One-year follow-up of patients treated for dental fear: effects of cognitive therapy, applied relaxation, and nitrous oxide sedation.
The effects of dental fear treatments were assessed in a 1-year follow-up study. Sixty-two patients had finished a controlled study in which they were randomly allocated to nitrous oxide sedation (NO), cognitive therapy (CT), or applied relaxation (AR). During the trial highly significant reductions in dental fear and general distress were observed. One year later a majority (95%) of the participants had attended dental treatment in general practice. On the whole, continued favorable effects with regard to dental fear and general distress were observed. Patients in the applied relaxation group evidenced the largest reductions on the dental fear measures. All patients judged the dental fear treatment to have been beneficial, and 80% judged the treatment given in the year after the dental fear treatment successful. All three treatment groups scored in the normative range for general distress both at the end of treatment and at follow-up.


Optimizing medical practice using a computerized hospital information system. Example of blood transfusions.
The recent focus on medical risks and dollar cost of blood transfusion has resulted in the need to define guidelines for transfusion of blood products. In 1987, a computerized knowledge-based system was implemented at LDS Hospital to screen transfusion requests and flag those not justified by criteria defined by the medical staff. The use of red blood cells (RBC) for the 9 month period from July 1, 1988 was reviewed. The number of units ordered that met the criteria used by LDS Hospital was 90%. Our results showed there was a need to refine knowledge about transfusion therapy to help physicians optimize the use of blood products.


Antioxidant protection against acoustic trauma by coadministration of idebenone and vitamin E.
Idebenone, a synthetic analogue of coenzyme Q, attenuates noise-induced hearing loss by virtue of its antioxidant properties. This study involves a guinea pig model of acoustic trauma where the effectiveness of idebenone is analyzed in comparison with Vitamin E (alpha-tocopherol) that exhibits a potent antioxidant activity in the inner ear. Idebenone and vitamin E were injected intraperitoneally 1 h before noise exposure and once daily for three days; functional and morphological studies were then carried out, respectively, by auditory brainstem responses evaluation, scanning electron microscopy and terminal deoxynucleotidyl transferase-mediated dUTP nick end labelling assay identification of missing and apoptotic cells was also performed. The results showed that the protective effects of idebenone and vitamin E were not additive implying that the two antioxidants may share competitive mechanisms.


Cross coupling reactions of organozinc iodides with solid-supported electrophiles: synthesis of 4-substituted benzoic and 3-substituted (E)- and (Z)-propenoic acids and amides.
The solid-supported iodobenzoic acid derivatives 8-10 were coupled with a range of organozinc reagents 1-4 under palladium(o) catalysis. The coupled products released by acidic cleavage with TFA were obtained in high purities after recrystallisation. Analogous coupling of solid-supported (E)- and (Z)-3-iodoacrylic acids 18a, 18b, 19 and 20 gave (E)- and (Z)-alpha,beta-unsaturated acids and amides 21-27 stereospecifically.


Removable prosthodontic therapy and xerostomia. Treatment considerations.
Successful management of complete and removable partial dentures is complicated by a reduction in saliva. Dental practitioners should be aware of the signs and symptoms of xerostomia, available diagnostic procedures, likely etiologies, expected sequelae, and appropriate therapeutic regimens. Effective evaluation and appropriate treatment will promote acceptable levels of comfort and function. Over-the-counter (Figure 12) and prescription medications may be needed to improve the clinical situation.


Outcomes of sinonasal squamous cell carcinoma with and without association of inverted papilloma: A multi-institutional analysis.
Sinonasal squamous cell carcinoma (SCC) accounts for <1% of all malignancies but represents 70% of sinonasal cancer. Up to 10% of SCCs are associated with inverted papilloma (IPSCC). Studies that compare patients, treatment, and outcomes of SCC and IPSCC are absent in the literature. A retrospective review of patients with SCC and those with IPSCC at Cleveland Clinic and Indiana University from 1995 to 2015. The records were analyzed for demographics, tumor characteristics, treatment, and outcomes. The study comprised 117 patients with SCC, of whom, 29 had IPSCC. The mean age at diagnosis was similar: 63 and 64 years for patients with SCC and patients with IPSCC, respectively; with female patients representing 36% and 34%, respectively (p > 0.99).Smokers represented 64% of the patients with SCC and 55% of patients with IPSCC (p = 0.3); excessive alcohol intake was noted in 16% of the patients with SCC and 21% of the patients with IPSCC (p = 0.56).The maxillary sinus was most commonly involved, followed by the nasal cavity (51% versus 35% SCC, 45% versus 38% IPSCC). Frontal ethmoid and sphenoid sinuses contained primary tumors only in patients with SCC. Upfront treatment was surgery in 84% of patients with SCC and 97% of patients with IPSCC (p = 0.18); 68 and 55% received radiation, respectively, and 25 and 21% received chemotherapy, respectively.Overall survival averaged 5.5 and 3.4 years for patients with SCC and patients with IPSCC, respectively (p = 0.12); disease-free survival was 4.8 and 2.9 years, respectively (p = 0.18). Nodal metastasis was more likely in patients with SCC (18 versus 0%; p = 0.02). When divided into high- and low-stage disease: more common nodal metastases were demonstrated in high-stage SCC than in low-stage disease (p = 0.03). Overall survival was decreased between high- and low-grade disease but not when subdivided between SCC and IPSCC. Although SCC with and without IP association are considered different diseases, their demographics and outcomes seem similar. Nodal metastasis was noted to be higher in the SCC cohort, which may indicate different tumor biology. Further study is warranted.


Dectection of spinal cord lesion using skin electrode recordings of spinal evoked potential.
The multi-channel recording of somatosensory spinal evoked potential (SSEP) was carried out on 30 patients with various neurological disorders. In some cases, SSEP changes corresponded well with the lesioned level. In general, the lesions of thoraco-cervical level were difficult to detect, because the appearance rate of SSEP peaks are reduced over the thoraco-cervical spine even in normal controls. In cases with spinal type of MS, SSEP revealed marked changes and subclinical sensory demyelinating lesions were detectable. Chronological SSEP recording in patients with acute transverse myelitis revealed functional improvements corresponding with clinical recovery. Surface and non-invasive SSEP recording is useful for detecting lesions in the spinal cord or peripheral nerves. It also offers valuable information about chronological modification of the lesions, and may reveal subclinical changes in certain neurological disorders.


Sleep disordered breathing concomitant with fibromyalgia syndrome.
To identify fibromyalgia syndrome in patients with sleep disordered breathing. We studied 50 patients seeking treatment at a sleep disorder clinic for snoring, apnea and excessive daytime sleepiness. Sleep disordered breathing was diagnosed through the use of polysomnography. To diagnose fibromyalgia syndrome, patients were evaluated in accordance with the criteria established by the American College of Rheumatology. Of the 50 patients, 32 were male. The mean (+/- standard deviation) age of the group was 50 +/- 12 years. The mean body mass index was 29.7 +/- 5.6 kg/m(2). The mean apnea-hypopnea index was 36 +/- 29 attacks of apnea or hypopnea per hour of sleep. Of the 18 women and 32 men evaluated, 9 and 2, respectively, met the American College of Rheumatology criteria for fibromyalgia syndrome. Considering the fact that the prevalence of fibromyalgia syndrome in the general population is 0.5% for men and 3.4% for women, the more than ten-fold higher proportion of fibromyalgia cases seen in this sample supports the hypothesis that there is an association between sleep disordered breathing and fibromyalgia syndrome.


Differential dimer activities of the transcription factor Oct-1 by DNA-induced interface swapping.
Two crystal structures of Oct-1 POU domain bound to DNA provide a rationale for differential, conformation-dependent recruitment of transcription cofactors. The POU-homeo and POU-specific subdomains of Oct-1 contain two different nonoverlapping pairs of surface patches that are capable of forming unrelated protein-protein interfaces. Members of the POU factor family contain one or two conserved sequence motifs in the interface that are known to be phosphorylated, as noted for Oct-1 and Pit-1. Modeling of Oct-4 reveals the unique case where the same conserved sequence is located in both interfaces. Our studies provide the basis for two distinct dimeric POU factor arrangements that are dictated by the architecture of each DNA response element. We suggest interface swapping in dimers could be a general mechanism of modulating the activity of transcription factors.


Mesopore control of high surface area NaOH-activated carbon.
Activated carbon with BET surface areas in a narrow range from 2318 to 2474 m2/g was made by soaking the char made from corncob in a concentrated NaOH solution at NaOH/char ratios from 3 to 6; the mesopore volumes of the activated carbon were significantly changed from 21 to 58%. The relationships between pore properties (Sp, Vpore, Vmicro/Vpore, Dp) and NaOH dosage were investigated. Comparisons between the methods of NaOH and KOH activation revealed that NaOH activation can suitably control the mesopore specific volume of the activated carbon. Elemental analysis revealed that the H/C and O/C values of the activated carbons of NaOH/char ratios from 3 to 6 were significantly lower. SEM observation of surface hole variation of the activated carbon ascertained that the reaction process was inner pore etching. Based on the above three measurements and experimental investigations, the assumption made by previous researchers, namely that NaOH and KOH produce similar results, was challenged. Furthermore, the adsorption kinetics was used to investigate the adsorption rate of an Elovich equation to determine the relationships between the adsorption behavior on larger molecules (dyes) and smaller molecules (phenols) and the pore structure of the activated carbon.


SERS as tool for the analysis of DNA-chips in a microfluidic platform.
A sequence-specific detection method of DNA is presented combining a solid chip surface for immobilisation of capture DNAs with a microfluidic platform and a readout of the chip based on SERS. The solid chip surface is used for immobilisation of different capture DNAs, where target strands can be hybridised and unbound surfactants can be washed away. For the detection via SERS, short-labelled oligonucleotides are hybridised to the target strands. This technique is combined with a microfluidic platform that enables a fast and automated preparation process. By applying a chip format, the problems of sequence-specific DNA detection in solution phase by means of SERS can be overcome. With this setup, we are able to distinguish between different complementary and non-complementary target sequences in one sample solution.


