Effect of P-450 inducers on biliary excretion of glutathione and its hydrolysis products. Correlation between hepatic gamma-glutamyltranspeptidase activity and the proportion of glutathione hydrolysis products in bile.
This study was designed to determine if a relationship exists between hepatic gamma-glutamyltranspeptidase (gamma-GT) activity and the biliary excretion of glutathione (GSH) and its hydrolysis products. Rats were pretreated with the following microsomal enzyme inducers: pregnenolone-16 alpha-carbonitrile (PCN), dexamethasone (DEX), 3-methylcholanthrene, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD), phenobarbital (PB), ethanol (ETOH), trans-stilbene oxide (TSO), butylated hydroxyanisole (BHA), isosafrole (ISF), clofibrate, and benzo(a)pyrene. Hepatic gamma-GT activity was quantitated spectrophotometrically; bile and liver samples were analyzed by HPLC for reduced and oxidized GSH and their hydrolysis products (cysteine, cysteinylglycine, and cysteinylglycine disulfide). Administration of the inducers had only minor effects on hepatic GSH concentration, as BHA was the only agent to increase GSH concentration. However, these inducers had a pronounced effect on the biliary excretion of total thiol-derived sulfur as PCN, PB, and ISF produced an increase, whereas TCDD, ETOH, and TSO caused a decrease. The relative amount of the GSH hydrolysis products in bile was highly dependent on gamma-GT activity. For example, hepatic gamma-GT activity was increased by PCN, DEX, BHA, TSO, and ISF. They also increased the GSH hydrolysis products to total thiol-derived sulfur ratio in bile. In conclusion, the ratio of GSH hydrolysis products to total thiol-derived sulfur excreted in rat bile reflects the hepatic gamma-GT activity.


Clinical determinants of poststroke dementia.
Frequency of poststroke dementia is high, and stroke considerably increases the risk of dementia. The risk factors for dementia related to stroke are still incompletely understood. We sought to examine clinical determinants of poststroke dementia in a large well-defined stroke cohort. The study group comprised 337 of 486 consecutive patients aged 55 to 85 years who 3 months after ischemic stroke completed a comprehensive neuropsychological test battery and MRI, including structured medical, neurological, and laboratory evaluations; clinical mental status examination; interview of a knowledgeable informant; detailed history of risk factors; and evaluation of stroke type, localization, and syndrome. The DSM-III definition for dementia was used. Frequency of any poststroke dementia was 31.8% (107/337), that of stroke-related dementia (mixed Alzheimer's disease plus vascular dementia excluded) was 28.4% (87/306), and that of dementia after first-ever stroke was 28.9% (79/273). The patients with poststroke dementia were older and more often had a low level of education, history of prior cerebrovascular disease and stroke, left hemispheric stroke (reflecting laterality), major dominant stroke syndrome (reflecting laterality and size), dysphasia, gait impairment, and urinary incontinence. The demented patients were also more frequently current smokers, had lower arterial blood pressure values, and more frequently had an orthostatic reaction compared with the nondemented stroke patients. The correlates of dementia in logistic regression analysis were dysphasia (odds ratio [OR], 5.6), major dominant stroke syndrome (OR, 5.0), history of prior cerebrovascular disease (OR, 2.0), and low educational level (OR, 1.1). When we excluded those with cerebrovascular disease plus Alzheimer's disease or those with recurrent stroke, the order of correlates remained the same. When the patients with dysphasia (n=30) were excluded, the correlates were major dominant syndrome (OR, 4.6) and low educational level (OR, 1.1). Our data suggest that a single explanation for poststroke dementia is not adequate; rather, multiple factors including stroke features (dysphasia, major dominant stroke syndrome), host characteristics (educational level), and prior cerebrovascular disease each independently contribute to the risk.


Examination of intramammary devices from infected and uninfected mammary quarters by scanning electron microscopy.
Polyethylene intramammary devices were removed from six infected and four uninfected mammary quarters of seven lactating cows and examined by scanning electron microscopy. Infecting organisms included Corynebacterium bovis, coagulase-negative staphylococci, and an unidentified fungus. Intramammary devices from infected quarters had amorphous material adhering to large areas of the polyethylene. Large numbers of inflammatory cells and microorganisms were found concentrated within the material. Devices from uninfected quarters had less amorphous material with few adhering inflammatory cells. The amorphous material appeared to be restricted to abraded surfaces of the polyethylene. Milk somatic cell counts in stripping milk of quarters infected with Corynebacterium bovis and coagulase-negative staphylococci before and 3 wk after removal of intramammary device averaged 1.2 X 10(6) and .2 X 10(6)/ml, respectively. Results suggest that increased cell counts of infected quarters containing intramammary devices were associated with microbial colonization of the amorphous material.


Cystic tumor of the atrioventricular node: rare antemortem diagnosis.
The cystic tumor of the atrioventricular node (TAV) is a rare, congenital cardiac tumor, typically located at the base of the atrial septum. Histologically benign, this multicystic mass is a tumor of the conduction system and is considered the smallest tumor capable of causing sudden and unexpected death. TAV has shown a predilection for women with a mean age at presentation of 38 years. The majority of cases are diagnosed incidentally at autopsy, while antemortem surgical excision is rare, with ours being the fifth and sixth reported cases in the medical literature. We present two cases, in 33- and 29-year-old women who were admitted for complaints of dyspnea, dizziness, palpitation or numbness, along with a review of the literature. One was known to have complete congenital heart block and ventricular septal defect, where an intraoperative transesophageal echocardiogram revealed a right atrial mass. The other patient had a right atrial mass visible on magnetic resonance imaging, which led to surgical resection and permanent pacemaker insertion. Histopathological examination revealed a tumor composed of cysts, some lined by squamous epithelium, and others by transitional epithelium. Irregular proliferation of glandular structures with squamoid nests within a fibrous stroma, with sebaceous-type differentiation, was also observed. A chronic inflammatory component with secondary lymphoid follicles was also noted. These cases are presented, along with a review of the four previously reported cases of TAV diagnosed antemortem. Awareness regarding this lesion could improve gross and microscopic characterization of TAV and increase antemortem diagnoses.


Pathology of bartonella endocarditis in six dogs.
In a 5-year retrospective study of dogs presenting to the Veterinary Medical Teaching Hospital at the University of California, Davis, there were 31 histologic diagnoses of valvular endocarditis. By polymerase chain reaction (PCR) amplification of embedded valvular tissue, Bartonella organisms were exclusively associated with 6 out of 31 cases (19%). Confirmed Bartonella cases involved the aortic valve alone (five out of six) or in combination with the mitral valve (one of six). Microscopic features of Bartonella endocarditis were compared with valves from non-Bartonella endocarditis and with valvular change unrelated to infectious agents (endocardiosis). Features of Bartonella endocarditis included a combination of fibrosis, mineralization, endothelial proliferation, and neovascularization with variable inflammation. None of these features is specific; however, the combination is distinct both from endocarditis caused by culturable bacteria and from endocardiosis. Ultrastructural analyses revealed both extracellular and intraendothelial bacteria. Clinical history, serology, and PCR are currently necessary to establish an etiologic diagnosis of Bartonella endocarditis.


Fractionation of Suwannee River fulvic acid and aldrich humic acid on alpha-Al2O3: spectroscopic evidence.
Sorptive fractionation of Suwannee River Fulvic Acid (SRFA) and Purified Aldrich Humic Acid (PAHA) on alpha-Al2O3 at pH 6 was probed in the supernatant using different spectroscopic techniques. Comparison of dissolved organic carbon (DOC) analysis with UV/vis spectrophotometric measurements at 254 nm, including specific UV absorbance (SUVA) calculation, revealed a decrease in chromophoric compounds for the nonsorbed extracts after a 24 h contact time. This fractionation, only observable below a certain ratio between initial number of sites of humic substances and of alpha-Al2O3, seems to indicate a higher fractionation for PAHA. C(1s) near-edge X-ray absorption fine structure spectroscopy (NEXAFS) confirmed this trend and points to a decrease in phenolic moieties in the supernatant and to an eventual increase in phenolic moieties on the surface. Time-resolved luminescence spectroscopy (TRLS) of Eu(III) as luminescent probe showed a decrease in the ratio between the (5)D0-->(7)F2 and (5)D0-->(7)F1 transitions for the fractionated organic matter (OM) that is thought to be associated with a lower energy transfer from the OM to Eu(III) due to the loss of polar aromatics. These modifications in the supernatant are a hint for the modification of sorbed humic extracts on the surface.


[TSC2/PKD1 contiguous gene syndrome. Report of two cases].
The two major genes responsible for autosomal dominant polycystic kidney disease and complex tuberous sclerosis are located on chromosome 16 at position 16p13.3, separated by only a few nucleotides. A simultaneous loss of both genes has been termed "the TSC2/PKD1 contiguous gene syndrome". It has been described essentially in young children. We report 2 new cases in French adults, in whom the diagnosis has been made fortuitously on the macroscopic and microscopic examination of the nephrectomy specimen. This diagnosis should be considered for the association of a polycystic kidney disease and numerous angiomyolipomas. It is necessary to set up a specific follow-up of both diseases.


Modeling HIV outbreaks: the male to female prevalence ratio in the core population.
What affects the ratio of infected men to infected women in the core population in a heterosexual HIV epidemic? Hethcote and Yorke [5] introduced the term "core" initially to loosely describe the collection of individuals having the most unprotected sex partners. We study the early epidemic during the exponential growth phase and focus on the core group because most infected people were infected by people in the core. We argue that in the early outbreak phase of an epidemic, there is an identity, which we call the "outbreak equation." It relates three ratios that describe the core men versus the core women, namely, the ratio E of numbers of all core men to all core women, the ratio C of numbers of infected core men to core women, and the ratio M of the infectiousness of a typical core man to that of a typical core woman. Then the relationship between the ratios is E=MC(2) in the early outbreak phase. We investigate two very different scenarios, one in which there are two times as many core men as core women (E=2) and the other in which core men equal core women (E=1). In the first case, the HIV epidemic grows at a much faster rate. We conclude that if the female core group was larger, that is, if more women in the total population were promiscuous (or if fewer men were promiscuous) then the HIV epidemic would grow more slowly.


