Type III talon cusp and Type III B dens invaginatus occurring simultaneously in a mandibular lateral incisor.
Talon cusp and dens invaginatus are developmental anomalies of the human dentition. They not only affect the esthetic appearance of teeth but also may create difficulties during dental treatment and lead to a number of dental problems. Both anomalies are observed most commonly in the lateral maxillary incisor and rarely in the mandibular dentition. The simultaneous occurrence of talon cusp and dens invaginatus in a single tooth is very rare in the mandibular dentition and, to the authors' knowledge, has not yet been reported in a mandibular lateral incisor. This article presents a rare case of dens invaginatus and talon cusp occurring concurrently in a mandibular lateral incisor. Three-dimensional imaging modality was used to describe the complex internal anatomy.


[Cardiac longitudinal study of children perinatally exposed to human immunodeficiency virus type 1].
To determine the frequency of cardiac abnormalities and its natural history in children perinatally exposed to HIV-1. Eighty-four children exposed to HIV-1 were evaluated by serial clinical, electrocardiographic (ECG), and Doppler-echocardiographic (ECHO) examinations. Group I--(seroreversion)--43 children (51.2%). Absence of clinical abnormalities. ECG: incomplete right bundle branch block (RBBB) 5 cases. ECHO: atrial septal defect (ASD) and ventricular septal defect (VSD)--1 case each. Group II--41 HIV-infected children (48.8%), of whom 51.2% were found to have cardiac abnormalities. Asymptomatic or mildly symptomatic children without immunosuppression: no clinical and echocardiographic abnormalities; ECG: incomplete right bundle branch block (RBBB)--(2 cases). Children with moderate and severe symptoms and immunological impairment: the following abnormalities were found: 1) clinical (31.7%)-isolated tachycardia (1 case), congestive heart failure (12 cases). 2) electrocardiographic (43.9%)- sinus tachycardia associated with other abnormalities (10 cases), incomplete right bundle branch block (5 cases), left anterior hemiblock (1 case), right anterior hemiblock (1 case), changes in ventricular repolarization (11 cases), right ventricular overload (2 cases), left ventricular overload (1 case), right QRS axis deviation (1 case), and arrhythmias (3 cases). 3) echocardiographic (26.8%)- dilated cardiomyopathy (5 cases), pericardial effusion with tamponade (2 cases), pulmonary hypertension (2 cases), and mitral valve prolapse (1 case). Cardiac involvement was a characteristic of the HIV-infected group. Higher prevalence of abnormalities was found among children belonging to the most advanced clinical and immunological category. The most commonly observed clinical, electrocardiographic and echocardiographic findings were congestive heart failure (CHF), changes in ventricular repolarization, and dilated cardiomyopathy, respectively. The latter was reversible in one case. Electrocardiogram changes were significantly more frequent than clinical and echocardiographic changes.


[Identification of the epidural space by air-fluid reflux (author's transl)].
Detection of the epidural space by Dogliotti's method with a Tuohy needle (inner gauge 1.6mm) is followed by introduction of 3.0-5.0 ml of test solution and rapid injection of 3.0-5.0 ml air with a 5.0ml syringe. After the introduction of the air, the syringe is immediately removed from the needle. Location of the needle tip in the epidural space is marked by air bubbles coated by a thin fluid film, which hang over the hub of the needle and then burst. In some instances a slight wheezing can be heard as the air introduced into the epidural space comes out. The air-fluid reflux is determined by the elasticity of the dura and points always at the location of the tip of the needle in the epidural space. This sign is present in 95 per cent of the cases. The intensity of the air-fluid reflux depends upon the elasticity of the dura, the diameter of the needle and of the syringe and the force by which the plunger is pushed down.


Molecular characterization of Neospora caninum MAG1, a dense granule protein secreted into the parasitophorous vacuole, and associated with the cyst wall and the cyst matrix.
In Neospora caninum and Toxoplasma gondii, the parasitophorous vacuole (PV) is synthesized at the time of infection. During tachyzoite-to-bradyzoite stage conversion, the PV is later transformed into a tissue cyst that allows parasites to survive in their host for extended periods of time. We report on the characterization of NcMAG1, the N. caninum orthologue of T. gondii MAG1 (matrix antigen 1; TgMAG1). The 456 amino acid predicted NcMAG1 protein is 54% identical to TgMAG1. By immunoblotting, a rabbit antiserum raised against recombinant NcMAG1 detected a major product of approximately 67 kDa in extracts of N. caninum tachyzoite-infected Vero cells, which was stained more prominently in extracts of infected Vero cells treated to induce in vitro bradyzoite conversion. Immunofluorescence and TEM localized the protein mainly within the cyst wall and the cyst matrix. In both tachyzoites and bradyzoites, NcMAG1 was associated with the parasite dense granules. Comparison between NcMAG1 and TgMAG1 amino acid sequences revealed that the C-terminal conserved regions exhibit 66% identity, while the N-terminal variable regions exhibit only 32% identity. Antibodies against NcMAG1-conserved region cross-reacted with the orthologuous protein in T. gondii but those against the variable region did not. This indicates that the variable region possesses unique antigenic characteristics.


Pancreatic enzymes generate cytotoxic mediators in the intestine.
Recent evidence indicates that shock is accompanied by a failure of the mucosal barrier in the intestine and entry of pancreatic digestive enzymes into the wall of the intestine. To investigate the formation of cytotoxic mediators produced by enzymatic digestion of the intestine, we applied homogenates of rat small intestinal wall to human neutrophils and used flow cytometry measurements of propidium iodide uptake to determine cytotoxicity. We show that homogenates of the small intestine after ischemia by occlusion of the superior mesenteric and celiac arteries for 3 h, but not without ischemia, are cytotoxic. Digestion of homogenates of nonischemic intestinal wall with purified trypsin, chymotrypsin, or elastase, proteases normally present in the intestinal lumen, yielded cytotoxic mediators. Before cell death, we saw cell damage in the form of bleb formation and flow cytometry measurements of cell size changes due to blebbing. Cytotoxicity was prevented by serine protease inhibition with phenylmethylsulfonyl fluoride (PMSF) before, but not after proteolytic digestion of the wall homogenates, indicating that enzymatic action of proteases on the homogenate is necessary for cytotoxicity. Cytotoxicity of wall homogenates digested by enzymes in the fluid collected from the lumen of the intestine was greater than digests by the individual purified proteases. Cytotoxicity is undetectable if digestive enzymes in the luminal fluid are inhibited with a combination of enzyme inhibitors PMSF and 6-amidino-2-naphthyl p-guanidinobenzoate dimethanesulfonate before addition of wall homogenates. Passage of digested intestinal wall homogenates across a hydrophobic glass-fiber filter reduced cytotoxicity. Furthermore, we found that luminal fluid itself may be cytotoxic, possibly because of digestion of ingested food. To test whether digested food can be cytotoxic, we homogenized rat food and digested it in vitro with chymotrypsin or endogenous enzymes in luminal fluid. Cytotoxicity was significantly increased after digestion of food by luminal fluid compared with luminal fluid or undigested food. These results indicate the presence of a previously unknown mechanism for hemorrhagic necrosis in shock.


Hydroxyapatite-chitosan biocomposites synthesized in the simulated body fluid and their drug loading studies.
Hydroxyapatite (HAp) is a bioceramic applied in the biomedical areas, such as matrices for drug release control. Chitosan (CTS), a natural polymer, is another material has been widely investigated for its potential use in the drug delivery systems. In this study, the composites of HAp-CTS are produced in order to investigate their drug loading and release studies. First of all, HAp-CTS composites are produced in the presence of simulated body fluid (SBF). Analysis confirmed the structure of HAp-CTS composites. Secondly, composites are encapsulated with 5-Fluorouracil (5-FU). The weight ratio of CTS is varied to realize its effect on drug loading of 5-Fluorouracil, a cancer drug, for the ratios of 1:1, 1:2 and 1:4 of HAp-CTS. The weight ratio giving the greatest drug load efficiency is selected for the last step of the study. Crosslinking agent, glutaraldehyde, are changed from 0 to 5% on the selected sample, then, drug loading is examined again in various environment owing different pH. Furthermore, drug release studies are conducted. To understand the structure and morphology of the samples, XRD, FTIR, SEM and Uv-Spectrum are applied. It is observed that weight ratio of polymer and crosslinking agent can be manipulated to adjust drug loading. Release kinetics are shown the Fickian diffusion. This new produced material can be applicable for drug delivery.


Experimental study of the pressure-volume and pressure-time relations in the completely obstructed pelvis of the porcine kidney. Part 4: Instability and blow out.
In a series of experiments with pigs the completely obstructed renal pelvis was filled with Ringer's lactate at a constant rate of 2 ml/min until the pressure did not longer increase linearly. By means of continuous X-ray monitoring and histological examination of the infused kidneys it was found that blow out may occur at pressure levels individually varying from 60 to 180 mmHg. The histological features of this phenomenon are presented and the clinical significance is discussed.


Transcuneiform and opening wedge medial cuneiform osteotomy with closing wedge cuboid osteotomy in relapsed clubfoot.
Ten patients (13 feet) aged 4 to 11 years with idiopathic clubfeet underwent bony correction for resistant supination and adduction deformities. A closing wedge cuboid osteotomy and medial cuneiform opening wedge and transcuneiform osteotomy were performed in all cases. The average improvement in anteroposterior talo-first metatarsal angle of 22 degrees, calcaneo-fifth metatarsal angle of 13 degrees, and lateral calcaneo-first metatarsal of 9 degrees confirmed the clinically satisfactory correction in all feet. However, one foot required repeat surgery 2 years after the index procedure.


Antiemetic effect of intravenous diazepam in patients receiving cis-diamminedichloroplatinum II: a pilot study.
A pilot study suggesting the usefulness of intravenous diazepam as an antiemetic for adult patients receiving cis-diamminedichloroplatinum is presented. Observations included 24 patients and 34 courses of therapy. Patients received diazepam and prochlorperazine, and the incidence of vomiting and subjective evaluation of nausea were compared to previous courses of therapy with prochlorperazine alone. A positive response was observed in 87% of the patients. Use of other antiemetics is briefly reviewed.