The effectiveness of nasal decongestants, oral decongestants and oral decongestant-antihistamines in the treatment of acute otitis media in children.
The aim of this study was to evaluate the effectiveness of nasal decongestants, oral decongestants and oral decongestant-antihistamines in the treatment of acute otitis media and resolution of the middle ear effusion in children. 355 ears of 318 children [160 boys (179 ears) and 158 girls (176 ears)] who were diagnosed to have acute otitis media and treated for it with different drug regimens were evaluated retrospectively regarding resolution of the middle ear fluid. 151 ears were treated with antibiotics and analgesics (group 1), 64 with antibiotics, topical decongestants and analgesics (group 2), 81 with antibiotics, oral decongestants and analgesics (group 3), and 59 with antibiotics, oral decongestant-antihistamine combinations and analgesics (group 4). The children with middle ear effusion were followed up for three months. Group 1, 2, 3 and 4 had persistent middle ear effusion and the presence of middle ear effusion was 27.2%, 18.8%, 25.9%, 28.8% at the 1st month and 5.8%, 0%, 0% and 5.9% at the end of the 3rd month, respectively. At the end of the 3rd month, there was no significant difference between the groups regarding the resolution rates of the middle ear fluids in the antibiotic group and decongestants groups (p>0.05). We do not recommend the use of decongestants and antihistamines in the treatment of acute otitis media as they do not change the natural course of the disease.


[99m-Tc alendronate as a new option in bone gammagraphy].
To compare the quality of bone scans obtained with 99mTc-ABP, a new radiopharmaceutical, and 99mTc-MDP. A comparative study within subjects was done in nine healthy volunteers, 5 female and 4 male, aged 23 to 39 years. The dose for both radiopharmaceuticals was 740 MBq; radiopharmacokinetic parameters were determined and a whole body bone scan was taken with a MultiSpect 2 gamma camera two hours post administration with a wash-out period of 72 hours between preparations. The images were independently evaluated by three nuclear medicine physicians by drawing of regions of interest (ROIs) on vertebrae, ribs, femur, sternum, joints and skull. Ratios bone/soft tissue were obtained drawing ROIs on several bones. The kappa test and the Wilcoxon rank test were used for statistical comparisons. The agreement on the quality of the images with Tc-ABP and Tc-MDP was fair (kappa 0.4). The femur/soft tissue ratio had a normal distribution and the Wilcoxon test showed no statistical difference between preparations. Even though bone uptake was higher and faster with Tc-ABP, the quality of the scans obtained with either radiopharmaceutical was similar. We recommend the use of Tc-ABP as a routine bone scan agent because of its less radiation exposure to the patient.


[Dermatosis-arthritis syndrome associated with Crohn's disease in a teenager].
Pustulosis, erythema nodosum, arthritis and systemic manifestations are associated in the dermatosis-arthritis syndrome. It is a well recognized complication of the bowel ileo-jejunal bypass but it is also associated with inflammatory bowel diseases. We report the case of an adolescent who presented with a dermatosis-arthritis syndrome associated to a Crohn's disease during a referring for pustulosis, erythema nodosum and fever. The evolution is complicated by proctorragia. Colonoscopy and intestinal biopsy found a Crohn's disease. Cutaneous and intestinal symptoms quickly improved with systemic corticosteroids. The dermatosis-arthritis syndrome can be associated with bowel bypass and with inflammatory bowel disease, more frequently with ulcerative colitis than with Crohn's disease. It consists in a vesiculo-pustular eruption, erythema nodosum, fever, arthritis and ocular manifestations. Histopathology bears a strong resemblance with Sweet's syndrome. Physiopathology implicates microbial proliferation, formation of immune complex against skin and activation and migration of neutrophils and increasing factors. The treatment is based on corticosteroids and non steroid anti-inflammatory drugs or dapsone.


Responses of molecular indicators of exposure in mesocosms: common carp (Cyprinus carpio) exposed to the herbicides alachlor and atrazine.
Common carp (Cyprinus carpio) were treated in aquatic mesocosms with a single pulse of the herbicides atrazine or alachlor to study the bioavailability and biological activity of these herbicides using molecular indicators: Liver vitellogenin gene expression in male fish for estrogenic activity, liver cytochrome P4501A1 gene expression, and DNA damage in blood cells using the single-cell gel electrophoresis method. Both alachlor and atrazine showed dose-related increases in DNA strand breaks at environmentally relevant concentrations (<100 ppb). Gene expression indicators showed that neither herbicide had estrogenic activity in the carp, whereas atrazine at concentrations as low as 7 ppb induced cytochrome P4501A1. These results support the study of molecular indicators for exposure in surrogate ecosystems to gauge relevant environmental changes following herbicide treatments.


Functional components of fibroblast growth factor (FGF) signal transduction in pituitary cells. Identification of FGF response elements in the prolactin gene.
Fibroblast growth factors (FGFs) have been implicated in pituitary lactotroph tumorigenesis; however, little is known about the molecular mechanisms of FGF signal transduction. We used a transient transfection approach, in GH4 cells, to identify components of the FGF signaling pathway leading to activation of the rat prolactin (rPRL) promoter. Using dominant-negative constructs of p21(Ras), Raf-1 kinase, and mitogen-activated protein (MAP) kinase, we show that FGF activation of the rPRL promoter is independent of Ras and Raf-1 but requires MAP kinase. Furthermore, MAP kinase but not Raf-1 kinase catalytic activity is stimulated by FGFs. The rPRL promoter FGF response maps to two Ets binding sites, centered at -212 (FRE1) and -96 (FRE2), and co-transfection of dominant-negative Ets inhibits FGF activation. FRE1 co-localizes with a composite, Ets/GHF-1, Ras response element. However, overexpression of Ets-1 and GHF-1, which potentiate the Ras response, inhibits FGF stimulation of the rPRL promoter, implying that Ras and FGF signaling pathways target distinct factors to elicit their effects. These data suggest that Ets factors serve to sort and integrate MAP kinase-dependent growth factor signals, allowing highly specific transcriptional responses to be mediated via the interaction of distinct Ets proteins and cofactors at common response elements.


Microsurgery in gynecology.
Microsurgical techniques have changed the outcome of infertility surgery. Tubal anastomosis for reversal of sterilization has resulted in pregnancy rates of up to 65%. In cases of salpingostomy, the ectopic pregnancy rate is quite high. In ovarian microsurgery, postoperative adhesions can be avoided and a 54% pregnancy rate achieved with endometriosis surgery.


Effects of Helicobacter pylori eradication on gastroesophageal reflux disease.
Helicobacter pylori infection appears to be a protective factor for gastroesophageal reflux disease (GERD). However, H. pylori is associated with the subtype of esophageal carcinoma, and long-term proton-pump inhibition usage would cause gastric atrophy in patients with persistent H. pylori infection, which is a precancerous lesion. The relationship between H. pylori infection and GERD is still unclear. We aimed to confirm whether the eradication of H. pylori would worsen or improve symptomatic or endoscopic GERD. A systematic review of the published data was undertaken, and a meta-analysis was performed to determine the effect of H. pylori eradication on the occurrence of symptomatic (heartburn, acid regurgitation) and endoscopically proven erosive (esophagitis) GERD in patients with or without pre-existing GERD. A total of 11 articles met the inclusion criteria and thus were included in the meta-analysis. There was no significant difference in the frequency of symptomatic or endoscopically proven erosive GERD after the eradication between patients with H. pylori eradicated and those with persistent infection, regardless of follow-up period, location, or the baseline disease. H. pylori eradication does not aggravate the clinical outcomes in terms of short-term and long-term posteradication occurrence of GERD. There is no association between H. pylori eradication and the development of GERD in the patients with different diseases, even those with GERD.


Uncoating of a rimantadine-resistant variant of influenza virus in the presence of rimantadine.
A rimantadine-resistant variant of the Texas strain of influenza virus (Tr) was obtained by serial passages in eggs in MDCK cells in the presence of the drug, and its uncoating in MDCK cells was compared to that of the sensitive variant (Ts). First and second steps of uncoating were defined respectively by the appearance of subviral particles (SVP) in nuclear-associated cytoplasm (NAC) and ribonucleoproteins (RNPs) in nucleoplasm. In cells infected with Ts, SVP and RNPs were revealed in NAC, while in the presence of rimantadine RNPs were neither found in NAC nor in the nucleoplasm. In cells infected with Tr, SVP but not RNPs were observed in NAC. The amount of RNPs in the nucleoplasm was almost unchanged in rimantadine-treated cells, demonstrating that rimantadine did not interfere with uncoating of the resistant variant. These findings confirm the suggestion that rimantadine blocks the second step of uncoating of sensitive influenza viruses, and are consistent with the idea that this event does account for the prevention of influenza virus infection by the drug.


Estimating trends in the effectiveness of seat belts in saving lives, 1975-1985.
We examine the effectiveness of seat-belt systems for preventing mortality in automobile crashes. In particular, we examine whether seat-belt effectiveness has been constant over this period and conclude that there has been a trend toward an increased effectiveness of seat-belt systems. The relative odds of death associated with wearing seat belts dropped from 0.80 in 1975 to 0.34 in 1985. This trend results from improvements in both the type and design of seat belts and from additional design changes, such as padded dashboards and collapsible steering columns, that protect occupants at the time of collision.


Association of prostaglandin-endoperoxide synthase 2 gene polymorphisms with asthma and atopy in Chinese children.
Cyclooxygenase-2 (COX-2) plays essential roles in inflammation. Previous studies have suggested associations between prostaglandin-endoperoxide synthase 2 (PTGS2) polymorphisms and prostaglandins production in asthma. We have investigated the effects of Chinese tagging single nucleotide polymorphisms (SNPs) of PTGS2 on asthma traits in 299 Chinese asthmatic children and 175 controls. Plasma total and allergen-specific IgE were measured by enzyme immunoassay. PTGS2.8473T-->C in the 3'-untranslated region of exon 10 and three tag SNPs covering most of the variations in PTGS2 haplotypes in Chinese were genotyped by restriction fragment length polymorphism. Among the four SNPs, only PTGS2.8473 showed significant association with asthma (P = 0.034) and atopy (P = 0.005 when compared with non-atopic controls; P = 0.023 with all controls). Carriers of the C allele had a 1.5-fold (95% confidence interval: 1.01-2.30) risk of developing asthma than those homozygous for the T allele. Multivariate regression revealed significant correlations between PTGS2.8473 and forced expiratory volume in 1 s (FEV(1); P = 0.002) and peak expiratory flow rate (PEFR; P = 0.001) with age and gender adjusted. Patients with the C allele of PTGS2.8473 had significantly lower FEV(1) (median: 90.0%vs 98.0%; P = 0.0047) and PEFR (70.0%vs 73.5%; P = 0.0065) than those homozygous for the T allele. No significant association between plasma total and allergen-specific IgE and these SNPs or with their haplotypes was found. PTGS2.8473 polymorphism is associated with asthma, atopy and lung function but not plasma IgE in Chinese children. This may help to explore the pharmacogenetics of COX-2 inhibitors.


