[Intracranial artery occlusive diseases in patients with hypertension and diabetes mellitus].
To investigate risk effects of hypertension (HT) and diabetes mellitus (DM) to intracranial artery occlusive lesions. 845 patients (South group) visiting the First Affiliated Hospital of Zhejiang University, and 2325 patients (North group) visiting the Peking Union Medical College Hospital were assessed respeitively. All the patients underwent transcranial Doppler detection to discover intracranial occlusive artery lesions. Age, sex, hypertension (HT) and diabetes mellitus (DM) were included in the analysis. Among the patients > or = 50 years old, the frequencies of middle cerebral artery(MCA) occlusive diseases were: 6.96%, 11.43%, 20.59% and 1.75% in South; 6.24%, 11.18%, 13.51% and 1.95% in North, when suffering from HT, DM, both of HT and DM(MIX), or neither of them(Nor). The risk ratios of HT, DM, MIX were: 4.0, 6.5 and 11.8 in South; 3.2, 5.7 and 6.9 in North; and 2.9, 16.9 and 37.3 when combining South and North. There were no statistical differences of frequencies of MCA occlusive lesions under HT, DM and MIX between the South and North. Multi-variable logistic regression analysis showed that HT and DM were significant and independent predictors for MCA occlusive lesion. The details of other cerebral arteries were canceled here. Hypertension and diabetes mellitus may contribute to the development of occlusive lesions of the cerebral arteries in Chinese people.


The amount of mobilizable stem cells in perturbed hemopoiesis.
The level of mobilizable 9-day colony-forming units (CFU-s), which represents a constant fraction of the normal mouse bone marrow CFU-s pool, was assayed in BDF1 mice with perturbed hemopoiesis (i.e., during increased turnover of CFU-s or increased CFU-s traffic after irradiation). After low-level irradiation, regeneration of the mobilizable CFU-s fraction was significantly slower than that of bone marrow CFU-s. Depletion of the mobilizable CFU-s pool was observed if a permanently increased outflow of CFU-s from the bone marrow was induced by endotoxin injection. After 40% withdrawal of the blood volume, the mobilizable CFU-s pool expanded marginally. Assuming that the level of mobilizable CFU-s is a consequence of production and outflow from the bone marrow compartment, changes in the pool size of mobilizable CFU-s may be a sensitive indicator of balanced or unbalanced hemopoiesis.


Community knowledge on HIV/AIDS and its relationship with sexual practices in Tabora and Igunga Districts, Western Tanzania.
HIV/AIDS represents one of the critical challenges to human development in sub Saharan Africa. This study was carried out to assess the knowledge of HIV/AIDS and its relationship with sexual practices among communities in Tabora and Igunga Districts in western Tanzania. The study employed both qualitative and quantitative methods, which included interviews and group discussions. A total of 568 participants (female = 49%; males = 51%) were involved in the study. Two hundred and eighty-four of the respondents were adults (> 25 years) and 284 were youths of 12 - 25 years. The results showed although the knowledge of the disease and its prevention was high (90%) among the community, some gaps regarding the knowledge on modes of transmission were observed. About 17.2% of the respondents reported to have multiple sexual partners and only about half of the respondents reported the use of condoms. The level of education correlated significantly with the individual knowledge on HIV/AIDS (P = 0.003). There was no significant difference between urban and rural communities on their knowledge on HIV/AIDS (P > 0.05). Health education on HIV/AIDS prevention needs to be strengthened and improved to include cognitive behavioural interventions that emphasize attitude changes, negotiation skills and decision-making skills that could be effective in changing and maintaining safe sexual behaviour.


Complete genotyping of mucosal human papillomavirus using a restriction fragment length polymorphism analysis and an original typing algorithm.
Due to the differences in the oncogenic activity of human papillomaviruses (HPV), it is clinically important to accurately identify HPV types in a simple and time effective manner. We aimed at developing a straightforward and cost-effective assay to individually identify all mucosal HPVs, based on the amplification of L1 gene using MY09/11 primers, and subsequent restriction fragment length polymorphism (RFLP) analysis. We made use of bioinformatic tools to analyze all published DNA sequences of 49 mucosal HPV types for PstI, HaeIII, DdeI and RsaI restriction sites. Based on the RFLP patterns, we have designed an original genotyping algorithm. Each HPV type presented a distinct RFLP pattern, which was visually distinguishable on polyacrylamide gels. A set of 27 pre-selected patient samples of known HPV types was confirmed positive for the same HPV type using this RFLP assay. Furthermore, in a random and blind HPV typing experiment performed in 30 untyped clinical samples, RFLP data consistently matched DNA sequencing results. Our polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method, using 4 restriction enzymes (PstI, HaeIII, DdeI, RsaI) and an original genotyping algorithm, allows discrimination of all individual mucosal HPV types in single infections, and even detection of multiple infections. This assay gives complementary information to commercially available methods, and may also be financially advantageous, particularly when financial resources are scarce.


Outcomes of compulsorily admitted schizophrenia patients who agreed or disagreed to prolong their hospitalization.
Compulsory admission is practiced around the world with legislative variations. The legal status during compulsory hospitalization might be changed to consent or the patient might be discharged against medical advice (AMA), if he no longer poses a risk. In the present study, we investigated the outcome of compulsory admitted patients who left the hospital after commitment period despite request by the treating psychiatrist to remain in the hospital (AMA) vs those who agreed to prolong their hospitalization. Of 320 patients with schizophrenia admitted involuntarily, 157 (49%) were discharged without converting to consent, and 163 (51%) agreed to stay in the hospital. There was no difference in baseline clinical and demographic characteristics and outcome measures (rate of readmission, legal status of next admission, and length of stay in the next admission) between the 2 groups. Prolongation of length of stay in compulsorily psychiatrist-ordered schizophrenia patients did not affect their rate of rehospitalizations or the length of next admission compared with those who left the hospital immediately after the change in their legal status AMA.


The combined use of DSC and TGA for the thermal analysis of atenolol tablets.
The New York Regional Laboratory's forensic pharmaceutical group used thermal analysis (TA) to ensure adherence to batch formulations by drug manufacturers. TA in our laboratory consisted of differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA). DSC and TGA were used to analyse finished dosage forms and their components. In this study the components of atenolol formulations were qualitatively identified by analysing individual components and comparing with the finished product. DSC and TGA were used together to develop a profile of batch formulations, with each analytical technique giving complementary types of information. For example, the excipient sodium starch glycolate was identified by DSC and confirmed by TGA. These experimental results demonstrated the use of TA for the characterization of finished dosage forms and the qualitative identification of some of the individual components in batch formulations.


Stretch-induced increase of resting intracellular calcium concentration in single guinea-pig ventricular myocytes.
Single guinea-pig ventricular myocytes were loaded with the fluorescent Ca2+ indicator Indo-1 AM and stretched by carbon fibres. Stretching increased resting tension. Sarcomere lengths were increased by 2-18%. It was observed that a stretch increased resting [Ca2+]i in seven out of eight cells. The change in [Ca2+]i increased with the size of the stretch and returned to pre-stretch levels on return to resting cell length. These observations suggest a means by which changes in resting muscle length can modify the contractile state of cardiac muscle.


The rationale for the use of dopamine agonists in Parkinson's disease.
Experimental and clinical studies indicate that both dopamine D2-like and D1-like receptors are important in reversing the motor symptoms of Parkinson's disease, and therefore stimulation of both D1 and D2 receptors may be advantageous in its treatment. At present, the role of other receptor subtypes, such as the D3 receptor, remains unknown, although in primates the D3 receptor might be of importance because it exists in significant amounts within the caudate-putamen. Both D1 and D2 agonists induce dyskinesias in drug-naive, MPTP-treated primates and provoke dyskinesias in levodopa-primed animals. D1 agonists in low doses, however, might have antiparkinsonian effects without inducing dyskinesias, and on repeated administration perhaps can diminish the intensity of dyskinesias in levodopa-primed, MPTP-treated primates. The production of dyskinesias in Parkinson's disease might reflect an imbalance in the D1-direct and D2-indirect GABAergic output pathways from the caudate-putamen, which colocalize tachykinins and enkephalins, respectively. Destruction of the nigrostriatal pathway decreases the mRNA for substance P but elevates the mRNA for enkephalin. Treatment with levodopa reverses the decrease in substance P mRNA but has either a partial or no effect on mRNA for enkephalin. This suggests that levodopa treatment leads to a new imbalance between output from the striatum through the direct and indirect pathways. In contrast, dopamine agonists appear less able than levodopa to manipulate basal ganglia outflow. This might reflect their decreased ability to reverse parkinsonian motor deficits or the greater ability of levodopa to provoke dyskinesias. Dopamine agonist drugs also might exert neuroprotective actions.(ABSTRACT TRUNCATED AT 250 WORDS)


Extraction of petroleum hydrocarbons from soil using supercritical argon.
The use of supercritical argon is described for the extraction of petroleum hydrocarbons from soil samples. Argon is an attractive solvent because it is inexpensive and inert. Additionally, it has a clear spectral window in the infrared region which makes it useful for on-line (i.e., directly coupled) experiments. Spiking studies conducted with gasoline, no. 1 fuel oil, and no. 5 fuel oil on sand, loam, and clay show that component recovery rates for argon supercritical fluid extraction (SFE) generally increase with increasing pressure and/or temperature. The highest recovery rates (and recoveries) were obtained for Ar SFE at 500 atm and 150 °C. Under these conditions, the components of the gasoline and no. 1 fuel oil spikes could be recovered in as little as 12 min. However, the no. 5 fuel oil components could not be quantitatively removed from the loam and clay matrixes even for extraction times as long as 100 min. We also show in this work that Ar SFE performs similarly to CO(2) SFE for petroleum hydrocarbon contamination in real-world soil samples under moderate pressure and temperature conditions. Specifically, Ar SFE and CO(2) SFE have similar recoveries and reproducibilities, but Ar SFE requires a slightly longer extraction time.


