Valproate, hyperandrogenism, and polycystic ovaries: a report of 3 cases.
Reproductive endocrine disorders characterized by menstrual disorders, polycystic ovaries, and hyperandrogenism seem to be common among women treated with sodium valproate for epilepsy. To describe the development of valproate-related reproductive endocrine disorders in women with epilepsy. Case report. Three patients developed a reproductive endocrine disorder during treatment with valproate. It was characterized by hyperandrogenism and polycystic ovaries in all cases, and it was associated with weight gain and menstrual disorders in 2 of the 3 women. Replacing valproate with lamotrigine resulted in a decrease in serum testosterone concentrations in all 3 women. The polycystic changes disappeared from the ovaries in 2 of the women after valproate therapy was discontinued, and the 2 women who had gained weight and developed amenorrhea while being treated with valproate lost weight and resumed menstruating after the change in medication. The 3 cases presented here illustrate the development of reproductive endocrine disorders after the initiation of valproate therapy in women with epilepsy. The disorders were characterized by hyperandrogenism and polycystic ovaries in all cases, and were associated with weight gain and menstrual disorders in 2 of the 3 women. An evaluation of ovarian structure and function should be considered in women of reproductive age being treated with valproate for epilepsy, especially if they develop menstrual cycle disturbances during treatment.


Turbulence at the top: a new perspective on governance structure changes and strategic change.
Organizational theorists have traditionally focused attention on the relationship between chief executive officer (CEO) succession and strategic change. This study extends that perspective and explores the effects of changes in an organization's management, ownership, and board of directors on the process of strategic change. The results of this research suggest that changes in ownership and board have significant independent and interactive effects on strategic change.


In situ assessment of the velocity of carbon transfer by tracing 13 C in trunk CO2 efflux after pulse labelling: variations among tree species and seasons.
Phloem is the main pathway for transferring photosynthates belowground. In situ(13) C pulse labelling of trees 8-10 m tall was conducted in the field on 10 beech (Fagus sylvatica) trees, six sessile oak (Quercus petraea) trees and 10 maritime pine (Pinus pinaster) trees throughout the growing season. Respired (13) CO2 from trunks was tracked at different heights using tunable diode laser absorption spectrometry to determine time lags and the velocity of carbon transfer (V). The isotope composition of phloem extracts was measured on several occasions after labelling and used to estimate the rate constant of phloem sap outflux (kP ). Pulse labelling together with high-frequency measurement of the isotope composition of trunk CO2 efflux is a promising tool for studying phloem transport in the field. Seasonal variability in V was predicted in pine and oak by bivariate linear regressions with air temperature and soil water content. V differed among the three species consistently with known differences in phloem anatomy between broadleaf and coniferous trees. V increased with tree diameter in oak and beech, reflecting a nonlinear increase in volumetric flow with increasing bark cross-sectional area, which suggests changes in allocation pattern with tree diameter in broadleaf species. Discrepancies between V and kP indicate vertical changes in functional phloem properties.


Nutritional status of HIV-1 seropositive patients in the Free State Province of South Africa: anthropometric and dietary profile.
To evaluate the nutritional intake and status of HIV-1 seropositive patients, as well as the relationship between malnutrition and disease stage. A cross-sectional study. The Immunology Clinic at the Pelonomi Hospital in Bloemfontein, South Africa. Eighty-one HIV/AIDS patients in different stages of disease were recruited consecutively from January to May 1995. Eleven of these patients were followed in 1997. Anthropometric data including current weight, height, triceps skinfold thickness, mid-upper-arm circumference, body mass index and bone-free arm muscle area were collected. Nutrient intake was estimated using a diet history in combination with a standardised food frequency questionnaire. The patients were divided into 3 groups according to their CD4+ T cell counts. The men were leaner (BMI = 18.9) than the women (BMI = 22.7) and patients with a CD4+ T cell count < 200 (stage III) tended to have the lowest median values for all anthropometric measurements. More than half the patients had a low intake (< 67% of the recommended dietary allowances) of vitamin C, vitamin B6, vitamin D, vitamin A, calcium, iron and zinc. The results confirms that HIV/AIDS patients from this population are malnourished. There was, however, no association between disease stage and nutritional status. Nutritional supplementation of HIV/AIDS patients should be considered, as this might lead to improved immune function in these patients.


Oropharyngeal colostrum administration in extremely premature infants: an RCT.
To determine the immunologic effects of oropharyngeal colostrum administration in extremely premature infants. We conducted a double-blind, randomized, placebo-controlled trial involving 48 preterm infants born before 28 weeks' gestation. Subjects received 0.2 mL of their mother's colostrum or sterile water via oropharyngeal route every 3 hours for 3 days beginning at 48 to 96 hours of life. To measure concentrations of secretory immunoglobulin A, lactoferrin, and several immune substances, urine and saliva were obtained during the first 24 hours of life and at 8 and 15 days. Clinical data during hospitalization were collected. Urinary levels of secretory immunoglobulin A at 1 week (71.4 vs 26.5 ng/g creatinine, P = .04) and 2 weeks (233.8 vs 48.3 ng/g creatinine, P = .006), and lactoferrin at 1 week (3.5 vs 0.9 μg/g creatinine, P = .01) were significantly higher in colostrum group. Urine interleukin-1β level was significantly lower in colostrum group at 2 weeks (55.3 vs 91.8 μg/g creatinine, P = .01). Salivary transforming growth factor-β1 (39.2 vs 69.7 μg/mL, P = .03) and interleukin-8 (1.2 vs 4.9 ng/mL, P = .04) were significantly lower at 2 weeks in colostrum group. A significant reduction in the incidence of clinical sepsis was noted in colostrum group (50% vs 92%, P = .003). This study suggests that oropharyngeal administration of colostrum may decrease clinical sepsis, inhibit secretion of pro-inflammatory cytokines, and increase levels of circulating immune-protective factors in extremely premature infants. Larger studies to confirm these findings are warranted.


Detection of IgA protease from Haemophilus influenzae by immunoblotting.
IgA protease produced by various strains of Haemophilus influenzae can digest serum IgA and yield its fragments which can react with anti-IgA serum. We assayed IgA protease activity by detecting the digests of IgA by SDS-PAGE and immunoblotting. The digests were separated with SDS-PAGE, transferred to nitrocellulose membranes and detected with anti- (alpha chain of human IgA, its Fab and its Fc) immunoglobulin conjugated peroxidases. Using this method, we can determine which type of IgA protease is produced by various of H. influenzae strains. All the 20 strains isolated from respiratory tracts produced IgA protease.


Comparison of off-clamp partial nephrectomy and on-clamp partial nephrectomy: a systematic review and meta-analysis.
To compare peri- and postoperative variables, surgical complications, oncological outcomes and renal outcomes of off-clamp partial nephrectomy (PN) and on-clamp PN. A systematic search of the electronic databases, including MEDLINE, Embase and Cochrane Library, was performed. The pooled estimates of tumour size, operative time, estimated blood loss, length of stay, overall complications, transfusion rates, urinary leaks, positive surgical margins and eGFR were calculated. 14 studies were included. There was no significant difference between off-clamp PN and on-clamp PN in terms of tumour size, operative time, estimated blood loss, length of stay, overall complications, transfusion rates, urinary leaks, and positive surgical margins. However, a non-statistically significant trend towards increased blood loss (p = 0.12) and transfusion rates (p = 0.07) in those undergoing off-clamp PN was noted. Off-clamp PN was associated with a significantly lower reduction in eGFR than on-clamp PN (standardised weighted mean difference 0.27, 95% CI 0.14, 0.40, p < 0.0001). Off-clamp PN may be associated with improved long-term renal outcomes when compared to on-clamp PN with no difference in in peri- and postoperative variables, surgical complications and oncological outcomes. However, the meta-analysis was limited by the design of the underlying studies, and hence further work is necessary.


Reduction of blood loss and transfusion requirement by aprotinin in posterior lumbar spine fusion.
Aprotinin reduces blood loss in many orthopedic procedures. In posterior lumbar spine fusion, blood loss results primarily from large vein bleeding and also occurs after the wound is closed. Seventy-two patients undergoing posterior lumbar spine fusion were randomly assigned to large-dose aprotinin therapy or placebo. All patients donated three units of packed red blood cells (RBCs) preoperatively. Postoperative blood loss was harvested from the surgical wound in patients undergoing two- and/or three-level fusion for reinfusion. The target hematocrit for RBC transfusion was 26% if tolerated. Total (intraoperative and 24 h postoperative) blood loss, transfusion requirements, and percentage of transfused patients per treatment group were significantly smaller in the aprotinin group than in the placebo group (1935 +/- 873 vs 2809 +/- 973 mL per patient [P = 0.007]; 42 vs 95 packed RBCs per group [P = 0.001]; 40% vs 81% per group [P = 0.02]). Hematological assessments showed an identically significant (a) intraoperative increase in both thrombin-antithrombin III complexes (TAT) and in activated factor XII (XIIa) and (b) decrease in activated factor VII (VIIa), indicating a similar significant effect on coagulation in patients of both groups (P = 0.9 for intergroup comparisons of postoperative VIIa, XIIa, and TAT). Intraoperative activation of fibrinolysis was significantly less pronounced in the aprotinin group than in the placebo group (P < 0.0001 for intergroup comparison of postoperative D-dimer levels). No adverse drug effects (circulatory disturbances, deep venous thrombosis, alteration of serum creatinine) were detected. Although administered intraoperatively, aprotinin treatment dramatically reduced intraoperative and 24-h postoperative blood loss and autologous transfusion requirements but did not change homologous transfusion in posterior lumbar spine fusion. In our study, aprotinin therapy significantly decreased autologous, but not homologous, transfusion requirements in posterior lumbar spine fusion.


Use of dodecyl-beta-D-maltoside in the purification and stabilization of RNA polymerase from brome mosaic virus-infected barley.
The activity and specificity of RNA-dependent RNA polymerase (replicase) isolated from brome mosaic virus-infected barley was enhanced by extraction with the nonionic detergent dodecyl-beta-d-maltoside. The enzyme was stable for at least 8 weeks when stored at -70 degrees . A further 100-fold purification was obtained by centrifugation through sucrose in the presence of detergent. The polymerase activity was associated with the pellet fraction; the template dependence and specificity were similar to those of the enzyme before sucrose purification. SDS-PAGE analysis revealed a 110-kd protein in the purified pellet fraction from infected leaves that was absent from a similar fraction from healthy leaves. The protein had an identical electrophoretic mobility to that of protein la, the product of brome mosaic virus RNA 1 translation in vitro, and the profile of its tryptic polypeptides was very similar to that of protein 1a. These results support data obtained by inoculation of protoplasts with separated BMV RNA components (Kiberstis, et al. (1981), Virology 112, 804-808) that are consistent with the notion that RNA 1 codes for the viral replicase, or a subunit thereof.