[Diagnostic value of various indices of the radioiodine accumulation test].
According to well documented histories a group of experts-endocrinologists determined the presence of one or another disease in 109 patients with different thyroid pathology. Two examinations were performed according to the clinical findings and on the basis of the same indices, added by results of the radioiodine test. Diagnostic informativity of different indices of the radioiodine test was evaluated according to the correlation (by means of calculation of the correlations) between the radiological parameter and the disease probability. It was concluded that the parameters of the routine research methods (131I absorption within 2, 4, 24 and 48 hours) are more informative than the values of more complicated variants of the radioiodine test. Informativity of the whole radiological and non-radiological findings was estimated, using a diagnostic coefficient method. It was shown that the role of radiological indices in making a correct diagnosis averages 17% and in cases of hypothyrosis and toxic forms of goiter this value increases up to 30%.


Monte Carlo calculation of the angular distribution of cosmic rays at flight altitudes.
The angular distribution of the secondary radiation produced by the galactic component of cosmic rays has been determined by simulating the penetration of the primary spectra in the Earth's atmosphere. The simulations have been carried out with the latest version of the FLUKA code. Particles have been scored at various altitudes according to their angle of incidence for some significant values of vertical cut-off rigidity and solar modulation parameter. The calculated results at typical cruise altitudes for a civil aircraft are presented. The data at 10.7 km have been fitted with simple mathematical equations. It has been demonstrated that the major contribution to the doses at aviation altitudes arises from downward-directed particles. The isotropic irradiation usually assumed for the evaluation of aircrew exposure could be a very poor approximation.


Human leukocyte antigen and cytokine gene variants as predictors of recurrent Chlamydia trachomatis infection in high-risk adolescents.
Antigen presentation and immune activation are essential to the effective control of infectious diseases. In 485 North American adolescents at high risk for genital Chlamydia trachomatis infection, we found 2 human leukocyte antigen variants (DRB1*03-DQB1*04 and DQB1*06) to be associated with recurrent Chlamydia infection (adjusted relative odds [RO], >2.0; P<.01, for both variants). A G-C-C haplotype corresponding to variants at IL10 (encoding interleukin-10 [IL-10]) promoter positions -1082, -819, and -592 was underrepresented in individuals with recurrent infection (RO, 0.59; P=.046). These genetic associations were independent of nongenetic factors, including number of sex partners, race, sex, duration of follow-up, and human immunodeficiency virus type 1 seropositivity. Consistent with the observed IL10 association, cervical secretions in female adolescents without the IL10 G-C-C haplotype had elevated IL-10 concentrations after Chlamydia infection, which may reflect involvement of a Chlamydia-specific mechanism for genetically mediated, differential IL-10 expression in the genital tract.


Visual and Haptic influences on memory: age differences in recall.
Older (age 60-75) and younger adults (age 20-35) participated in a within-subject experiment. All participants were given four lists of 17 items, a recall test followed each list. Each participant was given a separate list under each of the following conditions, at the rate of 1 item every 10 s. (1) control: list of nouns; (2) visual-only: visually shown objects; (3) visual-and-haptic: given objects to hold and visually examine; (4) haptic-only: blindfolded, given objects to hold. A final surprise recall test was given of all items presented in the study. Data indicated that younger adults recalled more than older adults under all conditions. However, both age groups had the highest recall under the haptic conditions.


Reflectivity and microwave absorption in crystals with alternating intrinsic Josephson junctions.
We compute the frequency and magnetic field dependencies of the reflectivity R(omega) in layered superconductors with two alternating intrinsic Josephson junctions with different critical current densities and quasiparticle conductivities for the electric field polarized along the c axis. The parameter alpha describing the electronic compressibility of the layers and the charge coupling of neighboring junctions was extracted for the SmLa1-xSr xCuO (4-delta) superconductor from two independent optical measurements, the fit of the loss function L(omega) at zero magnetic field and the magnetic field dependence of the peak positions in L(omega). The experiments are consistent with a free electron value for alpha.


Measurement of muscle fiber conduction velocity in the human masseter muscle using the surface EMG cross-correlation technique.
During sustained isometric contraction of the jaw muscles, the surface electromyography (EMG) power spectrum compresses into lower frequencies. This compression has been mainly attributed to the change of the conduction velocity of the action potentials along the muscle fibers. In this study, the muscle fiber conduction velocity of the masseter muscle was measured by using the surface electrode array and the cross-correlation technique. The conduction velocity of the masseter muscle varied from 6.83 to 18.01 m/s among the eight subjects, and slightly increased with the contraction level.


Brenner tumor of the ovary - ultrasound features and clinical management of a rare ovarian tumor mimicking ovarian cancer.
To describe the ultrasound features of benign Brenner tumor in the background of complex clinical and histopathological pictures. We retrospectively identified patients with histologically confirmed benign Brenner tumor of the ovary who were treated in our institution in 2003-2016, and for whom complete imaging, clinical, perioperative and histopathological data were available in the database. Ultrasound findings were drawn from images and reports using terms and definitions of the International Ovarian Tumor Analysis group and pattern recognition description was applied. Twenty-three patients were identified, most postmenopausal and asymptomatic. On ultrasound, 19/23 tumors were found unilaterally, 4/23 bilaterally, and 82% of tumors were detected in the left ovary. Most Brenner tumors (16/23) contained solid components and revealed no or minimal blood flow by subjective color score upon Doppler examination (19/23, 83%). Calcifications with shadowing were observed in 57% of all Brenner tumors and in 81% of tumors containing solid components. The complex appearance of the tumor misled the sonographers to describe the mass as malignant in 9 cases (39%), and frozen section was performed perioperatively. Surgery was performed via laparoscopy in 11 (48%) and via laparotomy in 12 (52%) cases. The complexity of the ultrasound picture, consisting of features like calcifications with acoustic shadowing, a poorly vascularized solid mass, and a left-sided localization could be signs of a benign Brenner tumor and could preop-eratively help to differentiate between benign and malignant tumor.


Modular extension of the ACR-NEMA DICOM standard to support new diagnostic imaging modalities and services.
The American College of Radiology-National Electrical Manufacturers Association (ACR-NEMA) Standard for Digital Imaging and Communications in Medicine (DICOM) (NEMA PS3-1993, DICOM) enables interconnection of imaging equipment and exchange of diagnostic images over standard networks. The widespread adoption of DICOM by industry and the benefits of standardized image management have attracted international attention. Other medical specialties, dentistry, and veterinary medicine have indicated strong interest in extending the DICOM Standard to support nonradiological image modalities. Parts 1 through 9 of DICOM were published in 1992 and 1993. Additional features developed in response to requests from the user community are being added in DICOM Supplements. The ACR, NEMA, and committees from other medical specialties working under the coordination of the American National Standards Institute Healthcare Informatics Standards Planning Panel Message Standards Developers Subcommittee Joint Working Group for Diagnostic Image Communication have defined new image object classes to support X-Ray Angiography, Radio-Fluoroscopy, Positron Emission Tomography, Endoscopy, and Light Microscopy. ACR-NEMA has also developed new service classes for Storage Commitment and Worklist Management. In joint work with the standards development committee of the Japanese Industries for Radiation Apparatus and the Japanese Medical Information System Development Center, ACR-NEMA has developed specifications for multibyte character set support and for a DICOM file format for transportable media. Other work is in progress. New DICOM features have provided and can continue to provide significant new functionality for digital image management systems. The demonstrated capability of efficient extension of the base standard is evidence of the effectiveness of the object oriented strategy of DICOM.


Evaluating an Intervention to Improve Communication Between Oncology Clinicians and Patients With Life-Limiting Cancer: A Cluster Randomized Clinical Trial of the Serious Illness Care Program.
Earlier clinician-patient conversations about patients' values, goals, and preferences in serious illness (ie, serious illness conversations) are associated with better outcomes but occur inconsistently in cancer care. To evaluate the efficacy of a communication quality-improvement intervention in improving the occurrence, timing, quality, and accessibility of documented serious illness conversations between oncology clinicians and patients with advanced cancer. This cluster randomized clinical trial in outpatient oncology was conducted at the Dana-Farber Cancer Institute and included physicians, advanced-practice clinicians, and patients with cancer who were at high risk of death. The primary outcomes (goal-concordant care and peacefulness at the end of life) are published elsewhere. Secondary outcomes are reported herein, including (1) documentation of at least 1 serious illness conversation before death, (2) timing of the initial conversation before death, (3) quality of conversations, and (4) their accessibility in the electronic medical record (EMR). We enrolled 91 clinicians (48 intervention, 43 control) and 278 patients (134 intervention, 144 control). Of enrolled patients, 58% died during the study (n=161); mean age was 62.3 years (95% CI, 58.9-65.6 years); 55% were women (n=88). These patients were cared for by 76 of the 91 enrolled clinicians (37 intervention, 39 control); years in practice, 11.5 (95% CI, 9.2-13.8); 57% female (n=43). Medical record review after patients' death demonstrated that a significantly higher proportion of intervention patients had a documented discussion compared with controls (96% vs 79%, P = .005) and intervention conversations occurred a median of 2.4 months earlier (median, 143 days vs 71 days, P < .001). Conversation documentation for intervention patients was significantly more comprehensive and patient centered, with a greater focus on values or goals (89% vs 44%, P < .001), prognosis or illness understanding (91% vs 48%, P < .001), and life-sustaining treatment preferences (63% vs 32%, P = .004). Documentation about end-of-life care planning did not differ between arms (80% intervention vs 68% control, P = .08). Significantly more intervention patients had documentation that was accessible in the EMR (61% vs 11%, P < .001). This communication quality-improvement intervention resulted in more, earlier, better, and more accessible serious illness conversations documented in the EMR. To our knowledge, this is the first such study to demonstrate improvement in all 4 of these outcomes. ClinicalTrials.gov identifier: NCT01786811.


Permeability of caulking compounds to 222Rn.
Caulking compounds have been tested as 222Rn barriers. Of these, the most effective is GE acrylic Latex Silicone Caulk, 0.2 cm of which attenuates 222Rn by 98% to 99.9%. The same thickness of two commercial 222Rn barriers attenuates radon by 75% to 90%. Permeabilities range from 0.3 to 140 x 10(-8) cm2 s-1.


Use of the transverse cerebellar diameter/abdominal circumference ratio in pregnancies at risk for intrauterine growth retardation.
A prospective study was conducted to evaluate the ability of the transverse cerebellar diameter/abdominal circumference ratio to identify growth-retarded fetuses. Of the cases analyzed, 48 of 87 (55%) were growth retarded by birth weight. The transverse cerebellar diameter/abdominal circumference ratio identified growth retardation with a sensitivity of 71%, specificity of 77%, positive predictive value of 79%, and negative predictive value of 68%. Fourteen growth-retarded fetuses were missed by the ratio; however, 57% of the missed cases were severely growth retarded. The transverse cerebellar diameter/abdominal circumference ratio can be useful for the assessment of fetal growth retardation; however, the ratio may be normal in cases of severe fetal growth retardation.