An ethical leadership program for nursing unit managers.
The aims of this study were to evaluate the effect of an ethical leadership program (ELP) on ethical leadership, organizational citizenship behavior (OCB), and job outcomes of nursing unit managers (UMs) and to examine changes in staff nurses' perception about UMs' EL, OCB, job outcomes, and ethical work environments (EWEs) post-ELP. A quasi-experimental (pre- and post-test design) study conducted six-month intervention (ELP) using self-reported UM survey (n=44), and staff nurses (n=158) were randomly extracted by two steps. The Korean version of Ethical Leadership at Work for UMs' self-ethical leadership, the Ethical Leadership Scale for staff nurses' perceived ethical leadership, a 19-item OCB scale, and six dimensions of the medium-sized Copenhagen Psychosocial Questionnaire II for job outcomes and EWEs were administered at baseline and post-intervention. UMs' ethical leadership scores differed significantly over time in people orientation (p=0.041) and concern for ethical leadership sustainability (p=0.002) adjusting for UM experience duration and nursing unit type. Total mean and level of power-sharing of ethical leadership among UMs with <5years of UM experience improved significantly over time. Of staff nurses' perception changes about UMs' ethical leadership, OCB, job outcomes, and EWEs, significant improvement over time appeared only in EWEs' work influence level (p=0.007). This study provides useful information for clinical ELP development and examining the program's effect on leadership skills and followers' outcomes. Program facilitation relies on practical training methods, participant motivation, and assessment outcome designs by controlling clinical confounding factors. Findings have implications as an attempt for intervention to promote competencies related to ethical leadership of nursing unit managers.


[Androgen therapy from the viewpoint of the internal medicine physician].
The partial androgen deficit of the ageing male is an essential part of the age-related changes of the endocrine system. Clinically relevant disturbances (co-) caused by a relative testosterone-deficit are: changes of body composition (increase of fat mass, decrease of lean tissue mass), decrease of muscle strength and mass, changes of the lipid profile, cardiovascular disease, osteoporosis and anemia. Controlled studies revealed a positive effect of testosterone substitution on body composition, muscle strength, bone metabolism and erythropoesis. Moreover, a protective effect on the development of coronary artery disease could be demonstrated by an improvement of the lipid profile, decrease of obesity and insulin resistance and by a direct effect on the coronary vessels. Clinically evident hypogonadism is a clear indication for testosterone-substitution also in the ageing male, whereas in the case of the partial testosterone-deficit in the absence of sufficient data at this time no general recommendation for substitution can be given; one has to decide about a (experimental) therapy in the individual patient. In every case the contraindications of a testosterone-supplementation (carcinoma of the prostate, elevated PSA-values, polyglobulia, sleep-apnea-syndrome) have to be observed, a continuous survey of the therapy, especially of the prostate is essential. A general recommendation for a substitution with dehydroepiandrosterone (DHEA) can not be given.


Treatment of Alzheimer's Disease: The Legacy of the Cholinergic Hypothesis, Neuroplasticity, and Future Directions.
In this issue, an article by Waring et al. provides a meta-analysis of the effects of apo-lipo-protein E (APOE) genotype on the beneficial effect of acetyl-cholinesterase inhibitors (AChEIs) in patients with Alzheimer's disease (AD). There was no significant effect found. As of 2015, AChEI medications are the mainstay of AD treatment, and APOE genotype is the most significant factor associated with AD causation. This lack of a significant effect of APOE is analyzed with respect to the "Cholinergic Hypothesis" of AD, dating from 1976, through the recognition that cholinergic neurons are not the sole target of AD, but rather that AD attacks all levels of neuroplasticity in the brain, an idea originated by Ashford and Jarvik in 1985 and which still provides the clearest explanation for AD dementia. The "Amyloid Hypothesis" is dissected back to the alpha/beta pathway switching mechanism affecting the nexin-amyloid pre-protein (NAPP switch). The NAPP switch may be the critical neuroplasticity component of all learning involving synapse remodeling and subserve all learning mechanisms. The gamma-secretase cleavage is discussed, and its normal complementary products, beta-amyloid and the NAPP intracellular domain (NAICD), appear to be involved in natural synapse removal, but the link to AD dementia may involve the NAICD rather than beta-amyloid. Understanding neuroplasticity and the critical pathways to AD dementia are needed to determine therapies and preventive strategies for AD. In particular, the effect of APOE on AD predisposition needs to be established and a means found to adjust its effect to prevent AD.


Psychophysical "blinding" methods reveal a functional hierarchy of unconscious visual processing.
Numerous non-invasive experimental "blinding" methods exist for suppressing the phenomenal awareness of visual stimuli. Not all of these suppressive methods occur at, and thus index, the same level of unconscious visual processing. This suggests that a functional hierarchy of unconscious visual processing can in principle be established. The empirical results of extant studies that have used a number of different methods and additional reasonable theoretical considerations suggest the following tentative hierarchy. At the highest levels in this hierarchy is unconscious processing indexed by object-substitution masking. The functional levels indexed by crowding, the attentional blink (and other attentional blinding methods), backward pattern masking, metacontrast masking, continuous flash suppression, sandwich masking, and single-flash interocular suppression, fall at progressively lower levels, while unconscious processing at the lowest levels is indexed by eye-based binocular-rivalry suppression. Although unconscious processing levels indexed by additional blinding methods is yet to be determined, a tentative placement at lower levels in the hierarchy is also given for unconscious processing indexed by Troxler fading and adaptation-induced blindness, and at higher levels in the hierarchy indexed by attentional blinding effects in addition to the level indexed by the attentional blink. The full mapping of levels in the functional hierarchy onto cortical activation sites and levels is yet to be determined. The existence of such a hierarchy bears importantly on the search for, and the distinctions between, neural correlates of conscious and unconscious vision.


Measures of central tendency in chaplaincy, health care, and related research.
The three measures of central tendency are discussed in this article: the mode, the median, and the mean. These measures of central tendency describe data in different and important ways, in relation to the level of measurement (nominal, ordinal, interval, or ratio) used to obtain the data. The results of published research studies, thought experiments, and graphs of frequency and percentage distributions of data are used as examples to demonstrate and explain the similarities and differences among these summary measures of data. The examples include the application of nominal, ordinal, interval, and ratios scales to measure pain, anxiety, chaplaincy services, religious behaviors, and treatment-related preferences, and their respective measures of central tendency. Examples of unimodal and bimodal distributions, and differences in the relative locations of the median and mean in symmetrical and skewed distributions are also presented and discussed.


Multiple origins of Tibetan Y chromosomes.
The genetic origin of Tibetans was investigated using Y chromosome markers. A total of three populations were studied, two from central Tibet speaking central Tibetan and one from Yunnan speaking Kham. Two dominant paternal lineages (>80%) were identified in all three populations with one possibly from central Asia (YAP+) and the other from east Asia (M122C). We conclude that Tibetan Y chromosomes may have been derived from two different gene pools, given the virtual absence of M122C in central Asia and YAP+ in east Asia, with drift an unlikely mechanism accounting for these observations.


Effect of competitive adsorption on zinc removal from aqueous solution and zinc smelting effluent by eucalyptus leaf-based magnetic biosorbent.
The objectives of this study were to investigate the competitive sorption behaviors and mechanisms of heavy metals onto ELMB, a novel eucalyptus-leaf-based magnetic biosorbent, and to study the potential application of ELMB in the treatment of actual zinc smelting effluent after a necessary pretreatment process. ELMB and ELMB-metals systems were characterized using several techniques. Competitive sorption of Zn2+ with Pb2+, Cu2+ and Cd2+ onto ELMB was studied by batch experiments and the used sorbent was separated under a magnetic field. The results show that the ELMB can be considered as paramagnetic material with various functional groups on its surface. The presence of Pb2+, Cu2+ and Cd2+ significantly decreases the sorption of Zn2+ in either the binary system or multimetal systems. The order of adsorption preference is Pb2+ > Cu2+ > Cd2+ > Zn2+ in multimetal systems and the sequence of competitive ability to zinc is: Pb2+ > Cu2+ > Cd2+. Non-competitive Langmuir multicomponent isotherm model fits to the adsorption data of Pb2+ and Cu2+ well in aqueous solution. The co-existent Ca2+ and SO42- decrease the removal efficiencies of heavy metals while the presence of Na+ and Cl- shows little effect in the multimetal solution. In the case of actual zinc smelting effluent, "pretreatment + ELMB sorption" is successfully applied to remove heavy metals and the contents of Zn2+ and its associated metals are well below discharge limits.


Thioredoxin and peptide methionine sulfoxide reductase: convergence of similar structure and function in distinct structural folds.
Thioredoxin (Trx) and peptide methionine sulfoxide reductase (PMSR) are small thiol oxidoreductases implicated in antioxidant defense and redox regulation of cellular processes. Here we show that the structures of Trx and PMSR exhibit resemblance in their alphabeta core regions and that the active site cysteines in two proteins occupy equivalent positions downstream of a central beta-strand and at the N-terminus of an alpha-helix. Moreover, we identified a PMSR subfamily that contains an active site CxxC motif (two cysteines separated by two other amino acids) positioned similarly to the catalytic redox active CxxC motif in Trx. However, Trx and PMSR are characterized by distinct ancient folds that differ in both orientation of secondary structures and their patterns. Trx is a member of the Trx-fold superfamily, whereas PMSR has a unique fold not found in other proteins. The data suggest that similar structures and functions of Trx and PMSR were acquired independently during evolution and point to a general strategy of identifying new redox regulatory proteins.


Laser balloon angioplasty: effect of exposure duration on shear strength of welded layers of postmortem human aorta.
Laser Balloon Angioplasty (LBA) is a technique that may improve the results of balloon angioplasty by thermally sealing arterial dissections and reducing elastic recoil. To define the relationship between laser-exposure duration and the strength of thermal welds made between separated layers of arterial wall, 360 1-cm discs of human postmortem aorta were lased for six different exposure intervals at three different temperature ranges, comparing shear strength of thermal welds in the different groups. Twenty discs were lased to achieve plateau adventitial temperatures of 95 degrees C-104 degrees C (group A), 105 degrees C-114 degrees C (group B), or 115 degrees C-124 degrees C (group C) at each of the exposure periods (5, 10, 15, 20, 25, and 30 sec). A 400-micron fiberoptic coupled to a 1.06 micron continuous wave neodymium:YAG laser was placed perpendicularly 8 mm above the luminal surface of each disc, which had been split midway between the intimal and adventitial surface and reapposed. Mean laser energy ranged 78-378 J delivered in a decremental stepwise fashion to achieve quickly and maintain the target plateau tissue temperature. Mean weld strength increased in relation to both achieved tissue temperature and laser-exposure duration, with at least 10 sec necessary, at temperatures greater than 95 degrees C, for reliable thermal welding. Laser exposure for greater than 20 sec provided no statistical increment in weld strength. In the anticipated clinical performance of LBA, these data suggest that when thermal fusion of disrupted arterial tissues is desired, a laser-exposure duration of 10-20 sec is optimal.