Serum hyaluronan (hyaluronic acid) in breast cancer patients.
Eighty-three women with breast cancer (57 with systemic metastasis, 26 without) were investigated for serum hyaluronan (HA) and compared to 50 patients with benign diseases of the breast. Hyaluronan was significantly increased in sera of metastatic patients compared to sera of non-metastatic patients (p less than 0.0001) and also in sera of non-metastatic patients when compared to control sera (p less than 0.01). The difference was not related to the number of metastatic sites involved. Three months after starting cytotoxic chemotherapy in metastatic patients, lower HA concentrations were observed in patients responding to chemotherapy. The initial level of serum HA had no predictive value concerning response to chemotherapy.


Validation of the short form-36 health survey supported with isokinetic strength testing after sport knee injury.
Valid patient-based outcome instruments are necessary for comprehensive patient care that focuses on all aspects of health, from impairments to participation restrictions. To validate the Slovenian translation of Medical Outcome Survey (MOS) Short Form Health Survey (SF-36) and to assess relations among various knee measurements, activity tested with Oxford Knee Score (OKS) and health-related quality of life as estimated with SF-36 domains. Descriptive validation study. Isokinetic laboratory in outpatient rehabilitation unit. 101 subjects after unilateral sport knee injury. All subjects completed the SF-36 and OKS, and isokinetic knee-muscle strength output at 60°/s was determined in 78 participants. Within a 3-d period, 43 subjects completed the SF-36 and OKS questionnaires again. Reliability testing included internal consistency and test-retest reliability. Correlations between SF-36 subscales and OKS were calculated to assess construct validity, and correlation between SF-36 subscales and muscle strength was calculated to assess concurrent validity. Chronbach α was above .78 for all SF-36 subscales. ICCs ranged from .80 to .93. The correlation between OKS and the physical-functioning subscale, showing convergent construct validity, was higher (r = .83, P < .01) than between OKS and mental health (r = .50, P < .01), showing divergent construct validity. Knee-extensor weakness negatively correlated with physical-functioning (r = -.59, P < .01) and social-functioning (r = -.43, P < .01) subscales. The Slovenian translation of the SF-36 is a reliable and valuable tool. The relationships between knee-muscle strength and activity and between knee-muscle strength and SF-36 subscales in patients after sport knee injury were established.


Silver(I)-Catalyzed Widely Applicable Aerobic 1,2-Diol Oxidative Cleavage.
The oxidative cleavage of 1,2-diols is a fundamental organic transformation. The stoichiometric oxidants that are still predominantly used for such oxidative cleavage, such as H5 IO6 , Pb(OAc)4 , and KMnO4 , generate stoichiometric hazardous waste. Herein, we describe a widely applicable and highly selective silver(I)-catalyzed oxidative cleavage of 1,2-diols that consumes atmospheric oxygen as the sole oxidant, thus serving as a potentially greener alternative to the classical transformations.


Crystal structure and relaxor-type transition in SrBi(2)Ta(2)O(9) doped with praseodymium.
The effects of Pr substitution in the structure and ferroelectric response for the Sr(1-x)Pr(x)Bi(2)Ta(2)O(9) (SBT-Pr) compound have been studied. Rietveld refinement of the x-ray diffraction patterns indicates that the Pr ion progressively replaces the Sr site in the A 2(1)am space group structure. The solubility of Pr in solid solution is around 15%. The replacement induces a change in the crystal structure and, as a consequence, the dielectric properties are affected. The ferroelectric transition at T(m)∼558 K is shifted to lower temperatures, T(m)∼413 K for x = 0.15 composition. Apparently, the tilt angle (α) associated with the c-axis does not play an important role since it remains essentially constant. However, the rotation in the ab-plane (β) as well as the octahedral distortion observed are strongly related to the coupling between T(m) and x. A relaxor-type transition is observed as Pr is increased, leading to polar microregions above the nominal ferroelectric transition. The local disorder induced by the Pr ion is confirmed by the continuous increase in the diffuseness coefficient according to Isupov's model. These facts hinder the displacement of the TaO(6) octahedra with respect to Bi(2)O(2) along the polarization axis, decreasing the polarization values.


Onchocerciasis control: biological research is still needed.
Achievements obtained by the onchocerciasis control programmes should not lead to a relaxation in the biological research on Onchocerco volvulus. Issues such as the Loa loa-related post-ivermectin serious adverse events, the uncertainties as to whether onchocerciasis can be eliminated by ivermectin treatments, and the possible emergence of ivermectin-resistant O. volvulus populations should be addressed proactively. Doxycycline, moxidectin and emodepside appear to be promising as alternative drugs against onchocerciasis but support to researches in immunology and genomics should also be increased to develop new control tools, including both vaccines and macrofilaricidal drugs.


Importin β3 mediates the nuclear import of human ribosomal protein L7 through its interaction with the multifaceted basic clusters of L7.
We show that importin β3 is essential for the nuclear import of L7. The import is mediated via the multifaceted basic amino acid clusters present in the NH(2)-region of L7, and is RanGTP-dependent. Using a (EGFP)(3) reporter system and a FRAP assay, the role the individual clusters play as a functional NLS has been characterized, and each cluster was found to exhibit a different rate of real time nuclear uptake. We assume that having such a multiple NLS may provide L7 with preferential nuclear uptake.


Epidermal growth factor and fibroblast growth factor-2 circulating levels in elderly with major depressive disorder.
Epidermal growth factor (EGF) and Fibroblast Growth Factor-2 (FGF-2) are growth factors involved neuronal growth and synaptic plasticity. These markers have been implicated in neuropsychiatric disorders, including major depression. However, no particular studies of EGF and FGF-2 have been conducted in older adults with major depressive disorder (MDD). In this study, we aim to investigate the plasma levels of EGF and FGF-2 in elderly with MDD. We included 89 older adults with MDD and 51 older (healthy control, HC) adults. The cognitive performance was evaluated by the Mattis Dementia Rating Scale (MDRS). The EGF and FGF-2 were measured by using multiplex assay for LUMINEX platform. There were also no significant differences between the patient group in terms of plasma levels of EGF and FGF-2 when compared to the HC group. There were not any significant correlations between plasma levels of EGF or FGF2 and MDRS total or individual scores in patient group and HC. There were significant correlations between plasma levels of EGF and FGF2 in both patient group and HC. Further study on plasma levels of EGF and FGF2 should be implemented in larger samples in elderly with MDD.


A study of serum bilirubin in neonates in relation to the maternal age.
A comparative study of neonatal serum bilirubin levels was done in neonates of different age groups of mothers. A total 122 healthy, new borns were selected for the study, born at Queen Mary's Hospital, Lucknow. Mothers were divided into two groups i.e. < 30 years and > 30 years of age. Samples of blood were collected thrice, first on day 1 from cord blood, 2nd and 3rd on days three and five of life from neonates by heel prick method, using small bore capillaries for blood collection, serum bilirubin estimation were done by the method of Malloy & Evelyn and Mean +/- SD were calculated. P-Value was observed between different age groups. In both the groups of mothers i.e. < 30 years and > 30 years serum bilirubin levels in their neonates raised to highly significant levels on day 3 (P-Value < 0.001) as compared to their cord blood serum bilirubin levels. On comparing serum bilirubin levels in neonates of both the maternal groups, it was observed that there is no significant difference between two groups on day of birth and day day 5 but statistically significant difference was observed on day 3 (P < 0.05), serum bilirubin levels were higher in neonates of younger age group mothers.


[Osteosarcoma and Ewing's sarcoma. Improved recovery chances in the past 25 years according to the experience of Balgrist Hospital].
At the Balgrist hospital 38 patients with osteosarcoma and 18 patients with Ewing sarcoma were treated from 1970 through 1992; a follow-up of at least three years is available for all patients. Disease-free survival in this period of time has increased from 20% (Ewing sarcoma) and 30% (osteosarcoma) to over 75%. While systemic tumor control was improved by systematic chemotherapy, local tumor control was improved by appropriate biopsy techniques, and amputations have been replaced by local resections, in most cases with reconstruction (arthrodesis, rotation plasty, endoprosthesis, allografts), which require further improvements. With respect to cure of the neoplastic disease, the currently available methods have been used to their maximum potential, and a steady state has been reached regarding survival. Further improvement of survival will therefore depend on the introduction of completely new modalities.


Accuracy of templates for navigated implantation made by rapid prototyping with DICOM datasets of cone beam computer tomography (CBCT).
The aim of this study is to evaluate the accuracy of a surgical template-aided implant placement produced by rapid prototyping using a DICOM dataset from cone beam computer tomography (CBCT). On the basis of CBCT scans (Sirona® Galileos), a total of ten models were produced using a rapid-prototyping three-dimensional printer. On the same patients, impressions were performed to compare fitting accuracy of both methods. From the models made by impression, templates were produced and accuracy was compared and analyzed with the rapid-prototyping model. Whereas templates made by conventional procedure had an excellent accuracy, the fitting accuracy of those produced by DICOM datasets was not sufficient. Deviations ranged between 2.0 and 3.5 mm, after modification of models between 1.4 and 3.1 mm. The findings of this study suggest that the accuracy of the low-dose Sirona Galileos® DICOM dataset seems to show a high deviation, which is not useable for accurate surgical transfer for example in implant surgery.


β-glucan degradation in malting sorghum.
In all of four malting sorghum varieties, β-glucan contents decreased by more than 50% 2 days after germination, due to enzymic digestion. The variety that had the least β-glucan content in the malt gave the highest filterable volume of sweet wort while the variety with the highest β-glucan content had the lowest volume of filterable wort.


Relaxation dynamics of deeply supercooled confined water in L,L-diphenylalanine micro/nanotubes.
The temperature dependence (10-290 K) of the low-frequency (20-150 cm(-1)) Raman-active phonon modes of deeply supercooled confined water in L,L-diphenylalanine micro/nanotubes was analyzed. The isolated dynamics of a specific geometry of a water cluster (pentamer) in a supercooled confined regime was studied in detail. A fragile-to-strong transition at 204 K was observed and related to the crossing of the Widom line. Analysis of peptide vibrational modes coupled to water hydrogen bonds indicated that hydrogen bond fluctuations play an irrelevant role in this system. Our results are in agreement with the second critical point of water existence hypothesis.