Regional differences in steroidogenesis and hormone levels in the epididymis and vas deferens of adult rats.
In vivo and in vitro studies with different parts of the epididymis and vas deferens were carried out to determine their inherent capacity to synthesize steroids and to correlate with the endogenous levels with or without the administration of hCG. Incubation with 14C-labelled pregnenolone and testosterone demonstrated that caput epididymidis was more active than other parts in synthesizing testosterone from 14C-pregnenolone and in converting labelled testosterone to 5 alpha-dihydrotestosterone (DHT). The cauda epididymidis and vas deferens accumulated more radioactivity in progesterone and dehydroepiandrosterone (DHEA) than the caput epididymidis. The levels of DHT, testosterone and 4-androstene-3, 17-dione in the caput epididymidis were reduced after ligation of ipselateral efferent ductules indicating the testicular origin of these steroids. The cauda epididymidis and vas deferens had higher levels of progesterone as compared to the other regions of the epididymis, which were decreased after the ligation. Intravenous injection of hCG increased the levels of oestradiol-17 beta in all tissues and markedly in the cauda epididymidis and vas deferens. The high levels of progesterone and oestradiol-17 beta present in these organs may be of importance in maintaining fertilizing ability of spermatozoa stored in the cauda epididymidis and vas deferens and their transport.


Immediate provisional implants as abutments for an overdenture in the mandibular edentulous jaw: case presentation.
Based on the need for provisionalization to provide sufficient phonetics, adaptation, and function following implant therapy, simultaneous placement of immediate provisional implants has evolved to allow abutment positioning following initial surgery. This modality allows the patient to be restored with a stable, functional, and aesthetic restoration during soft tissue healing prior to the removal of the provisional implants. This article presents the clinical protocol for treatment of the edentulous mandible using an immediately provisionalized implant supported overdenture.


Sensitive FRET Biosensor Reveals Fyn Kinase Regulation by Submembrane Localization.
Fyn kinase plays crucial roles in hematology and T cell signaling; however, there are currently limited tools to visualize the dynamic Fyn activity in live cells. Here we developed and characterized a highly sensitive Fyn biosensor based on fluorescence resonance energy transfer (FRET) to monitor Fyn kinase activity in live cells. Our results show that Fyn kinase activity can be induced in both mouse embryonic fibroblasts (MEFs) and T cells by ligand engagement. Two different motifs were further introduced to target the biosensor at the cellular membrane microdomains in MEFs, revealing that the Fyn-tagged biosensor had 70% greater response to growth factor stimulation than the Lyn-tagged version. This suggests that the plasma membrane microdomains can be categorized into different functional subdomains. Further experiments show that while the membrane accessibility is necessary for Fyn activation, the localization of Fyn outside of its microdomains causes its hyperactivity, indicating that membrane microdomains provide a suppressive microenvironment for Fyn regulation in MEFs. Interestingly, a relatively high Fyn activity can be observed at perinuclear regions, further supporting the notion that the membrane microenvironment has a significant impact on the local molecular functions. Our work hence highlights a novel Fyn FRET biosensor for live cell imaging and its application in revealing an intricate submembrane regulation of Fyn in live MEFs.


Changes in liver stiffness measurements and fibrosis scores following sofosbuvir based treatment regimens without interferon.
Accurate evaluation of the degree of liver fibrosis in patients with chronic liver diseases is crucial, as liver fibrosis is important in order to make therapeutic decisions, determine prognosis of liver disease and to follow-up disease progression. Multiple non-invasive methods have been used successfully in the prediction of fibrosis; however, early changes in non-invasive biomarkers of hepatic fibrosis under effective antiviral therapy are widely unknown. The aim of this study is to evaluate changes of transient elastography values as well as FIB-4 and AST to platelet ratio index (APRI) in patients treated with Sofosbuvir-based treatment regimen. This is a retrospective study including 337 chronic HCV Egyptian patients with genotype 4 mainly. They were treated with Sofosbuvir-based treatment regimen. Transient elastography values were recorded as well as FIB-4 and APRI were calculated at baseline and SVR12. There was a significant improvement of platelets counts, ALT and AST levels, which in turn cause significant improvement in FIB-4 and APRI scores at SVR12. Liver stiffness measurements were significantly lower in SVR12 (14.8 ± 10.7 vs 11.8 ± 8.8 kPa, P = 0.000). About 77% of responders and 81.1% of cirrhotic patients showed improvement in liver stiffness measurements at SVR12.Univariate and multivariate regression analysis showed that failure to achieve improvement in liver stiffness measurements were significantly associated with relapsers and low baseline liver stiffness measurement. Sofosbuvir-based treatment resulted in a clinically significant improvement in parameters of liver fibrosis.


Outcomes of Ultrasound-Guided Gastrocnemius Injection With Botulinum Toxin for Chronic Plantar Fasciitis.
The objective of this study was to determine whether the injection of botulinum toxin A (BTA) in the medial head of the gastrocnemius muscle could yield improvements in function and disability in patients with chronic plantar fasciitis with follow-up 12 months after treatment. Thirty-two patients with chronic plantar fasciitis were included in the study and randomly allocated to the BTA and placebo groups. The visual analog scale (VAS) and American Orthopaedic Foot & Ankle Society (AOFAS) scores were used to evaluate pain levels pre- and postinjection as well as function of the foot, respectively. Patients were also asked to rate their treatment satisfaction 1 year after injection. The range of dorsiflexion was measured before and 12 months after the injection. At the 12-month follow-up, the mean VAS decreased from 7.8 to 4 in the placebo group and from 8 to 0.33 in the BTA group. Furthermore, the mean AOFAS scores increased from 48.4 to 65.3 in the placebo group and from 45.5 to 90.6 in the BTA group. The postinjection scores in the BTA group were significantly higher than those in the placebo group (P < .001). Patient satisfaction in the BTA group was higher than that in the placebo group at the 12-month follow-up. In patients with chronic plantar fasciitis, the use of BTA had a positive effect on improvement in pain and foot function 1 year after treatment. Level I, prospective randomized controlled trial.


Functionalization of Elongated Tetrahexahedral Au Nanoparticles and Their Antimicrobial Activity Assay.
Gold nanoparticles are inert for the human body, and therefore, they have been functionalized to provide them with antibacterial properties. Here, elongated tetrahexahedral (ETHH) Au nanoparticles were synthesized, characterized, and functionalized with lipoic acid (LA), a natural antioxidant with a terminal carboxylic acid and a dithiolane ring, to generate ETHH-LA Au nanoparticles. The antioxidant activity of Au nanoparticles was investigated in vitro, showing that LA enhances the 2,2-diphenyl-1-picrylhydrazyl free-radical scavenging and Fe3+ ion reducing activity of ETHH-LA at higher amounts. The antimicrobial propensities of the nanoparticles were investigated against Gram-positive ( Bacillus subtilis) and Gram-negative ( Escherichia coli) bacteria through propidium iodide assay as well as disk diffusion assay. ETHH-LA Au nanoparticles showed significantly higher antimicrobial activity against B. subtilis compared with E. coli. Furthermore, ETHH-LA Au nanoparticles also showed significantly better antimicrobial activity against both bacterial strains when compared with ETHH. ETHH Au nanoparticles also bring about the oxidation of bacterial cell membrane fatty acids and produce lipid peroxides. ETHH-LA showed higher lipid peroxidation potential than that of ETHH against both bacteria tested. The hemolytic potential of Au nanoparticles was investigated using human red blood cells and ETHH-LA showed reduced hemolytic activity than that of ETHH. The cytotoxicity of Au nanoparticles was investigated using human cervical cancer cells, HeLa, and ETHH-LA Au nanoparticles showed reduced cytotoxicity than that of ETHH. Taken together, LA enhances the antimicrobial activity of ETHH Au nanoparticles and Au nanoparticles interact with the bacteria through electrostatic interactions as well as hydrophobic interactions and damage the bacterial cell wall followed by oxidation of cell membrane fatty acids.


Pharmacodynamics of high-dose vecuronium in children during balanced anesthesia.
To compare the speed of onset, intubating conditions, duration of action, and recovery from neuromuscular blockade with vecuronium to those with succinylcholine, 40 ASA physical status 1 or 2 children (ages 2-9 yr) were studied during N2O-O2-opioid anesthesia. Each child was randomly assigned to receive a bolus dose of one of the following muscle relaxants: succinylcholine 2.0 mg/kg (n = 10), vecuronium 0.1 mg/kg (n = 10), vecuronium 0.2 mg/kg (n = 10), or vecuronium 0.4 mg/kg (n = 10). The evoked electromyogram of the abductor digiti minimi to train-of-four stimulation was monitored. We found that with succinylcholine, the time to 95% twitch depression (speed of onset, mean +/- SD), 24 +/- 7 s, was significantly less than that with each dose of vecuronium: 0.1 mg/kg, 83 +/- 21 s; 0.2 mg/kg, 58 +/- 17 s; and 0.4 mg/kg, 39 +/- 11 s, respectively (P less than 0.05). The time to laryngoscopy and intubation did not differ significantly between succinylcholine (48 +/- 10 s) and vecuronium 0.4 mg/kg (57 +/- 13 s); however, both were significantly less than than with vecuronium 0.1 and 0.2 mg/kg (P less than 0.005). The intubating conditions were excellent in 100% of patients. The duration of action was least with succinylcholine (5.7 +/- 1.5 min) and increased with increasing doses of vecuronium: 0.1 mg/kg, 23.9 +/- 5.1 min; 0.2 mg/kg, 55.2 +/- 11.6 min; and 0.4 mg/kg, 74.6 +/- 9.9 min, respectively (P less than 0.001). The recovery index was most rapid with succinylcholine (1.6 +/- 0.4 min) and was slowest with vecuronium 0.4 mg/kg (22.6 +/- 2.1 min) (P less than 0.005).(ABSTRACT TRUNCATED AT 250 WORDS)


Serum carboxy-terminal propeptide of procollagen type I is a marker of myocardial fibrosis in hypertensive heart disease.
This study was designed to investigate whether the serum concentration of the carboxy-terminal propeptide of procollagen type I (PIP), a marker of collagen type I synthesis, is related to myocardial fibrosis in hypertensive patients. The study was performed in 26 patients with essential hypertension in which ischemic cardiomyopathy was excluded after a complete medical workup. Right septal endomyocardial biopsies were performed in hypertensive patients to quantify collagen content. Collagen volume fraction (CVF) was determined on picrosirius red-stained sections with an automated image analysis system. The serum concentration of PIP was measured by specific radioimmunoassay. Compared with normotensives, both serum PIP and CVF were increased (P<0.001) in hypertensives. A direct correlation was found between CVF and serum PIP (r=0.471, P<0.02) in all hypertensives. Histological analysis revealed the presence of 2 subgroups of patients: 8 with severe fibrosis and 18 with nonsevere fibrosis. Serum PIP was higher (P<0.05) in patients with severe fibrosis than in patients with nonsevere fibrosis. Using receiver operating characteristic curves, we observed that a cutoff of 127 microg/L for PIP provided 78% specificity and 75% sensitivity for predicting severe fibrosis with a relative risk of 4.80 (95% CI, 1.19 to 19.30). These results show a strong correlation between myocardial collagen content and the serum concentration of PIP in essential hypertension. Although preliminary, these findings suggest that the determination of PIP may be an easy and reliable method for the screening and diagnosis of severe myocardial fibrosis associated with arterial hypertension.