Neutrophil elastase mediates pathogenic effects of anthrax lethal toxin in the murine intestinal tract.
Neutrophils isolated from BALB/c or C57BL/6 mice and treated in vitro with anthrax lethal toxin release bioactive neutrophil elastase, a proinflammatory mediator of tissue destruction. Similarly, neutrophils isolated from mice treated with anthrax lethal toxin in vivo and cultured ex vivo release greater amounts of elastase than neutrophils from vehicle-treated controls. Direct measurements from murine intestinal tissue samples demonstrate an anthrax lethal toxin-dependent increase in neutrophil elastase activity in vivo as well. These findings correlate with marked lethal toxin-induced intestinal ulceration and bleeding in neutrophil elastase(+/+) animals, but not in neutrophil elastase(-/-) animals. Moreover, neutrophil elastase(-/-) mice have a significant survival advantage over neutrophil elastase(+/+) animals following exposure to anthrax lethal toxin, thereby establishing a key role for neutrophil elastase in mediating the deleterious effects of anthrax lethal toxin.


Human immune response to sand fly salivary gland antigens: a useful epidemiological marker?
Antibody (IgG) responses to salivary gland homogenate and to a recombinant salivary protein from the sand fly Lutzomyia longipalpis were investigated using sera from children living in an endemic area of visceral leishmaniasis in Brazil. We classified children into four groups according to their responses to Leishmania antigen: (Group I) positive serology and positive delayed type hypersensitivity (DTH), (Group II) positive serology and negative DTH, (Group III) negative serology and positive DTH, and (Group IV) negative serology and negative DTH. A highly significant correlation was found between anti-salivary gland IgG levels and DTH responses. An L. longipalpis salivary recombinant protein used as an antigen in an enzyme-linked immuno sorbent assay (ELISA) gave a significant but different result. A positive correlation was found between anti-Leishmania IgG and anti-recombinant protein IgG titers. The results indicate that sand fly salivary proteins may be of relevance to the study the epidemiology of leishmaniasis.


Examination of the MMPI-2 restructured form (MMPI-2-RF) validity scales in civil forensic settings: findings from simulation and known group samples.
The current study examined the effectiveness of the MMPI-2 Restructured Form (MMPI-2-RF; Ben-Porath and Tellegen, 2008) over-reporting indicators in civil forensic settings. The MMPI-2-RF includes three revised MMPI-2 over-reporting validity scales and a new scale to detect over-reported somatic complaints. Participants dissimulated medical and neuropsychological complaints in two simulation samples, and a known-groups sample used symptom validity tests as a response bias criterion. Results indicated large effect sizes for the MMPI-2-RF validity scales, including a Cohen's d of .90 for Fs in a head injury simulation sample, 2.31 for FBS-r, 2.01 for F-r, and 1.97 for Fs in a medical simulation sample, and 1.45 for FBS-r and 1.30 for F-r in identifying poor effort on SVTs. Classification results indicated good sensitivity and specificity for the scales across the samples. This study indicates that the MMPI-2-RF over-reporting validity scales are effective at detecting symptom over-reporting in civil forensic settings.


ANP-like immunoreactivity in neuronal perikarya and processes associated with vessels of the pia and cerebral parenchyma in dog.
The existence of neocortical neurons displaying processes which penetrate the glia limitans (GL) and closely approach pial as well as intracerebral microvessels was determined in the dog from immunohistochemical localization of atrial natriuretic peptide (ANP). Scattered ANP-positive pyramidal somata located in cortical layers II and III displayed spinous dendritic arbors and delicate, beaded axon collaterals. Dendritic branches, as well as axon collaterals, traversed the GL near blood vessels entering the parenchyma, or encircled microvessels deep to the GL. These findings suggest that single ANP-like immunoreactive cortical neurons may monitor and control local cerebrovascular flow or permeability of the blood-brain barrier.


Postpartum Depression: Pathophysiology, Treatment, and Emerging Therapeutics.
Postpartum depression (PPD) is common, disabling, and treatable. The strongest risk factor is a history of mood or anxiety disorder, especially having active symptoms during pregnancy. As PPD is one of the most common complications of childbirth, it is vital to identify best treatments for optimal maternal, infant, and family outcomes. New understanding of PPD pathophysiology and emerging therapeutics offer the potential for new ways to add to current medications, somatic treatments, and evidence-based psychotherapy. The benefits and potential harms of treatment, including during breastfeeding, are presented.


Poly-2-methoxyethylacrylate-coated bypass circuits reduce activation of coagulation system and inflammatory response in congenital cardiac surgery.
Surface-coated cardiopulmonary bypass (CPB) has been shown to have excellent biocompatibility during cardiac surgery in adults, but there have been only a few reports demonstrating the efficacy of this coating for congenital cardiac surgery. We tested the efficacy of poly-2-methoxyethylacrylate (PMEA) coating for CPB circuits in congenital cardiac surgery. Eleven operative cases of ventricular septal defect were studied: group C (control: no coating, n = 5) and group P (PMEA coating, n = 6). The platelet count and beta-thromboglobulin (beta TG), fibrinogen (FBG), thrombin-antithrombin complex (TAT), and neutrophil elastase levels were measured during the operation. Postoperative chest tube drainage was analyzed and the surface of the artificial lung was observed with an electron microscope. Elevation of TAT and neutrophil elastase was suppressed in group P (P < 0.05). Observation of the artificial lung surface using an electron microscope clearly revealed fewer blood cells were adherent to the surface in group P. The FBG level and postoperative bleeding were relatively lower in group P, but there were no significant differences between groups. The platelet count and beta TG level were the same in both groups. We concluded that the PMEA-coated circuit reduces activation of the coagulation system and the inflammatory reaction in pediatric cardiac surgery.


Age-related retinal vasculopathy.
Second and third order retinal arterioles and venules were studied by immunohistochemistry and electron microscopy in the uncomplicated ageing process and in association with central retinal vascular occlusive disease (CRVOD). Tissue was obtained from eight enucleated human eyes (4 control, 4 with manifestations of CRVOD) and the investigation was directed towards abnormalities in the myocytes and the nature of collagenous materials which are deposited during the process of hyalinization. In normal ageing and in two cases of CRVOD, the endothelial cell monolayer and the underlying cells (subendothelial myocytes) were preserved in arterioles and venules: there was no evidence of fibrin leakage. Degenerative changes were found in the medial myocytes in control tissue from the fifth decade and these included myocyte shrinkage, accumulation of intracytoplasmic membranous structures, cytoplasmic vacuolation and fragmentation. The 'hyalinized' acellular vessel wall seen in CRVOD contains scattered activated fibroblast-like myocytes and macrophages lying within a matrix of fibronectin, 65 nm collagen and multilayered basement membrane material. Endothelial cells and cohort subendothelial myocytes are involved in the formation of capillaries which bud into the hyalinized vessel wall in CRVOD. In two cases of CRVOD there was extensive cellular degeneration and cell debris accumulated within the degenerate stroma: this was attributed to superadded total ischaemia. The pathogenesis of hyalinization remains obscure but a subtle age-related dysfunction of the morphologically intact lining endothelium could be responsible for metabolic damage to myocytes in the media.


Impact of the in vitro technique used on the cytogenetic patterns in pleomorphic adenomas.
The cytogenetic observations in 97 new cases of pleomorphic adenomas are reported. They were all studied by in vitro technique using enzymatic pretreatment of the explanted material. The results, together with 26 previously reported cases studied by the same method (series II), were compared with a group of 130 adenomas (series I) investigated in cultures of only mechanically dispersed material. The results showed that in series II there was a substantial reduction of normal stemlines, an increase of cases with t(3;8)(p21;q12) and, in particular, of those with other 8q12 involvement. There was a similar frequency of cases with 12q13-15 aberrations in both series whereas, in series II, there was a moderate increase of the cases with "unique" abnormal stemlines. In comparison the German material, comprising 220 cases also studied by the enzymatic method, revealed a much higher frequency of cases with a normal stemline and a much lower frequency of adenomas with 8q12-involvement and of cases with unique stemlines. The results emphasize the need and importance of a meticulous documentation of all details of the in vitro technique used, for instance: explantation methods, composition of media, growth periods in vitro, and methods of harvest.


Outcomes following Peripheral Nerve Decompression with and without Associated Double Crush Syndrome: A Case Control Study.
Double crush syndrome, the association between proximal and distal nerve lesions, has been established. This investigation compares the outcomes of nerve surgery in patients with isolated peripheral compression versus those with double crush syndrome treated with peripheral nerve and cervical spine operations. This case-controlled study enrolled 80 patients: 40 underwent carpal or cubital tunnel surgery and cervical spine surgery (double crush group); and 40 controls, matched by age and sex, underwent only peripheral nerve decompression (peripheral nerve group). A minimum of 18 months was required after peripheral nerve and cervical spine surgery for office assessment (mean, 4.9 years and 6.0 years, respectively). Statistical analysis compared postoperative function and symptom severity questionnaires, physical examination, and patient-reported satisfaction between groups. Patients in the double crush group reported significantly more disability and persistent symptoms on the QuickDASH questionnaire (29 versus 13) and Levine Katz symptom severity (2.0 versus 1.4) and functional status scales (1.9 versus 1.4). Double crush patients reported significantly lower satisfaction. The double crush group exhibited a greater frequency of persistent signs of nerve irritability and muscle weakness compared with the control group. At a minimum of 18 months after peripheral nerve surgery, patients with a history of cervical spine surgery are likely to have inferior patient-reported outcomes, persistent nerve dysfunction, and lower satisfaction after peripheral nerve release compared with patients following isolated peripheral nerve surgery. Double crush syndrome was associated with poorer outcome after peripheral nerve surgery despite treatment of cervical spine nerve compression. Therapeutic, III.