A variant near the melanocortin-4 receptor gene regulates postprandial lipid metabolism in a healthy Caucasian population.
The melanocortin-4 receptor (MC4R) is an essential regulator of food intake and energy homeostasis. Previous data suggest an influence of MC4R activity on TAG levels. Thus, the aim of the present study was to determine whether the presence of the rs12970134 polymorphism near the MC4R gene could influence postprandial lipoprotein metabolism in healthy subjects. A total of eighty-eight volunteers were selected, fifty-three homozygous for the common genotype (G/G) and thirty-five carriers for the minor A-allele (G/A and A/A). They were given a fat-rich meal containing 1 g fat and 7 mg cholesterol/kg body weight and vitamin A (60,000 IU/m(2) body surface). Fat accounted for 60 % of energy, and protein and carbohydrates accounted for 15 and 25 % of energy, respectively. Blood samples were taken at time 0, every 1 h until 6 h and every 2·5 h until 11 h. Total cholesterol and TAG in plasma, and cholesterol, TAG and retinyl palmitate in TAG-rich lipoproteins (TRL, large and small TRL) were separated by ultracentrifugation. Individuals carrying the G/G genotype displayed a higher postprandial response of plasma TAG (P = 0·033), total cholesterol (P = 0·019) and large TRL-TAG (P = 0·023) than did carriers of the minor A-allele. Furthermore, G/G subjects showed a greater postprandial response of small TRL-apoB48 than did carriers of the A-allele (P = 0·032). These results suggest that the rs12970134 polymorphism near the MC4R gene region may partly explain the inter-individual differences in postprandial lipoprotein response in healthy subjects.


Dendritic effects on the ordered assembly and the interfacial one-electron oxidation of redox-active dendron-functionalized gold nanoparticles.
A higher generation dendron with a long-alkyl chain thiol (DA2-SH) induced the formation of nanoparticles with a small core with quite a narrow size distribution (1.5 +/- 0.1 nm), the self-assembly of one-dimensional arrays of these gold nanoparticles (DA2-Au), and the stabilization for the formation of the radical cation of the phenothiazine of DA2-Au nanoparticles from the interfacial one-electron oxidation of the nanoparticles with NOBF4.


Duplex scanning as the sole preoperative imaging method for infrainguinal arterial surgery.
to evaluate preoperative duplex as the sole investigation prior to lower limb reconstruction. Design retrospective analysis. between January 1995 and December 1999, 157 of 329 surgical interventions for chronic infrainguinal arterial or aneurysmal disease were performed without preoperative angiography. in patients undergoing femoral artery endarterectomy, the extent of the stenosis and the status of the distal deep femoral artery were correctly diagnosed with duplex scanning in all but one patient. Duplex scan findings in patients undergoing infrainguinal bypass procedures were in agreement with the findings obtained from on-table angiography in regard to the selection of optimal outflow anastomotic sites in 123 (98%). Duplex scanning correctly evaluated the status of runoff in 113 (90%). There were no significant differences in 30-day occlusion rate and patency at 12 months between reconstructions performed with and without preoperative angiography. in patients with conclusive duplex scan findings there is no need to perform angiography prior to lower limb reconstruction.


Inhibition by calcium antagonists of shape changes induced in vitro by pro-inflammatory mediators in venous endothelial cells.
The changes in shape of endothelial cells (ECs) lining rat inferior venae cavae in response to exposure in vitro to platelet activating factor (PAF, 5 x 10(-7) M), or 5-hydroxytryptamine creatinine sulphate (5HT, 3 x 10(-5) M), or calcium ionophore A23187 (1 x 10(-5) M), or cytochalasin B (CB, 1 x 10(-5) M) were assessed using an immunofluorescence technique and semi-automated image analysis. Most of these shape changes were prevented by lowering intracellular Ca2+ levels in several ways. Thus, pre-treatment with ryanodine (1 x 10(-6) M), verapamil HCl (2 x 10(-5) M), indomethacin (1 x 10(-4) M), isoprenaline sulphate (2 x 10(-6) M) or dibutyryladenosine 3'5' cyclic monophosphate (DbcAMP, 1 x 10(-5) M) significantly reduced the effects of PAF, 5HT and A23187. Pre-treatment of ECs with 8(N,N-diethylamino)octyl 3,4,5-trimethoxybenzoate HCl (TMB-8, 1 x 10(-5) M) or the nominal absence of Ca2+ in the extracellular medium prevented the effects of PAF and 5HT, but not those of A23187. The responses to 5HT were also reduced by cyproheptadine HCl (3 x 10(-6) M). However, only the absence of extracellular Ca2+ reduced the effects of CB. The calmodulin inhibitor N-(6-aminohexyl)-5-chloro-1-naphthalene sulphonamide HCl (W7, 1 x 10(-5) M) and the protein kinase C inhibitor 1-(5-isoquinolinyl sulphanyl)-2-methylpiperazine 2HCl (H7, 1 x 10(-5) M) were without effect against all the above agonists, but H7 and verapamil prevented EC shape changes induced by phorbol myristate acetate (PMA, 1 x 10(-6) M).(ABSTRACT TRUNCATED AT 250 WORDS)


Pulmonary vein thrombosis and peripheral embolization.
A 78-year-old-woman was admitted to the hospital with bilateral femoral arterial occlusion. Her medical history disclosed atrial fibrillation and a left thoracoplasty performed 50 years earlier for treatment of tuberculosis. A transesophageal echocardiogram demonstrated intraluminal thrombus in a left pulmonary vein. The patient recovered after thromboembolectomy. This case documents another uncommon cause of cardiac thromboembolism in which a transesophageal echocardiogram was essential to make the diagnosis.


[Stability of diurnal blood pressure rhythm during 48-hour ambulatory blood pressure monitoring].
Evaluation of nocturnal blood pressure (BP) fall is important for prognosis and selection of antihypertensive therapy. We assessed stability of BP diurnal rhythm in 56 hospitalized hypertensive patients by means of 48-hour ambulatory BP monitoring. According to the degree of congruence of BP fall during two nights of monitoring the following groups of patients were distinguished: with similar diurnal BP rhythm in both nights (72% of all patients, including 42% with sufficient and 30% with insufficient nocturnal BP decline), with different diurnal BP rhythms - with sufficient fall of BP in one night and insufficient in another (28% of all patients). BP variability in all patients did not change and could be considered very stable. Thus when insufficient nocturnal BP fall is detected its stability should be confirmed by repeat BP monitoring.


[Combined immunocorrection--a prospective method for treating secondary immunodeficiency].
Clinico-immunological examination of 180 patients with chronic bronchitis and 207 patients with rheumatic heart disease revealed high therapeutic efficacy of combined use of such immunomodulators as levamisole, hemodes, sodium nucleinate. Combined treatment removes immunity defects and normalizes clinical symptoms.


Prevalence of digital clubbing in bronchogenic carcinoma by a new digital index.
Clubbing can be a paraneoplastic manifestation of bronchogenic carcinoma. We assessed a new digital index of clubbing and used it to determine the prevalence of clubbing for different cell types of lung cancer. Clubbing was assessed by measurement of the thickness of both the base of the nailbed (distal phalangeal depth--DPD) and the distal interphalangeal depth (IPD) of the index finger in a control group compared to patient groups with either chronic obstructive lung disease, or lung cancer. Of the 55 normal subjects, no patient had a DPD/IPD ratio of more than 1.05 on either hand, while 11% of the patients with COPD had a ratio of more than one. For the cancer patients, 33% had a ratio greater than one, with 30 of 109 (37%) having a ratio > 1.05 (chi(2) = 17.6, p < 0.0001). There was no difference in the prevalence of clubbing between the 33 squamous cell patients, the 43 adenocarcinoma patients, and the 33 small cell lung carcinoma patients included. Measurement of the interphalangeal and distal phalangeal distance demonstrated that one-third of patients with lung cancer had evidence of clubbing. The type of bronchogenic carcinoma did not appear to affect the proportion of patients with clubbing.


Diabetes, metformin and lactic acidosis.
Metformin has long been thought to cause lactic acidosis (LA) but evidence from various sources has led researchers to question a direct causative relationship. We assessed the relationship of metformin prescription and other factors to the incidence of LA. All cases of LA at a single hospital were identified from laboratory lactate measurements. We compared patients classified as Cohen and Woods class A and B, patients with and without diabetes, and those taking metformin or not. LA was more common than in published analyses based on hospital coding of diagnoses. The incidence of LA was greater in diabetes than in the nondiabetic population but with no further increase in patients taking metformin. Lactate levels were no greater in patients on metformin than in patients with type 2 diabetes not on metformin even if patients with acute cardiorespiratory disturbance (Cohen and Woods class A) were excluded. Acidosis was greater in diabetes (hydrogen ion 94·9 ± 4·6 vs 83·2 ± 2·3 10(-9) m, P = 0·027) but factors besides lactate contributed. Acute cardiorespiratory illness, acute renal impairment and sepsis were the most common of the recognized precipitating factors. Age (P = 0·01), acute renal failure (P = 0·015) and sepsis (P = 0·005) were associated with mortality. Diabetes rather than metformin therapy is the major risk factor for the development of LA. Lactic acidosis occurs in association with acute illness particularly in diabetes. Current guidance for the prevention of lactic acidosis may overemphasize the role of metformin.


Studies on cis-trans isomerization of nitrofuran derivatives by bacterial nitroreductases.
cis-trans Isomerization of 3-(5-nitro-2-furyl)-2-(2-furyl)-acrylamide(AF-2) using Escherichia coli B/r and its two 5-nitro-2-furaldehyde semicarbazone (nitrofurazone)-resistant mutants was investigated. The isomerizing activity was detected in all three strains and markedly increased with acquiring resistance to nitro-furazone in intact cells and cell free extracts. Two distinct isomerases, nicotinamide adenine dinucleotide phosphate(NADPH)-dependent one with high activity and NAD(P)H-dependent with low activity were separated by Sephadex G-100 and Sepharose 4B columns. Both enzyme activities agreed with the nitrofurazone-reducing activity due to O2-sensitive nitroreductase as reported previously. Another nitroreductase, O2-insensitive one, was unable to isomerize cis AF-2 to trans form. These results suggest that bacterial cis-trans isomerases are not O2-insensitive nitroreductase, but O2-sensitive ones.