Multimodal prehabilitation improves functional capacity before and after colorectal surgery for cancer: a five-year research experience.
Multimodal prehabilitation is a preoperative conditioning intervention in form of exercise, nutritional assessment, whey protein supplementation, and anxiety-coping technique. Despite recent evidence suggesting that prehabilitation could improve functional capacity in patients undergoing colorectal surgery for cancer, all studies were characterized by a relatively small sample size. The aim of this study was to confirm what was previously found in three small population trials. Data of 185 participants enrolled in a pilot single group study and two randomized control trials conducted at the McGill University Health Center from 2010 to 2015 were reanalyzed. Subjects performing trimodal prehabilitation (exercise, nutrition, and coping strategies for anxiety) were compared to the patients who underwent the trimodal program only after surgery (rehabilitation/control group). Functional capacity was assessed with the six-minute walk test (6MWT), a measure of the distance walked over six minutes (6MWD). A significant functional improvement was defined as an increase in 6MWD from baseline by at least 19 m. Changes in 6MWD before surgery, at four and eight weeks were compared between groups. Of the total study population, 113 subjects (61%) underwent prehabilitation. Changes in 6MWD in the prehabilitation group were higher compared to the rehabilitation/control group during the preoperative period {30.0 [standard deviation (SD) 46.7] m vs. -5.8 (SD 40.1) m, p < 0.001}, at four weeks [-11.2 (SD 72) m vs. -72.5 (SD 129) m, p < 0.01], and at eight weeks [17.0 (SD 84.0) m vs. -8.8 (SD 74.0) m, p = 0.047]. The proportion of subjects experiencing a significant preoperative improvement in physical fitness was higher in those patients who underwent prehabilitation [68 (60%) vs. 15 (21%), p < 0.001]. In large secondary analysis, multimodal prehabilitation resulted in greater improvement in walking capacity throughout the whole perioperative period when compared to rehabilitation started after surgery.


S-nitrosoderivative of a recombinant fragment of von Willebrand factor (S-nitroso-AR545C) inhibits thrombus formation in guinea pig carotid artery thrombosis model.
Antiplatelet drugs are the mainstays of therapy for acute and chronic cardiovascular diseases. S-nitroso-AR545C - an S-nitrosoderivative of a recombinant von Willebrand factor fragment AR545C spanning Ala 444 to Asp 730 and containing an Arg 545 Cys mutation, was previously found to inhibit ristocetin- and ADP-induced platelet aggregation and the interaction of platelets with extracellular matrix (ECM). In the current study we tested the antithrombotic properties of S-nitroso-AR545C on guinea pig platelets and in a platelet-rich thrombosis model in the guinea pig. Preincubation of guinea pig platelets with 0.1 microM of S-nitroso-AR545C decreased ristocetin-induced agglutination by 40% (p = 0.009) and completely abolished ADP-induced aggregation (p <0.0001). At concentration of 1.0 microM, S-nitroso-AR545C completely inhibited platelet adhesion (represented by surface coverage - SC) and decreased aggregate formation (represented by average aggregate size - AS) by more than 50%. Treatment of guinea pigs with 1.0 mg/kg S-nitroso-AR545C resulted in a significantly delayed time to arterial occlusion (31.7+/-6.0 min vs. 13.9+/-3.2 min, p <0.02). Similarly, total patency time was longer in the group injected with S-nitroso-AR545C compared to the control group. However, the difference was not statistically significant (33.8+/-6.3 min vs. 20.2+/-3.3 min, p = 0.07). No change in platelet count, hematocrit and bleeding time was observed 60 min after injection compared to baseline. In contrast, a significant decrease in SC (p <0.0001) and AS (p <0.01) were observed 60 min after the injection of S-nitroso-AR545C, whereas no change in these parameters was observed in the control group. These observations indicate that S-nitroso-AR545C exhibits significant antiadhesive and antiaggregating effects in-vitro and inhibits clot formation in-vivo suggesting that this compound may have potential therapeutic advantages.


Microsatellite variation and differentiation in African and non-African populations of Drosophila simulans.
Drosophila simulans originated in sub-Saharan Africa or Madagascar and colonized the rest of the world after the last glaciation about 10 000 years ago. Consistent with this demographic history, sub-Saharan African populations have been shown to harbour higher levels of microsatellite and sequence variation than cosmopolitan populations. Nevertheless, only limited information is available on the population structure of D. simulans. Here, we analysed X-linked and autosomal microsatellite loci in four sub-Saharan African, one North African, one Israeli, and two European D. simulans populations. Bayesian clustering algorithms combined the North African, Israeli, and European populations into a single cosmopolitan group. The four sub-Saharan populations were split into two separate groups. Pairwise F(ST) analysis, however, indicated significant population differentiation between all eight populations surveyed. A significant signal for population reduction in cosmopolitan populations was found only for X-linked loci.


Magnetic-field effects on the size of vortices below the surface of NbSe2 detected using low energy beta-NMR.
A low energy radioactive beam of polarized 8Li has been used to observe the vortex lattice near the surface of superconducting NbSe2. The inhomogeneous magnetic-field distribution associated with the vortex lattice was measured using depth-resolved beta-detected NMR. Below Tc, one observes the characteristic line shape for a triangular vortex lattice which depends on the magnetic penetration depth and vortex core radius. The size of the vortex core varies strongly with the magnetic field. In particular, in a low field of 10.8 mT, the core radius is much larger than the coherence length. The possible origin of these giant vortices is discussed.


Reaction time distributions across normal forgetting: searching for markers of memory consolidation.
Volunteers studied pictures of objects and were then tested for yes/no recognition at 10 min and 1 week after learning (experiment 1), or at 10 min and 4 months after learning (experiment 2). Because the gradual consolidation of long-term memory is thought to occur across this time scale (weeks and months), the reaction time distributions of successfully retrieved items were analyzed in an attempt to detect markers of consolidation. At each retention interval, reaction times for items retrieved successfully were well fit by a model that assumed a single underlying distribution. No evidence for a bimodal distribution of reaction times was observed. Furthermore, there was no evidence that some small subset of items was actually retrieved faster after a long retention interval than after a short interval. The results are consistent with the idea that consolidation works not to increase memory trace strength but to change the nature of memory storage. This process occurs during the course of normal forgetting and may not be observable in the behavior of normal memory.


Exclusive breastfeeding for six months: the WHO six months recommendation in the Asia Pacific Region.
In 2001 the World Health Assembly adopted the infant feeding strategy which included the recommendation for exclusive breastfeeding until 6 months of age with continued breastfeeding while complementary foods are introduced. This recommendation has been endorsed by many national authorities, professional organisations and most countries in the Asia Pacific Region. Reviews by WHO, the US Surgeon General, Agency for Healthcare Research and Quality, US Department of Health and Human Services and others have documented the many benefits of breastfeeding. The introduction of solid foods before six months of age is associated with increased rates of infection, reduced breastmilk production, disruption to the microbiome and possibly obesity. If solids are introduced at around six months (by 26 weeks) there is no evidence of increases in allergic diseases.


Effect of cardiopulmonary bypass on pulmonary gas exchange: a prospective randomized study.
Conventional coronary artery bypass surgery is associated with postoperative pulmonary dysfunction. Inflammation due to cardiopulmonary bypass has been regarded as one of the main causes. In this study, we investigated the effect of coronary revascularization with or without cardiopulmonary bypass on pulmonary function. Fifty-two patients (40 male, mean age 60.1 years) were prospectively randomized to undergo coronary revascularization via median sternotomy, with or without normothermic cardiopulmonary bypass. Alveolar-arterial oxygen gradients were measured before and after induction of anesthesia, postoperatively in the intensive care unit during mechanical ventilation and 6 hours after tracheal extubation. The techniques of anesthesia and mechanical ventilation were standardized throughout. Patient characteristics were similar in the two groups. The alveolar-arterial oxygen gradients increased progressively throughout the perioperative period, with no significant differences in the two groups at any time during the study. Myocardial revascularization with or without cardiopulmonary bypass caused a similar degree of pulmonary dysfunction, as assessed by alveolar-arterial oxygen gradient. Our study suggests that the deterioration in pulmonary gas exchange associated with cardiac surgery is due to factors other than the use of cardiopulmonary bypass.


Patterns of lymph node metastasis and the management of neck dissection for parotid carcinomas: a single-institute experience.
There is no consensus about the indications and range of neck dissection in patients who have parotid carcinoma, with elective neck dissection for cN0 disease being particularly controversial. This study retrospectively reviewed 185 patients with newly diagnosed parotid carcinoma who were treated at our department between September 1999 and August 2018. 50 of the 185 patients had lymph node metastasis, including 7.7%, 12.2%, 36.0%, and 55.8% of patients with T1, T2, T3, and T4 disease, respectively. When classified by histological grade, 5.7% of patients with low/intermediate-grade disease had lymph node metastasis versus 55.0% of patients with high-grade disease. Multivariate analysis revealed that the histological grade and T classification were independent predictors of lymph node metastasis. Occult metastasis was found in 8 out of 73 clinically node negative patients undergoing neck dissection. The most common site of cervical metastasis was level 2, followed by the periparotid nodes, level 3, and level 4. Elective neck dissection may be most appropriate for parotid carcinoma patients with high grade disease and/or an advanced T classification. Because preoperative evaluation of the histological grade of parotid carcinoma has limited reliability, it is important to decide the indications and range of neck dissection from the results of frozen section biopsy.


Studies on the interaction between triphenyltin and bovine serum albumin by fluorescence and CD spectroscopy.
The interaction between triphenyltin (TPT) and bovine serum albumin (BSA) in physiological buffer (pH=7.4) was investigated by the fluorescence quenching technique. The results of fluorescence titration revealed that TPT could strongly quench the intrinsic fluorescence of BSA through a static quenching procedure. The apparent binding constants K and number of binding sites n of TPT with BSA were (7.04±0.0057)×10(2) and (0.77±0.016) which were obtained by the fluorescence quenching method. The thermodynamic parameters enthalpy change (ΔH), entropy change (ΔS) were positive, which indicated that the interaction of TPT with BSA was driven mainly by hydrophobic forces. The process of binding was a spontaneous process in which Gibbs free energy change was negative. The distance r between donor (BSA) and acceptor (TPT) was calculated to be 3.05nm based on Forster's non-radiative energy transfer theory. The results of synchronous fluorescence, three-dimensional fluorescence and Circular Dichroism (CD) spectra showed that the triphenyltin induced conformational changes of BSA.