[Effect of the anthelminthic levamisole on the first-stage larva of Angiostrongylus cantonensis in infected rats].
Effects of levamisole, orally administered at 1, 3, 5 or 7 successive daily doses of 30 mg/kg, on the number of first-stage larvae of Angiostrongylus cantonensis released in the faeces of treated rats were examined. First-stage larval counts (larvae per gram of faeces per female worm recovered, LPG/female) were conspicuously reduced 1 day after administration in all treated groups. In the group treated with a single dose, the larval counts increased 2 days after administration, but no larvae could be detected in the other treated groups. Histological observations of lung tissues of the host showed the degenerative changes in the reproductive system of the worms. These results suggest that levamisole affects the larval output of A. cantonensis through a direct paralyzing action and an indirect mode of action including inhibition in energy metabolism.


Role of NADPH oxidase and ANG II in diabetes-induced retinal leukostasis.
We studied whether angiotensin II (ANG II) via superoxide may contribute to retinal leukostasis and thus to the pathogenesis of retinopathies. We studied: 1) whether intravitreal ANG II induces retinal leukostasis that is altered by antioxidants or by apocynin, a NAD(P)H oxidase inhibitor and 2) whether retinal leukostasis induced by diabetes in rats is also altered by these treatments. Rats were injected intravitreally with ANG II (20 microg in 2 microl), and divided into the following three groups: 1) untreated; 2) treated with tempol doses ( approximately 3 mM/day) and N-acetylcysteine (NAC; approximately 1 g.kg(-1).day(-1)); and 3) treated with apocynin ( approximately 2 mM/day), both in the drinking water. Rats with streptozotocin-induced diabetes were similarly treated. Leukostasis was evaluated 48 h after ANG II or 2 wk after diabetes induction. ANG II increased retinal leukostasis from 0.3 +/- 0.5 to 3.7 +/- 0.4 leukocytes/ mm(2) (P < 0.01), and these changes were markedly decreased by treatment with tempol + NAC or apocynin, and also by a blocking antibody against vascular endothelial growth factor given intravitreally (P < 0.01). In addition, incubation of dihydroethidium-loaded retina sections with ANG II caused marked increase in superoxide formation. Compared with normal controls, retinal leukostasis in diabetic rats markedly increased from 0.2 +/- 0.3 to 3.8 +/- 0.1 leukocytes/mm(2) (P < 0.01). Diabetic retinal leukostasis was also decreased by treatment with tempol-NAC and normalized by apocynin. Thus increases in intravitreal ANG II can induce retinal leukostasis, which appears to be mediated via increasing superoxide generation by NAD(P)H oxidase, and by VEGF. The activity of NAD(P)H oxidase is required for leukostasis to occur in the diabetic retina.


Correlation of the Kennedy Osteitis Score to clinico-histologic features of chronic rhinosinusitis.
Osteitis is a feature of chronic rhinosinusitis (CRS) and often associated with recalcitrant disease. Radiological characteristics of osteitic sinus changes are commonly reported in practice but the clinical and pathologic significance is poorly defined. The objective of this study was to correlate the Kennedy Osteitis Score (KOS) to clinico-histologic features of CRS. A cross-sectional study of CRS patients undergoing sinus surgery was conducted. Osteitis was scored radiologically using the KOS. Associations between osteitis and histopathology, symptoms, 22-item Sino-Nasal Outcomes Test (SNOT-22), endoscopy, computed tomography (CT) mucosal score, and seromarkers were assessed. Interobserver correlation coefficient was performed. Additionally, the KOS was correlated to an alternate Global Osteitis Score. A total of 88 patients were assessed (45.5% female, age 50.3 ± 13.6 years); 45 (51.1%) patients had osteitis. Patients with KOS >0, had greater endoscopy score (6.1 ± 2.9 vs 4.4 ± 3.6, p = 0.03) and CT score (14.0 ± 6.0 vs 10.1 ± 5.7, p < 0.01) than those without osteitis. There was no difference in symptom score (2.4 ± 1.3 vs 2.4 ± 1.1, p = 0.89) and SNOT-22 (2.0 ± 1.0 vs 1.9 ± 1.1, p = 0.56) in patients with and without osteitis. KOS was higher in patients with tissue eosinophilia >10/high-power field (HPF) (median 3.0 [IQR, 1.0-5.3] vs 0.0 [0.0-4.0], p = 0.03) and serum eosinophilia >0.3 × 10(9) /L (4.0 [2.0-7.0] vs 1.0 [0.0-4.0], p < 0.01). Importantly, this was also true for those without prior surgery. The interobserver correlation coefficient was good (R = 0.86, p < 0.001). There was a significant correlation between the KOS and the Global Osteitis Score (R = 0.93, p < 0.001). The KOS is a simple, easy, and reproducible scale in assessing osteitic bones in patients with CRS and can predict measures of severity in eosinophilic rhinosinusitis.


On the move round up.
Promotions / new appointments.


Ivermectin in the treatment of Physaloptera preputialis in two cats.
Two mixed-breed cats were examined for intermittent vomiting of several months' duration. Adult Physaloptera preputialis nematodes were detected in the vomitus and melena was observed in both cases. Clinicopathological abnormalities including anemia and eosinophilia were found in one case. Clinical signs resolved following anthelmintic therapy with ivermectin (200 micrograms/kg body weight) administered subcutaneously.


GBD-2010 overestimates deaths from road injuries in OECD countries: new methods perform poorly.
We assessed the quality of Global Burden of Disease-2010 (GBD-2010) estimates of road injury deaths by comparing with government statistics for Organisation for Economic Co-operation and Development (OECD) countries that report to the International Road Traffic Accident Database (IRTAD). We obtained tabulated data for 25 OECD countries that report to IRTAD and also report vital registration (VR) data to WHO. We collated VR deaths corresponding to the GBD-2010 road injury definition and estimated 'traffic', 'non-traffic' and 'unspecified whether traffic or non-traffic' components. We estimated national road injury deaths by redistributing partially specified causes of death, as was done by GBD until this was replaced by more complex methods in GBD-2010. GBD-2010 estimates of road injury deaths exceeded IRTAD by 45% overall. IRTAD values fell below the GBD-2010 95% uncertainty interval in all but three countries. Mismatch of conceptual scope accounted for about 8% of this discrepancy, 5% was because GBD-2010 included cases other than road traffic and 3% because GBD-2010 (unlike IRTAD) includes deaths >30 days after injury. Pro rata distribution of partially specified causes in VR data gave estimates that were 18% higher than IRTAD but closer than GBD-2010 estimates for all but two countries. Cases in VR data specified as road injury gave estimates closer to IRTAD. GBD-2010 road injury mortality estimates are substantially higher than the road death toll in OECD countries. The discrepancy is not explained by wider scope of the GBD road injury construct nor by undercounting by IRTAD. GBD-2010 likely attributed substantially more deaths with partially specified causes to road injuries than is appropriate.


The value of adding mirror therapy for upper limb motor recovery of subacute stroke patients: a randomized controlled trial.
Upper limb paresis remains a relevant challenge in stroke rehabilitation. To evaluate if adding mirror therapy (MT) to conventional therapy (CT) can improve motor recovery of the upper limb in subacute stroke patients. Prospective, single-center, single-blind, randomised, controlled trial. Subacute stroke patients referred to a Physical and Rehabilitation Medicine Unit between October 2009 and August 2011. Twenty-six subacute stroke patients (time from stroke <4 weeks) with upper limb paresis (Motricity Index ≤ 77). Patients were randomly allocated to the MT (N.=13) or to the CT group (N.=13). Both followed a comprehensive rehabilitative treatment. In addition, MT Group had 30 minutes of MT while the CT group had 30 minutes of sham therapy. Action Research Arm Test (ARAT) was the primary outcome measures. Motricity Index (MI) and the Functional Independence Measure (FIM) were the secondary outcome measures. After one month of treatment patients of both groups showed statistically significant improvements in all the variables measured (P<0.05). Moreover patients of the MT group had greater improvements in the ARAT, MI and FIM values compared to CT group (P<0.01, Glass's Δ Effect Size: 1.18). No relevant adverse event was recorded during the study. MT is a promising and easy method to improve motor recovery of the upper limb in subacute stroke patients. While MT use has been advocated for acute patients with no or negligible motor function, it can be usefully extended to patients who show partial motor recovery. The easiness of implementation, the low cost and the acceptability makes this therapy an useful tool in stroke rehabilitation.


Comparison of effects of high and low carbohydrate diets on plasma lipoproteins and insulin sensitivity in patients with mild NIDDM.
Previous studies indicate that diets rich in digestible carbohydrates improve glucose tolerance in nondiabetic individuals, but may worsen glycemic control in NIDDM patients with moderately severe hyperglycemia. The effects of such high-carbohydrate diets on glucose metabolism in patients with mild NIDDM have not been studied adequately. This study compares responses to an isocaloric high-carbohydrate diet (60% of total energy from carbohydrates) and a low-carbohydrate diet (35% of total energy from carbohydrates) in 8 men with mild NIDDM. Both diets were low in saturated fatty acids, whereas the low-carbohydrate diet was rich in monounsaturated fatty acids. The two diets were matched for dietary fiber content (25 g/day). All patients were randomly assigned to receive first one and then the other diet, each for a period of 21 days, in a metabolic ward. Compared with the low-carbohydrate diet, the high-carbohydrate diet caused a 27.5% increase in plasma triglycerides and a similar increase in VLDL-cholesterol levels; it also reduced levels of HDL cholesterol by 11%. Plasma glucose and insulin responses to identical standard breakfast meals were studied on days 4 and 21 of each period, and these did not differ significantly between the two diets. At the end of each period, a euglycemic hyperinsulinemic glucose clamp study with simultaneous infusion of [3-3H]glucose revealed no significant changes in hepatic insulin sensitivity; and peripheral insulin-mediated glucose disposal remained unchanged (14.7 +/- 1.4 vs. 16.5 +/- 2.3 microM.kg-1.min-1 on the high-carbohydrate and low-carbohydrate diets, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)


Origin of chaotic transients in excitatory pulse-coupled networks.
We develop an approach to understanding long chaotic transients in networks of excitatory pulse-coupled oscillators. Our idea is to identify a class of attractors, sequentially active firing (SAF) attractors, in terms of the temporal event structure of firing and receipt of pulses. Then all attractors can be classified into two groups: SAF attractors and non-SAF attractors. We establish that long transients typically arise in the transitional region of the parameter space where the SAF attractors are collectively destabilized. Bifurcation behavior of the SAF attractors is analyzed to provide a detailed understanding of the long irregular transients. Although demonstrated using pulse-coupled oscillator networks, our general methodology may be useful in understanding the origin of transient chaos in other types of networked systems, an extremely challenging problem in nonlinear dynamics and complex systems.