Pseudocarcinomatous hyperplasia of the fallopian tube associated with salpingitis. A report of 14 cases.
We describe 14 cases of pseudocarcinomatous changes in the fallopian tube characterized by florid epithelial hyperplasia and in half the cases mesothelial hyperplasia and associated with chronic salpingitis. The patients' ages ranged from 17 to 40 years. Seven had clinical evidence of pelvic inflammatory disease. Tubal enlargement or thickening were observed in 12 cases and pyosalpinx, tubo-ovarian abscesses, or hydrosalpinx, in six cases. All cases showed no gross evidence of tumor. The reactive atypical hyperplasia mimicked carcinoma microscopically because of a cribriform pattern, penetration of the tubal wall by hyperplastic epithelium, florid mesothelial hyperplasia, or a combination of these findings; epithelial papillae were present in the lymphatics in two cases. In five cases, an erroneous microscopic diagnosis of carcinoma had been made or seriously entertained initially, and one patient underwent a radical hysterectomy as a result. The typically young age of the patients, absence of a gross tumor, presence of severe chronic inflammation, lack of solid epithelial proliferation, mildness of nuclear atypia, and paucity of mitotic figures facilitated the differential diagnosis. Nine patients for whom follow-up information was available had no recurrence of tubal disease.


Hemobilia associated with hepatic artery aneurysms: scintigraphic detection with technetium-99m-labeled red blood cells.
Biliary tract bleeding is an unusual cause of upper gastrointestinal hemorrhage. Rupture of hepatic artery aneurysms is one of the least common etiologies of hemobilia. Both cholescintigraphy and [99mTc]red blood cell scintigraphy are useful in the diagnosis of this rare disorder. The combination of focal obstruction on cholescintigraphy and intermittent visualization of the major bile ducts on red blood cell scintigraphy should suggest the diagnosis of hemobilia and prompt an angiogram to determine the cause.


Purely endoscopic resection of a choroid plexus papilloma of the third ventricle: case report.
The authors report an illustrative case of a purely endoscopic surgical approach to successfully remove a solid choroid plexus papilloma of the third ventricle in an infant. A 10-week-old male infant first presented with transient episodes of forced downward gaze, divergent macrocephaly, a tense anterior fontanel, diastasis of the cranial sutures, and papilledema. Brain MRI revealed a small, multilobulated contrast-enhancing mass situated within the posterior third ventricle, with resultant obstructive hydrocephalus. A purely endoscopic removal of the tumor was performed through a single right frontal bur hole. Intraoperatively, a unique vascular tributary was recognized coming from the tela choroidea and was controlled with coagulation and sharp dissection. Postoperative MRI confirmed complete tumor removal, and the tumor was classified as a choroid plexus papilloma. There has been no evidence of tumor recurrence over 42 months of follow-up. With this case report the authors intended to show that endoscopic surgery can be an additional tool to consider when planning a choroid plexus tumor approach. It seems to be of particular interest in selected cases in which there are concerns about the patient's total blood volume, as in infants with potential hemorrhagic tumors and when it is possible to preoperatively identify a single vascular pedicle that can be approached early in the surgery.


Persistence in periodic and almost periodic Lotka-Volterra systems.
It is shown that a strongly self-regulating (or resource limited) Lotka-Volterra population system can "persist" in a periodic or almost periodic environment if and only if the system tracks the environmental variations.


Differential effects of Nd-YAG laser on collagen and elastin production by chick embryo aortae in vitro. Relevance to laser angioplasty for removal of atherosclerotic plaques.
Aortae from 17-day old chick embryos were subjected to irradiation with a Nd:YAG laser at energy densities varying from 1.2 - 4.7 X 10(3) J/cm2. The aortae were pulse-labeled in vitro with [3H]proline or [14C]valine, and the synthesis of collagenous polypeptides and soluble elastin was examined by SDS-polyacrylamide gel electrophoresis, followed by fluorography and quantitative scanning densitometry. Irradiation of the aortae with Nd:YAG laser resulted in inhibition of the synthesis of the extracellular matrix proteins. The production of collagen was inhibited to a considerably larger degree than the production of elastin. Thus, the biosynthetic pathway for collagen production appears to be more susceptible to laser inhibition than the corresponding pathway for elastin production. These observations may have relevance to laser angioplasty which has been proposed to be applicable for removal of atherosclerotic plaques in human vessels. Specifically, the results suggest that inhibition of the extracellular matrix production may result in weakening of the vessel wall with subsequent aneurysm formation and rupture.


Fertility ratio in male rats: effects after denervation of two pelvic floor muscles.
Fertility ratio is defined here as the proportion of females that a male can impregnate after a constant period of in-polygyny living. This ratio was investigated in male rats after denervation of two pelvic floor muscles, the pubococcygeus and iliococcygeus. Denervation was carried out by transecting the somatomotor branch of the pelvic nerve. The lesion did not modify the sexual behavior of males or their overall fertility, but decreased the weight of the ejaculated seminal plug. Consequently, the number of days living in cohabitation to induce pregnancy was increased in lesioned males (approximately 13 days) compared with intact and sham animals (approximately 5 days). These results showed that the fertility ratio was optimal when intact/sham males cohabited with females for two consecutive estrous cycles, but that lesioned males needed up to four cycles to induce most pregnancies. Two hypotheses are raised by our results. The first is that pelvic floor denervation decreases the forceful tension required to expel the semen from the prostatic urethra to the vagina, then an incomplete seminal plug is expelled. The second is that denervation cut afferent fibers that reflexively promote the continence of the semen deposited in the prostatic urethra during seminal emission, allowing some to leak out before ejaculation. The latter hypothesis can also explain the recovery of the fertility ratio in lesioned males. It could be a compensatory mechanism mediated by the pudendal nerve supply to the coccygeus muscle, the other pelvic floor muscle.


[Social and psychological motives of frequency of calls for emergency care in advanced age].
The purpose of this investigation relates to the problem encountered by the elderly population. There is a current increase of the number of elderly people and the share of the elderly population in many countries of the world. Living on their own, people of advanced age create specific problems, both medically and socially. The current investigation presents the data showing their high and "ultrahigh" appliance for the emergency, which not always is a reflection of the level of a disease. Request for the emergency of this social category of the population is ten times higher than in other age groups. As a result, it causes unnecessary economical expenses and requires a correction of social programs.


Hereditary prothrombin deficiency.
Hereditary prothrombin deficiency is one of the rare congenital coagulation defects. We report a case of 4 months old child who initially presented at 11/2 month of age with high-grade fever, generalized convulsions and brownish aspirate through nasogastric tube, diagnosed and managed as meningitis and sepsis. He was readmitted at 4 months of age with bruises over legs. Coagulation profile was suggestive of common pathway defect. Further evaluation revealed absent prothrombin level while other factors were within normal limits.


Application of the Quantum Cluster Equilibrium (QCE) model for the liquid phase of primary alcohols using B3LYP and B3LYP-D DFT methods.
The Quantum Cluster Equilibrium (QCE) model was applied to the liquid phase for the first few members of the homologous series of unbranched aliphatic primary alcohols, methanol, ethanol, propan-1-ol, and butan-1-ol. Cluster structures and energies were calculated by density functional theory [B3LYP/6-311++G(2d,2p)]. For butan-1-ol the dispersion interaction was also considered with the B3LYP-D method. In agreement with previous findings, cyclic cluster structures are the most probable ones. In addition, weak C-H...O interactions as well as dispersion interactions between the longer alkyl chains were found to be important in the cluster formation. The reliability of the model was assessed by the calculated constant pressure heat capacity (C(p)) values. Larger deviations between theory and experiment were found for higher homologes (propan-1-ol, butan-1-ol) with the B3LYP method. When the B3LYP-D method was applied for butan-1-ol, adequate agreement was found between experimental and calculated C(p) values.


[Effect of valve type and valve function on chronic intravascular hemolysis after alloprosthetic mitral and aortic valve replacement].
In 1091 patients with isolated Björk-Shiley, Lillehei-Kaster, Starr-Edwards, and St. Jude Medical mitral and aortic valve replacement, hemolysis parameters were determined (hemoglobin, LDH, haptoglobin, free plasma hemoglobin, reticulocyte count, serum bilirubin, transferrin, urine hemosiderin, schistocyte count). In 1006 of these patients no valve dysfunction was detected, while in 85 patients either paravalvular leakage or a thrombosis of the prosthetic valve was present. Haptoglobin was the most sensitive parameter for detecting even mild intravascular hemolysis, which was present in two-thirds of patients after alloprosthetic heart valve replacement. For quantifying red cell damage LDH was useful. Hemolysis was somewhat higher after Lillehei-Kaster and Starr-Edwards than after Björk-Shiley or St. Jude Medical implantation. The variance of LDH levels can be explained in a high percentage by correlating them with the hemodynamic findings at rest and exercise, which are indirect parameters of velocity profiles. Hemolysis is higher after aortic than after mitral valve replacement, with the exception of St. Jude valves. In patients with perivalvular leakage or valve thrombosis, red cell damage is more pronounced than in normally functioning prostheses (p less than 0.0005). When the hemolysis characteristics of the individual types of prosthesis are taken into account, the degree of hemolysis is a reliable indicator (p less than 0.05) of the functional integrity of the prosthesis. However, the degree of hemolysis does not correlate with the hemodynamic significance of perivalvular regurgitation.


Factors Influencing the Diagnostic Yield of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration.
We describe the diagnostic performance of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in a heterogeneous population of patients with mediastinal lymphadenopathy secondary to suspected cancer (lung and nonlung) or recurrence after cancer therapy in a large academic cancer institute. A review was done of all patients referred for real-time EBUS-TBNA over an 18-month period at our institution. Cytological analysis of EBUS-TBNA aspirates was compared with a reference standard of definitive pathologic tissue diagnosis or a composite of ≥6 months' clinical follow-up with radiographic imaging. Adequate tissue was obtained in 225/236 procedures (95.3%) and a reference standard was available in 214. The overall diagnostic yield of EBUS-TBNA in those procedures with a reference standard was 87.4%. The sensitivity, specificity and diagnostic accuracy of EBUS-TBNA for malignancy was 86.1%, 100% and 92.9%, respectively. The sampling accuracy of EBUS-TBNA decreased with lymph node size ≤5 mm and with paratracheal location. Other factors, such as airway distortion and calcification, are also associated with less accurate EBUS-TBNA results. In a diverse population of patients with suspected cancer or recurrence, EBUS-TBNA is minimally invasive and highly accurate. Factors such as lymph node size and location influence the result of EBUS-TBNA.