[Contaminants in food and nutritional guidance: theoretical reflection].
Reflection study on the nutritional guidelines given to the population, which, in most parts of the world, emphasize on the consumption of fruits, vegetables and legumes over industrialized foods, which contain more sugar, sodium and calories, and increase body weight. However, when one reads about the ways of cultivating fresh food and about the quality of meat and fish products destined for consumption, the question arises as to whether there is coherence between said guidance and consumption, given that there are reports of contamination of these foods by pesticide residues, as well as soil and water contamination, a topic scarcely addressed by state entities. What should be done to face this reality? A viable perspective is to raise awareness in the population, which should demand better quality foods, in addition to returning to healthier practices such as the cultivation of home-grown organic gardens and acquiring as few industrialized foods as possible. Far from causing controversy, this reflection aims to encourage a critical view in health professionals on their role in disease prevention and the demand for healthier foods for human consumption.


Evaluation of a multiple regression model for the forecasting of the concentrations of NOx and PM10 in Athens and Helsinki.
Forecasting models based on stepwise multiple linear regression (MLR) have been developed for Athens and Helsinki. The predictor variables were the hourly concentrations of pollutants (NO, NO(2), NO(x), CO, O(3), PM(2.5) and PM(10)) and the meteorological variables (ambient temperature, wind speed/direction, and relative humidity) and in case of Helsinki also Monin-Obukhov length and mixing height of the present day. The variables to be forecasted are the maximum hourly concentrations of PM(10) and NO(x), and the daily average PM(10) concentrations of the next day. The meteorological pre-processing model MPP-FMI was used for computing the Monin-Obukhov length and the mixing height. The limitations of such statistical models include the persistence of both the meteorological and air quality situation; the model cannot account for rapid changes (on a temporal scale of hours or less than a day) that are commonly associated, e.g., with meteorological fronts, or episodes of a long-range transport origin. We have selected the input data for the model from one urban background and one urban traffic station both in Athens and Helsinki, in 2005. We have used various statistical evaluation parameters to analyze the performance of the models, and inter-compared the performance of the predictions for both cities. Forecasts from the MLR model were also compared to those from an Artificial Neural Network model (ANN) to investigate, if there are substantial gains that might justify the additional computational effort. The best predictor variables for both cities were the concentrations of NO(x) and PM(10) during the evening hours as well as wind speed, and the Monin-Obukhov length. In Athens, the index of agreement (IA) for NO(x) ranged from 0.77 to 0.84 and from 0.69 to 0.72, in the warm and cold periods of the year. In Helsinki, the corresponding values of IA ranged from 0.32 to 0.82 and from 0.67 to 0.86 for the warm and cold periods. In case of Helsinki the model accuracy was expectedly better on the average, when Monin-Obukhov length and mixing height were included as predictor variables. The models provide better forecasts of the daily average concentration, compared with the maximum hourly concentration for PM(10). The results derived by the ANN model where only slightly better than the ones derived by the MLR methodology. The results therefore suggest that the MLR methodology is a useful and fairly accurate tool for regulatory purposes.


Comparison of unilateral antegrade cerebral perfusion at 16 degrees C and 22 degrees C systemic temperature.
Unilateral antegrade cerebral perfusion can be performed with minimal manipulations to arch arteries, but whether it provides adequate brain perfusion remains unclear. Some authors believe that this technique can be inadequate without deep hypothermia. We investigated the reliability of unilateral cerebral perfusion at 22 degrees C hypothermia and the advantages of avoiding deep hypothermia. Study participants were 55 patients who underwent surgery with unilateral cerebral perfusion. Patients were divided into 2 groups; 18 patients underwent surgery at 16 degrees C hypothermia (group I) and 37 patients at 22 degrees C hypothermia (group II). The mean age of the patients was 59 +/- 10 years in group I and 55 +/- 14 years in group II. Supracoronary ascending aorta replacement was performed in 25 and hemiarch replacement in 15 patients. Nine patients underwent surgery for a Bentall procedure. Total arch replacement was performed in 4 patients and total thoracic aorta replacement in 2 patients. The hospital mortality was 11% in group I and 5.4% in group II (P = .59). Transient neurologic deficits were not detected in any of the patients. The rate of permanent neurologic deficits was 5.9% in group I and 2.8% in group II (P = .54). Although mean aortic cross-clamp and antegrade cerebral perfusion times were not significantly different, mean cardiopulmonary bypass time was longer in group I than group II (174 +/- 38 vs 142 +/- 37 minutes, P = .005). Postoperative bleeding, blood product usage, serum creatinine and hepatic enzyme level changes, inotrope usage, and arrhythmia occurrence were not different between the 2 groups. Mean mechanical ventilation time was longer in group I than group II (24 +/- 17 vs 16 +/- 6 hours, P = .02). Unilateral antegrade cerebral perfusion at 22 degrees C systemic hypothermia appears to be safe and reliable for brain protection. Advantages of this technique are avoidance of deep hypothermia and reduced cardiopulmonary bypass and mechanical ventilation times in patients undergoing aortic surgery.


Rapid-cycle testing cuts bed turnaround by 85%.
You can use rapid-cycle testing to try out new approaches to overcrowding much more frequently than with more traditional process improvement strategies. Improving bed turnaround notification can yield dramatic improvements. Telling staff they have to try a new process only for three days makes it easier to gain buy-in. Look for old policies that are no longer needed, yet continue to keep your staff bogged down.


Regioselective lithiation and functionalization of 3-(benzyloxy)isothiazole: application to the synthesis of thioibotenic acid.
Direct functionalization of the 3-oxygenated isothiazole heteroaromatic parental system has not yet been reported in the literature. Here, we report the first regioselective lithiation of the 5-position of 3-(benzyloxy)isothiazole (4) using LDA in diethyl ether. The versatility of the methodology was explored by quenching with a variety of electrophiles to give the desired products 7a,b,d-g in 54-68% yield. Only benzoylation aiming at the synthesis of 7c was unsuccessful. Furthermore, a highly convergent synthesis of thioibotenic acid (1), the sulfur analogue of the neurotoxic natural product ibotenic acid, was carried out.


The corticotropin-releasing factor (CRF)(1) receptor antagonists CP154,526 and DMP695 inhibit light-induced phase advances of hamster circadian activity rhythms.
The circadian activity of corticotropin releasing factor (CRF) and the hypothalamic-pituitary-adrenal axis is controlled by the master circadian pacemaker located in the hypothalamic suprachiasmatic nucleus. However, the reciprocal influence of CRF and the hypothalamic-pituitary-adrenal axis upon the circadian pacemaker is less well established. Therefore, in the present study, we tested two nonpeptidergic antagonists at CRF(1) receptors for their ability to modulate photic resetting of pacemaker time (phase). CP154,526 dose dependently and significantly inhibited light-induced phase advances in hamster circadian activity rhythms late in the subjective night by approximately 60% at a maximally effective dose of 20 mg/kg delivered intraperitoneally. Likewise, a further CRF(1) receptor antagonist, DMP695, inhibited phase advances by approximately 40% at a dose of 10 mg/kg. The attenuation of phase shifts by CP154,526 was specific to phase advances as light-induced phase delays of the circadian pacemaker achieved early in the subjective night were not affected by CP154,526 (20 mg/kg). We also tested one of the CRF(1) receptor antagonists for its potential ability to reset the pacemaker in the absence of light and found that CP154,526 did not elicit a nonphotic phase shifts in circadian activity rhythms at circadian times (CT) 2, 8, 14, 18, or 22. In conclusion, CRF(1) receptor antagonists selectively modulate the effect of light on the circadian pacemaker late at night. These novel data emphasize the suspected critical link between CRF and the hypothalamic-pituitary-adrenal axis, on the one hand, and stress (including stress caused by jet-lag) and depression on the other. These results also suggest that CRF(1) antagonists may not only improve affect but also counter the circadian disruption associated with depression and other stress-related disorders.


The plastid ribosomal proteins. Identification of all the proteins in the 50 S subunit of an organelle ribosome (chloroplast).
We have completed identification of all the ribosomal proteins (RPs) in spinach plastid (chloroplast) ribosomal 50 S subunit via a proteomic approach using two-dimensional electrophoresis, electroblotting/protein sequencing, high performance liquid chromatography purification, polymerase chain reaction-based screening of cDNA library/nucleotide sequencing, and mass spectrometry (reversed-phase HPLC coupled to electrospray ionization mass spectrometry and electrospray ionization mass spectrometry). Spinach plastid 50 S subunit comprises 33 proteins, of which 31 are orthologues of Escherichia coli RPs and two are plastid-specific RPs (PSRP-5 and PSRP-6) having no homologues in other types of ribosomes. Orthologues of E. coli L25 and L30 are absent in spinach plastid ribosome. 25 of the plastid 50 S RPs are encoded in the nuclear genome and synthesized on cytosolic ribosomes, whereas eight of the plastid RPs are encoded in the plastid organelle genome and synthesized on plastid ribosomes. Sites for transit peptide cleavages in the cytosolic RP precursors and formyl Met processing in the plastid-synthesized RPs were established. Post-translational modifications were observed in several mature plastid RPs, including multiple forms of L10, L18, L31, and PSRP-5 and N-terminal/internal modifications in L2, L11 and L16. Comparison of the RPs in gradient-purified 70 S ribosome with those in the 30 and 50 S subunits revealed an additional protein, in approximately stoichiometric amount, specific to the 70 S ribosome. It was identified to be plastid ribosome recycling factor. Combining with our recent study of the proteins in plastid 30 S subunit (Yamaguchi, K., von Knoblauch, K., and Subramanian, A. R. (2000) J. Biol. Chem. 275, 28455-28465), we show that spinach plastid ribosome comprises 59 proteins (33 in 50 S subunit and 25 in 30 S subunit and ribosome recycling factor in 70 S), of which 53 are E. coli orthologues and 6 are plastid-specific proteins (PSRP-1 to PSRP-6). We propose the hypothesis that PSRPs were evolved to perform functions unique to plastid translation and its regulation, including protein targeting/translocation to thylakoid membrane via plastid 50 S subunit.