Agranulocytosis associated with initiation of famotidine therapy.
To report a case of agranulocytosis associated with initiation of famotidine. An 87-year-old white man was admitted to the internal medicine department of an acute care hospital because of fever and agranulocytosis (granulocyte count 0). Eight days prior to admission, famotidine therapy had been initiated. Famotidine was discontinued and granulocyte-macrophage colony stimulating factor was administered, with concomitant recovery of the granulocyte count and subsequent development of a leukemoid reaction. According to the Naranjo probability scale, famotidine was the probable cause of agranulocytosis. This is a rare adverse effect of this medication; only a few other cases have been reported. Although agranulocytosis is a rare adverse effect of famotidine, the pharmacist and physician should be aware of this potentially fatal event. If any patient treated with famotidine develops fever, the clinician should consider, among other things, performing a white blood cell count.


Corneal Breakthrough Haze After Photorefractive Keratectomy With Mitomycin C: Incidence and Risk Factors.
To identify preoperative and intraoperative factors affecting breakthrough corneal haze incidence after photorefractive keratectomy (PRK) with mitomycin C (MMC). In this retrospective study of PRK performed at the Care Vision Refractive Laser Center, Tel Aviv, Israel, a total of 7535 eyes (n = 3854 patients; mean age ± SD, 26 ± 6 years; 55% men) underwent PRK with intraoperative MMC application. Patients with histories of corneal pathology or surgery were excluded. Incidence, time of onset, and corneal haze severity were documented on follow-up of 118 ± 110 days. Eyes were grouped by preoperative refraction [low (≤-3D), moderate (-3D to -6D), or high (>-6D) myopia; low (≤3D) or high (>3D) astigmatism; low or high hyperopia]; by intraoperative time (above or below 40 seconds); and by MMC application time (above or below 40 seconds). The main outcome measures were incidence, onset time, and severity of corneal haze. The haze incidence was 2.1% in eyes with high myopia versus 1.1% in those with low to moderate myopia (P = 0.002), and 3.5 times higher in eyes with high than with low astigmatism (P < 0.05). The overall incidence was higher in eyes treated for hyperopia (10.8%) than for myopia (1.3%) (P = 0.0001). In eyes with moderate myopia, the haze incidence was lower in MMC application time ≥40 seconds (0%) than in <40 seconds (1.3%) (P = 0.03). After surgery, a mild early haze incidence peaked at 68.8 ± 6 days and severe late haze at 115 ± 17 days (P = 0.02). Hyperopic and large myopic or astigmatic corrections carry higher risk of haze. Longer MMC application might have beneficial haze prevention.


Investigation of the requirements for plasma-induced polymerization of alcohols.
We analyzed the requirements for plasma-induced alcohol polymerization by comparing the reactions of several types of aliphatic alcohols and alkanes. The experiments revealed that alcohol polymerization requires the fixation of atmospheric nitrogen into alcohol. The OH group in alcohol physically contributes to initiate the airborne plasma reactions with its permittivity. However, the group chemically works to inhibit the fixation of nitrogen and successive polymerization of alcohols. Our study demonstrates that the ratio of OH groups per weight percent of each molecule decides the feasibility of the polymerization and the properties of the polymers.


A novel mutation (S227T) in domain II of the envelope gene of Japanese encephalitis virus circulating in North India.
Japanese encephalitis (JE) is an important arboviral infection of public health concern. There is a significant variation in mortality (10-30%) in JE viral infection. Epidemics of JE have become regular features in the northern states of India. The recent resurgence of the A226V mutation leading to a widespread Chikungunya epidemic motivated the investigators to search for any such mutational occurrence with Japanese encephalitis virus (JEV) isolated from this region. This study looked for mutation of clinical strains at amino-acid positions 176, 177, 227, 244, 264 and 279. A novel mutation S227T was detected corresponding to the loop region of domain II, E gene of JEV in comparison to Indian and other isolates from different parts of the world. Genotype III was found to be circulating in this geographical area. Further studies are required to ascertain its role in JE pathogenesis and vector competency.


Role of glycoconjugates of 3-methyl-4-hydroxyoctanoic acid in the evolution of oak lactone in wine during oak maturation.
Oak lactone is a natural component of oak wood, but it also exists in glycoconjugate precursor forms. This study concerned the role of glycoconjugates of 3-methyl-4-hydroxyoctanoic acid, specifically a galloylglucoside, glucoside, and rutinoside, in the evolution of oak lactone during cooperage and maturation. The glycoconjugate profiles of 10 French oak samples were obtained by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) using stable isotope dilution analysis. The galloylglucoside was found to be the predominant glycoconjugate precursor and ranged in concentration from 110 to 354 μg/g. Maturation trials indicated the galloylglucoside undergoes acid-catalyzed hydrolysis after extraction into wine; after 12 months of maturation, the glucoside was the most abundant precursor, present at between 2- and 11-fold higher concentrations than those observed for powdered oak. Thermal degradation of glycoconjugates was observed only when oak samples were heated at 200 °C for 30 min, demonstrating their thermal stability.


Interaction of Exo1 genotypes and smoking habit in oral cancer in Taiwan.
Exonuclease 1 (Exo1) is an important nuclease involved in the mismatch repair system that helps to maintain genomic stability, to modulate DNA recombination, and to mediate cell cycle arrest. Potential polymorphisms in Exo1 may alter cancer risks by influencing the repair activity of Exo1. Therefore, we hypothesized that single-nucleotide polymorphisms in Exo1 were associated with the risk of oral cancer. In this hospital-based study, the associations of Exo1 A-1419G (rs3754093), C-908G (rs10802996), A238G (rs1776177), C498T (rs1635517), K589E (rs1047840), G670E (rs1776148), C723R (rs1635498), L757P (rs9350) and C3114T (rs851797) polymorphisms with oral cancer risk in a central Taiwan population were investigated. In total, 680 patients with oral cancer and 680 age- and gender-matched healthy controls recruited from the China Medical University Hospital were genotyped. A significantly different distribution is found in the frequency of the Exo1 K589E genotype, but not the other genotypes, between the oral cancer and control groups. The A allele Exo1 K589E conferred a significant (P=6.18E-8) increased risk of oral cancer. Gene-environment interactions with smoking were significant for Exo1 K589E polymorphism (OR=2.509, 95% CI=1.914-3.287). Our results provide evidence that the A allele of the Exo1 K589E may be associated with the development of oral cancer.


Benign biopsies in the prevalent round of breast screening: a review of 137 cases.
In the first round of the National Health Service Breast Screening Programme, 35,533 women attended for screening at the two breast screening units served by St Bartholomew's Hospital. Further assessment was necessary in 2212 women (6.2%), of whom 412 (1%) subsequently underwent surgical biopsy. Of these 137 had benign lesions. The predominant mammographic abnormality leading to biopsy was microcalcification in 55, a mass in 48, parenchymal asymmetry in 18 and architectural distortion in 16. Histology revealed fibrocystic change in 66, fibroadenoma in 27, radial scar/complex sclerosing lesion in 23, atypical ductal hyperplasia only in eight, and a variety of unusual benign lesions in 13. In an attempt to determine criteria which would minimize unnecessary biopsy of benign lesions in future, the mammographic and cytological features of these benign lesions were reviewed and compared with the final histology. The most common diagnostic problems were clustered and variable microcalcification, the radial scar/complex sclerosing lesion, and mammographic features shown to be atypical hyperplasia on histology.


System 'optimises' theatre air quality.
Air-conditioning technology specialist, Weiss Klimatechnik, believes it has developed one of the world's first systems for continuous monitoring, and, where necessary, adjustment of laminar air flow quality and purity during, rather than prior to, surgical procedures, a technology it believes could substantially reduce rates of post-operative wound infection. Until now, explains Rupert Mack, general manager of the Mediclean business unit that will market the new Mediclean CPM technology globally, the air flow supplied by laminar flow systems is generally set once, during commissioning, and thereafter never changed; it is rare, he says, for air purity to be accurately monitored or adjusted during surgery, an anomaly Weiss Klimatechnik is determined to address.


Linezolid for the treatment of Nocardia spp. infections.
To review the available evidence regarding the use of linezolid for the treatment of Nocardia spp. infections. Data were identified through a search of MEDLINE (1966-May 2007), American Search Premier (1975-May 2007), International Pharmaceutical Abstracts (1960-2007), Science Citation Index Expanded (1996-2007), and Cochrane Databases (publications archived until May 2007) using the terms linezolid and Nocardia. Prospective and retrospective studies, case reports, case series, and in vitro studies were eligible for inclusion if they used linezolid for nocardiosis regardless of site of infection and outcome. We identified 11 published cases of linezolid use for Nocardia spp. infections. The predominant species isolated were N. asteroides (n = 4; 36%) and N. farcinica (n = 3; 27%). Nocardiosis with central nervous system involvement (n = 7; 64%) or disseminated disease (n = 4; 36%) were most common. The main reason for discontinuation of previous antimicrobials was most often related to adverse effects (n = 5; 45%), followed by clinical failure (n = 3; 27%). Linezolid was associated with cure or improvement in all cases (n = 11; 100%). However, the majority of patients developed serious complications that may have led to premature discontinuation of therapy with linezolid, including myelosuppression (n = 5; 45%) or possible/confirmed peripheral neuropathy (n = 2; 18%). The limited published data suggest that linezolid appears to be an effective alternative to trimethoprim/sulfamethoxazole for the treatment of nocardiosis. Unfortunately, the high cost and potentially serious long-term toxicities of linezolid appear to limit its use and relegate it to salvage therapy alone or in combination with other antimicrobials.


Pursley v. City of Fayetteville, Arkansas, 10 June 1987.
The plaintiff anti-abortion demonstrators challenged a city ordinance proscribing picketing a residence or dwelling place. The ordinance had been enacted after complaints of the neighbors of a physician whose home had been picketed. The Court held that the ordinance was over-broad and in violation of First Amendment free speech rights, since it dealt with picketing in a public area and did not distinguish between picketing in neighborhoods near commercial areas and purely residential neighborhoods.