Enhanced detoxification of p-bromophenol by novel Zr/Ag-TiO2@rGO ternary composite: Degradation kinetics and phytotoxicity evolution studies.
The toxicity and persistence of the halogenated aromatics, particularly brominated phenolic compounds have drawn serious concerns to the environment, emphasizing the potential effects on human health and ecosystems balance. Advanced oxidation process (AOP) has received much attention as an alternative for the conventional wastewater treatment methods to treat water contaminated with toxic pollutants. This study investigated the degradation and detoxification of p-bromophenol (p-BP) by a novel Zr/Ag-TiO2@rGO photocatalyst under visible light. Upon 3 h of visible light irradiation over Zr/Ag-TiO2@rGO, more than 95% of p-BP (15 mg/L) degradation was achieved at a rate of 0.23 min-1. The degradation products were identified by GC-MS and possible degradation pathway was proposed. The phytotoxicity evolution of the degraded products was assessed on Vigna radiata (V. radiata), in which seeds treated with pure p-BP showed less germination (40%) compared to degradation products (100%). Furthermore, the germination index (GI) of p-BP was found to be 11.1% before degradation while it increased to 80.5% after 3 h of degradation indicated that this photodegradation process achieved detoxification of p-BP. Thus, this study demonstrated that p-BP elimination and detoxification could be simply achieved with Zr/Ag-TiO2@rGO nanocomposite under visible light irradiation, which provides new solution for wastewater treatment and water reuse in crop irrigation.


Imprinting of Igf2 and H19 from a 130 kb YAC transgene.
A stringent test for imprint control elements is to examine their function at ectopic loci in transgenic experiments. Igf2 and H19 are part of a larger imprinting region and as a first step, we examined these reciprocally imprinted genes in transgenic experiments using a 130 kb YAC clone. After paternal inheritance, H19 was appropriately repressed and Igf2 was expressed, irrespective of copy number or genetic background. After maternal inheritance H19 was consistently expressed, albeit with some variability. The levels of H19 expression per copy of the transgene inversely correlated with Igf2 (-lacZ) expression in cis. The consistent imprinting of H19 from this YAC contrasts with the previously described imprinting of mini-H19 transgenes, which only occurs at multi-copy loci, is inconsistent, and is prone to genetic background effects. We propose a novel model in which silencing of the H19 gene is the default state and its activation after maternal inheritance is the key mechanistic event for imprinting in this region. In addition, in situ analysis of the Igf2-lacZ reporter indicates that additional mesoderm-specific enhancers are present within the YAC clone. No obvious phenotype was detected from the excess gene dosage of H19.


Epigenetic Control of Expression Homeostasis during Replication Is Stabilized by the Replication Checkpoint.
DNA replication introduces a dosage imbalance between early and late replicating genes. In budding yeast, buffering gene expression against this imbalance depends on marking replicated DNA by H3K56 acetylation (H3K56ac). Whether additional processes are required for suppressing transcription from H3K56ac-labeled DNA remains unknown. Here, using a database-guided candidate screen, we find that COMPASS, the H3K4 methyltransferase, and its upstream effector, PAF1C, act downstream of H3K56ac to buffer expression. Replicated genes show reduced abundance of the transcription activating mark H3K4me3 and accumulate the transcription inhibitory mark H3K4me2 near transcription start sites. Notably, in hydroxyurea-exposed cells, the S phase checkpoint stabilizes H3K56ac and becomes essential for buffering. We suggest that H3K56ac suppresses transcription of replicated genes by interfering with post-replication recovery of epigenetic marks and assign a new function for the S phase checkpoint in stabilizing this mechanism during persistent dosage imbalance.


Ability of practitioners to estimate client acceptance of single-subject evaluation procedures.
Practitioners' ability to estimate client acceptability of treatment evaluation procedures was investigated. Practitioners were able to predict accurately their clients' favorable responses to the use of single-subject procedures. The results lend support to those advocating continued research into variables affecting the use of systematic evaluation procedures by social work practitioners.


Fas(CD95)/FasL interactions required for programmed cell death after T-cell activation.
Receptor crosslinking of T-cell hybridomas induces cell activation followed by apoptosis. This activation-induced cell death requires de novo synthesis of RNA and proteins, but the actual gene products that provide the death signal have not been identified. We show here that receptor crosslinking induces Fas ligand and upregulates Fas, and that the ensuing engagement of Fas by Fas ligand activates the cell-death programme. Cell death, but not activation, can be selectively prevented by a soluble Fas-immunoglobulin fusion protein. Thus, Fas and Fas ligand are the death-gene products, and their interaction accounts for the molecular mechanism of activation-induced T-cell death.


Diabetic retinopathy in Ethiopia: A systematic review and meta-analysis.
this systemic review and meta-analysis was aimed at determining the level of diabetic retinopathy among diabetes mellitus patients in Ethiopia. PubMed, Science Direct, Google Scholar and Excerpta Medica Database (EMBASE) were searched. The data were extracted using Microsoft Excel and analyzed by using STATA version 11. Publication bias was checked by funnel plot and more objectively through Egger's regression test, with P < 0.05 considered to indicate potential publication bias. Heterogeneity of studies was checked using the I2 test. Pooled analysis was conducted. Subgroup analysis was done by region. Sensitivity analysis was employed to see the effect of single study on the overall estimation. STATA version 11 statistical software was used for meta-analysis. The overall prevalence of retinopathy was 19.48% (95% CI: 15.95, 23.01) Based on the subgroup analysis the prevalence of retinopathy was 12.48% in SNNPR, 24.8% in Oromia, 19.99% in Amhara, and 16.29% in Addis Ababa. The prevalence of diabetic retinopathy among Diabetes mellitus patients is high. Therefore, close monitoring of the patient prognosis and appropriate prevention techniques is essential.


The role of probability of reinforcement in models of choice.
A general account of choice behavior in animals, the cumulative effects model, has been proposed by Davis, Staddon, Machado, and Palmer (1993). Its basic assumptions are that choice occurs in an all-or-none fashion for the response alternative with the highest probability of reinforcement and that the probability of reinforcement for each response alternative is calculated from the entire history of training (total number of reinforced responses/total number of reinforced and nonreinforced responses). The model's reliance on probability of reinforcement as the fundamental variable controlling choice behavior subjects the cumulative effects model to the same criticisms as have been directed toward other related models of choice, notably melioration theory. Several different data sets show that the relative value of a response alternative is not predicted by the obtained probability of reinforcement associated with that alternative. Alternative approaches to choice theory are considered.


Signal transducer and activator of transcription 3 is required for glycoprotein 130-mediated induction of vascular endothelial growth factor in cardiac myocytes.
Activation of glycoprotein (gp) 130 transduces hypertrophic and cytoprotective signals in cardiac myocytes. In the present study, we have demonstrated that signals through gp130 increase the expression of vascular endothelial growth factor (VEGF) in cardiac myocytes via the signal transducer and activator of transcription (STAT) 3 pathway. After activation of gp130 with leukemia inhibitory factor (LIF), expression of VEGF mRNA rapidly increased with a peak at 3 h in cultured cardiac myocytes. Cardiotrophin-1 also enhanced VEGF mRNA expression in a dose-dependent manner. VEGF protein production and secretion to the medium were also enhanced by LIF and cardiotrophin-1 but not by interleukin-6. Adenovirus transfer of the dominant-negative form of STAT3 to cultured cardiac myocytes inhibited induction of VEGF expression induced by LIF, but neither PD98059 nor wortmannin was affected. In murine hearts, intravenous administration of LIF augmented expression of VEGF mRNA; however, the hearts of transgenic mice overexpressing dominant-negative STAT3 showed reduced expression of VEGF mRNA that was not induced after LIF stimulation. These data provide the first evidence that a STAT family protein functions as a regulator of angiogenic growth factors and suggest that gp130/STAT signaling in cardiac myocytes can control vessel growth during cardiac remodeling.


Organization of angiotensin II immunoreactive cells and fibers in the rat central nervous system. An immunohistochemical study.
The distribution of angiotensin II (AII)-immunoreactive cells and fibers was examined in adult male Sprague-Dawley rats with and without colchicine pretreatment. As seems to be the case for a number of other neuropeptides, AII is preferentially found in brain stem, hypothalamic, and limbic structures involved in the control of homeostatic functions. AII-stained cell bodies were most prominent in magnocellular parts of the paraventricular and supraoptic nuclei, and cells were also found in parvocellular parts of the former. Other hypothalamic nuclei containing cell bodies include the suprachiasmatic nucleus, the medial preoptic area, and perifornical parts of the lateral hypothalamic area. Of considerable interest was robust staining in several of the circumventricular organs, in particular the subfornical organ, where both cells and fibers were found. The results of water deprivation and nephrectomy suggest that this staining does not represent uptake of circulating peptide, but instead, represents AII-containing neural connections. In the thalamus, AII-stained cells were found in the paraventricular nucleus, the central medial nucleus, the nucleus reuniens, and rostral parts of the zona incerta. Two cell groups in the basal telencephalon, in the dorsal part of the bed nucleus of the stria terminalis and in the medial nucleus of the amygdala, lay at either end of an AII-stained pathway coursing through the stria terminalis. In the midbrain, immunoreactive cells were found in the interpeduncular and peripeduncular nuclei, and one pontine cell group was detected in the most lateral part of the lateral parabrachial nucleus. The only AII-stained cells in the medulla were in the nucleus of the solitary tract, near the margin of the area postrema. Fibers were found at all levels of the central nervous system, from the olfactory bulbs to the spinal cord, where terminal fields were observed in the substantia gelatinosa and in the intermediolateral cell column. Longitudinally oriented fibers were present throughout the periventricular fiber system and in the medial forebrain bundle, including its caudal extension in ventrolateral parts of the brain stem. It is suggested that, at many different levels, AII serves as both a hormone and neurotransmitter for fluid balance.


[Ultrasonographic and x-ray computed tomographic aspects of Mirizzi's syndrome].
The Mirizzi syndrome is due to common hepatic duct obstruction secondary to the impaction of a large gallstone in the neck of the gallbladder or the cystic duct. The sonographic and computed tomography features in 3 cases of Mirizzi syndrome are described and compared with percutaneous transhepatic cholangiography or endoscopic retrograde cholangiography findings. The Mirizzi syndrome was diagnosed preoperatively on sonography in 2 out of 3 cases and on plain computed tomography scans in all 3 cases. However pre or intraoperative visualization of the biliary tract is mandatory in suspected Mirizzi syndrome to detect the presence or absence of cholecystobiliary fistula, in order to adapt the operative strategy.