Antibiotic activity and synergistic effect of antimicrobial peptide against pathogens from a patient with gallstones.
HP (2-20) is a peptide derived from the N-terminus of Helicobacter pylori ribosomal protein L1 that has been shown to have antimicrobial activity against various species of bacteria. When we tested the effects of HP (2-20), we found that this peptide displayed strong activity against pathogens from a patient with gallstones, but it did not have hemolytic activity against human erythrocytes. We also found that HP (2-20) had potent activity against cefazolin sodium-resistant bacterial cell lines, and that HP (2-20) and cefazolin sodium had synergistic effects against cell lines resistant to the latter. To investigate the mechanism of action of HP (2-20), we performed fluorescence activated flow cytometry using pathogens from the patient with gallstones. As determined by propidium iodide (PI) staining, pathogenic bacteria treated with HP (2-20) showed higher fluorescence intensity than untreated cells, similar to melittin-treated cells, and that HP (2-20) acted in an energy- and salt-dependent manner. Scanning electron microscopy showed that HP (2-20) caused significant morphological alterations in the cell surface of pathogens from the patient with gallstones. By determining their 16S rDNA sequences, we found that both the pathogens from the patient with gallstones and the cefazolin sodium-resistant cell lines showed 100% homology with sequences from Pseudomonas aeruginosa. Taken together, these results suggest that HP (2-20) has antibiotic activity and that it may be used as a lead drug for the treatment of acquired pathogens from patients with gallstones and antibiotic-resistant cell lines.


[The role of nurses in the introduction of home parenteral nutrition (HPN)].
HPN makes it possible for patients, who otherwise must remain hospitalized, to be discharged and contributes to improve their QOL. We report 3 patients for whom HPN was introduced and could either stay out or to be discharged. Both strong will to be discharged and self-confidence acquired after a test stay out led the patients to HPN. It was important to design the contents of instruction, the methods, and the periods according to the comprehension, will and abilities of the patients. Since the HPN equipment weighs over 2 kg, it was hard for patients in a terminal stage and senile patients to carry them. All 3 patients had the cooperation of their families and the nurses to design various additional devices and thus continue the therapy at home. The nurses should participate in the renovation of the transfer equipment in order to improve the QOL of the patients. Moreover, it is important to promote the will of patients though active information and to suggest a management plan suitable to their lifestyles.


Implementation of quality improvement methodology and the medical profession.
Modern quality management (QM) has evolved in industry over the last few decades to be a major factor in organizational structure and focus. The health industry has to a degree recognized or perceived merits in this model and has applied the principles of QM to many of its activities. It has also incorporated the concept of a commitment to quality improvement (QI) into its most recognized peer-review structure, hospital accreditation (ACHS). Apparent resistance exists in the medical fraternity to a transition from audit-focused quality assurance to contemporary systematic QI. An understanding of this issue may be gained from analysis of the medical profession's perception of QI, factors in the historical structures within health, and a review of the factors which hinder the transition to QI. By considering within a framework of organisational behaviour theory (OBT), some key concepts it is possible to work towards some solutions and proposals. These concepts include attitude, motivation, conflict, organizational change and development. It is likely that the appropriate focus should be broader than the 'recalcitrant group of conservative practitioners who resist change'. Indeed where a deficiency exists, QI methodology would have us look beyond an individual or single group towards the processes that create the opportunity for deficiency to occur. Within the current context, such processes are inherently structural and are historically established within the health industry. A solution to this problem requires organizational commitment and a period of analysis as well as the transformation of attitudes and practices. Organizational commitment will take the form of adequate resourcing and a developmental approach to organizational change. Internal professional change (perhaps guided by organizational development) must address the interface between the 'medical profession' and the broader group of professional health-care providers.


T Cells in Allergic Asthma: Key Players Beyond the Th2 Pathway.
Asthma is a common chronic lung disease that affects 300 million people worldwide. It causes the airways of the lungs to swell and narrow due to inflammation (swelling and excess mucus build-up in the airways) and airway constriction (tightening of the muscles surrounding the airways). Atopic asthma is the most common form of asthma, and is triggered by inhaled allergens that ultimately promote the activation of the Th2-like T cells and the development of Th2-mediated chronic inflammation. Different subsets of T cells, including T follicular helper cells, tissue-resident T, cells and Th2 effector cells, play different functions during allergic immune response. Dendritic cells (DCs) are known to play a central role in initiating allergic Th2-type immune responses and in the development of the T cell phenotype. However, this function depends on the complex interaction with other cells of the immune system and determines whether the response to environmental allergens will be one of tolerance or allergic inflammation. This review discusses cell interactions leading to the initiation and maintenance of allergic Th2-type immune responses, particularly those associated with allergic asthma.


Comparing the effects of brushing with a new gel-to-foam dentifrice to brushing with regular fluoride control dentifrices on viable bacteria levels in saliva.
To compare the effects of a new gel-to-foam dentifrice to two standard fluoride control dentifrices on foam generation, levels of total viable anaerobes and total viable volatile sulfur compound (VSC)-producing bacteria in expectorate after brushing. 36 subjects participated in this investigator-blind, randomized, crossover study. After a 1-week wash-out period prior to each product use, participants reported to the test site having refrained from oral hygiene, eating and drinking on the morning prior to the visit. Subjects brushed with a full ribbon of assigned dentifrice (Aquafresh Iso-active, Aquafresh Extreme Clean or Aquafresh Fresh & Minty), then expectorated the slurry into a collection vessel after 30 and 60 seconds of supervised brushing. Total foam volume was immediately measured. Subjects then rinsed with sterile water for 10 seconds and expectorated into the same vessel, which was processed for microbiological analysis. Total viable anaerobes and total viable VSC-producing bacteria were enumerated using appropriate selective media. No statistically significant difference was indicated between the gel-to-foam dentifrice and either of the control dentifrices with respect to the level of total viable anaerobes (P > 0.05). The level of total viable VSC-producing bacteria was statistically significantly lower for the gel-to-foam dentifrice (Aquafresh Iso-active) than for one of the control dentifrices (Aquafresh Fresh & Minty) (P < 0.05), and numerically lower for the gel-to-foam dentifrice than for the other control dentifrice (Aquafresh Extreme Clean) (P = 0.0526). Use of the gel-to-foam dentifrice resulted in statistically significantly greater (P < 0.05) foam generation than the two control dentifrices.


GABAergic Interneurons are the Major Postsynaptic Targets of Median Raphe Afferents in the Rat Dentate Gyrus.
The termination pattern of median raphe axons was studied in the rat dentate gyrus using Phaseolus vulgaris leucoagglutinin as an anterograde tracer, in combination with postembedding immunostaining for gamma-amino-butyric acid (GABA), and pre-embedding immunostaining for calbindin D28k, parvalbumin and GABA. Postembedding immunogold staining for GABA revealed that the majority (73.7%) of anterogradely labelled median raphe boutons make synaptic contacts with GABA-immunoreactive postsynaptic targets, mainly with dendritic shafts and perikarya. Pre-embedding immunocytochemical double staining for the anterograde tracer and GABA confirmed the electron microscopic results and showed that varicose median raphe axons establish multiple contacts with fusiform interneurons in the hilus and different types of basket cells in the granule cell layer. Some of the innervated cells were shown to contain calbindin D28k, whereas GABAergic interneurons containing another calcium-binding protein, parvalbumin, were never seen to receive multiple contacts from axons of raphe origin. Our results suggest that serotonergic median raphe fibres influence the firing of dentate granule cells via local inhibitory interneurons. The mechanism of using these interneurons with extensive local connections as monosynaptic targets may explain the great efficacy of this pathway in the control of hippocampal electrical activity.


Analysis of short- and long-term effects of adaptation in human postural control.
The short-term (i.e., days) and long-term (i.e., months) effects of adaptation to posturography examinations were investigated in 12 normal subjects who were repeatedly examined for five consecutive days and again after 90 days. The examinations were conducted both with eyes open and closed, and the perturbations were evoked by a pseudorandomly applied vibration stimulation to the calf muscles. The evoked anteroposterior responses were analyzed with a method considering adaptation in the slow changes in posture and in the stimulus-response relationship. Repetition of examinations on a daily basis revealed a gradual improvement of postural-control performance. The body sway induced by the stimulation was significantly reduced and the dynamical properties changed. Most of the improvements remained after 90 days, but some parameters such as the complexity of the control system used were increased to the initial level. The results confirm previous observations that postural control contains several partially independent adaptive processes, observed in terms of alteration of posture and as a progressive reduction of body sway induced by stimulation. The method used for the adaptation analysis in this study could be applied to analyze biological systems with multiple individual adaptive processes with different time courses or characteristics, or where the adaptation processes are related to multiple internal or external factors.


Postpartum care center: follow-up care in a hospital-based clinic.
Because of ever-decreasing lengths of maternity stays and the emphasis on reducing health-care costs, there is a need for innovative, low-cost postpartum follow-up programs. The Postpartum Care Center, begun in 1991, is a model program that provides early postpartum assessment and support to mothers, infants, and their families for one third the cost of a home visit. This article reviews program development, description of services, and program outcomes.


Interpretation of transbronchial lung biopsies from lung transplant recipients: inter- and intraobserver agreement.
Transbronchial lung biopsy results are crucial for the management of lung transplant recipients. Little information is available regarding the reliability and reproducibility of the interpretation of transbronchial lung biopsies. To examine the inter-reader variability between two lung pathologists with expertise in lung transplantation. Fifty-nine transbronchial lung biopsy specimens were randomly selected. Active infection had been excluded in all cases. The original interpretations (as per the Lung Rejection Study Group) for acute rejection grade included 19 biopsies scored as A0 (none), 14 scored as A1 (minimal), 12 as A2 (mild), 11 as A3 (moderate) and three as A4 (severe). The pathologists worked independently without clinical information or knowledge of the original interpretation. The specimens were graded using the Lung Rejection Study Group criteria for acute rejection (grades A0 to A4), airway inflammation (grades B0 to B4) and bronchiolitis obliterans (C0 absent and C1 present). Between-reader agreement for each category was analyzed using a Kappa statistic. Because many transplant specialists initiate augmented immunosuppression with biopsy grades of A2 or higher, results for each reader were dichotomized as A0/A1 versus A2/A3/A4. Using this dichotomy, there was only moderate agreement (kappa 0.470, P < 0.001) between readers. For categories B and C, the results were dichotomized for the absence or presence of airway inflammation and bronchiolitis obliterans, respectively. The level of agreement between readers was fair for category B (kappa 0.333, P = 0.014) and poor for category C (kappa 0.166, P = 0.108). The intrareader agreement for acute rejection was substantial (kappa 0.795, P = 0.0001; kappa 0.676, P = 0.0001). Because the agreement between expert pathologists is only modest, optimum clinical decision-making requires that transbronchial lung biopsy results be used in an integrated clinical context.