Detection and Molecular Typing of Human Adenoviruses Associated with Respiratory Illnesses in Kerala.
Adenoviruses are responsible for approximately 5-10% of acute respiratory infections globally. However, there are a limited number of reports on the types of circulating respiratory human adenoviruses (HAdV) in India. We detected HAdV in the post-mortem specimens of a young child who died as a result of an acute febrile illness. To retrospectively investigate the circulating adenovirus types in the Alappuzha region, samples (n = 235) collected from patients with influenza-like illnesses who participated in the influenza surveillance program were screened for HAdV. Fourteen samples were identified as positive for adenovirus by PCR analysis. Adenovirus was isolated from 3 of the 14 PCR-positive samples cultured using HEK-293 cell lines. The viral strains isolated in the study were from children between 6 and 10 years of age. The isolates were identified as adenovirus species C and E. Sequencing analysis of the fiber gene and a BLAST search revealed that 2 of the isolates were type HAdV-C2, and the third isolate was a HAdV-E4. A fiber gene sequence-based phylogenetic tree showed that the HAdV-E4 isolate was similar to the Japanese HAdV-E4 strain, whereas the HAdV-C2 isolates formed a distinct cluster. Respiratory infections due to HAdV-E4 are generally observed in adults; this study is the first to demonstrate the involvement of the HAdV-E4 strain in respiratory illnesses in children.


Oral propranolol treatment in infants and children.
To determine the effectiveness of oral propranolol in children, we administered 0.5 to 4.0 mg/kg/day of the drug to 64 children (age one day to 20 years); 41 with cardiac dysrhythmias, six with isiopathic hypertrophic subaortic stenosis, and 17 with paroxysmal hypoxemic spells associated with right ventricular infundibular obstruction. A new liquid form of propranolol (10 mg/ml) was administered to 37 of the younger patients, and tablets were given to the other 27. Propranolol improved the dysrhythmia in 31 of 41 patients, being notably effective in supraventricular tachycardia and ventricular tachycardia associated with a prolonged QT interval. The drug also eliminated symptoms attributed to IHSS in six of six patients and abolished hypoxemic spells in 12 of 17. The liquid and tablets were equally effective; and the liquid had the advantage of allowing for accurate dose changes in younger children. We conclude that oral propranolol is an excellent drug for use in pediatric patients with certain types of cardiac disease.


Autophagy is involved in the acute lung injury induced by H9N2 influenza virus.
Influenza A virus usually leads to economic loss to breeding farms and pose a serious threat to human health. Virus infecting tissues directly and influenza virus-induced excessive production of inflammatory factors play the key role in pathogenesis of the disease, but the mechanism is not well clarified. Here, the role of autophagy was investigated in H9N2 influenza virus-triggered inflammation. The results showed that autophagy was induced by H9N2 virus in A549 cells and in mice. Inhibiting autophagy by an autophagy inhibitor (3-methyladenine, 3-MA) or knockdown of Atg5(autophagy-related gene) by Atg5 siRNA significantly suppressed H9N2 virus replication, H9N2 virus-triggered inflammatory cytokines and chemokines, including IL-1β, TNF-α, IL-8, and CCL5 in vitro and in vivo, and suppressed H9N2 virus-triggered acute lung injury as indicated as accumulative mortality of mice, inflammatory cellular infiltrate and interstitial edema, thickening of the alveolar walls in mice lung tissues, increased inflammatory cytokines and chemokines, increased W/D ratio in mice. Moreover, autophagy mediated inflammatory responses through Akt-mTOR, NF-κB and MAPKs signaling pathways. Our data showed that autophagy was essential in H9N2 influenza virus-triggered inflammatory responses, and autophagy could be target to treat influenza virus-caused lung inflammation.


FMRI of visual encoding: reproducibility of activation.
fMRI, a noninvasive technique to measure brain activation, is gaining clinical interest, because its sensitivity enables individual assessments. However, more insight in the reproducibility of these measurements during higher cognitive tasks is necessary. We performed an fMRI study involving within- and between-subject reproducibility during encoding of complex visual pictures. Ten healthy subjects were studied on three occasions: twice in the same scanning session (study 1 and 2), and a third time, 3-24 days later (study 3). On all 30 occasions but one, activation was found in areas expected on the basis of previous studies, including the fusiform and lingual gyri, occipital and parietal areas, the (para)hippocampal area, and the frontal inferior sulcus. The reproducibility of the number of activated voxels in the whole brain was 72% and 63% (respectively, studies 1 and 2, and 1 and 3). The reproducibility of anatomical identical pixels that supplement these results was 49% and 36%. These reproducibility measures increase about 5-15% when only areas of expected activation are included. The quantitative measurements indicate that there is substantial variation in the volume of activation. The recognition of pictures as tested afterward explains part of this variation between subjects. Our findings indicate that whereas consistent patterns of activation exist, more insight is needed into what determines the volume of activation, especially to assess cognitive alterations in patients over time.


The reliability of radiographic assessment of femoral neck-shaft and implant angulation in hip resurfacing arthroplasty.
Fifteen sets of patient radiographs were analyzed by 3 different observers on 2 occasions. Each observer measured the femoral neck-shaft angles (NSAs) of the preoperative digital radiographs and stem-shaft angles (SSAs) of the postoperative radiographs. The effect of femur position on SSA measured by digital radiographs was also investigated using a resurfaced synthetic femur. Radiographs were taken with the synthetic specimen positioned in 10 degrees increments of either flexion or rotation. Measurement by digital radiographs proved less than optimal in assessing preoperative NSA but was better in assessing the postoperative component SSA. External rotation of 30 degrees and flexion of 40 degrees resulted in a clinically significant disparity in SSA measurements. Patient malposition during radiographic imaging can contribute to erroneous NSA and SSA results.


Reappraisal of biomicroscopic classification of stages of development of a macular hole.
To update the biomicroscopic classification and anatomic interpretations of the stages of development of age-related macular hole and provide explanations for the remarkable recovery of visual acuity that occurs in some patients after vitreous surgery. Recent biomicroscopic observations of various stages of macular holes are used to postulate new anatomic explanations for these stages. Biomicroscopic observations include the following: (1) the change from a yellow spot (stage 1-A) to a yellow ring (stage 1-B) during the early stages of foveal detachment is unique to patients at risk of macular hole; (2) the prehole opacity with a small stage 2 hole may be larger than the hole diameter; and (3) the opacity resembling an operculum that accompanies macular holes is indistinguishable from a pseudo-operculum found in otherwise normal fellow eyes. The change from a yellow spot (stage 1-A) to a yellow ring (stage 1-B) is caused primarily by centrifugal displacement of retinal receptors after a dehiscence at the umbo. The hole may be hidden by semiopaque contracted prefoveolar vitreous cortex bridging the yellow ring (stage 1-B occult hole). Stage 1-B occult holes become manifest (stage 2 holes) either after early separation of the contracted prefoveolar vitreous cortex from the retina surrounding a small hole or as an eccentric can-opener-like tear in the contracted prefoveolar vitreous cortex, at the edge of larger stage 2 holes. Most prehole opacities probably contain no retinal receptors (pseudo-opercula). Surgical reattachment of the retina surrounding the hole and centripetal movement of the foveolar retina induced by gliosis may restore foveal anatomy and function to near normal.


Characterizing viral subtypes to assess patterns of HIV transmission.
We characterized HIV-1 subtypes among 204 persons newly diagnosed with HIV in Ontario from 2003 to 2005 using samples from the Canadian HIV Strain and Drug Resistance Surveillance Program. We examined HIV-1 subtype by demographic characteristics and exposure category, and determined independent predictors of infection with a non-B HIV subtype using multivariate logistic regression. The distribution of HIV subtypes was: B 77.0%, C 10.3%, AG 4.9%, A 2.5%, AE 2.5% and others 3.0%. Overall, 23.0% were non-B, greater in women than in men (62.8% versus 12.4%, P < 0.0001) and persons under 35 years (31.1% versus 18.5% in those ≥35, P = 0.04). Non-B subtype was predominant (78.9%) among persons from HIV-endemic regions and considerable (28.6%) among other persons infected heterosexually. In multivariate modelling adjusted for gender, non-B subtype was significantly associated with birth in an HIV-endemic region (adjusted odds ratio [aOR] 59.2, P < 0.0001) and heterosexual exposure (aOR 6.3, P = 0.02). Additionally, compared with men who had sex with men, non-B subtype was greater among heterosexual women (aOR 17.8, P < 0.001) and women who injected drugs (injection drug use, aOR 13.4, P = 0.01). We found a non-negligible proportion of non-B subtypes among women infected heterosexually not from HIV-endemic countries, providing interesting insights into HIV transmission patterns.


[SNP array analysis of three cases with partial 21q trisomy].
To analyze three cases with partial 21q trisomy, and correlate their genotypes with phenotypes. G-banding chromosomal analysis and single nucleotide polymorphism (SNP array) were performed for the three cases and their parents. SNP array has detected partial 21q trisomy in three cases and one mother, with variable size and location of the duplications. Case 1 harbored a 12.35 Mb duplication at 21q22.11q22.3, which spanned the Down syndrome critical region. Case 2 harbored a 35.32 Mb duplication at 9p24.3p13.3 and a 14.42 Mb duplication at 21q11.2q21.3, with the former spanning the partial 9p trisomy syndrome critical region excluding the Down syndrome critical region, and was inherited from his mother. Case 3 harbored a 4.17 Mb tetraploidy at 21q11.2q21.1 in the form of mosaicism, which spared the Down syndrome critical region. His mother carried a 4.17 Mb triploidy at 21q11.2q21.1, which was also a mosaicism. Partial 21q trisomy may occur in various forms and its clinical phenotypes are heterogeneous. Combined use of genetic techniques, particularly SNP array, is crucial for diagnosing partial 21q trisomy and delineating its genotype-phenotype correlation.


