thresholded dose-responses for DNA-oxidizing agents. The determination of NOGELs depends on the genotoxic endpoint studied and consequently requires different genotoxicity assays performed concurrently. NOGELs could only be defined for the induction of chromosomal aberrations and gene mutations, i.e. for an effect-endpoint but not for primary DNA damage, i.e. for an exposure-endpoint. Further statistical analyses of these data are now required in order to draw conclusions on the exact level of the thresholds.


Insights into the intestine immune of Marsupenaeus japonicus under the white spot syndrome virus challenge using RNA sequencing.
Intestine is not only the nutrients digestion and absorption centers, but also an important place of microbial infection. Therefore, intestine immunity plays a key defense means for the host against the invasion of pathogenic microorganisms. In this study, we use kuruma shrimp (Marsupenaeus japonicus) as a model to study the intestine immune characteristics of shrimp against WSSV through next-generation sequencing technique. A total of 63,458 and 44,350 unigenes were generated from the control sample and the WSSV infection sample, respectively. Based on homology searches, KEGG, GO, and COG analysis, 39,520 unigenes were annotated. Among them, 12,920 differentially expressed genes were identified. Some of them, including mucin, peritrophin, chitinase, et al., are involved in immune response. These results contribute to a better understanding of the intestine immune response of the shrimp to WSSV.


Genetic, metabolic and clinical characteristics of maturity onset diabetes of the young.
Maturity onset diabetes of the young (MODY) is a genetically and clinically heterogeneous subtype of non-insulin-dependent diabetes mellitus (NIDDM) characterised by early onset, autosomal dominant inheritance and a primary defect in insulin secretion. To date, three MODY genes have been identified on chromosomes 20q (MODY1/hepatic nuclear factor (HNF)-4alpha), 7p (MODY2/glucokinase) and 12q (MODY3/HNF-1alpha). Mutations in MODY2/glucokinase result in mild chronic hyperglycaemia as a result of reduced pancreatic beta-cell responsiveness to glucose, and decreased net accumulation of hepatic glycogen and increased hepatic gluconeogenesis after meals. In contrast, MODY1 and MODY3 are characterised by severe insulin secretory defects, and by major hyperglycaemia associated with microvascular complications. The role of the three known MODY genes in susceptibility to the more common late-onset NIDDM remain uncertain. Genetic studies seem to exclude a role as major susceptibility genes, but leave unresolved whether they may have a minor role in a polygenic context or an important role in particular populations.


Membrane permeability characteristics and osmotic tolerance limits of sea urchin (Evechinus chloroticus) eggs.
Development of effective cryopreservation protocols relies on knowledge of the fundamental cryobiological characteristics for a particular cell type. These characteristics include osmotic behaviour, membrane permeability characteristics, and osmotic tolerance limits. Here, we report on measures of these characteristics for unfertilized and fertilised eggs of the sea urchin (Evechinus chloroticus). In NaCl solutions of varying osmolalities, sea urchin eggs behaved as ideal linear osmometers. The osmotically inactive volume (vb) was similar for unfertilized and fertilised eggs, 0.367+/-0.008 (mean+/-SE) and 0.303+/-0.007, respectively. Estimates of water solubility (Lp) and solute permeability (Ps) and their respective activation energies (Ea) for unfertilized and fertilised eggs were determined following exposure to cryoprotectant (CPA) solutions at different temperatures. Irrespective of treatment, fertilised eggs had higher values of Lp and Ps. The presence of a CPA decreased Lp. Among CPAs, solute permeability was highest for propylene glycol followed by dimethyl sulphoxide and then ethylene glycol. Measures of osmotic tolerance limits of the eggs revealed unfertilized eggs were able to tolerate volumetric changes of -20% and +30% of their equilibrium volume; fertilised eggs were able to tolerate changes +/-30%. Using membrane permeability data and osmotic tolerance limits, we established effective methods for loading and unloading CPAs from the eggs. The results of this study establish cryobiological characteristics for E. chloroticus eggs of use for developing an effective cryopreservation protocol. The approach we outline can be readily adapted for determining cryobiological characteristics of other species and cell types, as an aid to successful cryopreservation.


The accuracy of musculoskeletal ultrasound examination for the exploration of meniscus injuries in athletes.
Meniscus injuries represent a frequently occurring pathology in athletes and require an optimum diagnosis protocol. This study aimed to evaluate the accuracy of ultrasound examination for the identification of meniscus injuries, in comparison with magnetic resonance imaging (MRI), using the arthroscopy as reference. This prospective longitudinal comparative study included 45 athletes who were clinically examined by MRI and further, by arthroscopy, in a medical center dedicated to sport traumatology. The conventional ultrasound exploration of the knee allowed the identification of a diverse pathology, presenting a sensitivity of 88.8% for the diagnosis of medial meniscus injuries and 70.0% for the lateral meniscus. The specificity was 77.7% for the medial meniscus and 96.0% for the identification of lateral meniscus injuries. Using MRI, a sensitivity of 69.4% was obtained for the medial meniscus and 75.0% for the lateral meniscus, with a specificity of 76.6% for the pathology of medial meniscus and 80.0% for the lateral meniscus. Statistical analysis, based on the comparison of ROC curves, did not show any significant difference between the two applied diagnostic techniques (P=0.061 for the medial meniscus and P=0.534 for the lateral meniscus). The musculoskeletal ultrasound exploration of the knee joint, performed in a medical center with high addressability, by an experienced examiner, was able to identify the medial and lateral meniscus injuries with an accuracy comparable to that of MRI examination.


[Flavonoids: antioxidative compounds and their role in prevention of ischemic heart disease].
Research on the biological activity of flavonoids shows that they are powerful antioxidants. The paper discusses the physical and biological factors which are fundamental to the antioxidant properties of these compounds. Experimental, clinical and epidemiological studies have shown that consumption of large amounts of food rich in polyphenolic compounds (such as vegetables, fruit, juices, tea, spices) may prevent or support the treatment of the cardiovascular disease.