A monoclonal thymocytotoxic autoantibody from autoimmune-disease-prone New Zealand black mouse recognizes beta-tubulin in neural tissue.
On the basis of our previous report that a thymocytotoxic monoclonal autoantibody (NTA260) derived from a New Zealand Black mouse reacts with brain tissues as well as lymphoid cells, the neuronal antigen reacting with this antithymocyte antibody was characterized in the present experiment. Double staining of cultured brain cells with NTA260 and anti-tubulin antibody revealed that both staining patterns closely resembled each other. NTA260 reacted with purified tubulin molecules on Western blotting. Two-dimensional gel electrophoresis of the whole lysate of embryonic mouse brain revealed that NTA260 stained the spot corresponding to that of beta-tubulin but not that of alpha-tubulin. These results suggest that beta-tubulin is a prominent neuronal antigen recognized by NTA260.


Megalencephaly and Macrocephaly.
Megalencephaly is a developmental disorder characterized by brain overgrowth secondary to increased size and/or numbers of neurons and glia. These disorders can be divided into metabolic and developmental categories based on their molecular etiologies. Metabolic megalencephalies are mostly caused by genetic defects in cellular metabolism, whereas developmental megalencephalies have recently been shown to be caused by alterations in signaling pathways that regulate neuronal replication, growth, and migration. These disorders often lead to epilepsy, developmental disabilities, and behavioral problems; specific disorders have associations with overgrowth or abnormalities in other tissues. The molecular underpinnings of many of these disorders are now understood, providing insight into how dysregulation of critical pathways leads to disease. The advances in molecular understanding are leading to improved diagnosis of these conditions, as well as providing new avenues for therapeutic interventions.


Pediatric rhabdomyosarcoma of the head and neck.
The optimal treatment for most patients with pediatric rhabdomyosarcoma (RMS) of the head and neck has been shown to be a combination of surgery, chemotherapy and radiation therapy. A retrospective review of patients seen at our institution is presented to analyze the impact of multimodality treatment on survival in 32 pediatric RMS patients. Sixty-five percent (21/32) of the patients were disease free at the most recent follow-up. The 5 year disease free survival was 57% (17/30). Combined modality treatment in 25 patients consisting of chemotherapy, radiation therapy and surgical resection (in 5 patients) rendered 18 (72%) patients free of disease. Only 1 of 7 (14%) patients who underwent surgery alone as primary management was cured. Two of these 7 patients were salvaged, both with combined modality treatment. The Intergroup Rhabdomyosarcoma Study (IRS) protocols have resulted in increased survival in pediatric patients with RMS of the head and neck. Our results reflect the significant improvement since the IRS study was completed.


Acetazolamide inhibits acidification by the turtle bladder independent of cell pH.
Acetazolamide (ACZL) inhibits luminal acidification by the turtle urinary bladder, a process thought to be mediated by the drug's ability to inhibit carbonic anhydrase (CA) and thus elevate cell pH. To test the hypothesis that these transport changes are actually mediated by changes of cell pH, we measured this parameter in single, identifiable mucosal cells using 4-methylumbelliferone and fluorescence microscopy. In control bladders 5 X 10(-4) M ACZL inhibited proton transport by 80 +/- 6%, and alkalinized cell pH, especially in a subpopulation of CA cells. A much larger cell alkalinization was induced by serosal HCO3- but proton transport fell only 30 +/- 7%. When cell pH was clamped at approximately 7.0 using 50 mM dimethyloxazolidinedione, or when cell pH was acidified using 7.5 mM propionate, transport rates still declined by 74 +/- 2, and 100 +/- 12%, respectively, in response to ACZL. In propionate-acidified bladders, 1 mM sodium azide blocked the inhibition of transport seen with 5 X 10(-4) M ACZL and reversed the inhibition with 10(-5) M ACZL. The apical endocytosis rate was increased by ACZL in normal and propionate-acidified bladders, but was not stimulated by alkalinizing the cell with NH4Cl. We conclude that ACZL can induce cellular alkalinization in this tissue, but that this pH change is not required for the inhibition of transport, or the ACZL-associated stimulation of endocytosis. The drug's ability to inhibit acidification appears to be the result of an azide-sensitive mechanism that has yet to be defined.


Two technetium-99m-labeled cholecystokinin-8 (CCK8) peptides for scintigraphic imaging of CCK receptors.
A broad spectrum of radiolabeled peptides with high affinity for receptors expressed on tumor cells is currently under preclinical and clinical investigation for scintigraphic imaging and radionuclide therapy. The present paper evaluates two (99m)Tc-labeled forms of the C-terminal octapeptide of cholecystokinin (CCK8): sulfated (s)CCK8, with high affinity for CCK1 and CCK2 receptors, and nonsulfated (ns)CCK8, with high affinity for CCK2 receptors but low affinity for CCK1 receptors. Peptides were conjugated with the bifunctional chelator N-hydroxysuccinimidyl hydrazino niconitate (s-HYNIC). (99m)Tc-labeling, performed in the presence of nicotinic acid and tricine, was highly efficient (approximately 95%) and yielded products with a high specific activity (approximately 700 Ci/mmol) and good stability (approximately 5% release of radiolabel during 16 h incubation in phosphate buffered saline at 37 degrees C). Chinese hamster ovary cells stably expressing the CCK1 receptor (CHO-CCK1 cells) internalized approximately 3% of added (99m)Tc-sCCK8 per confluent well during 2 h at 37 degrees C. Internalization was effectively blocked by excess unlabeled sCCK8. CHO-CCK1 cells did not internalize (99m)Tc-nsCCK8. Displacement of (99m)Tc-sCCK8 and -nsCCK8 by unlabeled CCK-8 (performed at 0 degrees C to prevent internalization) revealed 50% inhibitory concentrations (IC(50)) of 8 nM and >1 microM, respectively. CHO-CCK2 cells internalized approximately 25% and approximately 5% of added (99m)Tc-sCCK8 and -nsCCK8, respectively. In both cases internalization was blocked by excess unlabeled peptide. IC(50) values for the displacement of (99m)Tc-sCCK8 and -nsCCK8 were 3 nM and 10 nM, respectively. CHO-CCK1 cell-derived tumors present in one flank of athymic mice accumulated 2.0% of injected (99m)Tc-sCCK8 per gram tissue at 1 h postinjection. This value decreased to 0.6% following coinjection with excess unlabeled peptide. Uptake of (99m)Tc-nsCCK8 was low (0.2%) and not did change by excess unlabeled peptide (0.3%). Accumulation of (99m)Tc-sCCK8 and -nsCCK8 by CHO-CCK2 cell-derived tumors (present in the other flank) amounted to 4.2% and 0.6%, respectively. In both cases uptake was significantly reduced by excess unlabeled peptide to 1.0% and 0.4% for sCCK8 and nsCCK8, respectively. Accumulation of (99m)Tc-sCCK8 was also high in pancreas (11.7%), stomach (2.0%), and kidney (2.1%), whereas uptake of (99m)Tc-nsCCK8 was high in stomach (0.7%) and kidney (1.4%). Both radiolabeled peptides showed a rapid blood clearance. In conclusion, these data show that CCK8 analogues can be efficiently labeled with (99m)Tc using s-HYNIC as chelator and nicotinic acid/tricine as coligand system without compromising receptor binding. Furthermore, the present study demonstrates that CCK1 tumors hardly accumulate (99m)Tc-nsCCK8, CCK2 tumors accumulate 2 times more (99m)Tc-sCCK8 than CCK1 tumors, and CCK2 tumors accumulate 15 times more (99m)Tc-sCCK8 than (99m)Tc-nsCCK8. Although accumulation in some nontarget organs was also higher with (99m)Tc-sCCK8, this may not reflect the human situation due to a different receptor expression pattern in humans as compared to mice. Therefore, further studies are warranted to investigate the possible use of (99m)Tc-sCCK8 for scintigraphic imaging of CCK receptor-positive tumors in humans.


Strengthening the safety net for online seniors: factors influencing differences in health information seeking among older internet users.
Earlier studies clearly have shown that older adults are going online and accessing health information, but they are not a monolithic group. The goal of this study is to identify different types of older online Americans and to examine their online health information attitudes and behaviors. A total of 424 individuals age 55+ responded to an online survey. Three types of users were found based on demographic and computer-use factors: power users, well-to-do, and older men. Two types were found based on health attitudes and behaviors: health traditionalists and health technologists. The study found interesting relationships among these groups and also explored their use and evaluation of specific types of health-related websites and their motivations for going online. Suggestions are made for extending this research to other populations and further exploring the theoretical model of senior's online health interactions (SOHI) that drives the study.


Controlling Nutritional Status (CONUT) as a prognostic immunonutritional biomarker for gastric cancer after curative gastrectomy: a propensity score-matched analysis.
In clinical practice, it is not unusual to treat oncologic patients whose tumor markers are within normal range, even with advanced cancer. The Controlling Nutritional Status (CONUT) score could provide a useful nutritional and immunological prognostic biomarker for cancer patients. In this study, we assessed the prognostic value of the CONUT score for patients with gastric cancer, including a subgroup analysis with stratification based on serum carcinoembryonic antigen (CEA) level. We retrospectively reviewed the medical records of 368 consecutive patients who underwent curative laparoscopy-assisted gastrectomy. The prognostic value of the CONUT score was compared between patients with a low (≤ 2) and high (≥ 3) score, with propensity score matching (PSM) used to control for biasing covariates (Depth of tumor, Lymph node metastasis, pathological TNM (pTNM) stage). Overall survival (OS) among all patients was independently predicted by the tumor stage (hazard ratio (HR): 2.231, p = 0.001), the CONUT score (HR: 2.254, p = 0.001), and serum CEA level (HR: 1.821, p = 0.025). Among patients with a normal preoperative serum CEA level, tumor stage (HR: 2.350, p = 0.007), and the CONUT score (HR: 1.990, p = 0.028) were independent prognostic factors of OS. In the high serum CEA level group, tumor size (HR: 2.930, p = 0.015) and the CONUT score (HR: 3.707, p = 0.004) were independent prognostic factors of OS. It is advantageous to use both CEA level and the CONUT score to assess the prognosis of patients with gastric cancer, which reflect both tumor-related factors and host-related factors, respectively.