Novel Mechanism of Fatty Acid Sensing in Enteroendocrine Cells: Specific Structures in Oxo-Fatty Acids Produced by Gut Bacteria Are Responsible for CCK Secretion in STC-1 Cells via GPR40.
The secretion of gut hormones, such as cholecystokinin (CCK) is stimulated by fatty acids. Although a chain length-dependent mechanism has been proposed, other structural relationships to releasing activity remain unclear. We aimed to elucidate specific structures in fatty acids that are responsible for their CCK-releasing activity, and related sensing mechanisms in enteroendocrine cells. CCK secretory activities were examined in a murine CCK-producing cell line STC-1 by exposing the cells to various modified fatty acids produced by gut lactic acid bacteria. The effects of fatty acids on gastric emptying rate as a CCK-mediated function were examined using acetaminophen and phenol red methods in rats. Out of more than 30 octadecanoic-derived fatty acids tested, 5 oxo-fatty acids potently stimulated CCK secretion without cytotoxic effects in STC-1 cells. Three fatty acids had a distinct specific structure containing one double bond, whereas the other two had two double bonds, nearby an oxo residue. CCK secretion induced by representative fatty acids (10-oxo-trans-11-18:1 and 13-oxo-cis-9,cis-15-18:2) was attenuated by a fatty acid receptor G-protein coupled receptor 40 antagonist. Oral administration of 13-oxo-cis-9,cis-15-18:2 lowered the gastric emptying rate in rats in a dose- and structure-dependent manner. These results reveal a novel fatty acid-sensing mechanism in enteroendocrine cells.


Wrist Deformity in Children and Adolescents with b-thalassemia on Oral Iron Chelation Therapy.
To describe a novel wrist deformity in b-thalassemia major patients, and their radiographic and magnetic resonance imaging findings. 30 patients with b-thalassemia major who were noticed to have ulnar deviation at wrist joint were evaluated for previous history of medications, serum ferritin levels, presence of pain and swelling at the wrist joint, and the duration of iron chelation therapy. Radiographs of wrist and limited magnetic resonance imaging (MRI) sequences were obtained in 30 and 15 patients, respectively. Radiographs revealed varying severity of distal ulnar shortening, distal radial slanting and presence of soft tissue distal to the ulna. MRI showed similar deformities along with abnormal marrow signal at distal ulnar ends; in 8 patients, a soft tissue distal to the distal end of ulna was noted. Varying severity of radiological abnormalities, predominantly affecting the distal ulna, are present in children and adolescents with b-thalassemia receiving oral chelation therapy.


PRIME: automatically extracted PRotein Interactions and Molecular Information databasE.
With the exponentially increasing amount of information in the biomedical field, the significance of advanced information retrieval and information extraction, as well as the role of databases, has been increasing. PRIME is an integrated gene/protein informatics database based on natural language processing. It provides automatically extracted protein/family/gene/compound interaction information including both physical and genetic interactions, gene ontology based functions, and graphic pathway viewers. Gene/protein/family names and functional terms are recognized based on dictionaries developed in our laboratory. The interaction and functional information are extracted by syntactic dependencies and various phrase patterns. We have included about 920,000 (non-redundant) protein interactions and 360,000 annotated gene-function relationships for major eukaryotes. By combining the sequence and text information, the pathway comparison between two organisms and simple pathway deduction based on other organism interaction data, and pathway filtering using tissue expression data, are also available. This database is accessible at http://prime.ontology.ims.u-tokyo.ac.jp:8081.


Active X based standards for healthcare integration.
With cost pressures brought to the forefront by the growth of managed care, the integration of healthcare information systems is more important than ever. Providers of healthcare information are under increasing pressure to provide timely information to end users in a cost effective manner. Organizations have had to decide between the strong functionality that a multi-vendor 'best of breed' architecture provides and the strong integration provided by a single-vendor solution. As connectivity between systems increased, these interfaces were migrated to work across serial and eventually, network, connections. In addition, the content of the information became standardized through efforts like HL7 and ANSI X12 and Edifact. Although content-based standards go a long way towards facilitating interoperability, there is also quite a bit of work required to connect two systems even when they both adhere to the standard. A key to accomplishing this goal is increasing the connectivity between disparate systems in the healthcare environment. Microsoft is working with healthcare organizations and independent software vendors to bring Microsoft's powerful enterprise object technology, ActiveX, to the healthcare industry. Whilst object orientation has been heralded as the 'next big thing' in computer applications development, Microsoft believe that, in fact, component software is the technology which will provide the greatest benefit to end users.


In vitro and in vivo antimicrobial efficacy of natural plant-derived compounds against Vibrio cholerae of O1 El Tor Inaba serotype.
In this study, we investigated antibacterial activities of 20 plant-derived natural compounds against Gram-negative enteric pathogens. We found that both flavonoids and non-flavonoids, including honokiol and magnolol, possess specific antibacterial activities against V. cholerae, but not against other species of Gram-negative bacterium which we tested. Using various antibacterial assays, we determined that there was a dose-dependent bactericidal and biofilm inhibitory activity of honokiol and magnolol against Vibrio cholerae. In addition to antibacterial activities, these molecules also induced an attenuating effect on reactive oxygen species (ROS) production and pro-inflammatory responses generated by macrophages in response to lipopolysaccharides (LPS). Additionally, Caenorhabditis elegans lethality assay revealed that honokiol and magnolol have an ability to extend a lifespan of V. cholerae-infected worms, contributing to prolonged survival of worms after lethal infection. Altogether, our data show for the first time that honokiol and magnolol may be considered as attractive protective or preventive food adjuncts for cholera.


Emergency Medical Service (EMS) Utilization by Syrian Refugees Residing in Ankara, Turkey.
Introduction Many Syrians have left their country and migrated to other countries since March 2011, due to the civil war. As of March 2016, a total of 2,747,946 Syrian refugees had immigrated to Turkey. Some Syrian refugees have been living in camps, while 2,475,134 have been living in metropolitan areas, such as Ankara. Study Objective This study investigated Emergency Medical Service (EMS) utilization among Syrian refugees residing in Ankara. This study was a descriptive, cross-sectional database analysis using data obtained from the Department of EMS of the Ankara Provincial Health Directorate. Five stations in the Altındağ region of Ankara responded to 42% of all calls from Syrian refugees. Prehospital EMS in Ankara have been used mostly by Syrian refugees younger than 18-years-old. Study findings also suggest that medical staff in regions where Syrian refugees are likely to be treated should be supported and provided with the ability to overcome language barriers and cultural differences. Altıner AO , Tekeli Yeşil S . Emergency Medical Service (EMS) utilization by Syrian refugees residing in Ankara, Turkey. Prehosp Disaster Med. 2018;33(2):160-164.


[Comparison of power generation in microbial fuel cells of two different structures].
Low electricity productivity and high cost are two problems facing the development of microbial fuel cell (MFC). Comparative studies on electricity generation in MFCs of different designs while under the same conditions are important in enhancing the power output. Single-chamber MFC and dual-chamber MFC were constructed and acetate was used as the fuel. Power outputs in these MFC were compared side by side with a resistance of 1,000 Omega connected to each. Experimental results showed that the electricity was generated continuously and steadily in the MFCs. The average maximum output voltages obtained by the single-chamber and dual-chamber MFCs were 600 and 650 mV, respectively. The electric cycles were operated for 110 and 90 h for the single-chamber and dual-chamber MFCs, respectively. From the single-chamber and dual-chamber MFCs, the maximum area power densities were 113.8 and 382.4 mW/m2 respectively, and the maximum volumetric power densities were 1.3 and 2.2 mW/m3 respectively. The internal resistances of single-chamber and dual-chamber MFC were 188 and 348 Omega, respectively. Results indicated that the dual-chamber MFC had a better performance than the single-chamber MFC. The effective area of anode and the proton exchange membrane had a significant effect on the performance of MFCs.


State estimation for static neural networks with time-varying delay.
This paper is concerned with the state estimation problem for a class of static neural networks with time-varying delay. Here the time derivative of the time-varying delay is no longer required to be smaller than one. A delay partition approach is proposed to derive a delay-dependent condition under which the resulting error system is globally asymptotically stable. The design of a desired state estimator for such kinds of delayed neural networks can be accomplished by means of solving a linear matrix inequality. A simulation example is finally given to show the application of the developed approach.


Induction and evaluation of proliferative gill disease in channel catfish fingerlings.
Proliferative gill disease (PGD) was first reported in channel catfish Ictalurus punctatus at commercial farms in 1981 and is caused by the myxozoan parasite Henneguya ictaluri. The disease affects the gills and is characterized by severe branchial inflammation, epithelial hyperplasia, lamellar fusion, and lysis of chondrocytes. Presumptive diagnosis is based on the presence of lytic areas in the cartilage of the primary lamellae on microscopic examination and is confirmed histologically by the presence of the organism. In these trials, PGD was induced by exposing channel catfish fingerlings to fresh or aged infectious water collected from a pond containing fish diagnosed with severe PGD. The severity of disease was graded by histological scoring and microscopic examination of wet mounts to determine the percentage of gill filaments containing chondrolytic lesions. Exposure of fish to infectious pond water was shown to produce pathological lesions consistent with PGD, and the percentage of gill filaments containing chondrolytic lesions was positively correlated with histological scoring of gill pathology. The number of trophozoite stages in the gills was shown to increase with the severity of the disease. In most cases, however, parasitic cells were not observed in tissue samples with chondrolytic lesions during the early stages of infection. These observations indicate that pathology and lysis of chondrocytes can occur prior to detection of the organism by histopathology. Exposing fish to infectious pond water that was aged for 1 d produced negligible gill pathology and implies that the infectivity of the H. ictaluri actinospore stage is short lived. Removing fish from the source of infection promoted repair of damaged gill tissue; within 14 d of fish transfer to clean water, gill pathology associated with the acute infection was negligible.


Growth-associated traits in parental and F1 populations of chickens under different feeding programs. 2. Ad libitum and intermittent feeding.
Growth traits and digestive enzyme activities were compared in parental lines and F1 crosses under ad libitum and alternate-day feeding. Responses to the feeding regimens were, in general, dependent on the background genome and age. Population by feeding regimen interactions were more prevalent for growth traits than for enzymatic activities. Although chickens adapted morphologically and physiologically to the particular feeding regimen to which they were exposed, the degree of adaptation was population dependent. Moreover, a line of White Leghorns differed considerably in response compared to a line of White Rocks selected for low body weight, demonstrating that weight is primarily a result of metabolic and behavioral processes rather than the determiner of those processes.