Treatment of superior vena cava syndrome with recombinant tissue plasminogen activator in a sickle cell patient undergoing bone marrow transplantation.
Superior vena cava (SVC) syndrome is a well-recognized clinical entity seen with mediastinal malignancies and intraluminal venous thrombosis. The role of recombinant tissue plasminogen activator (rt-PA) in the resolution of SVC syndrome caused by thrombosis in the bone marrow transplant settings has not been described. The authors report a case of SVC syndrome with good clinical response in a 16-year-old female with sickle cell disease undergoing an allogeneic bone marrow transplant (BMT) from her HLA identical sibling. Shortly after her transplant, she was found to have significant facial edema and swelling above the neck. Concomitantly, her renal function deteriorated with progressive elevation of serum urea nitrogen and creatinine levels, requiring the use of continuous veno-venous hemofiltration. An upper extremity venogram showed complete SVC obstruction (type III) with apparent inferior reflux into the azygos system. rt-PA was started at a dose of (0.5 mg/kg/day) for 2 days. There was a dramatic resolution of her symptoms, including significant improvement in renal function with increase in urine output. A repeat venogram showed free flow from the distal tip of the central line consistent with a patent superior vena cava. There was no evidence of any bleeding manifestations with rt-PA. This report highlights the usefulness of rt-PA as a treatment modality for SVC syndrome in the BMT settings.


The prevalence and predictors of emotional distress and social difficulties among surviving cancer patients in Jordan.
This study examines the prevalence and degree of emotional distress, anxiety and depression, and social difficulties and their effect on cancer patients' quality of life (QoL). It describes the characteristics of patients who are at high risk of emotional distress. A descriptive cross-sectional design was used. A total of 226 patients with cancer completed the Hospital Anxiety and Depression scale (HAD), social difficulties inventory, comfort scale and EORTC-QoL-C30. Anxiety and depression were identified using the internationally recognized cut-off points of HAD-A ≥ 8 and HAD-D≥ 8. Adjusted odd ratio was calculated using socio-demographic and clinical factors. Both anxiety and depression were common among Jordanian cancer patients, although depression was the main emotional problem with a higher prevalence than anxiety (67.6% vs. 43%). Patients with anxiety or depression were more likely to have lower QoL scores and higher scores for complaints about symptoms. They were more likely to have social difficulties in everyday life. The results of logistic regression indicated that a high depression score was predicted by older age, a poor QOL total score, and a high social difficulty score. A high anxiety score was predicted by advanced cancer stage, in female patients, hospital readmission and a poor QOL total score. The significant level of emotional distress among cancer patients highlighted the importance of early assessment and identification of patients at greater risk of emotional distress, those with an advanced stage of cancer, having a poor quality of life and serious social difficulties.


Ectopic expression of a wheat MYB transcription factor gene, TaMYB73, improves salinity stress tolerance in Arabidopsis thaliana.
MYB transcription factors (TFs) play pivotal roles in the abiotic stress response in plants, but their characteristics and functions in wheat (Triticum aestivum L.) have not been fully investigated. A novel wheat MYB TF gene, TaMYB73, is reported here based on the observation that its targeting probe showed the highest salinity-inducibility level among all probes annotated as MYB TFs in the cDNA microarray. TaMYB73 is a R2R3 type MYB protein with transactivation activity, and binds with types I, II, and IIG MYB binding motifs. The gene was induced by NaCl, dehydration, and several phytohormones, as well as some stress-, ABA-, and GA-responsive cis-elements present in its promoter region. Its over-expression in Arabidopsis enhanced the tolerance to NaCl as well as to LiCl and KCl, whereas it had no contribution to mannitol tolerance. The over-expression lines had superior germination ability under NaCl and ABA treatments. The expression of many stress signalling genes such as AtCBF3 and AtABF3, as well as downstream responsive genes such as AtRD29A and AtRD29B, was improved in these over-expression lines, and TaMYB73 can bind with promoter sequences of AtCBF3 and AtABF3. Taken together, it is suggested that TaMYB73, a novel MYB transcription factor gene, participates in salinity tolerance based on improved ionic resistance partly via the regulation of stress-responsive genes.


Delay of the first onset of pouchitis by oral intake of the probiotic strain Lactobacillus rhamnosus GG.
Proctocolectomy with ileal pouch-anal anastomosis is the operation of choice for patients with refractory or fulminant ulcerative colitis. The most common long-term complication in these patients is pouchitis. This study was designed to investigate the efficacy of probiotic Lactobacillus rhamnosus GG in long-term delaying the first onset of pouchitis. Between 1989 and 2001, a consecutive series of 127 patients presenting with ulcerative colitis underwent an ileal pouch-anal anastomosis at the Erasmus Medical Center in Rotterdam. Histopathologic investigation of the resected specimens revealed unsuspected Crohn's disease in five patients. Postoperative complications resulted in pouch excision in five patients. The remaining 117 patients were included in this study. All episodes of pouchitis occurring in this group were analyzed. Pouchitis was diagnosed on the basis of clinical symptoms and endoscopic and histologic features. The 39 patients, who underwent an ileal pouch-anal anastomosis between 1996 and 2001, started immediately after the operation with the daily intake of L. rhamnosus GG in a fermented product. The 78 patients, in whom an ileal pouch-anal anastomosis was performed between 1989 and 1996, received no L. rhamnosus GG. Except for the duration of follow-up, the patient characteristics, indications for proctocolectomy, number of postoperative complications, and functional outcome were similar in both groups. First episodes of pouchitis were observed less frequently in patients with a daily intake of L. rhamnosus GG (cumulative risk at 3 years: 7 vs. 29 percent; P = 0.011). Daily intake of fermented products containing L. rhamnosus GG provides significant clinical benefit, without side effects. Based on the results of this study, we recommend a daily intake of Lactobacillus rhamnosus GG (dose 1-2 x 10(10) bacteria) to delay the first onset of pouchitis.


Environment impacts innate immune ontogeny.
Susceptibility to infection and response to vaccination differ between populations and as a function of age. The underlying mechanisms for this age- and population-dependent variation are not known. Specifically, it is unclear if these variations are due to differences in genetically encoded host programs or driven by environmental influences or a combination of both. To address the relationship between gene and environment regarding immune ontogeny, we determined the innate cytokine responses following PRR stimulation of blood mononuclear cells at birth, 1, and 2 yr of age in infants from Caucasian vs . Asian parents and were raised in the same city. At birth, we found that innate cytokine responses were significantly elevated in Asian compared with Caucasian infants. However, these differences waned and responses became more similar over the course of 1-2 yr of living in a similar environment. Our observations that innate response differences present at birth subsequently equalized rather than diverged suggest a key role for environmental effects common to both racial groups in shaping the innate immune responses early in life. Delineating the underlying environmental factors that modulate innate immune responses early in life could provide avenues for targeted beneficial immune modulation.


The efficacy of two prototype chewing gums for the removal of extrinsic tooth stain.
To compare the potential efficacy of two prototype chewing gums in extrinsic stain removal on natural teeth. Dental school clinics. Double-blind, two groups, parallel design. 76 adult volunteers (32m, 44f, mean age: 20.6 years old). Oral hard and soft tissue health was examined. The subjects were randomly assigned to use either Product A (without active ingredients) or Product B (with active ingredients). Each subject was asked to brush their teeth for one minute twice daily (mornings and nights) and chew the gums supplied for 15 min (2 dragees each time), three times daily, once after each meal (breakfast, lunch and dinner) for the entire four-week duration. Dental stain assessment was made on the 12 incisors using the Lobene Stain Index (LSI). The overall difference between the stain scores after 4-weeks' use of the chewing gums was statistically significant (p<0.01) for both test Product A (10.84) and Product B (7.77) with regard to the mean baseline stain scores (21.57). This difference represented a 48% reduction in stain scores for those subjects using Product A, while the reduction was 64% for the subjects using Product B. The results of this in vivo study suggest that chewing gums with and without active ingredients have potential effect on stain removal after regular use for one month.


Is melanoma survival influenced by month of diagnosis?
Despite being a well-documented phenomenon, seasonal variation in the incidence of cutaneous melanoma is poorly understood, and data on the seasonality of melanoma survival are scarce. We sought to explore the seasonal variation in melanoma incidence and survival in Belgium and to assess the characteristics and outcomes of cases diagnosed during the seasonal peak. All cases of invasive cutaneous melanoma-patients over 15 years of age and registered by the Belgian Cancer Registry (BCR) from 2004 to 2009-were included (n=9782). Monthly variations in incidence were estimated by the ratio of the number of cases diagnosed each month to that diagnosed in January (Rmonth/January) using Nam's method. The observed and relative 5-year survival rates were adjusted on patient and tumour characteristics using Cox proportional hazards regression models and generalised linear models with a Poisson error structure, respectively. A peak in melanoma incidence was observed in June (RJune/January=1.64, 95% confidence interval (CI)=1.54-1.73). The 5-year observed survival (OS) and relative survival (RS) rates were significantly higher for patients diagnosed in June compared with other months (OSJune=84%, 95%CI=81-86 versus OSOthermonths=79%, 95%CI=78-80; RSJune=93%, 95%CI=90-95 versus RSothermonths=87%, 95%CI=86-88). After adjustment, the 5-year OS remained significantly higher for patients diagnosed in June (hazard ratioJune=0.78, 95%CI=0.62-0.98); however, the 5-year RS was no longer significantly different for patients diagnosed in June compared with other months (relative excess riskJune=1.16, 95%CI=0.73-1.84). This study demonstrated a seasonal variation in melanoma incidence in Belgium with a peak in June for the period 2004-2009. When adjusted for patient and tumour characteristics, patients diagnosed in June had higher observed survival rates, but relative survival rates did not differ. Our findings do not support an influence of season of diagnosis on melanoma prognosis.


Group typicality, group loyalty and cognitive development.
Over the course of childhood, children's thinking about social groups changes in a variety of ways. Developmental Subjective Group Dynamics (DSGD) theory emphasizes children's understanding of the importance of conforming to group norms. Abrams et al.'s study, which uses DSGD theory as a framework, demonstrates the social cognitive skills underlying young elementary school children's thinking about group norms. Future research on children's thinking about groups and group norms should explore additional elements of this topic, including aspects of typicality beyond loyalty.