Mortality, crime and access to basic needs before and after the Haiti earthquake: a random survey of Port-au-Prince households.
On 12 January 2010 an earthquake measuring 7.0 on the Richter Scale struck Haiti, causing unprecedented death, injury and destruction for an event of this magnitude. Our aim was to generate a rapid assessment of the primary consequences for the population of the metropolitan area of Port-au-Prince, the national capital. During the summer of 2009 we conducted a survey of 1,800 households in metropolitan Port-au-Prince. Six weeks after the earthquake, we attempted to trace these households in order to re-interview them. The questionnaire examined mortality and injuries generated by the natural disaster, as well as the character of victimization, food security and living arrangements following the quake. Data analysis incorporated sampling weights and adjusted for clustering within households. The original 2009 survey featured a 90 per cent response rate; in 2010 we re-interviewed 93 per cent of these households. We estimate that 158,679 people in Port-au-Prince (95 per cent CI 136,813-180,545) died during the quake or in the six-week period afterwards owing to injuries or illness. Children were at particular risk for death. In the six weeks after the earthquake, 10,813 people (95 per cent CI 6,726-14,900) were sexually assaulted, the vast majority of whom were female. In the same period 4,645 individuals (95 per cent CI 1,943-7,347) were physically assaulted. Of all households, 18.6 per cent (95 per cent CI 16.6-20.8) were experiencing severe food insecurity six weeks after the earthquake. 24.4 per cent (95 per cent CI 22.1-26.9) of respondents' homes were completely destroyed. Many residents of Port-au-Prince died during or as a result of the earthquake, albeit fewer than were widely reported. More than half of the capital's population experienced moderate to severe food insecurity, though remittances are a major protective factor in promoting food security. Survivors continue to experience high levels of sexual assault and limited access to durable shelter.


Silencing lncRNA FOXD2-AS1 inhibits proliferation, migration, invasion and drug resistance of drug-resistant glioma cells and promotes their apoptosis via microRNA-98-5p/CPEB4 axis.
This study was conducted to elucidate the long non-coding RNA FOXD2-AS1 (lncRNA FOXD2-AS1) expression in glioma and its mechanism on the biological features of glioma cells and the drug resistance of temozolomide (TMZ). Highly expressed FOXD2-AS1 was found in glioma. There was more powerful chemotherapeutic resistance of TMZ resistant cell lines than that of the parent cell lines. Silence of FOXD2-AS1 suppressed proliferation and drug resistance and promoted apoptosis of drug-resistant glioma cells. Overexpressed FOXD2-AS1 presented an opposite trend. FOXD2-AS1 could be used as a competing endogenous RNA to adsorb miR-98-5p, thereby up-regulating CPEB4. Our study suggests that down-regulated FOXD2-AS1 repressed invasion, proliferation, migration and drug resistance of drug-resistant glioma cells while stimulating their apoptosis via increasing miR-98-5p and inhibiting CPEB4 expression. FOXD2-AS1, microRNA-98-5p (miR-98-5p) and cytoplasmic polyadenylation element binding (CPEB4) expression in glioma tissues were tested. Expression of E-cadherin, N-cadherin and Vimentin in glioma cells were explored. A series of assays were conducted to detect the function of FOXD2-AS1 in migration, proliferation, apoptosis, and invasion of glioma cells. Changes in drug-resistance of cells under TMZ treatment were examined, and tumor formation in nude mice was performed to test the changes of drug resistance in vivo.


The development of criteria for the assessment of complete dentures.
Criteria for the assessment of complete dentures have been published by several groups of workers but none have proved universally reliable. The present study was undertaken in an attempt to develop criteria of proven reliability for the assessment of the occlusion, articulation, retention, stability and appearance of complete dentures and the health of their supporting tissues. The criteria formulated were subjected to a series of evaluations of their reliability followed by attempts at refinement where this was unsatisfactory. Although levels of agreement between independent assessments made using the criteria improved as the study progressed, an acceptable level of reliability was not attained. The possible reasons for this are discussed.


Effect of context salience on heart rate orienting and habituation in preweanling and periadolescent rats.
Previous research indicates that target learning is facilitated in the presence of strong extraneous sensory cues (e.g., salient contextual cues) in infant, but not adult, rats (McKinzie & Spear, 1995). The present study assessed whether such facilitation of conditioning is due to age-related differences in the effect of a salient context on processing of the conditioned stimulus (tone in this case). Preweanling and periadolescent rats were presented with a tone in either the presence (salient context) or absence (plain context) of a potent odorant. Magnitude of the heart rate orienting response to the target stimulus and its subsequent rate of habituation served as dependent variables. The results revealed that preweanling, but not periadolescent, rats showed greater cardiac orienting to the auditory stimulus in the salient than in the plain context. The results suggest that a salient context may influence stimulus processing by increasing the perceived salience and, perhaps in terms of perceived intensity, of the target stimulus.


Selectins: interpreters of cell-specific carbohydrate information during inflammation.
Although a bewildering array of cell surface carbohydrate structures have been described, the physiological relevance of any of these complex molecules has often eluded biologists. A family of cell surface glycoproteins, the "selectins," has a characteristic ability to use some of these carbohydrate structures in adhesive mechanisms that help localize leukocytes to regions of inflammation. This article will review the biology of these carbohydrate-binding adhesive proteins and discuss the potential for developing anti-inflammatory antagonists that could inhibit binding events that are selectin-mediated.


A history of public health workforce enumeration.
During the 20th century, the United States' public health workforce has been of sufficient interest to policy makers that regular efforts have been made to enumerate it. Limited enumeration is found as early as 1908; the last direct federal survey occurred in 1964. After 1964, workforce size was estimated. The ratio of public health workers to population reached an estimated 220/100,000 in 1980. Data collected in 2000 yielded a ratio of 158/100,000--a 10 percent decrease. In the absence of a system to reliably collect public health workforce data such information is problematic to interpret or use for infrastructure planning and development.


Heat, safety or solitude? Using habitat selection experiments to identify a lizard's priorities.
Laboratory experiments with a rock-dwelling nocturnal gecko, Oedura lesueurii, showed that retreat-site selection (and other behaviours) are affected by the interplay between thermal benefits, social advantages and avoidance of predators. Velvet geckos were highly selective in habitat choice: they preferred artificial retreat-sites that mimic the thermal properties of natural rocks in full sun rather than those that mimic rocks in full shade; mature male geckos rarely shared retreat-sites with other adult males; and these lizards strongly avoided retreat-sites covered with the scent of a natural predator (the broadheaded snake, Hoplocephalus bungaroides). After documenting these preferences, we carried out additional trials in which two or more of these factors co-occurred, as is often the case in nature. Social dominance interacted with thermal benefits in determining retreat-site selection, with smaller (subordinate) males forced to use cooler retreat-sites when larger (dominant) males were present. Avoidance of predators was a higher priority than thermoregulation: the lizards would forego a warmer retreat-site with predator scent in favour of a cooler, unscented one. There was also an interplay between social dominance and predator scent: smaller males were forced to use either predator-scented retreat-sites or no retreat-site when larger males were present. General activity levels, and the frequencies of specific behavioural acts, also shifted in response to social and predator-scent cues. Our study emphasizes the complexity of habitat-selection behaviour in these lizards, and clarifies the criteria used in retreat-site selection when (as is commonly the case) the animal must choose between conflicting priorities. Copyright 1998 The Association for the Study of Animal Behaviour. Copyright 1998 The Association for the Study of Animal Behaviour.


Resonance frequency analysis: a new diagnostic tool for dental ankylosis.
Ankylosed teeth are considered in orthodontic treatment planning; however, diagnostic tools to quantify the rigidity of the tooth-to-bone connection are rare. Resonance frequency analysis (RFA) can quantify the rigidity of the dental implant-to-bone connection and thus may serve as a potential diagnostic tool to identify ankylosed teeth. To test this assumption, we examined 15 and 30 primary mandibular molars, with and without clinical signs of ankylosis, using the Osstell Mentor system. A cut-off implant stability quotient (ISQ) of 43 provided a specificity of 100% and a sensitivity of 53.3% when measured in the mesio-distal direction or a sensitivity of 20% when measured in the bucco-lingual direction. Based on a receiver-operating characteristic (ROC), the area under the curve (AUC) of 0.807 showed the mesio-distal direction of measurement to be a test of moderate discriminatory power. Given its non-invasiveness, RFA may serve as a quantitative diagnostic supplement to the clinical examination of potentially ankylosed primary molars.


Prevalence of renal involvement in Indian patients with systemic sclerosis.
Renal involvement in systemic sclerosis (SSc) either in the form of scleroderma renal crisis (SRC) or nonrenal crisis abnormalities has been reported to be in the range of 60-80%. Renal involvement is thought to be rare in Indian patients with SSc. However, there is paucity of data. To study the frequency and pattern of renal involvement in Indian patients with SSc. A single center prospective, cross sectional study. We prospectively evaluated the patients with SSc attending the Rheumatology Clinic. All patients were evaluated for renal involvement. All patients underwent measurement of blood pressure, urine examination, glomerular filtration rate (GFR) estimation using Cockcroft-Gault formula and kidney biopsy when indicated. Statistical analysis was performed using SAS 8.0 statistical package. Eighty-seven patients were included in the study from July 2001 to December 2004. Mean age of patients was 36.88 +/- 12.51 years. About 30% of patients had diffuse cutaneous SSc. None of these patients had SRC either at enrollment in the study or during follow-up. Eleven (12.6%) patients had hypertension. Six (6.9%) patients had abnormal urinary findings in the form of either active urinary sediment or significant proteinuria. Only one patient had azotemia (plasma creatinine > 1.8 mg/dl). Calculated GFR CONCLUSION: SRC is very rare in Indian patients with SSc. However, non-renal crisis abnormalities appear to be as common in Indian patients as compared to the western literature.


2-amino-3,4,5-trimethoxybenzophenones as potent tubulin polymerization inhibitors.
A series of novel 2-amino-3,4,5-trimethoxybenzophenone analogues exhibited excellent activity as tubulin polymerization inhibitors by targeting the colchicine binding site of microtubules. The lead compound 17 exhibited an IC50 value of 1.6 μM, similar to that of combretastatin A-4 (IC50=1.9 μM). It also displayed remarkable anti-proliferative activity, with IC50 values ranging from 7-16 nM against a variety of human cancer cell lines and one MDR(+) cancer cell line. SAR information indicated that the introduction of an amino group at the C2 position of benzophenone ring A and the C3' position of benzophenone ring B play important roles in maximizing activity.


Lichen depsides and depsidones reduce symptoms of diseases caused by tobacco mosaic virus (TMV) in tobacco leaves.
Two depsides and five depsidones, isolated from lichens, were tested to determine their in vivo protective effects on tobacco leaves challenged with tobacco mosaic virus (TMV). The results indicate that most of these compounds are able to reduce either the number and/or the size of necrotic lesions following virus infection. Pannarin, 1'-chloro-pannarin and stictic acid provided the more effective protective results, reducing by at least 45% the number and size of lesions. Real Time PCR assays were used to explore the target of action against TMV by examining the response behavior of genes involved in the plant defense mechanism. The application of the lichen substances did not lead to changes in the transcriptional levels of pathogen-related (PR1a), allene oxide synthase 2 (AOS2) or oxophytodienoate reductase (OPR3) genes. Thus, the protection observed in the tobacco leaves treated with the lichen compounds may be mediated by a mechanism which does not involved the SA- or JA-mediated defensive plant response. A possible structure-activity relationship is presented.