Splenosis mimicking pelvic mass.
Splenosis is a rare complication after splenectomy and generally does not cause clinical symptoms. A 34-year-old woman who had splenectomy in childhood after trauma presented with a pelvic mass. Ultrasound examination demonstrated a right adnexal mass and a myomatous uterus. Exploratory laparotomy revealed multiple splenic implants along the small and large bowel and in the ileocecal region, including the appendix. Total hysterectomy, right salphengectomy, and appendectomy were performed. After splenectomy, splenic implants may mimic benign or malignant tumors of the pelvis and may require surgical exploration.


Development of an atmospheric 222Rn concentration model using a hydrodynamic meteorological model: I. One-dimensional practical model.
A one-dimensional numerical model for 222Rn transport in an atmospheric boundary layer was developed. The model consists of two parts: a prognostic hydrodynamic model including a turbulence closure model and an atmospheric diffusion model for 222Rn. The first part predicts meteorological conditions to provide the second part with vertical turbulence conditions which affects the vertical motion of 222Rn near the Earth's surface. Calculations with the model are compared with 222Rn concentrations measured during a variety of meteorological conditions, from clear days with high radiation and low winds to cloudy days of low radiation with high winds. The model's results represent well the typical diurnal variations of the 222Rn concentrations.


Deposition Time Dependent Size of Si Quantum Dots Embedded in Amorphous SiC Matrix.
A series of hydrogenated amorphous SiC (a-SiC:H) films that contain Si quantum dots (QDs) were grown using PECVD at a substrate temperature of 320 degrees C by changing the deposition time from 0.5 h to 3 h. The chemical composition, phase constitution, microstructure and optical gap of the films were systematically studied by X-ray photoelectron spectroscopy, X-ray diffraction, Raman spectroscopy, high-resolution transmission electron microscopy, and UV-vis spectrophotometer, respectively. It was shown that long time deposition was equivalent to introduce an annealing process, which enhanced the Si QDs growth and the formation of gradient size distribution. With increasing the deposition time from 0.5 h to 3 h, the optical band gap E(opt) decreased from 1.92 eV to 1.45 eV. It was due to the reduced quantum confinement effect when the size of Si QDs increased from -1.5 nm to -4 nm. These results provide the experimental basis for the growth and controlling of Si QDs.


Micro-array for the identification of Shiga toxin-producing Escherichia coli (STEC) seropathotypes associated with Hemorrhagic Colitis and Hemolytic Uremic Syndrome in humans.
A micro-array has been developed, based on the GeneDisc(R) array, for the genetic identification of 12 O-types and 7 H-types of Shiga toxin-producing Escherichia coli (STEC) including the most clinically relevant enterohemorrhagic E. coli (EHEC) serotypes. The genes selected for determination of the O antigens (rfbE(O157), wzx(O26), wzx(O103), wbd1(O111), ihp1(O145), wzx(O121), wzy(O113), wzy(O91), wzx(O104), wzy(O118), wzx(O45), and wbgN(O55)) and H-types (fliC(H2), fliC(H7), fliC(H8), fliC(H11), fliC(H19), fliC(H21), and fliC(H28)) showed a high specificity and concordance with serology. The micro-array also had a high specificity for EHEC-associated virulence factors, including Shiga toxins 1 and 2 (stx1 and stx2), intimin (eae), enterohemolysin (ehxA), serine protease (espP), catalase peroxidase (katP), the type II secretion system (etpD), subtilase cytotoxin (subA), autoagglutinating adhesin (Saa) and type III secreted effectors encoded in the genomic islands OI-122 (ent/espL2, nleB, and nleE) and OI-71 (nleF, nleH1-2, and nleA). The eae gene was detected in all typical EHEC strains, and the pattern of nle genes encoded in OI-71 and OI-122 was found to be closely associated with certain serotypes of typical EHEC and emerging EHEC strains. Virulence plasmid associated genes such as katP, espP, and etpD were more common in EHEC than in STEC strains; this supports their association with virulence. This array constitutes a valuable approach for the identification of STEC strains with a high potential for human virulence.


Portuguese Norms of Name Agreement, Concept Familiarity, Subjective Frequency and Visual Complexity for 150 Colored and Tridimensional Pictures.
Pictures are complex stimuli that require a careful control of several characteristics and attributes standardized for different languages. In this work we present for the first time European Portuguese (EP) norms for name agreement, concept familiarity, subjective frequency and visual complexity for a new set of 150 colored pictures. These pictures were selected to represent exemplars of the most used semantic categories in research and to depict objects which, though familiar to the participants, were rarely used in daily life, which makes them particularly prone to speech failures such as tip-of-the-tongue (TOT) states. Norms were collected from 640 EP native speakers that rated each picture in the four variables through a web-survey procedure. Results showed, as expected, that a large number of pictures in the dataset elicited a TOT response, and additionally that the ratings obtained in each of the dimensions are in line with those observed in other pictorial datasets. Norms can be freely downloaded at https://www.psi.uminho.pt/en/Research/Psycholinguistics/Pages/Databases.aspx.


Unique structural and electronic features of perferryl-oxo oxidant in Cytochrome P450.
We have performed hybrid density functional theory (DFT) calculations on the geometric and electronic structures of low-lying doublet and quartet ferryl-oxo [Fe(IV)═O] oxidants and a doublet perferryl-oxo [Fe(V)═O] oxidant in Cytochrome P450. Fully optimized structures of compound I models have been determined, and the proper symmetry of wave functions has been restored by the spin-projection technique. The results show that the perferryl-oxo species is relatively low lying, as compared with the excited state of the ferryl-oxo species, if the iron-oxo bond is properly described as the mixing of several appropriate excited electronic configurations to minimize electron repulsion. This means that the perferryl-oxo species is virtually in a mixed-valent resonance state, ↑Fe(V)═O ↔ ↑Fe(IV)•↑-↓•O, containing a highly reactive pπ atomic oxygen radical. The anionic thiolate ligand acts as a Lewis σ base and functions to achieve the stability of the perferryl-oxo complex and to activate the oxo ligand trans to it by asymmetric bond distortion along the O-Fe-S axis by lengthening the Fe-O bond and shortening the Fe-S bond, prior to the hydrogen-atom abstraction from the substrate.


Outcome of COPD patients performing nocturnal non-invasive mechanical ventilation.
The role of non-invasive nocturnal domiciliary ventilation (NNV) in chronic obstructive pulmonary disease (COPD) patients with chronic hypercapnia is still discussed. The aims of this study were to evaluate the long-term survival, the clinical effectiveness and side-effects of NNV in these patients. Forty-nine stable hypercapnic COPD patients on long-term oxygen therapy (LTOT) were assigned to two groups: in Group 1, 28 patients performed NNV by pressure support modality in addition to LTOT; in Group 2, 21 patients continued their usual LTOT regimen. Treatment was assigned according to the compliance to NNV, after an in hospital period. Mortality rate, hospital stay (HS) and ICU admissions (IA) were recorded in the two groups. HS and IA were compared to those recorded in a similar period of follow-back. Lung and respiratory muscle function, dyspnoea, and exercise capacity (by 6-min walk test) were evaluated baseline and every 3-6 months up to 3 yr. Mean follow-up time was 35 +/- 7 months. Mortality rate was not different between the two groups: 16, 33, 46% and 13, 28, 50% at 1, 2 and 3 yr in Groups 1 and 2 respectively. Lung and respiratory muscle function did not significantly change over time. A significant increase in 6-min walk test (from 245 +/- 78 to 250 +/- 88, 291 +/- 75, 284 +/- 89 m after 1, 2 and 3 yr respectively, P < 0.01) was observed only in patients undergoing NNV. In comparison to the follow back HS significantly decreased in both groups (from 37 +/- 29 to 15 +/- 12 and from 32 +/- 18 to 17 +/- 11 days/pt/yr in Groups 1 and 2 respectively, P < 0.001) whereas IA significantly decreased only in patients performing also NNV (from 1.0 +/- 0.7 to 0.2 +/- 0.3/pt/yr, P < 0.0001). Addition of NNV by pressure support modality to LTOT does not improve long term survival but significantly reduces ICU admissions and improves exercise capacity in severe COPD with hypercapnia.


Recent developments in PET scan imaging of neuroreceptors in schizophrenia.
Among the brain imaging techniques developed during the past two decades, positron emission tomography (PET) has the highest sensitivity allowing the analysis of specific neurotransmitter mechanisms in the living human brain. By using a combination of selective ligands labeled with positron emitting isotopes D1- and D2 dopamine, serotonin 5HT2, and benzodiazepine receptors were examined in schizophrenic patients (DSM-III-R) and healthy control subjects. With this technique receptor populations could be excellently visualized and quantified with regard to number and binding characteristics in several brain regions. The characteristics of the total D1 and D2 dopamine receptor populations in the caudate and putamen did not differ in young drug-naive schizophrenic patients and age-matched control subjects. Also for 5HT2 and benzodiazepine receptors no major alteration of receptor characteristics was observed in several neocortical and limbic brain regions. However, in schizophrenic patients treated with chemically different types of antipsychotic drugs major reductions of ligand binding was observed indicating specific induction of neuroreceptor occupancy. Thus, all chemically different types of antipsychotic drugs examined induced a substantial occupancy of D2 dopamine receptors. Clozapine in high doses induced a significantly lower degree of D2 dopamine receptor occupancy than the conventional drugs. Some but not all antipsychotics also induced a significant D1 dopamine receptor occupancy. In spite of the fact that the selective D1 antagonist SCH 39166 induced a substantial D1 occupancy, this drug did not exhibit an antipsychotic effect in schizophrenic patients. A very high degree of 5HT2 occupancy in neocortical regions was observed after clinical treatment with antipsychotic drugs as clozapine, risperidone and thioridazine.(ABSTRACT TRUNCATED AT 250 WORDS)


Neurodevelopmental outcome of children with congenital heart disease.
Congenital heart disease (CHD) constitutes the most common congenital malformation, with moderate or severe CHD occurring in around 6 in 1000 live births. Due to advances in medical care, survival rates have increased significantly. Thus, the majority of children with CHD survive until adolescence and adulthood. Children with CHD requiring cardiopulmonary bypass surgery are at risk for neurodevelopmental impairments in various domains, including mild impairments in cognitive and neuromotor functions, difficulties with social interaction, inattention, emotional symptoms, and impaired executive function. The prevalence for these impairments ranges from 20% to 60% depending on age and domain ("high prevalence-low severity"). Domains are often affected simultaneously, leading to school problems with the need for learning support and special interventions. The etiology of neurodevelopmental impairments is complex, consisting of a combination of delayed intrauterine brain development and newly occurring perioperative brain injuries. Mechanisms include altered intrauterine hemodynamic flow as well as neonatal hypoxia and reduced cerebral blood flow. The surgical procedure and postoperative phase add to this cascade of factors interfering with normal brain development. Early identification of children at high risk through structured follow-up programs is mandated to provide individually tailored early interventions and counseling to improve developmental health.