The Psychometrics of the European Portuguese Version of the Temperament and Character Inventory-Revised.
Cloninger's psychobiological model of personality integrates contributions from behavioral genetics, neurobiology, and psychology in the description of the human personality. The temperament and character inventory (TCI) is its assessment instrument. The Brazilian Portuguese version of the TCI has shown good psychometric properties. However, Portuguese spoken in Brazil presents marked and substantial differences to that spoken in Portugal, and no study has yet described the psychometrics of the European Portuguese version. The objective of this study was thus to describe the psychometric properties of the European Portuguese adult version of the TCI (the temperament and character inventory-revised (TCI-R)). This study involved 1400 Portuguese adult participants. The factorial structure of the European Portuguese version was tested using four methods: exploratory factor analysis, orthogonal procrustes rotation analysis, confirmatory factor analysis, and exploratory structural equation modeling. The integration of data coming from these methods suggested that the Portuguese version of the TCI-R presented good structural validity (as revealed by the emergence of the temperament and character structures predicted by theory) and high levels of congruence between the American and the Portuguese versions. An improvement in the goodness of fit of the models for the Portuguese population was achieved by using exploratory structural equation modeling over confirmatory factor analysis. Although some facets registered questionable consistency, all dimensions had acceptable to good consistency (all ≥ .79). These results confirm the validity of the Portuguese TCI-R and its adequacy for use in European Portuguese samples.


Three-dimensional analysis of tooth dimensions in the MSX1-missense mutation.
A novel, 3D technique to measure the differences in tooth crown morphology between the MSX1 cases and non-affected controls was designed to get a better understanding of dental phenotype-genotype associations. Eight Dutch subjects from a single family with tooth agenesis, all with an established nonsense mutation c.332 C > A, p. Ser 111 Stop in exon 1 of MSX1, were compared with unaffected controls regarding several aspects of tooth crown morphology of incisor and molar teeth. A novel method of quantitative three-dimensional analysis was used to detect differences. Statistically significant shape differences were observed for the maxillary incisor in the MSX1 family compared with the controls on the following parameters: surface area, buccolingual dimension, squareness, and crown volume (P ≤ 0.002). Molar crown shape was unaffected. A better understanding of dental phenotype-genotype associations may contribute to earlier diagnosis of some multiple-anomaly congenital syndromes involving dental anomalies. A "shape database" that includes associated gene mutations resulting from developmental syndromes may facilitate the genetic identification of hypodontia cases.


Flocculation and coflocculation of bacteria by yeasts.
Biotransformations in natural environments frequently involve interactions between microorganisms. Although there are many reports on the interactions between bacteria, interactions between yeasts and bacteria have not been extensively studied. Previously we reported on the flocculation and coflocculation of Pediococcus damnosus by Saccharomyces cerevisiae. Now we report that several other yeasts, such as Candida utilis, Dekkera bruxellensis, Hanseniaspora guilliermondii, Kloeckera apiculata, and Schizosaccharomyces pombe, induce flocculation with several industrially or medically relevant bacteria, including Bacillus subtilis, Pseudomonas aeruginosa, and Staphylococcus aureus. Candida utilis was one of the best flocculation inducers. The results are discussed with respect to interactions between yeasts and bacteria and their applications in industry and medicine.


Safety climate in 5 intensive care units: a nationwide hospital survey using the Greek-Cypriot version of the safety attitudes questionnaire.
Patient safety is considered an antecedent of quality of hospital care. The explicit need to focus on quality of care underpins the aim of the study to evaluate the safety culture and teamwork climate in the public intensive care units (ICUs) of the 5 regional public hospitals in Cyprus as measured by a validated safety attitudes tool. A questionnaire that included the Greek version of the generic version of the Safety Attitudes Questionnaire has been used in all public ICUs across Cyprus. There were 132 (76.7%) fully completed questionnaires of 172 registered nurses who are currently positioned in Cyprus ICUs. The mean age of the participants was 33.09 ± 08.16 years. The mean of the total working years as a nurse was 10.82 ± 8.47 years, whereas the mean of the total work experience in the ICU units was 6.05 ± 5.16 years. The sample's age strongly correlated with teamwork, nurses with more years of experience rated higher teamwork (P = .02), and their perceptions of management were better than those of the inexperienced nurses. Considerable safety climate variations between the ICUs of the regional hospitals of Cyprus have been verified. Age, infrastructure, the severity of cases, and the nurse skill mix are variables that affect the patient safety culture in an ICU environment.


Assessment of motor recovery and decline.
Assessment of motor disorders forms an important ingredient of neurology, rehabilitation medicine and orthopaedics. Until now, however, many of the employed assessment tools are derived from empirical knowledge. Almost no relation exists with modern theoretical notions about motor control. In the present article, motor control theory is reviewed in the light of its potential contribution to understanding motor recovery. An attempt is made to present a theoretical framework for the assessment of motor disorders related to recent insights in motor control. The framework emphasizes the dynamical character of recovery. The principle of output optimization is discussed and it is stressed that compensation plays a permanent role in adapting to damage of the body or to changes in the environment. An assessment procedure is introduced to measure the (mental) costs of this compensation. It is argued that changes in the costs of compensation across time reflect recovery.


Biosynthesis of arachidonic acid in the oleaginous microalga Parietochloris incisa (Chlorophyceae): radiolabeling studies.
The fresh-water green alga Parietochloris incisa is the richest plant source of the PUFA arachidonic acid (20:4n-6, AA). To elucidate the biosynthesis of AA in this alga we labeled cultures of P. incisa with radioactive precursors. Pulse chase labeling with acetate resulted in its incorporation via the de novo biosynthesis pathway of FA. However, labeled acetate was also utilized for the elongation of C16 and C18 PUFA. Labeling with [1-14C]oleic acid has shown that the first steps of the lipid-linked FA desaturations utilize cytoplasmic lipids. PC and diacylglyceryltrimethylhomoserine are the major lipids involved as acyl carriers for the delta12 and delta6 desaturations of oleic acid, leading sequentially to linoleic and gamma-linolenic acids. The latter is released from its lipid carrier and elongated to 20:3n-6, which is reincorporated primarily into PE and PC and finally desaturated to AA. Galactolipids, mostly monogalctosyldiacyl-glycerol (MGDG), serve as substrates for the chloroplastic delta12 desaturase and, apparently, the omega3 desaturation, common to higher plants and many green algae. The predominant sequence desaturates the 18:1/16:0 molecular species of MGDG stepwise to the 18:3n-3/16:3n-3 molecular species similar to the prokaryotic pathway of higher plants and green algae.


Teaching undergraduate nursing students about environmental health: addressing public health issues through simulation.
Schools of nursing are challenged to find clinical placements in public health settings. Use of simulation can address situations unique to public health, with attention to specific concerns, such as environmental health. Environmental health is an integral part of public health nursing and is a standard of professional practice. Current simulations focus on acute care situations, offering limited scenarios with a public health perspective and excluding environmental health. This study's simulation scenario was created to enhance nursing students' understanding of public health concepts within an environmental health context. Outcomes from the simulation include the need for integration of environmental issues in public health teaching. Students stated that this scenario provided a broader understanding of the environmental influences that can affect the client's and family's health. This scenario fills a void in simulation content, while providing an interactive teaching and learning strategy to help students to apply knowledge to practice.


High-resolution whole genome tiling path array CGH analysis of CD34+ cells from patients with low-risk myelodysplastic syndromes reveals cryptic copy number alterations and predicts overall and leukemia-free survival.
Myelodysplastic syndromes (MDSs) pose an important diagnostic and treatment challenge because of the genetic heterogeneity and poorly understood biology of the disease. To investigate initiating genomic alterations and the potential prognostic significance of cryptic genomic changes in low-risk MDS, we performed whole genome tiling path array comparative genomic hybridization (aCGH) on CD34(+) cells from 44 patients with an International Prognostic Scoring System score less than or equal to 1.0. Clonal copy number differences were detected in cells from 36 of 44 patients. In contrast, cells from only 16 of the 44 patients displayed karyotypic abnormalities. Although most patients had normal karyotype, aCGH identified 21 recurring copy number alterations. Examples of frequent cryptic alterations included gains at 11q24.2-qter, 17q11.2, and 17q12 and losses at 2q33.1-q33.2, 5q13.1-q13.2, and 10q21.3. Maintenance of genomic integrity defined as less than 3 Mb total disruption of the genome correlated with better overall survival (P = .002) and was less frequently associated with transformation to acute myeloid leukemia (P = .033). This study suggests a potential role for the use of aCGH in the clinical workup of MDS patients.


[Distal radius anterior marginal fractures treated with anterior plating. Mid-term results].
We report a retrospective series of anterior marginal fractures of the distal radius treated by anterior plating in order to analyze results and identify prognostic factors. This continuous series included 22 patients with an anterior marginal fracture of the distal radius treated between 1993 and 1999. Three patients were lost to follow-up. This analysis thus concerned 19 fractures in 15 men and 4 women, mean age 39 years. Surgical reduction and T-plate anterior fixation was used in all cases. Mean follow-up was 26 months. Anatomic results were satisfactory in 15 patients and poor in one. Function was satisfactory in 17 patients and poor in one. We noted two types of complication: spontaneously regressive reflex dystrophy (n=2) and osteoarthritis which developed in two patients after incomplete reduction. Anterior plating can provide satisfactory results for anterior marginal fractures of the distal radius if anatomic reduction is achieved. This method remains our preferred therapeutic approach with special attention being required for anatomic reduction.


The use of a hydrogel matrix for controlled delivery of niacin to the gastrointestinal tract for treatment of hyperlipidemia.
Hyperlipidemia treatment based on niacin requires gastrointestinal administration of relatively high doses. The recommended dietary allowance of niacin as vitamin B3 is 14 to 16 mg daily in adults, while the doses of niacin used in the treatment of hyperlipidemia are generally in the range of 1 to 3 g. Administration of such large doses requires a high concentration of the active compound in the tablet and proper control of the drug release. In this study, a hydrogel matrix based on poly(2-hydroxyethyl methacrylate) and polyvinylpyrrolidone was investigated as delivery vehicle for controlled NA release into the gastrointestinal environment. The prepared hydrogel matrices varied in used monomer and crosslinker types and concentrations. The content of NA in tablets was between 65-80 %. The release profiles of NA from tablets were examined under three different pH values (1, 4.5 and 6.8) over the time period of 30 h. The effects of the monomer ratio, the crosslinking of the polymer network, and the solubility of niacin during drug release under various pH are discussed. The results showed that the release time period can be achieved in a relatively wide range of time and can be adjusted according to the medical requirements.