Type A and B neurotoxin genes in a Clostridium botulinum type AB strain.
The genetic structure of neurotoxin genes in a Clostridium botulinum strain producing both type A and B neurotoxins (type AB) was investigated. Analyses by polymerase chain reaction (PCR) using type-specific primers corresponding to the coding regions for N-terminals of light-chains and C-terminals of heavy-chains of type A and type B neurotoxins, and Southern hybridization of total DNA showed that the type AB strain I.P.7212 carries at least one copy each of type A and B neurotoxin genes. Partial nucleotide sequences obtained by direct sequencing of the PCR products indicate that the type A and B genes carried by this strain are not classical type A and non-proteolytic type B genes, but are similar to the type A gene present in a strain which had caused infant botulism in Kyoto and the type B gene present in a proteolytic type B strain.


Immunohistochemical localization of galectin-3 in the reproductive organs of the cow.
The protein levels and immunohistochemical localization of galectin-3, which is a beta-galactoside-binding protein, were studied in the cow reproductive organs. Using Western blot analysis, galectin-3 was detected at low levels in the ovary and oviduct, at moderate levels in the uterus, and at high levels in the cervix. Using immunohistochemistry, galectin-3 was immunolocalized in macrophages in the interstitium, in cells in the atretic follicles, and in luteal cells in the regressing corpus luteum, but not in the growing follicles in the ovary. In the oviduct, galectin-3 was detected in some macrophages in the lamina propria, submucosa and muscle layers, as well as in some cells in the covering epithelium. In the uterus, galectin-3 was immunolocalized in some epithelial cells and in some macrophages in the submucosa, but not in the endometrial glands at the non-pregnant stage. In the cervix, galectin-3 was immunolocalized in many mucus-secreting cells in the mucosa and in a few macrophages in the submucosa and muscle layers. Based on its localization, we postulate that galectin-3 in the covering epithelium is involved in the mucosal defense system, and that galectin-3-positive macrophages in all tissues are involved in either cell survival or death. In addition, galectin-3 plays an important role in the regression of follicles and the corpus luteum.


Chaos theory and schizophrenia: elementary aspects.
Elementary aspects of the usefulness and impact of chaos theory to an understanding of schizophrenia are discussed. In addressing the question 'Is there chaos in schizophrenia?', attention is limited to schizophrenic psychosis. A differentiated view of chaos as metaphor, analogy and mathematical/physical concept is presented with emphasis upon how the latter may apply to empirical knowledge of schizophrenic psychosis. The typical behavior of both psychotic schizophrenic patients and general chaotic systems, and the dynamical analysis of time-series data extracted from such systems, are reviewed. A general hypothesis connecting chaos and schizophrenia is introduced and analyzed. Arguments are provided in favor of the hypothesis at sociological, psychological, and biological scales of manifestation. This makes possible a model-independent 'chaos theory approach' to schizophrenia and the criteria necessary to test it. Some consequences of this approach are briefly considered. The original question is rephrased with the technical language of chaos theory: 'Are chaotic attractors diagnostic markers for schizophrenia?' or 'Is schizophrenia a dynamical disease?'. A few implications of viewing schizophrenia as a dynamical disease are discussed.


Patterns of chemotherapy, toxicity, and short-term outcomes for older women receiving adjuvant trastuzumab-based therapy.
Limited data are available regarding patterns of chemotherapy receipt and treatment-related toxicities for older women receiving adjuvant trastuzumab-based therapy. We used surveillance, epidemiology and end results (SEER)-Medicare data to identify patients ≥66 years with stage I-III breast cancer treated during 2005-2009, who received trastuzumab-based therapy. We examined patterns of chemotherapy receipt, and using multivariable logistic regression, we examined associations of age and comorbidity with non-standard chemotherapy. In propensity-weighted cohorts of women receiving standard and non-standard trastuzumab-based therapy, we also examined rates of (1) hospital events during the first 6 months of chemotherapy and (2) short-term survival. Among 2,106 women, 29.7 % were aged ≥76 and 66 % had a comorbidity score = 0. Overall, 31.3 % of women received non-standard chemotherapy. Compared to patients aged 66-70, older patients more often received non-standard chemotherapy [adjusted odds ratio (OR) = 4.1, 95 % confidence interval (CI) = 3.40-4.92 (ages 76-80); OR = 15.3, 95 %CI = 9.92-23.67 (age ≥ 80)]. However, comorbidity was not associated with receipt of non-standard chemotherapy. After propensity score adjustment, hospitalizations were more frequent in the standard (vs. non-standard) group (adjusted OR = 1.7, 95 % CI = 1.29-2.24). With a median follow-up of 2.8 years, 276 deaths occurred; the adjusted hazard ratio (HR) for death was lower in standard versus non-standard treated women (HR = 0.69, 95 % CI = 0.52-0.91). Among a population-based cohort of older women receiving trastuzumab, nearly one-third received non-standard chemotherapy, with the highest rates among the oldest women. Non-standard chemotherapy was associated with fewer toxicity-related hospitalizations but worse survival. Further exploration of treatment toxicities and outcomes for older women with HER2-positive breast cancer is warranted.


Eukaryotic translation initiation factor 5A induces apoptosis in colon cancer cells and associates with the nucleus in response to tumour necrosis factor alpha signalling.
Eukaryotic translation initiation factor 5A (eIF5A) is thought to function as a nucleocytoplasmic shuttle protein. There are reports of its involvement in cell proliferation, and more recently it has also been implicated in the regulation of apoptosis. In the present study, we examined the effects of eIF5A over-expression on apoptosis and of siRNA-mediated suppression of eIF5A on expression of the tumour suppressor protein, p53. Over-expression of either eIF5A or a mutant of eIF5A incapable of being hypusinated was found to induce apoptosis in colon carcinoma cells. Our results also indicate that eIF5A is required for expression of p53 following the induction of apoptosis by treatment with Actinomycin D. Depiction of eIF5A localization by indirect immunofluorescence has indicated, for the first time, that the protein is rapidly translocated from the cytoplasm to the nucleus by death receptor activation or following treatment with Actinomycin D. These findings collectively indicate that unhypusinated eIF5A may have pro-apoptotic functions and that eIF5A is rapidly translocated to the nucleus following the induction of apoptotic cell death.


Identification of a calmodulin-binding NAC protein as a transcriptional repressor in Arabidopsis.
Calmodulin (CaM), a ubiquitous calcium-binding protein, regulates diverse cellular functions by modulating the activity of a variety of proteins. However, little is known about how CaM directly regulates transcription. Screening of an Arabidopsis cDNA expression library using horseradish peroxidase-conjugated calmodulin as a probe identified a calmodulin-binding NAC protein (CBNAC). Using gel overlay assays, a Ca2+-dependent CaM-binding domain was identified in the C terminus of this protein. Specific binding of CaM to CaM-binding domain was corroborated by site-directed mutagenesis and a split-ubiquitin assay. Using a PCR-mediated random binding site selection method, we identified a DNA-binding sequence (CBNACBS) for CBNAC, which consisted of a GCTT core sequence flanked on both sides by other frequently repeating sequences (TTGCTTANNNNNNAAG). CBNAC was able to bind to CBNACBS, which resulted in the repression of transcription in Arabidopsis protoplasts. Interestingly, the transcriptional repression mediated by CBNAC was enhanced by CaM. These results suggest that CBNAC may be a CaM-regulated transcriptional repressor in Arabidopsis.


Bone Adaptation Induced by Non-Passively Fitting Implant Superstructures: A Randomized Clinical Trial.
Passive fit of implant-supported restorations is difficult to achieve. The aim of this randomized clinical trial was to test the null hypotheses that a reduction in misfit strain does not occur over time, regardless of the initial strain level, and that changes in prosthesis-induced bone strain do not differ between restorations with two different levels of fit. Twenty edentulous sites were restored with screw-retained fixed restorations on two implants either cast in one piece (misfit) or assembled by an intraoral bonding procedure (fit). The restorations had a bar-shaped pontic onto which a strain-gauged metal plate could be fixed. Repeated strain gauge measurements on patient-specific in vitro resin models and on the implants intraorally were performed every 4 weeks for a period of 6 months. Statistical analysis was based on Kruskal-Wallis tests, t tests, Welch two-sample t test (α = .05), and linear regression analysis. No reduction in misfit strain could be observed in vitro, indicating that alterations in prosthetic fit had not occurred in any restoration (Kruskal-Wallis; P > .05). Initial strain levels varied widely and differed significantly between fit and misfit restorations (t test; P = .0032). Regrouping the restorations with respect to a threshold strain level of 100 μm/m resulted in 10 fit and 9 misfit restorations; 1 restoration had to be excluded from analysis due to a malfunctioning strain gauge. Seven fit restorations and five misfit restorations showed strain reduction in vivo based on linear regression, while percentage strain reduction did not differ between groups (Welch two-sample t test; P = .8186). Within the limitations of this randomized clinical trial characterized by an observation period of 6 months and only healthy subjects being enrolled, bone adaptation around statically and dynamically loaded implants occurred, causing a decrease in misfit strain evoked by non-passively fitting prostheses. For maintaining osseointegration of dental implants, passivity of fit of multiunit restorations seems not to be as critical as previously thought.


The non-display of authentic distress: public-private dualism in young people's discursive construction of self-harm.
This article draws from focus groups and interviews investigating how young people talk about self-harm. Some of the research participants had personal experience of self-harm but this was not a prerequisite for their inclusion in the study. Thematic coding was used initially to organise and give an overview of the data, but the data were subsequently analysed using a discourse analytic approach. The article focuses on the young people's constructions of deliberate self-harm such as 'cutting'. Throughout the focus groups and interviews, a dichotomy was set up by the young people between authentic, private self-harm which is rooted in real distress (and warrants a sympathetic response) and public, self-indulgent attempts to seek attention. This dualistic construction is discussed in some detail and located in various socio-cultural contexts. It is argued that the dualism illustrates contemporary ambivalence about mental health and youth.


Data acquisition schemes for continuous two-particle time-of-flight coincidence experiments.
Three data acquisition schemes for two-particle coincidence experiments with a continuous source are discussed. The single-start/single-stop technique, implemented with a time-to-pulse-height converter, results in a complicated spectrum and breaks down severely at high count rates. The single-start/multiple-stop setup, based on a time-to-digital converter and the first choice in today's similar coincidence experiments, performs significantly better at high count rates, but its performance is still hampered if the time-of-flight range is large, and the false coincidence background is variable if the event frequency and the collection efficiency of the starts are both high. A straightforward, multistart/multistop setup is proposed for coincidence experiments. By collecting all detector data, it ensures the highest signal-to-noise ratio, constant background, and fast data acquisition and can now be easily constructed with commercially available time-to-digital converters. Analytical and numerically evaluated formulas are derived to characterize the performance of each setup in a variety of environments. Computer simulated spectra are presented to illustrate the analytically predicted features of the various raw time-of-flight distributions obtained with each technique.