Internet-delivered psychological interventions for clinical anxiety and depression in perinatal women: a systematic review and meta-analysis.
Perinatal anxiety and depression are common and associated with negative outcomes if left untreated. Internet-delivered treatments can improve treatment accessibility and have demonstrated effectiveness in treating anxiety and depression in the general adult population. However, little is known about how effective and acceptable these interventions are for perinatal women. This paper describes a systematic review and preliminary meta-analysis of internet-delivered psychological interventions for the treatment of clinical anxiety and depression in perinatal women. A systematic search was carried out of seven electronic databases. Seven studies evaluating six distinct internet-delivered psychological interventions were identified. Of the seven studies included, two were open trials and five were randomized controlled trials with a total of 595 participants. Preliminary findings indicate large improvements in depression (Hedges g = 1.67; 95% CI 1.38-1.96) and anxiety (Hedges g = 1.08; 95% CI 0.80-1.36) from pre- to post-treatment. However, between-group differences between interventions and control conditions were only moderate for depression (Hedges g = 0.60; 95% CI 0.43-0.78) and anxiety (Hedges g = 0.54; 95% CI 0.24-0.85). While our preliminary findings are promising, this review identifies an area of research still in its early stages with significant gaps in the literature that need to be addressed. Further research is needed to establish the efficacy and acceptability of these interventions in this population, especially for antenatal depression and anxiety disorders.


Association Between NOS1 Gene Polymorphisms and Schizophrenia in Asian and Caucasian Populations: A Meta-Analysis.
Schizophrenia is a complex psychiatric disorder characterized by memory impairments with delusions and hallucinations. Several investigations have focused on determining the association between NOS1 (nitric oxide synthase-1) polymorphisms and risk of schizophrenia (SZ). However, the association of rs2682826, rs3782206, rs499776, rs3782219, rs41279104, rs3782221, rs1879417, rs4767540, rs561712, and rs6490121 polymorphisms with schizophrenia remains inconclusive. We performed a systematic meta-analysis for each polymorphism to determine its association with SZ by calculating their pooled odds ratio and 95% confidence intervals. The heterogeneity between studies was evaluated using Cochran's Q test to adopt random effects or fixed effects model. Based on our analysis, the rs3782206 polymorphism showed a strongest association with schizophrenia in allelic OR 1.15 (95% CI [1.05-1.25]), homozygote OR 1.35 (95% CI [1.09-1.66]), dominant OR 1.16 (95% CI [1.04-1.29]), and recessive OR 1.29 (95% CI [1.05-1.58]) models in Asian population. Similarly, in Caucasian population, the rs499776 polymorphism attributes risk association in homozygote OR 0.70 (95% CI [0.50-0.98]), dominant OR 3.57 (95% CI [2.34-5.27]), and recessive models OR 0.68 (95% CI [0.50-0.93]) with schizophrenia. Further, the sensitivity analysis was carried out based on leave-one-out method to confirm the reliability of the analysis. Overall, our meta-analysis demonstrates the significance of NOS1 genetic variants that are functionally associated with cognitive and neuropsychiatric symptoms of schizophrenia.


Acute trauma with multiple injuries.
Trauma with multiple injuries is a leading cause of death. It presents a diversity of challenges and requires many healthcare workers to care for its victims. Advances continue in the organization of pre-hospital care, the techniques of trauma surgery and critical care, and understanding the pathophysiology of traumatic injuries.


Respiratory effects of TRH in preterm rabbits.
The respiratory activity in newborn preterm (29 days gestation) rabbits was studied after administration of thyrotropic releasing hormone. Intraperitoneal injection induced an increase in respiratory frequency (f) and a decrease in tidal volume (VT) resulting in a slight increase in pulmonary ventilation (VE). These effects were seen in parallel to a decrease in expiratory time (TE) and respiratory time (TTOT). An increase in the TI/TTOT ratio but (unaffected) VT/TI ratio indicates that thyrotropic releasing hormone affects "respiratory timing" mechanisms rather than "inspiratory drive." The changes in respiratory parameters are most probably due to an effect on the central respiratory controlling centers in the brain stem.


Human metabolism of phenothiazines to sulfoxides determined by a new high performance liquid chromatography--electrochemical detection method.
The metabolism of phenothiazine drugs may contribute to both their therapeutic and toxic actions by production of active metabolites in vivo. Idiosyncratic reactions or treatment failure may be a consequence of differing patterns of metabolism in different patients. In this report, a modification of our method for the detection of metabolites of phenothiazines is described, which also permits the simultaneous determination of sulfoxide metabolites in human plasma. Application of this method to human plasma identifies marked individual differences in patterns of phenothiazine metabolism.


Assignment of genes encoding dihydrofolate reductase and hexosaminidase B to Mus musculus chromosome 13.
The murine gene encoding dihydrofolate reductase (DHFR) has been localized to a particular mouse chromosome by complementation mapping. Microcells prepared from diploid mouse fibroblasts were fused with mutant hamster cells lacking the dihydrofolate reductase gene (Dhfr), and DHFR+ microcell hybrids were selected in medium lacking purines and pyrimidines. The complemented hybrids expressed wild-type levels of DHFR enzyme activity, and selectively retained a single mouse chromosome--chromosome 13. Genomic Southern blots of DNAs prepared from these hybrids and from an independently derived collection of clones isolated without selection on the DHFR phenotype confirmed the assignment of murine Dhfr gene sequences to chromosome 13. This assignment provides further evidence for the existence of genetic homology between regions of mouse chromosome 13 and human chromosome 5. In support of this view, we show that the gene encoding hexosamindase B, a chromosome 5 marker in man, also maps to mouse chromosome 13.


Blackgram mottle virus RNA and its in vitro translation.
In vitro translation of blackgram mottle virus RNA in rabbit reticulocyte lysate resulted in synthesis of five major virus specific polypeptides with mol wt 90,000(p90), 82,000(p82), 42,000(p42), 39,000(p39) and 32,000(p32), respectively. The polypeptide p39 was identified as coat protein based on its electrophoretic mobility and immunoprecipitation with BMoV-antiserum.


Drug effects on laboratory values.
An abnormal laboratory value in any patient must be explained. Three factors may alter the laboratory test results: diet, disease, and drugs. Perusal of the Physicians' Desk Reference reveals the enormous influence drugs can have on the laboratory test results. The prescribing physician should be aware of any potential side effects of a drug he or she is prescribing and enlist the assistance of a qualified pathologist to decide what effects, if any, the medication has on observed anomalies. The clinical pathologist can also help the clinician to decide what further steps need to be taken to elucidate the problem.


Synthesis and characterization of folate decorated albumin bio-conjugate nanoparticles loaded with a synthetic curcumin difluorinated analogue.
Albumin-bound paclitaxel colloidal nanoparticle (Abraxane®) is an FDA approved anticancer formulation available in the market. It is a suspension which is currently used therapeutically for treating cancers of the breast, lung, and pancreas among others. CDF is a novel new and potent synthetic curcumin analogue that is widely used for breast and ovarian cancer. The aim of this study was to use biocompatible albumin as well as folate decorated albumin to formulate colloidal nanoparticles encapsulating curcumin difluorinated (CDF). CDF has demonstrated a 16-fold improvement in stability and remarkable anticancer potency compared to its natural derivative, curcumin. CDF showed marked inhibition of cancer cell growth through down-regulation of multiple miRNAs, up-regulation of phosphatase and tensin homolog (PTEN), and attenuation of histone methyl transferase EZH2. However, CDF is highly hydrophobic and photodegradable with sparing aqueous solubility. In this study, we have formulated albumin nanoparticle using a modified desolvation method, which yielded high CDF loading in a nanoformulation. The physicochemical properties of CDF loaded albumin and folate-decorated albumin nanosuspensions were assessed for particle size, morphology, zeta potential, drug encapsulation efficiency/loading, solubility and drug release. Importantly, the folate ligand decorated albumin nanoparticles were formulated in principle to passively and actively target folate-overexpressing-cancers. In this study, the synthesis and optimization of BSA and folate decorated BSA conjugated CDF nanoparticles are assessed in detail that will be useful for its future clinical translation.


Extended DLVO theory: electrostatic and non-electrostatic forces in oxide suspensions.
According to classical DLVO theory all ions of background salt solution with the same ionic charge should result in the same effective force between colloidal particles. However, the relative effectiveness of different ions in influencing forces between ceramic oxide surfaces follows either a reversed Hofmeister sequence or a direct Hofmeister sequence depending on the type of oxide and if the pH is above or below the isoelectric point (iep). This ion specificity is inexplicable in classical double layer theory that deals only with pure electrostatic forces acting between the ions and the colloidal particles. A theoretical explanation is given here. At, and above, biological salt concentrations other, non-electrostatic (NES) ion specific forces act that are ignored in such modeling. In this overview we present the basic theory for the double layer near a single oxide surface and for the extended DLVO forces between oxide colloidal particles that accounts for these NES forces. We will demonstrate that ion specificity can be understood to a large degree once NES forces are included consistently in the non-linear theory.


Comparative phylogeography of three skink species (Oligosoma moco, O. smithi, O. suteri; Reptilia: Scincidae) in northeastern New Zealand.
Sea-level fluctuations during the Pliocene and Pleistocene have shaped the landscape of the Northland region of New Zealand. We examined the comparative phylogeography of three skink species (Oligosoma moco, O. smithi, O. suteri) in northeastern New Zealand in order to investigate the impact of the historical processes that have prevailed since the Pliocene on the Northland fauna. O. moco, O. smithi and O. suteri have similar distributions across northeastern New Zealand, frequently occurring in sympatry. We obtained sequence data from across the entire range of each species, targeting the ND2 mitochondrial gene. Using Neighbor-Joining, Maximum likelihood and Bayesian methods, our analysis revealed contrasting phylogeographic patterns in each species. We found substantial phylogeographic structure within O. moco, with three distinct clades identified. Similarly, deep phylogeographic divergence was evident within O. smithi, with three distinct clades present. Clade 1 included O. smithi populations from the Three Kings Islands and the western coastline of Northland, while Clade 2 encompassed the remainder of the range. However, since Clade 3 corresponded to a described species (O. microlepis), O. smithi might represent a species complex. In both O. moco and O. smithi, divergences among clades are estimated to have occurred in the Pliocene, with divergences within clades occurring during the Pleistocene. In contrast, genetic divergence among O. suteri populations was extremely limited and indicative of more recent divergences during the Pleistocene. The lack of phylogeographic structure in O. suteri might be a consequence of its oviparous reproductive mode, which restricted its distribution to warm northern refugia during glacial maxima. Differences in the ecology and biology of each species might have produced contrasting responses to the same historical processes, and ultimately diverse phylogeographic patterns. Our study reveals an absence of consistent and concordant phylogeographic patterns in the Northland biota, even within the same taxonomic group.