Tail short variable: characterization of a new mouse mutant, and its possible analogy to certain human vascular disruption defects.
A new mouse mutant, tail short variable (Tsv) produces a reduction deformity of the tail, growth retardation, and, in adults, a mild anemia. Genetic and embryological studies show that on all genetic backgrounds there is variable viability of Tsv/Tsv and Tsv/+ and phenotypic overlap within these and with +/+. A modifier is located to a short segment of chromosome 7, which alters the tail length of Tsv/+ mice up to 15%. The modifier, Tsv, and a coat texture mutant come from the same wild Peru mouse. The tail deformity is associated with, and may be caused by, a vascular disruption of the caudal aorta starting on day 11 of gestation. Thus Tsv appears to be different from each of the thirty known mouse mutants involving the tail. It is suggested that Tsv could be a mouse model for human conditions involving transverse terminal limb defects such as Moebius and de Lange syndromes.


Role of MR imaging in sports medicine research. Basic science and clinical research studies.
The advent and advancement of MR imaging have provided an entire new dimension for medical imaging. MR imaging has been especially useful because of its capacity to image nonmineralized tissues with a very high degree of resolution. Although modalities such as ultrasound and scintigraphy have proven useful for specific purposes, it is MR imaging that has the most utility and capabilities, especially in the area of sports-induced injuries. The technology associated with MR imaging has expanded greatly, and it continues to evolve at a rapid pace. The result has been an ever-increasing diagnostic capability that has become more economic with time. As described previously, MR imaging is gaining importance in the area of comparative medicine for animal athletes as well. It is also interesting to note that MR imaging now has a greater potential for monitoring physiological and biochemical changes as well as anatomic ones. Some newer MR units actually include physiologic data acquisition components. Consequently, new bioassays and nondestructive tissue tests can be performed to further understand the molecular biology and ongoing cellular processes in any given condition. Coupled with MR spectroscopy, the enhanced MR techniques should continue to contribute to the overall information that will be integrated into the training and rehabilitation of patients with sports-induced inflammation and injuries. The authors support and encourage ongoing efforts in the area of MR imaging research, both basic science and clinical studies.


Organization of the afferent connections of the mediodorsal thalamic nucleus in the rat, related to the mediodorsal-prefrontal topography.
The aim of the present study was to determine the organization of the afferents of the mediodorsal thalamic nucleus in relation to the reciprocal connections of this nucleus with different areas of the prefrontal cortex. For this purpose injections of horseradish peroxidase, or horseradish peroxidase conjugated to wheatgerm agglutinin were placed in different parts of the mediodorsal nucleus. These experiments revealed the organization of the reciprocal mediodorsal-prefrontal connections since wheatgerm agglutinin-horseradish peroxidase is transported effectively in anterograde and retrograde directions. Injections of wheatgerm agglutinin-horseradish peroxidase or fluorescent tracers were placed in different portions of the prefrontal cortex, and the lectin Phaseolus vulgaris leucoagglutinin was injected in the mediodorsal nucleus in order to verify in more detail the point-to-point relationship in the mediodorsal-prefrontal connections. The organization of a number of the subcortical afferents to the mediodorsal nucleus was determined in detail using injections of Phaseolus vulgaris leucoagglutinin, wheatgerm agglutinin-horseradish peroxidase, or tritiated amino acids in areas identified as a source of mediodorsal afferents in the retrograde tracing experiments. These anterograde tracers were injected in different parts of the pallidal complex, the amygdala, the lateral hypothalamus, the lateral entorhinal cortex, the ventral mesencephalon, the superior colliculus and the dorsal tegmental region. The results of the present experiments indicate that the mediodorsal nucleus, on the basis of its cyto-, myelo- and chemoarchitecture as well as the organization of its reciprocal connections with the prefrontal cortex, can be subdivided into a medial, a central, a lateral and a paralamellar segment. Apart from this subdivision along a mediolateral axis, rostrocaudal and dorsoventral differences are also evident in the structural organization and connectivity of the mediodorsal nucleus. A number of subcortical structures send fibres to all parts of the mediodorsal nucleus. The reticular thalamic nucleus projects to the mediodorsal nucleus in a topographical way such that its rostral part is connected with the rostral part of the nucleus, whereas more caudal and ventral areas in the reticular thalamic nucleus are connected with more caudal parts of the mediodorsal nucleus. Regions in the brainstem that project to all parts of the mediodorsal nucleus include the mesencephalic raphé nuclei, the locus coeruleus, the rostral part of the central gray substance and the reticular formation.(ABSTRACT TRUNCATED AT 400 WORDS)


Clinical pharmacist impact on parenteral cephalosporin prescribing.
A study was undertaken to evaluate clinical pharmacist influence on parenteral cephalosporin prescribing patterns. Two intervention methods were evaluated: (1) publication of pharmacy newsletter for physicians containing specific recommendations and emphasizing the primary use of cefazolin, and (2) personal interaction between the clinical pharmacy staff and physicians promoting the recommendations outlined in the newsletter. These two methods were compared with each other as well as with an initial time span during which no influencing efforts were made. The effect of the pharmacy newsletter as a sole means of influencing physician prescribing of parenteral cephalosporins was minimal. The effect of pharmacist-physician interaction, either as a sole means of in conjunction with a pharmacy newsletter, resulted in an increased use of cefazolin. An annual cost savings of up to $11,265.88 was projected. The results indicate that physicians can be influenced in their prescribing of parenteral cephalosporins, leading to significant cost savings.


Effect of seasonal acclimatization on the expression of the carp transcription factor Pit-1.
We isolated a clone comprising four exons of the carp Pit-1 gene. Using synthetic oligonucleotide probes derived from the carp Pit-1 sequence Pit-1 expression was assessed by in situ hybridization in pituitary sections from summer- and winter-acclimatized carp. Semiquantitative analyses of the hybridization signals revealed a significant higher Pit-1 expression in the proximal pars distalis (PPD) and pars intermedia (PI) of the pituitary glands from summer-acclimatized carp, compared to the winter-acclimatized fish. In both adaptive states, relative to the PPD and PI, only a basal Pit-1 expression was detected in the rostral pars distalis. Thus, during seasonal acclimatization of an eurythermal fish, Pit-1 seems to be involved in the mechanisms that underlie the compensatory response.


The need to know: informal carers and information.
There is a growing recognition that the carers of cancer patients require information. A key source of this information is the formal health care system that patients, and thus carers, encounter. However, the research literature suggests a lack of clarity on the part of service providers concerning the type, amount, timing and purpose of information for carers. This lack of clarity is reflected in the ways carers have been 'tacked on' to patients and thus are often treated as co-clients. That carers are also an active participants in the illness scenario is not always fully recognized, resulting in failure to provide appropriate information. Carers' interactions with health service providers are complex and context bound, and entail potential tensions of allegiance in the arena of information exchange. This article suggests that the following research and practice is required: a clearer understanding of the informational needs of carers in variable situations, specific ways to address these needs, where carers 'fit in' to the health care system, and how processes of information exchange with carers can be improved.


Magnetic resonance spectroscopy in adult-onset citrullinemia: elevated glutamine levels in comatose patients.
Adult-onset type II citrullinemia is an inborn error of urea cycle metabolism that can lead to hyperammonemic encephalopathy and coma. However, type II citrullinemia is rare outside Japan, and diagnosis and treatment can be delayed. Magnetic resonance spectroscopy may be a useful adjunct to magnetic resonance imaging, and has been applied to noninvasively study chemical metabolism in the human brain. We describe 2 patients with type II citrullinemia who presented with episodic postprandial somnolence and coma. Diffusion-weighted magnetic resonance imaging showed bilaterally symmetrical signal abnormalities of the insular cortex and cingulate gyrus. On magnetic resonance spectroscopy, glutamine and glutamate levels were elevated, and choline and myo-inositol levels were decreased. The diagnosis of citrullinemia was confirmed based on elevated plasma ammonia and citrulline levels. Characteristic features found at the time of magnetic resonance imaging and magnetic resonance spectroscopy may be helpful for early diagnosis of type II citrullinemia in adult patients who present with hyperammonemic encephalopathy and coma.


Differential gene expression for investigation of the effect of germinants and heat activation to induce germination in Bacillus cereus spores.
Differential gene expression was used to explore the mechanisms underpinning the differences in the impact of heat activation (70 °C for 30 min) on the germination of Bacillus cereus spores in the presence and absence of a germinant (L-alanine). The number of germinated cells, after heat activation plus L-alanine (3.5 ± 0.02 log CFU/ml) in the spore only initial population was found to be higher than that in only heat activated spores (2.01 ± 0.02 log CFU/ml). The concentration of DPA released by heat activated spores in the presence of L-alanine was 68.3 ± 0.1 and 112.1 ± 0.02 μg/ml after 30 and 60 min, compared to 96.5 and 166.2 ± 0.01 μg/ml after 30 and 90 min, respectively released by spores subjected only to heat activation. Gene (BC0784) encoding for the spore germination protein, gerA operon was up-regulated with a log2-transformed fold change value of 1.2 due to heat activation in the presence of L-alanine. The GerA operon located in the inner membrane is known to be involved in the uptake of L-alanine by B. cereus and has been reported to be involved in L-alanine mediated germination. In addition the up-regulation of genes involved in the uptake of L-alanine is proposed to provide the answer to the synergistic effect of heat and L-alanine in inducing germination in B. cereus spores. In short, heat activation increases the ability of L-alanine to penetrate into the spore's inner membrane, where it can be recognized by the receptors for initiation of the germination pathway. In the current study, the majority of the ribosomal proteins were down-regulated (when spores were heat treated in presence of germinants) this process also appeared to slow down protein synthesis by restricting the protein translation machinery. Differential gene expression revealed the genes responsible for the pathways related to transport and recognition of L-alanine into the spore that could have led to the accelerated germination process along with partial shutting down of protein synthesis pathway and ABC transporters. Knowledge of gene regulation in spores during heat activation will help in the development of approaches to prevent spore germination, which could provide an additional safeguard against bacterial growth and toxin production in improperly cooled heat treated foods.