Microbial Metabolite Signaling Is Required for Systemic Iron Homeostasis.
Iron is a central micronutrient needed by all living organisms. Competition for iron in the intestinal tract is essential for the maintenance of indigenous microbial populations and for host health. How symbiotic relationships between hosts and native microbes persist during times of iron limitation is unclear. Here, we demonstrate that indigenous bacteria possess an iron-dependent mechanism that inhibits host iron transport and storage. Using a high-throughput screen of microbial metabolites, we found that gut microbiota produce metabolites that suppress hypoxia-inducible factor 2α (HIF-2α) a master transcription factor of intestinal iron absorption and increase the iron-storage protein ferritin, resulting in decreased intestinal iron absorption by the host. We identified 1,3-diaminopropane (DAP) and reuterin as inhibitors of HIF-2α via inhibition of heterodimerization. DAP and reuterin effectively ameliorated systemic iron overload. This work provides evidence of intestine-microbiota metabolic crosstalk that is essential for systemic iron homeostasis.


Discovery of α7-nicotinic receptor ligands by virtual screening of the chemical universe database GDB-13.
The chemical universe database GDB-13 enumerates 977 million organic molecules up to 13 atoms of C, N, O, Cl, and S that are virtually possible following simple rules for chemical stability and synthetic feasibility. Analogs of nicotine were identified in GDB-13 using the city-block distance in MQN-space (CBD(MQN)) as a similarity measure, combined with a restriction eliminating problematic structural elements. The search was carried out with a Web browser available at www.gdb.unibe.ch . This virtual screening procedure selected 31 504 analogs of nicotine from GDB-13, from which 48 were known nicotinic ligands reported in Chembl. An additional 60 virtual screening hits were purchased and tested for modulation of the acetylcholine signal at the human α7 nAChR expressed in Xenopus oocytes, which led to the identification of three previously unknown inhibitors. These experiments demonstrate for the first time the use of GDB-13 for ligand discovery.


Local biometric features and visual prognosis after surgery for treatment of myopic foveoschisis.
To identify the local biometric factors associated with postoperative best-corrected visual acuity (BCVA) after surgical treatment of myopic foveoschisis by using spectral-domain optical coherence tomography. Eleven eyes of 10 patients that underwent vitrectomy combined with internal limiting membrane peeling for treatment of myopic foveoschisis were investigated. We measured the height and lateral width of the foveal detachment, subfoveal choroidal thickness, and height of the posterior staphyloma using spectral-domain optical coherence tomography. Foveal detachments found in 8 eyes were not significantly related to postoperative BCVA. Intraclass correlation coefficients of spectral-domain optical coherence tomography measurements were substantial to nearly perfect (0.786-0.951). The postoperative BCVA 12 months after surgery was significantly correlated with age (r(s) = 0.616, P = 0.044), preoperative BCVA (r(s) = 0.833, P = 0.001), preoperative subfoveal choroidal thickness (r(s) = -0.661, P = 0.027), and posterior staphyloma height (r(s) = 0.642, P = 0.033). Neither postoperative BCVA nor changes in BCVA showed significant correlations with the axial length or height or lateral width of the foveal detachment. These results at least raise the possibility that a thin choroid and likely severe posterior staphyloma before surgery can predict postoperative BCVA after vitrectomy for the treatment of myopic foveoschisis.


Social learning strategies in networked groups.
When making decisions, humans can observe many kinds of information about others' activities, but their effects on performance are not well understood. We investigated social learning strategies using a simple problem-solving task in which participants search a complex space, and each can view and imitate others' solutions. Results showed that participants combined multiple sources of information to guide learning, including payoffs of peers' solutions, popularity of solution elements among peers, similarity of peers' solutions to their own, and relative payoffs from individual exploration. Furthermore, performance was positively associated with imitation rates at both the individual and group levels. When peers' payoffs were hidden, popularity and similarity biases reversed, participants searched more broadly and randomly, and both quality and equity of exploration suffered. We conclude that when peers' solutions can be effectively compared, imitation does not simply permit scrounging, but it can also facilitate propagation of good solutions for further cumulative exploration.


Molecular mechanisms of G protein-coupled receptor desensitization and resensitization.
Beta-arrestin proteins play a dual role in regulating G protein-coupled receptor (GPCR) responsiveness by contributing to both receptor desensitization and internalization. Recently, beta-arrestins were also shown to be critical determinants for beta2-adrenergic receptor (beta2AR) resensitization. This was demonstrated by overexpressing wild-type beta-arrestins to rescue the resensitization-defect of a beta2AR (Y326A) mutant (gain of function) and overexpressing a dominant-negative beta-arrestin inhibitor of beta2AR sequestration to impair beta2AR dephosphorylation and resensitization (loss of function). Moreover, the ability of the beta2AR to resensitize in different cell types was shown to be dependent upon beta-arrestin expression levels. To further study the mechanisms underlying beta-arrestin function, green fluorescent protein was coupled to beta-arrestin2 (beta arr2GFP), thus allowing the real-time visualization of the agonist-dependent trafficking of beta-arrestin in living cells. Beta arr2GFP translocation from the cytoplasm to the plasma membrane proceeded with a time course, sensitivity and specificity that was indistinguishable from the most sensitive second messenger readout systems. Beta arr2GFP translocation was GRK-dependent and was demonstrated for 16 different ligand-activated GPCRs. Because beta-arrestin binding is a common divergent step in GPCR signalling, this assay represents a universal methodology for screening orphan receptors, GRK inhibitors and novel GPCR ligands. Moreover, beta arr2GFP provides a valuable new tool to dissect the biological function and regulation of beta-arrestin proteins.


[Functions of late embryogenesis abundant proteins in desiccation-tolerance of organisms: a review].
Late embryogenesis abundant (LEA) proteins are well associated with the desiccation tolerance in organisms. LEA proteins are categorized into at least seven groups by virtue of similarities in their deduced amino acid sequences. Most of the LEA proteins have the characteristics of high hydrophilicity and thermo-stability. The LEA proteins are in unstructured conformation in aqueous solution. However, they adopted amphiphilic alpha-helix structure during desiccation condition. LEA proteins are localized to the different organelles in the cells, i.e. cytoplasm, endoplasmic reticulum, mitochondria and nucleus. The multi-functional capacity of LEA proteins are suggested, as protein stabilization, protection of enzyme activity, membrane association and stabilization, antioxidant function, metal-ion binding or DNA protection, etc. Here, we review the structural and functional characteristics of LEA proteins to provide a reference platform to understand their protective mechanisms during the adaptive response to desiccation in organisms.


Ventricular tachycardia induced by slow ventricular pacing.
Two patients are described, in whom ventricular pacing at physiological rates (72 to 75 beats/min) repeatedly induced ventricular tachycardia (VT). In the first patient, pacing was required because of complete atrioventricular block following an inferior and right ventricular (RV) myocardial infarction. VT developed during RV posterobasal pacing, but not during RV outflow tract pacing at similar rates. The second patient had a postinfarction left ventricular aneurysm and was paced because of amiodarone-induced sinus node dysfunction. VT developed when the rate of ventricular pacing was similar to that of the sinus rate. We conclude that in patients whom VT is induced at physiological rates of pacing, the following factors may be involved in the triggering of VT: the rate of pacing, the site of ventricular stimulation; and the administration of antiarrhythmic drugs. Early recognition of these factors, which may facilitate reentry by aggravating previously existing intraventricular conduction disturbances, is imperative for the effective management of the arrhythmia.


Classification of melanoma in adults and children.
After a brief history of the classification of melanoma in adults, this chapter describes the major features of the classic histogenetic types as well as of uncommon variants. Particular attention is paid to the meaning of controversial terms such as "minimal deviation" and "borderline." Specific problems associated with the classification of melanoma in children are also addressed, along with interpretation of atypical lesions resembling Spitz nevi.


Practical stereoselective synthesis of beta-branched alpha-amino acids through efficient kinetic resolution in the phase-transfer-catalyzed asymmetric alkylations.
Phase-transfer-catalyzed alkylation of glycinate Schiff base with racemic secondary alkyl halides proceeded with excellent levels of syn- and enantioselectivities under the influence of chiral quaternary ammonium bromide 1d and 18-crown-6. The alkylation product can be selectively converted to the corresponding anti isomer, allowing the preparation of all the stereoisomers of beta-alkyl-alpha-amino acid derivatives, an extremely valuable chiral building block.


Assaying PTEN catalysis in vitro.
PTEN is a major tumour suppressor protein and a regulator of numerous diverse biological processes. It has an evolutionarily conserved role as a phosphoinositide lipid phosphatase, regulating the PI3K signalling pathway, but also has catalytic phosphatase activity against protein substrates, although the significance of this latter activity is less well understood. Unlike many tumour suppressors, even modest changes in PTEN activity can have strong effects on phenotypes, including tumour formation. Due to this recognised functional significance, several experimental platforms have been developed to assay the catalytic activity of PTEN against different substrates and are being applied to understand this cellular substrate diversity and the regulation of PTEN. Here we present and discuss methods to assay the phosphatase activity of PTEN in vitro.


Parametric relationships of individual digit movements to neuronal discharges in primate magnocellular red nucleus.
Single units were recorded in the magnocellular red nucleus (RNm) while digit movements were monitored in a monkey performing on an individual digit device. The monkey was trained to press switches for water reward while optical systems of infrared emitters and diodes were taped to thumb, index, middle and ring digits for monitoring movements. Of 53 neurons recorded while operating the individual digit device, 9 showed statistically significant parametric relationships with movement velocity and duration. Onset of activity preceded movement by an average of 90 +/- 26 ms. This result suggests that a small group of neurons in the forelimb area of RNm in the monkey is parametrically related to individual digit movements, even though the majority of neurons are related to grouped movements of the hand and digits as previously reported.


Effect of temperature upon the circular dichroism of bradykinin.
Analysis of the effect of temperature on the circular dichroism spectrum of bradykinin has led to a more precise understanding of the solution conformation of the peptide. Circular dichroism and 13C n.m.r. have been used in a complementary fashion to support the picture that bradykinin spends a maximum of about 20% of its time in a partially ordered conformation featuring a gamma-turn with Pro7 as the second residue. Since the gamma-turn probability is insensitive to temperature, some other conformational effect dominated by the structure of water presumably produces the pronounced change in the circular dichroism spectrum with increasing temperature.