[A Case of Subacute Thyroiditis during Chemotherapy after Distal Pancreatectomy].
A 68-year-old woman who underwent distal pancreatectomy combined with resection of the celiac axis had an abdominal wall recurrence and resection 2 years after the first surgery. She was treated with S-1 at an outpatient clinic following the surgery. She returned to the clinic with a high fever after the S-1 administration and was diagnosed with febrile neutropenia. However, treatment for febrile neutropenia including antibiotics and G-CSF did not improve her symptoms. Her history of chronic severe neck pain and painful enlargement of her thyroid gland suggested thyroiditis. After blood tests and thyroid scintigraphy, she was diagnosed with subacute thyroiditis and was treated with prednisolone. Her symptoms improved within a week. Although patients with neutropenia and a high fever during chemotherapy are likely to have febrile neutropenia, the possibility of another cause of neutropenia with fever should be considered if treatments for febrile neutropenia are not effective.


Assessment of sleep/wake patterns using a non-contact biomotion sensor.
We evaluate a contact-less continuous measuring system measuring respiration and activity patterns system for identifying sleep/wake patterns in adult humans. The system is based on the use of a novel non-contact biomotion sensor, and an automated signal analysis and classification system. The sleep/wake detection algorithm combines information from respiratory frequency, magnitude, and movement to assign 30 s epochs to either wake or sleep. Comparison to a standard polysomnogram system utilizing manual sleep stage classification indicates excellent results. It has been validated on overnight studies from 12 subjects. Wake state was correctly identified 69% and sleep with 88%. Due to its ease-of-use and good performance, the device is an excellent tool for long term monitoring of sleep patterns in the home environment in an ultraconvenient fashion.


Iron uptake mechanism in the chrysophyte microalga Dinobryon.
The mechanism of iron uptake in the chrysophyte microalga Dinobryon was studied. Previous studies have shown that iron is the dominant limiting elements for growth of Dinobryon in the Eshkol reservoir in northern Israel, which control its burst of bloom. It is demonstrated that Dinobryon has a light-stimulated ferrireductase activity, which is sensitive to the photosynthetic electron transport inhibitor DCMU and to the uncoupler CCCP. Iron uptake is also light-dependent, is inhibited by DCMU and by CCCP and also by the ferrous iron chelator BPDS. These results suggest that ferric iron reduction by ferrireductase is involved in iron uptake in Dinobryon and that photosynthesis provides the major reducing power to energize iron acquisition. Iron deprivation does not enhance but rather inhibits iron uptake contrary to observations in other algae.


Treatment of anthracycline extravasation in mice with dexrazoxane with or without DMSO and hydrocortisone.
Dexrazoxane has been reported to be protective against anthracycline induced subcutaneous ulceration in mice. It is currently under clinical investigation as an acute antidote in accidental anthracycline extravasation, for which indication topical dimethylsulfoxide (DMSO) and intralesional hydrocortisone are used empirically. We studied the effect in 72 mice of monotherapy with and combined therapy of intraperitoneal dexrazoxane, topical DMSO, and intralesional hydrocortisone as acute antidotes against ulceration after subcutaneous daunorubicin. Dexrazoxane completely prevented wounds from occurring, while neither DMSO nor hydrocortisone had any preventive effect. The addition of topical DMSO actually reduced the efficacy of dexrazoxane. In conclusion, the present study does not support the concomitant use of topical DMSO + systemic dexrazoxane or intralesional hydrocortisone + systemic dexrazoxane. Monotherapy with systemic dexrazoxane seems preferable and is highly efficacious in preventing ulceration.


Synthesis of a polymer-supported anthracene and its application as a dienophile scavenger.
A polymer-supported anthracene has been prepared and employed as a dienophile scavenger in Diels-Alder cycloadditions. [structure: see text]


Ultrasonic evaluation of benign and malignant nodules in echographically multinodular thyroids.
In 165 patients with ultrasound findings of multinodular thyroids in whom thyroid resection was performed, sonographic features and pathohistologic findings of removed nodules were analyzed. Of 426 nodules removed, 70 were carcinomas and 356 benign. Carcinomas are more often hypoechogenic (p < 0.01) and contain nodular calcifications (p < 0.01), while benign nodules are more often iso-hyperechogenic (p < 0.01), showing intranodular cystic degenerative changes (p < 0.01) and perinodular hypoechogenic rim (p < 0.01). Mean diameter of carcinomatous nodules is lower than in benign nodules (p = 0.022). The relative proportion of malignant nodules is highest in the upper halves of thyroid lobes (p < 0.01). Although certain sonographic signs increase the likelihood of a given lesion being malignant or benign, the lack of absolute specificity in the ultrasound evaluation of thyroid nodules was confirmed.


The active medicine user.
The purpose of the study is to analyse medicine behaviour seen from the user's point of view. The study intends to generate ideas to specify topics of problems and to try out a combination of qualitative research methods. The practitioners and four asthmatic patients attached to a health centre in Billund, Denmark, were interviewed. The patients kept a diary based on topics, the notes of which were elaborated by weekly telephone interviews. In a final interview all participants evaluated the course of the study. The combination of qualitative methods has been very suitable to provide the perspective of the user. The results of the study question the ideal picture of the patient as a passive user of medicine. The main trends show that: the users develop different strategies to evaluate medication therapy; it has negative consequences to the patient when medication is changed regardless of patient experience; the therapy improves when the doctor draws on the experience of the patient. The study contributes to the present, sparse knowledge about the consciously acting user of medicine and indicates the importance of incorporating the user's experience and life situation in the health care system's handling of health problems.


A Phase I Clinical Trial and Independent Patient-Derived Xenograft Study of Combined Targeted Treatment with Dacomitinib and Figitumumab in Advanced Solid Tumors.
Purpose: This phase I, open-label, single-arm trial assessed the safety and tolerability of dacomitinib-figitumumab combination therapy in patients with advanced solid tumors.Experimental Design: A standard 3 + 3 dose escalation/de-escalation design was utilized. Starting doses were figitumumab 20 mg/kg administered intravenously once every 3 weeks and dacomitinib 30 mg administered orally once daily. We also performed an independent study of the combination in patient-derived xenograft (avatar mouse) models of adenoid cystic carcinoma.Results: Of the 74 patients enrolled, the most common malignancies were non-small cell lung cancer (24.3%) and colorectal cancer (14.9%). The most common treatment-related adverse events in the 71 patients who received treatment across five dose levels were diarrhea (59.2%), mucosal inflammation (47.9%), and fatigue and acneiform dermatitis (45.1% each). The most common dose-limiting toxicity was mucosal inflammation. Dosing schedules of dacomitinib 10 or 15 mg daily plus figitumumab 20 mg/kg every 3 weeks after a figitumumab loading dose were tolerated by patients over multiple cycles and considered recommended doses for further evaluation. Objective responses were seen in patients with adenoid cystic carcinoma, ovarian carcinoma, and salivary gland cancer. Pharmacokinetic analysis did not show any significant drug-drug interaction. In the adenoid cystic carcinoma xenograft model, figitumumab exerted significant antitumor activity, whereas dacomitinib did not. Figitumumab-sensitive tumors showed downregulation of genes in the insulin-like growth factor receptor 1 pathway.Conclusions: Dacomitinib-figitumumab combination therapy was tolerable with significant dose reductions of both agents to less than the recommended single-agent phase II dose of each drug. Preliminary clinical activity was demonstrated in the potential target tumor adenoid cystic carcinoma. Clin Cancer Res; 23(5); 1177-85. ©2016 AACRSee related commentary by Sundar et al., p. 1123.


[A comparative evaluation of Apex D.S.P. and Root ZX Apex locators. An in vitro study].
In modern endodontics, no possibility of the root canal preparation is allowed, unless its length was individually determined. Only until recently, the length was assessed on the basis of the radiograph with the file placed into the root of the canal. However, apex locators have been in use for this assessment for some time. The newest ones, called the apex locators with different frequencies, in opposition to the classical ones, allow for accurate measurement even in teeth with wet content and periapical lesions. The aim of this in vitro study was a comparison of accuracy of two apex locators with different frequencies. Thirty single-rooted teeth were used in this study. After access cavity preparation, the actual canal length was determined, and subsequently they were placed in alginate impression material in order to perform measurements with Root ZX (Morita, Japan) and Apex D.S.P. (Septodont, France) apex locators. The obtained lengths were measured with endodontic ruler. Length concordance with the actual canal length for Root ZX apex locator was 93.3%. In two cases, electronic measurement was inaccurate--one too short and one too long. For Apex D.S.P. device precise measurements were obtained in 90% of cases with 10% of results being too long if compared to the actual values. Statistical analysis did not disclose significant differences between the measurements. Length value comparison, for the assessed apex locators, allowed to confirm result concordance in 28 of 30 measurements (93.3%). In 2 remaining cases, lengths determined by the Apex D.S.P. device were 1 mm longer than the values for Root ZX apex locator. Root ZX and Apex D.S.P. apex locators allow for relatively accurate assessment of the root canal length. Precision of these two devices is comparable.


Activation of bee venom phospholipase A2 through a peptide-enzyme complex.
Phospholipase A2 activation by membrane-bound peptides was investigated in order to understand the role of the membrane-induced conformation on activation, and to examine the occurrence of a peptide-enzyme complex at the lipid/water interface. For the peptides studies, bee venom phospholipase A2 was stimulated regardless of the membrane-bound conformation (alpha-helix, beta-sheet or random coil). Using antisera raised against melittin, we were able to demonstrate the occurrence of a calcium-dependent complex involving the enzyme, phospholipid substrate, and peptide.