Electrophysiologic changes in the lateral and basal amygdaloid nuclei in temporal lobe epilepsy: an in vitro study in epileptic rats.
The functional consequences of neuronal loss during epileptogenesis in the lateral and basal amygdaloid nuclei are poorly understood. The present study tested the hypothesis that electrical responsiveness varies in different amygdaloid nuclei in the chronically epileptic amygdala. Further, we examined the amygdaloid region most prone to seizure initiation. Epileptogenesis was triggered in 20 rats by inducing status epilepticus (SE) with electrical stimulation of the lateral nucleus of the amygdala. Electrode-implanted non-stimulated rats served as controls. The occurrence and duration of spontaneous seizures were monitored with video-electroencephalography (EEG) at 8-9 weeks after SE. Thereafter, animals were killed and extracellular recordings were made from slices of both amygdalas. In the lateral nucleus of epileptic animals, the frequency of spontaneous responses was reduced compared with controls (P < 0.05). The amplitudes of evoked field responses were reduced (P < 0.01), whereas paired pulse (PP) facilitation was enhanced (P < or = 0.05). In the basal nucleus of the epileptic animals, PP facilitation was enhanced (P < 0.05) and sensitivity to 4-aminopyridine (4-AP)-induced epileptiform activity was increased compared with controls (P < 0.05). In the epileptic animals, the basal nucleus was also more sensitive than the lateral nucleus to 4-AP-induced epileptiform activity (P < 0.05). Correlation analysis indicated that longer SE duration was associated with longer half widths (P = 0.001) and smaller slopes (P < 0.05) of evoked responses as well as with attenuated PP facilitation (P<0.01). Moreover, a higher frequency of spontaneous seizures was associated with longer half widths (P < 0.05) and smaller slopes (P < 0.05) of evoked responses as well as with enhanced PP facilitation (P < 0.05). These data suggest that there is a reduced release of glutamate and reduced inhibition in the lateral and basal amygdaloid nuclei in epileptic animals. Further, the basal nucleus is more prone to epileptic activity than the lateral nucleus. Finally, the severity of SE and spontaneous seizures in vivo is associated with electrophysiologic alterations in vitro.


Clarifying values, risk perceptions, and attitudes to resolve or avoid social conflicts in invasive species management.
Decision makers and researchers recognize the need to effectively confront the social dimensions and conflicts inherent to invasive species research and management. Yet, despite numerous contentious situations that have arisen, no systematic evaluation of the literature has examined the commonalities in the patterns and types of these emergent social issues. Using social and ecological keywords, we reviewed trends in the social dimensions of invasive species research and management and the sources and potential solutions to problems and conflicts that arise around invasive species. We integrated components of cognitive hierarchy theory and risk perceptions theory to provide a conceptual framework to identify, distinguish, and provide understanding of the driving factors underlying disputes associated with invasive species. In the ISI Web of Science database, we found 15,915 peer-reviewed publications on biological invasions, 124 of which included social dimensions of this phenomenon. Of these 124, 28 studies described specific contentious situations. Social approaches to biological invasions have emerged largely in the last decade and have focused on both environmental social sciences and resource management. Despite being distributed in a range of journals, these 124 articles were concentrated mostly in ecology and conservation-oriented outlets. We found that conflicts surrounding invasive species arose based largely on differences in value systems and to a lesser extent stakeholder and decision maker's risk perceptions. To confront or avoid such situations, we suggest integrating the plurality of environmental values into invasive species research and management via structured decision making techniques, which enhance effective risk communication that promotes trust and confidence between stakeholders and decision makers.


Compositional and sensory comparisons between normal- and high-oleic peanuts.
The high-oleic-acid trait improves the oxidative stability of peanuts (Arachis hypogaea L.) and their products. The explicit effect of the trait on sensory quality, particularly on off-flavors associated with oil rancidity, has not been well documented. To assess the effect of the trait on off-flavors, data from two independent databases were analyzed to compare sensory quality and composition in normal- versus high-oleic peanut genotypes. In data collected using a sensory panel in the Department of Food Science at North Carolina State University, there were small differences between near-isogenic lines for intensities of the roasted peanut, astringent, over-roast, and nutty attributes, with the high-oleic lines exhibiting slightly greater intensities of those attributes. There were no differences for off-flavors such as fruity, painty, stale, moldy, or petroleum. In data collected from the multistate Uniform Peanut Performance Test and evaluated by a panel in the USDA-ARS Market Quality and Handling Research Unit (MQHRU) at Raleigh, NC, there were differences in chemical composition associated with the high-oleic trait, including differences in oil content, tocopherols, and carbohydrates in addition to the expected differences in fatty acid contents. There were small decreases in the intensities of the sensory attributes cardboard and painty associated with the high-oleic trait in the MQHRU data when all high-oleic lines were compared with all normal-oleic lines. Comparison of the near-isogenic pair NC 7 and N00090ol showed differences in oil and glucose contents, but not in sensory attributes. The high-oleic trait does not appear to have a major impact on sensory quality on average, although there were individual instances in which the trait was associated with shifts in sensory attribute intensities that may be perceptible to consumers.


Song learning from playback in zebra finches: is there an effect of operant contingency?
Social interaction is often regarded as crucial for song copying in zebra finches, Taeniopygia guttata. Contingencies in the interaction between pupil and tutor might be essential for the song-copying process. The effect of contingency between a pupil's operant behaviour and tutor song has been studied previously, but with contradictory results. Our aim in this experiment was to provide a more rigorous test of the effect of operant contingent exposure to song playback in zebra finches. Eight experimental males were trained to expose themselves to tutor song by operant key pecking during their sensitive phase for song learning. Each bird had a yoked control, which heard the same tutor song at the same time. All birds were acoustically isolated. The results were surprising in two ways: (1) the control birds copied song to which they were passively exposed; and (2) the experimental birds did not copy more than the controls did. So, we found no effect of operant contingency on song learning. Furthermore, when tested as adults all but one male preferred the tutor song to an unfamiliar one. We conclude that zebra finches can copy playback song, and that social interaction is not crucial for song copying, although it might still be facilitating. Copyright 1999 The Association for the Study of Animal Behaviour.


[Argentine Consensus of Respiratory Rehabilitation].
A group of pulmonologists and physical therapists from the Asociacion Argentina de Medicina Respiratoria revised the scientific literature on Respiratory Rehabilitation (RR) to elaborate evidence-based national recommendations to promote its use. RR is a multidisciplinary program of care for patients with chronic respiratory impairment, individually tailored, designed to optimize physical and social performance and autonomy of patients. It is particularly indicated in patients with Chronic Obstructive Pulmonary Disease (COPD) with exercise intolerance. Inclusion and exclusion criteria, guidelines for initial evaluation and follow up have been defined. The resources needed were defined. It was recommended a hospital ambulatory program with domiciliary complement. A pulmonologist and physical therapist were required for the program as minimum. Aerobic training was recommended for lower limb (LL) (Evidence A) and upper limb (UL) (Evidence B), strength training for LL and UL (Evidence C), as well as respiratory muscles training by resistive inspiratory threshold load (Evidence D) and other physiotherapy techniques were recommended for specific patients. In addition recommendations have been made for educational objectives of the program, nutritional and psychological support. The positive impact of RR on health care was analyzed through the reduction in exacerbation of COPD, length of hospital stay and cost. RR is a key component in the treatment of COPD patients. This evidenced-based consensus statement was prepared to provide recommendations to be implemented nationally.


[Congenital dermatofibrosarcoma protuberans: a case report].
Dermatofibrosarcoma protuberans is a rare low-grade fibrohistiocytic tumor with onset normally at ages between 20 and 50 years. It presents as a violaceous plaque or macule with an appearance suggestive of vascular lesion, on which nodular lesions appear later. Histological diagnosis is based on the presence of a spindle-cell tumor arranged in small bundles in a characteristic cartwheel pattern. The local recurrence rate is high but metastases are rare. The treatment is surgical resection with wide margins. The tumor rarely affects children under 16 years of age and it is even less common at birth--only 27 congenital cases have been described in the literature. We describe the case of a 10-year-old boy with dermatofibrosarcoma protuberans present since birth and currently without signs of recurrence.


Imaging of colon carcinoma with 111-indium-labeled anti-CEA monoclonal antibodies (Indacea) prior to surgery.
Patients with primary and/or metastatic colorectal cancer who had been scheduled for operative intervention were injected intravenously with 200 micrograms of a high-affinity anti-carcinoembryonic antigen (CEA) monoclonal antibody labeled with 2 mCi of 111-indium (Indacea). Patients were imaged by gamma camera at 24 and 48 hours. Primary tumors were identified in 3/10 cases and were not visualized in 3/10 cases. Four scans were considered equivocal. Hepatic metastases were identified as image defects in 5/13 cases and were not visualized in 8/13 cases. All tumors contained CEA by immunoperoxidase staining. In all cases, the primary tumor uptake (5.44 +/- 1.07% ID/kg) was much higher than the uptake of the adjacent fat (0.18 +/- 0.04% ID/kg). There was a direct correlation between tumor CEA content, tumor radioactivity, and the imaging of primary tumor by Indacea. High liver uptake (30.3 +/- 3.0% ID/kg), seen when scanning all patients, was the main limitation of imaging and led to photopenic visualization of hepatic metastases. These results suggest that selection of patients with colorectal carcinoma on the basis of tumor CEA content will lead to improved rates of tumor imaging by Indacea in post-surgical scanning.


Giant intracranial aneurysms: diagnosis with special reference to computerised tomography.
The clinical presentation, radiological investigations and surgical management of 11 patients with giant intracranial aneurysm (greater than 2.5 cm) have been reviewed. Most patients had signs and symptomd haemorrhage. The most helpful plain film finding was intracranial calcification. This varied from a mere fleck to the classical curvilinear variety. Computerised tomography (CT) scans were available on all 11 patients. All showed a space-occupying lesion of high density. Two types of enhancement were seen following intravenous contrast medium, (a) homogeneous and (b) rim enhancement with or without a patchy increase in density centrally. The CT appearances in some of the cases resembled those shown by other lesions such as neoplasm. Arteriography in almost all cases demonstrated the aneurysm but often under-estimated its size. On two occasions the aneurysm did not fill and the nature of the lesion demonstrated on the plain CT remained unconfirmed. Direct surgical attack rather than carotid ligation was the operation of choice. Most patients responded very well to this treatment.


A new estra-1,3,5(10)-triene-3,17beta-diol solvate: estradiol-methanol-water (3/2/1).
The title solvate of the steroid 17beta-estradiol (E(2)) with methanol and water, C(18)H(24)O(2).0.67CH(4)O.0.33H(2)O, is the first E(2) derivative to contain three crystallographically independent molecules in the asymmetric unit. The three steroid molecules, along with two methanol molecules and a water molecule, create a three-dimensional hydrogen-bonded system. Three-sided columns are formed, with the estradiol molecules aligned lengthwise parallel to (101), and joined by solvent molecules at both hydrophilic ends. The three estradiol molecules differ slightly in their ring-bowing angles, i.e. the angle between the mean plane of the A ring and that of the BCD ring; this angle ranges from 7.1 to 12.2 degrees.