Surface Stabilized InP/GaP/ZnS Quantum Dots with Mg Ions for WLED Application.
One of the most highlighted cadmium-free quantum dots (QDs), InP-based QDs, have improved their optical properties. However, InP-based QDs have some practical drawbacks, for example, stability, compared with CdSe-based QDs. Poor stability of InP-based QDs yields critical problems, such as agglomeration and photoluminescence quenching in light emitting diode (LED). It has to be solved for applications and most research has focused on thick outer shells as an effective solution. We introduced magnesium cations for improving stability of InP-based QDs. We applied very small amounts of Mg cations as surface stabilizers, as a result, stability of QDs is clearly improved. Then, QD based LED chips also yield improved values including RA of 84.4, CCT of 3799 K, and luminous efficiency of 129.57 Im/W, which are highly improved data compared with our previous results.


[Estimation of abundance dynamics of gram-negative bacteria in soil].
Bacterial succession in soil was studied for two variants of initiation (moistening and moistening with addition of glucose). To determine the numbers of viable gram-negative bacteria, the modified nalidixic acid method was applied. The numbers of gram-negative bacteria revealed by this method were 2 to 3.5 times higher than those determined by the traditional method. In a developing community, the highest total bacterial numbers were observed on day 7; afterwards their numbers decreased and stabilized at a level exceeding four- to fivefold the initial one. In both experimental variants, the highest numbers of viable gram-negative bacteria were revealed on day 15 (75-85% of the total bacterial numbers). Morphology of these bacteria suggests their classification as cytophagas (chitinophagas) utilizing chitin from the dead fungal mycelium.


International variation in the interpretation of renal transplant biopsies: report of the CERTPAP Project.
The Banff working formulation of renal transplant pathology is intended to have international application. There remains a need to develop methods to harmonize the application of such grading systems between laboratories. Banff grades do not always permit precise management decisions to be made. Alternative schemes have been devised for the diagnosis of acute rejection, but there have been no independent tests of the different approaches. Sections from 55 renal transplant biopsies were circulated around the laboratories of 22 major transplant units for the Convergence of European Renal Transplant Pathology Assessment Procedures (CERTPAP) Project. Participating pathologists were asked to grade 32 different histological features, without any clinical information. After each circulation of five cases, feedback was provided to participants. Statistical evidence of improvement in interobserver variation was sought. At the end of the study, correlations with the original clinicopathological diagnosis were sought. Interobserver variation was greater than has previously been reported. For every feature studied, some pathologists consistently under-grade or over-grade. There was relatively little evidence of improvement in interobserver variation as a result of the feedback system. No single feature permitted a reliable diagnosis of acute rejection. Applying the Banff and CCTT schemas to the histological grades showed no clear diagnostic advantage for either system, but a simple computer-based inference network, which combined data from 12 histological features, out performed either approach. Within the "protocol" biopsies studied, long-term survival correlated better with "acute" than with "chronic" histological features. These results do not undermine the value of the Banff classification, but they demonstrate a need for caution when translating biopsy results between institutions. It is obvious that evaluation of biopsies in multicenter trials must be done in one center. In the management of individual patients, the need to interpret Banff grades in the light of local experience and clinical information is stressed.


Diagnosis and treatment of liver injury--the experience of the University Trauma Center.
The incidence of liver injury is increasing steadily because of serious injuries resulting mainly from traffic accidents. The aim of the study was to evaluate the results of the University Trauma Center, with consideration of the present diagnostic and therapeutic possibilities for liver injuries. Between January 1st 2000 and April 1st 2006 a total of 132 patients with various degrees of liver injury were admitted to the Trauma Center, University Hospital in Pilsen. 76 injured patients (57.6%) were treated conservatively, and only 56 (42.4%) received surgical treatment, with a total of 87 operations performed. 10 patients with polytrauma (7.6%) died of hemorrhagic shock (group Moore IV-VI). Six injured patients (4.5%) had a complicated course during their hospitalization. The average period of hospitalization was 17 days (1-69 days). The mortality and morbidity of patients with liver injury are comparable in the group presented here with the results of other large trauma centers. If compared with previous years, there has been a considerable decrease in mortality from this serious injury. At present the basic diagnostic means in liver injury are as follows: "bed-side" ultrasonography, spiral computed tomography, and in more complicated injuries magnetic resonance, angiography, or endoscopic retrograde cholangiography. In terms of therapeutic tactics conservative methods prevail in haemodynamically stable patients, irrespective of the degree of liver injury. The surgical policy applies "damage control surgery", where during the initial surgery life-saving and non-time-demanding procedures are the target (e.g. liver tamponade), correcting hypothermia, haemocoagulation and metabolic acidosis. Only after stabilization of the injured patient other definitive procedures are possible (Tab. 2, Ref. 16). Full Text (Free, PDF) www.bmj.sk.


Working memory and inferences: Evidence from eye fixations during reading.
Eye fixations during reading were monitored to examine the relationship between individual differences in working memory capacity-as assessed by the reading span task-and inferences about predictable events. Context sentences predicting likely events, or non-predicting control sentences, were presented. They were followed by continuation sentences in which a target word represented an event to be inferred (inferential word) or an unlikely event (non-predictable word). A main effect of reading span showed that high working memory capacity was related to shorter gaze durations across sentence regions. More specific findings involved an interaction between context, target, and reading span on late processing measures and regions. Thus, for high- but not for low-span readers, the predicting condition, relative to the control condition, facilitated reanalysis of the continuation sentence that represented the inference concept. This effect was revealed by a reduction in regression-path reading time in the last region of the sentence, involving less time reading that region and fewer regressions from it. These results indicate that working memory facilitates elaborative inferences during reading, but that this occurs at late text-integration processes, rather than at early lexical-access processes.


Proverbs provides guidelines for management in next century.
Management in the next century will require skills and techniques that focus on technology, financial planning, information processing, and other technical areas, but other critical management concerns cannot be ignored. The Chief of Naval Operations' Commission on Personal Excellence and National Security has defined education, health, and ethical behavior as the three critical national security issues in the next century. Certain trends in the United States--the shrinking size of the entry-level labor force, shortfall in high school graduates' ability to succeed in the workplace, escalating healthcare expenditures, and failure of training to produce its intended results--increase the need for managers to focus on these issues. Organizing people, groups, and organizations to achieve excellence requires a set of guidelines with proven sensitivity, truth in many situations, strength, and durability. The book of Proverbs, although 2000 years old, provides such rules that address the issues of education, health, and ethical behavior. These guidelines can be used to strengthen managers' ability to meet the challenges of the twenty-first century.


[The effect of ethanol exposure in pregnancy on maturation of monoaminergic systems in the developing rat bran].
Simultaneous study of the main neurotransmitter of monoaminergic system of the brain, its metabolites, activity of catechol-O-methyltransferase (COMT) and the state of different subtypes of dopamine (DA) receptors in the developing brain of offspring from mothers alcoholized in gestation and feeding periods revealed a decrease in activity of all monoaminergic systems studied with reduction of noradrenaline and DA level in alcoholized fetus as well as of mPNA of COMT, an enzyme of catecholamine metabolism, in the structures of the forebrain on the 17th day but not on 13th day of prenatal development. In parallel experiments, an increase of the contents of both long and short splice variants of D2 DA receptor was registered. In postnatal period (days 4, 10, 17), further decrease of the DA system activity was observed, particularly a reduction of DOPAC level and DOPAC/DA ratio in rat litter, mothers of whom took alcohol in the gestation period with withdrawal it after birth of offspring. The serotonin system activity was also reduced in alcoholized litter in the postnatal period and was registered in the early stages (on the 4th day of life). Therefore, the serotonin system activity is changing at early stages of development (the 4th day), whereas inhibition of the DA system activity is registered at later stages (the 10th day of life).


Stable hematopoietic recovery after peripheral blood stem cell transplantation in patients receiving high-dose chemotherapy for advanced germ cell tumors.
The objective of this study was to evaluate the utility of CD34-positive peripheral blood stem cell transplantation (PBSCT) in the hematopoietic recovery, in patients receiving high-dose chemotherapy (HDCT), for advanced germ cell tumor (GCT). This study included 41 patients with advanced GCT, who were treated with HTCT combined with PBSCT. PBSCs were harvested after conditioning chemotherapy followed by the administration of granulocyte colony-stimulating factor. A retrospective analysis of a total of 86 PBSCTs was carried out focusing on the effects of several factors, including age (<35 years versus > or = 35 years), CD34-positive cell dose (<5.0 x10(6)/kg versus > or =5.0 x10(6)/kg), indication of HDCT (first-line versus salvage) and previous history of HDCT before PBSCT (with versus without), on hematopoietic recovery after PBSCT. The median number of CD34-positive PBSCs collected during a single apheresis and the median cumulative number of CD34-positive PBSCs from each patient were 8.3x10(6)/kg and 23.2x10(6)/kg, respectively. The median number of PBSCT performed in each patient was two and the median number of CD34-positive cells transplanted during a single course was 5.7x10(6)/kg. The median recovery times to white blood cells (WBC) greater than 500/microl, 1000/microl and 2000/microl were 8, 9 and 10 days, respectively, following PBSCT, while that to neutrophils greater than 500/microl and that to platelets greater than 50000/microl were 9 and 13 days, respectively, following PBSCT Only the recovery time to platelet count greater than 50000/microl was significantly affected by age; however, there were no significant differences in the recovery of WBC, neutrophils and platelets in relation to several parameters examined. These findings suggest that CD34-positive PBSCT may facilitate stable hematopoietic recovery after HDCT in patients with advanced GCT, and that HDCT, if combined with PBSCT, could be performed with comparative safety in such patients, irrespective of their individual characteristics.