Initial Attempt to Select Patients for Mechanical Thrombectomy Using Noncontrast Computed Tomography and Symptom-Based Criteria: Single-Center Experience.
In the treatment of acute ischemic stroke (AIS), patients need to be selected for mechanical thrombectomy (MT) in the acute phase. Selection criteria vary, however, depending on the patient's situation. This study investigated the effectiveness of a noncontrast computed tomography and symptom-based protocol for selecting patients for MT. This retrospective study included 20 patients with AIS. The first 8 patients (earlier group) were screened by magnetic resonance imaging (MRI). Among the later 12 patients, MRI was deliberately skipped in 9, and major vessel occlusion was confirmed by digital subtraction angiography after meeting 4 criteria: 1) hospital arrival within 90 minutes from onset; 2) National Institutes of Health Stroke Scale score 9-25; 3) history or presence of atrial fibrillation; and 4) Alberta Stroke Program Early CT Score of 9-10. The clinical outcomes and time course were compared. Among the later period group, 9 of 12 patients skipped MRI-based confirmation of large vessel occlusion. They underwent the direct angiography protocol, which had a 78% (7/9) positive predictive value for identifying large-vessel occlusion. In this group, National Institutes of Health Stroke Scale scores on the next day had significantly improved (median -8 points) compared with those at admission. Good functional outcome did not differ between the groups at 3 months. Noncontrast computed tomography and symptom-based selection of MT to treat AIS can be useful for achieving better neurologic recovery in a subgroup of patients. This approach could broaden the use of MT.


Highly toxic and broad-spectrum insecticidal Bacillus thuringiensis engineered by using the transposon Tn917 and protoplast fusion.
The chromosome of the Bacillus thuringiensis strain S184 that was toxic against the third instar larvae of Spodoptera litura with the LC(50) of 9.74 microg/ml was successfully integrated into two genes of cyt1Aa and cry11Aa using the transposon Tn917, yielding the primary engineered strain TnX. The strain TnX was highly toxic to the third instar larvae of Culex pipiens fatigans with the LC(50) of 5.12 ng/ml which was 1.82-fold higher than that of B. thuringiensis subsp. israelensis, but lowly toxic to lepidopterous larvae. By the protoplast fusion of the strain TnX and the strain S184-Tet(r) (resistance to tetracycline), the target engineered strain TnY was obtained. Against the third instar larvae of S. litura, the strain TnY LC(50) was of 4.68 micro g/ml and increased by 2.08-fold in comparison with the parent strain S184. Against the third instar larvae of C. pipiens fatigans, the strain TnY LC(50) was of 103.20 ng/ml. The two target genes of cyt1Aa and cry11Aa integrated into the chromosome were extremely stable and had little possibility of a second transposition. It was unclear whether some factors existing in the parent strain, S184, contributed to the high toxicity of the strains TnX and TnY.


The natural history of somatic morbidity in disintegrative psychosis and infantile autism: a validation study.
In order to study the validity of disintegrative psychosis (DP) as defined in ICD-9, we compared the natural history of somatic morbidity of 13 patients given this diagnosis in childhood with a control group of 39 patients with infantile autism (IA) matched for gender, age, IQ and social class. Average follow-up time was 22 and 23 (11-33) years, respectively. Significantly more DP patients (85 versus 41%) had been admitted to a non-psychiatric hospital during the follow-up period. They also had significantly more admissions (3.6 versus 1.0) and stayed longer in hospital (78 versus 4 days) than patients with IA. Three of the DP individuals had an associated medical disorder and made extensive use of somatic services during the follow-up period. Altogether the DP group had utilised the medical health care system more than patients with IA suggesting that they had more medical symptoms than the IA group. On the whole our findings suggest that individuals with DP and IA should be conceptualised as essentially distinct and should be studied separately as regards aetiology, pathophysiology, course and treatment.


Measuring the orbital angular momentum of a single photon.
We propose an interferometric method for measuring the orbital angular momentum of single photons. We demonstrate its viability by sorting four different orbital angular momentum states, and are thus able to encode two bits of information on a single photon. This new approach has implications for entanglement experiments, quantum cryptography and high density information transfer.


A comparison of online and offline measurement of exhaled breath for diabetes pre-screening by graphene-based sensor; from powder processing to clinical monitoring prototype.
Several breath analysis studies have suggested a correlation between blood glucose (BG) levels and breath acetone, indicating acetone as a primary biomarker in exhaled breath for diabetes diagnosis. Herein, we have (i) fabricated and validated graphene-based chemi-resistive sensors for selective and sensitive detection of acetone, (ii) performed offline breath analysis by a static gas sensing set-up to acquire olfactory signals, and (iii) developed an LED-based portable on/off binary e-nose system for pre-screening diabetes through online analysis. The fabricated sensors showed selective detection for acetone with high sensitivity (5.66 for 1 ppm acetone vapor) and fast response and recovery times (10 s and 12 s) at low concentrations. The sensor responses of end tidal fractional breath (collected in Tedlar bags) in the fasting and postprandial conditions were compared with BG levels and glycated hemoglobin (HbA1c) levels taken at the same time in 30 volunteers (13 healthy and 17 diabetic subjects). The mean sensor responses of the diabetic subjects as obtained by offline analysis were 1.1 times higher than those of the healthy subjects. The optimal regression equation framed with the significant correlating variables for HbA1c estimation achieved an accuracy of 66.67%. The online breath analysis by on/off binary prototype exhibited an accuracy of 60.51%. Though there exists a minimal uncertainty in classification, the on/off type portable prototype is easy to operate, gives a quicker response with a refresh/recovery rate of 19 s and can be used for preliminary diagnosis, and can be used for preliminary diagnosis. This inexpensive sensor technology may revolutionize personalized medicine in the near future and greatly benefit the underprivileged.


Mathematical Modeling of Different Molecule Removal on On-Line Haemodiafiltration: Influence of Dialysis Duration and Infusion Flow.
In a previous study on a nocturnal, every-other-day online haemodiafiltration scheme, different removal patterns were observed for urea, creatinine, β2-microglobulin, myoglobin and prolactin. The aim of this study was to evaluate the influence of dialysis duration and infusion flow (Qi) on the removal of different molecular weight (MW) solutes, and to quantify the effect of the different treatments on the kinetics of the solutes by using a classical two-compartment model. This prospective, in-center study was carried out in 10 patients on a nocturnal, every-other-day online post-dilution haemodiafiltration program. Each patient received four dialysis sessions with different conditions, two 4-h sessions (with infusion flows of 50 or 100 ml/min) and two 8-h sessions (with infusion flows of 50 or 100 ml/min). To analyze the solute kinetics, blood samples were obtained hourly during the dialysis treatments and in the first 3 h post-dialysis. Removal patterns differed in the molecules studied, which were quantified by means of the two-compartment mathematical model. The main results show the impact of dialysis duration on the removal of low molecular weight molecules (urea and creatinine), while the impact of Qi is clearly shown for high molecular weight molecules (myoglobin and prolactin). For middle molecular weight solutes, such as β2-microglobulin, both factors (duration and Qi) enhance the removal efficiency of the dialyzer. Our study evaluates experimentally and mathematically how treatment time and infusion flow affect the filtration of solutes of different MW during post-dilution haemodiafiltration. The results provided by the present study should help physicians to select and individualise the most appropriate schedules to deliver an optimum diffusive and convective dialysis dose for each patient.


Tumor necrosis factor inhibits collagen and fibronectin synthesis in human dermal fibroblasts.
Tumor necrosis factor (TNF) caused inhibition of collagen production by confluent cultures of human dermal fibroblasts in a dose-dependent manner. Concomitant increase of prostaglandin E2 release was observed as a result of TNF-induced cell activation. However, a blockade of the cyclooxygenase pathway of arachidonate metabolism by indomethacin did not abrogate the inhibitory effect of TNF on collagen synthesis, suggesting that this effect could be independent of prostaglandin metabolism. Gel electrophoresis of the newly synthesized macromolecules from the culture media showed that both type I and type III collagens as well as fibronectin were affected by the inhibition. Electrophoresis of cell layer-associated proteins demonstrated that the reduction in amounts of collagen and fibronectin in the medium did not result from an intracellular accumulation of these macromolecules. Production of procollagens was reduced in parallel to that of collagens, suggesting that the effect of TNF is exerted before the processing steps of procollagens. These results clearly show that TNF could play a role in modulation of matrix deposition by fibroblasts during inflammatory processes.


Synthesis of (+/-) 8,12-trans-delta5-en-cis-9-keto-13,14-en-trans-15-R,S-hydroxyprostanoic acid methyl ester.
The synthesis of the title compound (X) is easily achieved by suitable transformations of the lateral chains of the 1-ethylenedioxy-2-allyl--trans-3-cyclopentane acetic acid (II).


Enhanced energy storage and suppressed dielectric loss in oxide core-shell-polyolefin nanocomposites by moderating internal surface area and increasing shell thickness.
Dielectric loss in metal oxide core/Al(2)O(3) shell polypropylene nanocomposites scales with the particle surface area. By moderating the interfacial surface area between the phases and using increasing shell thicknesses, dielectric loss is significantly reduced, and thus the energy stored within, and recoverable from, capacitors fabricated from these materials is significantly increased, to as high as 2.05 J/cm(3).


Radon and lung cancer: assessing and mitigating the risk.
Radon is a naturally occurring radioactive gas. Its progenies emit alpha particles capable of causing tissue damage. Radon exposure is estimated to be the second most common cause of lung cancer in the United States. Management of patients with a history of radon exposure should involve a lung cancer specialist.


Diagnostic role of radiolabelled choline PET or PET/CT in hepatocellular carcinoma: a systematic review and meta-analysis.
The role of fluorine-18-fluorodeoxygluose positron emission tomography/computed tomography ((18)F-FDG PET/CT) in hepatocellular carcinoma (HCC) has not been firmly established yet and its sensitivity has been reported to be in the range of 40-60 %. Because of this relatively low sensitivity alternative tracers have been proposed. The aim of our review is to analyse the literature data on the diagnostic role of (18)F/(11)C-choline PET/CT in the evaluation of HCC. A comprehensive computer literature search of PubMed/MEDLINE, Embase and Scopus databases was conducted to find relevant published articles about the role of whole-body (18)F-choline or (11)C-choline PET or PET/CT in patients with HCC. Furthermore, a meta-analysis about the detection rate of this method in HCC was performed. Six articles were included in this systematic review and discussed. The meta-analysis of five out of six articles showed a DR of 84 % (95 % CI 79-89 %). The DR increased when poorly differentiated HCC was excluded from the analysis. Radiolabelled choline PET or PET/CT could be a valuable tool in detecting HCC and it is better than (18)F-FDG PET/CT, especially in well to moderately differentiated lesions; on the other hand, poorly differentiated and higher-stage HCC could be better evaluated with (18)F-FDG and dual tracer imaging should be considered and could be potentially useful to increase accuracy.


[Kallikrein (urine) in pregnancy-induced hypertension].
Total, active and inactive renal kallikrein were compared between 25 patients with hypertensive disorders of pregnancy and 25 healthy pregnant women of corresponding gestational age. Values of all three fractions were twice as high in healthy women than in hypertensive patients and differed with statistical significance. A longitudinal examination of renal kallikrein during pregnancy showed a physiological decrease of values from the 16th-20th week until term. Asymptomatic women, who developed hypertension later on, showed decreased renal kallikrein values.