Malignant ovarian tumors in childhood: prognosis in relation to initial therapy.
Twenty-two children with malignant ovarian tumors (12 malignant teratomas, six endodermal sinus tumors, and four embryonal carcinomas) were studied from 1960 through March 1975. Comparison is made between different modalities of therapy, such as surgery alone or surgery in combination with either radiation or chemotherapy. Because of the poor results obtained with the aforementioned treatment methods, a new approach, consisting of more aggressive initial surgery followed immediately by radiation therapy and an intensive chemotherapeutic regimen called the T2 protocol, was begun in 1971 with encouraging results. To date six of ten patients are alive and free of disease with a median observation period of 22+ months. A new grouping defining the extent of disease is also provided. Of the ten patients on the T2 protocol, only one was a Group I; eight were Group III and one was Group IV at the time treatment was initiated. An analysis of the mode of spread, as well as a discussion of the results obtained with previous modalities of therapy in relation to initial grouping and pathology, constitute the background for the proposed treatment.


The ligand-receptor interactions of the endothelin systems are mediated by distinct "message" and "address" domains.
Pharmacologic responses to endothelins (ETs) are mediated by two subtypes of G-protein-coupled receptors, termed ETA and ETB. A chimeric receptor that has the transmembrane domains (TMDs) IV-VI with the adjacent loop regions from ETB embedded in the remaining regions from ETA exhibits specific binding to the N-terminally truncated ETB agonists 125I-BQ3020 and 125I-IRL1620, to the same level as that of wild-type ETB receptor. Furthermore, the ETA-selective antagonist BQ123 competed for the binding of these ETB-selective radioligands to this chimeric receptor, with Ki values similar to those determined by using wild-type ETA receptor and 125I-ET-1. These findings indicated that the endothelin systems consist of two distinct parts, both on the ligand and receptor sides. The N-terminal loop structure of the agonists and the TMDs IV-VI with adjoining loops of the receptors determine the isopeptide/subtype selectivity. On the other hand, the C-terminal linear portion of the isopeptides and the TMDs I-III and VII plus adjacent loops of the receptors are probably involved in ligand-receptor binding itself. This scheme can be explained by the classic "message-address" concept proposed for a number of peptidergic ligand families.


[Vaginal pelvic repair. Always with mesh or not?].
Several surgical methods are possible when aiming at reconstruction of pelvic organ prolapse in women, and the experienced surgeon implements the knowledge gained from open, laparoscopic, and vaginal techniques. These feature different rates of success and relapse as well as different complication risks. Because of the accumulating morbidity of aging patients, there is a search for a safe minimally invasive technique. With the advent of synthetic meshes, surgeons have used them frequently and often uncritically for reconstruction of the female pelvic floor. In these cases the vaginal approach is preferred as opposed to alternative techniques, as it is less invasive and allows for better convalescence. Furthermore, this approach leads to low complication and relapse rates even when synthetic meshes are omitted.


Lipid peroxidation inhibition capacity assay for antioxidants based on liposomal membranes.
An in vitro antioxidant assay has been developed to better reflect the in vivo conditions of antioxidants interacting with membrane and lipid surfaces. The lipid peroxidation inhibition capacity (LPIC) method measures the ability of both lipophilic and hydrophilic antioxidants to protect a lipophilic fluorescent probe 4, 4-difluoro-5-(4-phenyl-1,3-butadienyl)-4-bora-3a,4a-diaza-s-indacene-3-undecanoic acid, incorporated in the membrane, from 2,2'-azobis(2-amidinopropane)hydrochloride generated radicals in the surrounding aqueous solution. Antioxidant activities of test compounds were measured either after they were mixed with preformed liposomes (LPIC(Mixed)) or after they were incorporated into liposomes (LPIC(Inco)) as they were made. The results were analysed to determine how the method of mixing and the structures of the antioxidants influenced their protection of the membrane from free radical attack. The LPIC(Mixed) values were larger than the LPIC(Inco) values for a range of 12 structurally diverse antioxidant compounds. However, there was no linear correlation between the lipophilicities, as measured by their partition coefficient, log P and either LPIC(Inco) or LPIC(Mixed) values. A strong correlation was found between LPIC(Inco) and LPIC(Mixed) values.


Decreased expression of HLA class I on ocular melanoma cells following in vitro photodynamic therapy.
Our objective was to investigate whether photodynamic therapy (PDT) influences the expression of HLA Class I and beta 2-microglobulin molecules on cultured uveal melanoma cells. Uveal melanoma cells were incubated with hematoporphyrin esters (HPE) and illuminated using red light. HLA expression on cells was determined by flowcytometry. PDT treatment induced an immediate reduction in expression of HLA Class I and beta 2-microglobulin, followed by a transient increase in expression after 2 h. Normalization occurred after 6 h. Treatment of ocular melanoma cells with PDT temporally alters the expression of HLA Class I and beta 2-microglobulin, which may affect anti-tumor-immune responses.


Pore size in implanted polypropylene filters is critical for tissue organization.
Widely different implant materials induce surprisingly similar tissue reactions in vivo in contrast to their in vitro responses. Increasing attention has recently been given to the surface texture of the material. When both the material composition and the surface topography are varied, the surface topography seems to be the predominant factor for the induced tissue response. The present study addresses differences in the tissue response to commercially available Millipore mesh filters of polypropylene with pore sizes of 0.6, 10.0 or 30.0 microm. The Millipore filters with adjacent tissue were directly sectioned in a cryostat and evaluated via an immunofluorescence technique with double and triple staining, allowing simultaneous analysis of different antigens in tissue sections. These results show that macrophages, total cells, necrotic cells, nitric oxygen distribution, early angiogenesis, and capsule thickness were influenced by the surface structure. Implants with pore sizes of 0.6 microm, where entrance of inflammatory cells was inhibited, induce the most pronounced foreign body capsule formation. The 10- and 30-microm filters, in contrast, had large amounts of macrophages inside the filter structure, although very few inflammatory cells were found outside the filters. The inflammatory cells within the filters appeared not to influence the foreign body capsule induction. The critical factor for the formation of a foreign body capsule seems to be the localization of implant-close macrophages. Whether this is due to differences in cell activation or in signal transduction to collagen-synthesizing fibroblasts remains an open question.


Angiotensin converting enzyme inhibitors and pulmonary hypertension.
To evaluate the efficacy of angiotensin converting enzyme inhibitors Enalapril, Fosonopril and Moexipril on mean and systolic pulmonary artery pressure. The study included Ill patients with chronic obstructive bronchopneumopathies associated with arterial hypertension and mild to moderate heart failure (NYHA I-II class). The patients were examined at baseline and after 60 days of treatment. The central hemodynamic parameters and mean and systolic pulmonary artery pressure were studied by Doppler echocardiography (Phillips HD11XE). The pulmonary artery was viewed by left parasternal approach - cross section of the aorta. The following were measured: pulmonary artery flow acceleration and deceleration time (pafAT/ pafDT), right ventricular izovolumetric relaxation time (IVRT), mean and peak pulmonary blood flow velocities, right ventricular/pulmonary artery systolic pressure (RV/ PASP). The mean pulmonary artery pressure (MPAP) was estimated based on pulmonary flow acceleration time and right ventricular ejection time. Following the treatment with angiotensin converting enzyme inhibitors a positive dynamics of SF pattern close to the normal one - a domelike contour with the maximum almost in the middle of diastole was noticed. the quantitative estimation revealed the considerable reduction in pulmonary artery systolic pressure (PASP) (from 46.3 +/- 3.3 mmHg at baseline to 32.1 +/- 2.6 mmHg after treatment, p < 0.01) and MPAP - from 26.7 +/- 3.2 mmHg at baseline to 23.2 +/- 2.6 mmHg after treatment, p


AIDS repository.
In the article "Spotlight falls on science policy" (News and Comment, 10 May, p. 691) by Mark H. Crawford, the findings of a General Accounting Office report on the operating costs of the Continuous Electron Beam Accelerator Facility (CEBAF) were overstated. The report found that the Department of Energy's operating costs would rise by $80 million if both CEBAF and the Relativistic Heavy Ion Collider are constructed. CEBAF's operating cost is estimated to be $30 million. The report also found problems in accommodating the operating costs of the proposed Superconducting Super Collider in the department's budget.


Maternal mortality in the U.S. Department of Defense, 1993-1998.
To determine the maternal mortality ratio (MMR) in Department of Defense medical facilities from 1993 to 1998. We conducted a retrospective review of birth data from military medical facilities using the Standard Inpatient Data Records from 1993 through 1998. The total number of live births and dispositions due to maternal death were obtained. Twenty-two maternal deaths occurred in the study time out of 398,107 live births, for an MMR of 5.5 per 100,000 live births. The ratiosfor the service branches were: Army 7.0, Navy 5.3 and Air Force 3.6. The leading cause of death was embolic disease. The military MMR is closer to the Healthy People 2010 goal of 3.3 than is the national ratio, 13.2. Improved reporting of cases, patient education and treating high-risk conditions may help further decrease pregnancy-related mortality.


Investigations of the relationship between use of in vitro cell culture-quantitative PCR and a mouse-based bioassay for evaluating critical factors affecting the disinfection performance of pulsed UV light for treating Cryptosporidium parvum oocysts in saline.
Cryptosporidium parvum is an enteric coccidian parasite that is recognised as a frequent cause of water-borne disease in humans. We report for the first time on use of the in vitro HCT-8 cell culture-quantitative PCR (qPCR) assay and the in vivo SCID-mouse bioassay for evaluating critical factors that reduce or eliminate infectivity of C. parvum after irradiating oocysts in saline solution under varying operational conditions with pulsed UV light. Infections post UV treatments were detected by immunofluorescence (IF) microscopy and by quantitative PCR in cell culture, and by IF staining of faeces and by hematoxylin and eosin staining of intestinal villi in mice. There was a good agreement between using cell culture-qPCR and the mouse assay for determining reduction or elimination of C. parvum infectivity as a consequence of varying UV operating conditions. Reduction in infectivity depended on the intensity of lamp discharge energy applied, amount of pulsing and population size of oocysts (P < or = 0.05). Conventional radiometer was unable to measure fluence or UV dose in saline samples due to the ultra-short non-continuous nature of the high-energy light pulses. Incorporation of humic acid at a concentration above that found in surface water (i.e., < or =10 ppm) did not significantly affect PUV disinfection capability irrespective of parameters tested (P < or = 0.05). These observations show that use of this HCT-8 cell culture assay is equivalent to using the 'gold standard' mouse-based infectivity assay for determining disinfection performances of PUV for treating C. parvum in saline solution.