Moiré method for nanometer instability investigation of scanning hard x-ray microscopes.
We present a Moiré method that can be used to investigate positional instabilities in a scanning hard x-ray microscope with nanometer precision. The development of diffraction-limited storage rings offering highly-brilliant synchrotron radiation and improvements of nanofocusing x-ray optics paves the way towards 3D nanotomography with 10 nm resolution or below. However, this trend demands improved designs of x-ray microscope instruments which should offer few-nm beam stabilities with respect to the sample. Our technique can measure the position of optics and sample stage relative to each other in the two directions perpendicular to the beam propagation in a scanning x-ray microscope using simple optical components and visible light. The usefulness of the method was proven by measuring short and long term instabilities of a zone-plate-optics-based prototype microscope. We think it can become an important tool for the characterization of scanning x-ray microscopes, especially prior to experiments with an actual x-ray beam.


alpha and beta glycoprotein hormone subunits (hLH, hFSH, hCG) in the serum and pituitary of the human fetus.
Utilizing specific radioimmunoassay and gel chromatographic separation methods, the concentration of a glycoprotein hormone subunit and the beta subunit of hCG, hLH, and hFSH was determined. The alpha glycoprotein hormone subunit is present throughout gestation in the serum and pituitary of the human fetus; little or no subunit is apparent in contrast to that of intact LH and FSH.


Benzylidene anabaseines act as high-affinity agonists for insect nicotinic acetylcholine receptors.
Benzylidene anabaseines are agonists selective for vertebrate alpha7-nicotinic acetylcholine receptor (nAChR), while they exhibit antagonist activity toward vertebrate alpha4beta2-nAChR. To investigate the effects of benzylidene anabaseines on insect nAChRs, we performed [3H]epibatidine-binding assays and neurophysiological experiments using American cockroach (Periplaneta americana) nerve-cord preparations. Of the six compounds tested, 3-benzylideneanabaseine (BA) and 6'-chloro-3-benzylideneanabaseine (CBA) displayed the highest potency in the binding assays, with K(i)s of 35.0 and 21.2nM, respectively. The introduction of a nitro group at the 4-position of the phenyl group led to a decrease in affinity by two orders of magnitude, while that of a chlorine atom at the 6'-position had little effect on affinity. In neurophysiological experiments, BA at 3.3 microg/ml increased the spike frequency observed with the nerve preparation, as observed with nicotine at 16.6 microg/ml. These findings suggest that benzylidene anabaseines act as high-affinity agonists in P. americana nAChRs and that they might therefore prove useful as probes for insect nAChRs.


[The effects of an environmental education with newspaper in education (NIE) on the environmental concern and practice].
The purpose of this study was to develop an environmental education program using newspaper articles in education (NIE) and to evaluate changes in concern and practice for environmental protection after NIE. The design was a nonequivalent control group pretest-posttest design. The participants were university students in nursing, of which 31 were assigned to the experimental group and 43 to the control group. The education was carried out for 2 hr, once a week for 7 weeks. Data were analyzed with SPSS WIN 14 program, and included chi2 test, independent t-test, and repeated measure ANOVA. NIE showed significant differences in the changes of attitude toward environment (F=4.461, p=.036). Findings suggest that this NIE in environmental education was effective in changing students' attitudes toward the environment. Therefore this NIE is recommended for inclusion in education for university students in nursing.


MRI in successful aging, a 5-year follow-up study from the eighth to ninth decade of life.
This study aimed at evaluate the effect of aging on the central nervous system in "successfully aged" elderly subjects. The brain was studied with magnetic resonance imaging and neuropsychological tests at three different occasions during a time period of 5 yr. Twenty-four successfully aged elderly were repeatedly examined with cerebral MRI and neuropsychological tests. The first examinations were performed in 1987 and then followed-up in 1989 and 1993. Two different MRI systems were used, in 1987 and 1989, a system operating at 0.02 T and in 1993 a system operating at 0.5 T. Ten subjects (42%) did not participate in the follow-up studies. MRI was used to study the degree of and increase in signal hyperintensities in the cerebrum, the basal ganglia, and in the infratentorial areas as well as changes in the volumes of the cerebro spinal fluid (CSF) spaces. At the start of the study in 1987, mild signal hyperintensities were observed in 11 of the 13 subjects who completed the follow up study. A modest increase in signal hyperintensity was found in almost all of the subjects, with the increases in cerebral white matter and basal ganglia signal hyperintensity being statistically significant (p < .03 and p < .05). The increases in periventricular hyperintensity and the hyperintensity from the infratentorial areas did not reach statistical significance. Volumes of the lateral ventricles and the frontal CSF spaces increased significantly (p < .03 in both cases) during the observation period, whereas the other volumes remained unchanged. The neuropsychological tests were unchanged during the observation period with the exception of the psychomotor capacity, which deteriorated. No statistical significant correlations were seen between the degree of or increase in signal hyperintensities and results from any of the neuropsychological tests. During a 5-yr observation of successfully aged elderly it was found that there was a mild increase in signal hyperintensity in the cerebral white matter and basal ganglia, as well as an increase in the frontal and ventricular CSF volumes. These changes were not related to changes in psychometric test results, nor were they related to the clinical outcome during the time of observation.


Conceptual style and life satisfaction following spinal cord injury.
The major purpose of this study was to explore the relationship between conceptual style and life satisfaction following a physical loss. It was predicted that conceptual abstractness is positively associated with life satisfaction. Fifty-four men between the ages of 18 and 41 who were paraplegic or quadriplegic, because of a spinal cord injury that occurred at least 18 months prior to the interview, were asked to complete questionnaires designed to measure their conceptual styles and their satisfaction with various aspects of their lives. The data suggest that: the respondents were generally satisfied with life; dissatisfaction was frequently greatest in family and other intimate relationships; and physical trauma may trigger changes in conceptual style in the direction of greater complexity and abstractness. The predicted positive association between conceptual abstractness and life satisfaction was supported in several instances by the data.


Effect of a platinum chemotherapy drug on intracellular elements during the cell cycle, using X-ray microanalysis.
Intracellular elemental concentrations were measured in the cytoplasm, nucleus and nucleolus of cultured Chinese hamster ovary (CHO) cells, using energy dispersive electron probe X-ray microanalysis and transmission electron microscopy. Synchronous CHO cell populations were analyzed at different times during the growth cycle. The elements K, P, Mg and Zn were all more concentrated in the nucleus and nucleolus than in the cytoplasm, while no specific subcellular compartmentalization was evident for the elements Na, Cl, Ca, Fe and S. Significant changes in intracellular elemental concentrations were associated with the progression of cells from G1 phase to S phase of the growth cycle. Most significant were the effects on the monovalent ions, Na, K and Cl. The effect of a second generation platinum chemotherapy agent, cis-dichloro-bis (isopropylamine) trans-dihydroxy platinum IV (iproplatin) on intracellular elements was investigated by analyzing subcellular compartments of drug-treated synchronous CHO cell populations. Changes in intracellular elemental levels occurred, most notably in the nucleus of G1 phase cells, when a general depletion of most essential elements was evident. Attempts to analyze cells for their Pt content proved disappointing, since quantitation for Pt was not possible. However, measurement of Pt peak/background ratio yielded significant Pt peaks on analyzing lysosomes of cells treated with high concentrations of iproplatin. These Pt peaks were associated with high levels of S and Fe.


Histone deacetylase activity is necessary for chromosome condensation during meiotic maturation in Xenopus laevis.
Chromosome condensation is thought to be an essential step for the faithful transmission of genetic information during cellular division or gamete formation. The folding of DNA into metaphase chromosomes and its partition during the cell cycle remains a fundamental cellular process that, at the molecular level, is poorly understood. Particularly, the role of histone deacetylase (HDAC) activities in establishing and maintaining meiotic metaphase chromosome condensation has been little documented. In order to better understand how metaphase chromosome condensation is achieved during meiosis, we explored, in vivo, the consequences of HDAC activities inhibition in a Xenopus oocyte model. Our results show that deacetylase activity plays a crucial role in chromosome condensation. This activity is necessary for correct chromosome condensation since the earlier stages of meiosis, but dispensable for meiosis progression, meiosis exit and mitosis entry. We show that HDAC activity correlates with chromosome condensation, being higher when chromosomes are fully condensed and lower during interphase, when chromosomes are decondensed. In addition, we show that, unlike histone H4, Xenopus maternal histone H3 is stored in the oocyte as a hypoacetylated form and is rapidly acetylated when the oocyte exits meiosis.


Age-dependent, polyclonal hyperactivation of T cells is reduced in TNF-negative gld/gld mice.
The generalized lymphoproliferative disorder (gld) mouse strain is characterized by severe splenomegaly/lymphadenopathy, the production of autoimmune antibodies, and the appearance of CD4/CD8-negative T cells. An additional TNF deficiency of gld/gld mice attenuates the course of the disorder through a yet-unknown mechanism. In this study, we could demonstrate that the reduced splenomegaly and lymphadenopathy in B6.gld/gld.TNF-/- mice were correlated with a decreased peripheral T cell proliferation rate and a delayed polyclonal activation. A comparative analysis of naïve T cells and memory/effector T cells showed an age-dependent difference in the T cell activation pattern in the spleen of B6.gld/gld and B6.gld/gld.TNF-/- mice. T cells from B6.gld/gld.TNF-/- spleens and lymph nodes showed significantly higher levels of CCR7 and CD62 ligand on their surface compared with B6.gld/gld mice when mice of the same age were compared. Additionally, we found an increased titer of the Th1 cytokine IFN-gamma in the serum of B6.gld/gld mice, whereas the concentration of IFN-gamma was markedly reduced in the serum of B6.gld/gld.TNF-/- mice. These findings support the hypothesis that increased T cell activation and proliferation in the presence of TNF contribute to the exacerbation of the gld syndrome.


Management of macular edema secondary to branch retinal vein occlusion: an evidence-based update.
Retinal vein occlusions are common retinal vascular disorders with the potential for significant vision-related morbidity. Retinal vein occlusions are classified as either branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO), or hemiretinal vein occlusion (HRVO) based on the specific occlusion site. The most common cause of decreased vision in patients afflicted with BRVO is the accumulation of fluid within the macula (macular edema). The Branch Vein Occlusion Study (BVOS) demonstrated the efficacy of grid laser photocoagulation in the treatment of BRVO-related macular edema. After publication of that report, grid laser became the standard of care for decreased vision due to BRVO-associated macular edema in patients similar to those enrolled in the BVOS. However, several recent major randomized, controlled clinical trials have investigated new therapeutic modalities for the treatment of decreased vision due to macular edema secondary to BRVO. This article aims to provide insight into current evidence-based approaches to management of macular edema secondary to BRVO. A companion article reviews approaches for management of macular edema secondary to CRVO.