[Selective brain cooling].
The brain is especially sensitive to heat stress. To limit the increase of intracranial heat in case of hyperthermia or fever, a system of selective cooling is put on. It includes two heat-exchangers. The first one, in the face and scalp skin, disperses calories through sweat evaporation. The second one is intracranial, close to the arteries which irrigate the brain. They are connected by a vascular network. In these conditions, the arterial blood temperature, of which cerebral temperature depends upon, is reduced by the cooled venous blood which comes from subcutaneous tissues through the skull wall. On feverish children, increasing such a selective cooling by face fanning can limit cerebral thermal stress.


Estimation of blood loss is inaccurate and unreliable.
To determine the characteristics associated with improved accuracy or reliability of estimating operative blood loss. Operating room personnel at a tertiary care hospital evaluated 3 operative simulations and provided estimations of blood loss. The simulations utilized precise, known volumes of porcine blood and saline on tapes, sponges, and in suction containers. Low volume (50 mL), mid volume (300 mL), and high volume (900 mL) blood loss scenarios were used in this simulation. Information collected included the blood loss estimation, the participant's occupation, years of experience in the operating room, confidence level in estimating blood loss, and their opinion as to which group would provide the most accurate estimation. Sixty practitioners participated: 17 anesthesia providers, 22 surgeons, and 21 nurses and technicians. Overall, estimations were significantly inaccurate: scenario 1, mean error 52%; scenario 2, mean error 61%; scenario 3, mean error 85%. Ninety-five percent of participants provided estimations that had >25% error in at least 1 scenario. Only 27% demonstrated consistency in over or under-estimating the blood loss. There was no association between specialty, years of experience, or confidence in ability with consistency or accuracy of estimating blood loss. This study demonstrates that visual estimation of operative blood loss is unreliable and inaccurate. No provider specialty, level of experience, or self-assessment of ability was associated with improved estimation. Blood loss estimations are not a reliable metric to judge physician performance or patient outcomes. Consideration should be given to alternative reporting of operative blood loss to better direct perioperative care.


Barriers to human immunodeficiency virus related risk reduction among male street prostitutes.
Two hundred eleven male street prostitutes between the ages of 18 and 51 years were interviewed and tested for antibodies to the human immunodeficiency virus (HIV). Economic, social, and emotional barriers to the reduction of HIV-related risk behavior were examined within the context of several concepts present in the Health Belief Model (HBM). Three lifestyle factors were found to function as barriers to engaging in risk reduction behavior. Subjects who were more economically dependent on prostitution, perceived less control over the hustling encounter, and reported increased pleasure from sexual activity with their customers were more likely to engage in risk-taking behavior. Prostitutes' perception of the severity of HIV infection was not significantly associated with their risk behavior. Unexpected findings indicated that increases in perceived susceptibility to HIV and perceived benefit of condom use for HIV prevention were significantly related to increased risk-taking behavior. Practical applications of findings in the design and implementation of future HIV-related preventive health education programs are discussed.


Health of children whose parents seek psychiatric care.
The study comprises 69 pre-school children whose parents, mainly mothers, had sought care at a department of psychiatry in Stockholm. The majority of the parents had attended for recurrent ambulatory treatment (58%) or had only come to the emergency room (25%). The children demonstrated a significantly higher frequency of somatic and emotional symptoms than a matched control group. To a large extent, the index children showed failure to thrive without any apparent organic cause. In exceptional cases there had been co-operation between the departments of psychiatry and paediatrics (one case) as well as between the departments of psychiatry and social welfare (five cases). There is an urgent need to develop methods within the scope of psychiatric care whereby the best interests of both the parents and the children are taken into consideration.


Neuronal and glial plasma membrane carrier-mediated uptake of L-homocysteate is not selectively blocked by beta-p-chlorophenylglutamate.
The proposed action of beta-p-chlorophenylglutamate (chlorpheg) as a selective blocker of L-homocysteate uptake was studied in primary cultures of mouse brain neurons and astrocytes and in rat brain synaptosomes. The preparations were incubated with 1 microM to 10 mM L-homocysteate and D-aspartate in the absence and presence of 7.5 mM chlorpheg. In each preparation uptake of the two amino acids comprised a saturable uptake and a non-saturable (passive diffusion) component. L-Homocysteate was of at least 100-fold lower affinity than D-aspartate as a substrate for the amino acid transporter. Chlorpheg was shown to be essentially equieffective as a weak competitive inhibitor of only the saturable uptake of L-homocysteate and D-aspartate. It is concluded that chlorpheg is not a selective blocker of L-homocysteate uptake.


Clostridial bacteremia: implications for the surgeon.
Clostridial bacteremia is rare and has a variable presentation from asymptomatic to septic shock with disseminated intravascular coagulation (DIC), red cell hemolysis, and rapid death. In order to delineate the predisposing and prognostic factors in these patients, the authors reviewed 47 cases of clostridial bacteremia presenting over a seven year period at a major metropolitan teaching hospital. Predisposing factors included locally decreased oxidation reduction potential (Eh) in 43 per cent (including atherosclerosis, diabetes, and radiation therapy), systemic immunosuppression in 53 per cent (including alcohol abuse, chemotherapy, steroids, and malignancy), and a site of epithelial barrier disruption. The sites of clostridial invasion included: gastrointestinal tract (GI) (n = 22), pulmonary (n = 7), cutaneous (n = 7), undetermined (n = 7), and female genital tract (n = 4). Seven patients were found to have malignancy. Seventy-nine per cent of the blood culture isolates were histotoxic species (Clostridia perfringens and C. septicum). The overall mortality was 47 per cent. Significant differences between survivors and deaths included DIC, new onset renal failure, severe atherosclerotic disease, and age (P less than .05). The authors conclude that clostridial bacteremia is uncommon but highly lethal and may occur when decreased tissue Eh, systemic immunosuppression, and an epithelial barrier disruption are present. Poor outcome appears to be a reflection of advanced age, underlying illness, and presence of a histotoxic species.


Preliminary clinical results of photon energy recovery in simultaneous rest Tl-201/stress Tc-99m sestamibi myocardial SPECT.
The purpose of this study is to report the first clinical results obtained with the spectral deconvolution technique photon energy recovery (PER) for crosstalk correction in simultaneous rest thallium 201/stress technetium 99m sestamibi myocardial perfusion single photon emission computed tomography (SPECT). Thirty-four patients with suspected coronary artery disease received Tl-201 (111-130 MBq) at rest, followed by single SPECT. Tc-99m sestamibi (444-518 MBq) was then injected at stress, followed by dual SPECT. Single SPECT data were processed to obtain the following data sets: single raw (conventional) Tl-201 and single PER (scatter-corrected) Tl-201. Dual SPECT data were processed to obtain the following data sets: dual raw Tl-201, dual PER (scatter- and crosstalk-corrected) Tl-201, dual raw Tc-99m, and dual PER (scatter-corrected) Tc-99m. All data sets were automatically analyzed with Cedars-Sinai Quantitative Perfusion SPECT software to derive the relative segmental uptake, the summed score, and the summed difference score. The relative segmental uptake, the summed score, and the number of patients with significant reversibility (summed difference score >2) were 74.84% +/- 12.79%, 3.44 +/- 3.07, and 13, respectively, for single raw Tl-201; 80.5% +/- 10.18%, 1.97 +/- 2.25, and 20, respectively, for dual raw Tl-201; 69.47% +/- 14.08%, 6.41 +/- 3.68, and 17, respectively, for single PER Tl-201; and 69.99% +/- 13.39%, 6.58 +/- 3.63, and 17, respectively, for dual PER Tl-201. The differences between single and dual raw Tl-201 data sets were highly significant, whereas there was no significant difference between PER-corrected Tl-201 data sets. PER is quantitatively efficient to correct for crosstalk in patients investigated with simultaneous rest Tl-201/stress Tc-99m sestamibi myocardial SPECT.


Doctoral dissertations on hypnosis: 1980-1989.
This article extends Clark, Hungerford, and Reilley's (1984) review of dissertations accepted by American universities from 1923 to 1980 by examining dissertations of the 1980s. A table shows which areas of research received the most attention in each of the last 3 decades. There was an increase in the percentage of psychology and educational psychology researchers using hypnosis in dissertations.


Medicare's next voyage: encouraging physicians to adopt health information technology.
Although there is growing consensus that health information technology (HIT) will be critical to improving health care quality and reducing costs, physicians' investments in technology remain limited. As the largest single U.S. purchaser of health care services, Medicare has the power to promote physician adoption of HIT. The Centers for Medicare and Medicaid Services should clarify its technology objectives, engage the physician community, shape the development of standards and technology certification criteria, and adopt concrete payment systems to promote adoption of meaningful technology that furthers the interests of Medicare beneficiaries.


[Exposure to mercury in the population. II. Mercury release from amalgam fillings].
Urinary levels of mercury (HgU) were measured in 93 males and females aged 18-63 years. Subjects with amalgam fillings (n = 72) had, on average, significantly higher levels of mercury in urine (mean = 0.57 microgram Hg/l and 0.79 microgram Hg/g creatinine, respectively) than subjects without amalgam fillings (n = 21; mean = 0.18 micrograms Hg/l and 0.24 microgram Hg/g creatinine, respectively). Urinary mercury excretion was significantly correlated with the number of amalgam surfaces (log HgU (microgram/l) vs. number of amalgam fillings: r = 0.435, P less than 0.001; log HgU (microgram/g creatinine) vs. number of amalgam fillings: r = 0.575, p less than 0.001). The results indicate that internal mercury exposure from amalgam fillings is, on average, higher than internal exposure to mercury from food and other sources.


Reliability of the New AOSpine Classification System for Upper Cervical Traumatic Injuries.
The new AOSpine Upper Cervical Classification System (UCCS) was recently proposed by the AOSpine Knowledge Forum Trauma team to standardize the treatment of upper cervical traumatic injuries (UCI). In this context, evaluating its reliability is paramount prior to clinical use. To evaluate the reliability of the new AOSpine UCCS. A total of 32 patients with UCI treated either nonoperatively or with surgery by one of the authors were included in the study. Injuries were classified based on the new AO UCCS according to site and injury type using computed tomography scan images in 3 planes by 8 researchers at 2 different times, with a minimum interval of 4 wk between assessments. Intra- and interobserver reliability was assessed using the kappa index (K). Treatment options suggested by the evaluators were also assessed. Intraobserver agreement for sites ranged from 0.830 to 0.999, 0.691 to 0.983 for types, and 0.679 to 0.982 for the recommended treatment. Interobserver analysis at the first assessment was 0.862 for injury sites, 0.660 for types, and 0.585 for the treatment, and at the second assessment, it was 0.883 for injury sites, 0.603 for types, and 0.580 for the treatment. These results correspond to a high level of agreement of answers for the site and type analysis and a moderate agreement for the recommended treatment. This study reported an acceptable reproducibility of the new AO UCCS and safety in recommending the treatment. Further clinical studies with a larger patient sample, multicenter and international, are necessary to sustain the universal and homogeneity quality of the new AO UCCS.