Goal setting as a health behavior change strategy in overweight and obese adults: a systematic literature review examining intervention components.
This paper describes goal setting components used for behavior change specific to diet and physical activity in community-based interventions targeting overweight and obese adults. A systematic literature review was conducted. Studies were evaluated using the S.T.A.R.T. (Specificity, Timing, Acquisition, Rewards and feedback, and Tools) criteria which were developed for the purposes of this paper in order to elucidate which intervention features elicit optimal health behavior outcomes. Eighteen studies were included. Based on the S.T.A.R.T. criteria, it was determined that developing specific goals that are in close proximity, involve the participant in acquisition, and incorporate regular feedback, are common features in this context. Goal setting can be useful for effecting health behavior changes in this population. However, as different intervention components were often implemented concurrently (e.g., education sessions, self-monitoring records), it was not possible to ascertain which were responsible for positive changes independently. Goal setting shows promise as a tool that can be incorporated into weight reduction programs by health care professionals and researchers. Studies are warranted to identify the specific mechanisms through which individuals with overweight or obesity can apply the S.T.A.R.T. criteria with respect to goal setting for the purposes of weight loss.


Therapy of refractory nontuberculous mycobacterial lung disease.
The prevalence of nontuberculous mycobacterial (NTM) lung disease is increasing in the USA. Clinicians are therefore encountering these patients with increasing frequency, with the attendant multiple therapeutic challenges presented by NTM lung disease including relatively frequent (compared with tuberculosis) treatment failure. Critical elements for the successful treatment of Mycobacterium avium complex (MAC) lung disease include aggressive first therapeutic attempts and avoidance of the emergence of macrolide-resistant MAC strains, which are associated with worse treatment response and increased mortality. Reliably effective therapy for M. abscessus lung disease remains elusive but still usually requires parenteral agents. Lung resection surgery for selected patients is an important adjunct for both MAC and M. abscessus lung disease. Aside from surgery and parenteral antibiotics, there are very few data to support the efficacy of other drugs or interventions for patients who have failed the first-line therapy. Clinicians who manage NTM lung disease will inevitably encounter patients who fail the first-line therapy. The choices for effective treatment of these patients are depressingly sparse. It is critically important to avoid creation of macrolide-resistant MAC strains and to carefully choose those NTM lung disease patients who will benefit from surgery.


Development of a large scale production of 67Cu from 68Zn at the high energy proton accelerator: closing the 68Zn cycle.
A number of research irradiations of (68)Zn was carried out at Brookhaven Linac Isotope Producer aiming to develop a practical approach to produce the radioisotope (67)Cu through the high energy (68)Zn(p,2p)(67)Cu reaction. Disks of enriched zinc were prepared by electrodeposition of (68)Zn on aluminum or titanium substrate and isolated in the aluminum capsule for irradition. Irradiations were carried out with 128, 105 and 92 MeV protons for at least 24h. After irradiation the disk was chemically processed to measure production yield and specific activity of (67)Cu and to reclaim the target material. The recovered (68)Zn was irradiated and processed again. The chemical procedure comprised BioRad cation exchange, Chelex-100 and anion exchange columns. Reduction of the oxidation degree of copper allowed for more efficient Cu/Co/Zn separation on the anion exchange column. No radionuclides other than copper isotopes were detected in the final product. The chemical yield of (67)Cu reached 92-95% under remote handling conditions in a hot box. Production yield of (67)Cu averaged 29.2 μCi/[μA-h×g (68)Zn] (1.08MBq/[μA-h×g (68)Zn]) in 24h irradiations. The best specific activity achieved was 18.6 mCi/μg (688.2 MBq/μg).


[Lesions of the glenoid labrum].
The different lesions of the glenoid labrum are described. They may involve the antero-inferior, the posterior or the superior (SLAP lesions) part of the labrum. CT-arthrography is the gold standard imaging modality in this field of shoulder abnormalities.


Bioluminescence resonance energy transfer-based imaging of protein-protein interactions in living cells.
Bioluminescence resonance energy transfer (BRET) is a transfer of energy between a luminescence donor and a fluorescence acceptor. Because BRET occurs when the distance between the donor and acceptor is <10 nm, and its efficiency is inversely proportional to the sixth power of distance, it has gained popularity as a proximity-based assay to monitor protein-protein interactions and conformational rearrangements in live cells. In such assays, one protein of interest is fused to a bioluminescent energy donor (luciferases from Renilla reniformis or Oplophorus gracilirostris), and the other protein is fused to a fluorescent energy acceptor (such as GFP or YFP). Because the BRET donor does not require an external light source, it does not lead to phototoxicity or autofluorescence. It therefore represents an interesting alternative to fluorescence-based imaging such as FRET. However, the low signal output of BRET energy donors has limited the spatiotemporal resolution of BRET imaging. Here, we describe how recent improvements in detection devices and BRET probes can be used to markedly improve the resolution of BRET imaging, thus widening the field of BRET imaging applications. The protocol described herein involves three main stages. First, cell preparation and transfection require 3 d, including cell culture time. Second, image acquisition takes 10-120 min per sample, after an initial 60 min for microscope setup. Finally, image analysis typically takes 1-2 h. The choices of energy donor, acceptor, luminescent substrates, cameras and microscope setup, as well as acquisition modes to be used for different applications, are also discussed.


Fast preattentive processing of location: a functional basis for selective listening in humans.
Spatial separation of sound sources provides a primary cue for selecting relevant from irrelevant acoustic input. This competence for selective listening is important in every-day life, when several concurrent sound sources are simultaneously active. The present study demonstrated a temporal advantage in the preattentive processing of location information relative to frequency information. This was indicated by shorter latency of the mismatch negativity (MMN), generated by the brain's automatic detection of a sound change, to a location change than to a frequency change. Results suggest that the superior role of spatial location for selective listening may be due to faster automatic encoding of spatial information into the neural representations underlying attentional selection.


Pharmacological cognitive enhancement in schizophrenia.
Cognitive impairments in schizophrenia are common and severe. These impairments are also related to functional disability in schizophrenia. As a result, efforts are underway to enhance cognition in schizophrenia through a variety of pharmacological mechanisms. As part of this effort, a designated research design has been developed for this process, through an extensive consensus and validation effort. This paper reviews the methods for pharmacological cognitive enhancement, as well as previous results of efforts in the pharmacological domains. These domains include cholinergic, noradrenergic, serotonergic, glutamatergic, and GABA-ergic mechanisms. While previous results have not been particularly encouraging, there are many challenges that need to be overcome and many of the reasons for past failures may be due to resolvable issues. It is likely that this will be an area of research that will be developing extensively over the next decade and expanding to other conditions as well.


Diagnosis and prognostication of adult spinal cord injury without radiographic abnormality using magnetic resonance imaging: analysis of 40 patients.
Spinal cord injury without radiographic abnormality (SCIWORA) is not uncommon among middle-aged and elderly people. It is less reported in adults as compared with children. This study was undertaken to find the incidence, magnetic resonance imaging (MRI) changes, and outcome of SCIWORA in adults and to demonstrate the prognostic value of MRI in SCIWORA. Forty adult patients who sustained SCIWORA for a period of 2 years (January 1999 to December 2000) were admitted to our hospital. Methylprednisolone was given in therapeutic doses, for a period of 24 hours, to those arriving within 6 hours of injury. Magnetic resonance imaging was performed within 72 hours of admission to the hospital. In all patients, sagittal, axial, and coronal T1, spin, and T2 images of MRI were obtained. Clinical status of the patient at the time of admission and discharge was correlated with MRI. Four patients (10%), who were in Frankel grade D, with no demonstrable injury on MRI, improved to Frankel grade E at the time of discharge. Two patients (5%) with cord edema and extraneural injury improved to a useful neurological grade (Frankel grades D or E), whereas 13 patients (32.5%) with MRI features of cord contusion and hemorrhage did not achieve useful neurological function. Spinal cord injury without radiographic abnormality contributes 12% of cases of spinal cord injury. Magnetic resonance imaging is the investigation of choice, having diagnostic and prognostic value because it demonstrates neural and extraneural injuries and helps to pick up surgically correctable abnormality. Patients with minimal cord changes on MRI have the best outcome followed by those with cord edema. Patients with parenchymatous hemorrhage and contusion on MRI fare badly.


Evaluation of the Coat-A-Count 125I fentanyl RIA: comparison of 125I RIA and GC/MS-SIM for quantification of fentanyl in case urine specimens.
The Coat-A-Count solid phase 125I Fentanyl Radioimmunoassay was evaluated with respect to linearity and precision using equine urine fortified with fentanyl and then compared with a gas chromatographic/mass spectrometric method for quantification of fentanyl in urine. The RIA assay was found to be linear over the urine fentanyl concentration range of 0.25 to 7.5 ng/mL and precise with coefficients of variation (CV) ranging from 9.6 to 19.3%. The RIA calibrators, ranging in fentanyl concentrations from 0.25 to 7.5 ng/mL, and controls, at mean fentanyl concentrations of 0.46 and 1.32 ng/mL, were compared by both the RIA and GC/MS methods. The cross-reactivity with the 125I RIA test was determined for the fentanyl metabolites, norfentanyl and hydroxyfentanyl, and found to be 5% and 35%, respectively. The illicit fentanyl analogs were found to show significant cross-reactivity, ranging from 20 to 100%. The 125I RIA was compared to GC/MS quantifications of fentanyl in 35 positive and 20 negative case urine specimens.


Variations in size of the bony lumbar canal in patients with prolapse of lumbar intervertebral discs.
Prolapse of the lumbar intervertebral disc is one of the commonly accepted causes of low back pain. Most patients respond well to conservative treatment, but some may not respond at all. Though the reason for this variation is not clearly understood, it is felt that a developmentally narrow spinal canal might have some relation to the persistence of backache and sciatica. The canal was therefore measured at each of the lumbar vertebral level by a method described by Jones and Thomson (1969) in 100 consecutive patients operated upon for prolapsed lumbar intervertebral discs, in 100 normal patients for comparison. This method does not give direct measurements of the bony spinal canal but provides a ratio of the size of the canal to the adjacent vertebral body. We found a trend towards the presence of a narrower than normal lumbar canal in patients with prolapsed lumbar intervertebral discs. It is concluded that in patients with prolapsed lumbar intervertebral discs necessitating operation, the canal tends to be narrower than normal, and such narrowing enhances the effect of any disc protrusion leading to severe symptoms of backache and sciatica.