Influence of mating on surface nutrient exchange in schistosomes.
In schistosomes, the mating process influences male-female transfer and gender-specific exchange of nutrients. The paired male schistosome provides glucose to the female partner. Male-to-female intertegumental transfer of(14)C-labeled glucose,(14)C-labeled 3-O-methylglucose, [(14)C]2-deoxyglucose and 2-fluorodeoxyglucose has been demonstrated in schistosomes. This phenomenon has been studied extensively inSchistosoma mansoni, and confirmed inSchistosoma japonicum, as well asS. haematobium, using radioactive pulsing methods. Male schistosomes contain significantly greater quantities (nmol/mg worm water) of glucose than do females. The transfer of glucose is apparently not an energy-dependent process, but occurs along this concentration gradient. Most, if not all, of the glucose utilized by the female is transferred from the male partner via tegumentary-facilitated diffusion mechanisms, free diffusion, or some combination of these two components. Unpaired male schistosomes contain greater quantities of glycogen than do comparable paired schistosomes, indicating that the presence of a female in the gynecophoral canal depletes the reserves of the male partner; this is additional indirect evidence for male-to-female transfer of glucose. Tegumentary surface uptake of acidic amino acids has been compared in paired and separated male and female schistosomes. InS. mansoni, a saturable carrier-mediated mechanism has been defined which operates only in unpaired male and unpaired female teguments. In contrast, the uptake of aspartate and glutamate is not seen in paired worms of this species. Tegumental uptake of acidic amino acids is not observed in paired or unpaired male or femaleS. japonicum. However, inS. haematobium, significant quantities of aspartate are taken up by both paired and unpaired male schistosomes. Measurable aspartate uptake is seen in paired femaleS. haematobium, but in the separated female, there is minimal uptake of this acidic amino acid. Thus the permeability of the teguments of human schistosome species to acidic amino acids is modified in response to the paired state inS. mansoni andS. haematobium, but these characteristics are not shared byS. japonicum.


Combined thrombolysis with abciximab and rtPA in patients with middle cerebral artery occlusion.
In patients with acute middle cerebral artery (MCA) occlusion, recanalization rates with intravenous (IV) recombinant tissue plasminogen activator (rtPA) are limited. Aim- We evaluated the feasibility and safety of combined IV thrombolysis with abciximab and reduced dose rtPA in a 3- to 6-h time window. We prospectively (March 2002 to February 2005) studied patients with symptomatic MCA occlusion on computed tomography (CT) angiography and absence of major early ischemic changes (EIC) on non-contrast CT (NCCT) within 3-6 h from symptom onset. Patients were treated with IV abciximab and half-standard dose rtPA. Outcome parameters were symptomatic intracerebral hemorrhage (sICH), early clinical improvement and functional independence at discharge (modified Rankin Scale score < or = 2). Of 13 patients, mean age was 62 +/- 11 years, onset-to-treatment time 4.8 +/- 0.9 h and median baseline National Institutes of Health Stroke Scale score 11 (interquartile range 6.5-13.5). sICH occurred in one patient (8%). We observed early clinical improvement in four patients (31%). Six patients (46%) were functionally independent at discharge. In patients with acute symptomatic MCA occlusion and absence of major EIC on NCCT, combined IV thrombolysis with abciximab and half-standard dose rtPA was feasible and seemed to be safe if applied within 3-6 h from symptom onset.


Multiplexed CRISPR/Cas9 Genome Editing and Gene Regulation Using Csy4 in Saccharomyces cerevisiae.
Clustered regularly interspaced short palindromic repeats (CRISPR) technology has greatly accelerated the field of strain engineering. However, insufficient efforts have been made toward developing robust multiplexing tools in Saccharomyces cerevisiae. Here, we exploit the RNA processing capacity of the bacterial endoribonuclease Csy4 from Pseudomonas aeruginosa, to generate multiple gRNAs from a single transcript for genome editing and gene interference applications in S. cerevisiae. In regards to genome editing, we performed a quadruple deletion of FAA1, FAA4, POX1 and TES1 reaching 96% efficiency out of 24 colonies tested. Then, we used this system to efficiently transcriptionally regulate the three genes, OLE1, HMG1 and ACS1. Thus, we demonstrate that multiplexed genome editing and gene regulation can be performed in a fast and effective manner using Csy4.


Forest filter effect for polybrominated diphenyl ethers in a tropical watershed.
There is limited research characterizing the fates of persistent organic pollutants in tropical multi-use watersheds. This study aimed to evaluate the role of forests in the environmental fates of select polybrominated diphenyl ethers (PBDEs) for a case study tropical drainage basin, the Rio Cobre watershed. Field samples of deposition, soil, litterfall and the atmosphere of a forest and nearby clearing were analyzed for the presence of the PBDEs (PBDE-28, 47, 99, 100, 153, 154, 183 and 209), which are routinely detected in the environment. The mean air and litterfall concentrations of these PBDEs were generally lower in the forest than in the clearing, whereas the deposition flux rate and soil concentrations were higher in the forest. The results suggest that the forest filtered the PBDEs by transferring them from the atmosphere to the soil, despite the tropical nature of the study site.


Effects of long-term exercise on the biomechanical properties of the Achilles tendon of guinea fowl.
The purpose of this study was to determine the effect of long-term exercise on tendon compliance and to ascertain whether tendons adapt differently to downhill running vs. running on a level surface. We carried out this investigation on the gastrocnemius tendon of helmeted guinea fowl (Numida meleagris) that were trained for 8-12 wk before commencing experimental procedures. We used an in situ technique to measure tendon stiffness. The animals were deeply anesthetized with isofluorane during all in situ procedures. Our results indicate that long-term exercise increased tendon stiffness. This finding held true after normalization for the cross-sectional area of the free tendon, likely reflecting a change in the material properties of the exercised tendons. Whether training consisted of level or downhill running did not appear to influence response of the tendon to exercise. We hypothesize that the increased stiffness observed in tendons after a long-term running program may be a response to repeated stress and may function as a mechanism to resist tendon damage due to mechanical fatigue.


Non-Hodgkin lymphoma manifesting as massive malignant chylothorax: successful management with chemotherapy and ambulatory drainages using indwelling pleural catheter.
Recurrent cancer-related chylothorax is generally managed by talc pleurodesis or indwelling pleural catheter in the palliative care setting to relieve symptoms and improve quality of life. In chylothorax associated with curable/treatable malignancies like lymphoma, there are scarce data regarding the efficacy and safety of indwelling pleural catheters. We report a case of recurrent massive chylothorax associated with non-Hodgkin lymphoma who demonstrated long-term remission of lymphoma and complete regression of chylothorax after treatment with combination chemotherapy and ambulatory drainages using indwelling pleural catheter.


Expression of gap junction proteins (connexin 26, 30, 32, 43) in normal mucosa, hyperkeratosis and carcinoma of the human larynx.
Gap junction proteins (connexins = Cx) form transmembrane channels and mediate the transfer of small molecules and ions between the cytoplasm of adjacent cells. Most tissues express several Cx isoforms. The precise combination might play an important role in the maintenance of cell differentiation. Human carcinogenesis is accompanied by aberrant expression and function of Cx. While the larynx is a target organ for many tumor promoters, no data on Cx expression in laryngeal mucosa are available. The goal of the study was to observe the expression of different Cx (Cx26, -30, -32 and -43) in the normal mucosa, hyperkeratoses and carcinomas of the human larynx. The immunofluorescence method was performed in normal (n = 7) and dysplastic (n = 6) laryngeal mucosa and in squamous cell carcinoma (n = 7) using affinity-purified polyclonal rabbit antibodies against the 4 Cx isoforms and FITC-conjugated secondary antibodies. The immunofluorescence staining of the normal human vocal fold's epithelium showed the expression of Cx26 and Cx30 in the parabasal and intermediate layers, whereas Cx43 was localized in the basal, parabasal and lower intermediate layers. Cx epitopes could not be found in the upper layers. The precanceroses showed a similar expression of the Cx compared to normal laryngeal epithelium. Due to the higher degree of staining observed in dysplastic specimens, a hyperexpression of Cx26, -30 and -43 could be assumed. The squamous cell carcinomas were characterized by inhomogeneous staining for Cx26, -30 and -43. Regions of intensive expression alternated with regions of no expression. Cx32 could not be observed by immunofluorescence staining in laryngeal tissue. In immunohistochemical terms, there was no alteration of the expression of Cx isoforms during carcinogenesis in the laryngeal epithelium. These results do not exclude a loss of functional intercellular gap junction communication by posttranslational modifications of Cx isoforms or disturbed Cx integration into the gap junction channel. Further studies should investigate potential defective gap junctional intercellular communication in cancer cells based on molecular studies.


Cre/lox-mediated marker gene excision in transgenic maize (Zea mays L.) plants.
After the initial transformation and tissue culture process is complete, selectable marker genes, which are used in virtually all transformation approaches, are not required for the expression of the gene of interest in the transgenic plants. There are several advantages to removing the selectable marker gene after it is no longer needed, such as enabling the reuse of selectable markers and simplifying transgene arrays. We have tested the Cre/ lox system from bacteriophage P1 for its ability to precisely excise stably integrated marker genes from chromosomes in transgenic maize plants. Two strategies, crossing and autoexcision, have been tested and demonstrated. In the crossing strategy, plants expressing the Cre recombinase are crossed with plants bearing a transgene construct in which the selectable marker gene is flanked by directly repeated lox sites. Unlike previous reports in which incomplete somatic and germline excision were common, in our experiments complete somatic and germline marker gene excision occurred in the F(1) plants from most crosses with multiple independent Cre and lox lines. In the autoexcision strategy, the cre gene, under the control of a heat shock-inducible promoter, is excised along with the nptII marker gene. Our results show that a transient heat shock treatment of primary transgenic callus is sufficient for inducing cre and excising the cre and nptII genes. Genetic segregation and molecular analysis confirmed that marker gene removal is precise, complete and stable. The autoexcision strategy provides a way of removing the selectable marker gene from callus or other tissues such as embryos and kernels.