Pegylated interferon therapy in chronic hepatitis C: lights and shadows of an innovative treatment.
Pegylated interferon (PEG-IFN) in combination with ribavirin is the standard of treatment for chronic hepatitis C. Several viral and host factors influence the outcome of treatment, such as hepatitis C virus (HCV) genotype, baseline viral load, viral kinetics, race, body weight, advanced liver disease, HIV co-infection, and adherence to therapy. Monitoring the response of HCV to treatment during the early time points (4 weeks or 12 weeks) after initiation of therapy has emerged as a critical tool to predict sustained virologic response (SVR), defined as undetectable serum HCV RNA 24 weeks after the end of therapy. To counterbalance the influence of host and viral factors, treatment duration can be individualised to achieve an optimal treatment outcome, potentially reduce costs, and minimize side effects.


Experimental rectus abdominis myocutaneous and rectus abdominis myoperitoneal flaps as urinary bladder wall substitutes in miniature swine.
An experiment was performed in Yucatan miniature swine to determine the feasibility and characteristics of musculocutaneous or musculoperitoneal flaps as urinary bladder wall substitutes. In five swine, a single-pedicle skin island flap (rectus abdominis myocutaneous, RAM/C) was sutured into the bladder. In five other swine the flap was a peritoneum island (rectus abdominis myoperitoneal, RAM/P). Three swine were sham-operated controls. The patches were in place for 20 weeks, remaining viable and elastic. Inflammation, maceration, and infection were absent. Skin patch histology was unchanged. The peritoneal patches became resurfaced with uroepithelium. The sham bladder volume (ml/kg body weight) did not differ significantly from RAM/P bladder volume (p = 0.54). RAM/C bladders were slightly smaller than shams (p = 0.11) and significantly smaller than RAM/P bladders (p = 0.03). Substitution of the bladder wall with RAM patch flaps is feasible. This is an important preliminary step toward our goal of nonenteral urinary bladder wall substitution.


Health-Related Quality of Life and Health Utilities in Metastatic Castrate-Resistant Prostate Cancer: A Survey Capturing Experiences from a Diverse Sample of UK Patients.
The collection of preference-based health outcomes data (or utility values) is required to support cost-effectiveness analyses. This study aimed to collect health-related quality of life (HRQOL) data in men with metastatic castration-resistant prostate cancer (CRPC) stratified by disease states. Men with metastatic CRPC were recruited via UK patient associations, patient panels, and specialist recruiters and classified into four subgroups reflecting disease state: asymptomatic/mildly symptomatic before chemotherapy, symptomatic before chemotherapy, receiving chemotherapy, and postchemotherapy. HRQOL data (including five-level EuroQol five-dimensional questionnaire [EQ-5D-5L], European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire [EORTC QLQ-C30], and 25-item prostate cancer-specific questionnaire module designed to supplement the EORTC QLQ-C30) along with background and medical history data were collected via an online survey. The EQ-5D-5L and the EORTC-8D (EORTC-8D is an 8 dimensional utility index scored from QLQ-C30 data) were both used to estimate utilities. Data were collected from a total sample of 163 men with metastatic CRPC. Utility values elicited by the EQ-5D-5L ranged from 0.830 for the asymptomatic/mildly symptomatic before chemotherapy disease state (95% confidence interval [CI] 0.795-0.865) to 0.625 for the symptomatic before chemotherapy disease state (95% CI 0.577-0.673). EORTC-8D utilities ranged from 0.856 (95% CI 0.831-0.882) to 0.697 (95% CI 0.664-0.731) for the same disease/treatment states. This online survey was designed to capture real-world HRQOL data describing men with CRPC. The study estimated utilities using two alternative methods, and the results show good agreement, suggesting that they are robust. This methodology offers a potentially higher quality alternative to vignette-based methods that are commonly used in oncology submissions.


Control of phosphorylase kinase in the isolated glycogen particle by Ca2+-Mg2+ synergistic activation and cAMP-dependent phosphorylation.
The isolated glycogen particle provides a means to examine the regulation of glycogen metabolism with the components organized in a functional cellular complex. With this system, we have studied the control of phosphorylase kinase activation by Ca2+ and cAMP. Contrary to a previous report (Heilmeyer, L. M. G., Jr., Meyer, F., Haschke, R. H., and Fisher, E. H. (1980) J. Biol. Chem. 245, 6649-6656), phosphorylase kinase became activated during incubation of the glycogen particle with MgATP2- and Ca2+. Part of this activation could be attributed to the action of the cAMP-dependent protein kinase; however, it was not possible to quantitatively correlate activation with phosphorylation in the presence of Ca2+ and Mg2+ due to a large, but uncertain, contribution of synergistic activation caused by these ions. This latter activation had properties similar to those described by King and Carlson (King, M. M., and Carlson, G. M. (1980) Arch. Biochem. Biophys. 209, 517-523) with the purified enzyme, and its occurrence also explains why phosphorylase kinase activation in the glycogen particle was not observed previously. The cAMP-dependent activation of phosphorylase kinase in the glycogen particle has been characterized. It occurred in a similar manner when either the cAMP-dependent protein kinase or cAMP was added, thus indicating that the phosphorylation sites of phosphorylase kinase complexed in the glycogen particle were accessible to endogenous or exogenous enzyme. In the glycogen particle, both the alpha and beta subunits were phosphorylated by the cAMP-dependent protein kinase, but the alpha subunit dephosphorylation appeared to be preferentially regulated by Ca2+. The activity of phosphorylase kinase in the glycogen particle is regulated by the phosphorylation of both the alpha and beta subunits.


An experimental analysis of the contribution of 210Po and of 210Po produced by 210Pb decay to the gross alpha-particle activity of water samples.
The contribution of 210Po and of 210Po produced by 210Pb decay to the gross alpha-particle activity of water samples by U.S. Environmental Protection Agency Method 900.0 is investigated as a function of residue mass and geometry and time between sample collection and analysis. It is shown that these factors can cause the contribution to gross alpha-particle activity of 210Po to be up to 2.0 and 1.1 times the initial 210Po activity for grab and quarterly composite samples, respectively, and can cause the contribution to gross alpha-particle activity of 210Po from 210Pb decay to be up to 1.1 times and 1.5 times the 210Pb activity for grab and quarterly composite samples, respectively. It is also shown qualitatively that at least for some residues, there is a loss of polonium due to volatilization when the sample is heated over a flame.


Outcomes of police contacts with persons with mental illness: the impact of CIT.
The Crisis intervention team model (CIT) is possibly the most well known and widely adopted model to improve police response to persons with mental illness. A primary goal of CIT programs is to divert individuals with mental illness from the criminal justice system to mental health services. In this paper we examine the effectiveness of fielding CIT trained and supported officers for influencing call outcomes using data from patrol officers (n = 112) in four Chicago Police districts. Results from regression analysis indicate that CIT certified officers directed a greater proportion of persons with mental illness to mental health services than their Non-CIT certified peers. CIT did not have an immediate effect on arrest. Moderator analysis indicates that CIT had its biggest effect on increasing direction to services and decreasing "contact only" among officers who have a positive view of mental health services and who know a person with mental illness in their personal life. Additional moderators of the CIT effect on call outcomes include level of resistance and the presence of a weapon. Findings from this study have important implications for policy, practice and future research.


3D structural imaging of the brain with photons and electrons.
Recent technological developments have renewed the interest in large-scale neural circuit reconstruction. To resolve the structure of entire circuits, thousands of neurons must be reconstructed and their synapses identified. Reconstruction techniques at the light microscopic level are capable of following sparsely labeled neurites over long distances, but fail with densely labeled neuropil. Electron microscopy provides the resolution required to resolve densely stained neuropil, but is challenged when data for volumes large enough to contain complete circuits need to be collected. Both photon-based and electron-based imaging methods will ultimately need highly automated data analysis, because the manual tracing of most networks of interest would require hundreds to tens of thousands of years in human labor.


[Recurrent cardiac tamponade secondary to postpericardiotomy syndrome].
A 22-year-old woman underwent surgical repair of a secondary atrial septal defect. Thirty-five days after surgery, she developed fever, systemic venous congestion, and respiratory symptoms and chest pain. The echocardiogram demonstrated pericardial effusion (PE) quantified at approximately 3,500 cc, with signs of cardiac tamponade (CT). Pericardiocentesis was performed and symptomatology subsides when Prednisone 10 mg was administered every 24 h. Fourteen days after discharge, she was readmitted due to progressive dyspnea, orthopnea and fatigue. The echocardiogram showed the reappearance of PE and a mild CT. Prednisone 40 mg/day was given. After 10 days an echocardiogram showed are duction of the PE (600 cc) and the clinical condition of the patient improved. Three months later, PE disappeared in the echocardiogram and the patient remained asymptomatic.


X-linked spinal muscular atrophy (Kennedy's syndrome). A kindred with hypobetalipoproteinemia.
Kennedy's syndrome, X-linked adult-onset bulbospinal muscular atrophy, has been described in over 30 families. The characteristic distribution of weakness creates a recognizable syndrome, augmented by frequent findings of testicular atrophy and gynecomastia. Type IV or type II hyperlipoproteinemia has been found in some families. We have studied another family with Kennedy's syndrome, this one with hypobetalipoproteinemia. The diversity of serum patterns suggests that lipoprotein abnormalities are not causally related to either the endocrinopathy or the spinal muscular atrophy. However, gene linkage studies indicate proximity of the gene for Kennedy's syndrome and the gene encoding the androgen receptor, which could explain the combination of a motor neuron disorder and the endocrine abnormalities.


PR-segment deviation as the initial electrocardiographic response in acute pericarditis.
PR-segment deviations precede classic ST(J) deviations in acute pericarditis because the superficial myocarditis producing electrocardiographic changes is more encompassing in the thin atrial muscle. In patients with appropriate syndromes, PR-segment deviations should be recognized early after onset, as ST changes may be absent.


Quasiparticle relaxation mechanisms in superconductor/ferromagnet bilayers.
In this paper we review some recent results obtained on superconducting/ferromagnetic (S/F) structures when measuring the dynamic instabilities of the vortex lattice at high driving currents. The role played on the non-equilibrium properties of the hybrids by both the ferromagnetic and the superconducting materials has been analyzed with a special focus on the values and the temperature dependence of the quasiparticle relaxation times, τ(E). Knowledge of the relaxation mechanisms in these systems is extremely important in view of possible applications since it can drive the optimal choice of both materials to realize, in particular, ultrafast superconducting single photon detectors based on S/F hybrid structures.